[Treatment of opiate-dependent patients in a general practice]

A method for receival and follow-up of opioid-dependent patients in a general practice is described, and the results of an observational study of 146 such patients presented.

Opioid-dependent patients, who injected illegal opioids and had been treated with opioids by the first author from 01.08.97 to 01.08.06, were included in the study. Their medical records were examined; and mortality rates, treatment status and income status as of 01.08.06 recorded. The patients were also interviewed by telephone.

Mortality rates were low during opioid treatment; both when the regular general practitioner (RGP) was the only treatment provider (0.5% annual mortality) and when the patient in addition participated in a methadone support program (1.3%). No deaths by overdose were registered during RGP-supervised opioid prescription. Without opioid treatment, mortality was 5.1%. 97 % of the patients were followed up in some way at the time of observation. Opioid treatment had been prescribed by a RGP for more than one period to more than half the patients after specialist treatment had failed. Urine tests show a relatively low fraction of illegal opioid use (18% positive tests) during opioid treatment by a RGP. Patients became more financially independent, i.e. a smaller fraction of their income came from social security during the treatment period, indicating that the care given to these patients may have positive effects over time. In conclusion, RGPs may have an important role both in receival and follow-up of this patient group. This study has shown that stabilising patients with opioids prescribed by an interested and engaged RGP may have contributed positively to the treatment and rehabilitation of the patients and did not lead to dangerous situations.