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

Louisa Degenhardt, Meyer Glantz, Sara Evans-Lacko, Ekaterina Sadikova, Nancy Sampson, Graham Thornicroft, Sergio Aguilar-Gaxiola, Ali Al-Hamzawi , Jordi Alonso, Laura Helena Andrade, Ronny Bruffaerts, B Bunting, Evelyn J Bromet, José Miguel Caldas de Almeida, Giovanni de Girolamo, Silvia Florescu, Oye Gureje, Josep Maria Haro, Yueqin Huang, Aimee Karam & 17 others Elie G. Karam, Andrzej Kiejna, Sing Lee, Jean Pierre Lepine, Daphna Levinson, Maria-Elena Medina-Mora, Yosikazu Nakamura, Fernando Navarro-Mateu, Beth-Ellen Pennell, José Posada-Villa, Kate Scott, Dan J. Stein, Margreet ten Have, Yolanda Torres, Zahari Zarkov, Somnath Chatterji, Ronald Kessler

Research output: Contribution to journalArticle

16 Citations (Scopus)

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.
LanguageEnglish
Pages299-307
JournalWorld Psychiatry
Volume16
Issue number3
Early online date21 Sep 2017
DOIs
Publication statusPublished - Oct 2017

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Health Surveys
Substance-Related Disorders
Mental Health
Conservation of Natural Resources
Global Health
United Nations
Alcoholism
Compliance

Keywords

  • Substance use disorders
  • alcohol, drugs
  • treatment coverage
  • World Health Organization, United Nations Sustainable Development Goals

Cite this

Degenhardt, L., Glantz, M., Evans-Lacko, S., Sadikova, E., Sampson, N., Thornicroft, G., ... Kessler, R. (2017). Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys. 16(3), 299-307. https://doi.org/10.1002/wps.20457
Degenhardt, Louisa ; Glantz, Meyer ; Evans-Lacko, Sara ; Sadikova, Ekaterina ; Sampson, Nancy ; Thornicroft, Graham ; Aguilar-Gaxiola, Sergio ; Al-Hamzawi , Ali ; Alonso, Jordi ; Andrade, Laura Helena ; Bruffaerts, Ronny ; Bunting, B ; Bromet, Evelyn J ; Caldas de Almeida, José Miguel ; de Girolamo, Giovanni ; Florescu, Silvia ; Gureje, Oye ; Haro, Josep Maria ; Huang, Yueqin ; Karam, Aimee ; Karam, Elie G. ; Kiejna, Andrzej ; Lee, Sing ; Lepine, Jean Pierre ; Levinson, Daphna ; Medina-Mora, Maria-Elena ; 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. / Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys. 2017 ; Vol. 16, No. 3. pp. 299-307.
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Degenhardt, L, Glantz, M, Evans-Lacko, S, Sadikova, E, Sampson, N, Thornicroft, G, Aguilar-Gaxiola, S, Al-Hamzawi , A, Alonso, J, Andrade, LH, Bruffaerts, R, Bunting, B, Bromet, EJ, Caldas de Almeida, JM, de Girolamo, G, Florescu, S, Gureje, O, Haro, JM, Huang, Y, Karam, A, Karam, EG, Kiejna, A, Lee, S, Lepine, JP, Levinson, D, Medina-Mora, M-E, Nakamura, Y, Navarro-Mateu, F, Pennell, B-E, Posada-Villa, J, Scott, K, Stein, DJ, ten Have, M, Torres, Y, Zarkov, Z, Chatterji, S & Kessler, R 2017, 'Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys', vol. 16, no. 3, pp. 299-307. https://doi.org/10.1002/wps.20457

Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys. / Degenhardt, Louisa; Glantz, Meyer; Evans-Lacko, Sara; Sadikova, Ekaterina; Sampson, Nancy; Thornicroft, Graham; Aguilar-Gaxiola, Sergio; Al-Hamzawi , Ali; Alonso, Jordi; Andrade, Laura Helena; Bruffaerts, Ronny; Bunting, B; Bromet, Evelyn J; Caldas de Almeida, José Miguel; de Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; Huang, Yueqin; Karam, Aimee; Karam, Elie G.; Kiejna, Andrzej; Lee, Sing; Lepine, Jean Pierre; Levinson, Daphna; Medina-Mora, Maria-Elena; 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.

Vol. 16, No. 3, 10.2017, p. 299-307.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys

AU - Degenhardt, Louisa

AU - Glantz, Meyer

AU - Evans-Lacko, Sara

AU - Sadikova, Ekaterina

AU - Sampson, Nancy

AU - Thornicroft, Graham

AU - Aguilar-Gaxiola, Sergio

AU - Al-Hamzawi , Ali

AU - Alonso, Jordi

AU - Andrade, Laura Helena

AU - Bruffaerts, Ronny

AU - Bunting, B

AU - Bromet, Evelyn J

AU - Caldas de Almeida, José Miguel

AU - de Girolamo, Giovanni

AU - Florescu, Silvia

AU - Gureje, Oye

AU - Haro, Josep Maria

AU - Huang, Yueqin

AU - Karam, Aimee

AU - Karam, Elie G.

AU - Kiejna, Andrzej

AU - Lee, Sing

AU - Lepine, Jean Pierre

AU - Levinson, Daphna

AU - Medina-Mora, Maria-Elena

AU - Nakamura, Yosikazu

AU - Navarro-Mateu, Fernando

AU - Pennell, Beth-Ellen

AU - Posada-Villa, José

AU - Scott, Kate

AU - Stein, Dan J.

AU - ten Have, Margreet

AU - Torres, Yolanda

AU - Zarkov, Zahari

AU - Chatterji, Somnath

AU - Kessler, Ronald

PY - 2017/10

Y1 - 2017/10

N2 - 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.

AB - 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.

KW - Substance use disorders

KW - alcohol, drugs

KW - treatment coverage

KW - World Health Organization, United Nations Sustainable Development Goals

U2 - 10.1002/wps.20457

DO - 10.1002/wps.20457

M3 - Article

VL - 16

SP - 299

EP - 307

IS - 3

ER -

Degenhardt L, Glantz M, Evans-Lacko S, Sadikova E, Sampson N, Thornicroft G et al. Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys. 2017 Oct;16(3):299-307. https://doi.org/10.1002/wps.20457