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Perceived role of psychiatrists in the management of substance misuse

A questionnaire survey

Adult Service, Psychotherapy, Devon House, Mindelson Way, Off Vincent Drive, Edgbaston, Birmingham B18 5SD;

Jon Arcelus, Specialist Registrar in Child & Adolescent Psychiatry

Oaklands Centre, Selly Oak, Birmingham;

Ashraf Kahn, Consultant

Addictive Behaviours Centre, All Saints Hospital, Birmingham

^* Correspondence

Aims and methods A postal questionnaire sent to all psychiatrists working in four NHS trusts in and around Birmingham was used to survey the number of new cases of drug and alcohol misuse identified in the previous month and the degree of postgraduate training in the management of such cases. Attitudes and beliefs about substance misuse problems were also elicited.

Results A response rate of 70% was achieved across six sub-specialities in psychiatry and four levels of training. Of the 143 respondents, over half had identified at least one new case of alcohol (61%) or drug misuse (55%) in the previous month. Approximately half of the sample admitted to having received no training in management of substance misuse cases in the previous five years (45% alcohol, 50% drugs). There was general agreement about the potential management role of the doctor in the field, but less consensus on whether the clinician had a responsibility to intervene in such cases. A clear discrepancy was demonstrated between psychiatrists' perceptions of the evidence supporting various treatments and the actual evidence base.

Clinical implications The study highlights the pressing need for training psychiatristsat all levelsand in all subspecialities in the management of substance misuse.