CLINICAL GUIDELINES

Drug Misuse & Dependence: Guidelines on clinical management

The National Treatment Agency for Substance Misuse published, in September 2007, a UK-wide framework for the clinical treatment of drug misuse, on behalf of the Department of Health and devolved administrations.

This was an update of the 1999 Drug Misuse and Dependence – UK Guidelines on Clinical Mangement, commonly called the ‘Orange Book’.  The new version reflects changes in drug treatment over the eight years since, and recent guidance from the National Institute for Health and Clinical Excellence.

There is greater emphasis than previously on the importance of care and treatment planning, and the importance of keyworking in the delivery, coordination and review of all elements of a treatment package for individual patients.

There is guidance on opioid drug treatment, with a clearer distinction between detoxification and opioid-maintenance regimens.

There is more guidance on psychosocial treatment for drug misuse, both in the context of keyworking and formal psychosocial programmes for polydrug and alcohol misusers and non-opioid misusers.

The value of drug treatment as a protective mechanism against blood-borne viruses and overdose and a wide range of drug-related harm is recognised and clinicians advised to respond to a “failure in treatment” by optimising or increasing interventions rather than reducing or withdrawing treatment. There is also greater emphasis on wider and specific healthcare issues for drug misusers.

Copies of the Clinical Guidelines 2007 can be ordered via the DH publications orderline on 08701-555 455 or dh@prolog.uk.com, quoting UKCG07. Orders are limited to 5 copies.