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Posts tagged Addiction Treatment
Pathways between probation and addiction treatment in England: a follow-up study

By the U.K.Ministry of Justice, and the Office of Health Improvement and Disparities


Executive Summary This report presents follow-up analysis building on Pathways between probation and addiction treatment in England: report - GOV.UK focusing on people sentenced to community orders (COs) and suspended sentence orders (SSOs) with an Alcohol Treatment Requirement (ATR) or Drug Rehabilitation Requirement (DRR). It examines engagement with alcohol and drug treatment, how engagement relates to reconvictions https://www.sciencedirect.com/science/article/pii/S0955395926000332 outcomes, and their characteristics. The analysis covers all ATRs and DRRs issued between August 2018 and March 2023. The study linked probation case management records with the National Drug Treatment Monitoring System (NDTMS) using probabilistic data linkage. This was supplemented by Natural Language Processing (NLP) analysis of probation contact notes. This approach aimed to assess whether the absence of ATRs and DRRs in structured treatment data reflected a true lack of treatment or gaps in data linkage. A total of 45,943 ATR and DRR requirements were issued during the period. Of these, 22,636 were linked to structured treatment through data linkage. The NLP approach derived an engagement rate from the unlinked sample. This was then applied to all unlinked records, resulting in an estimated 18,712 requirements with evidence of treatment engagement. Key Findings 1. Up to 90%1 of ATRs and DRRs were estimated to involve some form of treatment engagement. This is based on 49% linked to structured treatment through probabilistic data linking and an additional 41% of unlinked records showing treatment engagement in probation contact notes. Engagement was estimated to be higher for ATRs (93%) than for DRRs (88%). 2. Reconviction was less common following ATRs and DRRs linked to structured treatment. Within 12 months of sentencing, 36% of those linked to structured treatment were reconvicted, compared with 44% of those not linked to structured treatment. 

3. Characteristics associated with being more likely to be linked to structured treatment included being: • aged over 50 • female • in settled accommodation, (least likely when associated with rough sleeping) • engaged by treatment services within: 


▪ 3 weeks of an ATR, ▪ 3–6 weeks of a DRR 4. Reconviction outcomes varied by treatment outcome: • Reconvictions associated with ATRs and DRRs were lowest when they remained in structured treatment at the end of the observation period (13% for ATR; 26% for DRR). • Reconvictions associated with ATRs and DRRs were highest when they dropped out of structured treatment (41% for ATR; 60% for DRR). • Reconvictions associated with ATRs and DRRs that were not identified in structured treatment were higher than completed or remained in structured treatment but lower than those that dropped out of structured treatment (37% for ATR; 51% for DRR). Conclusion The analysis shows clear associations between treatment engagement and both individual characteristics and justice system factors. Individuals with ATRs and DRRs who completed or remained in structured treatment had better reconviction outcomes than those who dropped out of or had no identified structured treatment. This highlights the value of sustained engagement. The report also demonstrates the value of AI based NLP methods to strengthen insight by identifying treatment activity not captured through data linkage alone.

London: U.K. Ministry of Justice and the Office of Health Improvement and Disparities, 2026. 47p.

A Qualitative Evaluation of a Fentanyl Patch Safer Supply Program in Vancouver, Canada

By Alexa Norton, Andrew Ivsins, Elizabeth Holliday, Christy Sutherland, Thomas Kerr, Mary Clare Kennedy

Background: The ongoing overdose crisis in Canada has prompted efforts to increase access to a “safer supply” of prescribed alternatives to the unregulated drug supply. While safer supply programs predominantly distribute hydromorphone tablets, the Safer Alternatives for Emergency Response (SAFER) program in Vancouver, Canada offers a range of prescribed alternatives, including fentanyl patches. However, little is known about the effectiveness of fentanyl patches as safer supply. Drawing on the perspectives and experiences of program participants, we sought to qualitatively evaluate the effectiveness of the SAFER fentanyl patch program in meeting its intended aims, including reducing risk of overdose by decreasing reliance on the unregulated drug supply. Methods: As part of a larger mixed-methods evaluation of SAFER, semi-structured qualitative interviews were conducted with 17 fentanyl patch program participants between February 2022 and April 2023. Thematic analysis of interview data focused on program engagement, experiences, impacts, and challenges. Results: The flexible program structure, including lack of need for daily dispensation, the extended missed dose protocol, and community pharmacy patch distribution fostered engagement and enhanced autonomy. Improved management of withdrawal symptoms and cravings due to steady transdermal dosing led to reduced unregulated drug use and overdose risk. Participants also experienced economic benefits and improvements in overall health and quality of life. However, skin irritation and patch adhesion issues were key barriers to program retention. Conclusion: Our findings demonstrate the value of including fentanyl patch safer supply in the substance use continuum of care and offer insights for innovations in delivery of this intervention.

International Journal of Drug Policy Volume 131, September 2024, 104547