Alcoholics who got treatment first received it, on average, at about age 30 — eight years after they developed dependence on drinking, researchers reported.
"That's a big lag," especially combined with the fact that only 24 percent of alcoholics reported receiving any treatment at all, said study co-author Bridget Grant of the National Institute on Alcohol Abuse and Alcoholism.
The treatment rate for alcoholics was slightly less than the rate found a decade earlier. The study did not look at reasons for the decline, but other research has revealed a belief among doctors and the public that treatment does not work.
However, Dr. Mark Willenbring, director of the institute's Division of Treatment and Recovery Research, said evidence indicates that substance-abuse treatment is more effective than treatments for many medical disorders.
Three common approaches to treating alcoholism are 12-step programs, cognitive behavioral therapy and motivational enhancement therapy. Medications such as Antabuse, naltrexone and Campral also can help in combination with counseling, he said.
"The important thing is to engage with treatment and stick with it," Willenbring said.
About 42 percent of men and about 19 percent of women reported a history of either alcohol abuse or alcoholism during their lives. Whites and Native Americans were more likely than other ethnic groups to report drinking problems.
Alcohol abuse was defined as drinking-related failure to fulfill major obligations at work, school or home; social or legal problems; and drinking in hazardous situations. Alcoholism was characterized by compulsive drinking; preoccupation with drinking; and tolerance to alcohol or withdrawal symptoms.
The definitions were based on the American Psychiatric Association's diagnostic manual.
Treatment, in the study's definition, could have been by a doctor or another health professional, in a 12-step program, at a crisis center or through an employee-assistance program.
The study, appearing in Monday's Archives of General Psychiatry, was based on a new analysis of the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions. The survey involved more than 43,000 face-to-face interviews with a representative sample of Americans, ages 18 and older.
A previous report on the same data found that 4.7 percent of adults reported alcohol abuse in 2001-2002, and 3.8 percent reported alcoholism.
The new analysis was the first to report on the prevalence of alcohol problems over a lifetime.
The study was funded by the New York State Psychiatric Institute and the National Institute on Alcohol Abuse and Alcoholism, a division of the National Institutes of Health.