NETWORK A national newsletter on substance misuse management in primary care
NETWORK 21 FEBRUARY 2008
High walls and no entry signs
When I think of a barrier, I think high walls and ‘no entry’ signs. So
when drug users are asked about ‘barriers’ what do they think of?
Probably the same as me. When you ask a drug user ‘What stops
you going for help? What are the problems getting treatment? Why
don’t you like picking up your script?’, then we start to get a sense of
what the real barriers are.
Where do I start? Being a former drug user myself I remember the
reasons I didn’t want to attend that notorious 9am appointment. It
wasn’t because I was ‘non compliant’, ‘untreatable’ or ‘incapable
of change’, which is how I had been described on numerous
occasions! It was more to do with spending days, months, years on
the streets completely mentally and physically addicted to drugs and
not having the facilities to clean myself up from whatever beating I
had had the night before. Funnily enough, I found attending drug
treatment humiliating enough without having to sit in an unfriendly,
back alley waiting room for an hour with workers and other users
complaining about the smell – and besides that did I really want to
give up my best friend? After all it was all I had, all I lived for, that
next hit, the only way out of reality.
In this issue
John Richmond gives a personal perspective on the process of
Hidden Harm is often referred to as an influential report, but has
recommissioning of drugs services in his area. Page 3.
practice improved regarding reducing the potential harm of parental
substance misuse on the children of substance users? David Best,
Vanessa Crawford reviews what is known about dual diagnosis Saffron Homayoun, and John Witton discuss the findings of
from available research and policy. She concludes that a multi-agency their survey of drug treatment services. Page 11.
approach is essential when working with people who are both using
drugs, and have mental health problems. Page 4.
Hugh Campbell offers advice to a GP who wants to provide the
best treatment for a patient who is being treated for drug use with
Gary Slapper describes the complexities of the legislature regarding dihydrocodeine and is experiencing problems with his mental health.
drugs, and gives an interesting historical analysis of cannabis and the Page 12.
law. Page 5.
Andy Lane replies to a GP who is treating a patient for both their drug
Jim Barnard gives us a history of the treatment of drug users in use and their alcohol problem. Page 14.
primary care. He describes how the pioneering spirit of a group of
doctors in the nineties has contributed to the enormous development of
We hope you enjoy this special edition.
drug treatment provided by GPs over the past two decades. Page 8.
Dr Prun Bijral and Kate Hall discuss the role of the in-patient unit
as a valuable component of tier 4 provision. They challenge the idea
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that individuals need to move through the tiers in a chronological order
to access in-patient services, and suggest that in-patient units can offer
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more than just detox. Page 9.
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