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The Barriers to Getting Treatment

The government’s Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that about 20 million people ages 12 and up require treatment for alcohol in a given year. Of those 20 million, 87 percent of them really don’t think they need treatment. Of the remaining 2.6 million people, 4.5 percent feel they need treatment but don’t get it, and only 8 percent—1.6 million—actually receive some kind of treatment for a substance use disorder.

Why don’t more people get treatment? What treatment barriers most often are identified?

The reason given most often is pretty lame. Most people shrug and say, “I don’t why you think I need treatment. I know people who use way more than I do.” According to SAMHSA, 42 percent of those who need treatment express this idea one way or another.

That leaves a whopping 58 percent—11.6 million people—untreated, and they often indicate more than one treatment barrier.

  • Just over a third of them simply cannot afford treatment. Most private insurance companies refuse to pay for treatment in a substance use treatment facility.
  • Almost 20 percent of those 11.6 million people worry about the social stigma if their family, friends, and coworkers find out that they have admitted to suffering from a substance use disorder. That’s a shame, because those same people end up being very embarrassed when their names are in the paper for driving under the influence or, worse, vehicular homicide.
  • About 12 percent of them state they have no access to treatment, and 11 percent claim they did not know where to go for help. Although substance use treatment facilities are everywhere, the people who work there will tell you that many of those who call for the first time express relief about finding a place that will help them. Maybe those places need to implement better marketing strategies—but most facilities spend their dollars on treatment, not advertising.
  • Another 11 percent of them believe that they can handle addiction or dependency issues on their own, without getting any professional help.  
  • There were 4 percent who claimed they simply did not have time to fit treatment into their lives.
  • Another 3 percent refuse to believe that treatment will actually help them.
  • People listed other barriers, as well. Those who are parents worry about how their family will function if they go into treatment. People with jobs fear they will end up getting fired for admitting they have a problem.

Where do you fit on that list? If you’re reading this because of your concern for another person, talk to them about why they aren’t getting treatment, because you might be surprised by the answer they give.

Most people don’t realize that treatment doesn’t automatically begin with a long stay in a residential facility. They are frightened that asking for help will result in an immediate admission to a lock-down facility, but only correctional rehab centers will admit the person who doesn’t want help.

The first actual step for treatment begins with an assessment, and that leads to a recommendation for a specific level of care. Most people begin with outpatient treatment, because substance use treatment facilities are required in most states to offer their new clients the least restrictive level of care. Outpatient treatment involves one or two weekly sessions, each of about one hour’s duration. The next level of care is intensive outpatient, which involves two to four weekly sessions at about three hours each.

For some people, ultimately, residential treatment will be the best option to get them started on the path to recovery.  Most counselors have master’s degrees and some level of professional certification or state licensure for specializing in substance abuse treatment, and they are trained to recognize the unique problems that affect people struggling with addiction issues. Maybe it’s time to call for help.

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