title: Opiate addiction and overdose: experiences, attitudes, and appetite for community naloxone provision.
abstract: BACKGROUND
  More than 200 opiate overdose deaths occur annually in Ireland. Overdose prevention and management, including naloxone prescription, should be a priority for healthcare services. Naloxone is an effective overdose treatment and is now being considered for wider lay use.
  
  
  OBJECTIVE
  To establish GPs' views and experiences of opiate addiction, overdose care, and naloxone provision.
  
  
  METHODS
  An anonymous postal survey to GPs affiliated with the Department of Academic General Practice, University College Dublin, Ireland.
  
  
  METHODS
  A total of 714 GPs were invited to complete an anonymous postal survey. Results were compared with a parallel GP trainee survey.
  
  
  RESULTS
  A total of 448/714 (62.7%) GPs responded. Approximately one-third of GPs were based in urban, rural, and mixed areas. Over 75% of GPs who responded had patients who used illicit opiates, and 25% prescribed methadone. Two-thirds of GPs were in favour of increased naloxone availability in the community; almost one-third would take part in such a scheme. A higher proportion of GP trainees had used naloxone to treat opiate overdose than qualified GPs. In addition, a higher proportion of GP trainees were willing to be involved in naloxone distribution than qualified GPs. Intranasal naloxone was much preferred to single (P<0.001) or multiple dose (P<0.001) intramuscular naloxone. Few GPs objected to wider naloxone availability, with 66.1% (n= 292) being in favour.
  
  
  CONCLUSIONS
  GPs report extensive contact with people who have opiate use disorders but provide limited opiate agonist treatment. They support wider availability of naloxone and would participate in its expansion. Development and evaluation of an implementation strategy to support GP-based distribution is urgently needed.
authors.affiliation: Centre for Emergency Medical Science, School of Medicine, Health Sciences Centre, University College Dublin, Dublin, Ireland.
authors.forename: Tomás
authors.initials: T
authors.lastname: Barry
authors.affiliation: Centre for Emergency Medical Science, School of Medicine, Health Sciences Centre, University College Dublin, Dublin, Ireland; British Columbia Centre for Excellence in HIV/AIDS, Department of Medicine, St Paul's Hospital, Vancouver BC, Canada.
authors.forename: Jan
authors.initials: J
authors.lastname: Klimas
authors.affiliation: Centre for Emergency Medical Science, School of Medicine, Health Sciences Centre, University College Dublin, Dublin, Ireland.
authors.forename: Helen
authors.initials: H
authors.lastname: Tobin
authors.affiliation: Centre for Emergency Medical Science, School of Medicine, Health Sciences Centre, University College Dublin, Dublin, Ireland.
authors.forename: Mairead
authors.initials: M
authors.lastname: Egan
authors.affiliation: Centre for Emergency Medical Science, School of Medicine, Health Sciences Centre, University College Dublin, Dublin, Ireland.
authors.forename: Gerard
authors.initials: G
authors.lastname: Bury
mesh_terms: D062787:Drug Overdose / Q000517:prevention & control*; D004503:Education, Medical, Graduate; D058006:General Practice; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007494:Ireland; D009270:Naloxone / Q000600:supply & distribution / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000600:supply & distribution / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000534:rehabilitation*; D010818:Practice Patterns, Physicians' / Q000458:organization & administration / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation
chemical_list: D009292:Narcotic Antagonists; D009270:Naloxone
keywords: family practice; medical education; methadone; overdose education and naloxone distribution; substance-related disorders