Rural GPs sought for alcohol and drug training

Rural areas have long struggled disproportionately with drug and alcohol issues, with residents seeking treatment at higher rates than those in major cities – and travel longer to get treatment.
 
For some, the stresses of life amid a pandemic have only added to these challenges.
 
To tackle this, the RACGP is encouraging rural GPs – who are often called upon to support people with dependencies – to join its new alcohol and other drugs (AOD) education program.
 
Dr Hester Wilson, who chairs the RACGP Specific Interests Addiction Medicine network, said the program is timely.  
 
‘Training up GPs outside of major cities is particularly important,’ she said.
 
‘That is because people in rural and remote regions are particularly at risk for drug and alcohol misuse. GPs working in some of these areas are sometimes isolated and treating patients with complex morbidities.
 
‘They are often working without real-time support from colleagues or experienced allied health professionals and it is essential that they are equipped with the training they need to help their patients.’
 
People in regional and remote Australia were more likely to drink daily (8% versus 5%), and more likely to drink at risky levels (21% versus 15%), according to Australian Institute for Health and Welfare data from 2016/17.  
 
The numbers of people using illicit drugs is comparable, at around 16% across cities and regional and remote areas, though the types of drug used vary.
 
During the pandemic, there has been a noticeable decline in use of illicit drugs produced mostly overseas – such as cocaine, heroin, ecstasy and methamphetamines – and an increase in cannabis and alcohol use, according to two recent surveys of people who use drugs.
 
Yet for people concerned about their drinking or drug use, seeking help can be a real challenge given the long distances. A quarter of those seeking treatment in the country had to travel an hour or more – compared to 10% in the major cities.
 
Funded by the Federal Government, the $8 million RACGP-run AOD program is designed to meet the needs of GPs across Australia.
 
The goal is to help GPs talk openly to their patients about alcohol or other drug use, as well as working collaboratively with colleagues to develop a whole-of-practice approach to the prescribing of pharmaceuticals to treat pain, insomnia and anxiety.
 
The training will also focus on putting in place best practice approaches to safely and effectively support patients presenting with alcohol and other drug use problems.
 
The aim is to minimise harm and improve health and wellbeing, as well as develop techniques on AOD patient assessment, harm minimisation, withdrawal and weaning, as well as pharmacotherapy options such as methadone and treatment pathways.
 
Local treatment pathways will be promoted, as part of a collaboration between the RACGP, Primary Health Networks, Local Health Districts and other AOD treatment services.
 
RACGP President Dr Karen Price strongly encouraged more rural and remote GPs to take up the training.
 
‘The COVID-19 pandemic has been a very trying time for many people and, as a result, substance use problems have worsened,’ she said.
 
‘So, there is no more important time for GPs in towns across the nation to put their hand up and further improve their skills.’
 
Dr Price said that helping people with dependencies can be challenging work.
 
‘This training can make a real difference. As the late Dr Harry Nespolon said last year – we can’t control how long this pandemic will last but we can control our primary care response to it,’ she said.
 
‘Those are wise words, so please do not hesitate to take up this AOD training.’
 
Dr Price added that the new training fills a gap by offering practical ways for GPs to support patients who find it difficult to talk about their alcohol intake, misuse of prescribed medications or other drug use.
 
The program has three streams:

• Essential skills training to provide an update for GPs wanting to improve their approach to conversations about alcohol and other drug use. This module is now available to all RACGP members as a self-directed e-learning option on gplearning.
• Treatment skills training aimed at improving the ability to discuss AOD use and collectively decide on a plan of action with patients. This is delivered through online workshops and self-directed e-learning modules.
• Advance skills training for GPs who already have a good grounding in AOD care and want to address specific drug and alcohol related challenges in their community. These GPs will be asked to take on a leadership role and share what they have learnt with their practice colleagues.

alcohol and other drugs GP education rural health