Table 3.
Perceived barriers to substance use disorder (SUD) treatment in 32,916 National Survey of Drug Use and Health 2005-2010 adult participants with past-year SUD with and without comorbid past-year major depressive episode (MDE).
| Male |
Female |
Effect Modification Wald –Test F( 1, 60) |
|||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Reasons for not receiving treatment |
SUD with MDE (N= 199) |
SUD without MDE (N= 521) |
OR (95% CI) |
aOR (95% CI) |
SUD with MDE (N= 233) |
SUD without MDE (N= 306) |
OR (95% CI) |
aOR (95% CI), |
|||||
| N | % | N | % | N | % | N | % | ||||||
| Financial Reasons | 88 | 51.8 | 197 | 36.1 |
1.91
*
(1.05, 3.47) |
1.97
*
(1.14, 3.39) |
92 | 41.2 | 103 | 33.8 | 1.37 (0.75, 2.51) |
1.41 (0.78, 2.55) |
0.57 (0.451) |
| Could not afford cost |
81 | 47.9 | 179 | 31.9 |
1.96
*
(1.06, 3.62) |
1.77 (0.97, 3.24) |
82 | 34.9 | 94 | 31.0 | 1.19 (0.66, 2.14) |
1.41 (0.79, 2.48) |
1.34 (0.251) |
| No insurance coverage |
11 | 6.3 | 23 | 4.4 | 1.48 (0.49, 4.44) |
3.22
*
(1.13, 9.16) |
12 | 6.7 | 14 | 5.9 | 1.16 (0.44, 3.03) |
0.57 (0.14, 2.33) |
0.10 (0.750) |
|
Stigmatization
Reasons |
53 | 23.7 | 98 | 21.3 | 1.15 (0.62, 2.13) |
1.15 (0.63, 2.11) |
72 | 23.9 | 76 | 22.4 | 1.09 (0.62, 1.93) |
1.05 (0.49, 2.22) |
0.02 (0.901) |
| Fear of neighbors’ opinion |
37 | 17.1 | 48 | 9.3 | 2.02 (0.89, 4.59) |
1.43 (0.61, 3.31) |
48 | 15.3 | 48 | 10.3 | 1.57 (0.77, 3.21) |
1.76 (0.67, 4.57) |
0.24 (0.626) |
| Fear of negative effect on job |
27 | 15.4 | 48 | 13.4 | 1.18 (0.56, 2.46) |
1.66 (0.83, 3.35) |
31 | 9.2 | 38 | 12.8 | 0.69 (0.31, 1.54) |
0.46 (0.18, 1.21) |
0.94 (0.335) |
| Did not want others to find out |
18 | 7.3 | 31 | 5.6 | 1.33 (0.51, 3.52) |
1.32 (0.50, 3.46) |
26 | 9.4 | 26 | 9.8 | 0.95 (0.39, 2.35) |
0.78 (0.32, 1.92) |
0.25 (0.622) |
|
Attitude toward
treatment |
98 | 47.2 | 218 | 47.5 | 0.99 (0.54, 1.82) |
0.97 (0.52, 1.81) |
107 | 42.4 | 165 | 55.0 | 0.60 (0.34, 1.05) |
0.58 (0.33, 1.03) |
1.60 (0.211) |
| Did not think treatment needed |
21 | 9.0 | 33 | 6.6 | 1.41 (0.52, 3.86) |
1.94 (0.56, 6.72) |
24 | 9.1 | 23 | 5.5 | 1.73 (0.58, 5.15) |
1.61 (0.60, 4.37) |
0.07 (0.789) |
| Did not think treatment would help |
12 | 5.7 | 17 | 4.1 | 1.40 (0.41, 4.72) |
1.37 (0.44, 4.50) |
13 | 5.5 | 8 | 1.1 | 5.30** (1.97,14.29) |
3.39* (1.24, 9.23) |
2.85 (0.097) |
| Thought could handle the problem without treatment |
34 | 13.0 | 42 | 8.3 | 1.65 (0.78, 3.46) |
1.65 (0.77, 3.52) |
40 | 11.7 | 39 | 10.4 | 1.14 (0.57, 2.25) |
1.03 (0.48, 2.21) |
0.61 (0.438) |
| Not ready to stop using |
78 | 40.7 | 174 | 38.5 | 1.10 (0.55, 2.20) |
1.17 (0.63, 2.18) |
78 | 31.4 | 129 | 44.7 | 0.57 (0.33, 0.96) |
0.57 (0.31, 1.05) |
2.49 (0.120) |
| Structural Reasons | 57 | 29.4 | 140 | 24.4 | 1.29 (0.61, 2.70) |
0.79 (0.38, 1.62) |
76 | 23.8 | 97 | 30.1 | 0.72 (0.41, 1.27) |
0.92 (0.52, 1.64) |
1.72 (0.194) |
| No program open or treatment type |
14 | 10.6 | 47 | 7.8 | 1.41 (0.37, 5.41) |
0.56 (0.22, 1.42) |
20 | 5.6 | 29 | 6.4 | 0.86 (0.32, 2.32) |
1.10 (0.37, 3.25) |
0.36 (0.551) |
| Did not know where to go |
29 | 11.8 | 55 | 9.6 | 1.26 (0.48, 3.29) |
0.91 (0.31, 2.64) |
37 | 12.4 | 55 | 17.3 | 0.68 (0.29, 1.59) |
0.87 (0.36, 2.14) |
1.22 (0.274) |
| Did not have time |
16 | 6.7 | 18 | 4.1 | 1.68 (0.56, 5.10) |
1.64 (0.57, 4.76) |
15 | 6.0 | 21 | 6.5 | 0.93 (0.34, 2.55) |
0.82 (0.22, 3.02) |
0.67 (0.415) |
| No transportation or inconvenient |
10 | 4.9 | 45 | 6.3 | 0.77 (0.28, 2.12) |
0.88 (0.30, 2.61) |
23 | 7.1 | 25 | 10.7 | 0.63 (0.23, 1.73) |
0.86 (0.36, 2.08) |
0.08 (0.781) |
Note: OR stands for odds ratio, aOR for adjusted odds ratio, CI for confidence interval. Adjusted odds ratios are from multivariate logistic models which controlled for age, race, marital status, education, income, insurance, employment and population density.
*
p<0.05,
†
p<0.01,
‡
p<0.001.
Terms in bold font are significantly different at p<0.05.