Redressing responses to the treatment gap for people with alcohol problems: The overlooked role of untreated remission from alcohol problems

Abstract

Abstract. Aims: The “treatment gap” for people with alcohol problems has been identified as very large in the literature. An array of responses to the treatment gap have been focussed upon, including changing the perceptions of untreated people in order to make them want treatment more. A separate approach identifies the treatment system itself as the cause of the treatment gap. The aim of this paper was to consider research on untreated remission from alcohol problems to better understand responses to the treatment gap. Methodology: Three areas of existing published literature were thematically reviewed and synthesised: treatment gap research, untreated remission from alcohol problems research, and treatment planning and system design research. Results: Including rates of untreated remission from alcohol problems reduces the size of the treatment gap considerably. Treatment planning models which estimate unmet demand are better suited than unmet need when identifying gaps in service provision. Responding to the treatment gap requires broadening the treatment system beyond the specialised setting, and the assumptions associated with the process and expected outcomes of remission may need revisiting. Conclusions: Treatment planning models are useful when identifying gaps in service provision, but more sophisticated inclusion of untreated remission data is required. The treatment response may need to be diversified to support the life circumstances and perspectives of people with alcohol problems, with one example (outlined in this paper) being the provision of digital support services.