To anyone who has never struggled with a substance use disorder, it can be almost impossible to understand why someone doesn’t get help even when it’s obvious that drugs and alcohol are ruining their lives. It’s easy to attribute this resistance to irrationality or rather, the fact that addiction has totally inverted their priorities, which is often true.

However, there are many reasons people don’t seek help for addiction, even when they know they need it. Some of these objections are even reasonable. Whether they are reasonable or not, it helps to understand someone’s motivations if you are trying to convince them to get help. The following are the most common reasons people don’t seek help for addiction, according to the 2011 National Survey on Drug Use and Health.  


They Don’t Believe They Have a Problem

First, the vast majority of people with substance use issues who don’t get help—more than 95 percent—don’t get help because they don’t believe they have a problem. This can be baffling in itself and there may be many factors involved.

Denial is perhaps the biggest factor but denial itself is complicated. It often has to do with fear—fear of admitting you don’t have control over your substance use, fear of change, fear of giving yourself over to the recovery process, fear of living without drugs or alcohol and so on.

Part of it may be that they gauge their substance use by the people around them, who also drink and use drugs excessively. Getting through to these people can be challenging and may require an intervention.


They Aren’t Ready to Quit

Of the people who have substance use issues but don’t get help, the roughly five percent remaining either tried to get help but couldn’t get it or made no effort to get help. For both groups, the reasons are similar. One of the biggest reasons is that they just aren’t ready to quit.

This can be frustrating to hear because it only seems reasonable that if you know drugs or alcohol are harming you, then you should make some effort to quit. However, it’s important to understand that people have their reasons for using drugs and alcohol.

It might help them cope with painful emotions, perhaps resulting from trauma or a mental health issue. They may enjoy it so much that they feel like it’s worth the obvious downsides. Whatever the case, if you’re trying to encourage someone to seek help for their substance use, you have to make an effort to understand their ambivalence.


They Don’t Think They Can Afford It

Many people assume they can’t afford treatment. They read about celebrities going to rehab for 30 or 90 days and they assume treatment is for rich people.

However, that’s not the case at all. First, there are many levels of treatment—what’s called a spectrum of care. In terms of cost, mutual-aid groups are at one end of the spectrum—the free end. These include 12Sstep programs like AA as well as other programs like SMART Recovery and LifeRing.

There are also publicly funded clinics. Moving up, in terms of cost, you can talk to your doctor or therapist. Therapists often work on a sliding scale, so you may be able to afford therapy even if you don’t have insurance or your insurance won’t cover it. Then, there are outpatient services and intensive outpatient programs. 

The most expensive programs are typically inpatient programs but even these are often more affordable than most people realize and the most expensive programs aren’t necessarily better. What’s more, there are now more ways than ever to pay for treatment.

If someone you care about needs treatment, call a few programs. They typically have people whose job it is to help you find a way to afford it.


They Worry It May Have a Negative Impact on Their Job

The fear that taking time off for addiction treatment might affect your job is perhaps one of the more reasonable objections to seeking treatment. However, there are several things to keep in mind. First, getting treatment isn’t an all-or-nothing proposition.

Most of the treatment options on the spectrum of care won’t require you to miss work. You can go to 12-Step meetings, go to therapy, and participate in outpatient programs without having to move or quit your job.

If you do require a residential treatment program to get sober, it’s likely that your substance use is affecting your work and your employer would welcome you taking some time to address the problem. If your substance use continues to get worse, you may be out of a job anyway. And under the Family Medical Leave Act, you are entitled to take off 12 weeks for addiction treatment without losing your job. 


They’re Afraid of the Stigma

We’ve come a long way in our understanding of substance use disorders, but there is still a stigma attached. A lot of people worry that if they seek help for addiction, their neighbors, coworkers, and friends will find out about their problem and they will be permanently labeled or perhaps even ostracized.

While the stigma is, unfortunately, real, avoiding treatment is the wrong way to deal with it. If you don’t get help, the problem will likely escalate and people will find out anyway. If you do get help, there’s no reason anyone needs to know. Addiction treatment providers are bound by the same laws as medical care providers. 


They Don’t Know Where to Get Treatment

This one may seem silly, given there are thousands of billboards, TV commercials, and internet ads telling you where to find addiction treatment, but where to get help is a real concern. There are more than 14,000 addiction treatment centers in the US and many of them aren’t very good.

There are a number of things to look for in a quality program but one way to simplify the process is to work with a treatment services provider like Hired Power to find a suitable program, as well as coordinate different aspects of recovery, such as transportation to the treatment facility and follow-up care after treatment.


They Think They Can Handle It on Their Own

It’s hard to admit you have no control over your substance use but, paradoxically, some people will admit this and then insist they can get sober on their own. This is understandable since the prospect of giving up control is scary.

People know they need to make a change but they don’t want the discomfort of change. They don’t want to face painful memories or sort out dysfunctional relationships. They want to know that they can drink or use drugs if they feel like they need them to cope.

Unfortunately, there’s no way to recover from addiction without some level of discomfort. And they have to understand that their best judgment got them into this mess and they need to be willing to accept help if they are going to get out of it.

If you want to persuade someone to get help for their substance use, it’s important to understand their reasons for resisting it. This is often a process. It’s crucial to do more listening than talking. Suspend your judgment and criticism and try to understand. 


At Hired Power, we can help you develop a treatment and recovery plan that fits your individual circumstances. We provide intervention services, if necessary, as well as sober escorts. After treatment, we provide various kinds of recovery support, including case management and sober companions. To learn more about our services, call us at 800.910.9299.