In the U.S., millions of people have addiction problems.
That’s no exaggeration.
According to the latest data on alcohol use disorder (AUD) and substance use disorder (SUD) – which are the clinical terms for alcohol addiction and drug addiction – over 27.6 million adults have AUD and over 17.9 million adults have SUD.
Those numbers are published in the National Survey on Drug Use and Health (NSDUH), which is a nationwide survey designed to assess – among other things – the prevalence of AUD and SUD among U.S. citizens.
The NSDUH also keeps track of how many people receive treatment for alcohol and drug addiction each year.
Those numbers might come as a surprise.
Of the 27 million adults with AUD, fewer than two million received specialized treatment for alcohol abuse. And of the 17.9 million adults with substance use disorder, fewer than 1.5 million received specialized treatment for SUD. These figures reveal that around 92 percent of adults with alcohol addiction did not receive the treatment they need, and around 91 percent of adults with drug addiction did not receive the treatment they need.
When we combine those numbers to reach a cumulative total, we see that only about 8.5 percent of people with addiction problems – AUD and SUD combined – got the treatment they need to overcome their addiction.
That means 91.5 percent of adults in the U.S. did not receive the treatment they needed.
Addiction professionals call this the treatment gap.
Like many of you reading this right now, those professionals wonder why the treatment gap in the U.S. is so large. There are many reasons, but one the most common contributing factors many people cite is a basic human emotion: fear.
But why do people fear addiction treatment?
Based on our experience in treating alcohol and substance use disorder, we compiled the following list.
Top Five Reasons People Fear Going to Addiction Rehab
- Fear of the Unknown
People fear what they don’t understand. When people think of rehab, they often imagine one of two things: a cold, clinical hospital environment or a luxury, spa-like rehab environment. The first sounds unappealing to most people, and the second sounds out of reach, financially, for most people. The fact is that a majority of rehab centers are neither hospital-like nor spa-like: they fall somewhere in the middle.
- Fear of Living without Alcohol or Drugs
For many people with a drinking or drug problem, using alcohol and/or drugs are their primary coping mechanisms. They use alcohol and drugs to deal with stress, handle uncomfortable emotions, or in an attempt to avoid memories and emotions surrounding adolescence, childhood, or early life trauma.
- Fear of Stigma
For decades, the dominant paradigm among medical professionals and laypeople alike was that addiction was the result of personal failures or deficiencies. The popular view was that people with addiction problems lacked willpower, made poor decisions, or had poor morals. Although the widespread acceptance of the disease model of addiction – which explicitly refutes the character/moral failing model – shows that this stigma is slowly fading, it’s still very real for many people. Because it’s still real, people with addiction still fear stigma in two areas:
- Professional: They fear work colleagues may learn about their time in treatment, and therefore, their addiction. They fear being shunned in the workplace, losing their current job, and being prevented from future employment opportunities because of their addiction and treatment history.
- Personal: They fear the disapproval, rejection, and judgment of family and friends. Part of this is the fact they don’t want to let anyone down or disappoint them. This works in all directions: parents with addiction don’t want to disappoint their children, adult children don’t want to disappoint their parents, and many people with addiction fear their friends would think less of them if they knew the truth.
- Fear of Relapse
This is a fear of failure: people worry that they’ll get sober but be unable to maintain their sobriety for an extended period of time. They fear the time and energy they spend in rehab will be meaningless if they relapse. They also fear that if they do relapse, they’ll confirm the views of people who stigmatize addiction and rehab.
- Fear of the Treatment Process
This is a big one. First, people fear going through withdrawal. Second, people fear they’ll have to face the things they use alcohol and drugs to avoid. Third, they fear opening up to strangers, whether those strangers are therapists/counselors or recovery peers. Finally, they fear the vulnerability treatment requires: knowing that part of detox treatment means sharing things they may never have shared with anyone, ever, can be very intimidating.
Addiction Treatment: Misconceptions and Misunderstanding
As we read over this list, we realize that while all these fears are real, they’re also all based on a lack of real knowledge and actual facts about addiction and addiction treatment. We’ll now address the five fears identified above, one by one, and offer simple ways to counter those fears.
- Fear of the Unknown
A person’s fear of the unknown can be mitigated by reading articles like this one, where we share the information that most inpatient rehab centers are filled with people from all walks of life, doing their best to overcome addiction – and the clinicians that work in them are there because they want to help. Most rehab centers are not celebrity spas or run-down clinics: as we mention above, they’re somewhere in the middle.
- Fear of Living Without Alcohol and Drugs
A person’s fear of living without alcohol and drugs can be addressed by meeting people that have done it before and are willing to share the details of how they did it. Recovery peers share empowering stories of learning to live a sober life in recovery. These peers and their stories give people in treatment comfort during treatment and hope for the future.
- Fear of Stigma
Fear of stigma can be reduced by teaching people about the disease model of addiction, which states that addiction is a chronic, relapsing disease – like diabetes or hypertension – that responds well to integrated, holistic treatment. It’s also important for people to know that no one – literally no one – has to know they went to treatment. Aside from the clinical staff at the treatment center, strict privacy laws govern information about any medical condition a person has or the treatment they receive for it – and that includes addiction and addiction treatment.
- Fear of Relapse
Fear of relapse can be diminished by the knowledge that when a person with AUD or SUD relapses, it’s not the end of the world. We won’t sugarcoat this, though: relapse happens, and that’s a fact. It’s also a fact that many people relapse, get right back on their program, and rediscover their sobriety – and they often report that relapse strengthens their resolve to stay sober.
- Fear of the Treatment Process
We won’t sugarcoat this one, either: facing emotions that have been suppressed or avoided for months, years, or decades is not easy. It takes bravery, honesty, humility, and commitment. What surprises most people who enter treatment is the warmth, kindness, and understanding they find in the treatment community. Recovery peers and clinical staff lead with compassion and empathy. They understand what people in treatment face, and their goal is simple: they want to help anyone who wants to get sober find their way to sobriety.
If you or someone you love has an alcohol or drug problem and wants to get treatment – but avoids it because of any of the reasons we mentioned above – please share this article with them. Let them know that treatment has evolved, and treatment works. The best treatment is evidence-based and involves a combination of individual therapy, group therapy, family therapy, experiential/mindfulness therapeutic support, and, in some cases, medication. When they dispel their fears with the facts, and they’re ready to commit to the process, they can find a high-quality treatment center and start their recovery journey with confidence, hope, and a vision of a future life without alcohol and drugs.
