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Why Most Americans Who Need Substance Use Disorder Treatment Don’t Get It

In 2022, the Substance Abuse and Mental Health Services Administration (SAMHSA) revealed alarming statistics: more than 39 million adults with substance use disorder (SUD) did not receive treatment. This staggering figure highlights the complex challenges that prevent individuals from accessing the care they need. Despite advancements in understanding and treating SUDs, barriers persist, ranging from stigma to socioeconomic factors.

Barriers to Treatment

Despite the availability of treatment options, barriers persist, hindering individuals from seeking and receiving necessary care. The stigma surrounding substance abuse continues to permeate society, spreading misconceptions and discrimination against individuals with SUD. Socioeconomic factors, including financial constraints and lack of insurance coverage, also pose significant obstacles to treatment access. The average cost of drug rehabilitation, estimated at $13,475 per person, according to the National Center for Drug Abuse Statistics, remains a prohibitive barrier for many. Additionally, logistical challenges, such as geographical disparities in service availability and concerns about confidentiality, further impact access to care.

Addressing The Stigma Around SUDs

Combatting stigma and discrimination is essential to fostering an environment conducive to SUD treatment and recovery. According to an empirical investigation published in the Journal of Drug Issues, people’s attitudes around the cause and controllability of SUDs play into stigmatization. Negative attitudes towards individuals with SUD not only hinder help-seeking behavior but also contribute to disparities in healthcare access and quality. 

Socioeconomic and Racial Disparities 

Historical injustices, such as discriminatory drug policies like the War on Drugs in the ’70s and the Anti-Drug Abuse Act of 1986, have disproportionately impacted communities of color, contributing to mistrust and reluctance to engage with healthcare systems. 

Research indicates that Black Americans and Hispanic individuals with SUDs are less likely to receive and fill prescriptions for medication-assisted treatment compared to their white counterparts. Structural barriers, including lack of access to healthcare facilities and culturally competent care, further widen treatment gaps, highlighting the urgent need for targeted interventions to address systemic inequities. The authors of this study state, “These disparities are unlikely to close without the structural barriers and structural racism obstructing equitable access to medications for OUD, such as stigma and geographic maldistribution of relevant providers, being addressed.”

Challenges in Treatment Accessibility

Accessing SUD treatment also comes with logistical and financial challenges, particularly for individuals residing in rural areas or facing economic hardship. Limited treatment capacity, coupled with insufficient insurance coverage, leaves many individuals without viable care options. Concerns about job security, childcare, and housing further deter individuals from seeking help, perpetuating cycles of untreated SUD and escalating healthcare costs. To enhance treatment accessibility, innovative solutions, such as telehealth services and mobile clinics, can be integrated into existing healthcare systems to reach underserved populations effectively.

While these barriers to receiving care in the US can be high, so is the toll on those who are not receiving the treatment they need. According to a study published in the Journal of General Internal Medicine, emergency department visits for alcohol use disorder (AUD) and SUDs increased by 30% on average in the US between 2014-2018.

By confronting stigma, addressing socioeconomic inequities, and fostering inclusive healthcare systems, we can create pathways to recovery for millions of individuals. Through collaborative efforts between policymakers, healthcare providers, and community stakeholders, we can strive towards a future where every individual with SUD receives the support they need.