Methods: Our data source was the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). We included 7,143 participants who met criteria for lifetime alcohol abuse or dependence, completed interviews at waves 1 and 2, and had at least one period in their lifetime of weekly at-risk drinking (4 or 5 drinks per day or 7 or 14 drinks per week, for women and men, respectively). The alcohol-adapted Perceived Devaluation-Discrimination scale assessed perceived alcoholism stigma at wave 2. We summed its 12 items to create a continuous variable. Our first logistic regression model examined the relationship between stigma and perceptions of treatment need for alcohol problems. We conducted a second logistic regression among those who had ever perceived a need for treatment (n=1,871) to determine if stigma was associated with alcohol treatment. Models took into account the complex design of NESARC and adjusted for sociodemographic characteristics (sex, age, race/ethnicity, and marital status) and alcohol problem severity (a count of lifetime alcohol problems).
Results: Stigma was inversely related to perceptions of treatment need (OR=0.91, 95% CI=0.87-0.95) when adjusting for sociodemographic characteristics and alcohol problem severity. Stigma was also inversely related to seeking help among those who perceived a need for it (OR=0.87, 95% CI=0.76-0.99).
Conclusions and Implications: Our findings suggest that perceived alcoholism stigma may play a role in both decreasing perceptions of treatment need as well as reducing help seeking among those who perceive a need for it. Interventions to facilitate treatment entry should boost awareness of treatment options and their effectiveness.