‘Public health’ initiatives by the drinks industry do not work and should not be allowed.

The 'Googly' is a deceptive delivery in cricket by a skilled spin bowler that turns the wrong way. In simple terms it moves in a direction you would not expect. In English speaking circles, it is called the ‘wrong’un’ because it is one that travels the wrong way. The recent controversy around the ‘Stop Out of Control Drinking’ campaign, funded by Diageo and chaired by Fergus Finlay, continues to rumble on. There have been strong objections to this ‘new’ initiative. To date, three of their stake holders have resigned from the board. A senior Diageo employee has also removed himself but the company continues to fund it to the tune of at least one million euro. At the same time they pay out many multiples of that figure on advertising and marketing for their products. The board cannot be independent from the vested interest. With due respect to some of the well-intentioned people still on that board, there are no public health experts, medical personnel or addiction counsellors involved....

Dealing with addiction.

GPs need more training and support to deal with patients presenting with addiction issues, Rolande Anderson, ICGP Alcohol Project Director, believes. One of the hot topics that will be covered at Toranfield House’s NEAR (Neuroscience and Evidence-based practices for Addiction and Recovery) Conference — which is being held in the Ritz Carlton Hotel in Enniskerry, Co Wicklow from 10-12 November — is how GPs can and should offer help and guidance to their patients when there are addictive features to their presentation, whether the patient asks for that help or not....

Helping patients with alcohol problems: a guide for primary care staff.

This leaflet gives reasons for, and methods on how to screen patients for alcohol problems. This leaflet is aimed at primary health care professionals and staff. It includes AUDIT and CAGE questionnaires

Alcohol Aware Practice Service Initiative April 2005 - March 2006: final report.

The Alcohol Aware Practice Service initiative involves 26 Doctors in the HSE Eastern region supported by 8 counsellors. Screening, advice and treatment are tailored to aid patients and families with alcohol problems. The basis of the project is that well resourced primary care can effectively address alcohol problems

Psychosocial Interventions for Alcohol use among problem drug users (PINTA) : protocol for a feasibility study in primary care

Background: Alcohol use is an important issue among problem drug users. Although screening and brief intervention are effective in reducing problem alcohol use in primary care, no research has examined this issue among problem drug users. Objectives: To determine if a complex intervention, incorporating screening and brief intervention for problem alcohol use among problem drug users, is feasible and acceptable in practice and effective in reducing the proportion of patients with problem alcohol use. Methods: PINTA is a pilot feasibility study of a complex intervention comprising screening and brief intervention for problem alcohol use among problem drug users with cluster randomisation at the level of general practice, integrated qualitative process evaluation, and involving general practices in two socioeconomically deprived regions. Participants: Practices (N=16) will be eligible to participate if they are registered to prescribe methadone and/or at least 10 patients of the practice are currently receiving addiction-treatment. Patient inclusion criteria are: aged 18 or over and receiving addiction treatment / care (e.g.methadone) or known to be a problem drug user. Interventions: A complex intervention, supporting screening and brief intervention for problem alcohol use among problem drug users (experimental group) compared to an 'assessment only' control group. A delayed intervention being available to 'control' practices after follow up. Outcome: Primary outcomes are feasibility and acceptability of the intervention to patients andprofessionals. Secondary outcome is the effectiveness of the intervention on care process (documented rates of screening and brief intervention) and outcome (proportion of patients with problem alcohol use at the follow up). Randomisation: Stratified random sampling of general practices based on level of training in providing addiction-related care and geographical area. Blinding: Single-blinded; GPs and practice staff, researchers and trainers will not be blinded, but patients and remote randomisers will. Discussion: This is the first study to examine feasibility and acceptability of primary care based complex intervention to enhance alcohol screening and brief intervention among problem drug users. Results will inform future research among this high-risk population and guide policy and service development locally and internationally.Author has checked copyrightTS 09.08.1

Tailoring a brief intervention for illicit drug use and alcohol use in Irish methadone maintained opiate dependent patients: a qualitative process.

BACKGROUND: The World Health Organization (WHO) recommend the tailoring of a brief intervention (BI) programme of research to ensure that it is both culturally and contextually appropriate for the country and the environment in which it is being tested. The majority of BI research has been conducted with non-opioid dependent participants. The current study developed a tailored BI for illicit drug use and alcohol use to a methadone maintained opioid dependent polydrug using cohort of patients. METHODS: Focus groups with staff and one-to-one qualitative interviews with patients guided the tailoring of all intervention materials for use in a subsequent cluster randomised controlled trial (RCT). This was done to make them contextually appropriate to an opioid dependent cohort and culturally appropriate to Ireland. Thematic analyses were utilised. RESULTS: The BI was modified to ensure its compatibility with the culture of an Irish drug using population, with elements of motivational interviewing (MI) and personalised feedback incorporated. Example scripts of a screening and BI were included, as was an algorithm to facilitate clinicians during a session. Modifications to the ‘Substance Use Risk’ cards included weighting the severity of the problems, writing the language in the first person to personalise the feedback and including tick boxes so as to further highlight the relevant risk factors for individual patients. Photographs of key risk factors were included to display pictorially risks for illiterate or semi-literate patients. Examples of the interaction of particular substances with methadone were of particular importance to this group. Modifications of the ‘Pros and Cons of Substance Use/Reasons to Quit or Cut Down’ included additional categories such as addiction, crime and money that were salient to this cohort. The manual was used to standardise training across trial sites. CONCLUSION: The research team was faithful to WHO recommendations to tailor BI programmes that are culturally and contextually appropriate to the treatment cohort and clinical environment. Outcome data from the cluster RCT have demonstrated that the tailored intervention was effective. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12888-016-1082-4) contains supplementary material, which is available to authorized users

Screening and brief interventions for illicit drug use and alcohol use in methadone maintained opiate-dependent patients: results of a pilot cluster randomized controlled trial feasibility study.

BACKGROUND AND OBJECTIVES: The present study evaluated the effectiveness of a single clinician delivered brief intervention (BI) to reduce problem alcohol use and illicit substance use in an opiate-dependent methadone maintained cohort of patients attending for treatment. METHODS: Four addiction treatment centers were randomly assigned to either treatment as usual (TAU; control group) or BI (intervention group). Clinicians screened patients using the alcohol, smoking, and substance involvement screening test (ASSIST) screening tool at baseline and again at three-month follow up. Fidelity checks were performed to ensure that training was delivered effectively and uniformly across all study sites. Feasibility of administering a BI within daily practice was assessed through intervention fidelity checks, patient satisfaction questionnaires and process evaluation. RESULTS: A total of 465 patients were screened (66% of the overall eligible population) with a total of 433 (93%) ASSIST positive cases. Randomization was effective, with no differences in the control versus the intervention arms at baseline for key demographic or clinical indicators including substance us. There was a statistically significant difference between global risk score for the intervention (x = 39.36, sd = 25.91) group and the control group (x = 45.27, SD = 27.52) at 3-month follow-up (t(341) = -2.07, p < .05). CONCLUSIONS: This trial provides the first evidence that a single clinician delivered BI can result in a reduction in substance use within a methadone maintained opiate-dependent cohort, and this effect is sustained at three month follow up

Additional file 1: of Tailoring a brief intervention for illicit drug use and alcohol use in Irish methadone maintained opiate dependent patients: a qualitative process

Clinician and Patient Interview Schedule. Intervention Development: Clinician Focus Group Interview Schedule and Intervention Development: Patient One-to-One Interview Schedule. Interview schedule outlines for data collection. (DOCX 88 kb