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Addiction Science & Clinical Practice
Published in: Addiction Science & Clinical Practice 1/2019

Open Access 01-12-2019 | Substance Abuse | Research

Identification and management of alcohol use and illicit substance use in outpatient psychiatric clinics in Sweden: a national survey of clinic directors and staff

Authors: Christopher Sundström, Elisabeth Petersén, Kristina Sinadinovic, Peter Gustafsson, Anne H. Berman

Published in: Addiction Science & Clinical Practice | Issue 1/2019

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Abstract

Background

Swedish national guidelines recommend that all health care settings systematically screen patients for alcohol use and illicit substance use. When hazardous use is identified, it should immediately be addressed, preferably through brief interventions (BI). It is well known that the prevalence of alcohol use and illicit substance use among psychiatric patients is high, but it is not known to what extent screening and BI are routinely carried out in such clinics.

Methods

Two online surveys investigating the use of screening and BI for alcohol and illicit substances were constructed; one for psychiatric outpatient clinic directors and one for staff at these clinics. The main analyses were calculated as simple frequencies. In secondary analyses, we investigated the associations between substance abuse training, type of clinic and screening/BI delivery. For these analyses, the Chi square test was used.

Results

Most clinic directors reported that they have guidelines to screen for alcohol (93.1%) and illicit substance use (78.9%) at initial assessment. Fifty percent reported having guidelines for delivering BI when identifying hazardous alcohol use (35.9% for hazardous illicit substance use). Among staff, 66.6% reported always screening for alcohol use and 57.8% reported always screening for illicit substance use at initial assessment. Further, 36.7% reported that they usually deliver BI when identifying hazardous alcohol use (35.7% for hazardous illicit substance use). Secondary analyses indicated that staff with substance abuse training were significantly more likely to screen for alcohol use than staff without such training. Further, staff at psychosis clinics were significantly less likely to screen for both alcohol and substance use than staff at both general and specialist psychiatric clinics.

Conclusions

Most clinic directors reported having clear guidelines for staff to screen for alcohol use and illicit substance use, but fewer staff members than expected indicated that these guidelines were adhered to. Providing training about substance use disorders for staff may increase use of screening for alcohol use, and psychosis clinics may need to improve their screening routines.
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Metadata
Title
Identification and management of alcohol use and illicit substance use in outpatient psychiatric clinics in Sweden: a national survey of clinic directors and staff
Authors
Christopher Sundström
Elisabeth Petersén
Kristina Sinadinovic
Peter Gustafsson
Anne H. Berman
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Addiction Science & Clinical Practice / Issue 1/2019
Electronic ISSN: 1940-0640
DOI
https://doi.org/10.1186/s13722-019-0140-x

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