Skip to main content
PMC home page
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 1995 Oct;71(840):593–597. doi: 10.1136/pgmj.71.840.593

The development of healthcare services for drug misusers and prostitutes.

C L Morrison 1, S M Ruben 1
PMCID: PMC2398250  PMID: 8545287

Abstract

With the advent of human immunodeficiency virus (HIV) and the increase of drug misuse in the UK, the Government wishes primary care to play a greater part in treating drug problems in the hope of preventing the spread of HIV. Drug misusers do not avail themselves of traditional services and many are not registered with general practitioners. In response to this Liverpool Health Authority and Family Health Service Authority commenced a new salaried post to provide primary care services to special groups such as injecting drug misusers and prostitutes. Judgemental attitudes towards drug misusers, their high mobility and being a transient population play a part in the reasons why drug misusers find it difficult to access primary healthcare. Drug misusers have high morbidity related to their drug misuse. Many of these conditions, if treated early, can prevent the need for more intensive intervention. Although drug misusers may present with a condition requiring immediate treatment, the opportunity is used to provide other healthcare such as hepatitis B vaccinations, sexually transmitted infection screening, contraception and HIV/hepatitis B testing. The sero prevalence of anti-HBc in injecting drug misusers is 45.5%. Due to their high morbidity and associated costs, the requirements of these groups may conflict with the objectives of budget-holding practices. If general practitioners are unable to respond to their problems, then health care providers and purchasers will have to consider similar schemes in areas which have a higher prevalence of drug misuse in order to provide appropriate healthcare for these vulnerable groups.

Full text

PDF
594

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. 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]
  2. Datt N., Feinmann C. The practical business of treatment--13. Providing health care for drug users? Br J Addict. 1990 Dec;85(12):1571–1575. doi: 10.1111/j.1360-0443.1990.tb01644.x. [DOI] [PubMed] [Google Scholar]
  3. Gerada C., Orgel M., Strang J. Health clinics for problem drug misusers. Health Trends. 1992;24(2):68–69. [PubMed] [Google Scholar]
  4. Green S. T., Goldberg D. J., Carr S. V., Taylor A., Frischer M., Gruer L. The value of acute medical services sited adjacent to areas of high drug-injecting activity. Addiction. 1994 Jun;89(6):763–764. doi: 10.1111/j.1360-0443.1994.tb00968.x. [DOI] [PubMed] [Google Scholar]
  5. Greenwood J. Creating a new drug service in Edinburgh. BMJ. 1990 Mar 3;300(6724):587–589. doi: 10.1136/bmj.300.6724.587. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hart G. J., Sonnex C., Petherick A., Johnson A. M., Feinmann C., Adler M. W. Risk behaviours for HIV infection among injecting drug users attending a drug dependency clinic. BMJ. 1989 Apr 22;298(6680):1081–1083. doi: 10.1136/bmj.298.6680.1081. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hind C. R. Pulmonary complications of intravenous drug misuse. 2. Infective and HIV related complications. Thorax. 1990 Dec;45(12):957–961. doi: 10.1136/thx.45.12.957. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Hindler C., Nazareth I., King M., Cohen J., Farmer R., Gerada C. Drug users' views on general practitioners. BMJ. 1995 Feb 4;310(6975):302–302. doi: 10.1136/bmj.310.6975.302. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Leaver E. J., Elford J., Morris J. K., Cohen J. Use of general practice by intravenous heroin users on a methadone programme. Br J Gen Pract. 1992 Nov;42(364):465–468. [PMC free article] [PubMed] [Google Scholar]
  10. McKeganey N. P., Boddy F. A. General practitioners and opiate-abusing patients. J R Coll Gen Pract. 1988 Feb;38(307):73–75. [PMC free article] [PubMed] [Google Scholar]
  11. Morrison C. L., Ruben S. M., Beeching N. J. Female sexual health problems in a drug dependency unit. Int J STD AIDS. 1995 May-Jun;6(3):201–203. doi: 10.1177/095646249500600311. [DOI] [PubMed] [Google Scholar]
  12. Morrison C. L., Ruben S. M., Wakefield D. Female street prostitution in Liverpool. AIDS. 1994 Aug;8(8):1194–1195. [PubMed] [Google Scholar]
  13. 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]
  14. Parker J., Gay M. Problem drug users known to Bristol general practitioners. J R Coll Gen Pract. 1987 Jun;37(299):260–263. [PMC free article] [PubMed] [Google Scholar]
  15. Richards T. Drug addicts and the GP. Br Med J (Clin Res Ed) 1988 Apr 16;296(6629):1082–1082. doi: 10.1136/bmj.296.6629.1082. [DOI] [PMC free article] [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. Robertson J. R. Drug abuse and HIV infection: general practice treatment and research agendas. Br J Gen Pract. 1992 Nov;42(364):451–452. [PMC free article] [PubMed] [Google Scholar]
  18. Robertson J. R. Drug users in contact with general practice. Br Med J (Clin Res Ed) 1985 Jan 5;290(6461):34–35. doi: 10.1136/bmj.290.6461.34. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Ronald P. J., Witcomb J. C., Robertson J. R., Roberts J. J., Shishodia P. C., Whittaker A. Problems of drug abuse, HIV and AIDS: the burden of care in one general practice. Br J Gen Pract. 1992 Jun;42(359):232–235. [PMC free article] [PubMed] [Google Scholar]
  20. Ruben S. M., Morrison C. L. Temazepam misuse in a group of injecting drug users. Br J Addict. 1992 Oct;87(10):1387–1392. doi: 10.1111/j.1360-0443.1992.tb01918.x. [DOI] [PubMed] [Google Scholar]
  21. Selwyn P. A., Feingold A. R., Hartel D., Schoenbaum E. E., Alderman M. H., Klein R. S., Friedland G. H. Increased risk of bacterial pneumonia in HIV-infected intravenous drug users without AIDS. AIDS. 1988 Aug;2(4):267–272. doi: 10.1097/00002030-198808000-00005. [DOI] [PubMed] [Google Scholar]
  22. Stone M. H., Stone D. H., MacGreggor H. A. Intravenous drug misusers presenting to the accident and emergency department of a large teaching hospital. A failure of clinical management? Scott Med J. 1989 Apr;34(2):428–430. doi: 10.1177/003693308903400205. [DOI] [PubMed] [Google Scholar]
  23. Van Trigt L., Kreuger H., Westerman R. F., Hull F. M. Morbidity at an Amsterdam inner city clinic in relation to drug use. Fam Pract. 1989 Dec;6(4):299–302. doi: 10.1093/fampra/6.4.299. [DOI] [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES