Pubdate: Fri, 8 May 1998
Source: Scotsman (UK) 
Author: Farnk Urquhart


Doctors tell of struggle to cope as Aberdeen suffers big rise in numbers
using hard drugs 

Doctors in Aberdeen are struggling to cope with a huge surge in demand for
help from drug addicts, some as young as 14.

One inner-city practice has had a 100-fold increase in the number of people
requiring treatment in just five years. Addicts outside the GP network are
having to wait up to ten months to be seen by the city's only dedicated drug
abuse service.

The burden facing the health services in Aberdeen was revealed yesterday at
a seminar for family doctors and pharmacists aimed at streamlining the
addiction service and forging it closer links among professionals trying to
cope with the heroin epidemic in the city.

Dr Stuart Scott, the chairman of a working group set up by the Aberdeen City
Drugs Action Team, said that the surge in addiction was already affecting
other NHS patients in his care.

Some patients are being turned away or have to wait days for an appointment
because of the flow of addicts seeking treatment.

Nineteen of the 27 GP practices in the Aberdeen area are treating victims of
drug abuse. The total number of intravenous drug mis-users in the city is
estimated to be between 2,000 and 4,000. And there are at least 850
registered heroin addicts.

Dr Scott, a partner in the Holburn Medical Group near the city centre, said:
"We have gone from seeing one or two people with a drug misuse problem each
month to seeing probably in the region of 25 a week.

"If you are seeing 25 drug misusers a week that is 25 other patients that
you can't see. It is becoming a large part of the workload which, of course,
knocks on to the availability of appointmants for people who don't have a
drug mis-use problem. It is becoming so widespread it really is becoming
difficult to find time to cope with it."

Asked how his ordinary patients felt about the situation, Dr Scott replied:
"To be honest, I don't think most of them would be aware that we had these
specialist clinics. Drug misusers are not easily identifiable. People can
sit in the waiting room with them and not have a clue what their problem is."

The explosion in heroin abuse has its roots in drug dealers offering heroin
as a substitute depressant when supplies of temazepam became scarce for
those on the rave scene trying to counter the effects of ecstasy.

Hundreds began smoking the opiate but quickly became addicted - as the
dealers intended.

Dr Scott said: "Most of the drug misusers we are dealing with are people who
have been with the practice all their lives. And that is the really scary
thing about it.

"These are not people who have moved into the area with a drug misuse
problem. It is people who have been brought up in Aberdeen and who have
developed the problem.

"The youngest patient I have with a heroin addiction problem at the moment
is 14 and the oldest is 44.

"We have also had a much increased incidence of crack cocaine use within the
past three months. I have seen two patients within the past week with major
crack cocaine problems, spending upwards of 1,200 per week on the drug."

Dr Scott stressed: "We don't have the biggest caseload by any means. There
are practices in the Northfield and Mastrick areas of the city who have 60
or 70 patients on a weekly basis."

He conceded that doctors were simply "fire fighting" a growing problem. But
the aim of the new strategy was to make the existing service, still starved
of the funds it needs, more effective.

The goal is to try to improve access tot he services for as many people as
possible. Joint patient records will be kept and jointly-agreed protocols
and guidelines will be worked to.

Dr Scott said: "Everyone at the coal-face of drug misuse, if you like, will
be trained to carry out this initial screening assessment so that hopefully
it is easier for the drug misuser to be directed to where they can access
the most appropriate help."

Dr Andrew Robinson, the consultant who heads the area's substance misuse
service, said the demands for help from addicts who could not be treated by
their own GPs was just as overwhelming.

The hospital-based centre, which also offers rehabilitation services to
addicts, is dealing with 400 drug misusers, the majority of them heroin
addicts, with a further 200 on the waiting list.

Dr Robinson said: "Having got the waiting list down to managing to see
people within three months of referral there are people waiting from July or
August of last year who have not been seen yet."

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Checked-by: Melodi Cornett