Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys. Issue 3 (21st September 2017)

• Record Type: Journal Article
• Authors: Degenhardt, Louisa; Glantz, Meyer; Evans‐Lacko, Sara; Sadikova, Ekaterina; Sampson, Nancy; Thornicroft, Graham; Aguilar‐Gaxiola, Sergio; Al‐Hamzawi, Ali; Alonso, Jordi; Helena Andrade, Laura; Bruffaerts, Ronny; Bunting, Brendan; Bromet, Evelyn J.; Miguel Caldas de Almeida, José; de Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; Maria Haro, Josep; Huang, Yueqin; Karam, Aimee; Karam, Elie G.; Kiejna, Andrzej; Lee, Sing; Lepine, Jean‐Pierre; Levinson, Daphna; Elena Medina‐Mora, Maria; Nakamura, Yosikazu; Navarro‐Mateu, Fernando; Pennell, Beth‐Ellen; Posada‐Villa, José; Scott, Kate; Stein, Dan J.; ten Have, Margreet; Torres, Yolanda; Zarkov, Zahari; Chatterji, Somnath; Kessler, Ronald C.;
• Other Names: Adamowski Tomasz investigator.; Aguilar‐Gaxiola Sergio investigator.; Al‐Hamzawi Ali investigator.; Al‐Kaisy Mohammad investigator.; Alonso Jordi investigator.; Altwaijri Yasmin investigator.; Andrade Laura Helena investigator.; Atwoli Lukoye investigator.; Auerbach Randy P. investigator.; Axinn William G. investigator.; Benjet Corina investigator.; Borges Guilherme investigator.; Bromet Evelyn J. investigator.; Bruffaerts Ronny investigator.; Bunting Brendan investigator.; Caldas de Almeida José Miguel investigator.; Cardoso Graça investigator.; Chardoul Stephanie investigator.; Chatterji Somnath investigator.; Filho Alexandre Chiavegatto investigator.; Cia Alfredo H. investigator.; Cuijpers Pim investigator.; Degenhardt Louisa investigator.; de Girolamo Giovanni investigator.; de Graaf Ron investigator.; de Jonge Peter investigator.; Ebert David D. investigator.; Evans‐Lacko Sara investigator.; Fayyad John investigator.; Florescu Silvia investigator.; Galea Sandro investigator.; Germine Laura investigator.; Ghimire Dirgha J. investigator.; Gilman Stephen E. investigator.; Glantz Meyer D. investigator.; Gluzman Semyon investigator.; Gureje Oye investigator.; Haro Josep Maria investigator.; Harris Meredith G. investigator.; He Yanling investigator.; Hinkov Hristo investigator.; Hu Chi‐Yi investigator.; Huang Yueqin investigator.; Karam Aimee Nasser investigator.; Karam Elie G. investigator.; Kawakami Norito investigator.; Kessler Ronald C. investigator.; Kiejna Andrzej investigator.; Koenen Karestan C. investigator.; Kovess‐Masfety Viviane investigator.; Lara Carmen investigator.; Lee Sing investigator.; Lepine Jean‐Pierre investigator.; Levav Itzhak investigator.; Levinson Daphna investigator.; Liu Zhaorui investigator.; Martins Silvia S. investigator.; McGrath John J. investigator.; McLaughlin Katie A. investigator.; Medina‐Mora Maria Elena investigator.; Mneimneh Zeina investigator.; Moskalewicz Jacek investigator.; Navarro‐Mateu Fernando investigator.; Nock Matthew K. investigator.; O'Neill Siobhan investigator.; Ormel Johan investigator.; Pennell Beth‐Ellen investigator.; Piazza Marina investigator.; Piotrowski Patryk investigator.; Posada‐Villa José investigator.; Ruscio Ayelet M. investigator.; Scott Kate M. investigator.; Slade Tim investigator.; Smoller Jordan W. investigator.; Stagnaro Juan Carlos investigator.; Stein Dan J. investigator.; Street Amy E. investigator.; Tachimori Hisateru investigator.; ten Have Margreet investigator.; Thornicroft Graham investigator.; Torres Yolanda investigator.; Vilagut Gemma investigator.; Viana Maria Carmen investigator.; Wells Elisabeth investigator.; Williams David R. investigator.; Williams Michelle A. investigator.; Wojtyniak Bogdan investigator.; Zaslavsky Alan M. investigator.;
• Is Part Of: World psychiatry. Volume 16:Issue 3(2017:Oct.)
• Page Start: 299
• Page End: 307
• Publication Date: 2017-09-21
• Subjects: Substance use disorders -- alcohol -- drugs -- treatment coverage -- World Health Organization -- United Nations Sustainable Development Goals; Psychiatry -- Periodicals; Mental illness -- Periodicals; 616.89005
• DOI: 10.1002/wps.20457
• Languages: English
• ISSNs: 1723-8617

Abstract

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.