The most recent National Survey of Drug Use and Health, published in September 2020, states that there were 21.6 million people, 12 and older, who needed substance abuse treatment within the past year.  However, of those who needed treatment, only 4.2 million received it.  Why do so few who need help decide not to get addiction treatment? The survey asked that question and received a number and variety of responses.
Reasons for Not Seeking Addiction Treatment
Of respondents 12 and older who had a substance use disorder within the past year, the top reasons for electing not to seek treatment are listed according to the number of responses given: 
- Not Ready to Stop Using
- Did Not Know Where to Go For Treatment
- No Healthcare Coverage and Could Not Afford Cost
- Might Cause Neighbors/Community to Have a Negative Opinion
- Might Have a Negative Effect on Job
The data suggest that financial constraints and shame are often the reasons why people decide not to get help for a substance use disorder. Only a small percentage of respondents felt that treatment wouldn’t help.
But why would the majority say they’re not ready to stop using?
Why Do People Begin Taking Drugs or Using Alcohol?
It seems odd that someone with a substance use disorder would say they’re not ready to stop using. What would cause this incongruence? The answer may lie in why people decided to use drugs in the first place.
Continued after video:
The National Institute on Drug Abuse states that an individual may decide to start using drugs in order to: 
- Feel pleasure and experience the high that accompanies the use of the substance
- Feel less pain – whether it’s physical or emotional, drugs and alcohol can make you feel numb
- Improve performance or thinking – some perceive specific drugs as performance enhancers
- Experiment – either because of their fear of missing out or due to peer pressure
Any of those reasons could be excuses for why people decide not to get treatment, even as their substance use is causing real problems in their lives.
Improved education related to substance abuse may help those reluctant to get care understand why it’s necessary and provide valuable information as to where they can receive help. Since many feel they cannot afford treatment, education should also include information about payment plans and other kinds of financial assistance so that money won’t be a barrier to seeking help.
Shame Factors in as a Reason People Don’t Seek Addiction Treatment
But it’s probably the shame associated with substance abuse that’s most likely to convince people to deny their addiction or determine that they’re beyond hope. Lacking hope – or feeling unworthy of getting help – these individuals are probably not going to proactively work to address their addiction. That’s why it’s crucial for caring family and friends to talk to their loved ones. They must express their concern, and gently encourage them to talk with a therapist or recovery coach. 
A qualified therapist or recovery professional can help these individuals to see that the mistakes they’ve made are not a reflection of their self-worth. Recovery at a treatment facility can provide the tools they’ll need to make different choices in the future.
When those with a substance use disorder recognize that their behaviors related to drug or alcohol use are not an indication they’re unworthy of receiving help, they can begin to understand that recovering from addiction involves learning new skills and welcoming supportive people into your life.
Get Addiction Treatment in a Welcoming and Supportive Environment
At Ocean Hills Recovery, we understand why people are reluctant to seek help for substance use disorders. Our trained staff is adept at letting every individual who contacts us know that they are worthy and capable of recovering. We offer a variety of programs and are qualified to customize treatment plans according to individual needs. Long-term recovery requires learning new skills, practicing them. You can build friendships and support systems, and make a plan to implement new routines once you’ve completed the program.
Asking for help is a difficult choice to make. But that decision leads to a series of positive steps that will ultimately free you from addiction and live a happier, more fulfilled life. Get in touch with us to find out how we can put your life back on track.
Sources: https://www.samhsa.gov/data/sites/default/files/reports/rpt29393/2019NSDUHFFRPDFWHTML/2019NSDUHFFR1PDFW090120.pdf  https://www.psychiatry.org/patients-families/addiction/what-is-addiction  https://www.psychologytoday.com/us/blog/addiction-and-recovery/201904/the-link-between-addiction-and-shame
About the author:
Nicole earned her doctoral degree in Psychology with an emphasis on marriage and family therapy at California School of Professional Psychology. Her doctoral thesis was a grounded theory study exploring the role of alienation and connectedness in the life course of addiction. She specializes in treating addiction and trauma. She is certified in DBT and EMDR, two of the most highly regarded evidence-based methods in psychotherapy. Dr. Doss is a strong LGBT advocate and provides open and affirming support to her LGBT clients.
Dr. Doss’s earlier education included graduating cum laude from the University of California, Irvine in June of 2007 with a Bachelor’s degree in Psychology. While there, she received honors recognition by Psi Chi and Golden Key honor societies.
Nicole has been working with alcoholics and addicts in our California drug and alcohol rehab center as an advisor and counselor for many years. She is passionate about providing quality counseling and care to her clients. Her main focus is on integrating the 12 Step and disease models of addiction with experiential therapeutic theory. She is married to Greg; they have two adorable sons together and an energetic yellow Labrador Retriever.