Irish Journal of Medical Science

, Volume 183, Issue 1, pp 89–101 | Cite as

Problem alcohol use among problem drug users: development and content of clinical guidelines for general practice

  • J. Klimas
  • W. Cullen
  • C.-A. Field
  • The Problem Alcohol/Drug Use Guideline Development Group
Original Article



Problem alcohol use is common and associated with considerable adverse outcomes among patients who attend primary care in Ireland and other European countries for opiate substitution treatment.


This paper aims to describe the development and content of clinical guidelines for the management of problem alcohol use among this population.


The guidelines were developed in three stages: (1) identification of key stakeholders, (2) development of evidence-based draft guidelines, and (3) determination of a modified ‘Delphi-facilitated’ consensus among the group members.


The guidelines incorporate advice for physicians on all aspects of care, including (1) definition of problem alcohol use among problem drug users, (2) alcohol screening, (3) brief intervention, and (4) subsequent management of patients with alcohol dependence.


Primary care has an important role to play in the care of problem alcohol use among problem drug users, especially opiate substitution patients. Further research on strategies to inform the implementation of these guidelines is a priority.


Clinical guidelines Brief interventions Poly-drug use Alcohol and other drug use Primary care Methadone maintenance 



All authors reviewed and approved the final draft of this manuscript. A core group of authors prepared this manuscript (JK, WC, CAF). A complete list of the members of the ‘Problem Alcohol/Drug Use Guideline Development Group (PADU-GDG)’ is at the end of this manuscript. The authors would like to thank the Health Research Board in Ireland who provided a research project grant for this work ( A limited portion of this manuscript was presented at the Annual Scientific Meeting Association of University Departments of General Practice in Ireland, hosted by the Royal College of Surgeons in Ireland on 9 March 2012 in Dublin.

Conflict of interest

The authors acknowledge that they have no conflict of interests regarding this study.


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Copyright information

© Royal Academy of Medicine in Ireland 2013

Authors and Affiliations

  • J. Klimas
    • 1
    • 2
  • W. Cullen
    • 1
    • 2
  • C.-A. Field
    • 2
  • The Problem Alcohol/Drug Use Guideline Development Group
  1. 1.Graduate Entry Medical School, Faculty of Education and Health SciencesUniversity of LimerickLimerickIreland
  2. 2.UCD School of Medicine and Medical ScienceCoombe Healthcare CentreDublin 8Ireland

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