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NETWORK A national newsletter on substance misuse management in primary care network NETWORK 35 MARCH 2013


Treating hepatitis C in patients with established cirrhosis


Steve Brinksman discusses encouraging advances in treatment of hepatitis C for patients who have liver cirrhosis. Ed.


Viral hepatitis is a significant cause of liver related morbidity and mortality as over time it causes inflammation and then fibrotic changes that can lead to cirrhosis and subsequent decompensated liver disease and an increased risk of developing hepatocellular carcinoma [HCC].


that have been made in terms of screening and the development of treatments that can be curative there is a large reservoir of people who have hepatitis C but are unaware of the fact


“despite the large strides


It has been estimated that approximately 50% of the infected population needs to be treated to have any discernible effect on morbidity and mortality 2


” a figure that here in the UK we are


In the UK liver disease is the fastest rising major cause of mortality and typically causes death at a younger age than the other major conditions1


. 1 Office for National Statistics (2008) Health Service Quarterly, Winter 2008, No. 40 p59-60


currently well short of achieving. Over the next few years if current trends continue there will be approximately 3000 cases per year of decompensated liver disease or HCC from hepatitis


2 Hepatitis C Trust (2009)An audit of Strategic Health Authority hepatitis C governance …continued overleaf


In this issue


Jim Orford and his colleagues highlight the difficulties that families of people with drug and alcohol problems can face, and outlines the 5-Step- Method to support them within a primary care setting. Page 4.


Julia Brown describes the important role primary care can play in the prevention and identification of foetal alcohol spectrum disorders. Page 6.


Jonathan Knight takes us through the role of the National Drug Treatment Monitoring System over the years, including some insight into primary care data. Page 7.


Paul Hayes, outgoing Chief Executive Officer of the National Treatment Agency, gives his account of the history of drug treatment, spanning the Thatcher years to the end of the New Labour era. His unique position gives some fascinating insights into the subject. Page 8.


Gill Burns suggests that the current enhanced service contracts are out of date, and we need to act now to protect investment in primary care drug and alcohol treatment. Page 12.


Chris Ford outlines the effect of unhealthy drug policies and argues that doctors have an important role in shaping and influencing a healthier approach to drug policy. Page 13.


Euan Lawson is Dr Fixit to a doctor working with an alcohol dependent patient who is struggling to become abstinent. Page 15.


See all the latest courses and events on page 16. We hope you enjoy this edition. Editor


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