Methadone maintenance in general practice: impact on staff attitudes

Abstract

GPs and receptionists in this sample had mixed views about methadone maintenance which were unchanged by six months experience of the service. The study illustrates important issues in the recruitment and support of general practice in meeting this need.

Barriers and Facilitators to Primary Care or Human Immunodeficiency Virus Clinics Providing Methadone or Buprenorphine for the Management of Opioid Dependence

“…5,6 The United States has had a limited-capacity system of segregated specialized clinics dedicated to treating drug dependence, while in Australia and Europe, primary care physicians deliver office-based management of opioid dependence. [7][8][9][10][11][12][13][14][15] Because the US treatment capacity does not meet demand and the office-based model of treatment for opioid dependence has been successful abroad and in domestic pilot programs, [16][17][18][19][20][21] modified federal regulations permit manage-ment of opioid dependence by qualified, trained, office-based physicians. 22,23 Methadone hydrochloride and buprenorphine hydrochloride are the primary pharmacological treatments for opioid dependence.…”

“…Successful approaches to expand this alternative for opioid-dependent persons could substantially increase treatment capacity 33,34 and potentially improve health outcomes. 35 European providers' attitudes toward treating drug users have been examined, 12,[36][37][38][39][40] but similar information about US providers' attitudes are needed to guide policy makers' efforts to increase acceptance in this country. In our statewide sample of roughly 250 medical directors of primary care and HIV specialty clinics, only one third were willing to provide methadone to stabilized drug users, while 59.8% expressed willingness to provide buprenorphine.…”

How to overcome hurdles in opiate substitution treatment? A qualitative study with general practitioners in Belgium

“…[9,28,29] Second, the need for more support (hands-on guidelines and information) for treating these patients, which also confirms previous research in the UK. [9,27,29] Clarification of the practical implications of the regulatory conditions is needed to increase the willingness of GPs to engage in OST. Previous research has pointed out that the willingness of GPs to treat opiate users depends on the attitude, behaviour and the motivation of the patients towards the treatment.…”

“…Previous research has pointed out that the willingness of GPs to treat opiate users depends on the attitude, behaviour and the motivation of the patients towards the treatment. [27,28] Our study discussed some relevant advantages for patients to receive OST in general practice instead of in the addiction centres. Since these are only a few results, further research is needed to know what patients' experiences are regarding OST in general practice.…”

General practitioners tackle complex addictions: how complex interventions can assist in dealing with addiction

“…Dr Bury's research team in Dublin introduced treatment with an opioid agonist medication, methadone, to general practice. Getting the GPs' buy in for this treatment in the early nineties wasn't easy, but none of them had concerns over patient workload, or treating opioid use disorders, three months later (Langton et al, 2000). Qualitative follow-up studies like this help make findings usable and interventions sustainable.…”