Perceived unmet need for alcohol and drug use treatments and future use of services: results from a longitudinal study.

Abstract

This study assessed the association of perceived need for and perceived barriers to treatments for substance use disorder (SUD) with subsequent use of these treatments in community settings. Drawing on data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we examined the association of perceived need and barriers to SUD treatments in waves 1 of NESARC (2001-2002; n=43,093) with the subsequent use of these treatments in the follow-up wave 2 (2004-2005; n=34,625). Only 8.5% (n=195) of the 2333 NESARC participants with an untreated 12-month SUD in wave 1 perceived a need for SUD treatment. Participants who reported a perceived need were more likely to use these services in follow-up than those who did not report such a need (14.8% vs. 4.9%, adjusted odds ratio [aOR]=3.16, 95% confidence intervals [CI]=1.70-5.90, P<0.001). Among participants who perceived a need, those who reported pessimistic attitudes towards treatments as a barrier were less likely than others to use services in follow-up (aOR=0.08, 95% CI=0.01-0.73, P=0.027). Other barriers, including financial barriers and stigma were not significantly associated with treatment seeking. The findings suggest the need for a two-pronged approach to improving treatment seeking for SUD in community settings: one focusing on enhancing recognition of these disorders, the other focusing on educating potential consumers regarding the benefits of SUD treatments.