Understanding low treatment seeking rates for alcohol use disorder: A narrative review of the literature and opportunities for improvement

Venegas, Alexandra; Donato, Suzanna; Meredith, Lindsay R.; Ray, Lara A.

doi:10.1080/00952990.2021.1969658

Cited by 29 publications

(23 citation statements)

References 124 publications

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“…An inverted U-shaped relationship with the peak treatment rate occurring in middle age (between 35 and 54 years), as in the USA, is not evident in the already diagnosed population. Rather there is a linear decrease ( 45 ). The higher rate of care among 16–24-year-olds may be due to covariates such as comorbidities and risky drinking habits, as well as a presumably lower rate of diagnosis among younger individuals with alcohol dependence.…”

Section: Discussionmentioning

confidence: 99%

“…The higher rate of care among 16–24-year-olds may be due to covariates such as comorbidities and risky drinking habits, as well as a presumably lower rate of diagnosis among younger individuals with alcohol dependence. In general, older patients with comorbidities are more likely to be diagnosed ( 19 ) and treatment motivation increases with the severity of negative consequences ( 45 , 46 ).…”

Section: Discussionmentioning

confidence: 99%

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Estimating the prevalence of alcohol-related disorders and treatment utilization in Bremen 2016/2017 through routine data linkage

et al. 2023

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BackgroundIn Germany, most individuals with alcohol dependence are recognized by the health care system and about 16% per year receive addiction-specific care. This paper aimed to analyze the prevalence and treatment utilization rate of people with alcohol dependence by type of addiction-specific care in the federal state of Bremen using routine and survey data.MethodsThe number of individuals with alcohol dependence was estimated using data from the 2018 Epidemiological Survey of Substance Abuse (ESA). Furthermore, linked routine data of two statutory health insurances (SHIs), the German pension insurance (GPI), and the communal hospital group Gesundheit Nord – Bremen Hospital Group (GeNo), from 2016/2017, were analyzed. Based on SHI data, the administrative prevalence of various alcohol-related diagnoses according to the International Classification of Diseases (ICD-10), in various treatment settings, was extrapolated to the total population of Bremen. Based on all routine data sources, treatment and care services for individuals with alcohol dependence were also extrapolated to Bremen’s total population. Care services included outpatient addiction care visits and addiction-specific treatments, [i.e., qualified withdrawal treatment (QWT), outpatient pharmacotherapy as relapse prevention, and rehabilitation treatment].ResultsOf the survey-estimated 15,792 individuals with alcohol dependence in Bremen, 72.4% (n = 11,427) had a diagnosis documented with an ICD-10 code for alcohol dependence (F10.2) or withdrawal state (F10.3–4). One in 10 individuals with alcohol dependence (n = 1,577) used one or more addiction-specific care services during the observation period. Specifically, 3.7% (n = 675) received outpatient addiction care, 3.9% (n = 736) initiated QWT, 0.8% (n = 133) received pharmacotherapy, and 2.6% (n = 405) underwent rehabilitation treatment. The share of seeking addiction-specific treatment after diagnosis was highest among younger and male patients.ConclusionAlthough more than half of the individuals with alcohol dependence are documented in the health system, utilization rates of addiction-specific treatments are low. These low utilization rates suggest that there are existing barriers to transferring patients with alcohol dependence into addiction-specific care. Strengthening primary medical care provision in dealing with alcohol-related disorders and improving networking within the addiction support system appear to be particularly appropriate.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Estimating the prevalence of alcohol-related disorders and treatment utilization in Bremen 2016/2017 through routine data linkage

et al. 2023

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“…One example was that sex was only collected as binary variable of biological sex: men or women, not including a gender perspective about the socially constructed sex. Nor does the data include certain variables that intersect with gender and that also plays a role in treatment seeking, as ethnicity or sexuality [ 43 ]. Future studies should also include a larger age span among the participants, as there are indications that age is an important factor for treatment seeking, where younger and older are less likely to perceive a need for AUD treatment [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Perceived barriers to seeking treatment for alcohol use disorders among the general Danish population – a cross sectional study on the role of severity of alcohol use and gender

2023

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Background A minority of all individuals with alcohol use disorders (AUD) seek treatment. Since the suffering from AUD has severe consequences for both the individual and for society, it is important to improve the understanding of barriers to seeking treatment. Most studies of barriers thus far have been conducted in the United States of America or the United Kingdom. There is a need for studies from other contexts. The overall aim is to investigate barriers to treatment seeking for AUD. The specific aims are to: 1) describe barriers to AUD treatment at different levels of alcohol use. 2) compare gender differences regarding barriers to AUD treatment. Methods Study design: Cross-sectional. Participants: 1594 representative Danish adults from the general population aged 30–65 years. An online questionnaire was administrated by a market research company. The questionnaire covered demographic data, barriers to treatment and level of alcohol use. Analyses were performed by means of chi-2 test and logistic regression. Results The most common barriers were related to stigma and shame: admitting to others of having a problem, being labelled, fear of the consequences and that others would find out. Participants with higher severity of alcohol use were more likely to endorse a wish to handle alcohol problems themselves and to report barriers related to treatment services. Women with high severity of alcohol use, endorsed higher level of fear of the consequences than men. Conclusions There is an urgent need to reduce stigma around AUD. Individuals with higher severity of alcohol use report a lower willingness to seek professional treatment if a problem occurs. Especially among individuals with high severity of alcohol use there is a need to address gender specific barriers.

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“…Although effective psychological and pharmacological interventions are available, relapse rates remain high [3]. As treatment seeking and adherence are low, researchers have called for new low-threshold as well as more appealing interventions [4].…”

Section: Introductionmentioning

confidence: 99%

“…Eur Addict Res 2023;29:30-33 DOI: 10.1159/000527877 low-threshold as well as more appealing interventions [4].…”

Section: Introductionmentioning

confidence: 99%

Combination of Two Behavioral Techniques Reduces Craving in Problematic Alcohol Consumption by One Third: A Randomized Controlled Trial

et al. 2022

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Introduction: Craving alcohol is a core symptom of alcohol use disorder (AUD) and an important target for treatment. A new line of treatment for AUD aims at overriding the urge to consume alcohol by changing implicit cognitions via approach bias modification (ApBM). In a prior study, we tested a variant of ApBM called imaginal retraining, which reduced craving. As addiction and body-focused repetitive behaviors (BFRBs) share important symptoms (e.g., inability to resist urges), for the present study we merged imaginal retraining with a technique aimed at BFRB, called decoupling, to augment treatment effects. We hypothesized that the new technique, which is called 3P, would lead to a greater reduction in craving relative to (active) control conditions. Methods: The study was conducted online. Data from 227 participants were considered. Participants were randomized to 1 out of 5 conditions. Craving for alcohol before and after the brief intervention was the primary outcome. Results: Only the 3P condition lessened craving by approximately one third at an almost medium effect size (improvement: 34.5%, p = 0.003, d = 0.458). Effects were significantly larger relative to the wait-list control and two active control conditions (p’s < 0.02; greater reduction than imaginal retraining at a small but nonsignificant effect size). Discussion/Conclusion: If replicated, the combination of imaginal retraining and decoupling (3P) represents a promising, easy-to-implement self-help technique to reduce immediate craving. Long-term effects in participants with formally diagnosed AUD have not yet been investigated.

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Understanding low treatment seeking rates for alcohol use disorder: A narrative review of the literature and opportunities for improvement

Cited by 29 publications

References 124 publications

Estimating the prevalence of alcohol-related disorders and treatment utilization in Bremen 2016/2017 through routine data linkage

Estimating the prevalence of alcohol-related disorders and treatment utilization in Bremen 2016/2017 through routine data linkage

Perceived barriers to seeking treatment for alcohol use disorders among the general Danish population – a cross sectional study on the role of severity of alcohol use and gender

Combination of Two Behavioral Techniques Reduces Craving in Problematic Alcohol Consumption by One Third: A Randomized Controlled Trial

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