For the next two days , the conference would look at the role and the culture of shared care , as well as topping up the expertise and knowledge base on specific subjects and medicines . How could GPs , their patients , addiction professionals , and experts by experience help to

change the landscape together ?

‘ Addiction can affect us all ,’ said Dr Victoria Tzortziou Brown , vice chair of RCGP . It was important to recognise that it involved many complex problems , and ‘ the solutions won ’ t come from medicine alone .’ Services needed a holistic and person-centred approach to care , informed by experts by experience , and what came out ‘ loud and clear ’ from this was that ‘ what we say and do when approached matters a lot ’. She gave feedback from patients at a GPs ’ surgery to illustrate the point :

‘ I need to be comfortable with somebody . If I feel judged I won ’ t go back .’

‘ To not be treated like a person knocks you back .’

‘ The receptionist apologised about me to other people in the waiting room and sprayed the room with air freshener .’

The challenge was to combine science with compassion , even though compassion was not easy to measure , she said . In a later session ( which was primarily about prescribing for chronic pain ), Dr Cathy Stannard , clinical lead at NHS Gloucestershire , said ‘ 84 per cent of the factors that influence a person ’ s total health are found outside clinical care . So we need to address all the other things going on in a person ’ s life .’

BIGGER CHALLENGES But first to business , and taking the stage for a progress report on the government ’ s strategy From harm to hope , Professor Dame Carol Black acknowledged that ‘ challenges have been bigger than expected in some areas ’.

‘ Drug-related deaths haven ’ t gone down , and the most likely reason is that we ’ re not finding the people who need treatment ,’ she said . ‘ So we need to persuade them that treatment is now better , and to have faith in us .’ The

The conference opened with a tribute to Lee Collingham , advocate , harm reduction activist , campaigner – and someone who had shared his experience and taught the shared care community so much . He died recently from cancer , but would be remembered with great fondness , said Dr Stephen Willott .

other contributory factor was an aging population of opioid users with failing health due to other illnesses – conditions that might ‘ tip them over the edge ’. So ‘ we won ’ t have been able to hit the target by the funding deadline – and we need to explain that ’ to the treasury , she said .

For drugs other than opioids , especially crack cocaine , treatment numbers were improving , including for young people . But we had to redouble our efforts to find people with problematic opioid addiction and attract them to treatment that felt relevant to them . The other important conclusion from her review was that ‘ prison doesn ’ t help many people at all ’ and that support on release , including housing ( a ‘ red flag ’), was wholly inadequate . ‘ The prison system should be an enormous opportunity for therapeutic intervention – it isn ’ t , but it should be , and we ’ re trying to change that ,’ she said .

Repairing and growing the workforce was another distinct challenge . ‘ What was distressing to me was the demoralisation ,’ she said , and it would take ‘ an amount of effort and time to reverse that ’. Many GPs had drifted

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