Opioid Substitution Therapy: A Study of GP Participation in Prescribing

Background: Opioid substitution therapy (OST) is the most commonly provided treatment for heroin dependence in Australia and has been shown to be effective. Access to OST outside of specialised public clinics and prisons relies on the participation of general practitioners. In Australia there is a shortage of GPs available to prescribe OST, which results in an unmet need for OST services. Studies have reported barriers to GP involvement in drug and alcohol work and there is little research looking at the perceptions and experiences of GPs involved in prescribing OST. Method: Semistructured qualitative interviews were conducted with eight experienced prescribers of OST in general practice settings in South Australia. Results: All participants described similar positive and negative aspects associated with prescribing OST. Some participants commenced prescribing in such a manner as to limit the scope of their involvement. Ceasing OST prescribing was not necessarily linked to negative experiences. Exprescribers indicated that they were unlikely to recommence prescribing. Discussion: This study has limited generalisability due to the small sample size but it does highlight some insights that can be gained from talking to experienced OST prescribers.