Attempts to reduce alcohol intake and treatment needs among people with probable alcohol dependence in England: A general population survey

Aims: To compare the proportion of people in England with probable alcohol dependence [Alcohol Use Disorders Identification Test (AUDIT) score ≥ 20] with those with other drinking patterns (categorized by AUDIT scores) in terms of motivation to reduce drinking and use of alcohol support resources. Design: A combination of random probability and simple quota sampling to conduct monthly cross-sectional household computer-assisted interviews between March 2014 and August 2017. Setting: The general population in all nine regions of England. Participants: Participants in the Alcohol Toolkit Study (ATS), a monthly household survey of alcohol consumption among people aged 16 years and over in England (n = 69826). The mean age was 47 years [standard deviation (SD) = 18.78; 95% confidence interval (CI) = 46.8-47] and 51% (n = 35560) were female. Measurements: χ² tests were used to investigate associations with demographic variables, motivation to quit drinking, attempts to quit drinking, general practitioner (GP) engagement and types of support accessed in the last 12 months across AUDIT risk zones. Findings: A total of 0.6% were classified as people with probable alcohol dependence (95% CI = 0.5-0.7). Motivation to quit (χ² = 1692.27, P < 0.001), current attempts (χ² = 473.94, P < 0.001) and past-year attempts (χ² = 593.67, P < 0.001) differed by AUDIT risk zone. People with probable dependence were more likely than other ATS participants to have a past-year attempt to cut down or quit (51.8%) and have received a specialist referral from their GP about drinking (13.7%), and less likely to report no motivation to reduce their drinking (26.2%). Those with probable dependence had higher use of self-help books and mobile applications (apps) than other ATS participants; however, 27.7% did not access any resources during their most recent attempt to cut down. Conclusions: Adults in England with probable alcohol dependence, measured through the Alcohol Use Disorders Identification Test, demonstrate higher motivation to quit drinking and greater use of both specialist treatment and self-driven support compared with those in other Alcohol Use Disorders Identification Test zones, but most do not access treatment resources to support their attempts.