Shadowland: general practitioners and the treatment of opiate-abusing patients

A number of calls have recently been made for general practitioners to become more closely involved in the treatment of opiate abusing patients. At present, however, very little is known of the sorts of problems general practitioners will face in working within what is held to be a very difficult area. The research reported in this paper aimed to explore the experience of a group of general practitioners currently being consulted by such patients. A combination of enhanced records and semi-structured interviews were used to collect detailed information on 50 consultations with opiate abusers. It is revealed that these doctors were experiencing a good deal of difficulty in sustaining a therapeutic role for themselves in relation to these patients. The nature of these difficulties, and their basis, are examined and recommendations are made as to how these difficulties may be resolved in the future.