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NETWORK A national newsletter on substance misuse management in primary care network NETWORK 31 FEBRUARY 2011


Times are a changing: what does the new Drug Strategy mean for primary care?


edition of Network we will look at some of the main themes of the new political environment and how they may impact on primary care based drug treatment. Much still remains unclear but we will try to guide you through the challenges and opportunities the moving landscape will bring. The Drug Strategy is out and we include a range of views on that: Paul Hayes, National Treatment Agency gives his thoughts on page 6 and Peter McDermott, Policy Officer, The Alliance reflects on the document on page 7.


The changes brought in by the coalition government are so numerous that it is difficult to keep apace with what is happening, how everything will fit together, and how it will affect drug and alcohol services in the future. In this


In this issue


The new Drug Strategy describes recovery as something the individual defines, rather than an end state. Peter Simonson gives a personal account of medically- assisted recovery. Page 3.


The damaging effects of stigma experienced by people who use drugs can be more problematic than the effect of the drugs themselves. Elsa Browne argues that for things to improve, stigma must be challenged at personal, cultural and structural levels. Page 5.


Paul Hayes, Chief Executive, National Treatment Agency outlines key points of the new Drug Strategy, and reflects upon the likely impact this will have on the drug and alcohol field. Page 6.


Peter McDermott, Policy Officer, The Alliance gives his views on the new Drug Strategy. Page 7.


We are please to give a special preview of the executive summary of the updated Royal College of General Practitioners Guidance for the use of substitute prescribing in the treatment of opioid dependence in primary care. Page 8.


Judith Yates looks back over her 30 year career as a GP and how her experience of working with drug users has echoed what the evidence tells us about good practice. Page 10.


In the early days of the government, news of changes to the field were based on speculative press reports; against the already worrying backdrop of drastic spending cuts came talk of time-limited methadone, abstinence as the only treatment option, and an end to welfare for drug users who refuse treatment. We don’t know whether it was through the consultation process or as a result


of back room discussions, but most of these non-evidence based interventions did not make it into the final document. Though references to harm reduction are greatly reduced in comparison to previous strategies, it remains within the 2010 Drug Strategy, with recognition that needle exchange reduces harm, and prevention in drug related deaths, and blood-borne viruses appearing as key outcomes for services. The concept of time-limited methadone is nowhere to be seen and ‘medically-assisted recovery’ (MAR) is recognised, and so to SMMGP’s great relief the evidence base has not been ignored at the cost of politically motivated policy. In this edition of Network, Peter Simonson gives his own personal account of MAR on page 3 and Judith Yates discusses the importance of the evidence base in her article on opioid substitution therapy on page 10. We are also excited to publish the executive summary of the updated Royal College


…continued overleaf …continued overleaf


Is gambling the poor relation of addiction services? Henrietta Bowden-Jones describes how she went about setting up an NHS clinic for problem gamblers. Page 11.


Ollie Batchelor tells the story of Recovery Rocks, a choir that offers more than good melodies. Page 12.


Joss Bray is Dr Fixit to a GP who wants advice on detoxification. Page 13.


Dr Fixit Chris Ford describes the different approaches to titration for methadone and buprenorphine. Page 14. See the latest courses and events. Page 16.


We hope you enjoy this edition. Editor


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