Managing alcohol use in primary care

People who struggle with alcohol problems are stigmatised in extraordinary ways. The UK treatment system has been partly dismantled and cheaper provision outside the National Health Service accepted.12 Predictably, much of the burden of alcohol related disease is borne by hospitals,2 not least because there is little alcohol treatment available in primary care.3

Even seemingly unremarkable drinking is implicated in a wide range of health issues.4 Usually unnoticed, alcohol interferes with the everyday work of primary care.5 This dysfunctional situation requires high level strategic planning6 to clarify the role of primary care in managing the UK’s problematic relation with alcohol.

The linked study by Cheng and colleagues (doi:10.1136/bmj.m3934) used network meta-analysis to examine the evidence underpinning mostly drug interventions for maintaining abstinence after detoxification.7 The authors found that existing evidence for drug treatments is weak. Treatment for problem drinking usually starts before detoxification, and what to do afterwards is the …