Stephen is a GP at the Windmill practice in the inner city of Nottingham & has worked there for the past 20 years. He also works as a “GP for the homeless” at the local Friary Drop-in; in both roles he sees a wide variety of people who use alcohol & other drugs, often in harmful ways. Twice weekly he works as a specialist for the city’s alcohol service. He has a public health role with Nottingham city council as clinical lead for alcohol, substance misuse and blood borne viruses. Finally he is the national chair for the RCGPs “Managing Drug and Alcohol Problems in Primary Care” conference, now in its twenty-fourth year. 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