Pathways into Services for Alcohol and Drug Disorders

描述（由申请人提供）：本申请的目的是加强我们对药物和酒精障碍患者进入药物和酒精服务的途径的理解。引起公共卫生关注的是，临床确定有服务需求（药物滥用或依赖）的个人缺乏服务利用，我们将其定义为未满足的需求。虽然研究已经确定了一系列治疗酒精和药物障碍的有效服务，包括初级保健和专业护理，但很少有患有这些障碍的人得到服务。我们将药物使用服务广泛地概念化，包括初级保健，

DESCRIPTION (provided by applicant): The purpose of this application is to enhance our understanding of the pathways into drug and alcohol services utilized by individuals with drug and alcohol disorders. Of public health concern is the lack of services utilization among individuals with clinically defined need for services (substance abuse or dependence), which we conceptualize as unmet need. While research has identified a range of effective services for treating alcohol and drug disorders, both in primary care and specialty care, few individuals with these disorders receive services. We conceptualize substance use services broadly, including primary care, specialty substance use services, and self-help groups. Further, while historically the alcohol/drug and mental health research fields have generally addressed only a particular service sector, we propose to study the interactions among substance abuse services, mental health services, and primary care services, with the ultimate focus on substance abuse services. We investigate these issues through secondary analysis of three large, nationally representative surveys: the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), Health Care for Communities (HCC) and the National Survey of Drug Use and Health (NSDUH). The Specific Aims are: (1) To investigate patterns and predictors of perceived need for drug and alcohol services, and the relationship between perceived need and receipt of substance use disorders (SUD) services; (2) To investigate patterns and predictors of primary care screening for drug and alcohol problems, and how screening relates to primary care substance abuse services and specialty referral; (3) To investigate patterns and predictors of mental health services utilization among individuals with substance disorders, and how this relates to receipt of substance abuse services; (4) to investigate patterns and predictors of "coerced" or "non-voluntary" SUD services among individuals with SUDs; (5) to investigate racial/ethnic and urban/rural differences in pathways into SUD services. The results of the study will inform policy to increase rates of utilization of effective substance abuse services among those with substance use disorders.