Abstract
BackgroundResearch indicates that 3% of people receiving opiate substitution treatment (OST) in the UK manage to achieve abstinence from all prescribed and illicit drugs within 3 years of commencing treatment, and there is concern that treatment services have become skilled at engaging people but not at helping them to enter a stage of recovery and drug abstinence. The National Treatment Agency for Substance Misuse recommends the involvement of families and wider social networks in supporting drug users’ psychological treatment, and this pilot randomized controlled trial aims to evaluate the impact of a social network-focused intervention for patients receiving OST.Methods and designIn this two-site, early phase, randomized controlled trial, a total of 120 patients receiving OST will be recruited and randomized to receive one of three treatments: 1) Brief Social Behavior and Network Therapy (B-SBNT), 2) Personal Goal Setting (PGS) or 3) treatment as usual. Randomization will take place following baseline assessment. Participants allocated to receive B-SBNT or PGS will continue to receive the same treatment that is routinely provided by drug treatment services, plus four additional sessions of either intervention. Outcomes will be assessed at baseline, 3 and 12 months. The primary outcome will be assessment of illicit heroin use, measured by both urinary analysis and self-report. Secondary outcomes involve assessment of dependence, psychological symptoms, social satisfaction, motivation to change, quality of life and therapeutic engagement. Family members (n = 120) of patients involved in the trial will also be assessed to measure the level of symptoms, coping and the impact of the addiction problem on the family member at baseline, 3 and 12 months.DiscussionThis study will provide experimental data regarding the feasibility and efficacy of implementing a social network intervention within routine drug treatment services in the UK National Health Service. The study will explore the impact of the intervention on both patients receiving drug treatment and their family members.Trial registrationTrial Registration Number: ISRCTN22608399ISRCTN22608399 registration: 27/04/2012Date of first randomisation: 14/08/2012
Highlights
Research indicates that 3% of people receiving opiate substitution treatment (OST) in the UK manage to achieve abstinence from all prescribed and illicit drugs within 3 years of commencing treatment, and there is concern that treatment services have become skilled at engaging people but not at helping them to enter a stage of recovery and drug abstinence
Staff recruitment and training This study aims to test the feasibility of training National Health Service (NHS) staff to deliver a social network intervention
The National Institute for Health and Clinical Excellence has highlighted the evidence for psychosocial treatments for heroin dependence [50], and family/social network interventions are promising for two reasons: (1) by involving family and friends in the treatment process there are opportunities for generalization of the effects beyond an episode of professional treatment; and (2) treatment may reduce the considerable physical and psychological health burden of drug misuse on family and friends
Summary
Research indicates that 3% of people receiving opiate substitution treatment (OST) in the UK manage to achieve abstinence from all prescribed and illicit drugs within 3 years of commencing treatment, and there is concern that treatment services have become skilled at engaging people but not at helping them to enter a stage of recovery and drug abstinence. Research in Scotland found that 3% of people in opiate substitution treatment (OST) manage to achieve abstinence from all prescribed and illicit drugs within 3 years of commencing treatment [4]. One goal of treatment interventions may be to help patients transform social networks that support drug use into those that offer competitive reinforcement for abstinence. The overall merits of this goal are illustrated by a series of studies showing that positive social supports are associated with a reduced risk of relapse to heroin and other drug use and with an overall better treatment response [10,11,12,13,14]
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