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Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys

Degenhardt, Louisa and Glantz, Meyer and Evans-Lacko, Sara and Sadikova, Ekaterina and Sampson, Nancy and Thornicroft, Graham and Aguilar-Gaxiola, Sergio and Al-Hamzawi, Ali and Alonso, Jordi and Andrade, Laura Helena and Bruffaerts, Ronny and Bunting, Brendan and Bromet, Evelyn J. and Caldas de Almeida, Jose Miguel and de Girolamo, G. and Florescu, Silvia and Gureje, Oye and Haro, Josep Maria and Huang, Yueqin and Karam, Aimee and Karam, Elie G. and Kiejna, Andrzej and Lee, Sing and Lepine, Jean Pierre and Levinson, Daphna and Medina-Mora, Maria Elen and Nakamura, Yosikazu and Navorro-Mateu, Fernando and Pennell, Beth-Ellen and Posada-Villa, Jose and Scott, Kate and Stein, Dan J. and ten Have, Margreet and Torres, Yolanda and Zarkov, Zahari and Chatterji, Somnath and Kessler, Ronald C. (2017) Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys. World Psychiatry, 16 (3). pp. 299-307. ISSN 1723-8617

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Identification Number: 10.1002/wps.20457

Abstract

Substance use is a major cause of disability globally. This has been recognized in the recent United Nations Sustainable Development Goals (SDGs), in which treatment coverage for substance use disorders is identified as one of the indicators. There have been no estimates of this treatment coverage cross-nationally, making it difficult to know what is the baseline for that SDG target. Here we report data from the World Health Organization (WHO)'s World Mental Health Surveys (WMHS), based on representative community household surveys in 26 countries. We assessed the 12-month prevalence of substance use disorders (alcohol or drug abuse/dependence); the proportion of people with these disorders who were aware that they needed treatment and who wished to receive care; the proportion of those seeking care who received it; and the proportion of such treatment that met minimal standards for treatment quality (“minimally adequate treatment”). Among the 70,880 participants, 2.6% met 12-month criteria for substance use disorders; the prevalence was higher in upper-middle income (3.3%) than in high-income (2.6%) and low/lower-middle income (2.0%) countries. Overall, 39.1% of those with 12-month substance use disorders recognized a treatment need; this recognition was more common in high-income (43.1%) than in upper-middle (35.6%) and low/lower-middle income (31.5%) countries. Among those who recognized treatment need, 61.3% made at least one visit to a service provider, and 29.5% of the latter received minimally adequate treatment exposure (35.3% in high, 20.3% in upper-middle, and 8.6% in low/lower-middle income countries). Overall, only 7.1% of those with past-year substance use disorders received minimally adequate treatment: 10.3% in high income, 4.3% in upper-middle income and 1.0% in low/lower-middle income countries. These data suggest that only a small minority of people with substance use disorders receive even minimally adequate treatment. At least three barriers are involved: awareness/perceived treatment need, accessing treatment once a need is recognized, and compliance (on the part of both provider and client) to obtain adequate treatment. Various factors are likely to be involved in each of these three barriers, all of which need to be addressed to improve treatment coverage of substance use disorders. These data provide a baseline for the global monitoring of progress of treatment coverage for these disorders as an indicator within the SDGs.

Item Type: Article
Official URL: http://onlinelibrary.wiley.com/journal/10.1002/(IS...
Additional Information: © 2017 World Psychiatric Association
Divisions: Personal Social Services Research Unit
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Sets: Research centres and groups > Personal Social Services Research Unit (PSSRU)
Date Deposited: 13 Oct 2017 14:10
Last Modified: 13 Oct 2017 14:10
URI: http://eprints.lse.ac.uk/id/eprint/84650

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