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Effective Interventions Unit: Residential detoxification and rehabilitation services for drug users: A review

Introduction

There is a wide range of services available to drug users for treatment, care and support. Among these are services which are provided to individuals in a residential setting. This review provides information specifically about residential detoxification and rehabilitation services for drug users. It includes:

• a description of the aims of residential detoxification and rehabilitation services and the interventions provided by them;

• a summary of the evidence on their effectiveness; and

• a mapping of these services in Scotland; and

• brief details of how Scottish residential services are used.

This review does not consider the effectiveness of residential services for alcohol users and it is likely that different factors impinge upon the outcomes of residential treatment for primary alcohol and primary drug misuse. It is worth noting, however, that most residential programmes for drug users in Scotland also provide services to alcohol users, although the reverse is not necessarily true - that is, not all residential services for alcohol users also provide services to drug users.

This review is intended to provide a basis for further research on the subject of residential and community rehabilitation for drug users, to be funded under the Scottish Executive's Drug Misuse Research Programme in Spring 2005. Therefore, the concluding chapter of the review makes some tentative suggestions about possible future research in this area.

Methods

In addition to a brief review of the literature on residential services for drug users, this review draws on information gathered from a number of other sources, including:

• a Directory of Specialist Drug Treatment Services in Scotland, available from the Scottish Drugs Forum (SDF) website

• the Drug and Alcohol Action Team (DAAT) Corporate Action Plan returns for 2002-04

• the Scottish Drug Misuse Database for the years 2002-04.

• a report of a qualitative investigation of residential services in Scotland undertaken in 2001/2002 as part of the Drug Outcomes Research in Scotland (DORIS) study

• the results of a survey of social workers' use of residential detoxification and rehabilitation services, undertaken between January and May 2004 by the Association of Directors of Social Work (ADSW) sub-group on Substance Misuse

• brief telephone interviews with a selection of practitioners, local authority budget holders and DAAT officers across Scotland undertaken in October 2003.

• A brief telephone survey of providers of residential services in Scotland, carried out between March and September 2004.

It became clear during the process of gathering evidence that this subject provokes strong views from practitioners, service providers, commissioners and researchers alike. We hope this review will provide a useful contribution to the on-going discussions and debates taking place in many areas of Scotland about the role that residential services have in relation to community services in providing integrated care to drug users.

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