Substance Abuse Treatment Facts
Many people who enter and remain in substance abuse treatment have a higher likelihood of stopping drug abuse, decreasing criminal activity, and generally improving the quality of their social and professional lives.1 Moreover, it has been shown that substance-abuse treatment helps reduce the number of drug-related deaths.2
Nevertheless, despite the clear benefits of treatment and a history of addiction treatment development that is over two centuries long, substance abuse treatment facts reflect that treatment realities are still complex. Although we have a growing body of knowledge on the nature of addiction and a lot of available addiction treatment resources, there is still more work to be done in making treatment more accessible to those who are struggling with addiction.
Global Substance Abuse Treatment Facts
A survey carried out by the World Health Organization (WHO) with 70,880 respondents in 26 countries worldwide found that 2.6% of people were suffering from a substance use disorder (SUD). The rates were somewhat higher in upper‐middle (3.3%) than in high (2.6%) and low/lower‐middle (2.0%) income countries.3
Although this study found that there are certain cross-country differences regarding the number of people who recognize treatment needs and are willing to seek treatment, the substance abuse treatment facts that this study established are far from encouraging. Treatment is sought by 10.3% in high income, 4.3% in upper-middle-income, and 1.0% in low/lower-middle-income countries. This means that even in high-income environments, relatively few people undergo treatment.
According to WHO, the most common barriers to treatment are:3
- Availability of treatment.
- Awareness of and access to effective treatment.
- Social stigma related to substance use.
- Financial barriers, in situations where an individual needs to pay for the cost of treatment.
- Legal issues related to seeking treatment for substance abuse.
U.S. Substance Abuse Treatment Facts
According to the official statistics of Substance Abuse and Mental Health Service Administration, out of 20.4 million people with substance use disorder in the U.S., 89.7% receive no treatment whatsoever. 4
These are the treatment types that are received, listed in the order of frequency:4
- Self-help groups
- Outpatient rehab
- Outpatient mental health center
- Private doctor’s office
- Inpatient rehabilitation
- Hospital inpatient treatment
- Emergency room intervention
Another issue related to substance abuse is the fact that SUD is closely linked with mental health disorders. A little less than half of the people with mental health issues in the U.S. receive no treatment, while out of 9.5 million people with co-occurring SUD and a mental health disorder, only around 10% receive treatment. This points to a significant treatment gap that is yet to be bridged: people who do get treatment are not treated for co-occurring disorders and the majority of co-occurring disorders get treatment for one disorder or no treatment at all.4
Although the figures are still far from good, the same survey also shows that treatment has given good results in some areas. Namely, the opioid use disorder in the U.S. decreased significantly: from 2 million in 2018 to 1.6 million in 2019. This decrease is attributed to conscious efforts to increase access to medication-assisted treatment, as well as psychosocial and community recovery.4
The Economic Effects of Addiction Treatment
According to the substance abuse treatment facts published by the National Institute on Drug Abuse, substance abuse costs the U.S. over $600 billion annually when taking into account the health and social costs that result from substance abuse.5 Substance abuse treatment can help reduce these costs, as according to some estimates, the cost of treatment programs is over 12 times lower than the costs resulting from drug-related crime and healthcare. No less importantly, there are some less measurable but valuable gains, such as better interpersonal relations and workplace productivity.
The Principles of Effective Treatment
Although substance abuse treatment facts may somewhat differ depending on the age, gender, and some other factors, there are still some general principles that lie at the base of any effective treatment:5
- No single treatment is right for everyone. The choice of appropriate treatment will depend on the individual condition and treatment needs. Moreover, in addition to health factors, there are some sociocultural factors that may determine which kind of treatment is more effective and more inviting to users. For example, some people prefer gender-specific treatment settings.6
- People need to have quick access to treatment.
- Staying in treatment long enough is critical. In order to maintain positive treatment outcomes, it is recommended that treatment lasts for longer than 90 days.7
- Treatment should be comprehensive and address the patient’s needs that are not limited only to drug use. Drug use is often a way for a person to cope with other issues
- Since SUD often happens together with another disorder, such as PTSD, depression, or anxiety, these co-occurring disorders need to be treated.
- The most frequently used approaches to treatment are various forms of counseling and other behavioral therapies, which are in some cases combined with medication.
- As treatment progresses, patients’ needs change, so treatment plans often need to be reviewed and modified.
- In some cases, substance users are reluctant to receive treatment. Nevertheless, effective treatment does not need to be voluntary.
- As people who abuse substances are at an increased risk of infectious diseases, treatment programs should test patients for HIV/AIDS, hepatitis B and C, tuberculosis, and other diseases. Treatment users should also learn how to reduce their risk of infection.
The Steps of Effective Treatment
The stages of effective treatment may be the following:8
- Behavioral therapy (individual or group)
- Medication for substances where it is applicable
- Diagnosis and treatment of co-occurring disorders
- Long-term follow-up activities with the aim of preventing relapse
Available Forms of Treatment
Nowadays, there are a number of different treatment approaches and settings. Some of the specialized treatment options may include:
- Gender-sensitive settings (both for men and women)
- Treatment programs for veterans
- Treatment programs for teens and adolescents
- Treatment programs for pregnant women
- Treatment programs with a spiritual component
As far as the logistics is concerned, there are outpatient treatment options and inpatient/residential treatments. Counseling can be done individually or in a group. Family therapy often also plays a vital role in addiction treatment.
1. National Institute on Drug Abuse. (2019).How effective is drug addiction treatment?
2. Swensen, I. D. (2015). Substance-abuse treatment and mortality. Journal of Public Economics, 122, 13-30.
3. Degenhardt, L., Glantz, M., Evans-Lacko, S., Sadikova, E., Sampson, N., Thornicroft, G., (…) (2017). Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys. World Psychiatry. 16(3), 299-307.
4. McCance-Katz, E. F. (2019).The National Survey on Drug Abuse and Health.
5. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).
6. Greenfield S. F., Grella C. E. (2009).Alcohol & Drug Abuse: What Is “Women-Focused” Treatment for Substance Use Disorders?Psychiatry online.
7. National Institute on Drug Abuse. (2018). How long does drug addiction treatment usually last?
8. National Institute on Drug Abuse. (2019).Treatment Approaches for Drug Addiction.