Apsley HB, Vest N, Knapp KS, Santos-Lozada A, Gray J, Hard G, Jones AA. Non-engagement in substance use treatment among women with an unmet need for treatment: A latent class analysis on multidimensional barriers.
Drug Alcohol Depend 2023;
242:109715. [PMID:
36495652 PMCID:
PMC9847351 DOI:
10.1016/j.drugalcdep.2022.109715]
[Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND
Women with substance use disorders experience multifaceted barriers in accessing substance use treatment. Little is known about how these barriers may aggregate. Using a person-centered approach, this study evaluates patterns of treatment barriers and the factors associated with experiencing distinct sets of barriers among women.
METHODS
Data were from the NSDUH (2015-2019). 461 adult women with an unmet need for substance use treatment in the last year reported on 14 treatment barriers. Latent class analysis examined classes of barriers; multinomial logistic regression assessed predictors of class membership.
RESULTS
Three classes were identified: just not ready to abstain (71.2%), logistical barriers and stigmatization (18.2%), and barriers across all dimensions (10.6%). Higher education (aOR:1.94, p = 0.03) and psychological distress (aOR:2.19, p = 0.02) predicted higher odds-and identifying as African American predicted lower odds (aOR:0.17, p = 0.02)-of belonging to the "Logistics and Stigma Barriers" class relative to the "Just Not Ready" class. Similarly, higher education (aOR: 2.57, p = 0.02) and having children (aOR:2.28, p = 0.03) predicted higher odds-and marriage predicted lower odds (aOR:0.22, p = 0.02)-of belonging to the "High and Diverse Barriers" class relative to the "Just Not Ready" class. Having children predicted higher odds (aOR: 2.93, p = .02), and marriage predicted lower odds (aOR:0.19, p = 0.02) of belonging to the "High and Diverse Barriers" class relative to the "Logistics and Stigma" class.
CONCLUSION
A lack of readiness to abstain, socioeconomic circumstances, and family obligations are main barriers to SUD treatment among women. Interventions incorporating motivational interviewing, family systems, and social networks are needed.
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