Objectives: The study was undertaken to investigate the role of private general practitioners (GPs) in the treatment of alcohol dependence in the Free State province.

Design: A descriptive cross-sectional study. A questionnaire was used to describe the experiences of GPs with patients with alcohol dependence.

Outcome measures: The treatment role of individual participants was defined in terms of the range of services provided and the enablers and obstacles faced in performing interventions in their local context.

Setting and subjects: Seventy-seven private GPs were selected by means of a stratified randomised sampling process from areas in the immediate proximity of regional hospitals, district hospitals, or basic environments (without local hospital services), in three geographical areas defined by existing health service delivery boundaries.

Results: 29.9% of participants practised medical detoxification, either in hospital or in outpatient settings. Involvement related to the local organisation of treatment services in a geographical area. GPs in resource-constrained environments played an extended role outside of the traditional office-based model of care. Medical scheme funding policies were regarded as an obstacle to involvement in the treatment of alcohol-dependent patients by 76.5% of participants. Other major obstacles were lack of multidisciplinary teams, in-patient facilities and referral structures.

Conclusion: Private GPs in the Free State play a context-dependent role in the treatment of alcohol-dependent patients in the province. This compensatory role needs to be acknowledged in service delivery planning in under-resourced areas, especially to ensure access to treatment and cost-effective management.