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

Louisa Degenhardt, Meyer D. Glantz, Sara Evans-Lacko, Ekaterina Sadikova, Nancy Sampson, Graham Thornicroft, Sergio Aguilar-Gaxiola, Ali Al-Hamzawi, Jordi Alonso, Laura Helena Andrade, Ronny Bruffaerts, Brendan Bunting, Evelyn J. Bromet, José Miguel Caldas de Almeida, Giovanni de Girolamo, Silvia Florescu, Oye Gureje, Josep Maria Haro, Yueqin Huang, Aimee KaramElie 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 C. Kessler, Tomasz Adamowski, Sergio Aguilar-Gaxiola, Ali Al-Hamzawi, Mohammad Al-Kaisy, Jordi Alonso, Yasmin Altwaijri, Laura Helena Andrade, Lukoye Atwoli, Randy P. Auerbach, William G. Axinn, Corina Benjet, Guilherme Borges, Evelyn J. Bromet, Ronny Bruffaerts, Brendan Bunting, José Miguel Caldas de Almeida, Graça Cardoso, Stephanie Chardoul, Somnath Chatterji, Alexandre Chiavegatto Filho, Alfredo H. Cia, Pim Cuijpers, Ron de Graaf, Peter de Jonge, David D. Ebert, Sara Evans-Lacko, John Fayyad, Silvia Florescu, Sandro Galea, Laura Germine, Dirgha J. Ghimire, Stephen E. Gilman, Meyer D. Glantz, Semyon Gluzman, Oye Gureje, Josep Maria Haro, Meredith G. Harris, Yanling He, Hristo Hinkov, Chi Yi Hu, Yueqin Huang, Aimee Nasser Karam, Elie G. Karam, Norito Kawakami, Ronald C. Kessler, Andrzej Kiejna, Karestan C. Koenen, Viviane Kovess-Masfety, Carmen Lara, Sing Lee, Jean Pierre Lepine, Itzhak Levav, Daphna Levinson, Zhaorui Liu, Silvia S. Martins, John J. McGrath, Katie A. McLaughlin, Maria Elena Medina-Mora, Zeina Mneimneh, Jacek Moskalewicz, Fernando Navarro-Mateu, Matthew K. Nock, Siobhan O'Neill, Johan Ormel, Beth Ellen Pennell, Marina Piazza, Patryk Piotrowski, José Posada-Villa, Ayelet M. Ruscio, Kate M. Scott, Tim Slade, Jordan W. Smoller, Juan Carlos Stagnaro, Dan J. Stein, Amy E. Street, Hisateru Tachimori, Margreet ten Have, Graham Thornicroft, Yolanda Torres, Gemma Vilagut, Maria Carmen Viana, Elisabeth Wells, David R. Williams, Michelle A. Williams, Bogdan Wojtyniak, Alan M. Zaslavsky

Research output: Contribution to journalArticle

22 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.

Original languageEnglish
Pages (from-to)299-307
Number of pages9
JournalWorld Psychiatry
Volume16
Issue number3
DOIs
Publication statusPublished - Oct 1 2017

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

Keywords

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

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Psychiatry and Mental health

Cite this

Degenhardt, L., Glantz, M. D., Evans-Lacko, S., Sadikova, E., Sampson, N., Thornicroft, G., ... Zaslavsky, A. M. (2017). Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys. World Psychiatry, 16(3), 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 D.; 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.; Adamowski, Tomasz; Aguilar-Gaxiola, Sergio; Al-Hamzawi, Ali; Al-Kaisy, Mohammad; Alonso, Jordi; Altwaijri, Yasmin; Andrade, Laura Helena; Atwoli, Lukoye; Auerbach, Randy P.; Axinn, William G.; Benjet, Corina; Borges, Guilherme; Bromet, Evelyn J.; Bruffaerts, Ronny; Bunting, Brendan; Caldas de Almeida, José Miguel; Cardoso, Graça; Chardoul, Stephanie; Chatterji, Somnath; Filho, Alexandre Chiavegatto; Cia, Alfredo H.; Cuijpers, Pim; de Graaf, Ron; de Jonge, Peter; Ebert, David D.; Evans-Lacko, Sara; Fayyad, John; Florescu, Silvia; Galea, Sandro; Germine, Laura; Ghimire, Dirgha J.; Gilman, Stephen E.; Glantz, Meyer D.; Gluzman, Semyon; Gureje, Oye; Haro, Josep Maria; Harris, Meredith G.; He, Yanling; Hinkov, Hristo; Hu, Chi Yi; Huang, Yueqin; Karam, Aimee Nasser; Karam, Elie G.; Kawakami, Norito; Kessler, Ronald C.; Kiejna, Andrzej; Koenen, Karestan C.; Kovess-Masfety, Viviane; Lara, Carmen; Lee, Sing; Lepine, Jean Pierre; Levav, Itzhak; Levinson, Daphna; Liu, Zhaorui; Martins, Silvia S.; McGrath, John J.; McLaughlin, Katie A.; Medina-Mora, Maria Elena; Mneimneh, Zeina; Moskalewicz, Jacek; Navarro-Mateu, Fernando; Nock, Matthew K.; O'Neill, Siobhan; Ormel, Johan; Pennell, Beth Ellen; Piazza, Marina; Piotrowski, Patryk; Posada-Villa, José; Ruscio, Ayelet M.; Scott, Kate M.; Slade, Tim; Smoller, Jordan W.; Stagnaro, Juan Carlos; Stein, Dan J.; Street, Amy E.; Tachimori, Hisateru; ten Have, Margreet; Thornicroft, Graham; Torres, Yolanda; Vilagut, Gemma; Viana, Maria Carmen; Wells, Elisabeth; Williams, David R.; Williams, Michelle A.; Wojtyniak, Bogdan; Zaslavsky, Alan M.

In: World Psychiatry, Vol. 16, No. 3, 01.10.2017, p. 299-307.

Research output: Contribution to journalArticle

Degenhardt, L, Glantz, MD, Evans-Lacko, S, Sadikova, E, Sampson, N, Thornicroft, G, Aguilar-Gaxiola, S, Al-Hamzawi, A, Alonso, J, Helena Andrade, L, Bruffaerts, R, Bunting, B, Bromet, EJ, Miguel Caldas de Almeida, J, de Girolamo, G, Florescu, S, Gureje, O, Maria Haro, J, Huang, Y, Karam, A, Karam, EG, Kiejna, A, Lee, S, Lepine, JP, Levinson, D, Elena Medina-Mora, M, Nakamura, Y, Navarro-Mateu, F, Pennell, BE, Posada-Villa, J, Scott, K, Stein, DJ, ten Have, M, Torres, Y, Zarkov, Z, Chatterji, S, Kessler, RC, Adamowski, T, Aguilar-Gaxiola, S, Al-Hamzawi, A, Al-Kaisy, M, Alonso, J, Altwaijri, Y, Andrade, LH, Atwoli, L, Auerbach, RP, Axinn, WG, Benjet, C, Borges, G, Bromet, EJ, Bruffaerts, R, Bunting, B, Caldas de Almeida, JM, Cardoso, G, Chardoul, S, Chatterji, S, Filho, AC, Cia, AH, Cuijpers, P, de Graaf, R, de Jonge, P, Ebert, DD, Evans-Lacko, S, Fayyad, J, Florescu, S, Galea, S, Germine, L, Ghimire, DJ, Gilman, SE, Glantz, MD, Gluzman, S, Gureje, O, Haro, JM, Harris, MG, He, Y, Hinkov, H, Hu, CY, Huang, Y, Karam, AN, Karam, EG, Kawakami, N, Kessler, RC, Kiejna, A, Koenen, KC, Kovess-Masfety, V, Lara, C, Lee, S, Lepine, JP, Levav, I, Levinson, D, Liu, Z, Martins, SS, McGrath, JJ, McLaughlin, KA, Medina-Mora, ME, Mneimneh, Z, Moskalewicz, J, Navarro-Mateu, F, Nock, MK, O'Neill, S, Ormel, J, Pennell, BE, Piazza, M, Piotrowski, P, Posada-Villa, J, Ruscio, AM, Scott, KM, Slade, T, Smoller, JW, Stagnaro, JC, Stein, DJ, Street, AE, Tachimori, H, ten Have, M, Thornicroft, G, Torres, Y, Vilagut, G, Viana, MC, Wells, E, Williams, DR, Williams, MA, Wojtyniak, B & Zaslavsky, AM 2017, 'Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys', World Psychiatry, vol. 16, no. 3, pp. 299-307. https://doi.org/10.1002/wps.20457
Degenhardt, Louisa ; Glantz, Meyer D. ; 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. ; Adamowski, Tomasz ; Aguilar-Gaxiola, Sergio ; Al-Hamzawi, Ali ; Al-Kaisy, Mohammad ; Alonso, Jordi ; Altwaijri, Yasmin ; Andrade, Laura Helena ; Atwoli, Lukoye ; Auerbach, Randy P. ; Axinn, William G. ; Benjet, Corina ; Borges, Guilherme ; Bromet, Evelyn J. ; Bruffaerts, Ronny ; Bunting, Brendan ; Caldas de Almeida, José Miguel ; Cardoso, Graça ; Chardoul, Stephanie ; Chatterji, Somnath ; Filho, Alexandre Chiavegatto ; Cia, Alfredo H. ; Cuijpers, Pim ; de Graaf, Ron ; de Jonge, Peter ; Ebert, David D. ; Evans-Lacko, Sara ; Fayyad, John ; Florescu, Silvia ; Galea, Sandro ; Germine, Laura ; Ghimire, Dirgha J. ; Gilman, Stephen E. ; Glantz, Meyer D. ; Gluzman, Semyon ; Gureje, Oye ; Haro, Josep Maria ; Harris, Meredith G. ; He, Yanling ; Hinkov, Hristo ; Hu, Chi Yi ; Huang, Yueqin ; Karam, Aimee Nasser ; Karam, Elie G. ; Kawakami, Norito ; Kessler, Ronald C. ; Kiejna, Andrzej ; Koenen, Karestan C. ; Kovess-Masfety, Viviane ; Lara, Carmen ; Lee, Sing ; Lepine, Jean Pierre ; Levav, Itzhak ; Levinson, Daphna ; Liu, Zhaorui ; Martins, Silvia S. ; McGrath, John J. ; McLaughlin, Katie A. ; Medina-Mora, Maria Elena ; Mneimneh, Zeina ; Moskalewicz, Jacek ; Navarro-Mateu, Fernando ; Nock, Matthew K. ; O'Neill, Siobhan ; Ormel, Johan ; Pennell, Beth Ellen ; Piazza, Marina ; Piotrowski, Patryk ; Posada-Villa, José ; Ruscio, Ayelet M. ; Scott, Kate M. ; Slade, Tim ; Smoller, Jordan W. ; Stagnaro, Juan Carlos ; Stein, Dan J. ; Street, Amy E. ; Tachimori, Hisateru ; ten Have, Margreet ; Thornicroft, Graham ; Torres, Yolanda ; Vilagut, Gemma ; Viana, Maria Carmen ; Wells, Elisabeth ; Williams, David R. ; Williams, Michelle A. ; Wojtyniak, Bogdan ; Zaslavsky, Alan M. / Estimating treatment coverage for people with substance use disorders : an analysis of data from the World Mental Health Surveys. In: World Psychiatry. 2017 ; Vol. 16, No. 3. pp. 299-307.
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title = "Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys",
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.",
keywords = "alcohol, drugs, Substance use disorders, treatment coverage, United Nations Sustainable Development Goals, World Health Organization",
author = "Louisa Degenhardt and Glantz, {Meyer D.} and Sara Evans-Lacko and Ekaterina Sadikova and Nancy Sampson and Graham Thornicroft and Sergio Aguilar-Gaxiola and Ali Al-Hamzawi and Jordi Alonso and {Helena Andrade}, Laura and Ronny Bruffaerts and Brendan Bunting and Bromet, {Evelyn J.} and {Miguel Caldas de Almeida}, Jos{\'e} and {de Girolamo}, Giovanni and Silvia Florescu and Oye Gureje and {Maria Haro}, Josep and Yueqin Huang and Aimee Karam and Karam, {Elie G.} and Andrzej Kiejna and Sing Lee and Lepine, {Jean Pierre} and Daphna Levinson and {Elena Medina-Mora}, Maria and Yosikazu Nakamura and Fernando Navarro-Mateu and Pennell, {Beth Ellen} and Jos{\'e} Posada-Villa and Kate Scott and Stein, {Dan J.} and {ten Have}, Margreet and Yolanda Torres and Zahari Zarkov and Somnath Chatterji and Kessler, {Ronald C.} and Tomasz Adamowski and Sergio Aguilar-Gaxiola and Ali Al-Hamzawi and Mohammad Al-Kaisy and Jordi Alonso and Yasmin Altwaijri and Andrade, {Laura Helena} and Lukoye Atwoli and Auerbach, {Randy P.} and Axinn, {William G.} and Corina Benjet and Guilherme Borges and Bromet, {Evelyn J.} and Ronny Bruffaerts and Brendan Bunting and {Caldas de Almeida}, {Jos{\'e} Miguel} and Gra{\cc}a Cardoso and Stephanie Chardoul and Somnath Chatterji and Filho, {Alexandre Chiavegatto} and Cia, {Alfredo H.} and Pim Cuijpers and {de Graaf}, Ron and {de Jonge}, Peter and Ebert, {David D.} and Sara Evans-Lacko and John Fayyad and Silvia Florescu and Sandro Galea and Laura Germine and Ghimire, {Dirgha J.} and Gilman, {Stephen E.} and Glantz, {Meyer D.} and Semyon Gluzman and Oye Gureje and Haro, {Josep Maria} and Harris, {Meredith G.} and Yanling He and Hristo Hinkov and Hu, {Chi Yi} and Yueqin Huang and Karam, {Aimee Nasser} and Karam, {Elie G.} and Norito Kawakami and Kessler, {Ronald C.} and Andrzej Kiejna and Koenen, {Karestan C.} and Viviane Kovess-Masfety and Carmen Lara and Sing Lee and Lepine, {Jean Pierre} and Itzhak Levav and Daphna Levinson and Zhaorui Liu and Martins, {Silvia S.} and McGrath, {John J.} and McLaughlin, {Katie A.} and Medina-Mora, {Maria Elena} and Zeina Mneimneh and Jacek Moskalewicz and Fernando Navarro-Mateu and Nock, {Matthew K.} and Siobhan O'Neill and Johan Ormel and Pennell, {Beth Ellen} and Marina Piazza and Patryk Piotrowski and Jos{\'e} Posada-Villa and Ruscio, {Ayelet M.} and Scott, {Kate M.} and Tim Slade and Smoller, {Jordan W.} and Stagnaro, {Juan Carlos} and Stein, {Dan J.} and Street, {Amy E.} and Hisateru Tachimori and {ten Have}, Margreet and Graham Thornicroft and Yolanda Torres and Gemma Vilagut and Viana, {Maria Carmen} and Elisabeth Wells and Williams, {David R.} and Williams, {Michelle A.} and Bogdan Wojtyniak and Zaslavsky, {Alan M.}",
year = "2017",
month = "10",
day = "1",
doi = "10.1002/wps.20457",
language = "English",
volume = "16",
pages = "299--307",
journal = "World Psychiatry",
issn = "1723-8617",
publisher = "Masson SpA",
number = "3",

}

TY - JOUR

T1 - Estimating treatment coverage for people with substance use disorders

T2 - an analysis of data from the World Mental Health Surveys

AU - Degenhardt, Louisa

AU - Glantz, Meyer D.

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 - Helena Andrade, Laura

AU - Bruffaerts, Ronny

AU - Bunting, Brendan

AU - Bromet, Evelyn J.

AU - Miguel Caldas de Almeida, José

AU - de Girolamo, Giovanni

AU - Florescu, Silvia

AU - Gureje, Oye

AU - Maria Haro, Josep

AU - Huang, Yueqin

AU - Karam, Aimee

AU - Karam, Elie G.

AU - Kiejna, Andrzej

AU - Lee, Sing

AU - Lepine, Jean Pierre

AU - Levinson, Daphna

AU - Elena Medina-Mora, Maria

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 C.

AU - Adamowski, Tomasz

AU - Aguilar-Gaxiola, Sergio

AU - Al-Hamzawi, Ali

AU - Al-Kaisy, Mohammad

AU - Alonso, Jordi

AU - Altwaijri, Yasmin

AU - Andrade, Laura Helena

AU - Atwoli, Lukoye

AU - Auerbach, Randy P.

AU - Axinn, William G.

AU - Benjet, Corina

AU - Borges, Guilherme

AU - Bromet, Evelyn J.

AU - Bruffaerts, Ronny

AU - Bunting, Brendan

AU - Caldas de Almeida, José Miguel

AU - Cardoso, Graça

AU - Chardoul, Stephanie

AU - Chatterji, Somnath

AU - Filho, Alexandre Chiavegatto

AU - Cia, Alfredo H.

AU - Cuijpers, Pim

AU - de Graaf, Ron

AU - de Jonge, Peter

AU - Ebert, David D.

AU - Evans-Lacko, Sara

AU - Fayyad, John

AU - Florescu, Silvia

AU - Galea, Sandro

AU - Germine, Laura

AU - Ghimire, Dirgha J.

AU - Gilman, Stephen E.

AU - Glantz, Meyer D.

AU - Gluzman, Semyon

AU - Gureje, Oye

AU - Haro, Josep Maria

AU - Harris, Meredith G.

AU - He, Yanling

AU - Hinkov, Hristo

AU - Hu, Chi Yi

AU - Huang, Yueqin

AU - Karam, Aimee Nasser

AU - Karam, Elie G.

AU - Kawakami, Norito

AU - Kessler, Ronald C.

AU - Kiejna, Andrzej

AU - Koenen, Karestan C.

AU - Kovess-Masfety, Viviane

AU - Lara, Carmen

AU - Lee, Sing

AU - Lepine, Jean Pierre

AU - Levav, Itzhak

AU - Levinson, Daphna

AU - Liu, Zhaorui

AU - Martins, Silvia S.

AU - McGrath, John J.

AU - McLaughlin, Katie A.

AU - Medina-Mora, Maria Elena

AU - Mneimneh, Zeina

AU - Moskalewicz, Jacek

AU - Navarro-Mateu, Fernando

AU - Nock, Matthew K.

AU - O'Neill, Siobhan

AU - Ormel, Johan

AU - Pennell, Beth Ellen

AU - Piazza, Marina

AU - Piotrowski, Patryk

AU - Posada-Villa, José

AU - Ruscio, Ayelet M.

AU - Scott, Kate M.

AU - Slade, Tim

AU - Smoller, Jordan W.

AU - Stagnaro, Juan Carlos

AU - Stein, Dan J.

AU - Street, Amy E.

AU - Tachimori, Hisateru

AU - ten Have, Margreet

AU - Thornicroft, Graham

AU - Torres, Yolanda

AU - Vilagut, Gemma

AU - Viana, Maria Carmen

AU - Wells, Elisabeth

AU - Williams, David R.

AU - Williams, Michelle A.

AU - Wojtyniak, Bogdan

AU - Zaslavsky, Alan M.

PY - 2017/10/1

Y1 - 2017/10/1

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 - alcohol

KW - drugs

KW - Substance use disorders

KW - treatment coverage

KW - United Nations Sustainable Development Goals

KW - World Health Organization

UR - http://www.scopus.com/inward/record.url?scp=85029725127&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85029725127&partnerID=8YFLogxK

U2 - 10.1002/wps.20457

DO - 10.1002/wps.20457

M3 - Article

AN - SCOPUS:85029725127

VL - 16

SP - 299

EP - 307

JO - World Psychiatry

JF - World Psychiatry

SN - 1723-8617

IS - 3

ER -