Services need to be adequately resourced

EDITOR,—I am sympathetic to Edwin Martin's view that training in substance misuse for general practitioners is lacking.1 Shared care for drug misuse will fail unless specialists in substance misuse and those working in primary care coordinate their efforts and are trained; a sense of failure and frustration will in turn be transmitted to patients. When shared care works effectively it has a significant effect on harm reduction, including a demonstrable impact on the level of drug related crime in the community.2

Unfortunately, current levels of specialist provision in the management of substance misuse are too low, and specialist training is unevenly developed throughout Britain. The report on the mental health of the nation by the Royal College of Psychiatrists in 1992 identified a need for 0.6 whole time equivalent consultants in substance misuse per 100000 population.3 The number of consultant sessions in substance misuse needs to increase fourfold if general practitioners are to receive anything approaching a proper level of support and locally based training for this complex task. If the rhetoric surrounding tackling drug problems together is to be given any meaning then the services need to be adequately resourced.