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 - --- MAP posted-by: Terry Liittschwager