Treatment techniques and tools to address alcohol use disorders (AUDs)* have multiplied over the last 30 years, moving beyond models based on Alcoholics Anonymous and its offshoot, the Minnesota Model. Care providers now can prescribe medications to aid people as they work to reduce their drinking. If a traditional mutual-help group model of care does not appeal to a patient, he or she has other behavioral therapy options. And Web-based approaches provide access to therapy 24 hours a day, 7 days a week.
Despite these developments, however, the majority of people with alcohol use disorders (AUDs) in the United States go untreated. According to data from NIAAA’s 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), only 14.6 percent of people with alcohol abuse or dependence receive treatment.1,2 Another survey3 of people who experienced the onset of alcohol dependence a year before the study found that only 25 percent ever received treatment. Though some people with AUDs do actually recover on their own without formal treatment, some achieve partial remission, and some cycle in and out of alcohol problems throughout their lives, novel approaches and further access to treatment could play an important role in helping people to reduce their drinking.2
This picture of a largely untreated population of patients has prompted researchers to explore better ways of engaging people who might not have considered treatment as an option for addressing their problems with alcohol. Improving diagnosis is one area under exploration, including screening for alcohol abuse and alcoholism and providing brief interventions in a variety of settings, such as primary care clinics and emergency departments. Scientists are examining the effectiveness of medications for treating patients and preventing relapse to drinking. Research also suggests that a large proportion of people with co-occurring psychological or medical conditions remain underserved by existing treatment systems; greater coordination of care might improve responses to AUD treatment for this group.
This Alcohol Alert summarizes the state of alcoholism treatment research, explores its use in a variety of settings, and reviews new efforts for engaging people in treatment. Efforts to improve continuing care for those in treatment and to coordinate care for those with co-occurring disorders also are included. The Alert then examines how health services and financing vehicles, such as private and public insurance, influence people’s ability to access and pay for that treatment.
