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Attitudes of family physicians towards adolescent cannabis users: a qualitative study in France
Philippe Vorilhon1, Valérie Picard2, Laurent Marty3
1Department of General Practice, Faculty of Medicine, University of Auvergne, 28 place Henri Dunant, 63001 Clermont-Ferrand, Faculty of Medicine, EA 4681, Périnatalité, grossesse, Environnement, Pratiques médicales et Developpement, 28 place Henri Dunant, 63001 Clermont-Ferrand, pvorilhon2@wanadoo.fr.
Background:
GPs are the health professionals most frequently consulted by adolescents. However, discussion between GPs and adolescents regarding cannabis use does not occur spontaneously.
Objective:
To identify obstacles to the identification and management of cannabis use by adolescents based on GPs' experiences.
Methods:
We conducted a qualitative study using focus groups of GPs from the Auvergne area (France). The GPs were selected according to descriptive and strategic variables. Three researchers--an anthropologist, a psychiatrist with expertise in addiction and a GP--performed a thematic analysis.
Results:
Twenty-four GPs participated in three consecutive focus groups. The GPs were aware of the health risks of cannabis, yet ambivalent about its use by adolescents. The GPs also reported a lack of patient questioning during consultation. The obstacles to the identification and treatment of cannabis use by adolescents identified included lack of GP knowledge about cannabis (e.g. consumption patterns and laws); difficulties in addressing the issue with adolescents, evaluating adolescents' consumption and its impact and proposing support and follow-up and the presence of parents. The GPs were aware that their role lies at the intersection between the medical, personal, familial and social fields.
Conclusion:
Despite these barriers, GPs are willing to ask adolescents about their cannabis use. An adolescent's awareness, environment and receptiveness favour a sustainable therapeutic relationship. Brief intervention is a tool that may be of assistance in this relationship and allow GPs to take the initiative.
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