Supporting GPs to manage drug users in general practice: an evaluation of the substance misuse management project

Abstract

Since 1982 in Britain, specialist reports and Government policy documents have encouraged the involvement of general practitioners (GPs) in the treatment of drug users. To date, and in spite of these policy initiatives, their involvement has been patchy and slow. This paper evaluates the work of the Brent and Harrow Health Authority, Substance Misuse Management Project (SMP), which was established in 1995 to facilitate GP treatment of problem drug users. The evaluation was designed as a cross sectional survey and gathered information from all GPs with whom the SMP were working, and who were treating opiate dependent drug users, and from the patients in receipt of that treatment. Three data collection instruments were employed for this purpose including a semi-structured interview schedule administered to the GPs; a structured survey form completed by the GPs for each patient they were currently treating for opiate dependency; and a patient satisfaction questionnaire. The findings support the conclusion that the SMP has been influential in facilitating the involvement of GPs in the care of drug users, and in maintaining their involvement. It is also apparent from the data that treatment is implemented in a considered and systematic way, which is congruent with patient need, and from which patients express high levels of satisfaction. Given the history of difficulties associated with the involvement of GPs in the treatment of problem drug users, the results from this study suggest that the SMP has found a workable solution. Their approach has been effective in Brent and Harrow and may have utility for other health authorities who wish to facilitate greater GP involvement in the care of problem drug users.