Martyn Hull is a GP Principal, Lead GPSI in substance misuse for Birmingham and Clinical Director of Turning Point, a national social enterprise providing health and social care services in over 300 locations across England.
Martyn is also a substance misuse specialist with experience in the community in primary and secondary care, and within in-patient and secure environment settings. Prior to his current role, he worked as Clinical Lead for the integrated drug and alcohol service in Sandwell, and as Swanswell’s inaugural Medical Director.
He currently sits on the PHE Expert Reference Group on prescribed medications that may cause dependence and the PHE OST Good Practice Working Group and has contributed to guidelines and policy with particular reference to primary care’s role in substance misuse management. He has no sources of funding.
SMMGP Session: Health consequences of addiction: Liver health, alcohol and hepatitis C
Kate Halliday – Liver health, alcohol and hepatitis C
Stephen Willott – Alcohol Dependency: Red flags to look out for
Martyn Hull – Early identification of Alcohol Harm and how can we reduce this in the primary care setting?
This session will consider two of the main factors associated with drug and alcohol use that can have an adverse effect on liver health: hepatitis C and alcohol. It will also address the related issues in both cases regarding the early identification of risk and access to appropriate treatment options.
We will briefly summarise the effect of hepatitis C on the liver.
We will then explore the optimisation of testing in primary care using a multi-agency approach across primary and secondary care, identifying potential barriers. The session will describe different testing methods, staff education, and suitable pathways in primary care.
An overview of current treatment for hepatitis C – and particularly a consideration of the issues pertaining to access and uptake of treatment – will also be discussed.
The potential effect of alcohol on the liver – and briefly other physical sequelae of alcohol use – will be assessed.
We will then consider alcohol use in the context of early identification of problematic drinking in the primary care setting. We will explore the process of screening for hazardous and harmful level drinking in practice, how to share risk with patients in a meaningful way, and how to optimise access to appropriate treatment. This approach will be considered in the context of non-dependent versus dependent alcohol users, and the differences in approach that may be required.
Finally we will cover Red Flags for alcohol problems including:
How to identify high-functioning dependent drinkers
Sudden stopping of drinking
Domestic violence and safeguarding
Mental health issues, including suicide risk
Drinkers presenting in crisis