Document Type

Capstone Experience

Graduation Date

5-2025

Degree Name

Master of Public Health

Department

Health Services Research & Administration

First Committee Member

Dr. Jungyoon "JY" Kim, PhD, MBA

Second Committee Member

Stephen Peters, MA

Third Committee Member

Megan Hopkins, MSW

Abstract

Background: Alcohol Use Disorder (AUD) remains a significant public health issue with extensive personal, societal, and economic impacts. Recent studies indicate that no amount of alcohol consumption is entirely safe, linking it directly to increased chronic disease risks, including cancer. Despite well-documented negative health outcomes, clear guidance on what constitutes AUD through diagnostic criteria provided by the DSM-5, AUD continues to be underdiagnosed and undertreated.

Objectives: This comprehensive literature review explores the key barriers and facilitators influencing AUD screening and treatment engagement.

Methods: A comprehensive literature review was conducted, gathering from various databases including, PubMed, PsycINFO, Scopus, Google Scholar, and relevant governmental resources (Centers for Disease Control and Prevention, SAMHSA, NIA, and WHO). Studies published from 2000 to 2025 were analyzed to identify recurrent themes and synthesize findings.

Results: The final review included 81 articles. This review identified significant barriers at the health care delivery systemic, provider, and individual levels, including 1) fragmented screening efforts in primary care, 2) stigma surrounding AUD, 3) racial and gender disparities in treatment access, 4) financial constraints, and 5) lack of perceived need for treatment among individuals with AUD. In contrast, facilitators, such as 1) integrated screening in primary care, 2) mental health comorbidity-driven engagement, 3) peer and family support, 4) harm reduction approaches, and 5) policy interventions, have been found to enhance treatment accessibility and retention.

Conclusion/Implications: Addressing AUD effectively requires systemic reforms, including normalizing AUD screening, integrated treatment approaches, and targeted stigma-reduction strategies. Recommendations include 1) enhancing routine AUD screening in primary care settings utilizing validated tools like AUDIT and SBIRT. 2) Increase provider training and competency on addiction management and stigma reduction. 3) Expand treatment approaches to incorporate multidisciplinary models including psychotherapy, pharmacology, harm reduction, and peer support. 4) Address disparities through culturally tailored interventions, target outreach for marginalized communities, and policy initiatives to reduce financial barriers to AUD treatment. The recommendations from this study inform public health policies, clinical best practices, and future research efforts, ultimately reducing the burden of AUD and improving health outcomes for affected populations.

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