Accessibility of substance use treatment: A qualitative study from the non-service users' perspective

Introduction

Despite having effective treatments for substance use disorders, the majority of people with a substance use disorder do not receive treatment, which leads to adverse personal, health, and social consequences. Experiences of non-service users have hardly been investigated in the literature. This study, which we conducted in the Netherlands, assessed the barriers to and facilitators of accessibility to substance use treatment for non-service users with substance use disorders.

Methods

The study team conducted a total of 10 individual, semi-structured interviews with participants recruited with the help of assertive outreach teams and public health services. A topic list guided the interviews. The interviews were transcribed, and the study team performed a thematic analysis.

Results

Six main themes related to the health care accessibility of substance use treatment emerged: treatment factors, stigmatization, personal factors, consequences of use, knowledge deficits, and social support. Personal factors, especially the non-service users' motivation, was a central determinant of whether they accessed substance use treatment. Social support and consequences of the substance use were perceived as facilitating access to treatment. Stigmatization and knowledge deficits had an important negative impact on the substance users' intrinsic motivation and thus on their ability to access health care. Specifically, stigmatization by health care professionals contributed to suboptimal treatment and recovery.

Conclusions

This study recommends interventions for health care professionals aimed at decreasing their stigma toward and knowledge deficits about substance use disorder. This study highlights the key role that primary health care providers can have in identifying substance use problems and facilitating the pathway to health care services for those with substance use disorders.