Pubdate: Sun, 10 Mar 2002
Source: Sunday Herald, The (UK)
Copyright: 2002 Sunday Herald
Contact:  http://www.sundayherald.com/
Details: http://www.mapinc.org/media/873
Author: Dr Colin Guthrie
Referenced: http://www.mapinc.org/drugnews/v02/n374/a10.html

READERS'VIEWS

I WAS glad to see that your drugs report was not distorted by the blinkered 
views of the usual drugs experts who are now so desperately trying to 
encourage more GPs to get involved in methadone treatments. These services 
remain in short supply despite inducements of more education, more staff 
and even the extra payments that each consultation now generates under 
localised methadone payment schemes.

In a recent UK survey the majority of General Practitioners stated that 
they did not feel that the treatment of such addiction should be part of a 
GP's responsibility. Ian McCartney is right when he states that addicts are 
chaotic and always looking to steal for their next fix. Unfortunately, the 
vast majority of treated methadone addicts continue to behave in exactly 
the same way. When a practice shows an interest in trying to provide 
addiction services then they are beseiged by desperate and chaotic 
sufferers. If that practice is vulnerable by virtue of its staffing levels 
or by its design, then anarchy soon takes over with thievery and violence.

When I tried to help these patients my practice and my life descended into 
the equivalent of a medical Hades. My Hoover and camcorder were stolen, 
they smoked in the toilets and threatened both staff and patients. It's 
fine if your premises have a security guard with video surveillance and 
patients who don't mind consulting in what isn't far removed from that of a 
prison environment. Most practices aren't like that and I believe that most 
patients and health workers don't want their surgeries to be penal 
institutions.

Don't get me wrong: these patients deserve good quality care. But GP 
premises are rarely suitable places to provide appropriate care for people 
in such constant chaos. It is not good for the other patients, it is not 
good for the practice staff and doctors involved and it is not good for the 
addicts.

Dr Colin Guthrie, Glasgow
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MAP posted-by: Terry Liittschwager