READERS'VIEWS

I WAS glad to see that your drugs report was not distorted by the blinkered
views of the usual drugs experts who are now so desperately trying to
encourage more GPs to get involved in methadone treatments. These services
remain in short supply despite inducements of more education, more staff
and even the extra payments that each consultation now generates under
localised methadone payment schemes.

In a recent UK survey the majority of General Practitioners stated that
they did not feel that the treatment of such addiction should be part of a
GP's responsibility. Ian McCartney is right when he states that addicts are
chaotic and always looking to steal for their next fix. Unfortunately, the
vast majority of treated methadone addicts continue to behave in exactly
the same way. When a practice shows an interest in trying to provide
addiction services then they are beseiged by desperate and chaotic
sufferers. If that practice is vulnerable by virtue of its staffing levels
or by its design, then anarchy soon takes over with thievery and violence.

When I tried to help these patients my practice and my life descended into
the equivalent of a medical Hades. My Hoover and camcorder were stolen,
they smoked in the toilets and threatened both staff and patients. It's
fine if your premises have a security guard with video surveillance and
patients who don't mind consulting in what isn't far removed from that of a
prison environment. Most practices aren't like that and I believe that most
patients and health workers don't want their surgeries to be penal
institutions.

Don't get me wrong: these patients deserve good quality care. But GP
premises are rarely suitable places to provide appropriate care for people
in such constant chaos. It is not good for the other patients, it is not
good for the practice staff and doctors involved and it is not good for the
addicts.

Dr Colin Guthrie, Glasgow