NETWORK A national newsletter on substance misuse management in primary care
I S S U E 1 5 A U G U S T 2 0 0 6
Poly drug use:
taking it on in UK general practice
Poly drug use is the norm and the Lonsdale Medical
Centre team of Chris Ford, James Oliver, Brian Whitehead
and Janet Gillespie describe successfully working with
Patterns of drug use in the United Kingdom have been subject
the person rather than the drug in general practice. Ed.
to variation in recent decades. Heroin use has been steadily
increasing and other sedatives have become more prominent
particularly benzodiazepines. The use of stimulants such
as amphetamines, cocaine (powder and crack) is becoming
1) Poly-drug use is now the norm in the UK – treating opioid
increasingly commonplace. Biphasic drugs such as alcohol,
dependence alone is no longer possible
cannabis and nicotine have been, and remain the most commonly
2) Poly-drug use can be successfully managed in General Practice used addictive substances.
3) Drug treatment needs to be about the person rather than drug
In this issue
Poly drug use is the norm. A must read – see above. pages 1-2.
Non-medical prescribing – one year on. Improving what’s been done for
Conference news ….and… it’s Birmingham! Next year’s 12th National
years and giving us a more accessible and flexible prescribing or indeed
Conference on Managing Drug Users in Primary Care is to be at the
taking us back to a narrow more prescriptive form of treatment? Still finding its Hilton Birmingham Metropole Hotel from 18th – 20th April. This year’s
way, Simon Greasley updates the discussion. Page 3. Manchester feedback indicated a resounding success with 91% of
Nat Wright describes Setting up a Drug Service in Prison as ‘the best of
delegates finding it good or excellent. Listening to other feedback
times and the worst of times’, find out why on page 4.
indicating room for improvement, planning is underway for next year. So
Readers views following our last edition GPwSI article – what is the future,
watch this space …
will some GPs us be redefined out of existence? Also, a personal tribute to Dr
Michael Varnam. Page 6.
The virtue of ignorance - Phil Barker challenges us to drop the ‘specialism’
2006 conference consensus statement
and remember it is the person that we work with. Consider ignorance as a
RCGP 11th National Conference: Management of Drug Users in Primary
starting point ... A fundamental and philosophical delight! Page 7.
Care. Are we Delivering Effective Care in General Practice? Manchester
Stephan Ibanez-de-Benito conducts a thorough examination of clinical
International Convention Centre 27th-28th April 2006
governance as the management of patient centred organisational change.
This conference believes that:
Kate Halliday reports on the Effective Coordination of Shared Care day
• Effective care for drug users is being delivered in general practice,
exploring support forums, role development and shared practice, held on
because we have inherent ability and flexibility to see the person
26th April in Manchester, page 10. Also on page 10, Nat Wright highlights
rather than the drug
the Joseph Rowntree report on the piloting of drug consumption rooms as a
• Good care is dependent upon all players, including service users and
pragmatic response to public injecting.
carers, working well together in a whole system approach which is
Keep updated with substance misuse texts and sources online…. Email adequately resourced
updates, feeds, blogs, alerts, listings… approving nods or maybe no idea what
• However, provision remains patchy
this means? Worth a read either way as Anne Welsh from DrugScope makes
the great web library a lot easier to access. Page 11.
• We all need to:
Heresy dogma and inquisition…supervised consumption. Counter-
– Take up the challenge to audit and evaluate our work
productive invasion of human rights or effective aid to treatment? In the first of
– Train and offer training opportunities to undergraduates and
two articles Nigel Modern distinguishes the articles of faith that make it heresy
for some and orthodoxy for others. Page 12.
– Actively promote good practice amongst other colleagues in
Charlie Lowe as Dr Fixit on using clinical governance to bring about change
general practice and the wider drugs field
with GPs who are under-dosing…akin to herding cats!? Page 13. Ewan
Stewart, continues his Dr Fixit from last issue with a patient who returns
– With colleagues, develop a nationally agreed outcome monitoring
with a HIV+ test result, page14. Kim Wolff addresses Sleep management
and methadone, a topic that many seem unsure about, page 15, also Models
• We call upon the NTA, HCC, Government and local commissioners
of Care for Alcohol Misusers by Linda Harris.
to take account of the effectiveness of primary care provision and
Updates and announcements on page 16. ensure universal coverage of this within an overall systems approach
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