Journal of Studies on Alcohol and Drugs. Supplement最新文献

{"title":"Alcohol Marketing and Youth Drinking: Is There a Causal Relationship, and Why Does It Matter?","authors":"J. Sargent, Samantha Cukier, T. Babor","doi":"10.15288/jsads.2020.s19.5","DOIUrl":"https://doi.org/10.15288/jsads.2020.s19.5","url":null,"abstract":"JAMES D. SARGENT, m.D.,a,* SAMANTHA CUKIER, pH.D., m.B.a.,b & THOMAS F. BABOR, pH.D., m.p.H.c aC. Everett Koop Institute, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire bThe Ottawa Hospital Research Institute, Centre for Journalology, Clinical Epidemiology Program, Ottawa, Ontario, Canada cDepartment of Public Health Sciences, University of Connecticut School of Medicine, Farmington, Connecticut","PeriodicalId":17103,"journal":{"name":"Journal of Studies on Alcohol and Drugs. Supplement","volume":"32 1","pages":"5 - 12"},"PeriodicalIF":0.0,"publicationDate":"2020-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88050401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Youth Cognitive Responses to Alcohol Promotional Messaging: A Systematic Review","authors":"Elizabeth R Henehan, Ansley E Joannes, Liam Greaney, Susan Knoll, Q. W. Wong, Craig S Ross","doi":"10.15288/jsads.2020.s19.26","DOIUrl":"https://doi.org/10.15288/jsads.2020.s19.26","url":null,"abstract":"Objective: This review examines the research of the effects of alcohol advertising on the cognitive mechanisms that precede underage alcohol use. Method: Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we reviewed 22 studies (1988–2016) selected from 22,040 articles. The final sample assessed cognitive responses of youth younger than the legal purchase age who were exposed to alcohol advertisements from television or magazines. Results: The studies were predominantly cross-sectional (59.1%), used convenience sampling (63.6%), had 74 to 3,521 participants, and were from six countries. The most common methods and applied theories for assessing advertising effects on cognitions were linear methods based on priming and modeling theories, and structural equation modeling based on information-processing models. Overall, advertising content appealed to youth, particularly advertisements that emphasized lifestyles of drinkers rather than the product quality. Youth exposed to alcohol advertisements were more likely to associate positive and arousing effects with alcohol, and in some studies effects were modified by sex, alcohol use, and age. Residual confounding and selection bias were a concern in the majority of studies. Conclusions: Exposure to alcohol advertising may affect underage perceptions of risks and rewards of alcohol use. Nevertheless, the ability to draw causal conclusions is limited because of study designs. Future studies should use nonlinear methods to assess the association between advertising and cognitions and avoid measuring alcohol advertising as a uniform and dose-response exposure among diverse populations. Future research would be strengthened by applying consistent theoretical frameworks, improving control for confounding bias, and using validated cognitive outcome measures.","PeriodicalId":17103,"journal":{"name":"Journal of Studies on Alcohol and Drugs. Supplement","volume":"60 1","pages":"26 - 41"},"PeriodicalIF":0.0,"publicationDate":"2020-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90850278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Alcohol Marketing Landscape: Alcohol Industry Size, Structure, Strategies, and Public Health Responses","authors":"D. Jernigan, Craig S Ross","doi":"10.15288/jsads.2020.s19.13","DOIUrl":"https://doi.org/10.15288/jsads.2020.s19.13","url":null,"abstract":"Objective: The purpose of this study is to inform public health efforts to reduce alcohol-related harm by describing the alcohol marketing landscape. We review the size, structure, and strategies of both the U.S. national and global alcohol industries and their principal marketing activities and expenditures and provide a summary of public health responses. Method: Primary data were obtained from advertising and alcohol industry market research firms and were supplemented by searches of peer-reviewed literature, business press, and online databases on global business and trade. Results: Worldwide, alcohol sales totaled more than $1.5 trillion in 2017. Control of alcoholic beverage production and marketing is concentrated globally in the hands of a small number of firms. The oligopoly structure of the producing industry helps to generate high profits per dollar invested relative to other industries, which in turn fund marketing expenditures that function as barriers to entry by other firms. Advertising expenditures are high and advertising is widespread. Stakeholder marketing and corporate social responsibility campaigns assist in maintaining a policy environment conducive to extensive alcohol marketing activity. The most common regulatory response has been alcohol industry self-regulation; statutory public health responses have made little progress in recent years and have lagged behind industry innovation in digital and social marketing. Conclusions: Alcohol marketing is widespread globally and a structural element of the alcoholic beverage industry. Given the level of alcohol-related harm worldwide, global and regional recommendations and best practices should be used to guide policy makers in effective regulation of alcohol marketing.","PeriodicalId":17103,"journal":{"name":"Journal of Studies on Alcohol and Drugs. Supplement","volume":"381 1","pages":"13 - 25"},"PeriodicalIF":0.0,"publicationDate":"2020-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72614252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alcohol Marketing and Adolescent and Young Adult Alcohol Use Behaviors: A Systematic Review of Cross-Sectional Studies","authors":"Laura J. Finan, Sharon Lipperman-Kreda, J. Grube, Anna Balassone, Emily Kaner","doi":"10.15288/jsads.2020.s19.42","DOIUrl":"https://doi.org/10.15288/jsads.2020.s19.42","url":null,"abstract":"Objective: This article provides a systematic review of cross-sectional research examining associations between exposure to alcohol marketing and alcohol use behaviors among adolescents and young adults. Method: Literature searches of eight electronic databases were carried out in February 2017. Searches were not limited by date, language, country, or peer-review status. After abstract and full-text screening for eligibility and study quality, 38 studies that examined the relationship between alcohol marketing and alcohol use behaviors were selected for inclusion. Results: Across alcohol use outcomes, various types of marketing exposure, and different media sources, our findings suggest that cross-sectional evidence indicating a positive relationship between alcohol marketing exposure and alcohol use behaviors among adolescents and young adults was greater than negative or null evidence. In other words, cross-sectional evidence supported that alcohol marketing exposure was associated with young peoples’ alcohol use behaviors. In general, relationships for alcohol promotion (e.g., alcohol-sponsored events) and owning alcohol-related merchandise exposures were more consistently positive than for other advertising exposures. These positive associations were observed across the past four decades, in countries across continents, and with small and large samples. Conclusions: Despite issues of measurement and construct clarity within this body of literature, this review suggests that exposure to alcohol industry marketing may be important for understanding and reducing young peoples’ alcohol use behavior. Future policies aimed at regulating alcohol marketing to a greater extent may have important short- and long-term public health implications for reducing underage or problematic alcohol use among youth.","PeriodicalId":17103,"journal":{"name":"Journal of Studies on Alcohol and Drugs. Supplement","volume":"1 1","pages":"42 - 56"},"PeriodicalIF":0.0,"publicationDate":"2020-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87805130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Similarities Between Alcohol and Tobacco Advertising Exposure and Adolescent Use of Each of These Substances","authors":"M. Weitzman, Lily Lee","doi":"10.15288/jsads.2020.s19.97","DOIUrl":"https://doi.org/10.15288/jsads.2020.s19.97","url":null,"abstract":"Objective: Underage alcohol use is a major public health problem and substantial corporate money supports alcohol advertising across multiple venues. A diverse research literature demonstrates that adolescent exposure to such advertising is associated with drinking attitudes and behavior, but no scientific body has determined these associations to be causal. The objective of this study was to assess the association between alcohol advertising and teen drinking in the context of the “Analogy” criterion of the Bradford Hill criteria and consider a determination that the association between exposure to alcohol advertising and alcohol use is causal. Method: This study was a narrative review on the association between adolescent exposure to alcohol advertising and subsequent alcohol use in the context of domains utilized in the Surgeon General’s 2012 Report, Preventing Tobacco Use Among Youth and Young Adults, which concluded, “Advertising and promotional activities by tobacco companies have been shown to cause the onset and continuation of smoking among adolescents and young adults.” Results: In every aspect compared (i.e., adolescent knowledge; attitudes toward; initiation of use; continuation of use; mediums of advertisement; the use of mascots, celebrities, and themes; and frequency and density of advertisements and retailers), the findings for both tobacco and alcohol and their association with exposure to advertising are analogous. Conclusions: Application of the Analogy criterion of the Bradford Hill criteria comparing alcohol and tobacco supports a judgment that the association between exposure to alcohol advertising and increased adolescent knowledge, attitudes toward, initiation, and continuation of alcohol use are causal in nature.","PeriodicalId":17103,"journal":{"name":"Journal of Studies on Alcohol and Drugs. Supplement","volume":"62 1","pages":"97 - 105"},"PeriodicalIF":0.0,"publicationDate":"2020-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81176416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why Research Should Pay Attention to Effects of Marketization of Addiction Treatment Systems.","authors":"Jessica Storbjörk, Kerstin Stenius","doi":"10.15288/jsads.2019.s18.31","DOIUrl":"10.15288/jsads.2019.s18.31","url":null,"abstract":"<p><strong>Objective: </strong>Researchers generally assume that addiction treatment systems can be viewed as entities and planned with the citizens' best interests in mind. We argue that another steering principle, the market logic, has permeated many Western World treatment systems but is neglected in research. We demonstrate how it may affect system-level planning, service provision, and the service users.</p><p><strong>Method: </strong>We draw on an ongoing Swedish study, with some Nordic references, using several data sources: (1) public statistics on treatment expenditures and purchases; (2) interviews with service users (n = 36) and their service providers (n = 23) on different market features; (3) an observation of a large public procurement process concluding framework agreements based on competitive tendering; (4) interviews with officials involved with steering of the system and procurement (n = 16); (5) a workshop on procurement in the Nordic countries (n = 11 participants); and (6) 77 interviews with professionals, managers, and elected representatives.</p><p><strong>Results: </strong>We outline seven propositions that call for further research attention: public procurement, as regulated in the European Union, is not suitable for addiction treatment; marketization challenges democracy, equity, needs assessment, and treatment planning; marketization causes new accountability problems and idle monitoring; marketization causes fragmentation and obstructs coordination and continuity of care; marketization causes unification of services and favors big bureaucratically sophisticated providers; treatment professionals' values are downplayed when a mistrust-based market logic replaces a trust- and needs-based logic; and marketization marginalizes treatment professionals and service users by limiting discretion.</p><p><strong>Conclusions: </strong>Findings point toward the importance of acknowledging and mitigating market principles in treatment systems to safeguard needs assessments and planning that serve the interests of the service users and the public.</p>","PeriodicalId":17103,"journal":{"name":"Journal of Studies on Alcohol and Drugs. Supplement","volume":" ","pages":"31-39"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36896262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Mixed-Methods Evaluation of the Implementation of a Performance Measurement System for South Africa’s Substance Use Treatment Services","authors":"B. Myers, P. P. Williams, R. Govender, R. Manderscheid, J. R. Koch","doi":"10.15288/jsads.2019.s18.131","DOIUrl":"https://doi.org/10.15288/jsads.2019.s18.131","url":null,"abstract":"Objective: Minimal knowledge exists on the factors that affect implementation of performance measurement systems, particularly in low- and middle-income countries (LMICs). To address this, we describe the implementation of a performance measurement system for South Africa’s substance abuse treatment services known as the Service Quality Measures (SQM) initiative. Method: We conducted a mixed-methods evaluation of system implementation. We surveyed 81 providers about the extent of system implementation within their agencies and the factors that facilitated implementation. We conducted 26 in-depth interviews of providers’ perceived barriers and facilitators to implementation. Results: The overall penetration of this system was high. Almost all providers viewed the system as feasible to implement, acceptable, appropriate for use in their context, and useful for guiding service improvements. However, the extent of implementation varied significantly across sites (p < .05). Leadership support (p < .05) was associated with increased implementation in multivariable analyses. Providers reflected that high rates of patient attrition, variability in willingness to implement the system, and limited capacity for interpreting performance feedback affected the extent of system implementation. Conclusions: It is feasible to implement a performance measurement system in LMICs if the system is acceptable, appropriate, and useful to providers. To ensure the utility of this system for treatment service strengthening, system implementation must be optimized. Efforts to enhance target population coverage, strengthen leadership support for performance measurement, and build capacity for performance feedback utilization may enhance the implementation of this performance measurement system. Objectifs : Peu de connaissance existe sur les facteurs influençant l’implantation d’un système de mesure du rendement, particulièrement dans les pays à revenu faible et intermédiaire (PRFI). Pour aborder cette question, nous décrivons l’implantation d’un système de mesure du rendement des services de traitement en toxicomanie d’Afrique du Sud, connu sous le nom du projet de Mesures de la qualité du service (MQS). Méthode : Nous avons mené une évaluation d’implantation du système à l’aide d’une méthode mixte. Nous avons interrogé 81 pourvoyeurs de services sur l’ampleur de l’implantation du système dans leur agence et les facteurs qui ont facilité l’implantation. Nous avons mené 26 entrevues approfondies sur les perceptions des pourvoyeurs concernant les obstacles et les facilitateurs de l’implantation. Résultats : L’appropriation générale de ce système était élevée. Presque tous les pourvoyeurs voyaient la faisabilité d’implantation du système et le considéraient comme étant acceptable, approprié à leur contexte et utile pour guider l’amélioration des services. Cependant, l’ampleur de l’implantation variait de façon significative à travers les sites (p < ,05). Le soutien de la direc","PeriodicalId":17103,"journal":{"name":"Journal of Studies on Alcohol and Drugs. Supplement","volume":"9 1","pages":"131 - 138"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78084671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimation of Needs for Addiction Services: A Youth Model.","authors":"Joël Tremblay,&nbsp;Karine Bertrand,&nbsp;Nadine Blanchette-Martin,&nbsp;Brian Rush,&nbsp;Annie-Claude Savard,&nbsp;Nadia L'Espérance,&nbsp;Geneviève Demers-Lessard,&nbsp;Rosalie Genois","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>In the field of health care services, resource allocation is increasingly determined based on a population needs model. Although service needs models have been developed for adults with substance use problems, it would seem inappropriate to apply them indiscriminately to young people.</p><p><strong>Method: </strong>The method used proposes six steps: (1) targeting the population, (2) estimating the proportion of the population affected by substance misuse and (3) the proportion of youths who should receive services, (4) identifying categories of services, (5) estimating the proportions of youths who should have access to each category of services, and (6) applying the model to real use of services by youths to recalibrate it.</p><p><strong>Results: </strong>Youths ages 12-17 from the Province of Québec were classified within a tiered model comprising four levels of substance use severity. Youths in need of services varied from 38% (weak response) to 95% (high response) for the highest severity cases. Service categories retained are detoxification/intoxication, outpatient, and residential, with each one being subdivided into four categories. The proportion of youths from each tier who should access categories and subcategories of services varied widely. After a pre-experimentation, the model was adjusted.</p><p><strong>Conclusions: </strong>The model can be applied in different jurisdictions, with the caution of adjusting prevalence to local reality. Further improvement will be based on more accurate information concerning the path of clients through services, better strategies to reach youths in need of services, and increased knowledge of optimal service categories. Models adapted to low- or moderate-income countries, where the health care system has minimal services in the areas of mental health and addiction, should be developed.</p>","PeriodicalId":17103,"journal":{"name":"Journal of Studies on Alcohol and Drugs. Supplement","volume":" ","pages":"64-75"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36896268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key Considerations in Planning for Substance Use Treatment: Estimating Treatment Need and Demand","authors":"A. Ritter, R. Mellor, J. Chalmers, M. Sunderland, K. Lancaster","doi":"10.15288/jsads.2019.s18.22","DOIUrl":"https://doi.org/10.15288/jsads.2019.s18.22","url":null,"abstract":"Objective: Estimates of the extent of treatment need (defined by the presence of a diagnosis for which there is an effective treatment available) and treatment demand (defined as treatment seeking) are essential parts of effective treatment planning, service provision, and treatment funding. This article reviews the existing literature on approaches to estimating need and demand and the use of models to inform such estimation, and then considers the implications for health planners. Method: A thematic review of the literature was undertaken, with a focus on covering the key concepts and research methods that have been used to date. Results: Both need and demand are important estimates in planning for services but contain many difficulties in moving from the theory of measurement to the practicalities of establishing these figures. Furthermore, the simple quantum of need or demand is limited in its usefulness unless it is matched with consideration of different treatment types and their relative intensity, and/or explored as a function of geography and subpopulation. Modeling can assist with establishing more fine-tuned planning estimates, and is able to take into account both client severity and the various treatment types that might be available. Conclusions: Moving from relatively simplistic estimates of need and demand for treatment, this review has shown that although such estimation can inform national or subnational treatment planning, more sophisticated models are required for alcohol and other drug treatment planning. These can help health planners to determine the appropriate amount and mix of treatments for substance use disorders. Objectif : L’estimation de l’ampleur du besoin de traitement, défini par la présence d’un diagnostic pour lequel un traitement efficace est disponible, et la demande de traitement, définie par la recherche de traitement, sont des éléments essentiels à une planification efficace du traitement, à la prestation de service et à son financement. Cet article passe en revue la littérature existante sur les approches pour estimer le besoin et la demande ainsi que l’utilisation de modèles pour documenter une telle estimation, puis considère les implications pour les planificateurs des services de santé. Méthode : Une revue thématique de la littérature a été entreprise en mettant l’accent sur les concepts clés et les méthodes de recherche qui ont été utilisées à ce jour. Résultats : Les estimations des besoins et de la demande sont toutes deux importantes dans la planification des services, mais constituent des défis importants lors du passage de la théorie de la mesure aux aspects plus pratiques de production de ces estimations. Par ailleurs, la simple estimation d’un nombre lié au besoin ou à la demande est limitée, à moins qu’elle ne soit appariée avec différents types de traitement et leur intensité respective, ou explorée avec d’autres facteurs géographiques et de sous-population. La modélisation aide à produire d","PeriodicalId":17103,"journal":{"name":"Journal of Studies on Alcohol and Drugs. Supplement","volume":"40 1","pages":"22 - 30"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85701831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling the Potential Impact of Changing Access Rates to Specialist Treatment for Alcohol Dependence for Local Authorities in England: The Specialist Treatment for Alcohol Model (STreAM).","authors":"Alan Brennan, Daniel Hill-McManus, Tony Stone, Penny Buykx, Abdallah Ally, Robert E Pryce, Robert Alston, Andrew Jones, Donal Cairns, Tim Millar, Michael Donmall, Tom Phillips, Petra Meier, Colin Drummond","doi":"10.15288/jsads.2019.s18.96","DOIUrl":"10.15288/jsads.2019.s18.96","url":null,"abstract":"<p><strong>Objective: </strong>We modeled the impact of changing Specialist Treatment Access Rates to different treatment pathways on the future prevalence of alcohol dependence, treatment outcomes, service capacity, costs, and mortality.</p><p><strong>Method: </strong>Local Authority numbers and the prevalence of people \"potentially in need of assessment for and treatment in specialist services for alcohol dependence\" (PINASTFAD) are estimated by mild, moderate, severe, and complex needs. Administrative data were used to estimate the Specialist Treatment Access Rate per PINASTFAD person and classify 22 different treatment pathways. Other model inputs include natural remission, relapse after treatment, service costs, and mortality rates. \"What-if\" analyses assess changes to Specialist Treatment Access Rates and treatment pathways. Model outputs include the numbers and prevalence of people who are PINASTFAD, numbers treated by 22 pathways, outcomes (successful completion with abstinence, successfully moderated nonproblematic drinking, re-treatment within 6 months, dropout, transfer, custody), mortality rates, capacity requirements (numbers in contact with community services or staying in residential or inpatient places), total treatment costs, and general health care savings. Five scenarios illustrate functionality: (a) no change, (b) achieve access rates at the 70th percentile nationally, (c) increase access by 25%, (d) increase access to Scotland rate, and (e) reduce access by 25%.</p><p><strong>Results: </strong>At baseline, 14,581 people are PINASTFAD (2.43% of adults) and the Specialist Treatment Access Rate is 10.84%. The 5-year impact of scenarios on PINASTFAD numbers (vs. no change) are (B) reduced by 191 (-1.3%), (C) reduced by 477 (-3.3%), (D) reduced by almost 2,800 (-19.2%), and (E) increased by 533 (+3.6%). The relative impact is similar for other outputs.</p><p><strong>Conclusions: </strong>Decision makers can estimate the potential impact of changing Specialist Treatment Access Rates for alcohol dependence.</p>","PeriodicalId":17103,"journal":{"name":"Journal of Studies on Alcohol and Drugs. Supplement","volume":"Sup 18 ","pages":"96-109"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10715945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}