Evidence for interventions
Types of interventions delivered to drug and service users have an impact on their achievement of recovery outcomes, and should follow a personcentred care approach, taking into account service users’ needs and preferences.
There are a number of approaches used in drug treatment interventions – pharmacological, psychosocial and recovery support.
Pharmacological approaches are the primary treatment option for opioid misuse, with psychosocial interventions providing an important element of the overall treatment package. Pharmacological treatments for cannabis and stimulant misuse are not well developed, therefore psychosocial interventions are seen as the foundation of effective treatment.
The settings in which interventions for drug users take place are in the community, inpatient units, primary care, residential, recovery houses and young person’s settings. Interventions mostly take place in the community, with 98% of intervention in North Tyneside taking place in the community for 2021-22, as user’s can be near family and a support network. However, residential rehabilitation may be cost effective for someone who is prepared for higher intensity treatment and any stage, and local areas are encouraged to provide this as part of an integrated recovery-oriented system. In 2020-21 a small number attended residential rehabilitation in North Tyneside.
Primary Prevention
Drug prevention interventions can have a broad range of aims including preventing any use of substances, reducing levels of use and preventing drug dependency.
There are three classifications used in prevention interventions that set out standards across the life course.
1 - Universal
Interventions are delivered to large groups, or entire populations, without prior screening for risk and aimed to prevent start of substance misuse. For example, TV audience, local communities or school pupils may receive universal prevention interventions.
2 - Selective
These interventions serve specific sub-populations who are at higher risk of substance misuse, and respond to this identified risk of starting or contributing to substance abuse, young people in particular. The benefit of this classification of intervention is that resource can be targeted to these identifiable, vulnerable groups.
3 - Indicated
This intervention would be used with people using substances and not yet dependent but may be showing signs of problematic use. They would be targeted with interventions to prevent use and the associated problems that are being experienced.
Figure.3 UNODC prevention standards across the life course
(source - Public Health England)
Harm Reduction
Harm reduction refer to policies and practices that aim to reduce harm that people do to themselves of others from their drug use. It focuses on ‘safer’ drug use. For example, providing opioid substitution treatment (OST), sterile injecting equipment and antiviral treatments to people who use drugs can help to prevent the spread blood-borne viruses (BBVs).
Examples of harm reduction interventions are:
- BBV testing
- Hepatitis B vaccination
- Hepatitis C treatment
- Needle and syringe exchange
- Administering Naloxone