Mirror

GPs integral to new detox centre

The Riverlands D&A detox centre is focused on being a GP oriented general service that co-manages patients with their regular GP.

David Helliwell, one of the two GPs staffing the service, sees their role as consultants and supporters of the GP.

“What the service is about is a service by GPs for GPs.”

The centre, operating since March, provides a therapeutic environment where patients can detox from a number of illicit and prescribed drugs: mainly alcohol, methadone and heroin.

Patients with cannabis and amphetamine problems are also admitted. They stay about a week, which takes them out of their usual surroundings and provides them with rehab care and future planning in a mutually supportive environment. They receive supportive care, counselling and discharge planning.

Riverlands can cater for 12 patients, with occupancy running between eight and 12 patients. The average length of stay is one week to 10 days. Patient feedback has been very good, Dr Helliwell says.

“It’s sort of like a mini rehab – there is no indication for hospital admission. We do group work because it’s a residential, therapeutic unit, not a hospital. They make their beds, do their laundry, serve their meals and wash up afterwards.”

There have been some early teething issues surrounding referrals. There is no self-referred out patient service. People can refer themselves for assessment for detoxification, but cannot admit themselves into the centre.

Dr Helliwell and his colleague Paul McGeown are interested in providing a phone consultation service to GPs either before or after their patient’s admission. “If we can talk to the GP before the referral we’ll get a better referral.”

They also offer this for D&A counsellors and the MERIT program. Some referrals will be managed in the community with the patient’s own GP, for example, home detox. They can also work with the GP to set up management plans for patients.

They plan to spend some time seeing groups of GPs to find out their specific needs and where they can help.

“It is great to work as part of a multi disciplinary team. It marks the end of the isolation working in D&A. We are trying to bring that model to GPs. I’d like to see us doing clinics with GPs in outlying towns and joint reviews with GPs, [thus] making it easier for patients and GPs.”

With the public methadone program operating from Riverlands, they are also willing to take the more difficult methadone patients.

Buprenorphine is another heroin substitute that will soon be available. Both Dr Helliwell in the Lismore area and Petrina Gilby in the Tweed area have completed their accreditation and train the trainer programs and will be recruiting GP methadone prescribers to also train in buprenorphine.

The centre is currently staffed by a GP for eight hours on a Monday, and four hours every other day. It is planned to increase the hours of GP availability and when this happens, they will look at appropriate out patient services.