title: Who seeks treatment for alcohol problems? Demography and alcohol-use characteristics of patients in taboo and non-taboo drinking groups attending professional alcohol services in Nepal.
abstract: BACKGROUND
  Only few individuals with alcohol problems seek help; those who do have not been described adequately. Here, we summarize the demographic and alcohol-related features of inpatients attending professional alcohol services in Nepal and examine differences between patients with and without social taboos about drinking.
  
  
  METHODS
  Fully structured interviews including the Composite International Diagnostic Interview and the Alcohol Use Disorder Identification Test were administered to 177 men and 21 women consecutively admitted to eight alcohol treatment centres in Kathmandu.
  
  
  RESULTS
  Altogether, 164 patients (83%) had alcohol dependence and 24 patients (12%) had alcohol abuse. The sample had a mean age of 35.3 years (SD 10.1) with a time lag of 16.8 years (SD 9.8) from start of habitual drinking to first entry into treatment. Most (62%) were married, lived in urban areas (72%), had above-average income (57%), received adequate social support (71%), and belonged to social groups in which drinking is taboo (57%). Individuals in non-taboo group more often lived in urban areas, had lower socioeconomic status, more often reported parental problem drinking and started drinking at a younger age, whereas individuals in the taboo group more often had late onset, risky drinking, and waited longer before seeking treatment (P<0.05).
  
  
  CONCLUSIONS
  Traditionally alcohol non-using castes and people with higher socioeconomic status over-represent professional alcohol services in Kathmandu. This, and high levels of hazardous and harmful alcohol use, indicate changing trends concerning social tolerance towards alcohol in Nepalese society in recent times and a heavy burden associated with alcohol disorders.
authors.affiliation: Norwegian Centre for Addiction Research (SERAF), University of Oslo, N-0315 Oslo, Norway; Department of Community Medicine, Institute of Health and Society, The Faculty of Medicine, University of Oslo, N-0450 Oslo, Norway. Electronic address: s.p.neupane@medisin.uio.no.
authors.forename: Sudan Prasad
authors.initials: SP
authors.lastname: Neupane
authors.affiliation: Norwegian Centre for Addiction Research (SERAF), University of Oslo, N-0315 Oslo, Norway; Department of Pharmacoepidemiology, Division of Epidemiology, Norwegian Institute of Public Health, N-0403 Oslo, Norway. Electronic address: j.g.bramness@medisin.uio.no.
authors.forename: Jørgen G
authors.initials: JG
authors.lastname: Bramness
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology*; D000437:Alcoholism / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009390:Nepal; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013609:Taboo / Q000523:psychology*; D055815:Young Adult
keywords: Alcohol; Characteristics; Nepal; Service users; Taboo