The Centers for Disease Control and Prevention estimate that three million individuals receive substance abuse treatment annually in the United States and that between 13 and 16 million additional people could benefit from services. Treatment programs vary widely in approach, goals, size and fees. Communities may resist the establishment of recovery homes even in diverse neighborhoods, citing privacy or regulatory concerns. A mix of interventions and public education may reduce barriers to treatment.
Stigma
Negative reactions keep many with drug abuse problems from seeking help.Tired of lectures and judgment, addicts may have little expectation of being received with compassion and understanding in unfamiliar treatment settings. Client attitudes of mistrust and resistance to participation in recovery programs may stem from a fear of legal consequences, fear of failure, and the client's perception that she is different or alone. During intake procedures, which involve many personal questions, clients may react defensively, due to feelings of vulnerability.
Limited Access
There are too few treatment providers. Those relying on public funds have suffered cuts, and gaps in insurance coverage hurt some private facilities, reducing the number of beds available for residential care. Even outpatient centers may be short staffed due to budget constraints. People needing treatment and their families may not know that programs exist or what kinds of services are available. Attempts to get help may be thwarted in several ways. It can be difficult to obtain a referral, if needed, or to take the required action to stay on a waiting list, such as coming in person to check in on certain weekdays. Other barriers include inconvenient treatment locations or hours of operation. It may be difficult to comply with interview appointments and fees, to fill out applications, and to prove residency. Inability to remain in a program for a long enough time is another barrier to accessing appropriate substance abuse treatment. The CDC states that programs of less than 90 days' duration have been found to have little or no efficacy, adding that clients who require methadone maintenance should receive at least one year of treatment.
Isolated Communities
Substance abuse problems are not limited to the inner cities. A 2005 survey on Drug Use and Health, conducted by the Substance Abuse and Mental Health Services Administration found high rates of binge drinking, methamphetamine use, and oxycodone dependence in rural areas. With no public transportation, rural residents may have to rely on unreliable vehicles. Accessing distant treatment providers is a hardship. Affordable childcare is also likely to be scarce, and 12-step support groups may be limited to meetings held only once a week.
