These generational differences likely reflect social and policy changes that created stigma and different landscapes of service use for each generation (again, these parallels discussed are speculative). Policy changes for AUD have strong roots in the social stigma around alcohol misuse and its classification as a social or moral problem until recently (HHS, 2016). In the 1970s and 1980s, the U.S. healthcare system responded to increasing rates of AUD by creating treatment programs that were separate from the rest of the healthcare system, leading to a push for more behavioral therapies, outpatient programs, and other help-seeking and treatment options (HHS, 2016). The exception was inpatient detox programs, which remained largely hospital-based. These programs would have been increasingly available for the silent generation, baby boomers, and older generation X individuals. This may partially explain the shift across generations from primarily seeking psychiatrists / another medical professional to seeking psychologists / another mental health professionals when seeking help - more psychologists were being tasked with treating AUD because treatment options were being removed from the hospital settings where psychiatrists and medical doctors
