Where have they been? Service use of regular substance users with and without abuse and dependence

• Published in: Social Psychiatry and Psychiatric Epidemiology Vol. 41; no. 6; pp. 470 - 479
• Main Authors: PERKONIGG, Axel, SETTELE, Angela, PFISTER, Hildegard, HÖFLER, Michael, FRÖHLICH, Christine, ZIMMERMANN, Petra, LIEB, Roselind, WITTCHEN, Hans-Ulrich
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.06.2006; Springer Nature B.V
• Subjects: Addictive behaviors; Adolescent; Adult; Adult and adolescent clinical studies; Alcohol use; Biological and medical sciences; Catchment Area (Health); Comorbidity; Diagnosis, Dual (Psychiatry); Drug abuse; Drug use; Epidemiology; Female; Germany - epidemiology; Health services; Humans; Incidence; Lifetime; Male; Medical sciences; Mental disorders; Mental health; Mental Health Services - utilization; Miscellaneous; Patient Acceptance of Health Care - statistics & numerical data; Prevalence; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapy - methods; Substance use disorder; Substance-Related Disorders - epidemiology; Substance-Related Disorders - therapy; Therapists; Young adults; Europe; Germany; United States > US; Social environment; Mental health; Tobacco smoking; Anxiety disorder; Health service; Epidemiology; Alcoholic beverage; Alkaloid; Dependence; Public health; Human; Consumption; Help seeking; Drug addiction; Abuse; Illicit drug; Alcoholism; Use; substance use disorders; Substance abuse; anxiety disorders; service use; help-seeking; Concomitant disease; Follow up study; Adolescent; Young adult; Nicotine
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-006-0044-4

To present lifetime rates of service use for psychological and substance use related problems among regular substance users and to examine factors associated with service use. Data come from a prospective-longitudinal, epidemiological study of a community sample of adolescents and young adults (n = 2548, age 14-24 years at baseline) in Munich, Germany. The Munich-Composite International Diagnostic Interview (M-CIDI) was used at baseline and at two follow-ups to assess substance use and service use. Cumulated lifetime incidence of any substance abuse or dependence was 43.7%. Of those with abuse and dependence 23% had ever used any services for psychological or substance use related problems. Illicit substance users especially those with dependence had the highest rates of lifetime service use (52.1%). Psychotherapists and counseling services were contacted most frequently among regular substance users over their lifetimes. Utlilisation rates of substance abuse services were low (2%). Comorbid anxiety disorders and distressing life events were associated with increased lifetime service use. Only a minority of adolescents and young adults with substance use disorders have ever sought professional help. Specialized substance abuse services play only a minor role. The core role of psychotherapists and non-substance abuse specialized services needs critical research attention. Linkages between psychotherapists and the substance use service system should be strengthened to detect and intervene at early developmental stages of abuse and dependence.