To identify the barriers that keep individuals with alcohol abuse or dependence from seeking treatment and the characteristics associated with these particular barriers, researchers from Pennsylvania State University and Johns Hopkins University analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions (2001-2002).
Within a sample of 1,053 treatment-naive adults with a lifetime alcohol disorder and a perceived treatment need, individuals were best characterized as belonging to one of two distinct groups: 87% reported attitudinal barriers as their only reason for avoiding treatment (low barriers) while 13% reported their reasons for avoiding treatment included attitudinal, financial, stigma, and readiness-for-change barriers (high barriers).
The most frequently reported attitudinal barrier to treatment by both cohorts was “I should be strong enough to handle [the problem] alone” (42%), followed by “the problem would get better by itself” (33%).
In the high-barriers cohort, the most common stigma-related barrier reported was “too embarrassed to discuss it with anyone” (19%). Also within this group, 14% reported not being able to afford the bill for treatment (a financial barrier) and 7% reported not being aware of places for health care services (a structural barrier). Additional analysis revealed strong associations between individuals in the high-barriers cohort and comorbid psychiatric disorders, alcohol dependence (compared with abuse), and a family history of alcohol problems.
“Routine screening may help identify individuals with an alcohol use disorder who do not seek treatment,” the study authors concluded. “Individuals in the low-barriers class may benefit from motivational interviewing, and those in the high-barriers class may require more innovative and comprehensive treatment strategies.”
To read more about the nationwide rates of individuals with AUD who are left untreated, see the Psychiatric News article “National Survey Reveals Alcohol Abuse is Prevalent, Often Untreated.”
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