Perceived Treatment Need and Utilization for Illicit Drug and Opioid Use Disorders in Non-Metropolitan Areas
Our objectives were to: 1) Describe any metropolitan versus non-metropolitan differences in the prevalence of past year perceived need for drug use treatment and actual treatment utilization amongst metropolitan and non-metropolitan adults with a past year drug use disorder, and 2) Describe any temporal changes in the prevalence of a past year perceived need for drug use treatment and actual treatment utilization amongst metropolitan and non-metropolitan adults with a past year drug use disorder.
We conducted analyses of nationally representative data from the National Survey on Drug Use and Health for the years 2008-2015. Metropolitan and non-metropolitan status was defined according to U.S. Office of Management and Budget definitions. We restricted our analyses to persons who satisfied DSM-IV criteria for a drug use disorder in the same survey year. Perceived need for drug use treatment was defined as self-reported need for the treatment of any drug use in the past 12 months. Drug use treatment utilization was defined as whether the respondent reported receiving treatment for any type of illicit drug use within specific settings.
The vast majority of both non-metropolitan and metropolitan adults ages 18-64 who satisfy criteria for any type of illicit drug use disorder do not perceive that they need treatment and do not receive any formal treatment services. Similarly, the vast majority of adults ages 18-64 with an opioid use disorder do not perceive a need for treatment. Treatment use is slightly higher for opioid use disorders than all types of illicit drug use disorders, which is likely because several medications are available for treating opioid use but are relatively unavailable for most other drug types, such as cocaine and methamphetamine. Among persons with an opioid use disorder, those with a heroin use disorder more frequently perceived a need for treatment.
Despite several health policies aimed at increasing access to substance use treatment services over the study period, our study found very few changes over time in perceived treatment need and utilization.