The Netherlands Drug Situation 2010 - Trimbos-instituut

this patient group (e.g. motivation enhancement, brief interventions, selfhelp groups, the12-step approach, cognitive-behavioural therapy), and 3) combinations of both types ofinterventions.Brief attention is paid to the up to now insufficient evidence for the effectiveness ofalternative treatment, e.g. transcendental meditation, biofeedback, and acupuncture. Theguideline also covers recommendations for treatment in case of comorbid psychiatric disorders.Furthermore, the guideline pays attention to the causes of and risk factors forsomatic complications of alcohol abuse and the role of general practitioners for the casefinding and diagnosis of alcohol problems. Next, existing legal arrangements for quasicompulsorytreatment are described, as well as options for interventions in the workplace. Finally, recommendations are formulated for enhancing the implementation of theguideline.The recommendations and advice are meant for professional use in the mental healthcare and the addiction care, but also for general medical practice and other professionalsinvolved with the care of individuals with alcohol problems. The guideline is also expectedto be of supportive value for the decision making for patients and their families.As mentioned in the introduction of § 11.2, two multidisciplinary guidelines on (problem)drug use are in development.11.2.10 Final remarksThe program Scoring Results is constructing a 'new generation' of guidelines (addenda)for the treatment of patients with comorbid disorders. These guidelines will be addendato the existing multidisciplinary guidelines for mental health. The first addendum will bethe Guideline Anxiety and Addiction (Snoek et al. 2009). Separate guidelines will be constructedfor patients with substance use disorder and other disorders like depression,schizophrenia, or borderline personality disorder.In recent years, the treatment demand for GHB addiction has increased at a numberof institutes for addiction care in the Netherlands (Van Laar et al. 2010). This far, no evidence-basedguideline has been developed yet for the treatment of GHB-addiction. Theinstitute for addiction care Novadic-Kentron was the first in the Netherlands to applymedical GHB for detoxification purposes. At Novadic-Kentron, scientific research is nowbeing conducted to establish an evidence-based guideline for the treatment of GHBaddiction(Willemen 2010).11.3 Experiences in the Netherlands with the implementation ofguidelinesThe experiences with the implementation of guidelines in the Netherlands will now bedescribed. Lessons from more general implementation evaluation reports will be describedfirst. These reports deal with the experiences with guidelines in the health sectorin general, the implementation of guidelines in the mental health care (see § 11.3.1),and experiences with the implementation of guidelines and other 'products' of the program"Scoring Results" (see § 11.3.2). Finally, the results of two guideline-specific implementationreports will be described (see § 11.3.3 and § 11.3.4).167