Background: There has been increasing emphasis on the role of primary health care in the prevention and management of alcohol-related harm. The aim of this study was to determine attitudes to and management of alcohol problems in general practice in rural South Africa.

Methods: A total of 61 general practitioners (GPs) were interviewed with the aid of a structured questionnaire (response rate 50%) in two rural districts.

Results: The results indicate that 51% of the GPs felt that alcohol is an important issue in general practice. GPs were able to discriminate accurately between cases of problem drinking and alcohol dependence. GPs who reported high levels of alcohol-related education and training were more prepared to counsel problem drinkers, expressed more therapeutic commitment in their role and reported more appropriate management of these patients than did GPs with lower levels of Continuing Medical Education (CME) experience. Alcohol problems are recognised as an important problem in general practice, and improved training could increase the identification and management of alcohol problems in primary care. GPs rated the most critical barriers to alcohol interventions as competency training, role endorsement, not being adequately reimbursed, health policy not supporting prevention and their own alcohol problem.

Conclusion: Alcohol problems are recognised as an important problem in general practice, and improved training, adequate reimbursement and health policy support could increase the identification and management of alcohol problems in primary care.