NIH Survey Shows Most People with Drug Use Disorders
Never Get Treatment
Authors Recommend National Educational Campaign
to Destigmatize Drug Disorders
Only 8 percent of people identified as drug abusers, and fewer
than 40 percent of those diagnosed with drug dependence, have ever
gotten any kind of intervention or treatment, according to the
National Epidemiologic Survey on Alcohol and Related Conditions
(NESARC). The study was conducted by scientists from the National
Institute on Drug Abuse (NIDA) and the National Institute on Alcohol
Abuse and Alcoholism (NIAAA), components of the National Institutes
of Health.
“Even though we know drug addiction treatment can work, lifetime
treatment rates are substantially lower than corresponding treatment
rates of other major psychiatric disorders,” says NIH Director
Dr. Elias Zerhouni. “This tells us that we should focus on strategies
designed to help us close the treatment gap."
“We are concerned because treatment rates are this low despite
the availability of effective interventions,” says NIDA Director
Dr. Nora D. Volkow. “We must encourage the public to view addiction
as a brain disease that needs to be treated like any other chronic
disease."
Says lead author Dr. Wilson Compton of NIDA, “Clearly, there is
a need for increased information and outreach to destigmatize drug
use disorders and develop approaches to educate physicians and
the public about treatment.”
The survey results, published in the May 2007 issue of the Archives
of General Psychiatry, show that rates of drug abuse and
dependence are generally higher among certain populations, including
men, respondents aged 18 to 44 years, and people who have never
married. The study also confirmed that the onset of drug abuse
and dependence typically occurs during late adolescence or early
adulthood. These findings suggest that certain groups are more
vulnerable and should be targeted for early intervention efforts.
“Our results indicate that in 2001-2002, two percent of American
adults experienced drug abuse or dependence in the preceding 12
months, while ten percent developed a drug use disorder at some
time during their lives,” says Dr. Compton. “We see high rates
of drug use disorders in persons who are now 30 to 44 years old.
This means we might expect increases in drug abuse and addiction
rates of older adults as that group ages."
This study and others indicate that significant associations exist
between drug abuse and co-occurring mental illness, including mood
and anxiety disorders, and personality disorders. In fact, help-seeking
behavior was more common in those with co-occurring psychiatric
disorders. The authors advise that a person with a substance use
disorder should also be evaluated for mental illness, and conversely,
a person with a mental disorder should be evaluated for possible
substance abuse.
The authors analyzed data gathered from face-to-face interviews
with more than 43,000 U.S. adults age 18 and older, as part of
the 2001-2002 NESARC. “The NESARC constitutes the largest study
conducted on the co-occurrence of psychiatric disorders among U.S.
adults,” said study co-author Dr. Bridget F. Grant, of NIAAA. “Because
drug use disorders so commonly co-occur with alcohol use disorders,
the NESARC provides rich information on the similarities and differences
between these conditions.”
“The findings are consistent with the Annual National Survey on
Drug Use and Health conducted by the Substance Abuse and Mental
Health Services Administration (SAMHSA),” said SAMHSA Administrator
Dr. Terry Cline. “The SAMHSA survey points to a huge denial gap.
Among individuals with drug or alcohol dependence or abuse who
have not received treatment, more than 94 percent do not feel they
need treatment.”
In the NESARC survey, among those individuals with drug use disorders
who received treatment, most went to physicians and other health
care professionals, although many also used self-help groups. This
finding underscores the continued importance of the detection and
referral roles of primary care physicians. Future research efforts
should focus on developing instruments to screen, identify, and
refer patients with suspected drug abuse or dependence in primary
care settings.
The study was funded by the National Institute on Alcohol Abuse
and Alcoholism (NIAAA) with supplemental support from the National
Institute on Drug Abuse (NIDA).
The National Institute on Drug Abuse and the National Institute
on Alcohol Abuse and Alcoholism are components of the National
Institutes of Health, U.S. Department of Health and Human Services.
NIDA supports most of the world’s research on the health aspects
of drug abuse and addiction. The Institute carries out a large
variety of programs to ensure the rapid dissemination of research
information and its implementation in policy and practice. Fact
sheets on the health effects of drugs of abuse and information
on NIDA research and other activities can be found on the NIDA
home page at http://www.drugabuse.gov.
The National Institutes of Health (NIH) — The Nation's
Medical Research Agency — includes 27 Institutes and
Centers and is a component of the U.S. Department of Health and
Human Services. It is the primary federal agency for conducting
and supporting basic, clinical and translational medical research,
and it investigates the causes, treatments, and cures for both
common and rare diseases. For more information about NIH and
its programs, visit www.nih.gov.
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