Intended for healthcare professionals

Practice 10-minute consultation

Problem drug use

BMJ 2006; 333 doi: (Published 21 September 2006) Cite this as: BMJ 2006;333:639
  1. Nigel Williams, general practitioner1 (
  1. 1 Sighthill Health Centre, Calder Road, Edinburgh EH11 4AU

    A 24 year old man asks you for help with his heroin problem. He has been taking the drug for about a year and is spending at least £60 (€90; $110) a day on it.

    What issues you should cover

    You should do a full assessment before deciding on any action; this is likely to take more than one consultation. An empathic and non-judgmental approach will engage him and help him to begin the process of change. You need to clarify why he has come to you now and what he wants—often, but not always, this is a prescription. All GPs should be able to gather the information they need for an appropriate referral and to provide general care.

    Current drug use—Ask about all illicit drugs he has taken in the past month (including cannabis). Record quantity and frequency of use, together with route of administration. Also note his smoking …

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