BACKGROUND: A variety of treatment options for people with alcohol use disorder (AUD) exist. Surveys estimate that 1 in 10 people with AUD utilise treatment, but real-world treatment pathways remain covert. This data-linkage study seeks to characterise treatment utilisation patterns to identify gaps in treatment access and delivery in Germany. METHODS: Linking individual-level data from three sources (statutory health insurance, pension funds, outpatient addiction care services) identified seven alcohol-related treatment types delivered in outpatient (brief psychiatric consultation
formal psychotherapy
pharmacotherapy
low-threshold counselling), inpatient (standard, somatic inpatient treatment
intensive inpatient treatment with somatic and psychosocial care), or either of the two settings (long-term rehabilitation treatment) during 2016-2021. For patients with a new AUD diagnosis (ICD-10: F10.1-9), treatment utilisation over 24 months was recorded and patterns were identified using latent class analyses. RESULTS: Of CONCLUSIONS: The real-world utilisation of alcohol-related treatments contrasts with existing guidelines, as most patients with diagnosed AUD do not receive adequate care. Structural and social barriers should be minimised to ensure healthcare provision for those affected.