According to the findings of a recent study by the Karolinska Institutet of Sweden, only a minority of Swedes with alcohol use disorders are prescribed anti-alcohol medication, a situation that has remained largely unchanged in the country since. the mid-2000s. The study published in the journal Drug and Alcohol Dependence also found that prescriptions for alcohol medications are unevenly distributed in society.
“The result shows that there is a great underuse of anti-alcohol drugs as well as an uneven supply of treatment between different groups in society,” says corresponding author Sara Wallhed Finn, researcher at the Department of global public health, Karolinska Institutet, and psychologist within the specialist. care at Beroendecentrum Stockholm (Stockholm Center for Addiction Disorders, a regional drug addiction center). “This is problematic given the great suffering caused by alcohol use disorders, both for the individual and for society as a whole.” Researchers say there are several plausible explanations, such as low awareness of these drugs both among doctors and patients, especially beyond the most prescribed alcohol drug Antabuse (Disulfiram).
Another reason may be that patients prefer psychological treatment to medication. In some cases, there may also be physical barriers, such as liver disease, which make certain types of medication inappropriate. “There are a myriad of possible explanations that we must continue to explore to understand why these approved and effective drugs are used to such a low extent, especially when we know that harmful alcohol consumption increases the risk of several diseases and premature death, ”says Sara Wallhed Finn.
In the current study, the researchers wanted to look at the prescriptions of four approved alcohol medications (Disulfiram, Naltrexone, Acamprosate, and Nalmefene) to people being treated for an alcohol use disorder. More than 130,000 adults diagnosed with alcohol use disorder in specialized care between 2007 and 2015 were included. The study showed that the proportion of people who collected prescriptions for alcohol medications ranged between 22.8 and 23.9 percent, and that the overall level did not change over the period of time. nine-year study. The researchers also found individual differences. For example, alcohol medications have been prescribed to a lesser extent for men, the elderly, people with lower education and income levels, people living in medium-sized cities or rural areas and people with comorbid somatic illnesses.
“We know very little about the causes of these individual differences,” said Sara Wallhed Finn. “One reason may be that access to care varies across the country, where specialized drug addiction care is widely organized in large cities. An important finding is that prescribing rates are particularly low for people with other somatic illnesses, even in cases where comorbidity was not a barrier to prescribing alcohol medications. This is something that we need to explore in order to fully understand. The researchers point out that the study only included people treated for an alcohol use disorder in specialist care and that the number of people with alcohol problems in the general population is much higher. . In total, it is estimated that around 4 percent of adults in Sweden meet the criteria for alcohol use disorder, but far from everyone receives some form of treatment. This means, according to the researchers, that only 2 to 2.5% of all alcohol addicts in Sweden receive alcohol medication.
The study only included data from specialist care; a limit is given that almost half of all diagnoses of alcohol use disorders are made in primary care. The study was also limited to the prescriptions collected; however, an earlier study showed great consistency between prescribed and collected prescriptions, which supports the results. The research was funded by grants from the Alcohol Research Council of the Swedish Alcohol Retail Monopoly, ALF Medicine, Stockholm Region, Psychiatry Research Center, Soderstrom Foundation Konig and the Swedish Medical Association. (ANI)
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