Drug misusers: whose business is it?

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7108.559 (Published 06 September 1997) Cite this as: BMJ 1997;315:559

Shared care can work well, but drug misusers still need specialist services

  1. Michael Farrel, Senior lecturer and consultant (m.farrell@iop.bpmf.ac.uk)a,
  2. Claire Gerada, General practitionerb
  1. aNational Addiction Centre, Maudsley Hospital and Institute of Psychiatry, London SE5 8AF
  2. b

    All indicators of illicit drug dependence have continued to climb over the past two decades, showing no sign of reversal. The one success has been the containment of HIV: through the provision of community services and the promotion of needle exchanges Britain has maintained one of the lowest HIV seroprevalence rates among injecting drug users globally.1 The increasing tide of drug misuse has, however, continued to place additional burdens on public services, from the criminal justice system to health and social services.2 How medical services should respond to drug dependence and its associated harms, and in particular which doctors should be responsible, is currently the subject of debate.

    In his personal view in this issue Scott argues that psychiatrists have neither the skills or the attitudes appropriate to looking after drug misusers and that general practitioners are far better at it (p 613).3 Primary care services are often the first port of call for users …

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