Treatment Seeking for Alcohol Use Disorders: Treatment Gap or Adequate Self-Selection?
OBJECTIVE
This study examines whether it is harmful that subjects with an alcohol use disorder (AUD) in the general population rarely seek treatment.


METHODS
Baseline and 3-year follow-up data from the Netherlands Mental Health Survey and Incidence Study-2 were used. Treatment utilization covered a 4-year period. The Composite International Diagnostic Interview 3.0 assessed AUD and other psychiatric disorders.


RESULTS
Of 154 subjects with baseline 12-month DSM-5 AUD, 35.4% used only general treatment (GenTx) for mental problems or alcohol/drugs problems; 10.3% used specialized AUD treatment (AUDTx); and 54.3% used no treatment at all. Of these 3 groups, AUDTx users had the highest severity on AUD characteristics, comorbid psychopathology and mental functioning. Compared to non-treatment (NonTx), GenTx users more often had 12-month emotional disorders at follow-up, but AUD remission rates and functioning were similar. NonTx users functioned similarly at follow-up as people in the general population without lifetime AUD or other psychopathology.


CONCLUSIONS
Adequate treatment seeking often occurs in the general population: the most severe AUD subjects use AUDTx, and most NonTx users have a mild AUD and a favorable course. Current findings suggest a smaller treatment gap than previously reported, but still one-quarter of the people with AUD do not seek AUDTx but could benefit from this, as they have a persistent AUD.
The Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
Marlous
M
Tuithof
Margreet
M
Ten Have
Wim
W
van den Brink
Wilma
W
Vollebergh
Ron
R
de Graaf
D000328:Adult; D019973:Alcohol-Related Disorders / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility / Q000639:trends*; D006306:Health Surveys / Q000639:trends*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011446:Prospective Studies; D011897:Random Allocation; D016896:Treatment Outcome