Communities Drugs

Therapeutic communities are supervised communal drug-free living situations for opioid and nonopioid drug abusers. Because substance abuse is viewed as a disorder of the whole person, the goal is a dramatic alteration of the addict s entire lifestyle (DeLeon 1985). Addicts are expected to five in these communities for 6—18 months. Therefore, they are not indicated for people who have a strong intimate relationship or stable employment. The community is a surrogate fam-... 

National Institute on Drug Abuse NIDA Community Drug Alert Bulletin Club Drugs. Rockville, MD, National Institute on Drug Abuse, 2004a. Available at http //www.drugabuse.gov/ClubAlert/ClubDrugAlert.html. Accessed May 9, 2005. 

Bolter, A. Heminger, A. Martin, G. and Fry, M. Out-patient clinical experience in a community drug abuse program with phencyclidine abuse. J. Toxicol Clin Toxicol 9 593 -600, 1976. 

Banta-Green CJ, Field JA, Chiaia AC, Sudakin DL, Power L, De Montigny L (2009) The spatial epidemiology of cocaine, methamphetamine and 3, 4-methylenedioxymethamphetamine (MDMA) use a demonstration using a population measure of community drug load derived from municipal wastewater. Addiction 104 1874—1880... 

Zuccato E, Chiabrando C, Castiglioni S, Calamari D, Bagnati R, Schiarea S, Fanelli R (2005) Cocaine in surface water a new evidence-based tool to monitor community drug abuse. Environ Health A Global Access Sci Source 4 1-7... 

LaBrie, S., Protein analysis in an array format using a novel, highly sensitive detection system. Presentation, International Business Communication, Drug Discovery Technologies, Session FI, Boston, MA, 2001. 

This document was drawn up at the international workshop on Future Perspectives in Pharmacovigilance, Ettore Majorana Centre for Scientific Culture, Erice, Sicily, 28 June-2 July 2006. It shares file values of file ice Declaration on Communicating Drug Safety Information of 1997, and of the Luxembourg Declaration on Patient Safety of 2005, but focuses on new and urgent contemporary issues. 

Providing clinical services Community drug services... 

The focus here is on treatment within community drug services, as these have evolved in the face of changing demands. 

Much of the ethos of community drug treatment as it has developed has been firmly grounded in harm-reduction policies. There is frequent debate as to exactly what such principles entail, and even how appropriate they are in countries at different stages of development. Those interested in the philosophy are referred to a paper by AL Ball (2007) from the department of HIV/Aids at the World Health Organization, which clearly still sees avoidance of HIV as one of the key aims of this policy agenda. A short commentary on that article succinctly sums up the areas of importance in drug service provision, as follows ... 

As already indicated, this chapter is a broad-brush picture of community services, which it is hoped will be of interest in areas and countries with other types of provision. The book in general concentrates on actual clinical treatment, and the special aspects of treatment in particular patient groups are discussed in the final chapter. Keeping matters very general, there have been three further significant trends in the development of community drug services in the UK. 

Much of the work of ours and other community drug services comes into the category of drug counselling, and this will now be examined in a little more detail. 

Strang J, Donmall M, Webster A Tantam D (1991). Comparison between community drug teams with and without inbuilt medical services. British Medical Journal, 303, 897... 

Strang J, Smith M Spurrell S (1992). The community drug team. British Journal of Addiction, 87, 169-78... 

Bilsen, H.P.J.G. van and Bennett, G.A. (1987) Motivational interviewing for addictive problems, Videotape produced by East Dorset Community Drug Team. 

This can be carried out either in an acute medical or psychiatric ward, or in a special drug-dependency in-patient unit. The advantages of the latter will include the initiation of a rehabilitation programme particularly geared towards the problems of addictions. However, some patients may well prefer a straightforward detoxification and then work in the community supported by other services, for example, from the Community Drug Team. There are several options for the in-patient detoxification of opiate dependents. These include ... 

Clonidine. This drug is now well established on the withdrawal of opiate addiction. However, due to its ability to produce postural hypotension and sedation, its use is often limited to in-patients. It is being used for out-patients in some centres but it is necessary to ensure daily contact with the patients so any side effects, particularly low blood pressure, can be monitored and this may be possible for example through the Community Psychiatric Nurse (CPN) of a Community Drugs Team. Further work is needed in its use for outpatients before it can be generally recommended. 

In the middle years of the 1980s some of the new statutory services for problem drug takers started calling themselves Community Drug Teams (CDTs). This title reflected the similarity between their aspirations and those of other Community Teams, particularly Community Alcohol Teams (CATs) which had developed during the previous few years. It is too early to provide a comprehensive description and evaluation of these services this chapter looks at three very different examples in order to provide a snapshot of their organisation, philosophy, and operation. 

Gillman, M. (1987) Community Drug Teams , Mersey Drug Journal, 1 11-12. 

The Community Drug Team lessons from alcohol and handicap services... 

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