Addiction and managing patients with substance use disorders was one of the farthest things from my mind when I entered medicine. Indeed, I was the general practitioner who 'refused to prescribe and would show people the door' if I was concerned about the medications they were taking. I used to feel that addiction was a problematic behaviour and that 'people should pull their socks up and straighten up'. I was concerned that I would be pushed to prescribe medications I was not comfortable prescribing or act in an unsafe manner. I was worried about me!
However, a funny thing occurred. The more people I started seeing with substance use disorder the more I started to recognise that addiction and substance use disorder was a medical problem. I saw that a lot of patients with substance use disorder had significant trauma histories or had sustained some great emotional hurt and responded well to kindness, empathy and compassion.
I also reviewed the literature and recognised that there were treatment protocols, paradigms and management plans for substance use disorder-backed up with high level evidence. I soon realised that addiction medicine was a fascinating area where a lot of patients go untreated or undertreated and simple interventions and linkages to services can have outsized effects and benefits. In short I realised that addiction and substance use disorder was a fascinating and intriguing area that was worth exploring in depth.