Probability and predictors of treatment-seeking for substance use disorders in the U.S.
BACKGROUND
Little is known about to what extent treatment-seeking behavior varies across individuals with alcohol abuse, alcohol dependence, drug abuse, and drug dependence.


METHODS
The sample included respondents from the Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who reported a lifetime diagnosis alcohol abuse, alcohol dependence, drug abuse, or drug dependence. Unadjusted and adjusted hazard ratios are presented for time to first treatment contact by sociodemographic characteristics and comorbid psychiatric disorders. Individuals were censored from the analyses if their condition remitted prior to seeking treatment.


RESULTS
In the first year after disorder onset, rates of treatment-seeking were 13% for drug dependence, 5% for alcohol dependence, 2% for drug abuse, and 1% for alcohol abuse. The lifetime probability of seeking treatment among individuals who did not remit was also highest for drug dependence (90%), followed by drug abuse (60%), alcohol dependence (54%), and alcohol abuse (16%). Having had previous treatment contact for a substance use disorder (SUD) increased the probability of seeking treatment for another SUD. By contrast, an early age of SUD onset, belonging to an older cohort, and a higher level of education decreased the lifetime probability of treatment contact for SUD. The role of comorbid mental disorders was more complex, with some disorders increasing and other decreasing the probability of seeking treatment.


CONCLUSIONS
Given high rates of SUD and their substantial health and economic burden, these patterns suggest the need for innovative approaches to increase treatment access for individuals with SUD.
New York State Psychiatric Institute, New York, NY, USA. Electronic address: cb255@columbia.edu.
Carlos
C
Blanco
New York State Psychiatric Institute, New York, NY, USA; Fundación Jiménez-Díaz, Department of Psychiatry, Madrid, Spain.
Miren
M
Iza
New York State Psychiatric Institute, New York, NY, USA.
Jorge Mario
JM
Rodríguez-Fernández
New York State Psychiatric Institute, New York, NY, USA; Fundación Jiménez-Díaz, Department of Psychiatry, Madrid, Spain.
Enrique
E
Baca-García
New York State Psychiatric Institute, New York, NY, USA.
Shuai
S
Wang
New York State Psychiatric Institute, New York, NY, USA.
Mark
M
Olfson
D000328:Adult; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011336:Probability; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D014481:United States / Q000453:epidemiology
Comorbidity; NESARC; Substance use disorders; Treatment-seeking