GPs speak out about AOD stigma

GPs have joined other health professionals as the faces of a new campaign shining a light on stigma linked to alcohol and other drug (AOD) use.
 
The ‘Raise It’ campaign, launched last month by the North Western Melbourne Primary Health Network, focuses on the lived experiences of clinicians working within an imperfect system.
 
Among several GPs to feature in the campaign is Dr Eric Hadinata, an award-winning GP and addiction medicine specialist.
 
‘I thought it was a good time to raise awareness of stigma in medicine,’ he told newsGP. 
 
‘I always thought it was an important topic due to my experiences working in the industry.
 
‘I witnessed a lot of stigma in the hospital setting where I was working and training to become a specialist.’
 
In a video filmed for the campaign, he recounts an episode when a patient with a heroin addiction visited the hospital where he was working as a junior doctor.
 
The patient’s treatment was not prioritised, and he ended up discharging himself.

 
‘After seven presentations to the emergency department – and he’s been stigmatised over and over again as someone who was seeking opioids or just wanting to get drugs because he was a heroin user – he actually had a spinal abscess,’ Dr Hadinata said.
 
‘Even though I never had an actual encounter with this patient, I was part of the problem because it took too long to see the patient.
 
‘I have to admit in my mind this patient probably was seeking opioids and at the time I didn’t know any better and perhaps that involuntary thought did lead me to not prioritise the patient.’
 
He says reflecting on this experience led to him pursuing a role in addiction medicine.
 
‘[It prompted me] to re-evaluate my practice, to re-evaluate what drove that initial prejudice, and rethink addiction or substance use,’ he said.
 
‘We talk about racism, we talk about gender discrimination, and this is just another form of discrimination.
 
‘I would encourage GPs to think about substance use disorder as just another chronic disease.’
 
While he believes that the medical profession is ‘making inroads’ into reducing stigma, Dr Hadinata also feels there is much more work to be done – and compares stigma related to AOD use to previous attitudes towards mental health.
 
‘There were not a lot of doctors who wanted to be involved in mental health, but as we understand more of substance use disorder, just like another chronic disease, it becomes easier,’ he said.  
 
‘It can be quite rewarding and you can make real change, it is possible to maintain long-term success with the right treatment and the right understanding behind the factors that drive these processes.’
 
Organisers hope the Raise It campaign will inspire more health professionals to broaden their knowledge, whether working as Medication Assisted Treatment for Opioid Dependence prescribers, undertaking further training, or joining a Balint group.
 
They are also encouraging health professionals to raise the topic of AOD with their patients and practice team.
 
Dr Hadinata emphasises the wide range of resources now available, including through the RACGP, and highlights the extent of substance use among the wider population.
 
‘Just be mindful of that when you’re treating your patients,’ he advises GPs.  
 
‘If you can do it in a non-judgmental way, in a welcoming way, you can do a lot of change in someone’s life. 
 
‘Substance use affects everybody, it affects people across broad socioeconomic backgrounds, it likely affects your friends and family.
 
‘We should look at this through a public health and a medical lens.’

The General Practice in Addiction (GPADD) Conference takes place in Melbourne from 28–29 August. Early bird tickets are available until 19 July. For more details see the RACGP website.

An Alcohol and Other Drugs GP Education Resource Library including a range of tools to support general practices is available on the RACGP website.
 
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alcohol and other drugs AOD substance use disorder