A new study published in JAMA Network Open has shed light on the troubling trends in substance use disorders (SUDs) in the United States over the past decade, highlighting a surge in treatment needs but a lagging response in access to care. The research, led by Dr. Ligang Liu and colleagues, offers a comprehensive examination of SUD prevalence, treatment receipt, and the systemic barriers that hinder access to effective interventions.
The study, utilizing data from the National Survey on Drug Use and Health (NSDUH), revealed that the prevalence of individuals needing SUD treatment more than doubled between 2013 and 2023, climbing from 8.2% to 17.1%. Alcohol use disorder (AUD) and drug use disorder (DUD) both contributed to this increase, with DUD showing a particularly steep rise from 2.6% to 9.6%. Opioid use disorder (OUD), a specific category within DUD, more than doubled in prevalence from 0.8% in 2016 to 2.0% in 2023.
Despite the sharp increase in treatment needs, access to care has been inconsistent. Treatment receipt initially declined, dropping to a low of 6.5% in 2020 during the COVID-19 pandemic. This decline coincided with widespread disruptions to healthcare services, heightened stress, and social isolation. Although treatment rates rebounded to 14.9% by 2022, a significant gap persists between those requiring care and those receiving it.
One of the most striking findings is the low percentage of individuals recognizing their need for treatment. Among those with SUD who did not receive care, only 5.7% acknowledged a need for treatment, and just 2.7% made efforts to seek help. This lack of perceived need was compounded by systemic barriers, including insufficient healthcare coverage, limited awareness of treatment programs, societal stigma, and fears of negative impacts on employment and community standing.
The pandemic further exacerbated these issues, delaying progress made in expanding access to care. The authors noted a resurgence in treatment accessibility starting in 2022, driven by the reopening of programs and the expansion of telehealth services. However, these measures alone are insufficient to bridge the substantial gaps identified in the study.
The findings underscore the urgent need for systemic changes to address the SUD crisis. The authors advocate for the integration of SUD care into primary healthcare settings, broader insurance coverage, and targeted public awareness campaigns to reduce stigma and increase understanding of available resources. They also highlight the potential of telehealth and digital interventions to reach underserved populations.
The full article is available in JAMA Network Open and can be accessed here:https://jama.jamanetwork.com/article.aspx?doi=10.1001/jamanetworkopen.2024.53317 (clearnet).
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