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Published in: BMC Primary Care 1/2005

Open Access 01-12-2005 | Research article

Difficulties associated with outpatient management of drug abusers by general practitioners. A cross-sectional survey of general practitioners with and without methadone patients in Switzerland

Authors: Anne Pelet, Jacques Besson, Alain Pécoud, Bernard Favrat

Published in: BMC Primary Care | Issue 1/2005

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Abstract

Background

In Switzerland, general practitioners (GPs) manage most of the patients receiving methadone maintenance treatment (MMT).

Methods

Using a cross-sectional postal survey of GPs who treat MMT patients and GPs who do not, we studied the difficulties encountered in the out-patient management of drug-addicted patients. We sent a questionnaire to every GP with MMT patients (556) in the French-speaking part of Switzerland (1,757,000 inhabitants). We sent another shorter questionnaire to primary care physicians without MMT patients living in the Swiss Canton of Vaud.

Results

The response rate was 63.3%. The highest methadone dose given by GPs to MMT patients averaged 120.4 mg/day. When asked about help they would like to be given, GPs with MMT patients primarily mentioned the importance of receiving adequate fees for the care they provide. Secondly, they mentioned the importance of better training, better knowledge of psychiatric pathologies, and discussion groups on practical cases. GPs without MMT patients refuse to treat these patients mostly for emotional and relational reasons.

Conclusion

GPs encounter financial, relational and emotional difficulties with MMT patients. They desire better fees for services and better training.
Literature
1.
go back to reference Byrne A: Nine-year follow-up of 86 consecutive patients treated with methadone in General Practice, Sydney, Australia. Drug Alcohol Rev. 2000, 19: 153-158.CrossRef Byrne A: Nine-year follow-up of 86 consecutive patients treated with methadone in General Practice, Sydney, Australia. Drug Alcohol Rev. 2000, 19: 153-158.CrossRef
2.
go back to reference Weinrich M, Stuart H: Provision of methadone treatment in primary care medical practice. JAMA. 2000, 283: 1343-1348. 10.1001/jama.283.10.1343.CrossRefPubMed Weinrich M, Stuart H: Provision of methadone treatment in primary care medical practice. JAMA. 2000, 283: 1343-1348. 10.1001/jama.283.10.1343.CrossRefPubMed
3.
go back to reference Fiellin DA, O'Connor PG, Chawarski M, Pakes JP, Pantalon MV, Schottenfeld RS: Methadone maintenance in primary care. A randomized controlled trial. JAMA. 2001, 286: 1724-31. 10.1001/jama.286.14.1724.CrossRefPubMed Fiellin DA, O'Connor PG, Chawarski M, Pakes JP, Pantalon MV, Schottenfeld RS: Methadone maintenance in primary care. A randomized controlled trial. JAMA. 2001, 286: 1724-31. 10.1001/jama.286.14.1724.CrossRefPubMed
4.
go back to reference Salsitz EA, Joseph H, Frank B, Perez J, Richman BL, Salomon N, Kalin MF, Novick DM: Treating chronic opioid dependence in private medical practice – A summary report. Mt Sinai J Med. 2000, 67: 388-397.PubMed Salsitz EA, Joseph H, Frank B, Perez J, Richman BL, Salomon N, Kalin MF, Novick DM: Treating chronic opioid dependence in private medical practice – A summary report. Mt Sinai J Med. 2000, 67: 388-397.PubMed
5.
go back to reference Lewis D, Bellis M: General practice or drug clinic for methadone maintenance? A controlled comparison of treatment outcomes. Int J Drug Policy. 2001, 12: 81-89. 10.1016/S0955-3959(00)00077-3.CrossRefPubMed Lewis D, Bellis M: General practice or drug clinic for methadone maintenance? A controlled comparison of treatment outcomes. Int J Drug Policy. 2001, 12: 81-89. 10.1016/S0955-3959(00)00077-3.CrossRefPubMed
6.
go back to reference Keen J, Oliver P, Rowse G, Mathers N: Does methadone maintenance treatment based on the new national guidelines work in a primary care setting?. Br J Gen Pract. 2003, 53: 461-467.PubMedPubMedCentral Keen J, Oliver P, Rowse G, Mathers N: Does methadone maintenance treatment based on the new national guidelines work in a primary care setting?. Br J Gen Pract. 2003, 53: 461-467.PubMedPubMedCentral
7.
go back to reference Gossop M, Stewart D, Browne N, Marsden J: Methadone treatment for opiate dependant patients in general practice and specialist clinic settings: Outcomes at 2-year follow-up. J Subst Abuse Treat. 2003, 24: 313-321. 10.1016/S0740-5472(03)00040-0.CrossRefPubMed Gossop M, Stewart D, Browne N, Marsden J: Methadone treatment for opiate dependant patients in general practice and specialist clinic settings: Outcomes at 2-year follow-up. J Subst Abuse Treat. 2003, 24: 313-321. 10.1016/S0740-5472(03)00040-0.CrossRefPubMed
8.
go back to reference Glanz A, Taylor C: Findings of a national survey of the role of general practitioners in the treatment of opiate misuse: extent of contact with opiate misusers. Br Med J. 1986, 293: 427-430.CrossRef Glanz A, Taylor C: Findings of a national survey of the role of general practitioners in the treatment of opiate misuse: extent of contact with opiate misusers. Br Med J. 1986, 293: 427-430.CrossRef
9.
go back to reference Davies A, Hexley P: Survey of general practitioners' opinions on treatment of opiate users. Br Med J. 1997, 314: 1173-1174.CrossRef Davies A, Hexley P: Survey of general practitioners' opinions on treatment of opiate users. Br Med J. 1997, 314: 1173-1174.CrossRef
10.
go back to reference Barrau k, Thirion X, Micallef J, Chuniaud-Louche C, Bellemin B, San Marco J: Comparison of methadone and high dosage buprenorphine users in French care centres. Addiction. 2001, 96: 1433-1441. 10.1046/j.1360-0443.2001.961014337.x.CrossRefPubMed Barrau k, Thirion X, Micallef J, Chuniaud-Louche C, Bellemin B, San Marco J: Comparison of methadone and high dosage buprenorphine users in French care centres. Addiction. 2001, 96: 1433-1441. 10.1046/j.1360-0443.2001.961014337.x.CrossRefPubMed
11.
go back to reference Cooper JR: Including narcotic addiction treatment in an office-based practice. JAMA. 1995, 273: 1619-1620. 10.1001/jama.273.20.1619.CrossRefPubMed Cooper JR: Including narcotic addiction treatment in an office-based practice. JAMA. 1995, 273: 1619-1620. 10.1001/jama.273.20.1619.CrossRefPubMed
12.
go back to reference Federal Office of Statistics and Federal Office of Public Health: Bern, Switzerland. Federal Office of Statistics and Federal Office of Public Health: Bern, Switzerland.
13.
go back to reference Miller SN, Sheppard LM, Colenda CC, Magen J: Why physicians are unprepared to treat patients who have alcohol- and drug-related disorders. Acad Med. 2001, 7: 410-418.CrossRef Miller SN, Sheppard LM, Colenda CC, Magen J: Why physicians are unprepared to treat patients who have alcohol- and drug-related disorders. Acad Med. 2001, 7: 410-418.CrossRef
14.
go back to reference Strang J, Sheridan J, Hunt C, Kerr B, Gerada C, Pringle M: The prescribing of methadone and other opioids to addicts: national survey of GPs in England and Wales. Br J Gen Pract. 2005, 55: 444-451.PubMedPubMedCentral Strang J, Sheridan J, Hunt C, Kerr B, Gerada C, Pringle M: The prescribing of methadone and other opioids to addicts: national survey of GPs in England and Wales. Br J Gen Pract. 2005, 55: 444-451.PubMedPubMedCentral
15.
go back to reference Blaney T, Craig RJ: Methadone maintenance: does dose determine differences in outcome?. J Subst Abuse Treat. 1999, 16: 221-228. 10.1016/S0740-5472(98)00031-2.CrossRefPubMed Blaney T, Craig RJ: Methadone maintenance: does dose determine differences in outcome?. J Subst Abuse Treat. 1999, 16: 221-228. 10.1016/S0740-5472(98)00031-2.CrossRefPubMed
16.
go back to reference Matherson C, Pitcairn J, Bond CM, Van Teijlingen E, Ryan M: General practice management of illicit drug users in Scotland: a national survey. Addiction. 2003, 98: 119-126. 10.1046/j.1360-0443.2003.00263.x.CrossRef Matherson C, Pitcairn J, Bond CM, Van Teijlingen E, Ryan M: General practice management of illicit drug users in Scotland: a national survey. Addiction. 2003, 98: 119-126. 10.1046/j.1360-0443.2003.00263.x.CrossRef
17.
go back to reference Strain EC, Bigelow GE, Liebson IA, Stizer ML: Moderate vs high-dose methadone in the treatment of opioid dependence: a randomized trial. JAMA. 1999, 281: 1000-1005. 10.1001/jama.281.11.1000.CrossRefPubMed Strain EC, Bigelow GE, Liebson IA, Stizer ML: Moderate vs high-dose methadone in the treatment of opioid dependence: a randomized trial. JAMA. 1999, 281: 1000-1005. 10.1001/jama.281.11.1000.CrossRefPubMed
18.
go back to reference Simoens S, Matheson C, Bond C, Inkster K, Ludbrook A: The effectiveness of community maintenance with methadone or buprenorphine for treating opiate dependence. Br J Gen Pract. 2005, 55: 139-146.PubMedPubMedCentral Simoens S, Matheson C, Bond C, Inkster K, Ludbrook A: The effectiveness of community maintenance with methadone or buprenorphine for treating opiate dependence. Br J Gen Pract. 2005, 55: 139-146.PubMedPubMedCentral
19.
go back to reference Cochrane Database of Systematic Review, Faggiano F, Vigna-Taglianti F, Versino E, Lemma P: Methadone maintenance at different dosages for opioid dependence. Cochrane Database of Systematic Reviews. 2005, Updated 02-03-2005 Cochrane Database of Systematic Review, Faggiano F, Vigna-Taglianti F, Versino E, Lemma P: Methadone maintenance at different dosages for opioid dependence. Cochrane Database of Systematic Reviews. 2005, Updated 02-03-2005
Metadata
Title
Difficulties associated with outpatient management of drug abusers by general practitioners. A cross-sectional survey of general practitioners with and without methadone patients in Switzerland
Authors
Anne Pelet
Jacques Besson
Alain Pécoud
Bernard Favrat
Publication date
01-12-2005
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2005
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-6-51

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