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Addictions Department Staff

Dr Ed Day

Senior Clinical Lecturer in Addiction Psychiatry

BA, BM, BCh, DM, MRCPsych

DrEdDayDr Ed Day is a Senior Lecturer at the National Addiction Centre and a Consultant in Addiction Psychiatry with Birmingham and Solihull Mental Health NHS Trust. His work is split between clinical research and teaching at King’s and clinical practice in a drug treatment team in Erdington in Birmingham. Much of his research focusses on developing and testing innovative psychosocial interventions for tackling addiction.

Other Roles

Ed is currently the Vice President of the Society for the Study of Addiction, and has previously been the academic secretary of the Addictions Faculty at the Royal College of Psychiatrists. He has been a member of a number of expert working groups to develop national clinical guidance in the field including the 2007 UK Guidelines on Clinical Management of Drug Misuse and Dependence (‘the Orange Book’) and the 2012 Medications in Recovery report. He was also been part of the working group that developed the NICE Guideline on Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence.

He is a trustee of Action on Addiction and Changes UK, two charities providing treatment for people with problems with addiction.

Background

Ed did his medical training in Cambridge and Oxford, before training as a psychiatrist in Birmingham. He became a member of the Royal College of Psychiatrists in 1999, and took a Senior Clinical Lecturer post at the University of Birmingham in 2003. He has worked in a range of clinical services in Birmingham treating both drug and alcohol problems, including a specialist inpatient unit, a community detoxification service, and an opiate substitution clinic. He has also worked with the COMPASS programme providing assessment and management of cases with ‘dual diagnosis’ of substance use and psychosis, and on the Liver Unit at the Queen Elizabeth Hospital providing assessments of patients requiring liver transplantation for alcoholic liver disease.

Teaching

Ed has taught both mental health and addictions topics undergraduate and postgraduate courses. In 2008 he set up an MSc programme in the Treatment of Substance Misuse at the University of Birmingham, and has been the External Examiner and Chair of the Exam Board for the MSc in Addiction Studies at King’s. He was deputy Senior Tutor for Welfare in the Birmingham Medical School for 3 years, and still teaches on the MBChB and Graduate Entry courses.

Ed set up the Addictions Training Academy in 2009 as a vehicle for delivering multidisciplinary training, focusing on innovative interventions developed in his clinical team. Working with the Institute of Behavioral Research in Texas and the National Treatment Agency, he developed a series of clinical manuals utilising node-link mapping interventions. These have been disseminated to treatment services around the country and are available at www.nta.nhs.uk/routes-to-recovery.aspx and http://www.nta.nhs.uk/uploads/phemappingmanual.pdf

Research

Ed’s research has focused on the broad theme of effective treatment interventions for drug and alcohol dependence. This has involved a combination of projects utilising medication or psychosocial interventions, projects exploring methods of implementation, and research into the organisational factors associated with effective outcomes.

Improving outcomes from opioid substitution treatment
He has conducted pragmatic studies exploring the effectiveness of medication delivery regimes (e.g. methadone [1] or buprenorphine [2] reduction), attempts at self-detoxification [3,4], prescribing injectable opioids [5], the influence of treatment on drug-using careers [6,7], and organisational factors in opioid substitution treatment delivery [8].

Psychosocial interventions
Ed has an interest in developing evidence-based psychosocial interventions in drug treatment services. He worked with colleagues from the University of Birmingham (Professor Jim Orford and Professor Alex Copello) to train drug treatment staff in the delivery of Social Behaviour and Network Therapy (SBNT) [9,10], and evaluated the impact in routine clinical practice.

Later work focussed on developing briefer interventions, breaking up the component parts into smaller pieces that could be delivered in one treatment session [11]. A potential framework for this approach came with the Birmingham Treatment Effectiveness Initiative, in conjunction with Professors Dwayne Simpson and Pat Flynn from the Institute of Behavioral Research in Texas, USA. This was a city-wide project involving all treatment agencies (both NHS and third sector) with three aims:

  1. To implement a validated system of patient assessment and outcome monitoring, and to feed back these results to improve clinical assessment and care
  2. To utilise a cognitive-based visual technique (node-link mapping) to assist counselling, and in particular enhance care planning and brief interventions
  3. To study organisational factors that influence the implementation of new clinical techniques.

This project yielded a number of benefits including a better understanding of the patient group attending treatment services [12,13], the correlation between clinician attributes and patient engagement [14], and an enhanced understanding of organisational factors linked to better patient outcomes [15]. The node-link mapping technique was been used to write a series of brief manuals for guiding treatment interventions [16-19].

Settings of service delivery

Ed’s DM thesis concerned the benefits of inpatient opioid detoxification as compared to equivalent treatment in a community setting. In addition to one of the few randomised trials ever conducted in this area [20], this body of work also included both a systematic review [21] and descriptive review (for the National Treatment Agency [22]) of the research evidence in this area, as well as a national survey of practice [23].

Mutual self-help and recovery orientation 

The barriers preventing treatment staff from promoting mutual self-help groups such as Alcoholics or Narcotics Anonymous to patients have become a focus of Ed’s research [24-26]. From this came an interest in drug-using careers and methods used to reach abstinence and recovery [27]. More recently he has explored methods of linking clients of professional treatment services to mutual self-help recovery communities.

A list of Ed's publications can be found on the King's Research Portal.

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