Adults who misuse opioids: Substance abuse treatment use and perceived treatment need

Background: Opioid use disorder (OUD) and overdose deaths among the US population continue to increase. This study examined associations of OUD and other substance use disorders with substance abuse treatment use and perceived treatment need among US adults aged 18+ who misused opioids. Methods: The 2015-2016 National Survey on Drug Use and Health provided data (n = 5100 respondents who misused opioids in the past year). We used multivariable logistic regression models to examine associations of opioid and other substance use disorders with treatment use and perceived treatment need, adjusting for sociodemographic and health statuses. Results: The data showed that 4.7% of adults misused opioids and 19.1% of those who misused had an OUD. Of those with an OUD, only 31.5% had received substance abuse treatment in the past year and 13.6% perceived the need for such treatment. Of those with an OUD, heroin use disorder (adjusted odds ratio [AOR] = 2.59, 95% confidence interval [CI] = 1.59-4.23) and having been arrested/booked (AOR = 1.98, 95% CI = 1.18-3.33) were associated with higher odds of receiving treatment, whereas lack of health insurance (AOR = 0.49, 95% CI = 0.25-0.94) was associated with lower odds. Heroin use disorder (AOR = 2.16, 95% CI = 1.23-3.83) and higher mental health impairment scores (AOR = 1.05, 95% CI = 1.01-1.09) were associated with higher odds of perceived treatment need. Conclusions: The overall low socioeconomic status and high rates of polysubstance use disorders among those with OUD indicate that they need financial and other help to access treatment and relapse prevention services. The very low rates of perceived treatment need also point to the need for strategies to increase individuals' recognition of their need for treatment.