Dr.Dagestani
19/06/03, 11 :58 11:58:04 PM
The system of care for addicts in the U.S. has come under increasing scrutiny. Spurred by increases in the cost of care, concern over drug-related crimes, and the urgent need for better access to treatment, the federal Health Care Financing Administration is developing guidelines to allow private physicians with some type of certification or accreditation to be able to prescribe methadone treatment and manage users.
"We have a social environment now that is so antagonistic to people that have heroin addiction that that spills over to the attitudes that probably many physicians have. And instead of seeing these as people with an illness, they may also see them as [people with] character flaws which is unfortunate," says Bristow, who is also a former vice chairman of Physician Leadership on National Drug Policy, a group that emphasizes treatment over punishment of drug offenders.
In Scotland, Stuart says, primary care physicians had responsibility for these addicts, who were first assessed by members of a local government unit. This organization takes an assessment, assigns a social worker, and links the patient to a private physician if they don't already have one.
In Edinburgh, doctors must agree to follow a clinical manual and supervise the administration of methadone by more difficult patients. Both cities have seen a big shift in the percentage of addicts who no longer inject heroin and an increase in the number of addicts receiving methadone treatment.
"The thing that was key, in both Edinburgh and Glasgow, was that you had to have leadership from the physician community and leadership from the government -- and then you could make changes," Stuart tells WebMD. Stuart is an associate professor in the department of sociology and anthropology at the University of Maryland in Baltimore.
"We have a social environment now that is so antagonistic to people that have heroin addiction that that spills over to the attitudes that probably many physicians have. And instead of seeing these as people with an illness, they may also see them as [people with] character flaws which is unfortunate," says Bristow, who is also a former vice chairman of Physician Leadership on National Drug Policy, a group that emphasizes treatment over punishment of drug offenders.
In Scotland, Stuart says, primary care physicians had responsibility for these addicts, who were first assessed by members of a local government unit. This organization takes an assessment, assigns a social worker, and links the patient to a private physician if they don't already have one.
In Edinburgh, doctors must agree to follow a clinical manual and supervise the administration of methadone by more difficult patients. Both cities have seen a big shift in the percentage of addicts who no longer inject heroin and an increase in the number of addicts receiving methadone treatment.
"The thing that was key, in both Edinburgh and Glasgow, was that you had to have leadership from the physician community and leadership from the government -- and then you could make changes," Stuart tells WebMD. Stuart is an associate professor in the department of sociology and anthropology at the University of Maryland in Baltimore.