Objective: To examine clinical characteristics and services being provided
to Alcohol Abuse/Dependent (AAD) patients in current psychiatric practice.
Method: In a national sample of psychiatrists (N = 417), each provided data
on three preselected patients (N = 1,245: 51.8% women) that included demog
raphics, DSM-IV diagnoses, treatment setting and health-plan measures. Logi
stic regression was used to compare patients with and without an AAD diagno
sis. Results: Only 12% of patients (n = 151) had an AAD diagnosis. AAD pati
ent care was more frequently subject to utilization review and restriction
or specification of medications to be prescribed (formulary). Psychiatrists
also perceived greater restrictions on AAD patient care (e.g., requirement
s to use specific practice guidelines or treatment algorithms). Conclusions
: Findings suggest that health care systems are subjecting treatment patien
ts with AAD to greater scrutiny and may be limiting the extent and nature o
f care provided to these patients. The low prevalence of AAD among patients
being seen by psychiatrists also warrants further attention. Study finding
s highlight the utility of practice-based research in addiction psychiatry.