General practice involvement in the management of alcohol misuse: dynamics and resistances

Older adult patient--doctor communication regarding alcohol use: A qualitative study

“…There is a growing body of evidence to suggest that physician intervention among patients with either a potential for a drinking problem or an already established drinking problems is effective (Durand, 1994). Specifically, these results have been found in emergency room patients.…”

Alcoholism: The Self-Reinforcing Feedback Loop

“…The physical and cognitive consequences of alcohol-related problems impact negatively on the ability to engage with treatment (Dorrian, 2010;Williamson, 2009a). Stigma and stereotypes surrounding alcohol-related problems frequently damage crucial support relationships with friends and family (Dorrian, 2010;Schomerus et al, 2011) and healthcare professionals (Crothers & Dorrian, 2011;Durand, 1994). Despite this, research suggests that, at a global level, attempts to address alcohol-related issues are inadequate (Casswell & Thamarangsi, 2009).…”

“…Research suggests that positive, supportive, non-judgemental interactions with healthcare professionals are critical (Sacks & Keks, 1998). However, healthcare professionals may have negative attitudes to working with patients with alcohol-use disorders (Clay, Allen, & Parran, 2008;Durand, 1994), particularly professionals without specialist training in working with individuals with substance use problems (Albery et al, 1996). Among doctors, including General Practitioners, reported barriers include lack of training, inadequate expertise and time constraints (Durand, 1994;Geirsson, Bendtsen, & Spak, 2005), prejudice against individuals with alcohol-use disorders, and negative perceptions about the potential efficacy of treatment (Carr, 2011).…”

“…However, healthcare professionals may have negative attitudes to working with patients with alcohol-use disorders (Clay, Allen, & Parran, 2008;Durand, 1994), particularly professionals without specialist training in working with individuals with substance use problems (Albery et al, 1996). Among doctors, including General Practitioners, reported barriers include lack of training, inadequate expertise and time constraints (Durand, 1994;Geirsson, Bendtsen, & Spak, 2005), prejudice against individuals with alcohol-use disorders, and negative perceptions about the potential efficacy of treatment (Carr, 2011). To address some of these negative attitudes, it has been argued that understanding pharmacological as well as cognitive-behavioural treatments should facilitate practitioner optimism in treatment of people with alcohol-abuse issues, specifically, "an understanding of the biological reality of addiction allows physicians to understand addicts as having a brain disease" (Clay et al, 2008, p1 Carr, 2011, p9-10.…”

“…Only one in four people with alcohol-use disorders will pursue treatment, and most will approach their General Practitioner (Schuckit, 2009). Patients may be worried about health care professionals maintaining confidentiality (Gordon, Ettaro, Rodriguez, Mocik, & Clark, 2011), or may be concerned about the treatment approaches (Durand, 1994). However, the difficulties that the patient must contend with relating to stereotyping and stigma from the general community as well as healthcare professionals should not be underrated.…”