Barriers to alcoholism treatment: Reasons for not seeking treatment in a general population sample

Objective: The present study reports responses to numerous direct questions related to reasons for not seeking alcoholism treatment given the perceived need for treatment among respondents classified with an alcohol use disorder (N=964, 69.8% male, 93.5% nonblack) in a large representative sample of the United States population. Method: Data were derived from the 1992 National Longitudinal Alcohol Epidemiologic Survey, a national probability sample of 42,862 respondents, aged 18 years and older, from the noninstitutionalized population of the contiguous states. Results: Lack of confidence in the alcoholism treatment system and its effectiveness, stigmatization and denial were identified as significant barriers to alcoholism treatment at the aggregate level. In general, enabling factors such as lack of financial resources or facilities for child care were much less important barriers to care than were individual predisposing factors including attitudes towards alcoholism treatment. Conclusions: Important sociodemographic differences in identified barriers to care are discussed in terms of their minimization through proposed changes in education, screening, outreach, detection, and referral patterns in alcoholism treatment delivery systems.