Primary health care and intervention in drug abuse: guidelines review

Abstract

Objectives: To identify the interventions in high-risk addictive behaviours, based on the evidence, with the potential for development in primary health care. Design: Systematic review of programmes and clinical guidelines based on the evidence. Data source: Medline database Bibliographic sources: PAPPS recommendations, US Preventive Services Task Force, Canadian Preventive Task Force, American Medical Association (AMA), AMA Guidelines for Adolescent Preventive Services (GAPS), American Academy of Family Physicians (AAFP) and Veterans Health Administration. Data extraction methods: We listed drug intervention activities and checked their levels of evidence and grades of recommendations in the selected guidelines, observing concordances and discrepancies. Results: An approach to addictive behaviours must be made throughout the entire health system, the key to success being coordination between all health care levels and community resources. Standardised resources, specifically primary care, are determinants in preventive activities: early detection, detection of risk situations and behaviours, harm reduction, the family approach, initiation of some drug rehabilitation and palliative cures, with external support where necessary. Promoting alternative life styles must be based on coordination between teachers and parents, and giving up drugs and social reinsertion with secondary level resources. Training professionals and improving the quality of scientific evidence as well as measuring the impacts of the actions at a community level, are also keys, particularly in primary health care. Conclusions: Solid evidence exists on diverse activities to be carried out in interventions in drug dependency in primary health care.