DRUG AND ALCOHOL POLICIES ARE RARE AT MEDICAL SCHOOLS IN UK

The consumption of alcohol and illicit substances is increasing among
medical students in the United Kingdom[1] and is also excessive among
junior house officers.[2] These findings emphasise the need for a
comprehensive approach towards health promotion in medical schools, with
locally negotiated and applied drug and alcohol policies being integrated
within this approach. The Working Group on the Misuse of Alcohol and Other
Drugs by Doctors has recommended that every medical school should have a
drug and alcohol policy,[3] and in view of this I attempted to discover the
number of such policies that have been implemented in the United Kingdom's
medical schools.

In May 1998 I wrote to the deans at each of the United Kingdom's 26 medical
schools, asking whether a drug and alcohol policy was currently implemented
at their medical school. Seventeen responded, six informing me that they
had written policies; these policies covered alcohol alone (three medical
schools); drugs alone (two); and alcohol and drugs (one). The target
population for these policies was almost exclusively medical students.
Similar findings were obtained by Bhopal et al in 1994.[4] Three other
medical schools stated that they adhered to the guidelines issued in the
General Medical Council's document Student Health and Conduct regarding
medical students' use of alcohol and other drugs.[5]

Although I conducted this study too early to be able to determine the
effect of the working group's recommendation regarding drug and alcohol
policies at medical schools, the fact that the number of such policies
remains low is a cause for concern. It is also worrying that the target
population for such policies remains mainly medical students despite the
potentially devastating effects that drug and alcohol misuse and dependency
may have on the health of all healthcare professionals and on the welfare
of their patients.

The number of drug and alcohol policies implemented in the United Kingdom's
medical schools should be reviewed periodically, and during this evaluation
process the target population of such policies must be determined. Further
research is needed to determine the quality and effectiveness of drug and
alcohol policies in medical schools, with particular reference to the
health and wellbeing of their target population.

Dafydd Fon Williams, Non-principal general practitioner. 30 Harthill
Avenue, Leconfield, East Yorkshire HU17 7LN

[1] Webb R, Ashton CH, Kelly P, Kamali F. An update on British medical
students' lifestyles. Med Educ 1998; 32: 325-331[Medline].

[2] Birch R, Ashton CH, Kamali F. Alcohol, drinking, illicit drug use, and
stress in junior house officers in north-east England. Lancet 1998; 352:
785-786[Medline].

[3] Working Group on the Misuse of Alcohol and Other Drugs by Doctors. The
misuse of alcohol and other drugs by doctors. London: BMA , 1998.

[4] Bhopal R, White M, Crombie AL. Health policies in British medical
schools. BMJ 1994; 308: 1044[Medline].

[5] General Medical Council. Student health and conduct. London: GMC , 1997.