Keywords: Addiction, screening, primary care, communication skill

Background:

Early sceening of addictive disorders in primary care is recommended but remains underutilized. General practitioners are often the first and unique point of contact with patient suffering from substance use disorders. General practitioners would like examples of questions to start talking about about addictive disorders during consultations

Research questions:

To determine the most appropriate validated questions for broaching the subject of addiction during consultation with a GP

Method:

15 non-substance-focused questions were selected by cross-referencing data from validated tests, the DSM-V, and nominal groups. A quantitative study was conducted between November 2024 and April 2025 among general practitioners and medical students recruited in primary care office, health centers, and at national meetings. Participants rated their comfort level with asking each of the 15 questions on a Likert scale 1 to 4. Participants were invited to choose their preferred question. A bonified means, incorporating the frequency of preferences, was used to establish the final ranking.

Results:

A total of 201 general practitioners responded. The sample was diverse in terms of status, gender, type, and location of practice. The three highest-ranked questions were: “Have you ever tried unsuccessfully to reduce or stop a consumption or behavior?” (bonified mean = 5), “Has a consumption or behavior ever caused you problems?” (4,73), and “Do you need a substance or behavior to relax, feel better, or cope?” " (4,58). The less popular question was "Do your relatives have a problem with your relationships?" (2,70).

Conclusions:

This study highlights three simple, validated, and cross-sectional formulations that general practitioners perceive as appropriate for broaching the subject of addiction. Testing them in real-life conditions and adapting them to other primary care professions is a relevant avenue for further research.

Points for discussion:

This study not just adopted new tool but sought to strengthen the role of primary care teams: how can we assume our role in screening for intimate issues?

Beyond national or European recommendations, how can we help primary care providers address intimate issues as part of a continuous care process?