Curriculum for General Practice - The Royal New Zealand College ...

A Addictions
Addictions
The effects of addiction are far-reaching,
and no sector of New Zealand society
is exempt. Addiction has an impact on
individuals, families, communities and beyond.
It is linked to poverty, crime, accidental
and non-accidental injury and poor health
outcomes. A growing number of people who
have an addiction also experience a mental
illness. 1 It is an area in which most general
practitioners will recognise conflicting values,
and in which it is all too easy to make hasty,
ill-considered judgments.
Addiction is wide-ranging and can include alcohol, tobacco,
recreational and prescription drugs, other substance misuse,
problem gambling and other gaming, sexual addiction,
obsessive shopping, eating disorders, obesity and social
networking. Some of these may be increasingly fuelled by
ease of access to the internet. Harmful effects on individuals
and families may be compounded by co-dependent or
dysfunctionally enabling behaviour by family members and
health professionals.
The general practitioner should be competent in
recognising signs or symptoms of addiction, including
co-dependency. Family history is becoming increasingly
evident as a factor in addiction, so using whānau ora 2
principles and concepts is essential if we are to break the
cycle of addiction within families.
We know almost half of all New Zealand adults aged between
16 and 64 years have used drugs for recreational purposes,
and that a third of those who seek help to reduce their use of
drugs seek that help from their general practitioner. 3
Māori are twice as likely to smoke tobacco compared to
non-Māori, with the highest prevalence of smoking being
in Māori women. 4 Māori are also more likely to be regular
cannabis smokers, and to have started smoking cannabis
when aged less than 14 years. While non-Māori are more
likely to consume alcohol, Māori are more likely to drink at a
hazardous level. 5
Misuse of prescription drugs is of particular concern as most
are obtained from general practitioners; doctors themselves
are especially at risk and should be wary of prescribing for
colleagues or for patients who are unknown to them.
1
Ministry of Health. 2005. Te Tahuhu: Improving Mental Health 2005-2015: The Second New Zealand Mental Health Plan. Ministry of Health, Wellington.
2
Ministry of Health. 2002. He Korowai Oranga – Maori Health Strategy. http://www.maorihealth.govt.nz
3
Ministry of Health. 2010. Drug use in New Zealand: Key results of the 2007/08 New Zealand Alcohol and Drug Use Survey
4
Ministry of Health. 2006. Tatau kahukura: Maori health chart book.
5
Ministry of Health. 2006. Tatau kahukura: Maori health chart book.
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Curriculum for General Practice