Alcoholism: Beliefs and attitudes among Canadian alcoholism treatment practitioners

Objectives: To explore differences in views concerning adjunctive medicatio ns and theoretical orientation among Canadian practitioners from different professional backgrounds who treat alcoholism. Methods: A survey of clinicians from different disciplines was conducted by mail. The response rate was 56%: 95 drug and alcohol counsellors, 46 socia l workers, 81 nonpsychiatrist addiction physicians, and 74 addiction psychi atrists. The number of items in the questionnaire was reduced using princip al component analysis. Group differences were explored using analysis of va riance with Bonferroni correction and Scheff's posthoc comparisons. Results: Physicians and nonphysicians differed in their view on the utility of medications in treating alcohol problems, the disease concept of alcoho l problems, and the classification of alcohol abuse or dependence as psychi atric conditions. No group differences emerged on views regarding cognitive -behavioural treatment, pharmacological-only interventions, combined treatm ent, and recovery without treatment. Psychopathology in the alcoholic was s ignificantly more likely to be considered as secondary to the use of alcoho l by nonpsychiatrist physicians. Nonphysician practitioners viewed alcoholi c behaviour as self-medication. Conclusions: Groups differed on questionnaire items concerning medication u se and the disease concept of alcoholism. Agreement on several areas may fa cilitate bridging the gap across disciplines. The implications of these res ults are discussed.