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

Background: We studied survey respondents aged 18 through 54 years to deter mine 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 Fres no, Calif (n=2874) and Mexico City,Mexico (n=1734)The analysis examined the effects of demographics, symptoms, and types of substances on treatment se eking. Results: Between 50% (Ontario) and 85% (Fresno) of people with substance us e disorders seek treatment but the time lag between onset and treatment see king aver ages a decade or more. Consistent predictors of treatment seeking include: (1) late onset of disorder (odds ratio [OR], 3.8; 95% confidence interval [Cl] 2.6-5.6 for late [greater than or equal to 30 years] vs earl) , [1-15 years] age at first symptom of disorder); (2) recency of cohort (OR , 3.4; 95% Cl, 2.3-5.0 for most recent [aged 15-24 years at interview] vs e arliest [aged 45 years] cohorts); (3) 4 specific dependence symptoms (using larger amounts than intended, unsuccessful attempts to cut down use, toler ance, and withdrawal symptoms), with ORs ranging between 1.6 (95% Cl, 1.3-2 .0) and 2.7 (95% Cl, 2.1-3.6) for people with vs without these Symptoms; an d (4) use vs nonuse of cocaine (OR, 2.1 95% Cl, 1.6-2.7) and heroin (OR, 2. 6; 95% Cl, 1.1-6.0). Conclusions: Although most people with substance use disorders eventually s eek treatment, treatment seeking often occurs a decade or more after the on set of symptoms of disorder. While treatment seeking has increased in recen t years, it is not clear whether this is because of increased access, incre ased demand, increased societal pressures, or other factors.