title: Failure to get into substance abuse treatment.
abstract: Among substance abusers in the US, the discrepancy in the number who access substance abuse treatment and the number who need treatment is sizable. This results in a major public health problem of access to treatment. The purpose of this study was to examine characteristics of Persons Who Use Drugs (PWUDs) that either hinder or facilitate access to treatment. 2646 participants were administered the Risk Behavior Assessment (RBA) and the Barratt Impulsiveness Scale. The RBA included the dependent variable which was responses to the question "During the last year, have you ever tried, but been unable, to get into a drug treatment or detox program?" In multivariate analysis, factors associated with being unable to access treatment included: Previously been in drug treatment (OR=4.51), number of days taken amphetamines in the last 30days (OR=1.18), traded sex for drugs (OR=1.53), homeless (OR=1.73), Nonplanning subscale of the Barratt Impulsiveness Scale (OR=1.19), age at interview (OR=0.91), and sexual orientation, with bisexual men and women significantly more likely than heterosexuals to have tried but been unable to get into treatment. The answers to the question on "why were you unable to get into treatment" included: No room, waiting list; not enough money, did not qualify, got appointment but no follow through, still using drugs, and went to jail before program start. As expected, findings suggest that limiting organizational and financial obstacles to treatment may go a long way in increasing drug abuse treatment accessibility to individuals in need. Additionally, our study points to the importance of developing approaches for increasing personal planning skills/reducing Nonplanning impulsivity among PWUDs when they are in treatment as a key strategy to ensure access to additional substance abuse treatment in the future.
authors.affiliation: Center for Behavioral Research and Services, California State University, Long Beach, 1250 Bellflower Blvd., Long Beach, CA 90840, USA. Electronic address: Dennis.Fisher@csulb.edu.
authors.forename: Dennis G
authors.initials: DG
authors.lastname: Fisher
authors.affiliation: Center for Behavioral Research and Services, California State University, Long Beach, 1250 Bellflower Blvd., Long Beach, CA 90840, USA. Electronic address: Grace.Reynolds@csulb.edu.
authors.forename: Grace L
authors.initials: GL
authors.lastname: Reynolds
authors.affiliation: Center for Health Equity Research, California State University, Long Beach, 1250 Bellflower Blvd., Long Beach, CA 90840, USA. Electronic address: Laura.DAnna@csulb.edu.
authors.forename: Laura H
authors.initials: LH
authors.lastname: D'Anna
authors.affiliation: Department of Mathematics and Statistics, University of Vermont, 128 Worcester Road, Stowe, VT 05672, USA. Electronic address: hosmer@schoolph.umass.edu.
authors.forename: David W
authors.initials: DW
authors.lastname: Hosmer
authors.affiliation: School of Nursing, California State University, Long Beach, 1250 Bellflower Blvd., Long Beach, CA 90840, USA. Electronic address: Kholoud.Khalil@csulb.edu.
authors.forename: Kholoud
authors.initials: K
authors.lastname: Hardan-Khalil
mesh_terms: D000328:Adult; D001727:Bisexuality / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006716:Homosexuality / Q000706:statistics & numerical data*; D006801:Humans; D007175:Impulsive Behavior; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000628:therapy*
keywords: Amphetamine; Bisexual; Cocaine; Homeless; Impulsiveness; Substance abuse treatment access