|Problematischer Konsum illegaler Substanzen, Hilfesuchve ...|
Perkonigg, A., Pfister, H., Lieb, R., Bühringer, G. & Wittchen, H.-U. (2004). Problematischer Konsum illegaler Substanzen, Hilfesuchverhalten und Versorgungsangebot in einer Region [Problematic use of illicit substances, help-seeking and the availability of substance use services in a region]. Suchtmedizin, 6 (1), 22-31.
|Objectives: To investigate cumulated incidence estimates of problematic use of illicit substances and help-seeking behavior of this group of users in the general population and to compare the findings with the structure and availability of substance use health care for consumers of illicit substances in the same area.|
Methods: In an epidemiological longitudinal study with a representative community sample of N=3021 respondents 14 to 24 years old at baseline, substance use and substance use disorders as well as several other mental disorders were repeatedly assessed with a standardized diagnostic interview (M-CIDI). Additionally a service review with all substance use services in the same area was conducted.
Results: 49.1% of all respondents used illicit substances at least once up to the last follow-up. 17.8% of all respondents reported of any problematic use of illicit substances during lifetime (associated with social, psychological or medical problems) including 3.1% respondents with a DSM-IV dependence. 95% of these respondents had used cannabis. Only one third of those with a problematic use of illicit substances was seeking help from any professional health service including family doctors. 15% of those have contacted substance use services. On the other hand, 92.9% of the clients or patients in the substance use services of the same area were rated as severely dependent. By far most of them contacted substance use services because of opioids.
Conclusions: There is a considerable degree of formal misallocation: Referring to epidemiological findings, most interventions are needed at early stages of abuse and dependence. The existing substance use service system, however, focuses on the much smaller number of persons with severe drug problems (cognitive addition substitution treatment). Secondary-preventive interventions and therapy programs are needed for the group of those with a problematic use of illicit substances.