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Services for opiate misuse: can primary care meet government expectations?

University of Birmingham, Queen Elizabeth Psychiatric Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2QZ

Prakash C. Naik, Consultant Psychiatrist and Honorary Senior Lecturer

University of Birmingham

Declaration of interest

None.

AIMS AND METHOD

In order to assess the current provision for patients who misuse opiates in primary care, the discrepancy between this, and government expectations and the resources required to bridge this gap, a purpose-designed questionnaire based on the Department of Health guidelines was distributed to all general practitioners (GPs) in Solihull and Warwickshire (n=379). Data were analysed with the Chi-squared, Fisher’s exact, Mann-Whitney U and Kruskal-Wallis tests, using the computer software SPSS version 10.

RESULTS

Replies were received from 205 GPs, representing 77.2% of the practices. Only 12 GPs (6%) provided all four key services studied and 71 (34%) provided none of these services. One hundred and six GPs (51.7%) had read the guidelines. Of these, 51 (49%) were not willing to change their practice. Forty-one (39.4%) were prepared to change their practice, but only with additional resources. The main resources identified as necessary were shared care and training.

CLINICAL IMPLICATIONS

There is a huge gap between current provision and government expectations, which may be unrealistic. If this gap is to be bridged, then resources should be targeted to shared care and training for GPs.