Skip to main content
SpringerLink
Log in

A prospective study of the factors influencing entry to alcohol and drug treatment

  • Special Section
  • Published:
The Journal of Behavioral Health Services & Research Aims and scope Submit manuscript

Abstract

Much is known about factors related to entering alcohol and drug treatment, but most research comprises cross-sectional “snapshots” in time. It is not known whether the reasons for entering treatment endure when problem drinkers are studied over time. This study contrasts characteristics predicting treatment entry in a cross-sectional analysis at baseline with a longitudinal perspective at 1- and 3-year follow-up interviews. Sociodemographic characteristics were less important in the longitudinal analysis. In contrast to the social consequences important at the baseline interview, physiologic symptoms of alcohol dependence and interventions by medical professionals were prominent at later interview points. The findings have implications for interventions by health professionals, both for the development of early interventions targeting individuals to treatment and for a continuing care service model.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Andersen RM. Revisiting the behavioral model and access to medical care: does it matter?Journal of Health and Social Behavior. 1995;36:1–10.

    Google Scholar 

  2. Andersen R, Newman JP. Societal and individual determinants of medical utilization in the United States.Milbank Memorial Fund Quarterly. 1973;51:95–124.

    Google Scholar 

  3. Aday LA.The Utilization of Health Services: Indices and Correlates. Washington, DC: National Center for Health Services Research and Development; 1972.

    Google Scholar 

  4. Aday L, Andersen RM. A framework for the study of access to medical care.Health Services Research. 1974;9:208–220.

    Google Scholar 

  5. Narrow WE, Regier DA, Rae DS, et al. Use of services by persons with mental and addictive disorders: findings from the National Institute of Mental Health Epidemiologic Catchment Area program.Archives of General Psychiatry. 1993;50(2):95–107.

    Google Scholar 

  6. Mechanic D. Sex, illness, illness behavior, and the use of health services.Journal of Human Stress. 1976;2:29–40.

    Google Scholar 

  7. Greenley JR, Mechanic D. Social selection in seeking help for psychological problems.Journal of Health and Social Behavior. 1976;17:249–262.

    Google Scholar 

  8. Tucker JA, King MP. Resolving alcohol and drug problems: influences on addictive behavior change and help-seeking processes. In: Tucker JA, Donovan DM, Marlatt GA, eds.Changing Addictive Behavior: Bridging Clinical and Public Health Strategies. New York: Guilford Press; 1999;97–126.

    Google Scholar 

  9. Weisner C, Greenfield T, Room R. Trends in the treatment of alcohol problems in the US general population, 1979 through 1990.American Journal of Public Health. 1995;85(1):55–60.

    Google Scholar 

  10. Weisner C, Schmidt L. Gender disparities in treatment for alcohol problems.Journal of the American Medical Association. 1992;268(14):1872–1876.

    Google Scholar 

  11. Weisner C. Toward an alcohol treatment entry model: a comparison of problem drinkers in the general population and in treatment.Alcoholism: Clinical and Experimental Research. 1993;17(4):746–752.

    Google Scholar 

  12. Bannenberg AF, Raat H, Plomp HN. Demand for alcohol treatment by problem drinkers.Journal of Substance Abuse Treatment. 1992;9(1):59–62.

    Google Scholar 

  13. Grant B. Toward an alcohol treatment model: a comparison of treated and untreated respondents with DSM-IV alcohol use disorders in the general population.Alcoholism: Clinical and Experimental Research. 1996;20(2):372–378.

    Google Scholar 

  14. Booth BM, Kirchner J, Fortney J, et al. Rural at-risk drinkers: correlates and one-year use of alcohol services.Journal of Studies on Alcohol. 2000;61(2):267–277.

    Google Scholar 

  15. Weisner C. The alcohol treatment-seeking process from a problems perspective: responses to events.British Journal of Addiction. 1990;85(4):561–569.

    Google Scholar 

  16. Bardsley PE, Beckman LJ. The health belief model and entry into alcoholism treatment.International Journal of the Addictions. 1988;23(1):19–28.

    Google Scholar 

  17. Hingson R, Scotch N, Day N, et al. Recognizing and seeking help for drinking problems.Journal of Studies on Alcohol. 1980;41:1102–1117.

    Google Scholar 

  18. Edmunds M, Frank R, Hogan M, et al, eds.Managing Managed Care: Quality Improvement in Behavioral Health. Washington, DC: Institute of Medicine, National Academy Press; 1997.

    Google Scholar 

  19. Clark WB, Hilton M, eds.Alcohol in America: Drinking Practices and Problems. Albany, NY: State University of New York Press; 1991.

    Google Scholar 

  20. Fillmore KM. Prevalence, incidence and chronicity among men as a function of age: a longitudinal and cohort analysis.British Journal of Addiction. 1987;82:77–83.

    Google Scholar 

  21. Fillmore KM. Women's drinking across the adult life course as compared to men's: a longitudinal and cohort analysis.British Journal of Addiction. 1987;82:801–811.

    Google Scholar 

  22. Booth BM, Yates WR, Petty F, et al. Patient factors predicting early alcohol-related readmissions for alcoholics: role of alcoholism severity and psychiatric co-morbidity.Journal of Studies on Alcohol. 1991;52(1):37–43.

    Google Scholar 

  23. Mertens J, Weisner C. Predictors of substance abuse treatment retention among women and men in an HMO.Alcoholism: Clinical and Experimental Research. 2000;24(10):1525–1533.

    Google Scholar 

  24. Moos RH, Brennan PL, Mertens JR. Diagnostic subgroups and predictors of one-year re-admission among late-middle-aged and older substance abuse patients.Journal of Studies on Alcohol. 1994;55:173–183.

    Google Scholar 

  25. Institute of Medicine.Broadening the Base of Treatment for Alcohol Problems. Washington, DC: National Academy Press; 1990.

    Google Scholar 

  26. Kaskutas LA, Weisner C, Caetano R. Predictors of help seeking among a longitudinal sample of the general population, 1984–1992.Journal of Studies on Alcohol. 1997;58(2):155–161.

    Google Scholar 

  27. Hingson R, Mangione T, Meyers A, et al. Seeking help for drinking problems: a study in the Boston metropolitan area.Journal of Studies on Alcohol. 1982;43:273–288.

    Google Scholar 

  28. Weisner C, Schmidt L. The Community Epidemiology Laboratory: studying alcohol problems in community- and agency-based populations.Addiction. 1995;90(3):329–342.

    Google Scholar 

  29. Greenfield TK, Weisner C. Drinking problems and self-reported criminal behavior, arrests and convictions: 1990 US alcohol and 1989 county surveys.Addiction. 1995;90(3):361–373.

    Google Scholar 

  30. Kaskutas L, Russell G, Dinis M.Technical Report on the Alcohol Treatment Utilization Study in Public and Private Sectors. Berkeley, CA: Alcohol Research Group; 1997.

    Google Scholar 

  31. Gordon N.1996 Kaiser Permanente Health Survey. Oakland, CA: Kaiser Permanente Division of Research, Northern California Region; 1997.

    Google Scholar 

  32. Tam T.Technical Report on the Alcohol Treatment Utilization Study in Public and Private Sectors: Within and across Sector Weights. Berkeley, CA: Alcohol Research Group; 1997.

    Google Scholar 

  33. Schmidt L, Weisner C, Wiley J. Substance abuse and the course of welfare dependency.American Journal of Public Health. 1998;88(11):1616–1622.

    Google Scholar 

  34. Wilsnack SC, Klassen AD, Schur BE, et al. Predicting onset and chronicity of women's problem drinking: a five-year longitudinal analysis.American Journal of Public Health. 1991;81(3):305–318.

    Google Scholar 

  35. Hilton ME. Demographic characteristics and the frequency of heavy drinking as predictors of self-reported drinking problems.British Journal of Addiction. 1987;82:913–925.

    Google Scholar 

  36. Caetano R, Weisner C. The association between DSM-III-R alcohol dependence, psychological distress and drug use.Addiction. 1995;90(3):351–359.

    Google Scholar 

  37. American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Washington, DC: American Psychiatric Association; 1994.

    Google Scholar 

  38. McLellan TA, Kushner H, Metzger D, et al. The fifth edition of the Addiction Severity Index.Journal of Substance Abuse Treatment. 1992;9(3):199–213.

    Google Scholar 

  39. Schmidt L.Technical Report: A Self-Report Approach to Measuring Insurance Coverage. Berkeley, CA: Alcohol Research Group; 1997.

    Google Scholar 

  40. Regier DA, Narrow WE, Rae DS, et al. The de facto US mental and addictive disorders service system: epidemiologic catchment area prospective 1-year prevalence rates of disorders and services.Archives of General Psychiatry. 1993;50(2):85–94.

    Google Scholar 

  41. Weisner C. The provision of services for alcohol problems: a community perspective for understanding access.Journal of Behavioral Health Services & Research. 2001;28(2):130–142.

    Google Scholar 

  42. Tam T, Schmidt L, Weisner C. Patterns in the institutional encounters of problem drinkers in a community human services network.Addiction. 1996;91(5):657–669.

    Google Scholar 

  43. McLellan AT, Metzger DS, Alterman AI, et al. Is treatment for substance abuse dependence “worth it”? Public health expectations, policy-based comparisons. In: Sirica C, ed.Training about Alcohol and Substance Abuse for All Primary Care Physicians. New York: Josiah Macy Press; 1995:165–212.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Research, Northern California Kaiser Permanente, 3505 Broadway Avenue, 12th Floor, 94611, Oakland, CA

    Constance Weisner DrPH (Investigator)

  2. Department of Psychiatry, University of California, San Francisco

    Constance Weisner DrPH (Investigator) & Helen Matzger MPH (Research Analyst)

  3. at Alcohol Research Group, Public Health Institute, USA

    Helen Matzger MPH (Research Analyst)

Authors
  1. Constance Weisner DrPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Helen Matzger MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Constance Weisner DrPH.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Weisner, C., Matzger, H. A prospective study of the factors influencing entry to alcohol and drug treatment. The Journal of Behavioral Health Services & Research 29, 126–137 (2002). https://doi.org/10.1007/BF02287699

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02287699

Keywords

Search

Navigation