Gaps in the evidence base
This is the last in a series of blog posts I’ve written covering the detail of Dame Carol Black’s second part of her independent Review of Drugs which sets out a way forward on drug treatment and recovery for the government and which was published last month (8 July 2021). There is consensus across the field that the Review is the most important drugs report of the century so far. This week’s post looks at Dame Carol’s recommendations that we should address several “obvious” research and evidence gaps relating to our response to drug issues. You can read the full series of posts summarising both Part 1 and Part 2 of the Review of Drugs here.
Dame Carol acknowledges the value of the National Drug Treatment and Monitoring System (NDTMS) and recommends that it should be routinely linked to other relevant data sets to create an extensive drugs data warehouse with the objective of allowing more rigorous evaluation of treatment and the effectiveness of innovations. She also says we need long-term cohort studies to identify those interventions that best help people to respond well to treatment and achieve recovery.
Dame Carol points out that there is a lack of research on psychosocial interventions, particularly for cocaine use and for other non-opioid substances. She says that more research should be conducted into which interventions are most effective, particularly for people who may have cognitive deficits due to past or current drug use, and for people with co-occurring mental illness. She recommends that funding should be made available for service providers to support this activity.
Dame Carol advocates that research on substance misuse should extend to look at the factors which promote recovery, a priority area also flagged in the government’s Drug Recovery Champion’s recent annual report. She says that research should be broad based, draw on different disciplines and bring practitioners and researchers together. Dame Carol also highlights a number of other areas where research is needed:
- The effectiveness of peer-led interventions and how these can be encouraged and facilitated by the treatment system.
- Drug use in ethnic minority communities, and its prevention and treatment.
- The possibility of developing new pharmacological solutions, in particular agonist and antagonist therapies to help prevent relapse.
In tune with the rest of her report and recommendations, Dame Carol urges a proactive government response saying that the Department of Health and Social Care should promote innovative research on addiction and its implementation in practice by offering incentives, rewards or prizes to companies and other organisations for effective developments in this field – for example, pharmaceutical advances.
She concludes by identifying a deficit in our addictions research and calls for training fellowships to improve the quality and value of the research undertaken and to create the next generation of researchers.
I hope you have found this blog series looking at the detail of Dame Carol’s review helpful. I will of course be following up to see to what extent the Government implements her far-reaching recommendations.
Thanks to Pretty Drug Things for the images in this post. Pretty Drug Things explores different visual aesthetics and marketing techniques used in either promoting or demonising different psychoactive substances in our society.