Treatment use and barriers among adolescents with prescription opioid use disorders

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham 27710, USA.
Addictive behaviors (Impact Factor: 2.76). 08/2011; 36(12):1233-9. DOI: 10.1016/j.addbeh.2011.07.033
Source: PubMed


This study examined national trends, patterns, correlates, and barriers to substance abuse treatment use by adolescents aged 12-17 years who met at least one of the past-year criteria for prescription opioid abuse or dependence (N=1788).
Data were from the 2005-2008 National Surveys of Drug Use and Health (NSDUH). Past-year substance use disorders, major depression, and treatment use were assessed by audio computer-assisted self-interviewing.
About 17% of adolescents with opioid dependence (n=434) and 16% of those with opioid abuse (n=355) used any substance abuse treatment in the past year compared with 9% of subthreshold users, i.e., adolescents who reported 1-2 prescription opioid dependence criteria but no abuse criteria (n=999). Only 4.2% of adolescents with opioid dependence, 0.5% of those with abuse, and 0.6% of subthreshold users reported a perceived need for treatment of nonmedical opioid use. Self-help groups and outpatient rehabilitation were the most commonly used sources of treatment. Few black adolescents used treatment (medical settings, 3.3%; self-help groups, 1.7%) or reported a need for treatment (1.8%). Talking to parents/guardians about dangers of substance use increased the odds of treatment use. Barriers to treatment use included "wasn't ready to stop substance use," "didn't want others to find out," and "could handle the problem without treatment."
Adolescents with prescription opioid use disorders markedly underutilize treatment. Non-financial barriers are pervasive, including stigma and a lack of perceived treatment need.

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    • "Addiction is often attributed to moral or personal failings, and such stigmatization can significantly impede treatment seeking and aggravate substance use (Livingston, Milne, Fang & Amari, 2012). Failure to seek treatment may be attributed to concerns about the negative opinions of others or an inability to recognize the dangers of NMPOU (Wu et al., 2011). Intervention strategies should highlight the harms associated with prescription opioid misuse while reducing stigma surrounding mental health and addiction . "
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    • "Due to costs, stigma, and fragmentation of the health care system, individuals with SUD often received inadequate care for their condition (Pating et al., 2012; Wu et al., 2011b). Passage of the Affordable Care Act is expected to improve healthcare for all medical conditions, especially SUD, for members of nonwhite communities (Pating et al., 2012). "
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