There is wide agreement that substance abuse, like other chronic conditions, requires effective mana

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• There is wide agreement that substance abuse,
  like other chronic conditions, requires effective
  management, in which GPs play a role .

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What do we know about GPs and AD?

• their attitudes
• their role
• their training
• their relationships with the AD service system
• their existing support services within AD
• the current reality

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How can GP involvement in AD service system be
improved?

• compare to working with clients
• appreciate GPs perspective
• assess their stage of change
• support and encourage
• provide choices
• plenty of room for outreach

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• CASE DISCUSSION

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Client history number one

• Male age 44
• Alcohol acquired brain injury
• Cognitive impairment moderate to severe
• Alcohol related chronic health issues
• peripheral neuropathy
• advanced liver disease
• Partner providing 24 hour care
• Multiply bone fractures - alcohol intoxication
  contributing factor
• Depression and anxiety but no mental health
  service involvement
• G.P. and drug treatment providing only service
  support

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Client number one outcome following collaboration

• Chronic health issues managed in collaboration
• Palliative care
• District nurses
• Brokerage personal care attendant
• Carer support and extensive extended family
  involvement
• Drug treatment providing support and secondary
  consultation role
• Client died with dignity and surrounded by family

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Client history number two

• Male age 48
• Alcohol and trauma acquired brain injury
• Cognitive impairment severe
• Chronic health issues
• Cardiac coronary artery disease
• Peripheral vascular disease
• Peripheral neuropathy
• Liver disease alcohol related
• Ex partner and children providing full time
  support
• Multiply services involved from disability,
  mental health, drug treatment all aspects, GP,
  HACC.
• Mental health service involvement
• Suicide attempts x 10
• Crisis presentation x numerous management plan
  developed

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Client number twooutcome following collaboration

• Dramatic reduction in services involved
• Planned and managed withdrawal episodes
• Chronic health issues managed in conjunction with
  ongoing alcohol use
• Nil reported suicide attempts/crisis
  presentations to mental health for 2 years
• NFR order removed
• Independent living with supports
• ABI Case Management moved to Linkages with
  brokerage
• Carer provided support but significant issues
  raised separate to client.

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