The identification and management of substance misuse problems by general practitioners

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Abstract
Central policy has increasingly encouraged general practitioners to be involved in treating patients with problems of substance misuse. A postal questionnaire was sent to all 416 general practitioners in the South East London Health Authority area to explore the extent of their identification and management of patients who smoke, or misuse alcohol or illicit opiates. A high response rate (78%) was achieved over three waves. Most doctors reported asking their patients about smoking and drinking and offering advice where a problem is found. Two-thirds of the general practitioners reported having seen at least one opiate misusing patient in the previous four weeks. More than a quarter reported always or often prescribing medication such as methadone for opiate misusing patients. Our findings differ from previous surveys and suggest that general practitioners may be becoming more active in the treatment of patients with problems of substance misuse.