BC is the first jurisdiction in Canada to implement screening, intervention, and care planning in primary care to prevent problem drinking and treat it as a chronic disease.

As of April 1, 2011, family doctors in BC have access to new guidelines covering problem-drinking screening and assessment, intervention, and treatment resources similar to those available for other chronic diseases, such as diabetes or hypertension to treat their patients with problem drinking, including alcohol addiction.

The new Problem Drinking Guidelines for practitioners, along with the following practical information on how to conduct screening, assessment, and management for problem drinking in adults (listed below), can be found on the Guidelines and Protocols Advisory Committee (GPAC) web site,

Problem Drinking Part 1 - Screening and Assessment

Problem Drinking Part 2 - Brief Intervention

Problem Drinking Part 3 - Office Based Management of Alcohol Withdrawal and Prescribing Medications for Alcohol Dependence

These guidelines were developed by GPAC, a joint committee of the BC Medical Association (BCMA) and the Ministry of Health. By including problem drinking under the Chronic Disease Management framework, BC has taken a major step forward in providing training and support for primary care physicians to help their patients who show signs of alcohol abuse.

Screening for problem drinking, along with brief intervention, is the third most clinically effective
prevention service after smoking cessation and daily aspirin use. The intervention helps prevent alcohol-related injuries, falls and accidents such as motor vehicle crashes, and reduces the risk of alcohol-linked long-term problems, such as cardiovascular disease and some cancers.

Helping patients to lower their alcohol consumption will reduce alcohol-related harm to individuals and families and reduce costs to the health care system.

In addition to the prevention benefits, this approach helps doctors identify and treat those whose
drinking has resulted in chronic dependence and addiction.

For BC, the impacts of problem drinking, including addiction, are staggering:

• The total direct and indirect social costs (health, enforcement, and absenteeism) of alcohol in BC
  were estimated at approximately $2.2 billion in 2002, according to a 2008 report from BC’s ProvincialHealth Officer.
• In 2006, 1986 British Columbians died from an alcohol-related event.
• Over 500,000 British Columbians aged 15 or older, self-reported as engaging in hazardous drinking in
  2004, according to Health Canada data.
• In 2008, over 20,000 hospitalizations in BC were attributable to problem drinking.
• Close to 31% of people attending an emergency department on late-night weekends in Victoria
  reported having used alcohol in the 6 hours prior to the onset of their injury or illness (Centre for
  Addictions Research of BC, University of Victoria, 2010).
• Almost 1 in 3 late-night weekend attendees at the Victoria ER showed positive results of alcohol
  consumption on voluntary breathalyzer tests. In Vancouver, about 1 in 5 had positive results (CARBC,
  University of Victoria, 2010).

The recognition of addiction as a chronic disease is the top recommendation made by the BCMA’s Addiction Strategy Group in its 2009 policy paper titled Stepping Forward: Improving addiction care in British Columbia. For the next 18 months after the report’s release, the BCMA worked with the Ministry of Health to develop guidelines for family physicians to use to identify their patients who are problem drinkers and to assist in their treatment.

Funding for the new problem drinking initiative will come from the existing Mental Health planning fee developed by the GPSC.

Through the Mental Health planning incentives, the GPSC supports physicians in the screening, planning, and follow-up for patients who screen positive for problem drinking. The incentive will assist physicians to seamlessly provide services, as some people may suffer from problematic drinking as well as mental illness.

Visit www.gpscbc.ca/system/files/Mental_Health_Billing Guide - May 2011 for more information on these incentives.