Australian surveys of those with cannabis use disorder (CUD) reveal that general medical practitioners (GPs) are the preferred source of treatment as they are seen as trust worthy and confidential. A small body of research has identified four commonly held concerns by GPs regarding the delivery of substance use treatment. First, the content of GP interventions is not well known, and commonly disregarded as ineffective. Second, GPs report avoiding substance use discussions due to an anticipated negative reaction from patients or the belief that the patient will not be honest about their substance use. Third, GPs are not typically well trained or resourced to provide substance use interventions and have a limited time to do so. Fourth, GPs may have a negative view of a substance user and find it challenging to intervene on their behalf.
The aim of this survey was to ascertain the attitudes, knowledge, experiences and support needs of GPs when managing cannabis treatment seekers.
Professional development seminars throughout Australia were targeted for participant recruitment (n=782 GPs). Delegates to these seminars received documents in their satchels and were asked to self-complete the survey and return it to the researchers.
The majority of participants were female (80%) and GPs (70%). In their mean of 29 clinical hours per week they typically screened 4 individuals for cannabis use, delivered 2 interventions and made one referral. The majority felt that their training (88%), knowledge (59%), screening skills (64%) and management skills (77%) were unacceptably poor. When asked what prevented them from screening or treating an individual with a CUD the two most common responses were: a lack of skills (69%), and not having enough time (41%). When asked what would encourage greater screening or treatment the two most common responses were: additional training (83%) and the provision of guidelines or recommendations for treatment (78%).
These findings identified a serious gap in the capacity of the primary health care workforce to address cannabis related problems in the community. GPs are a popular and trusted source of assistance for those with CUD but GPs do not feel sufficiently equipped or motivated to screen/treat those with CUD. Given the breadth of this problem, this training would ideally be evidence-based, sourced through the web, and provide continuing medical education (CME) points.
Some of these findings were presented to several drug and alcohol conferences in 2012 and have been published as:
Norberg, M.M., Gates, P., Dillon, P., Kavanagh, D.J., Manocha, R., Copeland, J. (2012) Screening and managing cannabis use: comparing GP's and nurses' knowledge, beliefs, and behaviour, Substance Abuse Treatment, Prevention, and Policy, 7(1):31, DOI: 10.1186/1747-597x-7-31
To develop an understating of how GPs and other health professionals manage clients who present with cannabis use concerns and to identify any capacity gaps that prevent health professionals from providing screening and intervention. Upon identifying these gaps NCPIC resources and external training seminars can be tailored to better equip GPs and other health professionals to provide cannabis screening and intervention.