Use of general practice by intravenous heroin users on a methadone programme.
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.
Leaver
E J
EJ
Department of Public Health and Primary Care, Royal Free Hospital School of Medicine, London.
Elford
J
J
Morris
J K
JK
Cohen
J
J
D000328:Adult; D005194:Family Practice; D005260:Female; D003932:Heroin; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D010342:Patient Acceptance of Health Care; D015819:Substance Abuse, Intravenous / Q000188:drug therapy*; D016526:Workload
D003932:Heroin; D008691:Methadone