Title of the Study: Practice and Attitude of Doctors Towards Patients with Substance Use: A Study from South India

Aim: To evaluate the practice and attitude of doctors towards substance use disorders (SUD) and their management.

Methods: Following stratified proportionate random sampling, selected doctors in the south zone of Bengaluru, India, were interviewed face-to-face using a structured questionnaire.

Results: 150 doctors were interviewed. In their practice, a quarter of patients (median of 27.5 (IQR: 11.45-45) use one or other form of Alcohol, Tobacco or Other Drugs of abuse (ATOD). Doctors, in general, enquire about substance use but do not actively intervene. They have mixed attitudes (both positive and negative) towards persons with SUD. A significant positive correlation was noted between the number of years of experience (post-MBBS) with practices related to "brief-intervention" (p = 0.014) and "concerned and sympathetic" attitudes (p < 0.001). However, a significant negative correlation was observed between the number of years of experience and "substance-specific management" practices (p < 0.001). Further, there was a positive correlation between "brief-interventions" practices with the attitude of being "concerned and sympathetic" (p < 0.001). A mediation analysis revealed that nearly a third of the overall effect of the number of years of experience on brief-interventions practices was mediated by a concerned and sympathetic attitude.

Conclusions: Serious efforts must be made to train doctors in the effective management of SUD. Attitudes of the doctors influence practices such as brief interventions. Programs directed towards changing the attitudes of doctors can bring changes in their practices.