Heroin addict (first consultation in primary care)

During the first consultation with a heroin addict it is important to:

• obtain an adequate drug history
  • type of drug, injected or taken by other route
  • length of drug abuse
  • effects of withdrawal
  • how does the patient support his habit
    
    
• measures to limit harm
  • does the patient practise 'safe sex'
  • does the patient share needles/use 'shared' needles
  • does the patient use a needle exchange scheme/ counselling agency
  • what is the family support available to the patient
    
    
• agree a contract with the patient
  • if being treated in primary care agree what is expected from the patient, what treatment is offered by the practice, the keeping of appointments etc.
  • if the patient is referred for treatment then agreement is still required about future contacts with the practice
    
    
• register with regional drug misuse database/ notification of addicts
  
  
• referral if specialized treatment and counselling not available from within the practice