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Heroin Addiction and Related Clinical Problems: 2016, 18, N4 (pages: 43 - 50)

General Practitioner Perspectives on and Attitudes toward the Methadone Treatment Programme in Ireland.

Delargy I., O'Shea M., Van Hout M.C., and Collins C.

Summary: Background. Methadone maintenance treatment in Ireland is provided in addiction clinics, and in primary community care settings by Level 1 and 2 specialist trained General Practitioners (GPs). The Irish College of General Practitioners (ICGP) provides training and regulates the Methadone Treatment Programme (MTP). Aim The study aimed to assess and compare GP perceptions of the scale of local illicit drug use, attitudes toward and obstacles in the provision of methadone treatment and preferred adjunct modalities. Methods In 2006 and 2015, an online survey was undertaken with all Level 1 and 2 registered GPs in the MTP. Results. The majority of participants were male, aged between 35 and 60 years, treated between 1 and 25 patients in urban areas. In 2015, 44.7% with registered methadone patients reported no obstacles to taking on more (32% in 2006). In relation to GPs with no current methadone patients, reasons for not taking patients in 2015 were similar to 2006, and centred on no referrals or demand, and concern for negative affect on private patients. Majority attitudes toward the MTP remained positive, with one exception relating to greater disagreement in 2015 with the statement that supervised daily dispensing prevents patients from working (p < .05). Preferred adjunct services remained constant; addiction counselling, in-patient detoxification, employment schemes and consultant psychiatric services. Conclusions. The study illustrates a generally positive attitude toward the Irish MTP. Efficient referral mechanisms for stabilised patients to primary care settings, and greater psycho-social, vocational and detoxification supports are warranted.