CPD Articles

Primary healthcare approach to substance abuse management

Ramprakash Kaswa
South African Family Practice | Vol 63, No 1 : Part 2| a5307 | DOI: https://doi.org/10.4102/safp.v63i1.5307 | © 2021 Ramprakash Kaswa | This work is licensed under CC Attribution 4.0
Submitted: 23 March 2021 | Published: 26 May 2021

About the author(s)

Ramprakash Kaswa, Department of Family Medicine and Rural Health, Walter Sisulu University, Mthatha, South Africa


Substance abuse is common amongst patients attending primary healthcare settings. Despite the substantial impact on one’s health, substance abuse is often underdiagnosed by primary care providers owing to a lack of training and time for screening. Self-reported screening tools are easy to administer and efficient to make a substance abuse diagnosis in primary care settings. Comorbid mental illness and intimate partner violence are common amongst patients presenting with substance abuse in primary care. An early diagnosis and a brief behavioural change counselling are effective in managing substance abuse before it develops into dependency. A brief motivational communication rather than a confrontation during substance abuse screening, counselling and treatment is important to achieve optimum patient outcomes.


substance abuse; primary healthcare setting; screening tools; brief behavioural change counselling; co-morbidity


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