The treatment outcomes profile (TOP), a treatment outcomes monitoring instrument is used at the start, during and after substance misuse treatment, and is reported through the national drug treatment monitoring system. TOP comprises of a series of questions, asked by the key worker and answered by the client about the nature and extent of the client's substance use, crime, health and social functioning, in order to measure outcomes in a meaningful way that is sensitive to change over time.
TOP went through a rigorous development process and all items on the TOP form had to meet stringent methodological and statistical criteria to be included on the final form. Drug treatment service users who took part in testing the TOP found it difficult to accurately and consistently remember and report the amount and frequency of their benzodiazepine use so the question did not validate and is no longer included. However, benzodiazepine use can be recorded on the TOP form as an “other problem substance” for clinical purposes and should always be included in comprehensive assessments and the resulting care plans.
The Department, along with the National Treatment Agency for substance misuse are involved in other work to ensure that benzodiazepine use among illegal or illicit drug misusers is addressed effectively in a clinical setting. Importantly, ‘Drug Misuse and Dependence—UK guidelines on clinical management’ (the ‘Clinical Guidelines’) gives guidance for clinicians on treating drug misusing patients who also may misuse benzodiazepines. The guidance is available on the Department's website at:
www.dh.gov.uk/en/Policyandguidance/Healthandsocialcaretopics/Substancemisuse/index.htm