Last Updated on August 10, 2021
In 2019, 21.6 million people aged 12 and above in the United States needed substance use treatment. Only 4.2 million actually received it.
This daunting statistic comes from the 2019 National Survey on Drug Use and Health, a large-scale survey on substance use and addiction in the USA conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA)1. In it, the researchers confirm what many of us have seen in our own communities: Despite the devastating impacts of addiction, many people aren’t getting the help they need.
But why should this be the case? With so many people suffering from such a serious illness, why aren’t more people getting treatment? Below, we’ll discuss some of the most common reasons why addicts don’t seek help, and some recent solutions that may help solve the problem.
Why Don’t Alcoholics Get Help?
The reasons people don’t get help for addiction are as many and varied as the people who struggle with substances. But here are some of the most commonly recognized barriers to substance abuse treatment, and alcohol addiction treatment in particular:
Denial is one of the biggest obstacles to treatment for addiction. Of the individuals in the SAMHSA survey who needed treatment but did not get it, only 4.3 percent agreed that treatment was necessary2.
Many people find it difficult to ask for help or admit to having a problem. It’s common for alcoholics to believe their drinking isn’t that serious, or that they can quit any time. Even those who have experienced consequences, like fractured relationships or lost jobs, tend to blame factors other than alcohol for their struggles.
Unfortunately, denial is a difficult obstacle to overcome. There’s no way to solve a problem that a person doesn’t admit to having. But examining some other reasons alcoholics don’t seek treatment may help us understand why denial is so common, and how to help others who may be ready.
Stigma and Shame
When it comes to barriers to substance abuse treatment, stigma and shame loom large3. Stereotypes and judgements aimed at people who struggle with substances can cause people to hide their addiction from others. If loved ones do not know, they cannot help that person. And if they do know, shame and stigma can make it hard to have an open conversation.
The broader social stigma around alcohol abuse can also lead to “self-stigma,” where an individual experiences a loss of self-worth and self-respect. Individuals struggling with addiction may question whether they’re valuable enough to bother getting treatment. They may also drink even more in an attempt to cope with such feelings of shame and low self-esteem, making the problem worse.
Mistrust of Rehab Programs
Fear of the unknown is another reason some people avoid seeking treatment. They may not know what to expect from a rehab program, or they may have heard negative stories about rehab from others. In other cases, a person may have already tried inpatient treatment, had a negative experience, and be hesitant to try again.
A particular issue for many is the loss of independence and the high level of structure that comes with inpatient treatment. Some also feel uncomfortable with the 12 step philosophy used in many programs, or the idea of total abstinence.
Treatment Is Too Expensive
Another major issue people encounter when considering rehab is the expense. The cost of alcohol treatment varies widely—depending on the length of treatment, the quality of the facility, and whether the program is inpatient or outpatient. But in many cases individuals can expect to pay thousands of dollars for alcohol rehab. In fact, some “luxury” treatment centers can cost $50,000 or more.
Insurance policies often cover at least a portion of treatment, but this is not always the case. Of the people who admitted to needing treatment in the SAMHSA survey, 20.9 percent said they did not get it due to a lack of health coverage, or excessive cost4.
Finding Help Can Be Confusing
It can also be hard to know where to find effective treatment. In some areas, nearby treatment options are extremely limited or of low quality. Many people also just don’t know where to begin when it comes to searching for a program. In the SAMHSA survey cited previously, 23.8 percent of people who admitted a need for treatment said they simply didn’t know where to go for help5.
If finding the right treatment program seems too overwhelming, many people are likely to give up. This is especially true for those struggling with co-occurring mental health disorders such as depression and anxiety.
Unable To Put Life on Hold
Inpatient rehab typically involves a 30-90 day stay in a treatment facility. Outpatient rehab generally requires several hours of meetings and appointments each week. Many people don’t pursue treatment because they don’t think they have the time to do so.
People with jobs and families—especially those with young children—face significant challenges if they step away for an extended period of time. Will they lose their job? Who will take care of their children, and how much will that cost? What about bills, mail, pets, and the upkeep of their home? For some, the logistics and expense of pausing their life can make treatment seem impossible.
Not Ready To Stop Using
Finally, some people are simply not ready to stop using drugs or alcohol. In the 2019 SAMHSA survey, 39.9 percent of people who admitted they needed treatment said they didn’t get it because they weren’t ready to stop6.
People often worry about what life will be like without alcohol or drugs. If alcohol is a coping mechanism for mental health issues or trauma, they may be afraid to face life without it. And if alcohol is at the center of their social circle and friendships, they might have no desire to cut it out of their life.
So, what can you do when an alcoholic doesn’t want help?
Unfortunately, a person has to want help in order to get it. If someone is forced or coerced into treatment, it won’t be effective. Relapse is practically inevitable. Of course, you can still talk to your loved ones about your concerns and provide information on treatment options. Sometimes, all you can do is plant a seed and hope it will eventually take root, and make it clear that you care about that person.
How Telemedicine Can Help
Telemedicine, or online treatment, helps eliminate many of the barriers to getting help. App-based programs are accessible from anywhere, at any time—often at a significantly lower cost. By its very nature, this type of treatment is also more private and flexible. A person can control how public they want to be about getting help, continue with their daily life, and even set their own drinking goals.
Online programs like Ria Health include expert medical counseling, weekly coaching meetings, online support groups, and even prescription anti-craving medication. Putting the whole thing on an app also means you can track your progress through your phone, access help whenever you need it, and conduct the whole thing from the comfort of home.
Learn more about Ria’s unique approach to online treatment, and how we’re working to make help for alcohol addiction more accessible.