Patterns and predictors of treatment seeking after onset of a substance use disorder

Ronald C. Kessler, Sergio Aguilar-Gaxiola, Patricia A. Berglund, Jorge J. Caraveo-Anduaga, David J. DeWit, Shelly F. Greenfield, Bohdan Kolody, Mark Olfson, William A. Vega

Research output: Contribution to journalArticle

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Abstract

Background: We studied survey respondents aged 18 through 54 years to determine consistent predictors of treatment seeking after onset of a DSM-III-R substance use disorder. Methods: Survey populations included a regional sample in Ontario (n=6261), a national sample in the United States (n=5388), and local samples in Fresno, Calif (n=2874) and Mexico City, Mexico (n=1734). The analysis examined the effects of demographics, symptoms, and types of substances on treatment seeking. Results: Between 50% (Ontario) and 85% (Fresno) of people with substance use disorders seek treatment but the time lag between onset and treatment seeking averages a decade or more. Consistent predictors of treatment seeking include: (1) late onset of disorder (odds ratio [OR], 3.8; 95% confidence interval [CI], 2.6-5.6 for late [≥30 years] vs early [1-15 years] age at first symptom of disorder); (2) recency of cohort (OR, 3.4; 95% CI, 2.3-5.0 for most recent [aged 15-24 years at interview] vs earliest [aged ≥45 years] cohorts); (3) 4 specific dependence symptoms (using larger amounts than intended, unsuccessful attempts to cut down use, tolerance, and withdrawal symptoms), with ORs ranging between 1.6 (95% CI, 1.3-2.0) and 2.7 (95% CI, 2.1-3.6) for people with vs without these symptoms; and (4) use vs nonuse of cocaine (OR, 2.1; 95% CI, 1.6-2.7) and heroin (OR, 2.6; 95% CI, 1.1-6.0). Conclusions: Although most people with substance use disorders eventually seek treatment, treatment seeking often occurs a decade or more after the onset of symptoms of disorder. While treatment seeking has increased in recent years, it is not clear whether this is because of increased access, increased demand, increased societal pressures, or other factors.

Original languageEnglish (US)
Pages (from-to)1065-1071
Number of pages7
JournalArchives of General Psychiatry
Volume58
Issue number11
StatePublished - 2001
Externally publishedYes

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Substance-Related Disorders
Confidence Intervals
Odds Ratio
Ontario
Mexico
Substance Withdrawal Syndrome
Heroin
Cocaine
Diagnostic and Statistical Manual of Mental Disorders
Demography
Interviews
Pressure
Population
Surveys and Questionnaires

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Kessler, R. C., Aguilar-Gaxiola, S., Berglund, P. A., Caraveo-Anduaga, J. J., DeWit, D. J., Greenfield, S. F., ... Vega, W. A. (2001). Patterns and predictors of treatment seeking after onset of a substance use disorder. Archives of General Psychiatry, 58(11), 1065-1071.

Patterns and predictors of treatment seeking after onset of a substance use disorder. / Kessler, Ronald C.; Aguilar-Gaxiola, Sergio; Berglund, Patricia A.; Caraveo-Anduaga, Jorge J.; DeWit, David J.; Greenfield, Shelly F.; Kolody, Bohdan; Olfson, Mark; Vega, William A.

In: Archives of General Psychiatry, Vol. 58, No. 11, 2001, p. 1065-1071.

Research output: Contribution to journalArticle

Kessler, RC, Aguilar-Gaxiola, S, Berglund, PA, Caraveo-Anduaga, JJ, DeWit, DJ, Greenfield, SF, Kolody, B, Olfson, M & Vega, WA 2001, 'Patterns and predictors of treatment seeking after onset of a substance use disorder', Archives of General Psychiatry, vol. 58, no. 11, pp. 1065-1071.
Kessler RC, Aguilar-Gaxiola S, Berglund PA, Caraveo-Anduaga JJ, DeWit DJ, Greenfield SF et al. Patterns and predictors of treatment seeking after onset of a substance use disorder. Archives of General Psychiatry. 2001;58(11):1065-1071.
Kessler, Ronald C. ; Aguilar-Gaxiola, Sergio ; Berglund, Patricia A. ; Caraveo-Anduaga, Jorge J. ; DeWit, David J. ; Greenfield, Shelly F. ; Kolody, Bohdan ; Olfson, Mark ; Vega, William A. / Patterns and predictors of treatment seeking after onset of a substance use disorder. In: Archives of General Psychiatry. 2001 ; Vol. 58, No. 11. pp. 1065-1071.
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