Experiences and expectations of people with alcohol use disorder and their families in general medical settings in Japan: a qualitative study.

AIMS: This study aimed to explore the factors influencing the transition from non-psychiatric medical institutions (NPMIs) (e.g. internal medicine or emergency departments) to specialized treatment from the perspectives of people with alcohol use disorder (AUD) and their families. METHOD: A qualitative study using semi-structured in-depth interviews with people with AUD and their families who had visited NPMIs. Participants were recruited through purposive sampling from self-help groups. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed. RESULTS: Interviews were conducted from July to October 2024 with 13 people with AUD and eight family members. Four themes were identified: (1) Lack of knowledge and stigma among people with AUD and families affects early AUD support; (2) Situations where interactions with non-specialists do not lead to AUD support; (3) Collaboration between families and healthcare providers helped enable access to specialized treatment; and (4) Expectations for AUD support in NPMIs based on an empathetic approach. CONCLUSIONS: To improve the transition of people with AUD from NPMIs to specialized treatment, healthcare providers should recognize the risks of offering inappropriate reassurance or general advice such as 'cut down' or 'have alcohol-free days,' which may reinforce existing harmful behaviours. Providers should understand how people with AUD and their families interpret medical interactions, work to enhance collaboration with families, cultivate a non-stigmatizing approach, and proactively share knowledge about alcohol-related harm and self-help group resources.