General Practice and Other Primary Care Settings

There is substantial under-recognition of unhealthy alcohol use in primary care settings. At a global level, up to 60% of patients with alcohol use disorder are not detected when practitioners rely solely on their clinical judgments. Data from Australian and global contexts indicate that screening and early intervention in primary care settings is effective in reducing alcohol intake and cost effective. Detection and brief intervention activities should therefore be encouraged in general and relevant specialist medical practices. Because of their role in primary health care and their high rate of contact with the general public, general practitioners are ideally placed to detect and offer patients help with drug and alcohol problems. 

Several initiatives to encourage screening in Australian general practice settings exist. They include the Smoking, Nutrition, Alcohol and Physical Activity (SNAP) framework for general practitioners (University of New South Wales) and the Drink-Less program (University of Sydney). 

Data from Australian and global primary care providers has identified a number of barriers to the implementation of early detection and screening. Key amongst those identified were (i) lack of institutional support or time, (ii) stigma and stereotypes of “problem drinking”, and (iii) perceived threat to the patient-doctor relationship.