Controlled drug use

Many users do not wish to give up drugs, and the treatment aim is therefore 'harm reduction'. Advice includes instruction on safer injection techniques, giving out clean needles to reduce needle sharing, and encouraging change from injected to oral drugs. Some teams adopt an 'assertive outreach' approach to drug users who lack the initiative to seek regular help for themselves.

Physical complications often need attention, and many addicts have social difficulties or personality problems for which extensive and prolonged help may be given, to uncertain effect. There are no accurate statistics on outcome of treatment, and results must be considered in relation to the natural history of drug misuse as a behaviour of adolescence and young adulthood that tends to die away in later life.

Treatment services vary greatly around the country. Informal, advice-based services are common, and may be run by a charity, a local authority, or health services; community drug teams are often part of mental health services. Some GPs (http://www.smmgp.org.uk/index.php) have developed a special interest in the area.

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