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Managing Drug Misuse: Understanding, Treatment & Referral in Primary Care

Enhance knowledge on drug misuse management, treatment framework, social implications, and referral processes. Gain awareness of drug use figures, classification, reasons for misuse, and primary care responsibilities in managing substance abuse. Explore local services and management options for patients with substance misuse disorders. Comprehensive session outline for healthcare practitioners.

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Managing Drug Misuse: Understanding, Treatment & Referral in Primary Care

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Presentation Transcript

  1. Drug misuse and dependence

  2. How did we get here? • Recently finished VTS- leeds/bradford • Interested in the field, work in a practice with similarly minded doctors. • RCGP part 1 and 2 courses.

  3. Afternoon outline • What do you want to know • Try to answer some of this and give outline of treatment in drug uses in UK • Coffee break • Some cases to discuss • Expect to be in interrupted

  4. Aims • Increase understanding, awareness and confidence in managing drug misusers • Have framework to help deal with drug users in surgery • Knowledge of where to get help.

  5. What do you want to know?

  6. Some figures • 141000 in treatment 2001/2 • 38% of 15yr olds used a drug in last year • One study of 160 homeless 16-25yr olds 89% in last year (95% ever) • 65% of all arrestees positive for some form of drugs • 1.2% mortality per year in heroin users

  7. Classification of drugs • Class A – cocaine, heroin, methadone, morphine, PCP, ecstacy, LSD. Any injected class B drug • Class B – amphetamine, dihydrocodeine, Ritalin, barbiturates • Class C – cannabis, benzodiazepines

  8. Another language • Gear, brown, smack • Rocks, white, crack • Uppers, downers • Blues and yellows • Skunk?

  9. The Drug Addict • What do you think are the characteristics of a stereotypical drug addict? • Are all drug addicts the same?

  10. Reasons for starting • Peer group pressure • Enjoyment • Self manage mental health illness • Self manage chronic pain • Iatrogenic

  11. Risk factors • Prior delinquent behaviour • Social class • Peer group influences • Risk taking behaviour • Parental • Poor quality of relationships • Inconsistent parenting • Lack of participation in conventional activities eg employment and education

  12. How do you feel??

  13. Primary care role • Assessment • Management • Education • Signposting

  14. Aims of treatment • Accessibility and health improvement • Harm minimisation • Reducing associated deaths • Reducing associated criminal activity • Appropriate treatment and referral • Improve social, personal and family fctn.

  15. Assessment • History – Why now? primary drug, present problems, drug history, physical symptoms, worries and concerns. Children and other family members • Examination – injecting sites, evidence of DVT, general health inc dental. BMI • Discuss options ahead

  16. Presentation of substance misuse in general practice

  17. Local services • Current treatment agencies in Bradford • SMS (Fountains Hall), Ripple, NBPCT DS, Bridge Project, Henry Street, CDAT • GP surgeries inc Kensington St, Farrar MC, Ling House • Could change with new pct?

  18. Management options • Needle exchange • Methadone • Subutex • (dihydrocodeine) • Detox • Daycare • Rehabilitation

  19. Sources of further information • RCGP website • www.smmgp.org.uk • www.scan.uk.net • Drugscope • Loads of possibilities- a lot of independent sites eg urban75

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