What is the role of primary care in addiction treatment? How can be addiction treatment better integrated in the general medical settings? These and other puzzles were discussed during the addiction talks at the meeting of the primary care academics in Ireland. University College Cork hosted this year’s meeting attended by approximately 80 delegates.
The drug-related research was scattered in the 12 parallel sessions from 10.30-16.30, one of which was specifically focused on drugs in primary care. North Dublin City general practices (GP) training presented two decades of experiences with GP placements in Dublin low-threshold services for people without home or with addiction (see www.primarycaresafetynet.ie). Students in the final year of 4-year GP training benefited from the experiences greatly; it was different though. They provided mainly social medicine and had to adjust to a different culture of people living on the brink of our society. To prevent burnout and emotional detachment, the administrators introduced Mindfulness for trainees.
From the same environment, a survey followed-up physical and mental health of people without home in 1997, 2005 and again in 2013. The situation of mental disorders hasn’t changed – it remains bleak, but the baseline data is important for service organisation and delivery. The study now compares Dublin and Limerick.
Among the 39 conference posters, addiction was represented by my poster was (no 15) shown in Figure 2.
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| Figure 2 Poster by Klimas et al (Cork, March 7, 2014) |
Research priorities of general practitioners were explored by the PRIMary healthcarE research group at University of Limerick. They organised a novel World café – a self-facilitated focus group with coffee for participants – 4 key questions prepared by organizers (www.theworldcafe.com). Music & flowers on the tables helped to break ice. Tablecloths served as writing paper. The researchers took the tablecloths with them and put participants’ notes in the computer; Visio programme facilitated mind maps. The doctors and community members prioritized the bigger picture: they wanted more accessible and responsive primary care.
The drugs-focused parallel session brought 3 presentations from Galway, Limerick and Dublin. Field et al., studied the management of problem alcohol use among problem drug users in primary care; Henderson et al., analysed key performance indicators for mental health and substance use disorders, and Whiston et al., pilot-tested brief interventions for illicit drug and alcohol use in methadone-maintained patients in 4 methadone maintenance treatment clinics in Dublin.