Abstract
Objective:
To compare the pathways to care of patients attending a tertiary care psychiatry hospital with those attending a hospital-based deaddiction camp.
Methods:
Pathways to care were compared among 155 patients with alcohol use disorders (AUDs) across two settings: a tertiary care hospital (n = 110) and a hospital-based deaddiction camp (n = 45). Data were collected using a sociodemographic questionnaire, the modified Kuppuswamy socioeconomic status scale, the WHO Encounter Form, and the alcohol use disorders identification test (AUDIT).
Results:
Sixty-nine percent of patients attending the hospital-based deaddiction camp first consulted a psychiatrist, compared with only 9% of patients attending the tertiary care hospital. Consultation with religious or other indigenous service providers was low in both groups. A significant difference was observed in the decision-makers at each point of service between the two groups (P < 0.001).
Conclusion:
Patients with AUDs attending the tertiary care hospital and the deaddiction camp followed distinct pathways to care and demonstrated different treatment needs.
Keywords: Alcohol use disorders, hospital-based deaddiction camp, pathways to care, tertiary care
INTRODUCTION
Alcohol use has a complex and negative association with health and health outcomes and is a major contributor to the global disease burden and significant health deterioration.[1,2,3] A meta-analysis reported a pooled prevalence of 12.5% for alcohol use disorders (AUDs) in India.[4] Care for individuals with substance use disorders (SUDs) is provided through various services, including informal community care, primary healthcare services, specialized drug dependence services, and long-term residential facilities.[5] A tertiary care psychiatry hospital is a specialized center for the treatment of AUDs, offering focused care through a multidisciplinary team of professionals on an inpatient or outpatient basis.
One community-based approach for the treatment of SUDs, including alcohol, is the camp approach, which has been practiced in India for many years.[6,7] In this approach, a specific area is selected based on the high prevalence of SUDs. Members of the hospital team—psychiatrists, trainee physicians, nursing personnel, and psychiatric social workers—coordinate with community leaders to identify target individuals (patients and providers) and ensure the availability of necessary infrastructure.
A patient pathway refers to the sequence of key clinical events during a patient’s healthcare journey, including movement through the healthcare system and the barriers encountered at each stage.[8] Understanding the real-world pathways to care is essential for planning and improving training and clinical services and for addressing the treatment gap.[9,10]
Research has largely focused on the pathways to care of patients attending tertiary care centers, while pathways to deaddiction camps remain relatively underexplored. Therefore, the present study compared the pathways to care for AUDs among patients attending a tertiary care center and those attending a hospital-based camp treatment program. We expected that this cross-sectional comparison would shed light on the similarities and differences in treatment-seeking behaviors, reasons for consultation, decision makers, and service providers at each stage of care between the groups.
METHODS
Study settings
The pathways of care were examined in two settings: a tertiary care center and a hospital-based camp. The tertiary care center is a private medical college located in the Udupi district of Karnataka and provides comprehensive medical and superspecialist services. The Department of Psychiatry offers specialized outpatient services for individuals with SUD every Wednesday and Saturday. Additionally, patients admitted to other departments of medical college for various medical conditions are routinely referred to the Psychiatry Department for further evaluation and management of SUD.
The hospital-based camp is conducted annually at a private psychiatry hospital during a fixed period. Although the location differs from that of community camps, the treatment approach adheres to the core principles of the camp model. The private psychiatry hospital situated approximately 5 km from the tertiary care center, individuals with a wide range of mental illnesses, including SUD, through both inpatient and outpatient services. Each year, the hospital conducts a 10-day camp exclusively for patients with AUD, held from January 1st to January 10th. Only one such camp is organized annually.
Participants
We studied the pathways to care among patients with AUD, who received treatment at a tertiary care hospital; the findings of the study have been published elsewhere.[11] The study included 110 patients diagnosed with AUD. Patients with other SUD (except tobacco) or those for whom AUD was not the primary reason for seeking treatment were excluded. Patients were recruited from three primary sources within the hospital: the psychiatry outpatient department (OPD), the psychiatry inpatient department (IPD), and inter-departmental referrals. In addition, all patients who participated in the hospital-based deaddiction camp conducted in 2025 were included. The camp was held from December 31, 2024 to January 10, 2025, with assessments initiated from the fifth day onward. A total of 47 patients attended the camp, of whom two discontinued on the second day. Thus, 45 participants from the camp were included in the study.
Outcomes
The primary outcome of the study was the pathway to care. Patient pathways were assessed using the WHO Encounter Form,[10] while the severity of alcohol use was evaluated using the alcohol use disorders identification test (AUDIT).[12] Socioeconomic status was determined using the Modified Kuppuswamy’s Socioeconomic Status Scale.[13] All assessment tools were administered to participants in both groups. Data were collected through interviews with the patient and at least one accompanying family member.
Ethical considerations
The study was approved by the Institutional Ethics Committee of Kasturba Medical College and Kasturba Hospital (IEC1:516/2024 dated 11/12/2024), and written informed consent was obtained from all patients and their family members.
Statistical analysis
Data analysis was performed using Jamovi version 2.6.19. Descriptive statistics, including means and standard deviations, medians and interquartile ranges, and frequencies and percentages, were used to summarize the data. Comparisons of demographic characteristics, clinical variables, and pathways to care between the two groups were conducted using Fisher’s exact test and the Mann–Whitney U test, as appropriate. A P value of < 0.05 was considered statistically significant.
RESULTS
Sample characteristics
A total of 110 patients were evaluated for tertiary care, and 45 for the hospital-based deaddiction camp [Supplementary Table 1]. Camp patients-initiated alcohol uses earlier, but the duration of use was similar across groups, while alcohol use severity was higher in tertiary-care patients. Camp attendees were more often single, locally residing, and had higher rates of psychiatric comorbidity and family history of alcohol use, whereas many tertiary-care patients travelled long distances. Sociodemographic profiles were otherwise comparable. Reasons for consultation differed markedly: tertiary-care patients commonly presented with complicated withdrawal and severe medical problems, while camp patients predominantly reported uncomplicated withdrawal and psychosocial issues.
Supplementary Table 1.
Comparison of sample characteristics of AUD patients attending tertiary care and deaddiction camp
| Types of pathways |
Mann-Whitney Z | P | ||
|---|---|---|---|---|
| Tertiary care center (n=110) | Deaddictioncamp (n=45) | |||
| Age | 45 (15) | 42 (9) | -1.37* | 0.172 |
| Age of initiation of alcohol | 20 (8) | 18 (7) | -2.17* | 0.030* |
| Total duration of alcohol use | 22 (16) | 21 (11) | -0.32 * | 0. 752 |
| Gender | 0.410 | |||
| Male | 106 (96.4) | 42 (93.3) | ||
| Female | 4 (3.6) | 3 (6.7) | ||
| Marital status | 0.003* | |||
| Single | 13 (11.8) | 14 (31.1) | ||
| Married | 95 (86.4) | 28 (62.2) | ||
| Divorced | 1 (0.9) | 1 (2.2) | ||
| Widower/widowed | 1 (0.9) | 2 (4.4) | ||
| Religion | 0.739 | |||
| Hindu | 102 (92.7) | 41 (91.1) | ||
| Muslim | 1 (0.9) | 1 (2.2) | ||
| Christian | 7 (6.4) | 3 (6.7) | ||
| Family type | 0.432 | |||
| Nuclear | 68 (61.8) | 31 (68.9) | ||
| Extended | 33 (30) | 13 (28.9) | ||
| Joint | 9 (8.2) | 1 (2.2) | ||
| Residence | 0.365 | |||
| Rural | 54 (49.1) | 28 (62.2) | ||
| Urban | 35 (31.8) | 11 (24.4) | ||
| Suburban | 21 (19.1) | 6 (13.3) | ||
| Socioeconomic status | 0.514 | |||
| Upper middle | 14 (12.7) | 3 (6.7) | ||
| Lower middle | 54 (49.1) | 22 (48.9) | ||
| Upper lower | 39 (35.5) | 20 (44.4) | ||
| Lower | 3 (2.7) | 0 | ||
| Distance from hospital | <0.001* | |||
| Less than 5 Km | 14 (12.7) | 8 (17.8) | ||
| 6-50 Km | 20 (18.2) | 22 (48.9) | ||
| 51-100 Km | 15 (13.6) | 8 (17.8) | ||
| 101-200 Km | 16 (15.5) | 3 (6.7) | ||
| Over 200 Km | 45 (40.9) | 4 (8.9) | ||
| Physical illness | ||||
| Yes | 80 (72.7) | 29 (64.4) | 0.336 | |
| No | 30 (27.3) | 16 (35.6) | ||
| Mental illness | 0.002* | |||
| No | 106 (96.4) | 36 (80) | ||
| Yes | 4 (3.6) | 9 (20) | ||
| Mental illness in the family | 0.118 | |||
| Yes | 7 (6.4) | 7 (15.6) | ||
| No | 103 (93.6) | 38 (84.4) | ||
| Family history of alcohol use | 0.016* | |||
| Yes | 97 (88.2) | 32 (71.1) | ||
| No | 13 (11.8) | 13 (28.9) | ||
| Predominant reason for current consultation | <0.001* | |||
| Alcohol withdrawal, complicated | 38 (34.6) | 7 (16.6) | ||
| Medical complications† | 20 (18.1) | 0 | ||
| RTA or drunken driving or fracture | 5 (4.5) | 0 | ||
| Alcohol withdrawal, uncomplicated | 22 (20) | 25 (55.6) | ||
| Psychosocial problems | 25 (22.7) | 13 (28.9) | ||
| AUDIT total score | 26 (8) | 21 (10) | -2.80 | 0.005* |
*P<0.05 (2-tailed). All values are median (IQR) or n (%). Mann‒Whitney U test for continuous variables and Fisher’s exact test for categorical variables. †Cardiac or hepatic or renal or pancreatic complications; RTA: Road traffic accident; AUDIT: Alcohol Use Disorder Identification Test
Comparison of pathways to care-related variables
The care pathways are summarized in Figure 1. Decision-making in treatment involved family members, patients, and various formal and informal agents [see Table 1]. Family members played a major role at the initial contact in both groups (80.9% in tertiary hospital, 82.2% in camp). In the tertiary-care pathway, the involvement of patients and families declined across subsequent contacts (second contact 37.5%, third contact 28.9%, and fourth contact 10%), with medical practitioners increasingly directing referrals (second contact 34.6%, third contact 47.4%, fourth contact 77.5%, and fifth contact 100%). In contrast, among camp patients, patients (second contact 20%, third contact 10.5%, fourth contact 8.3%, fifth contact 42.8%), and family members (second contact 71.4%, third contact 62.9%, fourth contact 83.3%, and fifth contact 57.1%) continued to play a substantial decision-making role throughout treatment, while medical practitioners had a limited influence.
Figure 1.
Pathways to care of AUD patients in (a) hospital-based deaddiction camp, and (b) tertiary care center. AUD = Alcohol use disorder
Table 1.
Comparison of decision makers and service providers at each service contact
| Decision makers | Service contacts |
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 1 |
2 |
3 |
4 |
5 |
||||||
| Tertiary care (n=110) | Camp (n=45) | Tertiary care (n=104) | Camp (n=35) | Tertiary care (n=76) | Camp (n=27) | Tertiary care (n=41) | Camp (n=12) | Tertiary care (n=6) | Camp (n=7) | |
| Himself/herself | 0 | 0 | 12 (11.5) | 7 (20) | 8 (10.5) | 8 (29.6) | 2 (5) | 1 (8.3) | 0 | 3 (42.8) |
| Relative/friends | 0 | 6 (13.3) | 6 (5.8) | 3 (8.6) | 3 (3.9) | 2 (7.4) | 1 (2.5) | 1 (8.3) | 0 | 0 |
| Neighbor | 0 | 0 | 11 (10.6) | 0 | 7 (9.21) | 0 | 2 (5) | 0 | 0 | 0 |
| Police | 4 (3.6) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Medical practitioner | 0 | 0 | 36 (34.6) | 0 | 36 (47.4) | 0 | 32 (77.5) | 0 | 6 (100) | 0 |
| Family member | 89 (80.9) | 37 (82.2) | 39 (37.5) | 25 (71.4) | 22 (28.9) | 17 (62.9) | 4 (10) | 10 (83.3) | 0 | 4 (57.1) |
| Social worker | 15 (13.6) | 1 (2.2) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Community nurse | 2 (1.8) | 1 (2.2) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Fisher’s exact P | <0.001* | <0.001* | <0.001* | <0.001* | <0.001* | |||||
|
| ||||||||||
| Service providers |
Service contact
|
|||||||||
|
1
|
2
|
3
|
4
|
5
|
||||||
| Tertiary care (n=110) | Camp (n=45) | Tertiary care (n=104) | Camp (n=35) | Tertiary care (n=76) | Camp (n=27) | Tertiary care (n=41) | Camp (n=12) | Tertiary care (n=6) | Camp (n=7) | |
|
| ||||||||||
| Religious healer | 9 (8.2) | 1 (2.2) | 4 (3.8) | 1 (2.9) | 2 (2.6) | 1 (3.7) | 0 | 1 (8.3) | 0 | 0 |
| Social worker | 2 (1.8) | 0 | 1 (1) | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Mother hospital† | 20 (18.2) | 10 (22.2) | 33 (31.7) | 9 (25.7) | 25 (32.9) | 2 (7.4) | 6 (15.0) | 1 (8.3) | 0 | 0 |
| Medical practitioner‡ | 17 (15.5) | 1 (2.2) | 18 (17.3) | 2 (5.7) | 4 (5.3) | 1 (3.7) | 0 | 0 | 0 | 0 |
| Other general hospital§ | 32 (29.1) | 6 (13.3) | 11 (10.6) | 7 (20.0) | 4 (5.3) | 1 (3.7) | 0 | 1 (8.3) | 0 | 0 |
| Psychiatric services‖ | 6 (5.5) | 10 (22.2) | 28 (26.9) | 11 (31.4) | 36 (47.4) | 18 (66.7) | 35 (85.0) | 7 (58.3) | 6 (100) | 7 (100) |
| Other deaddiction camp | 16 (14.5) | 5 (11.1) | 4 (3.8) | 2 (5.7) | 1 (1.3) | 4 (14.8) | 0 | 2 (16.7) | 0 | 0 |
| Pharmacist | 2 (1.8) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Naati vaidya⁋ | 2 (1.8) | 0 | 0 | 1 (2.9) | 2 (2.6) | 0 | 0 | 0 | 0 | 0 |
| Other psychiatric service | 4 (3.6) | 11 (24.4) | 5 (4.8) | 2 (5.7) | 1 (1.3) | 0 | 0 | 0 | 0 | 0 |
| Television advertisement | 0 | 1 (2.2) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Community nurse | 0 | 0 | 0 | 0 | 1 (1.3) | 0 | 0 | 0 | 0 | 0 |
| Fisher’s exact P | <0.001* | 0.359 | 0.023* | 0.007* | - | |||||
*P<0.05 (2-tailed); †Refers to the tertiary care hospital and the hospital which runs the camp; ‡Medical practitioners (non-psychiatrists) in small clinics or nursing homes; §Hospitals other than mother hospitals providing general medical care; ‖Psychiatry services of the tertiary care hospital or the camp hospital; ⁋Local or native healer
Service-use patterns differed significantly: most camp patients (69%) first consulted a psychiatrist, whereas few tertiary-care patients (95%) did so, instead initially consulting general medical services. The median number of treatment contacts did not differ between groups (tertiary care 3 (IQR 2), camp 3 (IQR 2), P = 0.129). Use of religious or indigenous services was low in both groups (tertiary hospital 10%, camp 0%), with no significant group differences. We categorized patients from both groups into those who had ever consulted a faith healer and those who had consulted only modern medicine, and the difference was not significant (P = 0.615). While service providers were similar at the second contact, significant differences emerged at later contacts (P < 0.05). Most tertiary-care patients (74.5%) accessed psychiatry through other hospital departments, whereas fewer camp patients (33.3%) reached care via the mother hospital.
We compared the time from alcohol initiation to first consultation and intervals between successive consultations across groups [see Supplementary Figure 1 (299.5KB, tif) ]. No significant differences were observed, except for the interval between the first and second contacts, which was longer in the hospital-based deaddiction camp [24 (IQR = 35.5) months] than in the tertiary care pathway [11 (IQR = 28) months; P < 0.05]. Although not significant, the median time to first consultation was longer in the tertiary care group (20 vs 18 years). The interval between first and final contacts did not differ significantly [22 vs 24 months; P = 0.867]. Overall, patients in tertiary care transitioned more rapidly between services.
DISCUSSION
A comparison of the two pathways showed that 22.2% of patients accessed a hospital-based deaddiction camp as their first treatment contact, whereas only 5.5% visited a tertiary care psychiatry hospital initially. In contrast, previous pathway studies in tertiary care settings have reported that 44.4% of patients directly accessed psychiatry services,[14] over 50% consulted tertiary care hospitals,[15] and many patients with substance use disorders met psychiatrists as their first service provider.[16]
Hospital-based deaddiction camps, organized with the support of local organizations, offer treatment at minimal cost, with registration fees only and free food, accommodation, and treatment. These camps may therefore represent a more accessible and direct treatment option. The findings suggest that primary- and secondary-level services—such as deaddiction camps, general hospitals, and medical practitioners—are relatively well established and financially accessible. In contrast, tertiary care services may not be the initial choice for many patients due to concerns about cost and the perception that such facilities are meant for severe or critical illnesses.
Among psychiatric service providers, 69% of camp patients first consulted a psychiatrist, compared to only 9% in the tertiary care pathway, where most patients initially consulted medical practitioners or general hospitals. Similar patterns have been reported in earlier studies, with patients with AUD more likely to seek help from general medical services than psychiatrists.[14,16] This difference may be explained by the reasons for first consultation: patients in the tertiary care group commonly reported complicated withdrawal and significant medical comorbidities, whereas camp patients more often reported uncomplicated withdrawal and psychosocial problems. Given the well-established association between alcohol use and physical health complications[17,18] patients with AUD may initially seek care for medical issues. Strengthening screening and identification of AUD in general medical settings could facilitate earlier intervention.
Religious and faith healing are culturally sanctioned ways of dealing with health and mental health problems, and help-seeking from traditional healers is reported among patients with mental health problems.[19,20] However, only a small proportion of patients in both groups sought help from traditional healers, consistent with prior pathway studies in AUD.[14,15]
There was no significant difference between the groups in the gaps between successive treatment contacts. However, the median delay from alcohol initiation to first treatment contact was substantial (20 years in the tertiary care group and 18 years in the camp group), indicating marked treatment delay despite the community-based and affordable nature of camps, as also reported previously.[14,15,16] Subsequent treatment gaps were shorter, particularly among tertiary care patients, who transitioned more rapidly between providers, had more severe withdrawal, and more often sought medical rather than psychiatric care. This suggests that the two pathways represent distinct patient groups: one characterized by rapid progression, medical complications, and medical help-seeking, and the other by socio-occupational impairment and less severe withdrawal.
Studies examining pathways of care among patients with AUD are limited, and the present study adds to this literature. Comparison of the two cohorts highlighted distinct treatment trajectories, reflecting differing needs: camp patients predominantly presented with psychosocial complications, whereas tertiary care patients more often had medical complications related to AUD. However, the findings should be interpreted with caution due to methodological limitations. The sample size and sampling procedures were not uniform across groups, and recruitment and assessment occurred at different time points, which may have influenced care processes. Additionally, the hospital-based deaddiction camp does not fully represent a traditional camp model. As the camp was conducted on hospital premises, hospital staff played a central role, while community involvement was largely limited to awareness generation, resource mobilization, and patient identification and referral. Female patients were underrepresented, precluding meaningful gender-based comparisons of pathways to care.
Overall, significant differences were observed between the groups in demographic, clinical, and pathway characteristics, as well as in decision-making regarding consultation and service providers. However, gaps between service points did not differ significantly. These findings highlight important differences in help-seeking behavior among patients with AUD.
Conflicts of interest
There are no conflicts of interest.
Comparison of time lags between service contacts in AUD patients in tertiary care center and the deaddiction camp
Funding Statement
Nil.
REFERENCES
- 1.Rehm J, Room R, Monteiro M, Gmel G, Graham K, Rehn N, et al. Alcohol as a risk factor for global burden of disease. Eur Addict Res. 2003;9:157–64. doi: 10.1159/000072222. [DOI] [PubMed] [Google Scholar]
- 2.Shield K, Manthey J, Rylett M, Probst C, Wettlaufer A, Parry CDH, et al. National, regional, and global burdens of disease from 2000 to 2016 attributable to alcohol use: A comparative risk assessment study. Lancet Public Health. 2020;5:e51–61. doi: 10.1016/S2468-2667(19)30231-2. [DOI] [PubMed] [Google Scholar]
- 3.Griswold MG, Fullman N, Hawley C, Arian N, Zimsen SRM, Tymeson HD, et al. Alcohol use and burden for 195 countries and territories, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2018;392:1015–35. doi: 10.1016/S0140-6736(18)31310-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Joseph J, Varghese A, Vijay VR, Grover S, Sharma S, Dhandapani M, et al. The prevalence of alcohol use disorders using alcohol use disorders identification test (AUDIT) in the Indian setting:-A systematic review and meta-analysis. J Ethn Subst Abuse. 2024;23:2–20. doi: 10.1080/15332640.2022.2056105. [DOI] [PubMed] [Google Scholar]
- 5.Geneva: World Health Organization and United Nations Office on Drugs and Crime; 2020. International standards for the treatment of drug use disorders: revised edition incorporating results of field-testing. License: CC BY-NC-SA 3.0 IGO. [Google Scholar]
- 6.Ranganathan S. The Manjakkudi experience: A camp approach towards treating alcoholics. Addiction. 1994;89:1071–5. doi: 10.1111/j.1360-0443.1994.tb02783.x. [DOI] [PubMed] [Google Scholar]
- 7.Chavan BS, Priti A. Treatment of alcohol and drug abuse in cAMP setting. Indian J Psychiatry. 1999;41:140–4. [PMC free article] [PubMed] [Google Scholar]
- 8.Kwok CS, Muntean EA, Mallen CD. The patient pathway review: A new method of evaluating clinical practices to understand the complexities of real-world care. Crit Pathw Cardiol. 2021;20:213–9. doi: 10.1097/HPC.0000000000000267. [DOI] [PubMed] [Google Scholar]
- 9.Gater R, Jordanova V, Maric N, Alikaj V, Bajs M, Cavic T, et al. Pathways to psychiatric care in Eastern Europe. Br J Psychiatry. 2005;186:529–35. doi: 10.1192/bjp.186.6.529. [DOI] [PubMed] [Google Scholar]
- 10.Gater R, De Almeida E Sousa B, Barrientos G, Caraveo J, Chandrashekar CR, Dhadphale M, et al. The pathways to psychiatric care: A cross-cultural study. Psychol Med. 1991;21:761–74. doi: 10.1017/s003329170002239x. [DOI] [PubMed] [Google Scholar]
- 11.Somashekar VM, John S, Praharaj SK. Pathways to care in alcohol use disorders: A cross-sectional study from a tertiary hospital in South India. J Ethn Subst Abuse. 2025;24:153–66. doi: 10.1080/15332640.2023.2189197. [DOI] [PubMed] [Google Scholar]
- 12.Bohn MJ, Babor TF, Kranzler HR. The alcohol use disorders identification test (AUDIT): Validation of a screening instrument for use in medical settings. J Stud Alcohol. 1995;56:423–32. doi: 10.15288/jsa.1995.56.423. [DOI] [PubMed] [Google Scholar]
- 13.Saleem SM, Jan SS. Modified Kuppuswamy socioeconomic scale updated for the year 2021. IJFCM. 2021;8:1–3. [Google Scholar]
- 14.Bagyathilagareshmi, Ponnusamy S, Kantipudi SJ. Alcohol dependence care pathway for psychiatric settings: A cross-sectional study from an urban psychiatric center. Ann Indian Psychiatry. 2024;8:209–16. [Google Scholar]
- 15.Pal Singh Balhara Y, Prakash S, Gupta R. Pathways to care of alcohol -dependent patients: An exploratory study from a tertiary care substance use disorder treatment center. Int J High Risk Behav Addict. 2016;5:e30342. doi: 10.5812/ijhrba.30342. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.Tripathi R, Singh S, Sarkar S, Lal R, Balhara YPS. Pathway to care in co-occurring disorder and substance use disorder: An exploratory, cross-sectional study from India. Adv Dual Diagn. 2021;14:20–32. [Google Scholar]
- 17.Gomez KU, McBride O, Roberts E, Angus C, Keyes K, Drummond C, et al. The clustering of physical health conditions and associations with co-occurring mental health problems and problematic alcohol use: A cross-sectional study. BMC Psychiatry. 2023;23:89. doi: 10.1186/s12888-023-04577-3. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Bethesda (MD): National Institutes on Drug Abuse (US); 2020. Common Comorbidities with Substance Use Disorders Research Report. [PubMed] [Google Scholar]
- 19.Ibrahim A, Hor S, Bahar OS, Dwomoh D, McKay MM, Esena RK, et al. Pathways to psychiatric care for mental disorders: A retrospective study of patients seeking mental health services at a public psychiatric facility in Ghana. Int J Ment Health Syst. 2016;10:1–1. doi: 10.1186/s13033-016-0095-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20.Jain N, Gautam S, Jain S, Gupta ID, Batra L, Sharma R, et al. Pathway to psychiatric care in a tertiary mental health facility in Jaipur, India. Asian J Psychiatr. 2012;5:303–8. doi: 10.1016/j.ajp.2012.04.003. [DOI] [PubMed] [Google Scholar]
Associated Data
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Supplementary Materials
Comparison of time lags between service contacts in AUD patients in tertiary care center and the deaddiction camp