Managing opiate misusers in primary care: a local study of support and training issues

Abstract

Government policy encourages primary care involvement with opiate misusers. The Consultancy Liaison Addiction Service (CLAS) was set up to help support increased primary care involvement. From 18 study practices, 133 of the 156 staff (85.3%) completed the interviews or self-completion questionnaires. Many general practitioners had a considerable involvement and seemed to have met their basic role requirements, although there appeared to be room for improvement in some areas of management. Other general practitioners had less involvement and could potentially benefit from input from CLAS. However, they expressed strong feelings against this sort of work, which could make such input difficult. Practice nurses had less involvement than general practitioners and expressed an interest in being trained. In their position of initial screening, practice nurses might be in a good position to offer preventative health measures to opiate misusers. Practice managers and receptionists described difficulties they had had with opiate misusers and might benefit from additional training and support. Some practices were treating many opiate misusers. National policy to rely more on primary care runs the risk of overstretching a small number of highly active practices, rather than spreading the load across a broad base of practices.