Primary health care for patients with alcohol use disorders

Introduction. In France, alcohol represents the second cause of avoidable death after smoking. One in three adults has at-risk alcohol use (AAU). General practitioners (GP) are at the front line for screening and providing appropriate care for patients with AAU. This article provides a critical review of screening methods and health care solutions for patients with MU in primary care. Screening and diagnosis of alcohol use disorders (AUDS). Alcohol consumption should be characterized with an evaluation of the number of drinks per day and per occasion, and the patient's context. Primary care validated questionnaires such as the AUDIT-C or the CAGE can be used. An associated AUD can be diagnosed using DSM-5 criteria. Screening and Brief Intervention (SBI). SBI is an intervention protocol internationally recommended to screen for at-risk alcohol use. Its efficacy has been proven only for at-risk alcohol use without AUD. The evidence regarding SBI efficacy is of moderate quality. The main outcome is always self-reported alcohol use, with no clinical outcome. What should GPs do with patients with AUDs? Non pharmacological tools such as motivational interviewing have shown efficacy in primary care. Some medications are available, such as acamprosate and naltrexone to help maintain abstinence, nalmefene to reduce alcohol consumption, or baclofen on temporary use. The evidence regarding their efficacy is of low quality and their effect is moderate. Conclusion. Screening tools and treatment options exist that can be used in primary care by GPs to help their patients with AAU. Their efficacy is moderate and evidence regarding this efficacy is of low quality, but while research improves, they represent treatment options for GPs. Research on AUDs to help develop high quality evidence for health problems they are on the front line to screen and care for would be helpful.