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5 years ago

NAT 6/08 - THL

NAT 6/08 - THL

olaF G. aasland arne

olaF G. aasland arne johannesen Screening and brief intervention for alcohol problems in Norway Not a big hit among general practitioners Screening and brief intervention for alcohol problems has been difficult to implement among general practitioners in Norway. The aim of this article is to sum up the efforts and reflect on the relatively limited achievements so far. The doctors’ role in Norwegian alcoholism care In the 1950s and 1960s there were some Nor- wegian psychiatrists and general practitioners who for various reasons had a special interest in alcoholic patients. Around 1960, they contacted the National Social Security System (RTV) with the message that working with alcoholic patients was very time consuming, and there was a need for a special remuneration scheme for this kind of work. In response, RTV made an official list of doctors who were approved “alcohol therapists”, and the listed doctors could use the special fee for “long lasting consultations” without the additional documentation that would normally accompany such a claim. This successful initiative also led to the inception of a new branch organization under the Norwegian Medical Association called “The Nor- A B S T R A C T O. Aasland & A. Johannesen: Screening and brief intervention for alcohol problems in Norway. Not a big hit among general practitioners Screening and brief intervention (BI) for alcohol problems has been difficult to implement among general practitioners (GPs) in Norway. The aim of this article is to sum up the efforts and reflect on the relatively limited achievements so far. In the 1980’s, data for the identification (AUDIT) part of the wHO-project was collected from GPs and general hospitals in Norway. Also high risk patients were recruited for BI from health centres and GPs in the Bergen area. The recruitment of candidates turned out to be difficult, as few patients met the inclusion criteria; their alcohol risk was not high enough. Another problem has been that not many GPs are interested in using new BI technology. In a survey we found that Norwegian GPs felt more competent to give advice on smoking than on alcohol. The most important obstacles for better alcohol counseling were lack of time and BI competence. The doctors also preferred to use BI selectively - only on patients with symptoms of high risk consumption. General screening was regarded as an intrusion of patient autonomy. NORDIC STUDIES ON ALCOHOL AND DRUGS V O L . 25. 2008 . 6 Country report 515

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