Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
Tallahassee Memorial HealthCare, Tallahassee, FL, USA.
Am J Drug Alcohol Abuse. 2023 Jul 4;49(4):519-529. doi: 10.1080/00952990.2023.2230611. Epub 2023 Jul 28.
A better understanding of factors associated with not ready to stop using substances may inform provider engagement with clients who have an unmet treatment need. This study explores how treatment barriers, the number of SUD symptoms, and types of substances used are associated with not ready to stop using substances among adults with an unmet treatment need. The data came from the 2015-2019 National Survey on Drug Use and Health. Eligible adults met DSM-IV criteria for substance abuse and dependence and reported an unmet need for treatment. Among our sample ( = 1,017), a majority self-identified as male (weighted 59.3%). We employed multivariable logistic regression to examine individual-level factors associated with not being ready to stop using substances. About 38% of the respondents reported that they were not ready to stop using substances. Reporting access barriers (aOR = 0.44, 95% CI: 0.29, 0.68) and attitudinal barriers (aOR = 0.47, 95% CI: 0.28, 0.80) was associated with a lower odds of not ready to stop using. Each additional increase in SUD symptoms was associated with 23% higher odds of not being ready to stop using (aOR = 1.22, 95% CI: 1.12, 1.34). Having a diagnosis of alcohol and/or marijuana abuse or dependence was associated with higher odds of not being ready to stop using when compared to respondents without these diagnoses (aOR = 2.13, 95% CI: 1.33, 3.40; aOR = 1.82 95% CI: 1.11, 2.99). Not ready to stop using substances may be impacted by the type of SUD, number of SUD symptoms, and certain barriers like access and attitude to care.
更好地了解与未准备好停止使用物质相关的因素,可以为有未满足治疗需求的患者提供更好的服务。本研究探讨了治疗障碍、物质使用障碍症状的数量以及使用的物质类型与未准备好停止使用物质的成年人之间的关系。数据来自 2015-2019 年全国药物使用与健康调查。合格的成年人符合 DSM-IV 物质滥用和依赖标准,并报告有未满足的治疗需求。在我们的样本中(n=1017),大多数人自我认同为男性(加权 59.3%)。我们采用多变量逻辑回归分析来检查与未准备好停止使用物质相关的个体因素。大约 38%的受访者表示他们还没有准备好停止使用物质。报告存在获取障碍(aOR=0.44,95%CI:0.29,0.68)和态度障碍(aOR=0.47,95%CI:0.28,0.80)与较低的未准备好停止使用的可能性相关。物质使用障碍症状每增加一个,未准备好停止使用的可能性就会增加 23%(aOR=1.22,95%CI:1.12,1.34)。与没有这些诊断的受访者相比,被诊断为酒精和/或大麻滥用或依赖的人更有可能没有准备好停止使用(aOR=2.13,95%CI:1.33,3.40;aOR=1.82,95%CI:1.11,2.99)。未准备好停止使用物质可能会受到物质使用障碍的类型、物质使用障碍症状的数量以及某些障碍(如获取障碍和对待治疗的态度)的影响。