United States Fails to Meet Growing Substance Use Care Needs

TOPLINE:

A public health crisis related to substance use disorder is evident in the United States, marked by a surge in cases since the COVID-19 pandemic and a decline in treatment due to disrupted healthcare services. However, rates of people receiving treatment began improving in 2022, likely due to the reopening of programs and an increased use of telehealth services.

METHODOLOGY:

• This cross-sectional study analyzed data from the National Survey on Drug Use and Health of treatment needs, treatment receipts, perceived needs, and treatment barriers associated with substance use disorders among 657,583 noninstitutionalized Americans aged 12 years or more from 2013 to 2023.
• Substance use disorder was categorized into alcohol, drug, or opioid use disorder.
• Respondents were deemed in need of treatment if they met the criteria outlined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.
• Participants who reported unmet treatment needs were asked to specify reasons for not receiving care.

TAKEAWAY:

• The proportion of individuals needing treatment for substance use disorders more than doubled from 8.2% in 2013 to 17.1% in 2023.
• Despite an increase in the need for treatment, treatment rates for substance use disorder initially declined from 9.3% in 2013 to 6.5% in 2020 before recovering to 14.9% in 2022. Similar patterns were observed for both alcohol use disorder and drug use disorder.
• Among those with substance use disorder who did not receive treatment, only 5.7% recognized their need for treatment, with an even smaller proportion of individuals (2.7%) actively seeking care.
• The primary reasons for not receiving treatment included reluctance to stop substance use, inadequate healthcare coverage, lack of awareness about treatment programs, and concerns about employment and community perceptions.

IN PRACTICE:

“These results call for urgent interventions to bridge the gap between the need for and receipt of SUD treatment, especially after the pandemic. Effective strategies should include enhancing access to counseling services, expanding insurance coverage for treatments, raising public awareness through targeted campaigns, and integrating SUD care into primary healthcare settings,” the authors wrote.

SOURCE:

The study was led by Ligang Liu, PharmD, of the Institute of Therapeutic Innovations and Outcomes in the College of Pharmacy at The Ohio State University in Columbus, Ohio. It was published online on January 6, 2025, in JAMA Network Open.

LIMITATIONS:

Reliance on self-reported data was a major limitation of this study.

DISCLOSURES:

No source of funding was reported for this study. The authors declared no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.