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Drug misuse and dependence. How did we get here? Recently finished VTS- leeds/bradford Interested in the field, work in a practice with similarly minded.

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Presentation on theme: "Drug misuse and dependence. How did we get here? Recently finished VTS- leeds/bradford Interested in the field, work in a practice with similarly minded."— Presentation transcript:

1 Drug misuse and dependence

2 How did we get here? Recently finished VTS- leeds/bradford Interested in the field, work in a practice with similarly minded doctors. RCGP part 1 and 2 courses.

3 Afternoon outline What do you want to know Try to answer some of this and give outline of treatment in drug uses in UK Coffee break Some cases to discuss Expect to be in interrupted

4 Aims Increase understanding, awareness and confidence in managing drug misusers Have framework to help deal with drug users in surgery Knowledge of where to get help.

5

6 What do you want to know?

7 Some figures in treatment 2001/2 38% of 15yr olds used a drug in last year One study of 160 homeless 16-25yr olds 89% in last year (95% ever) 65% of all arrestees positive for some form of drugs 1.2% mortality per year in heroin users

8 Classification of drugs Class A – cocaine, heroin, methadone, morphine, PCP, ecstacy, LSD. Any injected class B drug Class B – amphetamine, dihydrocodeine, Ritalin, barbiturates Class C – cannabis, benzodiazepines

9 Another language Gear, brown, smack Rocks, white, crack Uppers, downers Blues and yellows Skunk?

10 The Drug Addict What do you think are the characteristics of a stereotypical drug addict? Are all drug addicts the same?

11 Reasons for starting Peer group pressure Enjoyment Self manage mental health illness Self manage chronic pain Iatrogenic

12 Risk factors Prior delinquent behaviour Social class Peer group influences Risk taking behaviour Parental Poor quality of relationships Inconsistent parenting Lack of participation in conventional activities eg employment and education

13 How do you feel??

14 Primary care role Assessment Management Education Signposting

15 Aims of treatment Accessibility and health improvement Harm minimisation Reducing associated deaths Reducing associated criminal activity Appropriate treatment and referral Improve social, personal and family fctn.

16 Assessment History – Why now? primary drug, present problems, drug history, physical symptoms, worries and concerns. Children and other family members Examination – injecting sites, evidence of DVT, general health inc dental. BMI Discuss options ahead

17 Presentation of substance misuse in general practice

18 Local services Current treatment agencies in Bradford SMS (Fountains Hall), Ripple, NBPCT DS, Bridge Project, Henry Street, CDAT GP surgeries inc Kensington St, Farrar MC, Ling House Could change with new pct?

19 Management options Needle exchange Methadone Subutex (dihydrocodeine) Detox Daycare Rehabilitation

20 Sources of further information RCGP website Drugscope Loads of possibilities- a lot of independent sites eg urban75


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