Probability and predictors of treatment-seeking for substance use disorders in the U.S

Abstract

Background Little is known about to what extent treatment-seeking behavior varies across individuals with alcohol abuse, alcohol dependence, drug abuse, and drug dependence. Methods The sample included respondents from the Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who reported a lifetime diagnosis alcohol abuse, alcohol dependence, drug abuse, or drug dependence. Unadjusted and adjusted hazard ratios are presented for time to first treatment contact by sociodemographic characteristics and comorbid psychiatric disorders. Individuals were censored from the analyses if their condition remitted prior to seeking treatment. Results In the first year after disorder onset, rates of treatment-seeking were 13% for drug dependence, 5% for alcohol dependence, 2% for drug abuse, and 1% for alcohol abuse. The lifetime probability of seeking treatment among individuals who did not remit was also highest for drug dependence (90%), followed by drug abuse (60%), alcohol dependence (54%), and alcohol abuse (16%). Having had previous treatment contact for a substance use disorder (SUD) increased the probability of seeking treatment for another SUD. By contrast, an early age of SUD onset, belonging to an older cohort, and a higher level of education decreased the lifetime probability of treatment contact for SUD. The role of comorbid mental disorders was more complex, with some disorders increasing and other decreasing the probability of seeking treatment. Conclusions Given high rates of SUD and their substantial health and economic burden, these patterns suggest the need for innovative approaches to increase treatment access for individuals with SUD.

Alcohol consumption, mental health status, and treatment in Nigeria and Uganda

“…Our finding on good and very good MHS being negatively associated with seeking help for drinking or alcohol-related problems in both countries is in line with other research findings regarding associations between level of mental health and seeking help for problematic alcohol use (e.g., Blanco et al, 2015). Taking the high prevalence of current and heavy episodic drinkers in both countries into account, this finding underlines the need to continue the identification of problematic alcohol consumption and related harms to self and others, especially in Uganda, where the prevalence of youth drinkers is nearly 50%.…”

Mental disorder comorbidity and treatment utilization

“…To our knowledge, there has been only one attempt to integrate treatment utilization research with findings from latent transdiagnostic comorbidity research [70]. Treatment utilization studies typically focus on individual disorders or on limited (e.g., pair-wise) comorbidity patterns while controlling for presence of other disorders [17, 25, 31, 32]. To these ends, we applied a well-supported latent transdiagnostic factor model to understand how multivariate comorbidity was associated with utilization of treatments for various types of disorders.…”

“…Despite the availability of effective treatments for most common mood, anxiety, and substance use disorders (SUDs) [1–9], such treatments remain underutilized [10–17]. For example, treatment utilization among those with alcohol use disorders has lingered around 20% since the early 1990s [11, 18].…”

“…However, some anxiety and personality disorders are inversely related to SUD treatment [17], and antisocial personality disorder appears to be a barrier to treatment for anxiety disorders [31]. Given these complexities, examining the effects of comorbidity by considering pairs of individual disorders (the usual approach) may miss important information [33].…”

Attempts to stop or reduce daily cannabis use: An intensive natural history study.

“…One likely reason for this is the lack of an adequate description of the process of successful and unsuccessful attempts to stop or reduce cannabis use (Klingemann et al, 2001). Although some studies have described attempts to quit cannabis among treatment seekers, as with other drugs, the large majority of attempts to change cannabis use do not involve treatment (Blanco et al, 2015) (Klingemann et al, 2001). Previous natural history studies have described how cannabis use changes over a lifetime (Kandel & Raveis, 1989; Swift, Hall, & Copeland, 2000; VonSydow et al, 2001; Aitken, DeSantis, Harford, & FeCaces, 2000; Ellingstad, Sobell, Sobell, Eickleberry, & Golden, 2006).…”