TOP TIPS WHEN VISITING YOUR GP
Seeking treatment for alcohol dependence?
Going to your GP can be a scary prospect. We are here to help you make that move towards your road of recovery. If you think you might have a problem with alcohol dependence, here is some useful advice to help you and your GP discuss treatment.
Read out Top Tips for your first GP appointment. Plus help your GP understand with our free Give to your GP download to guide them when suggesting treatment.
Addictions come in many forms. The main addictions that affect our physical health are alcohol, drugs, food and smoking, all of which can be discussed with your GP. We also have a Recovery Resource List of various support groups for you.
TIPS FOR YOUR FIRST GP APPOINTMENT
WHAT TO DO BEFORE & DURING YOUR VISIT
Below are some vital Top Tips to help you reach out to your GP and get the help you need to start your journey of recovery. Stay safe and feel secure.
MAKING THE APPOINTMENT & THINGS TO DO BEFORE ATTENDING
Take someone you trust with you if you feel it will make things easier for you like a family member or friend.
Don’t feel rushed this is an important topic, you can request a longer appointment if you need one.
Write down any questions you might want to ask your GP about your drinking or treatment.
WHAT WILL HAPPEN DURING YOUR APPOINTMENT?
Your doctor will ask you some questions about your drinking, be honest, and try to give as much information as possible about your recent and historical drinking habits. This will help your doctor to recommend the right treatment for you.
Keeping a retrospective drinking diary may help with the step above. Your GP may also ask your trusted person for some input during this stage.
Your GP may ask you to complete The Alcohol Use Disorders Identification Test. (AUDIT) A questionnaire comprising of 10 questions scored out 40 to assess your drinking behaviour. A score of 20 or more may indicate alcohol dependence. In this case your GP may ask you to complete the Severity of Alcohol Dependence Questionnaire (SADQ) to determine the level of your dependence.
Your doctor may also take some lab tests to help identify any potential complications that may have occurred because of your drinking.
Depending on the results of the lab tests and score on the questionnaires, it is likely that you will need to enter assisted withdrawal, to prevent complications like seizures, when you stop drinking. Your doctor may prescribe medication to help these issues. Do not stop drinking by yourself.
Depending on the level of your dependence this can be done at home, in a community setting, hospital, or residential detox facility.
Medical treatment is only part of the recovery process and there may be a wait for these services, so your GP will suggest some community based support in your local area, such as fellowships like AA (Alcoholics Anonymous) while you wait.
GP’S GUIDE ALCOHOL DEPENDENCE
This information is designed to offer doctors who aren’t familiar with treating addiction some tips, to ensure the person gets help quickly. It is based upon the (NICE, 2011) guidelines as well as other peer-reviewed research.
TAKE CARE WHEN TALKING WITH THE PERSON
Addiction can affect everyone differently and can present a range of psychosocial issues affecting all aspects of a person’s life. NICE (2011) suggests that when treating someone with suspected alcohol dependence it is important that they do so with empathy, respect and without judgment, taking into account their individual needs in any treatment plan. Studies show that stigma towards addiction is one of the biggest barriers to successful recovery. (van Boekel, Brouwers, van Weeghel, & Garretsen, 2013)
SOCIAL / COMMUNITY SUPPORT IS IMPORTANT
NICE (2011) guidelines state social support such as, fellowship or community groups like Alcoholics Anonymous (AA) are a vital part of the recovery process, particularly for those without family or friends. During the appointment it would be useful to suggest they join one of these groups. Studies suggest that when a GP encourages a person to join a recovery community it improves their effectiveness. (Manning et al., 2012)
See our list of resources
NICE (2011) suggest addiction can affect the people close to the addict. If the person also brings a family member or partner to the appointment try to assess their needs and offer support if needed.
ALCOHOL DEPENDENCE CAN BE COMORBID WITH OTHER MENTAL HEALTH CONDITIONS
Alcohol addiction often presents with other mental illnesses including; depression, Boschloo et al. (2011) anxiety disorder, Kushner, Abrams, and Borchardt (2000) bipolar, Farren, Hill, and Weiss (2012) and borderline personality disorder. (Zikos, Gill, & Charney, 2010) These conditions can lead to a range of negative psychosocial and treatment outcomes. If you suspect the person is showing signs of these refer them to a specialist right away.
WHAT TO DO IF YOU ARE SHORT ON TIME
There is a shorter version of the Alcohol Use Disorder Identification Test (AUDIT) called the AUDIT C. it has fewer questions and can be completed in 5 minutes and is just as effective at diagnosing as AUDIT, so they can be referred to a specialist. If you don’t have time to do a full retrospective drinking history then using NICE’s CAGE questions may help you identify alcohol dependence.
If any of these measures come back positive a full Audit should be taken.
Remember that a person with alcohol dependence will need medical, community and psychological support to recover. Refer them to a specialist as quickly as possible to increase the chances of positive outcomes.
Boschloo, L., Vogelzangs, N., Smit, J. H., van den Brink, W., Veltman, D. J., Beekman, A. T., & Penninx, B. W. (2011). Comorbidity and risk indicators for alcohol use disorders among persons with anxiety and/or depressive disorders: findings from the Netherlands Study of Depression and Anxiety (NESDA). Journal of Affective Disorders, 131(1-3), 233-242.
Farren, C. K., Hill, K. P., & Weiss, R. D. (2012). Bipolar Disorder and Alcohol Use Disorder: A Review. Current Psychiatry Reports, 14(6), 659-666.
Kushner, M. G., Abrams, K., & Borchardt, C. (2000). The relationship between anxiety disorders and alcohol use disorders: A review of major perspectives and findings. Clinical Psychology Review, 20(2), 149-171.
Manning, V., Best, D., Faulkner, N., Titherington, E., Morinan, A., Keaney, F., . . . Strang, J. (2012). Does active referral by a doctor or 12-Step peer improve 12-Step meeting attendance? Results from a pilot randomised control trial. Drug and Alcohol Dependence, 126(1-2), 131-137.
NICE. (2011). Alcohol-use disorders: diagnosis, assessment and management of harmful drinking (high-risk drinking) and alcohol dependence. Retrieved from https://www.nice.org.uk/guidance/cg115
Van Boekel, L. C., Brouwers, E. P., van Weeghel, J., & Garretsen, H. F. (2013). Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: Systematic review. Drug and Alcohol Dependence, 1(131), 23-35.
Zikos, E., Gill, K. J., & Charney, D. A. (2010). Personality disorders among alcoholic outpatients: prevalence and course in treatment. The Canadian Journal of Psychiatry, 55(2), 65-73.