Early intervention in the general practice setting

There is a growing pressure on general practitioners to become more involved in the detection and management of alcohol related problems. However, there is evidence to suggest that general practitioners are unaware of the alcohol consumption of many of their patients, and even when they are aware that their patients are drinking too much, they are reluctant to manage these problems. This paper discusses some of the reasons why general practitioners avoid dealing with their heavy drinking patients. It is argued that advising patients to modify their alcohol consumption should be viewed as an exercise in health promotion, analogous to advising them to stop smoking or lose weight. The disease model of alcoholism, which is adhered to by many general practitioners, is seen as an impediment to the effective management of heavy drinkers within general practice.