Alcohol and primary health care: a difficult way towards integration

Abstract

Alcohol consumption and alcohol related problems expand through a continuum that ranges from occasional drinking to severe dependence. According to that, Health authorities must guarantee a continuity of care, that starts with health education and early identification of risky drinkers, and finishes at residential centers for severely impaired alcoholics. Primary Health Care Centers should focus on early identification of risky drinkers, delivery of brief interventions to reduce alcohol consumption, and appropriate referral of severe cases to specialized centers. Two key points seem to be crucial to ensure continuity of care: appropriate training of Primary Health Care professionals, and good coordination between Primary Health and specialized services. Training is feasible when integrated in the regular CME hours already existing in Primary Health Care Centers. Alcohol specialists with whom coordination will be established later on, may also act as trainers. Finally, it is stated that preventive activities in Primary Health Care should be recognized and incentivated through contractual measures. Some health authorities have already started to use this strategy but they have not been evaluated yet...