Likelihood of Treatment Access and Barriers to Treatment by Substance Use Recovery Status Among United States Adults.

BACKGROUND

The process by which individuals change their substance use is personal and often non-linear, with periods of recovery, return to use, and treatment re-entry. This study characterizes utilization of substance use services and barriers to treatment access among United States (U.S.) adults with a self-identified lifetime alcohol and/or drug use problem who are versus are not in recovery.

METHODS

This study uses a subset of adults from the 2023 National Survey on Drug Use and Health (NSDUH) who self-identified as having had a problem with alcohol and/or drugs at some point in their lifetime (unweighted n=5,260, 38.4% female, 24.5% people of color).

RESULTS

Most participants (72.9%) self-identified as being in recovery. Individuals in recovery (relative to those with a lifetime problem but not in recovery) were more likely to report past-year substance use treatment (aOR=1.48); this difference appeared to be driven by the greater likelihood of using support groups (aOR=1.53) and peer support specialists or recovery services (aOR=1.17) among those in recovery. No differences were observed for other treatment types. Among those with past-year perceived unmet need for treatment (8.0% of the overall sample), individuals in recovery were significantly less likely to endorse concerns regarding stigma (aOR=0.25) and readiness to change (aORs=0.17-0.20). Otherwise, no differences were observed for other barriers.

CONCLUSIONS

Our findings highlight stigma as a unique distinguishing feature between those who are and are not in recovery from a substance use problem. Stigma-reducing interventions are needed to ensure that a greater proportion of individuals receive effective treatment.

CLINICAL IMPACT STATEMENT: Of people with a lifetime self-identified problem with alcohol and/or drug use, most also self-identified as being in recovery. We found that people in recovery were more likely to use support groups and peer-based services, while stigma stood out as a unique barrier to accessing treatment among those not in recovery. Increasing access to recovery-focused services might help to promote a recovery identity, thereby reducing stigma as a barrier to accessing treatment.