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"Yes, I've received treatment": what does this mean in the context of epidemiological surveys for alcohol problems?

Article Excerpt
Determining treatment status is an important issue in natural-history research about alcohol problems. When examining pathways to change, it is essential to be able to identify those who recovered with or without substance abuse treatment. In studies that employ face-to-face interviews (reviewed in Blomqvist, 1996, 1999), respondents are asked detailed questions regarding use of treatment services. However, in research that involves the secondary analysis of epidemiological surveys, detailed assessments of treatment use are usually not possible. Such secondary analyses are important, providing the opportunity to estimate the prevalence of treated and of untreated recoveries in the general population (Cunningham, 1999). However, this research is limited because treatment status is often determined by the respondent answering yes or no to a single question about the use of treatment services for alcohol problems. Although most respondents report recovering from an alcohol problem without help or treatment (e.g., 77% in Sobell, Cunningham & Sobell, 1996), a "yes" to such a single question provides very little information. Within such analyses, it is impossible to know: 1) the type of treatment the respondent received; 2) when the treatment occurred (i.e., did the treatment occur at roughly the same time as the respondent's recovery?); 3) how much treatment the respondent actually received (i.e., did the respondent go through the entire program or just attend an initial assessment before dropping out?); and 4) whether the respondent received more than one treatment and/or the same treatment more than once. The present study takes advantage of an epidemiological telephone survey (the natural-history telephone survey; Cunningham, Blomqvist, Koski-Jannes, Cordingley & Callaghan, 2004) to address some of these issues, using a sample of former heavy drinkers who either reduced or stopped their drinking.

Method

The natural-history telephone survey (Cunningham et al., 2004) interviewed a representative sample of 3,006 adults living in Ontario, Canada. Former heavy drinkers were defined as respondents who at some point in their lives drank five or more drinks on one occasion at least once a week for a...