Factors associated with receipt of behavioral health services among persons with substance dependence

This study sought to identify demographic and clinical variables that predict use of behavioral health services among persons with substance dependence.

Interviews were conducted with 1,893 adults who endorsed items on the National Household Survey on Drug Abuse in 1995 and 1996 that were consistent with a DSM-IV-TR diagnosis of dependence on at least one substance, excluding cigarettes. Logistic regression analyses were conducted to identify significant predictor variables.

Among persons with substance dependence, only 18.3 percent had sought substance abuse or mental health treatment, or both, in the previous year. Female sex, high family income, a history of being arrested or booked, concurrent psychiatric comorbidity, self-perception of having a drug or alcohol problem, and the number of substances involved all predicted treatment use. One-third of substance-dependent individuals who used services reported receiving mental health care that did not include any substance use component. Persons with higher education levels were more likely to use mental health care only. In contrast, persons who used public insurance or were uninsured, had been booked or arrested, or perceived themselves as having a drug or alcohol problem were less likely to obtain mental health care only.

Several clinical and demographic variables were predictive of some type of treatment use by substance-dependent individuals. Persons who used mental health care only were more likely to be female, to be of higher socioeconomic status, not to have a history of involvement with the legal system, and to have problems with alcohol or marijuana but not to perceive themselves as needing addiction treatment.