The Most Formidable Barriers Facing Someone Who is Seeking Addiction Treatment Today

Abstract

This paper discusses the barriers that faced by persons seeking treatment for addiction at rehabilitation centers. It starts by painting a scenario of a substance user and the effect addiction has had on their personal and social-economic life. Substance users are recognized as patients, and reference to the fact are made several times in the paper. Statistics are used throughout the paper to show the extent of the problem of addiction and the reasons why the addicts do not seek rehabilitative interventions. The paper has only highlighted a few of the barriers. Cost is seen as a major obstacle in seeking help because the patient is often jobless, and there are many expenses like boarding, treatment, counselling, laboratory tests, and so on involved. Patients resist joining the facilities because they are ashamed of themselves and afraid that society will judge them harshly.  Other patients are identified as people in denial about their addiction, which hinders them from seeking treatment from the rehab centers. Some addicts do not plan to stop their habits and therefore are less inclined to go through with the program. Others lack self-control and cannot cope without the drugs.  Some addicts have sunk deep into drugs and lost hope of recovery. Economic challenges bar some addicts from seeking help, instead they have to spend more time fending for their families and their addictions. Lack of insurance cover for rehabilitation programs prevents many addicts from seeking help. The paper concludes by mentioning lack of enabling environment at the rehabs, and lack of transport for day visits.

Introduction

Jennifer needs another shot of heroin and would do anything to get a high. Ever since the first time she seeped a beer and puffed a “joint” at the high school prom, she got hooked to cigarettes, alcohol, and marihuana. Years later she graduated to hard drugs like heroin, cocaine and synthetic substances which are more lethal than cocaine. Despite her college education, Jennifer has wasted her life, shooting needles up her arm, being sickly, haggard and depressed, binging, and pregnant from one of the drug parties. She cannot even hold a relationship for long, neglects her hygiene and grooming, and has no regular job. She is thinking of suicide if somebody does not come to her rescue. She needs to turn her life around but she cannot check into a rehab facility.

Barriers to Seeking Addiction Treatment

Substance addiction is recognized as a long-term medical condition just like diabetes or cancer. In 2008, 21 million people or 8.3% of the US population aged 12 years and above in 2008 needed medical care but did not seek it, 10% or 2.3 million people sought medical attention, 3.7% did not think intervention was necessary, and 1.1% attempted to get medical attention (Elements Behavioral Health, 2009). Social outreach programs, private clinics, and government has established centers for alcohol and substance rehabilitation, but many persons are unable to access treatment because of barriers like economic, social and medical barriers.

Some addicts cannot afford the cost of treatment, especially at private rehab centers. A number of government and sponsored centers offer treatment for free (Appel, Ellison, Jansky & Oldak, 2004). The cost of monitoring, therapy, detoxifiers, boarding, and counselling are prohibitively high for 47% of Americans seeking rehabilitation, and reason for 43% who fail to seek help (Elements Behavioral Health, 2009).

There is resistance by patients to checking into facilities because they feel embarrassed to expose their addiction. Patients are mostly referred to the facilities by the justice system and doctors who are treating them for other ailments attributed to drug abuse. According to Elements Behavioral Health (2009), 95% of addicts did not admit to having an addiction problem and were therefore not willing to seek help. The majority of patients at rehab centers are not voluntary, but are referred by a doctor, family members, employer or the justice system. About 8% attached social stigma to attending rehab and 9% worried about confidentiality about their addiction ((Elements Behavioral Health, 2009).

Some addicts, especially alcohol abusers, live in denial because they do not believe that they have a problem. According to Elements Behavioral Health (2009), 27% of the group felt they could handle the problem by themselves. They believe that they can continue abusing the drugs but still remain in control of the situation without intervention. They fear that because the rehabs can easily discover abuse within their facilities through urine tests, they would cut them off from drugs completely. Some addicts believe they are beyond redemption, and they would still be ostracized by society even after reforming. Some addicts procrastinate hoping that the problem will resolve itself in time. It is different from denial because the addict acknowledges there is a problem, but instead of seeking a solution they hide it from society and allow themselves to sink deeper into the problem. They reluctantly come out when the problem is too big to handle. Social stigma prevents 12% of addicts from seeking rehabilitation. They fear rejection by family, colleagues, neighbors and surrounding communities.

More than one third of addicts in rehab centers are not keen to stop their addiction, instead they seek to control it to a manageable level (National Institute of Drug Abuse, 2014). According to Appel (2004), addicts dislike rehab centers because while the addicts crave for drugs, the centers have zero tolerance to substance use. The impact is to create fear and cause avoidance of the centers altogether. Some addicts, particularly men, avoid rehabilitation centers because they lack self-control over drug use, are socially isolated, and so they seek comfort in drugs as a coping mechanism. They manipulate other people into accepting their state instead of taking them to rehabilitation (National Institute of Drug Abuse, 2014).

Many addicts acknowledge the problem but they have fears that they cannot manage to go through the treatment at the rehab center. They are either ignorant about rehab services or perceive danger in the final outcome, some feel treatment is hopeless, and that they would still relapse into the habit (National Institute of Drug Abuse, 2014). 7% of the addicts believe they cannot give up the habit despite knowing the dangers to their health, life, family and society. Like Jennifer, some addicts have a death wish, having lost hope of rehabilitation, opportunities in life, and fearful that society would spite them, and some result to suicide barriers.

Some addicts fear to check into rehab because of the stigma attached to rehabs, especially if the person is a celebrity. Some religious groups do not tolerate drug addiction, and in organ transplants confirmed addicts are placed low on the donor list, for example those in rehab treatment. Some addicts feel that nobody cares about them anymore and despite their efforts at rehabilitation, they have lost the support of their families and so there is no need to reform.

According to Appel (2004), of the addicts who did not seek interventions, 8% did not get a facility that catered for their specific needs. For example some substance users could only find an alcohol recovery center instead of a drug recovery center. Some rehabs may be strictly residential, and others may offer only counselling services. Some addicts even feel uncomfortable being in a mixed race center (Appel, Ellison, Jansky & Oldak, 2004).

In some cases, there is lack of convenient transport which discourages patients, particularly outpatients, from seeking help. Patients are not encouraged to drive themselves because they might be driving under the influence of substances, which dissuaded 8% of the patients. The addicts feel they will spend a lot of money and time commuting to the centers, and so it would not be worthwhile.

It was found that in 14% of the cases willing to attend and 20% of cases willing to attend rehab, patients failed to so because their lifestyle did not allow them time (Elements Behavioral Health, 2009). They were too busy with family chores and working or going to school, and little time for rehabilitation. This problem was made worse by the fact that after another episode of substance abuse, they are too sick or worn out to attend to these chores or seek treatment.

Economic challenges prevent addicts from seeking treatment. Some people work two or three jobs to make ends meet, and have little to spare for rehab treatment barrier. Booking into a rehab also means that the person has lost income for the period they are in the rehab. Some employers do not compensate for time not worked, and may even lay off the addict on account of unproductivity.

Many citizens lack insurance or have inadequate insurance to cover specific cases. Substance abuse is considered an inappropriate and risky lifestyle choice which has high probability of serious health problems. For that reason it is not covered in general medical insurance barrier. 27% of addicts seeking help do not have any insurance or have inadequate cover, which raises the out of pocket cost of treatment by as much as $20,000 per month (Elements Behavioral Health, 2009).

Another 12% of addicts feared losing their jobs as a consequence of coming out about their addiction. Already, unemployment rate is as high as 90% among addicts (Appel, Ellison, Jansky & Oldak, 2004). Many employers do not wish their companies being associated with users, and they consider such workers unproductive, bad influence to other workers, and a risk factor at the workplace. The employers do not release addicted employers to attend rehabilitation because it is a personal choice.

Amongst patients, 8% of the patients do not know the location of help centers (Elements Behavioral Health, 2009). Although a search through the internet could reveal such information, they might be unwilling to find out. This is because many times they are buying time or want somebody else to make the choice for them. Many addicts do not want to take responsibility for their addictions, and therefore they also want somebody else to seek help for them. Others are daunted by the task of starting the process.

In conclusion, the barriers to accessing rehabilitation can be summarized as being economic, social and medical. Economic barriers are to do with cost of rehabilitation, unemployment, and risk of losing job. The social barriers are to do with personality, social prejudices, and discrimination of the addicts. The medical barriers are to do with type of service offered by the rehab facility, and the extent of addiction of the patient.  

References

Appel, P., Ellison, A., Jansky, H., & Oldak, R. (2004). Barriers to Enrollment in Drug Abuse Treatment and Suggestions for Reducing Them: Opinions of Drug Injecting Street Outreach Clients and Other System Stakeholders. Dekker.com. Retrieved 4 December 2015, from http://www.dekker.com/servlet/product/DOI/101081ADA120029870

Elements Behavioral Health,. (2009). Common Reasons Why Those Who Need Treatment Don’t Get It. Addiction Treatment | Elements | Drug Rehab Treatment Centers. Retrieved 4 December 2015, from http://www.elementsbehavioralhealth.com/addiction-treatment/common-reasons-why-those-who-need-treatment-dont-get-it/

National Institute of Drug Abuse,. (2014). Drugs of Abuse. Drugabuse.gov. Retrieved 4 December 2015, from http://www.drugabuse.gov/drugs-abuse