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Cochrane Database of Systematic Reviews

Pharmacological interventions for drug‐using offenders

Overview of attention for article published in Cochrane database of systematic reviews, June 2015
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Title
Pharmacological interventions for drug‐using offenders
Published in
Cochrane database of systematic reviews, June 2015
DOI 10.1002/14651858.cd010862.pub2
Pubmed ID
Authors

Amanda E Perry, Matthew Neilson, Marrissa Martyn‐St James, Julie M Glanville, Rebecca Woodhouse, Christine Godfrey, Catherine Hewitt

Abstract

The review represents one in a family of four reviews focusing on a range of different interventions for drug-using offenders. This specific review considers pharmacological interventions aimed at reducing drug use or criminal activity, or both, for illicit drug-using offenders. To assess the effectiveness of pharmacological interventions for drug-using offenders in reducing criminal activity or drug use, or both. We searched Fourteen electronic bibliographic databases up to May 2014 and five additional Web resources (between 2004 and November 2011). We contacted experts in the field for further information. We included randomised controlled trials assessing the efficacy of any pharmacological intervention a component of which is designed to reduce, eliminate or prevent relapse of drug use or criminal activity, or both, in drug-using offenders. We also report data on the cost and cost-effectiveness of interventions. We used standard methodological procedures as expected by Cochrane. Fourteen trials with 2647 participants met the inclusion criteria. The interventions included in this review report on agonistic pharmacological interventions (buprenorphine, methadone and naltrexone) compared to no intervention, other non-pharmacological treatments (e.g. counselling) and other pharmacological drugs. The methodological trial quality was poorly described, and most studies were rated as 'unclear' by the reviewers. The biggest threats to risk of bias were generated through blinding (performance and detection bias) and incomplete outcome data (attrition bias). Studies could not be combined all together because the comparisons were too different. Only subgroup analysis for type of pharmacological treatment were done. When compared to non-pharmacological, we found low quality evidence that agonist treatments are not effective in reducing drug use or criminal activity, objective results (biological) (two studies, 237 participants (RR 0.72 (95% CI 0.51 to 1.00); subjective (self-report), (three studies, 317 participants (RR 0.61 95% CI 0.31 to 1.18); self-report drug use (three studies, 510 participants (SMD: -0.62 (95% CI -0.85 to -0.39). We found low quality of evidence that antagonist treatment was not effective in reducing drug use (one study, 63 participants (RR 0.69, 95% CI 0.28 to 1.70) but we found moderate quality of evidence that they significantly reduced criminal activity (two studies, 114 participants, (RR 0.40, 95% CI 0.21 to 0.74).Findings on the effects of individual pharmacological interventions on drug use and criminal activity showed mixed results. In the comparison of methadone to buprenorphine, diamorphine and naltrexone, no significant differences were displayed for either treatment for self report dichotomous drug use (two studies, 370 participants (RR 1.04, 95% CI 0.69 to 1.55), continuous measures of drug use (one study, 81 participants, (mean difference (MD) 0.70, 95% CI -5.33 to 6.73); or criminal activity (one study, 116 participants, (RR 1.25, 95% CI 0.83 to 1.88) between methadone and buprenorphine. Similar results were found for comparisons with diamorphine with no significant differences between the drugs for self report dichotomous drug use for arrest (one study, 825 participants, (RR 1.25, 95% CI 1.03 to 1.51) or naltrexone for dichotomous measures of reincarceration (one study, 44 participants, (RR 1.10, 95% CI 0.37 to 3.26), and continuous outcome measure of crime, (MD -0.50, 95% CI -8.04 to 7.04) or self report drug use (MD 4.60, 95% CI -3.54 to 12.74). When compared to non-pharmacological treatment, agonist treatments did not seem effective in reducing drug use or criminal activity. Antagonist treatments were not effective in reducing drug use but significantly reduced criminal activity. When comparing the drugs to one another we found no significant differences between the drug comparisons (methadone versus buprenorphine, diamorphine and naltrexone) on any of the outcome measures. Caution should be taken when interpreting these findings, as the conclusions are based on a small number of trials, and generalisation of these study findings should be limited mainly to male adult offenders. Additionally, many studies were rated at high risk of bias.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 271 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 271 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 36 13%
Researcher 31 11%
Student > Ph. D. Student 30 11%
Student > Bachelor 26 10%
Other 18 7%
Other 52 19%
Unknown 78 29%
Readers by discipline Count As %
Medicine and Dentistry 79 29%
Psychology 33 12%
Nursing and Health Professions 27 10%
Social Sciences 18 7%
Pharmacology, Toxicology and Pharmaceutical Science 4 1%
Other 21 8%
Unknown 89 33%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 January 2016.
All research outputs
#19,939,786
of 25,376,646 outputs
Outputs from Cochrane database of systematic reviews
#12,014
of 13,057 outputs
Outputs of similar age
#188,154
of 274,274 outputs
Outputs of similar age from Cochrane database of systematic reviews
#244
of 273 outputs
Altmetric has tracked 25,376,646 research outputs across all sources so far. This one is in the 18th percentile – i.e., 18% of other outputs scored the same or lower than it.
So far Altmetric has tracked 13,057 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 35.6. This one is in the 6th percentile – i.e., 6% of its peers scored the same or lower than it.
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