John Mc Quaide
I was a Higher Education lecturer for 18 years, teaching Harm Reduction and Hidden Harm on a Foundation Degree in Substance Use. Prior to this, I worked as an Addiction Counsellor within a residential treatment facility where I did individual, family and groupwork. I am a qualified Social Worker, initially working in rehabilitative mental health in a community-based residential facility. I am a PhD researcher (year 2) at Ulster University. My research is entitled “Harm Reduction Interventions to improve the health-related quality of life of people with long-term alcohol dependence”. My work takes a harm reduction approach to understanding models of care in long-term alcohol dependence. It aims to influence policy and practice to support alcohol harm reduction as a central pillar of policy approaches and service provision. My PhD is supervised by Dr. Lynn Dunwoody, Dr. Julie Harris (UU), Dr. Gillian Shorter (QUB), Dr. Hannah Carver (Stirling).
Clinical guidelines for the treatment of individuals with severe, long-term alcohol dependence or alcohol use disorder: a systematic review
Background: The aim of this review is to establish what clinical practice guidelines, treatment protocols, and consensus statements are available for those with severe, long-term alcohol use disorder or alcohol dependence (AUD/AD) who are unlikely to achieve abstinence or engage in structured treatment.
Methods: A systematic review and narrative synthesis of clinical guidelines from 8 databases was undertaken (January 1980 – December 2019). In addition, 14 websites representing national and international societies and agencies were searched. Clinical practice guidelines, treatment protocols and consensus statements containing recommendations for the identification and management of AUD/AD in adults aged 18 or over were included. The Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument was used to appraise guidelines. The review was conducted using Centre for Reviews and Dissemination (CRD) guidance and pre-registered on the OSF (DOI:OSF.10/T7GH3)
Results: Database searches identified 5805 records, 4546 were reviewed for eligibility following de-duplication. The 47 records which did not clearly violate criteria moved to full text appraisal with 43 additional records retrieved from non-database searches. Preliminary results from 26 clinical guidelines find the predominant treatment goal recommendation is abstinence. Reduced or controlled drinking is recommended as a potential treatment goal where abstinence is not achieved. However, the guidelines lack evidence and specificity on recommendations for controlled drinking.
Conclusions: The review highlights a significant gap in clinical practice guidelines for individuals with AUD who are unlikely to achieve abstinence or engage in structured treatment and a need to develop specific clinical practice guidelines for this client group.