King's College London

Research portal

Treatment and Intervention for Opiate Dependence in the United Kingdom: Lessons from Triumph and Failure

Research output: Contribution to journalArticle

Nicola J. Kalk, J. Roy Robertson, Brian Kidd, Edward Day, Michael J. Kelleher, Eilish Gilvarry, John Strang

Original languageEnglish
Pages (from-to)1-18
Number of pages18
JournalEuropean Journal on Criminal Policy and Research
Early online date28 Dec 2017
DOIs
Publication statusE-pub ahead of print - 28 Dec 2017

Documents

King's Authors

Abstract

The history of opiate treatment in the United Kingdom (UK) since the early 1980s is a rich source of learning about the benefits and pitfalls of drug treatment policy. We present five possible lessons to be learnt about how factors outside the clinic, including government, charities and researchers can influence treatment and outcomes. First, do not let a crisis go to waste. The philosophical shift from abstinence to harm reduction in the 1980s, in response to an HIV outbreak in injecting users, facilitated expansion in addiction services and made a harm reduction approach more acceptable. Second, studies of drug-related deaths can lead to advances in care. By elucidating the pattern of mortality, and designing interventions to address the causes, researchers have improved patient safety in certain contexts, though significant investment in Scotland has not arrested rising mortality. Third, collection of longitudinal data and its use to inform clinical guidelines, as pursued from the mid-1990s, can form an enduring evidence base and shape policy, sometimes in unintended ways. Fourth, beware of the presentation of harm reduction and recovery as in conflict. At the least, this reduces patient choice, and at worst, it has caused some services to be redesigned in a manner that jeopardises patient safety. Fifth, the relationship between the third and state sectors must be carefully nurtured. In the UK, early collaboration has been replaced by competition, driven by changes in funding, to the detriment of service provision.

Download statistics

No data available

View graph of relations

© 2018 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454