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Teaching postgraduates about managing drug and alcohol misuse

BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e5816 (Published 04 September 2012) Cite this as: BMJ 2012;345:e5816

Rapid Response:

Re: Teaching postgraduates about managing drug and alcohol misuse

The working group chaired by Julia Lawton for the Academy of Medical Royal Colleges [1] deserves congratulation for its excellent work in achieving consensus on 12 alcohol competencies for all trainees. Following recent work on alcohol for the Academy of Social Sciences [2] I was delighted to see the inclusion of Knowledge on:

* Effects of alcohol and other drugs on the unborn child, children and families.

Risk and actual harm to health in family members of drinkers, is common and possibly affects more people than the population directly harmed by ethanol. Nonetheless, it is unwise just to see these family members as victims of collateral damage. Care by clinicians is often greatly enhanced when one or more relatives collaborate with the doctor. Long term and valued relationships can make a big difference to motivation and perseverance for alcohol treatment. [2]

Sometimes a different Significant Other can help more effectively than, say, a family member who has suffered abuse or betrayal. The working group [1] included a representative of the Faculty of Occupational Medicine, and a trusted work colleague may also add a significant enhancement to employee alcohol programmes. Anecdotally, other long term relationships (e.g. with probation officers or pastors) may also help. In situations where the drinker feels friendless and worthless, mutual aid in peer groups is not only compatible with medical care but adds benefit. [3]

1. Academy of Medical Royal Colleges. Alcohol and other drugs: core medical competencies. London: Royal College of Psychiatrists, 2012.

2. Caan W. Alcohol and the family. Contemporary Social Science 2012; 7: in press.

3. Baldacchino A, Caan W, Munn-Giddings C. Mutual aid groups in psychiatry and substance misuse. Mental Health and Substance Use 2008; 1: 104-117.

Competing interests: An advisor to the All Party Parliamentary Group on alcohol misuse and academic member of the East of England MUSE regional group for substance use.

11 September 2012
Woody Caan
Editor
Journal of Public Mental Health
Duxford CB22 4PA