A 21 y/o has surgery for a condition expected to improve. He fills a discharge prescription for 5 days of an opioid at a standard dose. At 1-week follow-up with his family doctor for suture removal, he describes ongoing pain. Can prescribers avoid contributing to opioid use disorder? Is a renewal of opioid appropriate, potentially dangerous, or both? Read more …
So what has the Cochrane membership done for me? Inspired by Dr Jeremy Grimshaw’s question: “So what has the Cochrane Collaboration ever done for us?” I submit a report card, a mosaic of my previous blogs, on my first 10 years with Cochrane.
What are the training needs of newly trained professionals working in addiction medicine around the world? Do they get enough and appropriate training to treat people who live with addictions? A new study protocol plans to answer these questions. (more…)
Out-of-hospital cardiac arrest is a major cause of death. It occurs when a person’s heart stops pumping blood around the body. It is most often caused by an abnormal heart rhythm. Cardiac arrest causes death within minutes unless this rhythm restarts. (more…)
Updating Cochrane systematic reviews makes them most useful and fresh for readers. We updated our review on concurrent alcohol and drug problems again.
Which new studies we found?
We found seven studies that examined 825 people with drug problems. Six of the studies were funded by the National Institutes for Health or by the Health Research Board; one study did not report its funding source.
One study focused on the way people think and act versus an approach based on Alcoholics Anonymous. It aimed to motivate the person to develop a desire to stop using drugs or alcohol.
Three studies looked at a counselling style for helping people to explore and resolve doubts about changing their behaviour (group, individual and intensive formats). Their controls were education, or less intensive counselling, or assessment-only.
Two Irish studies and one Swiss study looked at practices that aimed to identify an alcohol problem and motivate the person to do something about it versus usual treatment.
This study has been made into a podcast available at Cochrane.org news item at https://www.cochrane.org/news/podcast-which-talking-therapies-work-people-who-use-drugs-and-also-have-alcohol-problems
and a Network news item https://mhn.cochrane.org/news/podcast-which-talking-therapies-work-people-who-use-drugs-and-also-have-alcohol-problems Listen to the podcast below:
Updating Cochrane Review – Key results
The Swiss and Irish studies were directly compared. They took place in general practices (one trial) or methadone clinics (two trials). They included 170 participants with a mean age of 37 years. All participants had positive alcohol screening test upon entry to the trial. At the end, the scores between groups were similar (average difference in scores: -0.6, 1.7 and -2, respectively).
One study found that a brief motivational intervention led to a reduction of alcohol use (by seven or more days in the past month at 6 months).
It remains uncertain whether talking therapies affect drinking and drug-using in people who have problems with both alcohol and other drugs. We lack high quality studies.
Cited cochrane review: Klimas J, Fairgrieve C, Tobin H, Field C-A, O’Gorman CSM, Glynn LG, Keenan E, Saunders J, Bury G, Dunne C, Cullen W. Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users. Cochrane Database of Systematic Reviews 2018, Issue 11
Read a summary of the previous version of this review here