A Share of the Action: General Practitioner involvement in drug misuse treatment in Greater Manchester

This paper describes the development of shared care for drug misuse in Greater Manchester. Particular attention is given to Trafford, where a successful system has been developed involving all GPs in the district, and which provides direct access for GPs to a variety of support services for drug misusers, including training, rehabilitation and supported home detoxification. The Greater Manchester Shared Care Training Initiative is described. Local research is summarized relating to GP and patient attitudes. Unfortunately, there is still much resistance by GPs to involvement in treating illicit drug misuse. The authors draw on their experience of developing shared care schemes in a number of districts, and suggest ways of overcoming resistance among GPs and primary care staff. Attention must be paid to the attitudes and skill base of primary care staff, the amount of support they receive and the effectiveness and enthusiasm of the specialist service. An important first step is to recruit at least a few local GPs as champions of shared care. With the help of appropriate training and support, and sensitive evangelism, most GPs can be brought to realize that treatment of drug misuse is a satisfying and beneficial component of normal family practice.