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Thursday 29 April 2010 – DAY FOUR –
Daily Update
– 7
GPs are ‘best placed for
continuity of care’
‘ONE ADVANTAGE
we do have is
continuity of care,’ said Dr Chris
Ford, considering the role of general
practice in harm reduction. It was
often difficult to tackle people’s
diverse problems in the required ten-
minute appointment slot, but with up
to 40 per cent of people being
treated in primary care there were
plenty of chances to dispense
ongoing harm reduction advice.
The creation of SMMGP
(Substance Misuse Management in
General Practice) 15 years ago had
provided a network for GPs and
others working in primary care and
had given support and training. New training qualifications, including harm
reduction and hepatitis B and C had been added, and SMMGP were actively
supporting international doctors in developing healthy drug policies.
The unit cost for a GP treating a patient for drug problems was much lower
than specialist services, said Dr Ford. Furthermore, the benefits were two-way:
‘I’m proud and pleased that all I know as a GP has come from people who use
drugs – so they have to be the centre of everything,’ she said.
James Rowan Blogg explained how IDHDP – International Doctors for Healthy
Drug Policies – had borrowed from the SMMGP model to form a network for doctors
to share expertise and ‘act as a bridge between practice and policymakers’.
‘Doctors in different countries have huge variation in training and capacity,’ he
said. ‘There is urgent need to mobilise and train more doctors to work with IDUs.’
Implementing harm reduction programmes was not enough. The IDHDP would
help to share good practice and experience, foster dialogue, and provide evidence
of effectiveness of harm reduction measures. ‘We need imaginative approaches,’
he said.
If you would like to know more about IDHDP or SMMGP, visit their booths in
the exhibition hall.
Harmreduction a
challenge for Russia
THE CHALLENGES
of
integrating harm reduc-
tion into a narcology
clinic were explained by
Liliya Khalabuda from
Russia.
Narcology clinics had
a large number of IDUs
who continued to inject
after treatment, she
said. Patients tended to
have very risky behav-
iour and often shared
needles and had un-
protected sex. The
challenge had been to
get narcologists to support integration of harm reduction
into the clinic. They had previously considered harm
reduction ‘useful, but not for the purpose of narcology’.
Some doctors had been ‘very negative’ about
overdose training, saying it didn’t correspond with the
aims of treatment, and it had been important to give them
motivation to include harm reduction.
They had taken a two-stranded approach of devising a
harm reduction programme for the specialists and another
comprehensive programme for patients, involving con-
sultations, counselling, and condom distribution, said Ms
Khalabuda. All patients already knew their HIV status,
which made HIV counselling possible.
With public health in Russia underfinanced it was
difficult to get money for programmes, so it had to be
integrated to harm reduction practice, she said. This was
being achieved through everyday consultations with
doctors and nurses for those who attended the clinic.
Dr Chris Ford:
‘I’m proud and pleased
that all I know as a GP has come from
people who use drugs.’
Liliya Khalabuda:
Difficult to
get money for programmes.
Changes to the IHRA Board...
IHRA is pleased to announce changes to the IHRA Board
of Directors. Tasnim Azim and Lisa Norman have been
appointed to the Board, and Marcus Day, Bill Stronach
and Marcus Day were re-elected at the Annual General
Meeting. They join Mukta Sharma (IHRA's chair),
Ananda Pun, John-Peter Kools, Danny Kushlick (not
pictured), Emran Razaghi, and Stephane Ibanez-de-
Benito. The Board would like to thank Guy-Pierre
Levesque and Nick Crofts, whose terms expired this year,
for their major contribution to IHRA. The Board also
expresses warm thanks to Jennifer Curcio, who many
conference goers will remember as IHRA's former
administrator. Jenn has now left IHRA to take up a new
appointment in Melbourne.