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2008 年至 2017 年期间,酒精使用障碍治疗利用和治疗环境的变化趋势。

Trends in Alcohol Use Disorder Treatment Utilization and Setting From 2008 to 2017.

机构信息

Mathematica Policy Research, Washington, D.C. (Larsen); Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta (Cummings, Druss); Center for Public Partnerships and Research, University of Kansas, Lawrence (von Esenwein).

出版信息

Psychiatr Serv. 2022 Sep 1;73(9):991-998. doi: 10.1176/appi.ps.202000323. Epub 2022 Feb 23.

Abstract

OBJECTIVE

Little is known about recent trends in treatment for alcohol use disorder. The authors used national data to examine treatment trends among individuals with alcohol use disorder.

METHODS

A sample of nonelderly adults (ages 18-64 years, N=36,707) with alcohol use disorder was identified from the National Survey on Drug Use and Health. Multinomial logistic regression analysis was conducted to examine trends in treatment for alcohol use disorder in 2008-2010, 2011-2013, and 2014-2017 in any medical setting (hospitals, rehabilitation centers, mental health centers, emergency departments, and private doctors' offices), self-help groups only (no medical setting), and no setting (i.e., no treatment). Additional analyses investigated trends in mental health treatment. Regression models adjusted for predisposing, enabling, and need-related characteristics.

RESULTS

Among those with an alcohol use disorder, the percentage who received any treatment was significantly lower in 2011-2013 (5.6%) than in 2008-2010 (6.9%) (p<0.05). In adjusted analyses, the probability of receiving no treatment increased by 1.5 percentage points in 2014-2017 (95% CI=0.5-2.5) compared with the 2008-2010 baseline. Significant declines were observed in the receipt of any treatment in a medical setting (marginal effect [ME]=-1.0%, 95% CI=-2.0 to -0.0) and self-help treatment only (ME=-0.5%, 95% CI=-0.8 to -0.1) in 2014-2017 compared with the baseline period. The probability of receiving any mental health treatment did not change during the study period.

CONCLUSIONS

Among persons with an alcohol use disorder, treatment declined from 2008 to 2017. Future studies should examine the mechanisms that may be responsible for this decline.

摘要

目的

对于治疗酒精使用障碍的最新趋势知之甚少。作者利用全国性数据,研究了患有酒精使用障碍的个体的治疗趋势。

方法

从全国毒品使用与健康调查中确定了一个患有酒精使用障碍的非老年成年人(18-64 岁)样本。采用多项逻辑回归分析,在 2008-2010 年、2011-2013 年和 2014-2017 年期间,在任何医疗环境(医院、康复中心、心理健康中心、急诊室和私人医生办公室)、自助团体(无医疗环境)和无环境(即无治疗)中,研究治疗酒精使用障碍的趋势。进一步的分析调查了心理健康治疗的趋势。回归模型调整了倾向因素、促成因素和需求相关特征。

结果

在患有酒精使用障碍的人群中,2011-2013 年(5.6%)接受任何治疗的比例明显低于 2008-2010 年(6.9%)(p<0.05)。在调整分析中,与 2008-2010 年的基线相比,2014-2017 年(95%CI=0.5-2.5)未接受治疗的可能性增加了 1.5 个百分点。与基线期相比,2014-2017 年在医疗环境(边际效应[ME]=-1.0%,95%CI=-2.0 至-0.0)和仅自助治疗(ME=-0.5%,95%CI=-0.8 至-0.1)中接受任何治疗的比例显著下降。在研究期间,接受任何心理健康治疗的可能性没有变化。

结论

在患有酒精使用障碍的人群中,治疗从 2008 年下降到 2017 年。未来的研究应该研究可能导致这种下降的机制。

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