Addiction can be terribly destructive. It can destroy families, ruin careers, and end lives. Viewed from the outside, addictive behavior is almost impossible to understand. Often, people struggling with addiction know their addictions are ruining their lives. Many hate their addictions and even hate themselves. Despite this, in the US, only about 10 percent of people with substance use issues seek and receive treatment. Given all the pain addiction can cause, and given there are now better treatment options than there have ever been, why don’t more people seek help?
People who haven’t gotten treatment for addiction fall broadly into three categories: people who don’t think they need treatment, people who believe they need treatment but don’t seek it, and people who seek treatment but don’t get it.
People who don’t think they need treatment.
Of the three groups of people who need treatment but don’t get it, this one is by far the largest, accounting for about 95 percent. No doubt, some of the people in this group genuinely don’t believe they have a problem. Addiction isn’t an all-or-nothing situation. Many people have substance use disorders that need to be addressed, but they may live in a nice house, drive a nice car, have a good job and see all this as evidence they don’t have a problem. They may have a stereotypical image of an addict in mind, and because they don’t fit that image, they assume there is no problem. In reality, many successful people struggle with addiction, and they are able to keep things on track for a while. Eventually, though, substance use will start to take a toll, and by then it will be much harder to deal with.
A large percentage of people who don’t think they need treatment are simply in denial. They probably know on some level that they have a substance use issue, but they can’t admit it to others, or even themselves. It’s easy to criticize someone for denying she has a problem, but addiction is a difficult thing to face. It means admitting you’ve lost control of your behavior and your life. And once you admit it, you will face greater pressure to do something about it. That would at least entail giving up your primary coping mechanism, which can be frightening. It may also mean making major changes in your life. That kind of uncertainty is what many people are trying to avoid in the first place. Helping someone get past this initial phase where she doesn’t even believe she needs treatment requires compassion and understanding.
People who believe they need treatment but don’t seek it.
This group accounts for just under four percent of people who need help but don’t get it. These are people who see how destructive their addictions are and may even want to seek help, but don’t. There are a number of reasons for this. Nearly 40 percent of this group is just not ready to quit. As strange as it sounds, they see there’s a problem but they aren’t ready to do anything about it. They may buy into the dangerous myth that they need to “hit bottom” before they can quit, or they might not feel up to making the effort.
More than 30 percent of this group is ready to get help, but they believe they can’t afford treatment, often because they have no health insurance. Around 13 percent of people don’t know where to get help, just over 12 percent worry that getting treatment will have a negative impact on their jobs, and just under 12 percent worry about damage to their reputation as a result of seeking treatment.
The concerns about treatment affecting their work or reputation are especially misplaced. Eventually, addiction will affect both much more than seeking treatment will. And most employers want their employees to get treatment if they need it. A sober employee does better work, and sending an employee to treatment is much cheaper and easier than restaffing her position.
People who seek treatment but don’t get it.
Fortunately, this category is very small, just over one percent of people who need treatment but don’t get it. This group makes some kind of effort to get treatment, but then doesn’t get it for a variety of reasons. Nearly 30 percent of this group is just not ready to stop. Just over 27 percent of this group could not afford treatment. About 13 percent of this group was able to stop without treatment. The rest of the reasons are things like not being able to find a suitable program, not having transportation, and not knowing where to go. A small percentage of this group was also worried about the effect on their jobs and reputations.
Deciding to get treatment for addiction is not easy. Some studies have shown that the brain changes caused by addiction actually make pattern recognition more challenging. That means someone with a substance use disorder might actually have a lot of difficulty recognizing it, even if it seems obvious to everyone else. Even if they are aware of a problem, acknowledging it can challenge your sense of identity and security. It’s perfectly normal to be afraid to confront addiction, but the consequences of not confronting it are far worse.
If you’re struggling with addiction or mental illness, The Dawn Medical Rehab and Wellness center can help. We are one of Thailand’s most respected addiction treatment and wellness centers. We use cutting-edge treatment modalities to provide personalized care to treat addiction, depression, anxiety, bipolar disorder, personality disorders, PTSD, and executive burnout. See our contact page to reach us by phone or email.