A Glasgow GP practice has been criticised for stigmatising drug users after it warned them they must detox from drugs they have been prescribed if they wanted to register for treatment.
Signs at Springburn Health Centre list nine drugs people with drug dependency might be prescribed as opiate substitutes and warn would-be patients they will only be accepted if they withdraw from the substances.
The sign warns patients hoping to register for the practice of Dr Aileen Polding at the Springburn clinic that they are unlikely to continue to be prescribed any of a number of drugs they may be taking, including Diazepam, Temazepam, Dihydrocodeine, Gabapentin or Morphine.
However experts expressed concern that the type-written A4 sheet is designed to deter people from even applying to join a practice and warned the approach runs counter to national and local policies which prioritise providing people with support.
Launching the Scottish Government's drug and alcohol strategy a year ago minster for public health Joe Fitzpatrick said: "There is a growing awareness that those experiencing problematic alcohol and drug use are often carrying other burdens such as poverty, inequality and health challenges. This means they need to be supported rather than be stigmatised."
Meanwhile NHS Greater Glasgow and Clyde and the city's Health and Social Care Partnership have been pushing for permission to run a 'safer injecting pilot', predicated on the need to get people in contact with health services, as a way to begin to address their wider needs.
Anna Ross was Special Advisor to the Scottish Affairs Select Committee Inquiry into Problem Drug Use in Scotland and works as a policy consultant.
She said: "This appears to be incredibly stigmatising and discriminatory and goes against government policy which looks to create environments - particularly within GP services - that encourage more honest conversations between drug users and their doctors.
"The implication is that individuals will not in fact be able to have an open conversation with their doctors about any drugs they are taking."
A spokesman for Scottish Drugs Forum said the approach risks driving people to street suppliers and criminality and say there is “a need for leadership and clarity”.
Policy Officer Austin Smith said: "This appears to be discriminatory against people who have a dependence on these medications. These patients are vulnerable and require support around prescribing and other issues they may have. In the light of the level of drug overdose deaths this is concerning."
"People who have become dependent on medications prescribed by the NHS need to be supported by the NHS. Prescribers should be raising their specific concern directly with patients and patients should be able to communicate issues or concerns they have," he said.
Some patients dependent on prescribed medication could be deterred from seeking help at all, and be forced to move to street supply of the same, or similar drugs, he said.
"The danger is that the exact content and strength of street drugs is not guaranteed and people are then drawn into using larger quantities. And, of course, they are drawn into criminality.
"This is what has happened in North America with huge public health consequences including rises in overdose deaths."
When the Herald contacted the practice we were told noone was available discuss the policy, and when we asked if someone could call us back we were met with a flat refusal.
A spokesman for NHS Greater Glasgow and Clyde said: "GPs routinely review the medicines prescribed to ensure they are still appropriate for the patient and are not causing harm. This is important when new patients join a GP practice.
"These reviews may include reducing the daily dose of certain prescribed drugs or stopping them altogether in line with the Chief Medical Officer’s Realistic Medicine policy.
"It is widely recognised that this is a difficult area with GPs constantly having to weigh up risks of prescribed medication against the benefits of prescribing."
He said reviewing medicines was in line with guidance on prescribing set by the General Medical Council. "Where GPs identify any patient as having a substance misuse problem they should be referred for support to drug services," he added.
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