Barriers associated with treatment seeking for alcohol dependence

Despite the high prevalence and burden associated with alcohol dependence (AD), few seek treatment. This study investigated how many with AD identify the need to seek treatment and the reasons, or barriers, reported for not seeking treatment. Using data from NESARC, the cohort included subjects meeting DSM-IV criteria for AD (n=1484). Only 21% of this cohort reported ever experiencing a time when they thought they should see a professional for drinking, whereas 25% reported ever seeking treatment. Of those who reported barriers (21%), it was more common to seek treatment (59%) than not (41%), suggesting that these barriers do not play a critical role in treatment seeking behavior. Similarly, for those who sought treatment, whether or not a barrier was reported did not appear to impact the behavior (13% no barrier reported; 12% barrier reported). Attitudinal barriers were most frequently reported (88%), such as being “strong enough to handle it alone.” Structural barriers such as financial or insurance coverage were less common (40%). Overall, results suggest a large discrepancy between having AD and recognizing the need to seek treatment. When the need is recognized, many still do not get help, citing a variety of reasons. In some cases, finances and insurance coverage play a role. To be most impactful, public policy and educational efforts should target individuals' recognition of needing help in order to address the high unmet treatment needs of those with AD.