Alcoholism ranked behind obesity, cancer, heart disease, drug addiction, AIDS, and depression in a list of the most important health-related issues facing the nation. Alcoholism was considered a top health priority by only 4% and 6% of surveyed physicians and the general public, respectively. Despite this, 74% of the general public who were surveyed indicated that alcoholism affects their daily lives, whether their own addiction, addiction of a friend or family member, or any other experience (Figure 3). Additionally, 41% of the public reported having encouraged a loved one to seek help for an alcohol problem.
Among the 3 survey groups, there were differences as to what was perceived as the most important factors contributing to alcohol addiction. For example, the general public and physician groups both indicated that stress, anxiety, and insecurity about work, family, and other problems were the most important factors contributing to alcohol addiction, whereas people in recovery believed that genetics or family history played the predominate role.
Table 3 lists the other factors contributing to alcohol addiction and the respective attitudes held by each of the 3 survey groups.
Stigma Persists as a Barrier to Seeking and Receiving Treatment
Despite advances in the scientific understanding of alcoholism, the stigma surrounding this disease is still pervasive; these misperceptions may prevent people from seeking and receiving treatment. The vast majority of those surveyed (91% of primary care physicians, 89% of people in alcohol addiction recovery, and 80% of the general public) say that there is a stigma toward alcoholics. That stigma extends to people in recovery. About three quarters (73%) of primary care physicians and individuals in recovery (71%) believe that there is a stigma toward alcoholics in recovery, compared with 51% in the general public survey sample. As a side comparison, when an obese person is losing weight, it is often viewed in a positive light — not so for recovering alcoholics. In all 3 survey populations, denial or refusal to admit severity of the problem and fear of social embarrassment were the top 2 reasons for not seeking help with alcohol addiction (Table 4). In the general public, 66% believe that social embarrassment and fear of discrimination are major barriers to treatment for people with alcohol addiction. The majority of the general public (63%) believes that alcoholism is caused, at least in part, by moral weakness, compared with 43% of physicians and 11% of individuals in recovery.
Obstacles to Screening for Alcoholism
About 50% of the physicians who were surveyed reported asking about drinking habits during routine patient office visits half the time or less. The reasons cited as to why patients are not asked about their drinking habits more often are inadequate resources (48%), denial of any problem with alcohol (41%), and lack of expertise (24%). Forty-nine percent of the primary care physicians reported that they would refer a patient with alcohol addiction to a treatment facility, counselor, another physician, or addiction specialist. Another 20% would refer a patient to support groups, and 13% would recommend a combination of medication and counseling. The survey also revealed opportunities for physicians to drive treatment:
Attitudes on Treatment Medications
The survey revealed that most Americans are open to medications to treat alcoholism. The general public and people in recovery would recommend medications for themselves or their loved ones: