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

Abstract

Background

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.

Aims

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

Methods

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.

Results

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.

Conclusions

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.

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Notes

  1. ‘Project Steering Committee’ members (www.drugsandalcohol.ie/15260)

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Acknowledgements

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 (www.drugsandalcohol.ie/15260). 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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Corresponding author

Correspondence to W. Cullen.

Additional information

The Problem Alcohol/Drug Use Guideline Development Group (PADU-GDG) in 2011-12 included 21 members, for complete listing of experts, see Appendix.

Complete listing of authors (PADU-GDG)

Complete listing of authors (PADU-GDG)

Rolande Anderson

Counselling Consultant, the Charlemont Clinic, Dublin 2, e-mail: rolandea@eircom.net

Joseph BarryFootnote 1

Department of Public Health and Primary Care, TCD and Health Service Executive, e-mail: joebarry@tcd.ie

Declan Bedford

Department of Public Health, Health Service Executive North East Area, Navan, e-mail: declan.bedford@maile.hse.ie

Margaret Bourke

Addiction Treatment Services, South Western Area Health Board, e-mail: margaret.bourke@hse.ie

Gerard Corrigan

Medical Centre, Ballingarry, Co. Limerick, e-mail: rylanesmedicalcentre@yahoo.com

Walter Cullen*

General Practitioner and Professor, Graduate Entry Medical School, University of Limerick (UL), e-mail: walter.cullen@ul.ie

Joseph Doyle

National Rehabilitation Coordinator, Integrated Services Directorate, HSE, Dublin, e-mail: joseph.doyle@hse.ie

Catherine Anne Field*

Project Researcher / PhD student, School of Medicine and Medical Science, UCD, e-mail: catherine-anne.field@ucd.ie

Jean Flanagan

Hepatitis C Liaison Nurse Specialist, Addiction Services, HSE Northern Area, e-mail: jean.flanagan@hse.ie

Hugh Gallagher

Addiction Treatment Services, HSE Northern Area & Solas Clinic, e-mail: hugh.gallagher@hse.ie

Noreen Geoghegan

Nurse Manager, Addiction Services HSE Dublin, e-mail: noreen.geoghegan@hse.ie

Kieran Harkin

General Practitioner, Inchicore Medical Centre, Dublin 8, e-mail: kieran@inchicoredoctors.ie

Eamon Keenan*

Addiction Services, Health Service Executive, e-mail: eamon.keenan@hse.ie

Jan Klimas*

Project Researcher, UCD and UL, e-mail: jan.klimas@ucd.ie

John Lambert

Consultant physician, Mater Misericordiae University and Rotunda Hospitals, e-mail: john.lambert@ucd.ie

Ruaidhri McAuliffe

Union for Improved Services Communication and Education, Dublin (UISCE), e-mail: uiscepost@hotmail.com

Mary Ellen McCann

School of Applied Social Science, University College Dublin (UCD), e-mail: mary.mccann@ucd.ie

Aiden McCormick

Department of Hepatology, St Vincent’s University Hospital, Dublin, e-mail: a.mccormick@ucd.ie

Denis O’Driscoll

Chief Liaison Pharmacist, HSE Dublin Mid-Leinster, e-mail: denis.odriscoll@hse.ie

Colin O’Gara

Department of Psychiatry, Saint John of God Hospital, Stillorgan, County Dublin, e-mail: colin.ogara@sjog.ie

Nicola Perry

Community Response, Meath St, Dublin 8, e-mail: nicolaper@gmail.com

Bobby Smyth*

Addiction Services, Health Service Executive, e-mail: bobby.smyth@hse.ie

Fiona Weldon

Rutland Centre, Templeogue, Dublin, e-mail: fionaweldon@rutlandcentre.ie

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Klimas, J., Cullen, W., Field, CA. et al. Problem alcohol use among problem drug users: development and content of clinical guidelines for general practice. Ir J Med Sci 183, 89–101 (2014). https://doi.org/10.1007/s11845-013-0982-2

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Keywords

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