The following is a summary of “Expectations and needs of people with illicit substance use disorders in general practice: a qualitative study in Belgium,” published in the August 2024 issue of Primary Care by Richelle et al.

Individuals who use illicit drugs often face compounded medical and psychosocial challenges, necessitating a comprehensive, holistic approach to healthcare. However, barriers to accessing adequate care frequently arise, both from healthcare providers and the patients themselves, leading to suboptimal health outcomes. This study aimed to explore the specific needs and expectations of patients with substance use disorders in general practice settings.

A qualitative research approach was employed, utilizing semi-structured interviews with 23 individuals diagnosed with illicit substance use disorders in Brussels in 2020. Participants were recruited from multiple centers to ensure a diverse mix of sociodemographic backgrounds and healthcare experiences. Thematic analysis of the interview data was conducted using RQDA package software, enabling an in-depth exploration of the participants’ perspectives.

The study revealed several key vulnerabilities among the participants. A significant finding was the pervasive self-stigmatization and guilt experienced by many, often to the point of self-dehumanization, even after years of medical treatment. These emotional and psychological burdens were compounded by the frequent masking of suicide attempts through overdoses and the early onset of memory disorders. The interviews also highlighted a prevalent pattern of multiple substance use, including widespread smoking and the misuse of benzodiazepines among nearly all participants.

Despite these challenges, the majority of participants expressed a clear need for general practitioners (GPs) who are open-minded, non-stigmatizing, and empathetic, with a holistic approach to care that extends beyond the narrow focus on substance use disorders. Interestingly, the specific expertise of GPs in addiction medicine was deemed less critical by the participants compared to the importance of a compassionate, non-judgmental attitude. The ability of GPs to effectively coordinate care and collaborate with mental health networks was identified as a valuable asset in managing the complex health needs of these patients.

In conclusion, the study underscores the necessity for GPs to develop strong interpersonal skills characterized by a non-stigmatizing attitude and an empathetic approach to care. 

The role of the GP as a care coordinator, who addresses not only the medical aspects of substance use disorders but also the broader social determinants of health, emerged as a crucial element in meeting the needs of this vulnerable population. These findings highlight the importance of adopting a holistic, patient-centered approach in general practice to improve health outcomes for individuals with substance use disorders.

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02493-3