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The British Journal of General Practice logoLink to The British Journal of General Practice
. 1992 Jun;42(359):232–235.

Problems of drug abuse, HIV and AIDS: the burden of care in one general practice.

P J Ronald, J C Witcomb, J R Robertson, J J Roberts, P C Shishodia, A Whittaker
PMCID: PMC1372058  PMID: 1419244

Abstract

Responsibility for many of the problems of intravenous drug abuse and human immunodeficiency virus (HIV) infection lies with community care agencies, such as general practitioners, community psychiatric and district nurses and drug agencies. It is in general practice that this burden is most clearly observed, given that general practitioners are in charge of the day-to-day care of patients. In an attempt to quantify this workload in an inner city practice with 11,200 patients, data were gathered from several sources relating to drug use and HIV infection. The study identified 432 patients who had consulted with problems of drug abuse and/or HIV infection over the period 1981-90. Among this group of patients 161 (37%) were HIV antibody positive. Among 191 drug abusers who were still registered with the practice in 1990 dihydrocodeine was the most commonly prescribed substitute treatment (130 patients) and only nine patients were prescribed methadone. Forty seven per cent of drug users continued to inject drugs occasionally. However, analysis of urine samples revealed that there was a shift away from injecting mainly heroin to multiple drug use, including benzodiazepines, usually originating from prescribed sources. Drug abusers who were HIV positive consulted their general practitioner significantly more often over one year than those who were not (mean 24.9 versus 15.8 consultations, P < 0.01). However, there was no significant difference between these two groups in terms of days spent in hospital. A total of 61 patients were referred to a community psychiatric nurse over an eight month period.(ABSTRACT TRUNCATED AT 250 WORDS)

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Selected References

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  1. Anderson P., Mayon-White R. General practitioners and management of infection with HIV. Br Med J (Clin Res Ed) 1988 Feb 20;296(6621):535–537. doi: 10.1136/bmj.296.6621.535. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Angarano G., Pastore G., Monno L., Santantonio T., Luchena N., Schiraldi O. Rapid spread of HTLV-III infection among drug addicts in Italy. Lancet. 1985 Dec 7;2(8467):1302–1302. doi: 10.1016/s0140-6736(85)91581-8. [DOI] [PubMed] [Google Scholar]
  3. Burgess P. M., Gill A. J., Pead J., Holman C. P. Methadone: old problems for new programmes. Drug Alcohol Rev. 1990;9(1):61–66. doi: 10.1080/09595239000185081. [DOI] [PubMed] [Google Scholar]
  4. Bury G. AIDS: can we cope? Ir Med J. 1989 Dec;82(4):168–169. [PubMed] [Google Scholar]
  5. Chu S. Y., Buehler J. W., Berkelman R. L. Impact of the human immunodeficiency virus epidemic on mortality in women of reproductive age, United States. JAMA. 1990 Jul 11;264(2):225–229. [PubMed] [Google Scholar]
  6. France A. J., Skidmore C. A., Robertson J. R., Brettle R. P., Roberts J. J., Burns S. M., Foster C. A., Inglis J. M., Galloway W. B., Davidson S. J. Heterosexual spread of human immunodeficiency virus in Edinburgh. Br Med J (Clin Res Ed) 1988 Feb 20;296(6621):526–529. doi: 10.1136/bmj.296.6621.526. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Gallagher M., Foy C., Rhodes T., Philips P., Setters J., Moore M., Naji S., Donaldson C., Bond J. HIV infection and AIDS in England and Wales: general practitioners' workload and contact with patients. Br J Gen Pract. 1990 Apr;40(333):154–157. [PMC free article] [PubMed] [Google Scholar]
  8. Greco D., Declich S., Pezzotti P., Bellomi G., Visco G. Hospital use by HIV patients in Italy: a retrospective longitudinal study. National Study Group on HIV-Related Hospital Use. J Acquir Immune Defic Syndr. 1991;4(5):471–479. [PubMed] [Google Scholar]
  9. Johnson A. M., Petherick A., Davidson S. J., Brettle R., Hooker M., Howard L., McLean K. A., Osborne L. E., Robertson R., Sonnex C. Transmission of HIV to heterosexual partners of infected men and women. AIDS. 1989 Jun;3(6):367–372. doi: 10.1097/00002030-198906000-00005. [DOI] [PubMed] [Google Scholar]
  10. Marmor M., Krasinski K., Sanchez M., Cohen H., Dubin N., Weiss L., Manning A., Bebenroth D., Saphier N., Harrison C. Sex, drugs, and HIV infection in a New York City hospital outpatient population. J Acquir Immune Defic Syndr. 1990;3(4):307–318. [PubMed] [Google Scholar]
  11. Milne R. I., Keen S. M. Are general practitioners ready to prevent the spread of HIV? Br Med J (Clin Res Ed) 1988 Feb 20;296(6621):533–535. doi: 10.1136/bmj.296.6621.533. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Naji S. A., Russell I. T., Foy C. J., Gallagher M., Rhodes T. J., Moore M. P. HIV infection and Scottish general practice: knowledge and attitudes. J R Coll Gen Pract. 1989 Jul;39(324):284–288. [PMC free article] [PubMed] [Google Scholar]
  13. Newman R. G. Methadone treatment. Defining and evaluating success. N Engl J Med. 1987 Aug 13;317(7):447–450. doi: 10.1056/NEJM198708133170710. [DOI] [PubMed] [Google Scholar]
  14. Peters B. S., Beck E. J., Coleman D. G., Wadsworth M. J., McGuinness O., Harris J. R., Pinching A. J. Changing disease patterns in patients with AIDS in a referral centre in the United Kingdom: the changing face of AIDS. BMJ. 1991 Jan 26;302(6770):203–207. doi: 10.1136/bmj.302.6770.203. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Robert C. F., Déglon J. J., Wintsch J., Martin J. L., Perrin L., Bourquin M., Gabriel V., Hirschel B. Behavioural changes in intravenous drug users in Geneva: rise and fall of HIV infection, 1980-1989. AIDS. 1990 Jul;4(7):657–660. [PubMed] [Google Scholar]
  16. Robertson J. R., Bucknall A. B., Welsby P. D., Roberts J. J., Inglis J. M., Peutherer J. F., Brettle R. P. Epidemic of AIDS related virus (HTLV-III/LAV) infection among intravenous drug abusers. Br Med J (Clin Res Ed) 1986 Feb 22;292(6519):527–529. doi: 10.1136/bmj.292.6519.527. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Ronald P. J., Robertson J. R., Roberts J. J. Risk-taking behaviour on the decline in intravenous drug users. Br J Addict. 1992 Jan;87(1):115–116. doi: 10.1111/j.1360-0443.1992.tb01907.x. [DOI] [PubMed] [Google Scholar]
  18. Shapiro J. A. General practitioners' attitudes towards AIDS and their perceived information needs. BMJ. 1989 Jun 10;298(6687):1563–1566. doi: 10.1136/bmj.298.6687.1563. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Skidmore C. A., Robertson J. R., Robertson A. A., Elton R. A. After the epidemic: follow up study of HIV seroprevalence and changing patterns of drug use. BMJ. 1990 Jan 27;300(6719):219–223. doi: 10.1136/bmj.300.6719.219. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Smits A., Mansfield S., Singh S. Facilitating care of patients with HIV infection by hospital and primary care teams. BMJ. 1990 Jan 27;300(6719):241–243. doi: 10.1136/bmj.300.6719.241. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Swadi H., Wells B., Power R. Misuse of dihydrocodeine tartrate (DF 118) among opiate addicts. BMJ. 1990 May 19;300(6735):1313–1313. doi: 10.1136/bmj.300.6735.1313. [DOI] [PMC free article] [PubMed] [Google Scholar]

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