TY - JOUR
T1 - A 10-year study of factors associated with alcohol treatment use and non-use in a U.S. population sample
AU - Chartier, Karen G.
AU - Miller, Kierste
AU - Harris, T. Robert
AU - Caetano, Raul
N1 - Funding Information:
The authors acknowledge Jonali Baruah, PhD for her large effort in preparing the dataset for this study and Cache Steinberg, PhD for providing critical review and editing of the paper’s content. We thank Nathaniel Thomas for his work to prepare this document for publication. The research reported in this publication was supported by the National Institute on Alcohol Abuse and Alcoholism of the NationalInstitutes of Health (NIH) under award number R01AA016319 (PI:Caetano). The content and writing are the responsibility of the authors and does not represent the official views of the NIH.
Funding Information:
We expected, over the 10 years, that the relationship between public insurance and treatment use would strengthen, while the relationship with private insurance would weaken. We found support for the first half of this hypothesis, although the strength of this effect from 1991–92 to 2001–02 was small. The second half of this hypothesis was not supported. Our measure of insurance coverage may not have adequately assessed the changes in private insurance that relate to alcohol treatment use at this time, which included the implementation of managed care techniques ( Steenrod et al., 2001 ). For public insurance, Cartwright and Solano (2003) provide data that validate the increased dependence on public funding for substance abuse treatment between 1987 and 1997. This included public insurance as well as federal block grants and state and local grant programs. During the study years public financing of treatment increased by 9.3% compared to 5.0% for private funding. Fully, 62.4% of substance abuse treatment in 1997 was funded by the public sector and 25.3% by public insurance programs. Regardless, this growth in public funding was not sufficient to meet the U.S. population’s treatment need ( Cartwright and Solano, 2003 ). This could help explain why this strengthened relationship was small and paralleled by reductions in treatment use ( Chartier and Caetano, 2011 ).
Publisher Copyright:
© 2016 Elsevier Ireland Ltd.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Background: This study seeks to identify changes in perceived barriers to alcohol treatment and predictors of treatment use between 1991-92 and 2001-02, to potentially help understand reported reductions in treatment use at this time. Social, economic, and health trends during these 10 years provide a context for the study. Methods: Subjects were Whites, Blacks, and Hispanics. The data were from the National Longitudinal Alcohol Epidemiologic Survey (NLAES) and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). We conducted two analyses that compared the surveys on: (1) perceived treatment barriers for subjects who thought they should get help for their drinking, and (2) variables predicting past-year treatment use in an alcohol use disorder subsample using a multi-group multivariate regression model. Results: In the first analysis, those barriers that reflected negative beliefs and fears about seeking treatment as well as perceptions about the lack of need for treatment were more prevalent in 2001-02. The second analysis showed that survey year moderated the relationship between public insurance coverage and treatment use. This relationship was not statistically significant in 1991-92 but was significant and positive in 2001-02, although the effect of this change on treatment use was small. Conclusions: Use of alcohol treatment in the U.S. may be affected by a number of factors, such as trends in public knowledge about treatment, social pressures to reduce drinking, and changes in the public financing of treatment.
AB - Background: This study seeks to identify changes in perceived barriers to alcohol treatment and predictors of treatment use between 1991-92 and 2001-02, to potentially help understand reported reductions in treatment use at this time. Social, economic, and health trends during these 10 years provide a context for the study. Methods: Subjects were Whites, Blacks, and Hispanics. The data were from the National Longitudinal Alcohol Epidemiologic Survey (NLAES) and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). We conducted two analyses that compared the surveys on: (1) perceived treatment barriers for subjects who thought they should get help for their drinking, and (2) variables predicting past-year treatment use in an alcohol use disorder subsample using a multi-group multivariate regression model. Results: In the first analysis, those barriers that reflected negative beliefs and fears about seeking treatment as well as perceptions about the lack of need for treatment were more prevalent in 2001-02. The second analysis showed that survey year moderated the relationship between public insurance coverage and treatment use. This relationship was not statistically significant in 1991-92 but was significant and positive in 2001-02, although the effect of this change on treatment use was small. Conclusions: Use of alcohol treatment in the U.S. may be affected by a number of factors, such as trends in public knowledge about treatment, social pressures to reduce drinking, and changes in the public financing of treatment.
KW - Alcohol treatment utilization
KW - National trends
KW - Perceived barriers to treatment
KW - Predictors of treatment use
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U2 - 10.1016/j.drugalcdep.2016.01.005
DO - 10.1016/j.drugalcdep.2016.01.005
M3 - Article
C2 - 26850510
AN - SCOPUS:84960124364
SN - 0376-8716
VL - 160
SP - 205
EP - 211
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
ER -