Solna [Sweden], 13 September (ANI): According to the results of a recent study at Karolinska Institutet, only a minority of Swedes with alcohol disorders receive alcohol medication, a situation that has remained largely unchanged in the country since mid-2000.
The study, which was published in the journal Drug and Alcohol Dependence, also found that prescriptions for alcohol medicine are unevenly distributed in society.
“The results show that there is a large underutilization of alcohol medicine and unequal treatment between different groups in society”, says corresponding author Sara Wallhed Finn, researcher at the Department of Global Public Health, Karolinska Institutet and psychologist in specialist care at Beroendecentrum Stockholm (Stockholm Center for Dependency Disorders, a regional addiction center). “This is problematic given the great suffering caused by alcohol disorder, both for the individual and for society at large.” The researchers say that there are several probable explanations, for example low knowledge about these drugs among both doctors and patients, especially outside 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, that make certain types of medication inappropriate.
“There are a myriad of possible explanations that we need to continue to explore to understand why these approved and effective drugs are used so little, especially when we know that harmful alcohol use increases the risk of multiple diseases and premature death,” Sara Wallhed Finn says.
In the current study, the researchers wanted to investigate the prescriptions of four approved alcohol drugs (Disulfiram, Naltrexone, Acamprosate and Nalmefene) for people treated for alcohol disorder. More than 130,000 adults who were diagnosed with alcohol disorder in specialist care between 2007 and 2015 were included.
The study showed that the proportion of individuals who collected prescriptions for alcohol medicine varied between 22.8 and 23.9 percent and that the overall level did not change during the nine-year study period. The researchers also found individual differences. For example, alcohol medication was prescribed to a lesser extent to men, older individuals, individuals with lower education and income levels, people living in medium-sized cities or rural areas, and people with comorbid somatic diseases.
“We know very little about the causes of these individual differences,” said Sara Wallhed Finn. “One reason may be that the availability of care varies across the country, where specialist addiction care is largely organized in the big cities. An important discovery is that the prescription amount is particularly low for people with other somatic diseases, even in cases where co-morbidity was not a This is something we need to investigate further to fully understand. “The researchers emphasize that the study only included people who were treated for alcoholism in specialist care and that the number of people with alcohol problems in the population is much larger. In total, approximately 4 percent of the adults in Sweden are estimated to meet the criteria for alcohol disorder, but far from all receive some form of treatment. According to the researchers, this means that only about 2-2.5 percent of all people with alcohol dependence in Sweden receive alcohol medication.
The study included only data from specialist care; a limitation is given that almost half of all diagnoses of alcohol disorder are canceled in primary care. The study was also limited to collected recipes; however, a previous study showed a strong similarity between prescribed and collected prescriptions that support the results.
The research was funded by grants from the Alcohol Research Council for the Swedish Alcohol Trade Monopoly, ALF Medicine, the Stockholm Region, the Center for Psychiatric Research, the Soderström Konig Foundation and the Swedish Medical Association. (ANI)