Division of General Internal Medicine, University of Pennsylvania School of Medicine, 1123 Blockley Hall/6021, 423 Guardian Drive, Philadelphia, PA 19104, USA.
Curr Psychiatry Rep. 2009 Oct;11(5):345-52. doi: 10.1007/s11920-009-0052-7.
Despite the high prevalence of problem drinking among Americans, primary care physicians often fail to address this major health threat. In addition, once alcohol use disorders are identified, patients often fail to receive coordinated medical and substance abuse treatment. This article reviews four types of barriers as well as potential facilitators to improving the prevention and management of problem drinking. First, primary care physicians are poorly trained about the clinical relevance of addressing alcohol problems in their daily patient care. Second, primary care physicians are concerned about the stigma and health insurance problems encountered by patients diagnosed with alcohol use disorders. Third, primary care practices have limited organizational and financial support to identify and address alcohol problems. Fourth, primary care and alcohol treatment settings communicate and collaborate poorly in delivering patient care. Opportunities to overcome these challenges are discussed and must be initiated to reduce the myriad of adverse outcomes resulting from problem drinking.
尽管美国人酗酒问题普遍存在，但初级保健医生往往未能解决这一重大健康威胁。此外，一旦确定存在酒精使用障碍，患者往往无法接受协调一致的医疗和药物滥用治疗。本文综述了四种类型的障碍以及改善酗酒预防和管理的潜在促进因素。首先，初级保健医生在日常患者护理中解决酒精问题的临床相关性方面接受的培训很差。其次，初级保健医生担心被诊断患有酒精使用障碍的患者会遇到污名化和医疗保险问题。第三，初级保健实践在确定和解决酒精问题方面的组织和财务支持有限。第四，初级保健和酒精治疗环境在提供患者护理方面沟通和协作不佳。讨论了克服这些挑战的机会，必须发起这些机会来减少因酗酒导致的众多不良后果。
