Department of Economics and Business Economics

Cross-national patterns of substance use disorder treatment and associations with mental disorder comorbidity in the WHO World Mental Health Surveys

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

DOI

  • Meredith G. Harris, The University of Queensland, Park Centre for Mental Health
  • ,
  • Chrianna Bharat, UNSW, National Drug & Alcohol Research Centre
  • ,
  • Meyer D. Glantz, National Institute on Drug Abuse
  • ,
  • Nancy A. Sampson, Harvard Medical School
  • ,
  • Ali Al-Hamzawi, Al-Qadisiya University
  • ,
  • Jordi Alonso, Hospital del Mar, Universitat Pompeu Fabra, Barcelona
  • ,
  • Ronny Bruffaerts, Dentistry, University Hospitals, KU Leuven
  • ,
  • José Miguel Caldas de Almeida, Universidade Nova de Lisboa
  • ,
  • Alfredo H. Cia, Anxiety Disorders Center
  • ,
  • Giovanni de Girolamo, IRCCS Istituto Centro San Giovanni di Dio-Fatebenefratelli
  • ,
  • Silvia Florescu, National School of Public Health, Management and Professional Development
  • ,
  • Oye Gureje, University College Hospital, Ibadan
  • ,
  • Josep Maria Haro, Universitat Pompeu Fabra, Barcelona
  • ,
  • Hristo Hinkov, National Center of Public Health and Analyses
  • ,
  • Elie G. Karam, Balamand University, St George Hospital University Medical Center, Institute for Development Research Advocacy and Applied Care (IDRAAC)
  • ,
  • Georges Karam, St George Hospital University Medical Center, Research
  • ,
  • Sing Lee, Chinese University Hong Kong
  • ,
  • Jean Pierre Lépine, Université Descartes, Sorbonne Paris Cité
  • ,
  • Daphna Levinson, Ministry of Health
  • ,
  • Victor Makanjuola, University College Hospital, Ibadan
  • ,
  • John McGrath
  • Zeina Mneimneh, University of Michigan, Ann Arbor, Michigan.
  • ,
  • Fernando Navarro-Mateu, Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP)
  • ,
  • Marina Piazza, Universidad Cayetano Heredia
  • ,
  • José Posada-Villa, Colegio Mayor de Cundinamarca University
  • ,
  • Charlene Rapsey, Dunedin School of Medicine
  • ,
  • Hisateru Tachimori, National Center for Neurology and Psychiatry
  • ,
  • Margreet ten Have, Netherlands Institute of Mental Health and Addiction
  • ,
  • Yolanda Torres, CES University
  • ,
  • Maria Carmen Viana, Espírito Santo
  • ,
  • Somnath Chatterji, World Health Organization
  • ,
  • Alan M. Zaslavsky, Harvard Medical School
  • ,
  • Ronald C. Kessler, Harvard Medical School
  • ,
  • Louisa Degenhardt, UNSW, National Drug & Alcohol Research Centre
  • ,
  • on behalf of the World Health Organization's World Mental Health Surveys collaborators

Aims: To examine cross-national patterns of 12-month substance use disorder (SUD) treatment and minimally adequate treatment (MAT), and associations with mental disorder comorbidity. Design: Cross-sectional, representative household surveys. Setting: Twenty-seven surveys from 25 countries of the WHO World Mental Health Survey Initiative. Participants: A total of 2446 people with past-year DSM-IV SUD diagnoses (alcohol or illicit drug abuse and dependence). Measurements: Outcomes were SUD treatment, defined as having either received professional treatment or attended a self-help group for substance-related problems in the past 12 months, and MAT, defined as having either four or more SUD treatment visits to a health-care professional, six or more visits to a non-health-care professional or being in ongoing treatment at the time of interview. Covariates were mental disorder comorbidity and several socio-economic characteristics. Pooled estimates reflect country sample sizes rather than population sizes. Findings: Of respondents with past-year SUD, 11.0% [standard error (SE) = 0.8] received past 12-month SUD treatment. SUD treatment was more common among people with comorbid mental disorders than with pure SUDs (18.1%, SE = 1.6 versus 6.8%, SE = 0.7), as was MAT (84.0%, SE = 2.5 versus 68.3%, SE = 3.8) and treatment by health-care professionals (88.9%, SE = 1.9 versus 78.8%, SE = 3.0) among treated SUD cases. Adjusting for socio-economic characteristics, mental disorder comorbidity doubled the odds of SUD treatment [odds ratio (OR) = 2.34; 95% confidence interval (CI) = 1.71–3.20], MAT among SUD cases (OR = 2.75; 95% CI = 1.90–3.97) and MAT among treated cases (OR = 2.48; 95% CI = 1.23–5.02). Patterns were similar within country income groups, although the proportions receiving SUD treatment and MAT were higher in high- than low-/middle-income countries. Conclusions: Few people with past-year substance use disorders receive adequate 12-month substance use disorder treatment, even when comorbid with a mental disorder. This is largely due to the low proportion of people receiving any substance use disorder treatment, as the proportion of patients whose treatment is at least minimally adequate is high.

Original languageEnglish
JournalAddiction
Volume114
Issue8
Pages (from-to)1446-1459
Number of pages14
ISSN0965-2140
DOIs
Publication statusPublished - 2019

    Research areas

  • Comorbidity, mental disorders, minimally adequate treatment, substance use disorders, treatment, World Mental Health Surveys

See relations at Aarhus University Citationformats

ID: 159844814