It should be noted that some of the reasons mentioned above presuppose a certain degree of problem insight while others do not. In a theoretical framework (see Fig. 1), Saunders linked the treatment seeking process and related barriers to the degree of problem insight [21, 22, 17]. According to this framework, at an early stage of AUDs people deny having a problem with alcohol or do not recognize their drinking behavior as problematic. However, once the problem is acknowledged, those affected might wish to handle it on their own, partly because of their fear of stigmatization. Previous research has shown that patients that seek treatment do so after postponing treatment seeking for several years and a number of failed attempts to quit or control drinking on their own [23]. Those with more severe symptoms might encounter barriers like accessibility/affordability once they recognize that treatment seeking is necessary.
