Perceived Need for Treatment for Alcohol Use Disorders: Results From Two National Surveys

Edlund, Mark J.; Booth, Brenda M.; Feldman, Zach M.

doi:10.1176/appi.ps.60.12.1618

Cited by 46 publications

(54 citation statements)

References 19 publications

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“…On the other hand, a major cause of low rates of AUD treatment may be failure to perceive a need for AUD treatment. Only 1 in 10 individuals with an AUD perceives a need for treatment (Edlund et al, 2009;Grant, 1997;Grella et al, 2009). It is unknown to what extent failure to perceive a need for treatment is because individuals (a) do not believe they have a disorder, (b) do not believe treatment is effective, (c) believe they can recover on their own, or (d) simply do not wish to give up alcohol misuse.…”

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confidence: 99%

Who Seeks Care Where? Utilization of Mental Health and Substance Use Disorder Treatment in Two National Samples of Individuals with Alcohol Use Disorders

Edlund

Booth

Han

2012

J. Stud. Alcohol Drugs

100

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ABSTRACT. Objective: Only a fraction of individuals with alcohol use disorders (AUDs) receive any AUD treatment during a given year. If a substantial proportion of individuals with unmet need for AUD treatment are receiving mental health treatment, accessibility of AUD treatment could potentially be improved by implementing strategies to ensure that individuals receiving mental health care are referred to the AUD sector or by increasing rates of AUD treatment in individuals receiving mental health treatment. Method: We assessed patterns and predictors of mental health treatment and AUD treatment among individuals with 12-month AUDs, using secondary data analyses from two national surveys, the National Survey on Drug Use and Health (NSDUH; n = 4,545 individuals with AUDs) and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; n = 3,327 individuals with AUDs). Results: In both NSDUH and NESARC, 8% of individuals with AUDs reported past-year AUD treatment. Among individuals with AUDs, mental health treatment was more common than AUD treatment, with 20% of NSDUH respondents and 11% of NESARC respondents reporting receiving mental health treatment. Greater mental health morbidity increased the odds of mental health treatment, and AUD severity increased the odds of AUD treatment. Mental health morbidity also increased the odds of AUD treatment, mainly by increasing the odds of receiving the category of both AUD and mental health treatment. Conclusions: Because individuals with AUDs are more likely to receive mental health treatment than AUD treatment, a key opportunity to improve the overall accessibility of treatment for AUDs may be to focus on improving AUD treatment among individuals receiving mental health treatment. (J. Stud.

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confidence: 99%

Who Seeks Care Where? Utilization of Mental Health and Substance Use Disorder Treatment in Two National Samples of Individuals with Alcohol Use Disorders

Edlund

Booth

Han

2012

J. Stud. Alcohol Drugs

100

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“…Perceived need for AUD treatment is strongly associated with the decision to enter treatment (Carlson et al, 2010; Edlund, Booth, & Feldman, 2009; Kapczinski, Lima, Souza, & Schmitt, 2003). However, as noted above, the majority of individuals with alcohol and drug use disorders do not perceive a need for treatment (Edlund et al, 2009; Falck et al, 2007; Mojtabai, Olfson, & Mechanic, 2002;Substance Abuse and Mental Health Administration, 2006), even though in the same interview they often endorse multiple negative consequences of their alcohol use.…”

Section: Introductionmentioning

confidence: 99%

“…However, as noted above, the majority of individuals with alcohol and drug use disorders do not perceive a need for treatment (Edlund et al, 2009; Falck et al, 2007; Mojtabai, Olfson, & Mechanic, 2002;Substance Abuse and Mental Health Administration, 2006), even though in the same interview they often endorse multiple negative consequences of their alcohol use. A failure to perceive a need for treatment is observed across psychiatric disorders (e.g., depression, generalized anxiety disorder, bipolar disorder) yet rates are 2–5 fold higher for substance use disorders (Edlund, Unutzer, & Curran, 2006).…”

Section: Introductionmentioning

confidence: 99%

Criminal justice and alcohol treatment: Results from a national sample

Booth¹,

Curran²,

Han³

et al. 2013

Journal of Substance Abuse Treatment

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This study investigates the associations of recent criminal justice involvement with perceived need for alcohol treatment and alcohol treatment utilization, adjusting for demographic and clinical characteristics. We examined a national sample of adults with alcohol use disorders (AUD, N=4,390) from the 2006 National Survey on Drug Use and Health (NSDUH). Almost 15% reported criminal justice involvement in the past year. Generalized logit models regressed perceived need for alcohol or drug treatment and past year treatment utilization (versus neither) on past year legal involvement, demographic, and clinical information. In general, results found stronger associations between frequency of criminal justice involvement for treatment utilization compared to perceived need for treatment alone. Treatment utilization was also associated with being on probation, arrests for drug possession/sale and DUI but perceived need was not. Study results suggest opportunities for interventions to increase treatment rates or treatment need, a major correlate of treatment utilization.

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“…Common structural factors include lack of service provision (Probst, Manthey, Martinez, & Rehm, 2015); lack of information about services (Harris et al, 2013;Probst et al, 2015); costs, including travel and childcare costs (Grant, 1997); service inflexibility, particularly in relation to opening times (Cummings, Wen, Ritvo, & Druss, 2014;Rapp et al, 2006); and lack of community outreach (Grant, 1997;Saunders, Zygowicz, & D' Angelo, 2006). More individual barriers to accessing alcohol treatment include perceived feelings of stigma, shame, and embarrassment (Browne et al, 2016;Fortney et al, 2004;Grant, 1997;Keyes et al, 2010;Probst et al, 2015;Wallhed Finn, Bakshi, & Andreasson, 2014); problem denial or ambivalence to change (Edlund, Booth, & Feldman, 2009;Edlund, Unutzer, & Curran, 2006;Grant, 1997;Mojtabai & Crum, 2013;Probst et al, 2015;Rapp et al, 2006;Saunders et al, 2006); fear and concerns about disclosing private information (Rapp et al, 2006); lack of confidence in treatment services (Grant, 1997); and a misperception that treatment requires abstinence (Wallhed Finn et al, 2014).…”

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confidence: 99%

How Do People Who Frequently Attend Emergency Departments for Alcohol-Related Reasons Use, View, and Experience Specialist Addiction Services?

Parkman¹,

Neale

Day³

et al. 2017

Substance Use & Misuse

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Background: People who frequently attend emergency departments (EDs) for alcohol-related reasons, cost health systems greatly. Although specialist addiction services may be more appropriate for their needs, drinkers often experience barriers accessing specialist alcohol-related support. Objectives: This study explores how people who frequently attend EDs for alcohol-related reasons use, view, and experience specialist addiction services. Methods: We conducted semi-structured interviews with 30 individuals recruited from six EDs across London, United Kingdom. Data relating to participants' sociodemographic characteristics and service use were systematically coded using qualitative software, and analyzed following the Framework. Results: ED usage over the last 12 months was high, whereas current use of specialist addiction services was low. We found little evidence that structural barriers were preventing participants from attending specialist services; rather, participants seemed not to require help with their alcohol use. When asked what support they desired for their drinking, only 11/30 participants identified alcohol-specific treatment. More commonly, they wanted help relating to mental health problems; social contact; paid or voluntary work; housing-related issues; or gym access. Women were more likely to be receiving, and to have support from a specialist addiction service. Conclusions/Importance: People who frequently attended EDs for alcohol-related reasons expressed low levels of interest in, and motivation for, alcohol-specific treatment but desired broader psychosocial support. Case management and assertive outreach appear to be valuable models of service delivery for this population (particularly for men). However, further qualitative and quantitative research is now needed to verify these findings in different countries, regions, and health care systems.

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Perceived Need for Treatment for Alcohol Use Disorders: Results From Two National Surveys

Cited by 46 publications

References 19 publications

Who Seeks Care Where? Utilization of Mental Health and Substance Use Disorder Treatment in Two National Samples of Individuals with Alcohol Use Disorders

Who Seeks Care Where? Utilization of Mental Health and Substance Use Disorder Treatment in Two National Samples of Individuals with Alcohol Use Disorders

Criminal justice and alcohol treatment: Results from a national sample

How Do People Who Frequently Attend Emergency Departments for Alcohol-Related Reasons Use, View, and Experience Specialist Addiction Services?

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