Glasgow model should be replicated in other general practices

Editor—The novel Glasgow model of methadone maintenance described by Laurence Gruer and colleagues has allowed large numbers of drug misusers to be treated economically in the community by general practitioners.1 This example of shared care should be replicated elsewhere as it offers several advantages over traditional clinics, which have proved unpopular in some quarters. Problems of misuse are now so widespread that general practitioners are the professionals best placed to deliver such services when patients are stable.

Opiate dependency is a chronic relapsing behaviour which needs a lot of intervention at certain times and little or no intervention at others. Unlike in hypertension or diabetes, we still do not have clear guidance as to when to refer patients back for specialist treatment. Patients who continue to use illicit drugs should probably be seen regularly and it may be that all patients taking methadone would benefit from an annual review by a specialist. …