Tieu Lina, Pourat Nadereh, Bromley Elizabeth, Simhan Rajat, Bastani Roshan, Glenn Beth
Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA, USA.
Subst Use. 2024 Nov 25;18:29768357241301990. doi: 10.1177/29768357241301990. eCollection 2024 Jan-Dec.
Unhealthy alcohol use is one of the leading preventable causes of mortality in the U.S. Despite evidence of the growing burden of alcohol-associated mortality and disease, treatment is severely underutilized. Prior literature has often focused on assessing treatment among patients with severe alcohol use.
Assess factors associated with uptake of treatment for alcohol use among a broad population of those regularly exceeding U.S. guidelines for alcohol use.
Cross-sectional study.
Using data from the National Epidemiologic Survey on Alcohol and Related Conditions - Wave III (NESARC-III) collected April 2012 to June 2013, weighted descriptive statistics were used to describe the U.S. population who self-reported regularly exceeding U.S. guidelines for moderate alcohol use at least monthly. Weighted multivariable regression was used to assess the association of individual-level factors with receipt of help for unhealthy alcohol use.
In weighted analyses of 6467 NESARC-III participants, 17% of the U.S. population reported regular engagement in unhealthy alcohol use (76% use exceeding guidelines, 14% binge drinking, 11% heavy drinking) and were predominantly male (62%), below age 65 (93%), non-Hispanic White (65%), and had lower levels of education and income. Half (53%) met criteria for alcohol use disorder. Only 5% reported receipt of help for their alcohol use. Compared to non-Hispanic White individuals, non-Hispanic Asian/Native Hawaiian or Other Pacific Islander (odds ratio [OR] 0.40, 95% confidence interval [CI] 0.18-0.90) and non-Hispanic Black (OR 0.68, 95% CI 0.48-0.96) individuals were less likely to receive help for alcohol use. Factors associated with greater receipt of help included being older, educational attainment, Medicaid insurance, concomitant drug use, liver disease, acute healthcare utilization, and greater alcohol-related problems.
Identification of the factors associated with receipt of alcohol-related treatment, including race and ethnicity, age, education, insurance, and drug use can inform interventions to increase treatment receipt.
不健康的饮酒行为是美国主要的可预防死亡原因之一。尽管有证据表明与酒精相关的死亡率和疾病负担在不断增加，但治疗的利用率却严重不足。先前的文献常常侧重于评估重度饮酒患者的治疗情况。
评估在广泛的经常超过美国饮酒指南标准的人群中，与接受酒精使用治疗相关的因素。
横断面研究。
利用2012年4月至2013年6月收集的全国酒精及相关状况流行病学调查第三波（NESARC-III）的数据，采用加权描述性统计来描述自我报告至少每月经常超过美国适度饮酒指南标准的美国人群。使用加权多变量回归来评估个体层面因素与接受不健康饮酒帮助之间的关联。
在对6467名NESARC-III参与者的加权分析中，17%的美国人群报告经常有不健康的饮酒行为（76%的饮酒量超过指南标准，14%的人狂饮，11%的人酗酒），且主要为男性（62%），年龄在65岁以下（93%），非西班牙裔白人（65%），教育程度和收入水平较低。一半（53%）符合酒精使用障碍的标准。只有5%的人报告接受过饮酒方面的帮助。与非西班牙裔白人相比，非西班牙裔亚洲人/夏威夷原住民或其他太平洋岛民（优势比[OR]为0.40，95%置信区间[CI]为0.18 - 0.90）以及非西班牙裔黑人（OR为0.68，95% CI为0.48 - 0.96）接受饮酒帮助的可能性较小。与更多接受帮助相关的因素包括年龄较大、教育程度、医疗补助保险、同时使用药物、肝病、急性医疗服务利用以及更多与酒精相关的问题。
确定与接受酒精相关治疗相关的因素，包括种族和民族、年龄、教育、保险和药物使用等，可为增加治疗接受度的干预措施提供参考。
