Letters

General practitioners' attitudes towards treatment of opiate misusers

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7108.601 (Published 06 September 1997) Cite this as: BMJ 1997;315:601

Study in Lothian confirms findings

  1. Edwin van Teijlingen, Lecturera,
  2. Mike Porter, Senior lecturerb
  1. a Department of Public Health, Medical School, University of Aberdeen, Aberdeen AB25 2ZD
  2. b Department of General Practice, University of Edinburgh, Edinburgh EH8 9DX
  3. c Spittal Street Centre, Edinburgh EH3 9DU
  4. d Centre for HIV/AIDS and Drugs Studies, City Hospital, Edinburgh EH10 5SB
  5. e West Dorset Community Alcohol and Drugs Advisory Service, Dorchester, Dorset DT1 1UP
  6. f Postgraduate Centre, Dorset County Hospital, Dorchester, Dorset DT1 1TS
  7. g Department of General Practice, University of Birmingham, Birmingham B15 2TT
  8. h West Suffolk Drug Advisory Service, Blomfield House Health Centre, Bury St Edmunds, Suffolk IP33 1 HE

    See editorial by Farrell and pp 581, 613

    Editor—Ann Davies and Peter Huxley comment that little research is being done on general practitioners' attitudes and practice in the treatment of opiate misusers even though general practitioners are now seeing more drug misusers.1 According to the authors the last substantial report was by Glanz in 1985.2 We would like to draw attention to similar studies conducted in Lothian in 1988 and 1993.3 The 1993 study was a postal survey of the experience of, attitudes toward, and confidence in dealing with drug misusers among general practitioners in Lothian. Questionnaires were sent to all 517 general practitioners (response rate 75%). The study also compared changes in general practitioners' involvement with and confidence in dealing with drug misusers from 1988 to 1993; there was a significant increase in both areas. Davies and Huxley found that 80% of the general practitioners in Greater Manchester prescribed substitute drugs for opiate misusers; we found that 73% of the general practitioners in Lothian prescribed substitute drugs, while only 12% stated that they would not do so. Moreover, 67% of the general practitioners in Lothian had given advice on safer drug use and only 2% stated that they would not give such advice.

    General practitioners in Lothian, like their colleagues in Greater Manchester, expressed the need for more training in dealing with drug misusers. For example, in Lothian they showed a lack of confidence in the management of drug related aggression and violence in the practice, a problem shared with general practitioners in other areas.4 Training can help build confidence. A positive similarity between the two studies is that general practitioners in both Greater Manchester and Lothian generally have an understanding approach toward drug misuse.

    References

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    Local guidelines and support increase confidence

    1. Judy Bury, Primary care facilitator, HIV/AIDS and drugsc,
    2. Jim Sherval, Researcherd
    1. a Department of Public Health, Medical School, University of Aberdeen, Aberdeen AB25 2ZD
    2. b Department of General Practice, University of Edinburgh, Edinburgh EH8 9DX
    3. c Spittal Street Centre, Edinburgh EH3 9DU
    4. d Centre for HIV/AIDS and Drugs Studies, City Hospital, Edinburgh EH10 5SB
    5. e West Dorset Community Alcohol and Drugs Advisory Service, Dorchester, Dorset DT1 1UP
    6. f Postgraduate Centre, Dorset County Hospital, Dorchester, Dorset DT1 1TS
    7. g Department of General Practice, University of Birmingham, Birmingham B15 2TT
    8. h West Suffolk Drug Advisory Service, Blomfield House Health Centre, Bury St Edmunds, Suffolk IP33 1 HE

      Editor—We were encouraged to read about the generally positive attitudes …

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