Nearly one in three Americans experience alcohol use disorders at some point in their lives, but most of these people do not get any form of treatment, and those who actually seek help wait up to a decade to do so.

These are results from a new analysis of the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The findings are published in the July 2007 issue of the Archives of General Psychiatry.

Alcohol use disorders are defined as alcohol abuse and alcohol dependence. Alcohol abuse refers to continued drinking even when it leads to social, legal, or health problems. Alcohol dependence--also called alcohol addiction or alcoholism--refers to the total inability to limit drinking.

More specifically, researchers found that:

• Nearly 30 percent of survey respondents had met the criteria for an alcohol use disorder at some point in their lives.
• Of those with alcohol abuse, only 7 percent had received treatment.
• Of those with alcohol dependence, only 24.1 percent had received any type of treatment. Treatment was defined broadly--anything from Twelve Step programs to services from a medical professional, crisis center, or employee assistance program.
• On average, alcohol dependence began at about age 22. However, the average age of first treatment was nearly 30--a delay of 8 years.
• The average age when alcohol abuse began was also 22. Yet the average age of first treatment was 32--a gap of 10 years.

"A lost decade between AUD [alcohol use disorders] onset and treatment leads to personal disability and societal damage," says Dr. Ting-Kai Li, director of the National Institute on Alcohol Abuse and Alcoholism. Li adds that the report "signals the need for intensive efforts to educate professionals and the public to identify and address AUDs early in their course."

Results from NESARC did not come as a total surprise. Other studies yield similar findings. For example, the 2005 National Survey on Drug Use and Health revealed that 23.5 million Americans needed treatment for an alcohol or illicit drug use problem. Of these, only 2.3 million--10 percent--received treatment at a specialty facility.

What the studies do not explain is why people wait so long to get help.

William Cope Moyers, vice president of External Affairs for Hazelden, says that many factors are at work. He describes them as a "perfect storm of uncertainties" that make treatment the exception rather than the rule.

"This is a notable moment in our country's history around alcohol and drug problems," says Moyers. "On the one hand, there seems to be a lot of awareness about the pervasiveness of these issues. But on the other hand, denial, shame, public policy, and economics are all coming together in a way that makes it difficult to bridge the gap between need and help."

Moyers calls for a three-part solution:

First is a "public dialogue around the reality that addiction doesn't discriminate--and neither should recovery." This conversation needs to begin in schools, workplaces, and other community settings. From there it can move to the halls of Congress, which sets the national agenda for addiction treatment.

Second, says Moyers, is public policy based on the latest research: "Science is telling us a lot more about addiction than we've ever known--that addiction does have its origins in the brain, and that there are pharmacological tools that can help treat addiction and sustain recovery."

Finally, we need to remember that the brain-based disease of addiction is "an illness of the body and the soul." Recovery depends on factors that transcend science--courage to tell the truth, willingness to receive help, and sustained practice of new beliefs and new behaviors. In summary, says Moyers, "we must continue to treat the whole person."

September is National Alcohol and Drug Addiction Recovery Month, as sponsored by the Center for Substance Abuse Treatment, a department of the Substance Abuse and Mental Health Services Administration. This year's theme is "Join the Voices for Recovery: Saving Lives, Saving Dollars." The awareness campaign helps inform people of the human and financial costs of substance use disorders and the benefits of investing in addiction treatment. It can direct people in need of help to assessment and treatment resources and it will explain how individuals and communities can make recovery a call to action. For more information, go to www.recoverymonth.gov.

--Published September 3, 2007