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Aims The Randomized Injectable Opioid Treatment Trial ( RIOTT) compared supervised injectable heroin ( SIH) and supervised injectable methadone ( SIM) with optimized oral methadone ( OOM) ( ISRCTN0133807). Heroin addicts (previously unresponsive to treatment) made significant reductions in street heroin use at 6 months when treated with SIH. We now examine secondary outcomes. Design Multi-site randomized controlled trial ( RCT) comparing SIH versus OOM and SIM versus OOM. Setting Three supervised injectable opiate clinics in England. Participants Chronic refractory heroin addicts continuing to inject street heroin virtually daily despite oral substitution treatment ( n = 127), randomized to either SIH( n = 43), SIM( n = 42) or OOM( n = 42). All received high levels of medical and psychosocial support. Measurements Secondary outcomes: wider drug use, crime, health and social functioning at 6 months. Findings At 6 months, no significant differences were found between treatment groups in wider drug use (crack/cocaine, benzodiazepines, alcohol), physical and mental health ( SF-36) or social functioning. Within each treatment group, significant reductions were observed in crime [ SIH = odds ratio ( OR) 0.05; P < 0.001; SIM = OR 0.11; P = 0.002; OOM = OR 0.11; P = 0.003] and money spent per week on illicit drugs ( SIH = mean change £-289.43; P < 0.001; SIM = mean change £-183.41; P < 0.001; OOM = mean change £-162.80; P < 0.001), with SIH significantly more likely to have reduced money spent on illicit drugs versus OOM (mean difference £-92.04; P < 0.001). Significant improvements were seen in physical health for SIH and SIM ( SIH = mean change 3.97; P = 0.008; SIM = mean change 4.73; P = 0.002) and mental health for OOM (mean change 6.04; P = 0.013). Conclusions Supervised injectable heroin treatment and supervised injectable methadone treatment showed no clearly identified benefit over optimized oral methadone in terms of wider drug use, crime, physical and mental health within a 6-month period, despite reducing street heroin use to a greater extent. However, all interventions were associated with improvements in these outcomes. [ABSTRACT FROM AUTHOR]

Introduction and Aims Sociological work on social capital and its impact on health behaviours have been translated into the addiction field in the form of 'recovery capital' as the construct for assessing individual progress on a recovery journey. Yet there has been little attempt to quantify recovery capital. The aim of the project was to create a scale that assessed addiction recovery capital. Design and Methods Initial focus group work identified and tested candidate items and domains followed by data collection from multiple sources to enable psychometric assessment of a scale measuring recovery capital. Results The scale shows moderate test-retest reliability at 1 week and acceptable concurrent validity. Principal component analysis determined single factor structure. Discussion and Conclusions The Assessment of Recovery Capital ( ARC) is a brief and easy to administer measurement of recovery capital that has acceptable psychometric properties and may be a useful complement to deficit-based assessment and outcome monitoring instruments for substance dependent individuals in and out of treatment. [ABSTRACT FROM AUTHOR]

Recovery group participation is relevant to both clinical and research activity. Its measurement with the Recovery Group Participation Scale (RGPS) is an attempt to have a measurement of participation across a range of recovery groups. The factor structure, among other psychometric properties of the scale, is however, undefined. The present study examined the factor structure of the RGPS in alcohol and drug recovery populations in Birmingham and Glasgow, United Kingdom. Participants from the Birmingham (n = 219) and Glasgow (n = 205) recovery studies who had a completed form of the RGPS formed the basis for the factor structure examination. Principal component analysis extracted one factor, which accounted for 39.3% and 67.4% in the Birmingham and the Glasgow samples, respectively. Overall scores on the RGPS were associated with higher quality-of-life scores and with greater self-esteem and social networks of nonusers in recovery. The key question that remains to be addressed is the evolving role of recovery group participation in prospective studies of growth of recovery capital and sustained recovery. [ABSTRACT FROM AUTHOR]

This article examines the academic sources and origins of the 'recovery movement' in the drugs field in the United Kingdom and considers a series of disparate evidence sources that have been applied and used in this regard. Only two of these originate in traditional addictions materials-treatment outcome and cohort studies-with the remaining studies reviewed coming from a range of other areas. In particular, the sources include a switch in focus from the specialist treatment clinic to the community, and from the therapeutic to the more broadly social. The framework for this approach is explicitly developmental and attends to the published research around crime careers and addiction careers. The final sections of the article review recent UK addiction recovery research and assess where we are and what we currently know-and as a consequence the key gaps and the methodological questions that need to be addressed. [ABSTRACT FROM AUTHOR]