It was reported recently by the National Treatment Agency (NTA) for Substance Misuse that the number of crack and heroin users is at a record low.
But can we GPs claim the credit for these optimistic figures, following the massive rollout of substitute prescribing in general practice? Or are we looking at a piece of spin from a target-driven Government agency whose income depends on box-ticking?
My practice had around 75 patients on substitution prescribing, though assiduous Read coding found more than 300 who were known to use heroin, most far from wanting the sort of treatment on offer.
None of the drug users I have ever met come in asking for a lifetime of substitution, but that is what is on offer. We have created a massive cohort of substitute users, marching into the future dependent on our services.
But it is churlish to pick too many holes in the headlines – perhaps we can instead use this opportunity to move on to some new targets? How about a new prescribing contract that includes regular hair clippings for all children whose parents have access to home substitution to ensure they are still drug free? That one could save some little lives that weren’t mentioned in the NTA’s report.
Dr Stefan Cembrowicz, appraiser and retired GP, Bristol
