Sachini N Bandara1, Hillary Samples2, Rosa M Crum3, Brendan Saloner4. 1. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, United States of America. Electronic address: sbandar2@jhu.edu. 2. Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W. 168th Street, New York, NY 10032, United States of America. 3. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe, Baltimore, MD 21205, United States of America. 4. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, United States of America.
Abstract
BACKGROUND: Most individuals with alcohol use disorder do not receive treatment and little national-level United States (U.S.) data exist on the association between screening and intervention with receipt of treatment. METHODS: The sample includes adults 18 years and older reporting prior year symptoms of alcohol use disorder from 2013 and 2014 National Survey on Drug Use and Health. Survey-weight adjusted prevalence of prior year receipt of ambulatory care, alcohol screening in a medical setting, alcohol intervention in a medical setting and alcohol treatment receipt and setting were calculated. Regression-adjusted odds ratios were calculated for alcohol treatment outcomes of interest. RESULTS: Despite high use of ambulatory care (74.4%, 95%CI: 72.8, 75.6), prevalence of screening (52.5%, 95%CI: 50.5, 54.5), intervention (13.5%, 95%CI: 12.1, 15.0) and treatment (6.8%, 95%CI: 5.8, 7.9) were low. Screening (AOR: 1.7, p < 0.050) and intervention (AOR: 4.7, p < 0.001) were associated with increased odds of treatment. Screening and intervention were associated with increased odds of receiving treatment in medical and specialty behavioral health settings and decreased odds of receiving treatment in only self-help groups. CONCLUSIONS: While prior year receipt of screening and intervention were low overall among adults with alcohol use disorder, receipt of these services was strongly associated with use of alcohol treatment. This likely indicates a missed opportunity to encourage a high-risk population to access treatment services. Receipt of screening and intervention was most strongly associated with treatment in medical and specialty behavioral health settings. Future research should examine this prospectively to assess whether entry into treatment settings may be mediated by screening and intervention in ambulatory care settings or if brief intervention is occurring at the time of treatment.
BACKGROUND: Most individuals with alcohol use disorder do not receive treatment and little national-level United States (U.S.) data exist on the association between screening and intervention with receipt of treatment. METHODS: The sample includes adults 18 years and older reporting prior year symptoms of alcohol use disorder from 2013 and 2014 National Survey on Drug Use and Health. Survey-weight adjusted prevalence of prior year receipt of ambulatory care, alcohol screening in a medical setting, alcohol intervention in a medical setting and alcohol treatment receipt and setting were calculated. Regression-adjusted odds ratios were calculated for alcohol treatment outcomes of interest. RESULTS: Despite high use of ambulatory care (74.4%, 95%CI: 72.8, 75.6), prevalence of screening (52.5%, 95%CI: 50.5, 54.5), intervention (13.5%, 95%CI: 12.1, 15.0) and treatment (6.8%, 95%CI: 5.8, 7.9) were low. Screening (AOR: 1.7, p < 0.050) and intervention (AOR: 4.7, p < 0.001) were associated with increased odds of treatment. Screening and intervention were associated with increased odds of receiving treatment in medical and specialty behavioral health settings and decreased odds of receiving treatment in only self-help groups. CONCLUSIONS: While prior year receipt of screening and intervention were low overall among adults with alcohol use disorder, receipt of these services was strongly associated with use of alcohol treatment. This likely indicates a missed opportunity to encourage a high-risk population to access treatment services. Receipt of screening and intervention was most strongly associated with treatment in medical and specialty behavioral health settings. Future research should examine this prospectively to assess whether entry into treatment settings may be mediated by screening and intervention in ambulatory care settings or if brief intervention is occurring at the time of treatment.
Authors: Bridget F Grant; Risë B Goldstein; Tulshi D Saha; S Patricia Chou; Jeesun Jung; Haitao Zhang; Roger P Pickering; W June Ruan; Sharon M Smith; Boji Huang; Deborah S Hasin Journal: JAMA Psychiatry Date: 2015-08 Impact factor: 21.596
Authors: Carrie M Mintz; Sarah M Hartz; Sherri L Fisher; Alex T Ramsey; Elvin H Geng; Richard A Grucza; Laura J Bierut Journal: Alcohol Clin Exp Res Date: 2021-05-16 Impact factor: 3.928