Alcohol Use Disorder Severity and Reported Reasons Not To Seek Treatment: A Cross-Sectional Study in European Primary Care Practices

Below:  Probabilities of reporting reasons for not seeking treatment, predicted by alcohol use disorder severity. Severity of alcohol use disorders in the past 12 months ranged from sub threshold (reference) to severe as defined by DSM-5. Predictions are based on multinomial logistic regression. Reasons are grouped by Saunders' theoretical framework. 95 % confidence intervals are indicated

Below:  Theoretical framework of the treatment seeking process as suggested by (Saunders et al. [17]). Each step in the process of seeking treatment for an alcohol use disorder is related to specific reasons for not seeking treatment. Reprinted from Journal of Substance Abuse Treatment, 30 (3), Saunders, Zygowicz, & D'Angelo, Person-related and treatment-related barriers to alcohol treatment, p. 261–270, © 2006, with permission from ELSEVIER

Of 1,008 patients diagnosed with an alcohol use disorder (via general practitioner or patient interview) in the past 12 months, the majority (N = 810) did not receive treatment and 251 of those gave a reason for not seeking treatment. The most frequent reason was ‘lack of problem awareness’ (55.3 % of those who responded), the second most common response was ‘stigma or shame’ (28.6 %), followed by ‘encounter barriers’ (22.8 %) and ‘cope alone’ (20.9 %). The results indicated lower probabilities of reporting ‘denial’ and higher probabilities to report ‘encounter barriers’ as alcohol use disorders severity increases. However, both trends were discontinued for patients with severe alcohol use disorders.

Particularly at lower levels of alcohol use disorder severity, a lack of problem awareness prevents patients from seeking treatment. Routinely alcohol consumption monitoring in primary care practices could help primary and secondary prevention of alcohol use disorders and increase treatment coverage.

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