Abstract
Users of intravenous heroin represent a major challenge for general practice. A study was undertaken in a general practice in central London in 1990 to investigate the use of general practice made by intravenous heroin users who were on a methadone programme. Using information recorded in the patients' notes, 29 intravenous heroin users on a methadone programme were identified; 58 non-drug users (two controls per case) were matched for age, sex and general practitioner. A study of the number of routine consultations, missed appointments, emergency appointments and prescribed items showed that during the study period, those on a methadone programme made a larger number of routine consultations than the control subjects (median number of consultations 14 versus 0). When consultations at which only a prescription was issued were excluded this difference disappeared. Appointments were missed by 14 drug abusers (48%) but by none of the control group (P < 0.001). Emergency appointments were made by seven drug abusers (24%) compared with only two controls (3%) (P < 0.01). Even after prescriptions for methadone hydrochloride had been excluded from the analysis, patients on the methadone programme were prescribed significantly more items than patients in the control group (P < 0.001). This research has shown that intravenous heroin users on a methadone programme used general practice to a greater extent than non-drug users, according to the criteria used in the study. The implications that this may have in discouraging budget holding practices from running such schemes are discussed.
Full text
PDF



Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Balarajan R., Yuen P., Soni Raleigh V. Ethnic differences in general practitioner consultations. BMJ. 1989 Oct 14;299(6705):958–960. doi: 10.1136/bmj.299.6705.958. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bennett T., Wright R. Opioid users' attitudes towards and use of NHS clinics, general practitioners and private doctors. Br J Addict. 1986 Dec;81(6):757–763. doi: 10.1111/j.1360-0443.1986.tb00403.x. [DOI] [PubMed] [Google Scholar]
- Bucknall A. B., Robertson J. R., Foster K. Medical facilities used by heroin users. Br Med J (Clin Res Ed) 1986 Nov 8;293(6556):1215–1216. doi: 10.1136/bmj.293.6556.1215. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cohen J., Schamroth A. The challenge of illicit drug addiction for general practice. Drug Alcohol Depend. 1990 Jun;25(3):315–318. doi: 10.1016/0376-8716(90)90157-a. [DOI] [PubMed] [Google Scholar]
- Neville R. G., McKellican J. F., Foster J. Heroin users in general practice: ascertainment and features. Br Med J (Clin Res Ed) 1988 Mar 12;296(6624):755–758. doi: 10.1136/bmj.296.6624.755. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Roberts J. J., Skidmore C. A., Robertson J. R. Human immunodeficiency virus in drug misusers and increased consultation in general practice. J R Coll Gen Pract. 1989 Sep;39(326):373–374. [PMC free article] [PubMed] [Google Scholar]
- Robertson J. R. Treatment of drug misuse in the general practice setting. Br J Addict. 1989 Apr;84(4):377–380. doi: 10.1111/j.1360-0443.1989.tb00580.x. [DOI] [PubMed] [Google Scholar]
- Yuen P., Balarajan R. Unemployment and patterns of consultation with the general practitioner. BMJ. 1989 May 6;298(6682):1212–1214. doi: 10.1136/bmj.298.6682.1212. [DOI] [PMC free article] [PubMed] [Google Scholar]
