Tackling alcohol misuse: opportunities and obstacles in primary care

Alcohol misuse is a major public health issue. Primary care has been recognized as an ideal setting for the health promotional activity needed to reduce the general population's alcohol consumption. This paper explores the background to the current belief that primary care is suitable for this work by examining the evidence of the potentially successful interventions the general practitioner (GP) can undertake with alcohol misusing patients, GPs' attitudes towards this work, and the impediments that exist. Computer searches of the MEDLINE database up to 1997 and a manual literature search of the bibliographies of published papers that were identified as relevant were carried out. Research points to GP interventions being effective, but it also provides evidence of their negative attitudes. It concludes that more training and support from local services are needed if primary care is to meet its rich potential.