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Issue 2 July 2002
A national newsletter on substance misuse management in primary care
Primary care responds
to the challenge
Recent statistics show that the government’s target on GP would very much like to hear from anyone in areas with very low
involvement in drug dependency treatment (originally 20% involvement to explore strategies to support primary care
subsequently increased to 30% in the NHS plan) were not as wide of involvement.
the mark as many people thought. Recent research involving a 10% *See Audit Commission Report below
sample of all GPs in England commissioned by SMMGP in
**See policy document review on page 6
collaboration with the National Addiction Centre showed 25% of GPs
*** Dual Diagnosis Good Practice Guide, Department of Health, 2002 - see
doing some substitute prescribing with 19.8% of GPs doing this in
review on page 6
shared care. This is backed up by the National Treatment Agency’s
statistics gathered from Drug Action Team treatment plan returns,
which showed 19.4% of GPs involved in shared care. The Audit
Commission Report
found that 25% of GPs felt confident in
treating drug users.
These statistics do, however, mark very significant regional
variations. In some areas most GPs are involved in drug dependency
treatment, some areas officially claiming 100% involvement. In
other areas very few are involved even as low as an official 0%
involvement. Even in such cases there are usually a few committed
GPs doing the work quietly. With publication after publication
supporting primary care based services and the Royal College of The Audit Commission Report 2002
General Practitioners (RCGP) obtaining funding for a second round
Changing Habits: The Commissioning and
of ‘special interest’ GP training, the 30% GP involvement target
should be obtainable. There is recent Department of Health
Management of Community Drug Treatment
guidance that dual diagnosis treatment is now the responsibility of Services for Adults. We will be regularly referring to this
mainstream mental health
. This may well assist improved excellent report (Network Issue 1, page 2). It highlights amongst
treatment delivery in specialist and GP based services, but we will other things the need for more support to be given to primary care
have to wait and see how this gets translated into practice. SMMGP and principles for effective treatment:

We need to understand the complex nature of drug misuse

People who use drugs will need varying combinations of services
during the course of their treatment and will need to be supported
along a ‘treatment pathway’
Urine screening - The benefits and limitations 2

The approach that works for one person will not necessarily work for
Alcohol – What is a brief intervention? 3
Specialists, GPs with Special Interest, and GPs working as
specialists. What are the differences and what is the future? 4-5

Good assessment procedures and access to a range of services are
essential if services are to be matched effectively to people’s needs.
Up to speed on clubbing health 5
Read the full version at
Classics revisited – Methadone Maintenance Treatment and Other
Opioid Replacement Therapies 6
Paper review and policy document review 6
Dr Fixit on under-dosing 7
Visit our on-line clinical
discussion forum
Bulletin board 8
Please inform us if
you wish to be on the
Hot Topics - The French connection – substitute prescribing and mailing list or of
reduction in deaths and crime 8
changes of address
Hot Topics – Heroin prescribing - will this affect GPs? 8
Hot Topic - the new GP contract 8
Project contact information 8
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