According to the National Survey on Drug Use and Health, about 20 million people each year have a substance use issue that requires specialized treatment but only about 10 percent ever receive treatment. That’s a surprisingly small percentage, given the negative effects a substance use disorder can have on your family, your health, your finances, your career, and every other aspect of your life. Despite the increased attention the opioid crisis has brought to addiction and addiction treatment in recent years, the percentage of people seeking help for substance use issues has remained about the same. Why do relatively few people seek help for addiction?

Most don’t believe they need help.

The biggest reason by far that people with substance use disorders don’t seek help is that they don’t believe they need help. Of all the people who need help but don’t seek it, 96 percent say they don’t need it. They might mean that they believe they have a substance use problem but they can handle it on their own. Many people assume they can stop whenever they feel like it but they haven’t actually tried. It may also mean that they don’t believe they have a problem at all. People are ingenious when it comes to rationalizing their behavior, especially when it involves addiction. Denial and rationalization are huge barriers to convincing someone to get help.

They aren’t yet ready to quit drinking or using drugs.

Of the remaining four percent, the majority know they need help but they don’t seek it. Of this group, more than a third say they just aren’t ready to quit drinking or using drugs. This attitude might seem contradictory. If you know that substance use is hurting you and your family and you know you need help to quit, how can you say you’re not ready to quit? For many people, substance use involves tradeoffs. They may see that it has some negative consequences but it may also be the most enjoyable thing in their lives or they may feel like they need drugs or alcohol to cope with difficult emotions. Being aware of negative consequences isn’t necessarily enough to make someone want to quit. They have to believe the bad outweighs the good, usually by a lot.

Some can’t afford it or believe they can’t.

Just over a quarter of people who need help but don’t seek it don’t have insurance or believe they can’t afford treatment. In reality, addiction treatment is more accessible and more affordable than it has ever been. There is a continuum of care ranging from outpatient services to intensive inpatient programs and most of these services are available at a range of prices. Most people can afford some level of treatment. What’s more, most insurers cover some level of addiction treatment now and most quality treatment programs accept several forms of insurance. Recent changes to Medicare and Medicaid in the SUPPORT act allow federal money to be used by more treatment programs. Most treatment facilities have people who specialize in helping clients find ways to pay for treatment, so don’t automatically assume treatment is out of reach.

Some don’t know where to go for treatment or couldn’t find the kind of treatment they wanted.

This reason is slightly perplexing because there are so many treatment options marketing themselves so aggressively. The real problem is not finding a treatment program but rather choosing from a huge variety of options. There are around 14,000 addiction treatment centers in the US. Most of them are not great. Surprisingly few use evidence-based treatment methods and many use unscrupulous business practices. Of the quality providers, not every program is a good fit for every client. A recovery services provider can help you find a quality program that’s a good fit for you. Another place to start might be to ask your doctor or therapist about treatment options. 

Some are worried what others will think.

We’ve come a long way in recent years in how we view people with substance use disorders. Most people now know someone who has been affected by the opioid crisis in the US and increased media coverage has challenged many inaccurate assumptions about addiction. However, we still have a long way to go. A 2018 poll found that although a slight majority of Americans–53 percent–now see addiction addiction as a disease that requires treatment, 44 percent see it as a lack of discipline or willpower and fewer than 20 percent are willing to closely associate with someone with a substance use disorder. It’s no wonder then that people worry about the effect that seeking treatment will have on their reputation. However, there are two things to remember. First, treatment centers, like hospitals, are legally required to keep your information confidential unless you authorize someone to see it. You can ask about their privacy policy if you have concerns. Second, if you don’t get treatment and your substance use continues to get worse, it will come out in ways you will have less control over, such as losing your job, getting divorced, or possibly getting arrested. 

The rest worry about the effect on their jobs.

The remaining people who don’t seek help–about 12 percent–are worried about the effect it will have on their jobs. This might be a concern about their reputation among colleagues or clients, making this similar to the issue above. They might also be concerned about losing their jobs if they ask for time off for treatment or missing out on professional opportunities. Under the Family Medical Leave Act, you can take up to 12 weeks off for addiction treatment without losing your job. As for missing out on professional opportunities, substance use will cause you to miss out on a lot more opportunities in the long run. Getting your substance use under control is probably the best thing you can do for your career.

If you have a loved one who is struggling with addiction, Hired Power and our team of dynamic, experienced recovery professionals are here to guide you every step of the way. We offer many services, including helping you choose the best treatment program and transitional services, including interventions, sober monitoring, and personal recovery assistants. Call us today for information on our recovery services: 714-559-3919.

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