Skip to main content
NCBI home page
The British Journal of General Practice logoLink to The British Journal of General Practice
. 1997 Nov;47(424):705–709.

The general practitioner, the drug misuser, and the alcohol misuser: major differences in general practitioner activity, therapeutic commitment, and 'shared care' proposals.

A Deehan 1, C Taylor 1, J Strang 1
PMCID: PMC1409931  PMID: 9519515

Abstract

BACKGROUND: The primary care setting has been regarded in government policy and the scientific literature as an ideal setting for the work needed to meet the Health of the Nation drug and alcohol targets. Although studies have pointed to the negative attitudes held by general practitioners (GPs) towards alcohol- and drug-misusing patients, there has been no direct comparison of the work and attitudes of the GP towards these patients. AIM: To compare the work and attitudes of GPs towards alcohol- and drug-misusing patients. METHOD: All GPs in an outer London area (157 doctors) were surveyed, using an eight-page postal questionnaire, collecting clinical and attitudinal data alongside demographics and practice information. A response rate of 52% was achieved. RESULTS: General practitioners reported working with only 3.5 patients drinking above recommended guidelines in the previous four working weeks, and even fewer drug-using patients (0.75). While they viewed the alcohol-misusing patients negatively, the drug misuser elicited substantially more negative attitudes. The primary care setting was seen as appropriate to work with the alcohol-misusing patient but not with drug users. Training and support from local services would encourage substantially more GPs to work with alcohol misusers but not with drug misusers. CONCLUSIONS: Our findings indicate that there are some cautious grounds for optimism that GPs are willing to work with alcohol misusers; however, with regard to drug misusers, we find a GP workforce that is only minimally involved with this group and would not be greatly encouraged by the provision of additional training, support, or incentives. The Health of the Nation targets are not being met, and GPs are not detecting adequate numbers of the patients at whom these targets are aimed. Emphasis has been placed on the role of primary care, but the real achievements that can be made require detection of the less severe drinkers and injecting drug misusers.

Full text

PDF
705

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson P. Managing alcohol problems in general practice. Br Med J (Clin Res Ed) 1985 Jun 22;290(6485):1873–1875. doi: 10.1136/bmj.290.6485.1873. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Baker R. Research in general practice. Br J Gen Pract. 1993 Jul;43(372):307–307. [PMC free article] [PubMed] [Google Scholar]
  3. Bowling A., Jacobson B., Southgate L., Formby J. General practitioners' views on quality specifications for "outpatient referrals and care contracts". BMJ. 1991 Aug 3;303(6797):292–294. doi: 10.1136/bmj.303.6797.292. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Buchan I. C., Buckley E. G., Deacon G. L., Irvine R., Ryan M. P. Problem drinkers and their problems. J R Coll Gen Pract. 1981 Mar;31(224):151–153. [PMC free article] [PubMed] [Google Scholar]
  5. Bucknall A. B., Robertson J. R., Foster K. Medical facilities used by heroin users. Br Med J (Clin Res Ed) 1986 Nov 8;293(6556):1215–1216. doi: 10.1136/bmj.293.6556.1215. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cartwright A. Professionals as responders: variations in and effects of response rates to questionnaires, 1961-77. Br Med J. 1978 Nov 18;2(6149):1419–1421. doi: 10.1136/bmj.2.6149.1419. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Cockburn J., Campbell E., Gordon J. J., Sanson-Fisher R. W. Response bias in a study of general practice. Fam Pract. 1988 Mar;5(1):18–23. doi: 10.1093/fampra/5.1.18. [DOI] [PubMed] [Google Scholar]
  8. Fullard E., Fowler G., Gray M. Facilitating prevention in primary care. Br Med J (Clin Res Ed) 1984 Dec 8;289(6458):1585–1587. doi: 10.1136/bmj.289.6458.1585. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Glanz A., Taylor C. Findings of a national survey of the role of general practitioners in the treatment of opiate misuse: extent of contact with opiate misusers. Br Med J (Clin Res Ed) 1986 Aug 16;293(6544):427–430. doi: 10.1136/bmj.293.6544.427. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. King M. At risk drinking among general practice attenders: prevalence, characteristics and alcohol-related problems. Br J Psychiatry. 1986 May;148:533–540. doi: 10.1192/bjp.148.5.533. [DOI] [PubMed] [Google Scholar]
  11. McDonald P. Response rates in general practice studies. Br J Gen Pract. 1993 Nov;43(376):484–484. [PMC free article] [PubMed] [Google Scholar]
  12. McKeganey N. Shadowland: general practitioners and the treatment of opiate-abusing patients. Br J Addict. 1988 Apr;83(4):373–386. doi: 10.1111/j.1360-0443.1988.tb00483.x. [DOI] [PubMed] [Google Scholar]
  13. Templeton L., Deehan A., Taylor C., Drummond C., Strang J. Surveying general practitioners: does a low response rate matter? Br J Gen Pract. 1997 Feb;47(415):91–94. [PMC free article] [PubMed] [Google Scholar]
  14. Wallace P., Cutler S., Haines A. Randomised controlled trial of general practitioner intervention in patients with excessive alcohol consumption. BMJ. 1988 Sep 10;297(6649):663–668. doi: 10.1136/bmj.297.6649.663. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners

RESOURCES