A review of guidelines for collaboration in substance misuse management

Background: Substance abuse among the working population results in increasing economic costs. General practitioners (GP) and occupational physicians (OP) can play a central role in detecting and managing substance abuse in the working population. Their collaboration could be critical in coordinating care, in facilitating rehabilitation and in reducing sick leave.
Aims: To search in guidelines for evidence on collaboration between GPs and OPs in substance abuse detection and management in the working population.
Methods: International guidelines regarding collaborative care for alcohol abuse, illicit drug use and hypnotics and tranquilizers were identified by a systematic search in the Guidelines International Network (GIN) and US National Guidelines Clearinghouse (NGC) databases.
Results: In total 20 guidelines were considered of sufficient methodological quality, based on criteria of the Appraisal of Guidelines for Research and Education (AGREE) II instrument. Only two guidelines reported on the OP’s role in screening and intervention for alcohol abuse.
Conclusion: There is a lack of evidence on the OP’s role and on collaboration between GPs and OPs.
We recommend studying their respective roles in substance abuse management, the effectiveness of workplace interventions, pros and cons of collaboration as well as the best way to achieve this if recommended.