Among individuals with an alcohol use disorder, treatment rates remain relatively low.
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Among individuals with an alcohol use disorder, treatment rates remain relatively low.
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Yet, despite the fact that most individuals who meet criteria for alcohol use disorder do not seek specialty care for it, these individuals often do access primary care settings making it an ideal place to screen and intervene on this debilitating disorder. Increasing the treatment rates requires greater understanding of the reasons why patients do not seek treatment and whether these reasons vary according to severity of the illness.
Consequently, this study examined self-reported reasons for not seeking treatment and their association with alcohol use disorder severity among primary health care patients diagnosed with an alcohol use disorder.
As part of the Alcohol Dependence in Primary Care Study, alcohol use disorders and reasons for not seeking treatment were assessed using interviews on regionally representative samples of primary care patients from 6 European countries (Italy, Germany, Hungary, Latvia, Poland and Spain). General practitioners and study personnel completed questionnaires assessing their patients’ alcohol use. Study refusal rate was 56.4%.
Although the authors started with sample of 9,098 primary care patients (3,715 males and 5,383 females), 1,008 were diagnosed with a current alcohol use disorder (past 12 months) and an additional 1,774 had a past alcohol use disorder at some point in their life (excluding the past 12 months). The majority of patients did not receive treatment who had a current (810) or lifetime diagnosis (1,372). Of the patients with a current diagnosis, 251 (25%) provided a reason for not receiving treatment compared to 664 (37%) patients with a lifetime diagnosis.
A theoretical framework proposed by Saunders was used to test the theory that reasons for not seeking treatment are related to alcohol use disorder severity. The theory states that at low levels of alcohol use disorder severity ‘a lack of problem awareness/denial’ is the primary reason; however, as severity increases, denial becomes challenged and individuals are more likely to consider treatment and encounter barriers in the process.
Further analysis was conducted to investigate the association between reasons for not seeking treatment and alcohol use disorder severity. The results indicated lower probabilities of reporting ‘lack of awareness/denial of problem’ and higher probabilities to report ‘encounter barriers’ as alcohol use disorders severity increases.
Overall, among primary care patients with a diagnosable alcohol use disorder, this study found that the most frequently reported reason for not seeking treatment was ‘lack of problem awareness/denial’. This was especially true at low levels of alcohol use disorder severity.
Alcohol use disorder is a major contributor to premature death, disease, and disability in Europe, the US, and in nearly all high-income countries.
As alcohol use disorder severity increases, individuals are more likely to consider and seek alcohol use disorder treatment and to encounter actual barriers associated with the treatment seeking process. The desire not to stop drinking completely was the barrier reported most frequently among patients with a current alcohol use disorder.
Treatment approaches that focus on helping patients to initially try reductions in drinking, instead of complete abstinence, may help attract and engage more of these individuals into treatment and help reduce harm whether or not these same individuals choose to abstain at a later time.
Many treatment programs in Europe these days often incorporate client-centered and harm reduction approaches to alcohol and other drug problems, so the perceived barrier of treatment being abstinence-only may be outdated.
Methods by which general practitioners can provide routine assessment of patients alcohol use deserve further exploration. For example, the screening and monitoring of patients’ blood pressure could serve as a model for routine alcohol use assessment in primary care.
Furthermore, blood pressure monitoring itself may offer a destigmatized approach to screening for alcohol use disorder since it is correlated with alcohol use and is standard in yearly checkups.
Probst, C. Manthey, J., Martinez, A., & Rehm, J. (2015). Alcohol use disorder severity and reported reasons not to seek treatment: A cross-sectional study in European primary care practices. Substance Abuse Treatment, Prevention, and Policy, 10:32. DOI 10.1186/s13011-015-0028-z
l
Yet, despite the fact that most individuals who meet criteria for alcohol use disorder do not seek specialty care for it, these individuals often do access primary care settings making it an ideal place to screen and intervene on this debilitating disorder. Increasing the treatment rates requires greater understanding of the reasons why patients do not seek treatment and whether these reasons vary according to severity of the illness.
Consequently, this study examined self-reported reasons for not seeking treatment and their association with alcohol use disorder severity among primary health care patients diagnosed with an alcohol use disorder.
As part of the Alcohol Dependence in Primary Care Study, alcohol use disorders and reasons for not seeking treatment were assessed using interviews on regionally representative samples of primary care patients from 6 European countries (Italy, Germany, Hungary, Latvia, Poland and Spain). General practitioners and study personnel completed questionnaires assessing their patients’ alcohol use. Study refusal rate was 56.4%.
Although the authors started with sample of 9,098 primary care patients (3,715 males and 5,383 females), 1,008 were diagnosed with a current alcohol use disorder (past 12 months) and an additional 1,774 had a past alcohol use disorder at some point in their life (excluding the past 12 months). The majority of patients did not receive treatment who had a current (810) or lifetime diagnosis (1,372). Of the patients with a current diagnosis, 251 (25%) provided a reason for not receiving treatment compared to 664 (37%) patients with a lifetime diagnosis.
A theoretical framework proposed by Saunders was used to test the theory that reasons for not seeking treatment are related to alcohol use disorder severity. The theory states that at low levels of alcohol use disorder severity ‘a lack of problem awareness/denial’ is the primary reason; however, as severity increases, denial becomes challenged and individuals are more likely to consider treatment and encounter barriers in the process.
Further analysis was conducted to investigate the association between reasons for not seeking treatment and alcohol use disorder severity. The results indicated lower probabilities of reporting ‘lack of awareness/denial of problem’ and higher probabilities to report ‘encounter barriers’ as alcohol use disorders severity increases.
Overall, among primary care patients with a diagnosable alcohol use disorder, this study found that the most frequently reported reason for not seeking treatment was ‘lack of problem awareness/denial’. This was especially true at low levels of alcohol use disorder severity.
Alcohol use disorder is a major contributor to premature death, disease, and disability in Europe, the US, and in nearly all high-income countries.
As alcohol use disorder severity increases, individuals are more likely to consider and seek alcohol use disorder treatment and to encounter actual barriers associated with the treatment seeking process. The desire not to stop drinking completely was the barrier reported most frequently among patients with a current alcohol use disorder.
Treatment approaches that focus on helping patients to initially try reductions in drinking, instead of complete abstinence, may help attract and engage more of these individuals into treatment and help reduce harm whether or not these same individuals choose to abstain at a later time.
Many treatment programs in Europe these days often incorporate client-centered and harm reduction approaches to alcohol and other drug problems, so the perceived barrier of treatment being abstinence-only may be outdated.
Methods by which general practitioners can provide routine assessment of patients alcohol use deserve further exploration. For example, the screening and monitoring of patients’ blood pressure could serve as a model for routine alcohol use assessment in primary care.
Furthermore, blood pressure monitoring itself may offer a destigmatized approach to screening for alcohol use disorder since it is correlated with alcohol use and is standard in yearly checkups.
Probst, C. Manthey, J., Martinez, A., & Rehm, J. (2015). Alcohol use disorder severity and reported reasons not to seek treatment: A cross-sectional study in European primary care practices. Substance Abuse Treatment, Prevention, and Policy, 10:32. DOI 10.1186/s13011-015-0028-z
l
Yet, despite the fact that most individuals who meet criteria for alcohol use disorder do not seek specialty care for it, these individuals often do access primary care settings making it an ideal place to screen and intervene on this debilitating disorder. Increasing the treatment rates requires greater understanding of the reasons why patients do not seek treatment and whether these reasons vary according to severity of the illness.
Consequently, this study examined self-reported reasons for not seeking treatment and their association with alcohol use disorder severity among primary health care patients diagnosed with an alcohol use disorder.
As part of the Alcohol Dependence in Primary Care Study, alcohol use disorders and reasons for not seeking treatment were assessed using interviews on regionally representative samples of primary care patients from 6 European countries (Italy, Germany, Hungary, Latvia, Poland and Spain). General practitioners and study personnel completed questionnaires assessing their patients’ alcohol use. Study refusal rate was 56.4%.
Although the authors started with sample of 9,098 primary care patients (3,715 males and 5,383 females), 1,008 were diagnosed with a current alcohol use disorder (past 12 months) and an additional 1,774 had a past alcohol use disorder at some point in their life (excluding the past 12 months). The majority of patients did not receive treatment who had a current (810) or lifetime diagnosis (1,372). Of the patients with a current diagnosis, 251 (25%) provided a reason for not receiving treatment compared to 664 (37%) patients with a lifetime diagnosis.
A theoretical framework proposed by Saunders was used to test the theory that reasons for not seeking treatment are related to alcohol use disorder severity. The theory states that at low levels of alcohol use disorder severity ‘a lack of problem awareness/denial’ is the primary reason; however, as severity increases, denial becomes challenged and individuals are more likely to consider treatment and encounter barriers in the process.
Further analysis was conducted to investigate the association between reasons for not seeking treatment and alcohol use disorder severity. The results indicated lower probabilities of reporting ‘lack of awareness/denial of problem’ and higher probabilities to report ‘encounter barriers’ as alcohol use disorders severity increases.
Overall, among primary care patients with a diagnosable alcohol use disorder, this study found that the most frequently reported reason for not seeking treatment was ‘lack of problem awareness/denial’. This was especially true at low levels of alcohol use disorder severity.
Alcohol use disorder is a major contributor to premature death, disease, and disability in Europe, the US, and in nearly all high-income countries.
As alcohol use disorder severity increases, individuals are more likely to consider and seek alcohol use disorder treatment and to encounter actual barriers associated with the treatment seeking process. The desire not to stop drinking completely was the barrier reported most frequently among patients with a current alcohol use disorder.
Treatment approaches that focus on helping patients to initially try reductions in drinking, instead of complete abstinence, may help attract and engage more of these individuals into treatment and help reduce harm whether or not these same individuals choose to abstain at a later time.
Many treatment programs in Europe these days often incorporate client-centered and harm reduction approaches to alcohol and other drug problems, so the perceived barrier of treatment being abstinence-only may be outdated.
Methods by which general practitioners can provide routine assessment of patients alcohol use deserve further exploration. For example, the screening and monitoring of patients’ blood pressure could serve as a model for routine alcohol use assessment in primary care.
Furthermore, blood pressure monitoring itself may offer a destigmatized approach to screening for alcohol use disorder since it is correlated with alcohol use and is standard in yearly checkups.
Probst, C. Manthey, J., Martinez, A., & Rehm, J. (2015). Alcohol use disorder severity and reported reasons not to seek treatment: A cross-sectional study in European primary care practices. Substance Abuse Treatment, Prevention, and Policy, 10:32. DOI 10.1186/s13011-015-0028-z
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