Preventing drug habits by changing physician habits: Obstacles and opportunities.

Abstract

Primary care physicians are strategically placed in their relationship with families to engage in the primary prevention of drug abuse in their practices and communities. The cluster of family warning signs for identifying individuals at high risk for drug abuse that has begun to emerge from the clinical literature is described. Other modes of primary prevention of drug abuse in primary care are described, including appropriate physician prescribing practices, continuity of care, anticipatory guidance through the family life cycle, family-centered drug education, and the expansion of the social support networks of at-risk patients and families. Family interventions with individuals with drug problems may serve as important primary prevention strategies for other family members who are at-risk. Obstacles to primary prevention of drug abuse by family physicians are described, including necessary conceptual shifts, existing knowledge deficits, attitudinal barriers, financial disincentives, and patient expectations.