Question 4Should psychosocial interventions versus no psychosocial interventions be used among PWID?

RecommendationNot offering psychosocial interventions is suggested over offering psychosocial interventions to PWID, when the goal is to reduce the incidence of viral hepatitis. (Conditional recommendation, low quality evidence)
Key considerations
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Psychosocial interventions should not be precluded as part of comprehensive interventions with goals broader than reducing the incidence of viral hepatitis. However, they should not be recommended as a standalone intervention.

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This recommendation does not address peer delivered interventions

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Referral to psychosocial pharmacotherapy guidelines1

  • PWID should be offered access to needle and syringe programs
  • PWID should be offered access to effective substance use treatment programs
Justification
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There is lack of evidence for the effectiveness of psychosocial interventions and it's uncertain whether benefits outweight harms. The intervention require significan human and other resources. The quality of evidence is low

Implementation considerations
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When implemented, psychosocial interventions need to be part of a comprehensive approach aiming at a wider range of behavioural problems as recommended by the psychosocial pharmacotherapy guidelines2

Research priority
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RCTS comparing the effects of psychosocial interventions versus no psychosocial interventions on HCV, HBV, and HIV incidence, and on quality of life among PWID.

1

WHO, WHO Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence. Geneva, WHO, 2009. http://whqlibdoc​.who​.int/publications/2009​/9789241547543_eng.pdf

2

WHO, WHO Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence. Geneva, WHO, 2009. http://whqlibdoc​.who​.int/publications/2009​/9789241547543_eng.pdf

WHO, WHO Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence. Geneva, WHO, 2009. http://whqlibdoc​.who​.int/publications/2009​/9789241547543_eng.pdf

WHO, WHO Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence. Geneva, WHO, 2009. http://whqlibdoc​.who​.int/publications/2009​/9789241547543_eng.pdf

From: Annex 5, Risk benefit/decision tables

Cover of Guidance on Prevention of Viral Hepatitis B and C Among People Who Inject Drugs
Guidance on Prevention of Viral Hepatitis B and C Among People Who Inject Drugs.
Geneva: World Health Organization; 2012 Jul.
Copyright © 2012, World Health Organization.

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