[Increasing trends in screening for addictives behaviors among general practitioners in France]

Make an inventory of screening of addictive behaviours among general practice since the end of the 1990s.

A representative sample of 2,083 general practitioners was surveyed in 2008/2009. They were asked about their prevention practices.

Two thirds of the general practitioners (GPs) reported discussing tobacco consumption at least once with each patient. This assessment was less systematic for alcohol (23% of GPs) and cannabis (8% of GPs). Approximatively 70% reported addressing cannabis or alcohol use issues only with patients at risk. One third reported using tobacco smoking screening questionnaires, while there were only 6% in 2003. Only 13% of GPs used alcohol standardized questionnaires, a clear rise since 1998 (1.4% in 1998, 2.0% in 2003). Using alcohol standardized screening tests was more frequent among GPs belonging to a drug addiction network, but no significant link was found with gender, age or area. Only 2% of GPs used cannabis use screening tests. The care for cannabis users seemed particularly linked to the practitioners' inclination to discuss this issue without waiting for a demand arising from the patient. The proportion of practitioners reporting helping patients kick their nicotine addiction in the last seven days proved stable since 2003, after a very significant increase between 1998 and 2003. The proportion of GPs reporting seeing a patient for an alcoholic weaning (52%) was stable since 1998.

This study illustrates the development of addiction care practices integrating smoking cessation help and, to a more limited extent, screening of alcohol and cannabis abuse, evidenced by the expanded application of standardized questionnaires in general practice. Consideration given to cannabis and alcohol use assessment appeared correlated to GPs feeling at ease with addressing drug use issues, this feeling being linked to their ability to rely on institutional directives or validated screening tools. It seems thus important to encourage the implementation of a health educational approach including early screening and brief intervention during consultation.