Why Only 1 in 8 People Get Treatment for Addiction

Michelle McGinnis, LCSW


The National Survey on Drug Use and Health is the nation’s most comprehensive annual survey on key indicators of substance abuse and mental health in the United States. In September of 2018, they released the results from the latest survey, comprised of data collected over the course of 2017.

This data tells us not only about the scope of substance abuse issues in the United States, but also how many people are seeking treatment for addiction, how many are receiving treatment for addiction, and how many people are still in need of treatment for addiction.

According to the survey, as many as 20.7 million people are in need of treatment for substance abuse in the United States and yet, only 2.5 million will receive treatment.

Below, we’ve broken down the results of the survey to find out exactly how many people need treatment, and what barriers stand in the way of them getting it.

How Many People Need Treatment?

First, here is a breakdown of how many people in the U.S. are in need of treatment, broken down by age demographic.

Number/Rate of People In Need of Substance Use Treatment in the Past Year, by Age Group: 2017

Here are the biggest takeaways from the data:

  1. Broken down by age, we can see that the group most at risk and with the highest rate of substance abuse issues is the 18 – 25-year-old demographic. Roughly 1 in 7 individuals in this age demographic have substance abuse issues.
  2. For adolescents (aged 12 to 17) that rate falls to 4.1% of the age demographic, or roughly 1 in 24 adolescents. For adults (aged 26 or older) the rate is 6% of that demographic, or roughly 1 in 15 adults.

How Many People Who Need Treatment Get It?

The NSDUH also polled all respondents in need of treatment as to whether or not they had ever received clinical treatment in the past year. Here is the same breakdown of responses by demographic:

Number/Rate of People Who Received Treatment in the Past Year among People In Need of Substance Use Treatment, by Age Group: 2017

Here’s a breakdown of what we can learn from this data:

  1. Roughly 1 in 8 people in the United States in need of treatment actually received clinical treatment for their addiction, equating to roughly 2.5 million people.
  2. Of the total percentage of people in need of treatment who received clinical care for their addiction, the greatest percentage came from the 26 and older demographic, a difference that could be attributable to any number of factors such as economic prospects, different generational stigmas, or lack of understanding about addiction.
  3. The demographic with the highest rate of substance abuse issues, the 18 to 25-year-old demographic, was also the demographic with the lowest rate for receiving clinical treatment, an alarming disparity.

Why Don’t People Who Need Treatment Receive It?

The NSDUH also polled respondents on the reasons they had not received treatment.

The biggest reason? Most people don’t think they need help.

Of the 18.2 million people in the U.S. who needed but did not receive treatment, the vast majority (94.3%) of respondents claimed that they did not think they needed treatment. This is a huge number, representing over 17.1 million people in need of treatment but in denial about it.

Of the remaining 5.7% who responded that they did need treatment, the NSDUH asked for the reasons that these individuals had not sought treatment.

Reasons for Not Receiving Substance Use Treatment Among People Who Felt They Needed Treatment in the Past Year: Percentages, 2017

Why Only 1 in 8 Substance Abusers Get Treatment

In other words, here is what we know about why so few people suffering from substance abuse issues ever receive treatment.

Statistically, the primary reason that the vast majority of people (94%) do not seek treatment for substance abuse issues is that most people don’t think they need treatment. This could stem from a number of reasons.

  1. They are in denial about their addiction
  2. They do not believe that treatment will help their addiction
  3. They believe they can stop using without professional help

Second, is that many people who acknowledge they have a problem are simply not ready to stop using. This could be due to the fear of withdrawal symptoms, the belief that they are right around the corner of quitting, or that they simply never want to stop using.

Third, is that many people cannot access quality programs. Whether due to inadequate health insurance coverage, expensive co-pays, or the inability to find and access the types of program they need, as many as 500,000 people who know they need help are unable to access quality and affordable programs.

Fourth, is that stigma prevents many people from enrolling in the treatment they need. While these people may acknowledge they have a problem, they fear being judged by members of their community for enrolling in rehab. Many are also afraid of being judged by coworkers or losing their job.

So, now that we know why people are not getting the treatment they need, how do we work to increase the number of people in treatment? Here are the step-by-step actions we can take to address this “Treatment Gap”.

Addressing the Treatment Gap

Most People Do Not Believe They Need Treatment

Why would someone struggling with substance abuse issues not feel the need to get help? For one, it could be a lack of awareness about how severe their issues are. It could also be a lack of faith in the efficacy of clinical treatment. They may also feel like getting sober isn’t worth the effort and they would prefer to be high the rest of their lives.

Inadequate Screening

There is a lack of adequate screening measures in place to monitor behavioral health, allowing many cases of addiction to go unnoticed and untreated. By incorporating vital screening measures for substance abuse, suicidal ideation, and other mental health indicators into more organizations, people can get the help they need sooner rather than later.

Screening for substance abuse, suicidal ideation, and other mental health indicators is a critical step that healthcare systems and businesses can implement to begin saving lives. The Substance Abuse and Mental Health Services Administration has a specific outline known as the SBIRT method (Screening, Brief Intervention, and Referral to Treatment) that has been linked to lower healthcare costs, lower rates of drug and alcohol misuse, and reduced risk of trauma. School, businesses, and healthcare organizations can use this tool to help identify individuals at risk for suicide or developing a substance abuse disorder. The process is as follows:

SBIRT Method

  • Screening: Involves screening patients on a regular basis using age-appropriate questionnaire
  • Brief Intervention: Involves an intervention with patients that show at-risk behaviors by introducing feedback on their unhealthy behaviors while educating them about available tools and resources involved with substance abuse and suicidal ideation.
  • Referring for Treatment: If a patient is considered at high risk, they are referred for further professional assessment and services.

Lack of Understanding About Addiction

Along with these impediments, many people may be unaware of their substance abuse problems and can even have little understanding about addiction in general. Addiction is a serious and life-threatening issue that leads to the death of tens of thousands of Americans each year. And then you have treatment centers that are ill equipped, not properly trained to deal with co-occurring disorders, and do not have licensed clinicians or medical personnel. People get a bad experience through this and do not want to try others.

Lack of Access to Care

One of the many reasons that people don’t seek out or get the care that they need is because not everyone has access to proper health care coverage. Some treatment centers have to turn patients away because they are unable to take certain insurance or they lack insurance altogether.

Moreover, some people may be unable to afford quality programs even with the help of insurance. Quality, affordable addiction healthcare is something that can be hard to come by, and it may require some searching in order to find the right facility for you. Additionally, the lack of financial means to maintain sobriety through sober living, IOP, ongoing therapy, and access to transportation can hinder an individual’s ability to achieve and maintain sobriety.

Michelle McGinnis is the Chief Clinical Officer at Landmark Recovery, a drug and alcohol rehab organization. McGinnis is a Licensed Clinical Social Worker and has been working in the healthcare space since 2007.If you’re searching for help for you or your loved one, Landmark Recovery may be able to help you.