title: Characteristics of individuals presenting to treatment for primary alcohol problems versus other drug problems in the Australian patient pathways study.
abstract: People seeking treatment for substance use disorders often have additional health and social issues. Although individuals presenting with alcohol as the primary drug of concern (PDOC) account for nearly half of all treatment episodes to the Australian alcohol and other drug (AOD) service system, previous treatment cohort studies have focused only on the profile of Australian heroin or methamphetamine users. While studies overseas indicate that clients seeking treatment primarily for their drinking are less likely to experience social and economic marginalisation than those seeking treatment primarily for illicit or pharmaceutical drug use, very little research has directly compared individuals presenting with alcohol as the PDOC to those primarily presenting with other drugs as their PDOC.
  
  
  
  Seven hundred and ninety-six participants were recruited at entry to specialist AOD treatment in Victoria and Western Australia, and completed measures of demographic and social factors, substance use, quality of life, service use, and criminal justice involvement. We compared those with alcohol as their PDOC to those with other drugs as their PDOC using Pearson chi-square and Mann-Whitney U tests.
  
  
  
  Rates of social disadvantage, poor quality of life, high severity of substance dependence, and past-year AOD, mental health, acute health, and social service use were high in all groups. However, participants with alcohol as the PDOC were older; more likely to have an educational qualification; less likely to report criminal justice involvement, housing/homelessness service use, tobacco smoking, or problems with multiple substances; and reported better environmental quality of life; but were more likely to have used ambulance services, than those with other drugs as their PDOC.
  
  
  
  While those seeking treatment primarily for alcohol problems appear less likely to suffer some forms of social and economic disadvantage or to use multiple substances than those with a primary drug problem, they experience similarly high levels of substance dependence severity and mental health and AOD service use. These findings reinforce the need for AOD services to integrate or coordinate care with programs that address the many complexities clients frequently present with, while also acknowledging differences between those seeking treatment for alcohol versus other drug problems.
authors.affiliation: Turning Point and Monash University, 54-62 Gertrude Street, Fitzroy, VIC, 3065, Australia. dan.lubman@monash.edu.
authors.forename: Dan I
authors.initials: DI
authors.lastname: Lubman
authors.affiliation: Turning Point and Monash University, 54-62 Gertrude Street, Fitzroy, VIC, 3065, Australia.
authors.forename: Joshua B B
authors.initials: JB
authors.lastname: Garfield
authors.affiliation: Turning Point and Monash University, 54-62 Gertrude Street, Fitzroy, VIC, 3065, Australia.
authors.forename: Victoria
authors.initials: V
authors.lastname: Manning
authors.affiliation: Centre for Health and Social Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, VIC, 3000, Australia.
authors.forename: Lynda
authors.initials: L
authors.lastname: Berends
authors.affiliation: , Room HC.2.14, Heart of the Campus Building, Collegiate Crescent, Collegiate Campus, Sheffield, S10 2BQ, UK.
authors.forename: David
authors.initials: D
authors.lastname: Best
authors.affiliation: Centre for Alcohol Policy Research, La Trobe University, 215 Franklin St., Melbourne, 3000, VIC, Australia.
authors.forename: Janette M
authors.initials: JM
authors.lastname: Mugavin
authors.affiliation: National Drug Research Institute, 10 Selby Street, Shenton Park, WA, 6008, Australia.
authors.forename: Tina
authors.initials: T
authors.lastname: Lam
authors.affiliation: University of Sheffield School of Health and Related Research (ScHARR), Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
authors.forename: Penny
authors.initials: P
authors.lastname: Buykx
authors.affiliation: Turning Point and Monash University, 54-62 Gertrude Street, Fitzroy, VIC, 3065, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Larner
authors.affiliation: Turning Point and Monash University, 54-62 Gertrude Street, Fitzroy, VIC, 3065, Australia.
authors.forename: Belinda
authors.initials: B
authors.lastname: Lloyd
authors.affiliation: Centre for Alcohol Policy Research, La Trobe University, 215 Franklin St., Melbourne, 3000, VIC, Australia.
authors.forename: Robin
authors.initials: R
authors.lastname: Room
authors.affiliation: National Drug Research Institute, 10 Selby Street, Shenton Park, WA, 6008, Australia.
authors.forename: Steve
authors.initials: S
authors.lastname: Allsop
mesh_terms: D000293:Adolescent; D000328:Adult; D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D002648:Child; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011788:Quality of Life; D063508:Social Discrimination; D019966:Substance-Related Disorders / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D014739:Victoria / Q000453:epidemiology; D014904:Western Australia / Q000453:epidemiology; D055815:Young Adult
keywords: Alcohol; Drug; Quality of life; Service use; Socioeconomic disadvantage; Substance use disorder; Substance use treatment