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Too little treatment for people with alcohol use disorder – Global survey

Results from World Mental Health Surveys have found that in two dozen countries, fewer than half of people with alcohol use disorder who sought treatment perceived their treatment as being helpful, reports the National Drug and Alcohol Research Centre (NDARC) at the University of New South Wales in Australia.

This material from NDARC was published on 9 November 2021:

Using survey data from the World Health Organisation (WHO) in 24 countries, researchers from the centre and other universities around the world found that of 9,378 people with lifetime alcohol use disorder, one in eight (11.8%) reported ever obtaining treatment for the disorder. Of these, just under half (44%) reported that treatment was helpful.

Chrianna Bharat, Research Associate at NDARC, said: “This level of perceived helpfulness was far lower for alcohol use disorders than for others like mental health disorders.”

“The reasons for these differences are likely manifold. In comparison to treatment for mental disorders, treatment for substance use disorders is often far less well resourced. There are also significant issues around stigma and accessibility of treatment for substance use disorders that are likely far greater than those for mental disorders.”

The probability of obtaining helpful treatment from the first professional seen was around one in five (21.8%) responders.

“In the face of ongoing unhelpful treatment and as the number of professionals seen by the responders increased, the likelihood that the next treatment would be helpful tended to decrease,” said Bharat.

The study also found that persisting in seeking treatment, despite having received unhelpful treatment, was important in increasing the likelihood of receiving helpful treatment.

“Among those who sought help from up to seven health professionals, 79.7% would receive helpful treatment. However, only 13.2% of those ever-seeking treatment persisted in seeing up to seven professionals,” Bharat said.

People with alcohol use disorder in low- and middle-income countries were only half as likely to obtain helpful treatment as those in high-income countries.

“Quality improvement initiatives, such as adoption of the evidence-based WHO mental health gap action programme (mhGAP) Intervention Guide and the work of the United Nations Office on Drugs and Crime and WHO in improving treatment quality in low- and middle-income countries could be helpful in this regard,” said Bharat.

“Future research should examine how to increase the likelihood that alcohol use disorder treatment is found to be helpful on any given contact.”

 

Study details

Perceived helpfulness of treatment for alcohol use disorders: Findings from the World Mental Health Surveys

Louisa Degenhardt, Chrianna Bharat, Wai Tat Chiu, Meredith G Harris, Alan E Kazdin, Daniel V Vigo, Nancy A Sampson, Jordi Alonso, Laura Helena Andrade, Ronny Bruffaerts, Brendan Bunting, Graça Cardoso Giovannide Girolamo, Silvia Florescu, Oye Gurejeqe, Josep Maria Haro, Chiyi Hu, Aimee N Karam, Elie G Karamtu, Viviane Kovess-Masfety, Sing Lee, Victor Makanjuola, John J McGrathey, Maria Elena Medina-Mora, Jacek Moskalewicz, Fernando Navarro-Mateu, José Posada-Villa, Charlene Rapsey, Juan Carlos Stagnaro, Hisateru Tachimori, Margreetten Have, Yolanda Torres, David R Williams, Zahari Zarkov and Ronald C Kesslerb

Available online in the journal Drug and Alcohol Dependence from November 2021.

 

Abstract

We examined prevalence and factors associated with receiving perceived helpful alcohol use disorder (AUD) treatment, and persistence in help-seeking after earlier unhelpful treatment.

Methods

Data came from 27 community epidemiologic surveys   of adults in 24 countries using the World Health Organisation World Mental Health surveys (n = 93,843). Participants with a lifetime history of treated AUD were asked if they ever received helpful AUD treatment, and how many professionals they had talked to up to and including the first time they received helpful treatment (or how many ever, if they had not received helpful treatment).

Results

11.8% of respondents with lifetime AUD reported ever obtaining treatment (n = 9378); of these, 44% reported that treatment was helpful. The probability of obtaining helpful treatment from the first professional seen was 21.8%; the conditional probability of subsequent professionals being helpful after earlier unhelpful treatment tended to decrease as more professionals were seen.

The cumulative probability of receiving helpful treatment at least once increased from 21.8% after the first professional to 79.7% after the seventh professional seen, following earlier unhelpful treatment. However, the cumulative probability of persisting with up to seven professionals in the face of prior treatments being unhelpful was only 13.2%.

Conclusion

Fewer than half of people with AUDs who sought treatment found treatment helpful; the most important factor was persistence in seeking further treatment if a previous professional had not helped. Future research should examine how to increase the likelihood that AUD treatment is found to be helpful on any given contact.

 

National Drug and Alcohol Research Centre material – Low rates of people with alcohol use disorder are having 'helpful' treatment (Open access)

 

Drug and Alcohol Dependence article – Perceived helpfulness of treatment for alcohol use disorders: Findings from the World Mental Health Surveys (Restricted access)

 

See also from the MedicalBrief archives

 

Five things to know about anti-craving medication for alcohol abuse

 

Alcohol consumption linked to 4% of global cancer cases – WHO study

 

Restricting alcohol ads for SA public health – A justifiable rights infringement?

 

Tobacco and alcohol – the largest substance abuse health burdens

 

 

 

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