Family doctors key to spotting alcohol abuse, researchers say

More than one million Canadians suffer from alcohol use disorder in any given year. But most never get the professional help they need, according to researchers at the Centre for Addiction and Mental Health (CAMH) in Toronto.

“The key are family physicians,” said Jürgen Rehm, a senior scientist at CAMH and senior author of an article published in the medical journal the Lancet. 

Rehm says routine screening should start in the doctor’s office, and should be followed up with specialized care if needed.

“General practitioners should regularly ask patients about their alcohol intake,” he said. But these interventions are rare in Canada and elsewhere.

Despite their significant public health impact, alcohol use disorders remain some of the most undertreated mental disorders, say the authors. One of the main reasons, according to Rehm, is the stigma associated with alcoholism.

Alcohol abuse is undertreated partly because of the stigma associated with alcoholism, says Jürgen Rehm, a senior scientist at CAMH. (Craig Chivers/CBC)

Patients often avoid going to their doctor or conceal their alcohol consumption, and some doctors just won’t ask about it.

“The stigma works both for the patients and the doctors,” Rehm told CBC News. 

Iris Gorfinkel, a family doctor in Toronto, has been seeing patients with alcohol problems for 25 years. She admits doctors can stigmatize alcohol disorders, but says talking about addiction is a two-way conversation.

“Part of my role is setting a stage for normalcy to have a good conversation about just how much they’re drinking,” she said. “To create a safe zone … it’s very much a back and forth.”

“Instead of thinking about alcohol in terms of being reactive … I have to start thinking more preventatively. I have to start identifying them before they get to be drinking that much.” 

Jamie Game says alcohol was a big part of his life, and he was pretty close to rock bottom when he went to see his family doctor. 

“My drinking was getting out of hand,” he said. “I was in dire straits. I needed some help.”

Even though his doctor was “old school,” Game wasn’t prepared for his answer. 

“He said, ‘Well then, just don’t drink so much.'”

In the end, his doctor did recommend treatment. But only after Game says he insisted on it. Now 57, he’s been sober for eight years.

Jamie Game says he had to insist on treatment from his family doctor when he needed help with his drinking. (Craig Chivers/CBC)

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