ISSN 09595235 print/ISSN 14653370 online/00/02016506 © Australian Professional Society on Alcohol and Other Drugs Drug and Alcohol Review (2000) 19, 165170 George Abouyanni MB, BCh, CertAMC, Dip Paed, FRACGP, Leonie. J. Stevens RGN, RMRN, RPN, Mark F. Harris MBBS, DRACOG, FRACGP, MD, Wendy A. Wickes MBBS BSc(Hon), Smita S. Ramakrishna MBBS, Eng Ta MBBS, Sheila M. Knowlden MBBS, FRACGP, Department of General Practice, Fairfield Hospital, PO Box 5, Fairfield, New South Wales 2165, Australia. Correspondence to Professor Mark Harris, Department of General Practice, Fairfield Hospital, PO Box 5, Fairfield, New South Wales 2165, Australia. Received 12 January 1999; revised version 3 August 1999; accepted for publication 24 November 1999. GP attitudes to managing drug- and alcohol-dependent patients: a reluctant role GEORGE ABOUYANNI, LEONIE J. STEVENS, MARK F. HARRIS, WENDY A. WICKES, SMITA S. RAMAKRISHNA, ENG TA & SHEILA M. KNOWLDEN Department of General Practice, Fairfield Hospital, Fairfield, New South Wales, Australia Abstract The aim of this study was to determine the experience, confidence and views of GPs in South West Sydney towards managing drug and alcohol dependence and their interest in participating in shared care methadone prescribing. Five hundred and forty-eight GPs were mailed a self complete questionnaire. Non-responders were followed-up by telephone. Seventy-six per cent of GPs responded; 52% considered methadone maintenance to be effective. GPs were more confident managing smoking than alcohol and benzodiazepine dependence and least confident in illicit drug dependence. Fifty per cent reported having no patients on methadone and 40% between one and five patients. GPs in Fairfield and Liverpool reported having most patients; 25% were interested in prescribing methadone for patients in their own practice and 17% for patients referred to them. GPs who had more patients on methadone in their practice (especially those in Fairfield and Liverpool) considered methadone effective and were more likely to be interested in having patients referred to them. The most frequent reasons for not being interested were concerns about patients being demanding or aggressive or the impact on their practice. The most frequently requested support for shared care prescribing was for 24-hour back-up from specialist services, especially requested by those with less experience with patients on methadone. A shared-care approach to facilitating greater GP involvement in prescribing appears feasible, especially among GPs with some previous experience with patients on methadone. [Abouyanni G, Stevens LJ, Harris MF, Wickes WA, Ramakrishna SS, Ta E, Knowlden SM. GP attitudes to managing drug- and alcohol-dependent patients: a reluctant role. Drug Alcohol Rev 2000;19:165170] Key words: general practice, drugs, alcohol, methadone, shared care.