Barriers to Seek Deaddiction Services in Subjects with Alcohol Use Disorder â€“ A Cross Sectional Study
Background: Kerala consumes 8.3 liters of liquor per person annually, the highest in India. Various factors have been identified as barriers among subjects with Alcohol Use Disorder (AUD) in approaching psychiatric care centers for deaddiction treatment.
Aims & Objectives: (1) To identify barriers to seek alcohol deaddiction treatment in subjects with AUD. (2) To assess their perception about the new alcohol regulation policy of the Government of Kerala.
Methodology: A purposive sample of 100 people with AUD at two government run alcohol outlets of Kannur district were interviewed with a self-rated questionnaire (Barriers Questionnaire v.1.0Aâ€“CASAA Research Division) over a period of one month. Their sociodemographic variables were also collected.
Results: The main treatment barriers were lack of need (79%), confidence of handling problem on their own (77%), risk of losing job and friends (70%), privacy concerns (71%), lack of time (53%), embarrassment to patient and family (51%), financial burden (59%) and fear of treatment (59%). Majority (68%) supported new regulations by the government, but pointed out the need to create awareness among public regarding ill effects of substance use and to check the rise in usage of illicit drugs.
Conclusion: Several barriers prevent people in Kerala from seeking deaddiction for AUD. These need to be considered during making of policies and implementation of treatment strategies.Â
Keywords: alcohol, barriers, deaddiction treatment
Deb P, Jindal B. Drinking in rural areas: a study in selected villages of Punjab. Punjab Agricultural University. Department of economics and sociology: 1975.
Mohan D, Chopra A, Ray R, Sethi H. Alcohol consumption in India: a cross-sectional study. Surveys of drinking patterns and problems in seven developing countries. Geneva: World Health Organization; 2001. pp 103-14.
Chakravarthy C. Community workers estimate of drinking and alcohol-related problems in rural areas. Indian J Psychol Med 1990; 13 (1): 49-56.
Das SK, Balakrishnan V, Vasudevan D. Alcohol: its health and social impact in India. Med Soc 2006; 19(2): 94-9.
George A, Varghese C, Sankaranarayanan R, Nair MK. Use of tobacco and alcoholic beverages by children and teenagers in a low-income coastal community in south India. J Cancer Educ 1994; 9(2):111-3.
K. S. B. C. Ltd, Kerala State Beverages Units. http://www.ksbc.kerala.gov.in/units.htm.
Cunningham JA, Sobell LC, Sobell MB, Agrawal S, Toneatto T. Barriers to treatment: Why alcohol and drug abusers delay or never seek treatment. Addict Behav 1993; 18(3):347-53.
Kar N, Sengupta S, Sharma P, Rao G. Predictors of outcome following alcohol deaddiction treatment: a prospective longitudinal study for one year. Indian J Psychiatry 2003; 45 (3):174.
Melnyk AM. Barriers to care: operationalizing the variable. Nursing Research 1990; 39(2):108-12.
Andersen R, Newman JF. Societal and individual determinants of medical care utilization in the United States. Milbank Q 2005; 83 (4).
Grant BF, Barriers to alcoholism treatment: reasons for not seeking treatment in a general population sample. J Stud Alcohol 1997; 58(4):365-71.
Appel PW, Ellison AA, Jansky HK, Oldak. Barriers to enrollment in drug abuse treatment and suggestions for reducing them: opinions of drug injecting street outreach clients and other system stakeholders. Am J Drug Alcohol Abuse 2004; 30 (1):129-53.
Tucker J, Vuchinich R, Rippens P. A factor analytic study of influences on patterns of help-seeking among treated and untreated alcohol dependent persons. J Subst Abuse Treat 2004; 26(3):237-42.
Barman R, Mahi R, Kumar N, Sharma KC, Sidhu B S, Singh D, et al. Barriers to treatment of substance abuse in a rural population of India. Addiction 2011; 4:65-71.
Pal HR, Yadav S, Joy PS, Mehta S, Ray R. Treatment nonseeking in alcohol users: a community-based study from North India. J Stud Alcohol 2003; 64 (5):631-3.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Washington DC: American Psychiatric Publishing; 2013.
Miller W R, Sovereign R G, Krege B. Motivational interviewing with problem drinkers: II. The Drinker's Check-up as a preventive intervention. Behavioural Psychotherapy 1988;16 (04), 251-68.
Wiseman M. The second World Cancer Research Fund/American Institute for Cancer Research expert report. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Proc Nutr Soc 2008; 67(03):253-6.
Wechsler H, Lee JE, Gledhill-Hoyt J, Nelson TF. Alcohol use and problems at colleges banning alcohol: results of a national survey. J Stud Alcohol 2001; 62 (2):133-41.