Alcohol or Drug Self-Help Use Among Adults in the United States: Age, Period, and Cohort Effects Between 2002 and 2018
International journal of mental health and addiction(2023)
摘要
In the context of an ongoing and worsening drug overdose epidemic in the USA, increases in free support services like self-help groups may be expected. We estimated differences in self-help use by age, period, or cohort among people who may have needed treatment. We included N = 92,002 adults from the 2002–2018 National Surveys on Drug Use and Health who met past-year DSM-IV substance use disorder criteria or received alcohol/drug treatment in any location. We used hierarchical age-period-cohort (HAPC) modeling to estimate average age-period-cohort associations with self-help. Level-1 covariates included age, race and ethnicity, household income, and sex. We quantified level-2 variance components using the median odds ratio (MOR). We found small positive HAPC period effects for alcohol/drug self-help that were driven by alcohol-specific effects. Birth cohort differences were observed starting at age 48. Younger birth cohorts, especially among Black adults, were less likely to report self-help use than older birth cohorts. MOR was consistently elevated for cohort effects (MOR = 1.17; covariance parameter: 0.15; 95% CI [0.11, 0.23]) but not for period effects. Overall, self-help use did not increase in the context of substantial treatment needs and worsening overdose racialized disparities. Instead, cohort effects explained trends in alcohol/drug self-help. Findings could indicate that younger birth cohorts may need additional supports, especially services tailored for Black and Hispanic people.
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关键词
Age-period-cohort analysis,12 step groups,Self-help,Alcohol use disorder,Drug use disorder
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