King's College London

Research portal

Prevalence of at-risk drinking recognition: a systematic review and meta-analysis

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Article number109449
JournalDrug and alcohol dependence
Issue number1
Published1 Jun 2022

Bibliographical note

Funding Information: Triggers of help seeking for alcohol problems in ex-Serving personnel: the roles of recognition and mental health comorbidity’ has been funded by the Forces in Mind Trust (FiMT), a £35 million funding scheme run by FiMT using an endowment awarded by The National Lottery Community Fund. S Stevelink is supported by the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and the National Institute for Health and Care Research , NIHR Advanced Fellowship, Dr Sharon Stevelink, NIHR300592 . N Fear reports grants from the US Department of Defence and the UK Ministry of Defence. The views expressed in this publication are those of the author(s) and not necessarily those of the funding organisations. Publisher Copyright: © 2022 The Authors


King's Authors


Background: There is a prominent “treatment gap” in relation to at-risk drinking (ARD), whereby a minority of at-risk drinkers ever access treatment. Research suggests that recognition of problem drinking is a necessary precursor for help-seeking and treatment. Objective: This systematic review and meta-analysis aimed to estimate the prevalence of ARD recognition within those meeting criteria for ARD. Method: PsycINFO, Web of Science, Scopus, and MEDLINE were searched using the terms: problem* AND (recogni* OR perceive* OR perception OR self-identif*) AND alcohol - to identify studies published in English between 2000 and 2022. Studies reported the frequency (weighted or unweighted) of participants meeting ARD criteria that also directly identified ARD, perceived a need for help, or endorsed a readiness to change. The prevalence of ARD recognition was estimated using a random-effects meta-analysis with 95% confidence intervals (CIs). Results: 17 studies were included which provided data for 33,349 participants with ARD. Most (n = 14) were US studies. ARD was self-identified via a single indicator in 7 studies, whereas recognition was assessed via stages of change in 4 studies and need for help in 6 studies. The pooled prevalence of ARD recognition was 31% (95% CI: 25%−36%), and subgroup analyses indicated alcohol use severity, measure of recognition, and population type to be significant sources of heterogeneity. Conclusions: Most individuals with ARD fail to recognise their drinking problem so preventive approaches that promote recognition may be helpful. However, we must be cautious of how inconsistency in question framing affects self-reported problem recognition.

Download statistics

No data available

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454