Problem Areas: Victims, Community and Doctors

Abstract

Abstract: For most doctors and health workers in clinical practice, the problem of alcohol abuse is too hard. Its many subtle presentations elude ready recognition and defy set routines of management.A major difficulty is that it cannot easily be classified or encompassed by a neat diagnostic box. It is much more than a medical problem, even though there is often a definite pathology with clinical signs and accepted treatment regimes; it is much more than a psychological problem, though it has important emotional antecdents and associations; it is certainly a social problem closely woven into the fabric of Australian society, but one seemingly inaccessible to established processes of education or legislation.At a time when many doctors seek to make allies of their patients, enlisting their aid in life‐style changes for health improvements, alcohol abuse seems to mock the well‐intentioned exhortation to participatory self‐improvement. Instead, it seems to demand techniques of consistent confrontation and community recruitment which run in the face of the individual entrepreneurial style of private doctoring.For the physician, there is neither money nor success to be gained in the management of a client who abuses alcohol. The response of private practice to the problem is therefore largely one of avoidance and this constitutes a major contribution to the conspiracy of silence.