Alcohol treatment services underused due to perception of negative stigma

Despite the existence of effective programs for treating alcohol dependencies and disorders, less than a quarter of people who are diagnosed actually seek treatment. In a recent study by Columbia University's Mailman School of Public Health researchers report that people diagnosed with alcoholism at some point in their lifetime were more than 60% less likely to seek treatment if they believed they would be stigmatized once their status is known.

This is the first study to address the underuse of alcohol services specifically with regard to alcohol-related stigma. Findings are published in the November issue of the American Journal of Epidemiology.

Based on a survey of 34,653 individuals in the general population (6,309 of whom had an alcohol use disorder) drawn from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), researchers found that individuals with an alcohol use disorder who perceived negative stigma were 0.37 times less likely to seek treatment for their disorder compared to individuals with similarly serious alcohol disorders who did not perceive stigma.

In the general population, younger individuals perceived less stigma, and also were less likely to seek treatment for an alcohol disorder. Men perceived more stigma compared to women (38.1%vs. 37.7%). Non-Hispanic blacks and Hispanic adults overall reported a higher mean stigma compared to Whites (39 % vs. 37%) and were less likely to utilize alcohol services. However, the data also suggest that individuals with more severe alcohol disorders had a greater likelihood to seek treatment. Overall, perceived stigma was significantly higher for those with lower personal income, lower education, and individuals previously married compared to those who had never married.

"People with alcohol disorders who perceive high levels of alcohol stigma may avoid entering treatment because it confirms their membership in a stigmatized group," said Katherine Keyes, PhD, in the Mailman School of Public Health Department Epidemiology. "Given that alcohol use disorders are one of the most prevalent psychiatric disorders in the United States, the empirical documentation of stigma as a barrier to treatment is an important public health finding. Greater attention to reducing the stigma of having an alcohol disorder is urgently needed so that more individuals access the effective systems of care available to treat these disabling conditions."