Barriers to Addiction Treatment: Why Addicts Don’t Seek Help
There is a marked discrepancy between the number of people who need addiction treatment in the United States and those who actually receive it.
What Are The Most Common Barriers to Addiction Treatment?
Barriers to finding addiction treatment may vary by personal situation, but the most common barriers include:
- Geographic Location
- Co-Occurring Disorder Treatment Availability
In 2018, about 21.2 million people age 12 and older, or approximately 1 in 13 people in this age group, needed substance abuse treatment.1 People go untreated for many reasons. They may be reluctant to seek treatment because they hold certain beliefs about it, or they may not have insurance to cover the costs. Or they may live in an area where treatment isn’t available.
Whatever the case may be, there are changes occurring on several fronts that can make treatment more accessible for more people. Changes in insurance coverage may open the door for increasing numbers of people to get the treatment they need. Innovations, such as teleheath, allow people in secluded areas to connect with providers without having to travel long distances. Additionally, alternative options to treatment—such as 12-step groups and other self-help programs—are free and widely available.
Even though many barriers remain, some encouraging signs point to treatment becoming more within reach for populations who have struggled to find recovery help in the past.
Financial limitations are one of the major barriers that prevent people from receiving treatment.
Insurance can help cover the cost of substance abuse treatment, but many people remain uninsured due to:11
- The high cost of insurance.
- The loss of a job.
- Losing Medicaid.
- Lack of insurance through an employer.
- Change in family status.
- Believing that they don’t need coverage.
In 2016, 27.6 million people ages 0–64 did not have health insurance. About 44% of these people were white, 33% were Hispanic, 15% were black, 5% were Asian/Native Hawaiian or Pacific Islander, and 3% were of another race, and three-quarters of them were in a household with one or more full-time workers.11
The National Comorbidity Survey-Replication, a nationally representative survey of more than 9,000 people, asked why people with mental health and substance abuse disorders did not seek treatment. About 15% of the respondents cited financial barriers such as lack of insurance and concerns about cost. Almost 17% said they left treatment early due to treatment costs and their insurance not paying for further treatment.12
Socioeconomic status may also play a role in whether someone can access and complete treatment. It has already been established as a risk factor that can prevent people from entering treatment, and one study found that blacks and Hispanics were less likely to complete addiction treatment largely due to differences in socioeconomic status—particularly higher unemployment and unstable housing among these groups.13
Even people with insurance may run into problems when they try to get treatment because plans do not always cover medication-assisted treatment (MAT) for opioid addiction. And while Medicaid covers MAT, many states impose limitations and requirements on it that make it more difficult to receive—though this may be changing (see “How to Overcome These Obstacles” section below).14
A large portion of the rehab programs in the United States are concentrated in states with high populations. In 2020:7
- California had 2,350 treatment facilities.
- New York had 1,057 facilities.
- Florida had 939 facilities.
- Illinois had 891 facilities.
Conversely, states with low populations tend to have fewer facilities, and many of these states are quite large geographically—which means facilities are more spread out and harder to access for people in rural areas. In 2016:7
- Vermont had 61 treatment facilities.
- Wyoming had 5874facilities.
- Montana had 162 facilities.
Other Challenges & Rehab Hurdles
In addition to the issues outlined above, there are a number of other reasons why people have a hard time getting help for an addiction.
How to Overcome These Treatment Obstacles
Overcoming the barriers presented above is challenging because they occur on a number of levels: structural, systemic, personal, societal, and socioeconomic.
That said, there are some potential solutions to help more people get help for their addictions and begin to live more fulfilling lives.