I’m continuing to write the SMMGP Clinical Update on a bi-monthly basis. It’s a summary of some of the key clinical papers on substance misuse relevant to primary care. Generally, it’s around 3000 words long and I might cover anything from seven to ten papers in that. There is a summary of the methodology and findings of the paper and I make an attempt to put it all into some sort of appropriate context. The team at SMMGP read it through, make helpful comments, and try to filter out any blatant libels. It’s available at www.smmgp.org.uk under the ‘Resource Library’ heading. If you’ve an interest in substance misuse in primary care then you should join SMMGP – it’s free.
I’ve been writing this every couple of months since August 2009 so I’ve now racked up quite a few of these – my next one will be my 20th Clinical Update.
The last one was the Aug-Sep 2012 version and covered the following papers:
Prevalence of common chronic respiratory diseases in drug misusers: a cohort study. Palmer F, Jaffray M, Moffat MA, et al. Primary Care Respiratory Journal. Published online: 8 August 2012.
An interesting retrospective study from Scotland looking at this sorely neglected area. And there are few surprises in the findings – even without smoking (and smoking is pretty terrible in this group) respiratory diseases are much more likely.
Persistent cannabis users show neuropsychological decline from childhood to midlife. Meier MH, Caspi A, Ambler A, et al. Proc Natl Acad Sci USA Published online: 27 August 2012.
This is a deeply impressive study based on the New Zealand Dunedin cohort. It goes a long way to settling a fair few questions around harms from cannabis – and adolescents looks particularly vulnerable.
Substance misuse of gabapentin. Smith BH, Higgins C, Baldacchino A, et al. Br J Gen Pract 2012;62:406–7.
A brief report/letter in the BJGP highlights an issue that won’t come as a surprise to many folk working in substance misuse (or particularly prisons). Gabapentin is highly abusable and this report points out some of the issues.
Retrospective accounts of injection initiation in intimate partnerships. Simmons J, Rajan S, McMahon JM. Int J Drug Policy 2012;23:303–11.
This qualitative study does what a good qualitative study should – it’ll really make you step back and consider some of your attitudes. Recommended.
Brief case finding tools for anxiety disorders: Validation of GAD-7 and GAD-2 in addictions treatment. Delgadillo J, Payne S, Gilbody S, et al. Drug Alcohol Depend 2012;125:37–42.
This UK study studied whether or now GAD-7 is actually of any value in an addiction setting.
Involvement of general practitioners in managing alcohol problems: a randomized controlled trial of a tailored improvement programme. van Beurden I, Anderson P, Akkermans RP, et al. Addiction 2012;107:1601–11.
This Dutch study had a bit of a torrid time as they struggled with poor recruitment and not very impressive participation. Some good lessons on how we might go about improving the management of alcohol problems in general practice.
Buprenorphine/naloxone and dental caries: a case report. Suzuki J, Park EM. Am J Addict 2012;21:494–5.
This was just a short case that reported on a woman who developed marked dental caries while on buprenorphine/naloxone. It’s a good opportunity to reflect on the dire state of oral health in many of those with substance misuse issues.