Substance Misuse

Pre-course work for DRC

Don't feel that you have to read all of this study guide in detail. Dip into it and pick out what you need.

The practical tips page has my advice on what actually to do if a patient wants help with their addiction. This is something that the DoH guidelines are rather short on. They are my own views, and other GPs may disagree with them.

1) Print the page off and discuss it with one of the GPs in your practice. Debate with the GP:

• how it compares with what they do;
• do they disagree with my advice, and if so, why?
• what are their own tips?
• what facilities there are in your patch (e.g. drug teams, pharmacists who can manage on-site methadone consumption)?

2) Sean Foster says he's addicted to diazepam as well as heroin. He's agreed to see the drugs worker, and says he'll need 30mg diazepam daily as well as methadone. How do you respond?

3) Jean McAleer is a new patient who sees you in your Friday evening surgery. She says she's just moved from Bristol where she was getting methadone 30ml daily, prescribed by her previous GP. She say's she's been managing very well, with no on-top use. Her prescription has just run out and she needs her usual 2-week prescription now, as the chemist closes in half an hour. She says on-site consumption isn't possible as she works long hours. How do you handle this?