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Quick reference guide


Issue date: July 2007

Drug misuse
Psychosocial interventions and opioid detoxification




NICE clinical guidelines 51 and 52
Developed by the National Collaborating Centre for Mental Health

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Drug misuse




About this booklet
This is a quick reference guide that summarises the recommendations NICE has made to the NHS
in `Drug misuse: psychosocial interventions' (NICE clinical guideline 51) and `Drug misuse: opioid
detoxification' (NICE clinical guideline 52).

Who should read this booklet?
This quick reference guide is for…

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Drug misuse Contents




Contents
Key priorities for implementation 4

Organising and developing care for people who
misuse drugs 7

Supporting families and carers 7

Identification and assessment 8

Brief interventions and self-help 9

Formal psychosocial interventions 10

Opioid detoxification 12

Settings of care 16

Implementation 18

Further information 18




Person-centred…

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Drug misuse Key priorities for implementation




Key priorities for implementation: psychosocial
interventions

Brief interventions
Opportunistic brief interventions focused on motivation should be offered to people in limited
contact with drug services (for example, those attending a needle and syringe exchange or
primary care settings) if concerns about drug misuse are…

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Drug misuse Key priorities for implementation




Contingency management to improve physical healthcare
For people at risk of physical health problems (including transmittable diseases) resulting from
their drug misuse, material incentives (for example, shopping vouchers of up to £10 in value)
should be considered to encourage harm reduction. Incentives should be…

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Drug misuse Key priorities for implementation




The choice of medication for detoxification
Methadone or buprenorphine should be offered as the first-line treatment in opioid detoxification.
When deciding between these medications, healthcare professionals should take into account:
­ whether the service user is receiving maintenance treatment with methadone or buprenorphine;
if…

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Organising and developing care
Drug misuse Supporting families and carers




Organising and developing care for people who
misuse drugs
At initial contact and at formal reviews, explain options for abstinence-oriented, maintenance-
oriented and harm-reduction interventions.
Discuss with people who misuse drugs whether to involve families and carers in their assessment…

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Drug misuse Identification and assessment




Identification and assessment
Asking questions about drug misuse
In mental health and criminal justice settings (in which drug misuse is known to be prevalent),
routinely ask service users about recent legal and illicit drug use, including type, method of
administration, quantity and frequency.
In settings…

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Drug misuse Brief interventions and self-help




Brief interventions and self-help
At routine contacts and opportunistically (for example, at needle and syringe exchanges), provide
information and advice to all people who misuse drugs about reducing exposure to blood-borne
viruses.
­ Give advice on reducing sexual and injection risk behaviours.
­ Consider…

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Drug misuse Formal psychosocial interventions




Formal psychosocial interventions
Contingency management
Drug services should introduce contingency management programmes ­ as part of the phased
implementation programme led by the NTA ­ to reduce illicit drug use and/or promote:
engagement with services for people receiving methadone maintenance treatment
abstinence and/or engagement with…

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