Perceived Barriers to Treatment for Alcohol Use Disorders in a National Sample

Aims: Among a population-based sample of adults with alcohol use disorders and a perceived need for alcohol treatment, we (a) describe latent classes of perceived barriers to seeking alcohol treatment and (b) identify characteristics associated with class membership.

Methods: Data are from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) wave 1 (2001-02), a nationally representative survey of adult US residents; analyses were restricted to adults with alcohol use disorders who perceived a need for, yet did not obtain, alcohol treatment (N=1,053). Latent class analysis was performed to identify subgroups of barriers to treatment; latent class regression was performed to identify variables associated with subgroup or class membership.

Results: Two subgroups emerged: Class 1 (87%) was characterized primarily by attitudinal barriers, with few reported structural or financial barriers, and Class 2 (13%) was characterized by significant attitudinal, financial, stigma and readiness for change barriers. In both classes, the most commonly identified barrier was attitudinal, namely the belief that they should be “strong enough” to handle alcohol problems on their own. Latent class regression indicated that a lifetime anxiety disorder, education level, having a mother who was a problem drinker, and income level were associated with membership in Class 2.

Conclusion: Findings suggests that attitudinal barriers are generally most common, and highlight the existence of a subgroup of individuals with multiple perceived barriers, including financial and stigma-related barriers, who may require additional resources and support in order to enter treatment.