How Often Do People With Substance Problems Seek Treatment?

New research from a team of American and Spanish doctors indicates that the rate of treatment-seeking among people with substance problems varies according to the types of substances under consideration, as well as the nature of the problems involved.

Millions of Americans have diagnosable problems with substance abuse or substance addiction related to the consumption of alcohol or various mind-altering drugs and medications. In a study published in February 2015 in the journal Drug and Alcohol Dependence, researchers from the New York State Psychiatric Institute and Spain’s University Hospital Foundation Jimenez-Diaz used data from a large-scale American project called the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to help determine how often people affected by abuse or addiction related to the consumption of alcohol or drugs/medications seek treatment.

Drug and Alcohol Problems

Some people affected by diagnosable substance problems have a condition known as addiction or dependence, which is characterized by a physical, brain-based need to consume more drugs or alcohol. Other people don’t have problems related to dependence/addiction but still abuse drugs or alcohol in ways that seriously disrupt their ability to lead stable, productive lives. A third group of affected individuals have overlapping symptoms of substance addiction/dependence and substance abuse. Under guidelines currently used throughout the U.S., all three groups of people qualify for a diagnosis of an umbrella condition called substance use disorder, as well as for a diagnosis of a subtype of this disorder that specifically reflects the nature of the substance causing the observed problems (e.g., alcohol use disorder, opioid use disorder or stimulant use disorder).

According to figures compiled by the National Institute on Drug Abuse, about 17.7 million Americans had diagnosable problems with alcohol dependence (alcoholism) and/or alcohol abuse in the year 2012. In that same year, 4.3 million Americans had diagnosable problems with marijuana abuse/addiction. In descending order of frequency, other common sources of substance abuse/addiction included opioid medications, the stimulant drug cocaine, tranquilizers, non-cocaine stimulants and heroin.

Substance Treatment Approaches

Substance treatment programs use a range of approaches to help people recover from serious problems with alcohol, drugs and/or mind-altering medications. In some cases, doctors and other addiction specialists have access to medications with proven effectiveness, as well as verified forms of psychotherapy and other non-medication-based therapy techniques. Conditions known to respond to medication, therapy or a combination of medication and therapy include alcohol use disorder and opioid use disorder. Some other substance-based conditions, like cocaine-related stimulant use disorder, have no reliable medication option. In such circumstances, treatment relies entirely on psychotherapy and other non-medication-based approaches. Support programs like 12-step programs can also play an important role in recovery from substance problems.

How Often Do People Seek Treatment?

In the study published in Drug and Alcohol Dependence, the American and Spanish researchers used data from NESARC, a nationwide survey project conducted in the first decade of the 21st century, to help determine how often people in the U.S. with diagnosable substance problems seek treatment for those problems. Unlike some earlier researchers who grouped all treatment seekers together, the researchers conducting the current study separated people with alcohol problems from people with drug/medication problems. They also, to the best of their ability, separated people affected by issues of dependence/addiction from people affected by abuse-related issues. In addition, the researchers separately considered short-term trends of treatment-seeking and lifetime trends of treatment-seeking.

After analyzing the collected data, the researchers concluded that people affected by drug or medication addiction/dependence have the highest chances of seeking treatment within a year after first developing diagnosable problems; still, just 13 percent of these individuals seek treatment in a one-year timeframe. Additional rates of treatment-seeking within a year of the onset of problems span from a high of 5 percent for people affected by alcoholism to a low of 1 percent for people affected by alcohol abuse. Throughout their lifetimes, people affected by drug or medication addiction/dependence have a roughly 90 percent chance of seeking treatment for their condition. The lifetime treatment-seeking rate for drug/medication abuse is 60 percent. Approximately 54 percent of all Americans with alcoholism will seek treatment in their lifetimes, while the lifetime treatment-seeking rate among people affected by alcohol abuse is just 16 percent.

The study’s authors concluded that a previous history of substance treatment increases the odds that an affected individual will seek treatment in the future. Conversely, several factors—including developing substance problems early in life and being an older person with substance problems—decrease the likelihood of future treatment-seeking.

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