What role for general practitioners in the care of opiate Users?

Abstract

This article reviews the evidence on relationships between general practitioners and opiate users, and considers the feasibility of introducing and expanding treatment services for opiate dependence in general practice. Policy for drugs services has been influenced by increases in the prevalence of opiate use and by the spread of HIV among injecting drug users, and general practice is increasingly regarded as an appropriate setting for treatment of dependence. A small number of opiate prescribing programmes in general practice have produced encouraging results on which wider initiatives could build, but the general lack of confidence and expertise among GPs, along with safety and cost factors, appear to militate against dramatic increases in the scale of GPs' involvement with opiate dependence. In the longer term, improvements could be made in the level of training for GPs in the treatment of drug dependence. In the shorter term, any new arrangements for the treatment of opiate users in general practice would benefit by maximising the support available from established drug services, especially where GPs' are less experienced.

Key Words:

• General practice
• Opiate users
• HIV
• Drug treatment services