[Excessive alcohol consumption and the role of the general practitioner. When and how should he react?]

Patients who are excessive drinkers, at different degrees of severity, are frequent in a general practice consultation. These patients are at risk of developing several medical and psychosocial complications and to evolve towards a worsened situation. This condition is frequently under diagnosed and not considered during consultations, the patients seldom asking for help and frequently reluctant to talk about that issue. It is worthwhile to look for excessive alcohol consumption and dependence, and to discuss it with the patient. It is possible to increase motivation for change and to positively influence the consumption outcome. Moreover it is necessary to conduct early intervention, because the older the behaviour is the more difficult it is to change. We present here several attitudes and strategies that may be useful to increase motivation for change, and that can be used to complement those each general practitioner is already fruitfully using.