Understanding substance dependence

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Many doctors are uncomfortable asking questions about drug or alcohol intake, and often patients are likely to deny the problem

While many people with the dependence do not know where to find help, GPs, the most likely source of information, often do not have the time, training or resources to be able to explore this issue with patients.

According to Australian government national household surveys five per cent of the population have dependence on illegal or prescription drugs. Dr Oliver O’Connell who heads up the Addiction Recovery Centre at Wesley Hospital Ashfield said while many doctors are treating people for mental illness, the underlying issue can be addiction.

“Many doctors are aiming to relieve the patient’s anxiety or depression by proscribing anxiolytics like benzodiazepines,” he said. “However, people struggling with addiction will then just become addicted to the prescription drug.”

Dr O’Connell said that many doctors were uncomfortable asking questions about the drug or alcohol intake of patients, and often the patient is likely to deny the problem. “There are ways of identifying the problem such as gamma GTs or facial features,” he said. “However, there are also techniques like motivational interviewing which can help keep the issue on the table long enough to provide information to the patient about the problem and where they can get help.

“Really it boils down to doctors being comfortable asking patients about substance abuse.” For most people, Dr O’Connell said, conquering an addiction is not something they can do without assistance. Trained staff and the right environment are key.

“People assume that by coming for treatment at a place like Wesley Hospital they will be surrounded by ‘no-hopers’ without jobs  but many patients are actually workaholics,” he said.

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