Excessive substance use among young people consulting family doctors: a cross-sectional study

Background. Family doctors can only play a role in the prevention of excessive substance use in young people if those affected are seen in the practice. Objective. To describe the prevalence of excessive substance use among young people consulting family doctors in a European context. Methods. As part of a trial of an intervention addressing substance use we collected data from young people consulting 32 family doctors in the French-speaking part of Switzerland. Before the consultation, consecutive patients aged 15-24 years completed a self-administered questionnaire on their general health and substance use. Outcomes were excessive alcohol (defined as >= 1 episode of binge drinking), excessive cannabis (use >= 1/week), regular tobacco (>= 1 cigarettes a day) and/or any other substance use in the past 30 days. Prevalence data were computed with 95% confidence intervals (CIs) adjusted for clustering within practices, stratified by age and gender. Results. Between February 2009 and November 2010, 636 patients were eligible. Participation rate was 93.4% (n = 594, 53% female). The prevalence of excessive use in the past 30 days was alcohol 44.9% (95% CI: 37.8-52.1), cannabis 11.1% (95% CI: 8.0-14.1), tobacco 23.4% (95% CI: 19.0-28.1) and any other drug 2.6 (95% CI: 1.4-4.2). Excessive use was higher in males than in females. Except for tobacco prevalence of excessive use was only slightly higher in young adults compared to adolescents. Conclusion. Excessive substance use is frequent among young people consulting family doctors in a European context. Future research should provide guidance about how to best seize this window of opportunity for prevention and early intervention.