Addiction help from your GP

A person may talk to their GP about an addiction because they have recognised they have a problem or because their GP has raised concerns.

What can you expect from your GP?

Your GP is there to help you, not criticise or judge you, so don't be frightened about discussing your concerns about your addiction.

If you're unable to get help from your GP, you may want to think about changing your doctor to one who is more comfortable dealing with addictions.

Telling your GP about drug use

The more information you give your GP, the easier it is for them to help you. If you don't mention anything about smoking, drug misuse or alcohol consumption, don't be surprised or upset if your GP asks you. It's now routine for these questions to be asked during a consultation. Your GP may need this information to reach the right diagnosis and give you the best treatment.

Likewise, when joining a new practice all patients are offered a registration health check and routine questions asked will be whether someone is now using, or has ever used, recreational drugs, whether they smoke and how much alcohol they drink each week.

When someone has an addiction

When a problem with addiction has been highlighted, the first question a GP is likely to ask is 'Do you want help to overcome this problem?' If the answer is no, the GP will encourage the person to think about the possible health and social problems of the addiction and to always feel welcome to come and ask for help in the future. If the answer is yes, help may be provided by the GP. For example, they may recommend a self-help group, or refer you to a specialist in the field of addiction

For problems with drug misuse, for example, care may then be provided by the GP themselves, or the community drug team or specialist drug unit (that includes psychiatrists, specialist nurses and social workers, for example), or a combination of these, called shared-care.

As part of the assessment of any addiction you'll be asked many questions. This may sometimes feel like the third degree but, once again, the more information provided, the more appropriate the support and treatment given.

The following questions may be asked if someone has a problem with drug misuse to help assess the level of addiction:

• Why do you want to stop using drugs?
• How long have you been using drugs?
• What made you start using drugs?
• What drugs have you used in the past and in the past month, and what drugs are you using now?
• How have you used drugs in the past and in the past month - for example, have you ever injected drugs?
• How often have you used drugs in the past?
• Have you ever stopped using drugs? If so, for how long and how did you feel when you were not using drugs and what support and treatment did you have?
• If you had stopped, what made you start again?
• Are you willing to help yourself overcome your problem with drugs?

Additional information

Doctors will also need to know how much support a person has - are they living alone, are they working, do they already have a social worker, are they in trouble with the law, for example a physical examination will also be performed to try to identify any problems that may have arisen because of the addiction including, with a person's consent, a urine screen for drugs and blood tests may be taken to establish blood count, liver, kidney function, and hepatitis B and C, and HIV status.

Where will treatment be provided?

Some GPs have undergone additional training in addiction management and run special clinics within their own surgery. When this is the case a GP may not necessarily refer someone to another centre. These in-house clinics are becoming more available, particularly for people who want to give up smoking, for example.

Many GPs, however, will refer the person to the local addiction specialist for an assessment and a treatment plan. These units have specialist addiction management psychiatrists and nurses, counsellors, and social workers working with them. When appropriate these units are able to arrange for in-patient care too, for example, in the case of drug or alcohol addiction.

Often treatment is provided on a 'shared-care' basis. This may involve the GP providing certain parts of treatment, for example, appropriate prescriptions and treatment for addiction-related health problems, while the specialist addiction team unit provides ongoing monitoring and counselling.

Where possible, a person is given the choice of where he or she is treated. Some prefer to be looked after in the familiar surroundings of their general practice, and even if the GP is not able to provide the treatment then often arrangements can be made for the person to be seen by the community specialist addiction nurse or counsellor within the general practice. Other people, however, prefer to be looked after at a specialist addiction unit because of the anonymity this allows and the fact that everyone is there for the same reason.

If every time you raise the issue of wanting to overcome an addiction your GP doesn't seem particularly interested then it's perfectly acceptable for you to consult a different doctor. In the case of drug addiction most local community drugs units have a self-referral system whereby people looking for help can drop-in without needing to be referred by their GP.

There are also many organisations that can be contacted for help and advice. These will point people in the right direction when they wish to overcome an addiction.