Barriers to Drug Abuse Treatment Enrollment in Drug Dependent Patients of the Autonomous Region of Valencia, Spain

Antonio Vidal-Infer

Vidal-Infer, Antonio; Tomas, Sofia; Torrijo, M., Josefa; Vidal, Antonio; Sanchez, Lorenzo FEPAD/ Direccion General de Drogodependencias, Conselleria de Sanitat, Generalitat Valenciana, Spain/ FEPAD, Spain/ Consultoria de Estudios y Gestion de Proyectos S.L, Spain

By itself, treatment effectiveness is not the definitive factor for decreasing drug use; treatment must also be accessible to the highest number of potential users. Thus, treatment accessibility is one of the most important principles of a sound health care system. The study analyzed the conditioning factors that delay the demand for treatment among heroin, cocaine, alcohol, and cannabis abusers. We selected a sample of 2,123 patients, 1,681 male (79.2 percent) and 442 female (20.8 percent), heroin, cocaine, alcohol, and/or cannabis addicts, being treated at Addictive Behaviors Units in the autonomous Region of Valencia, Spain. A 54 item-specific survey was designed considering variables such as demographics, previously demanded services, and reasons to avoid treatment. A factorial analysis using the Varimax rotation method with Kaiser was carried out. We found six basic factors involved in enrollment and treatment avoidance: (1) level of awareness of the illness; (2) perceived seriousness of the problem; (3) existence of drug use-related problems; (4) resistance to change; (5) the nature of treatment process; and (6) the perceived stigma (shame). Furthermore, the most cited reasons to delay treatment demand were that patients decided to cope with the problem by themselves (56.7 percent), and they believed that treatments are for individuals who are in a worse situation than they are (49.3 percent). From a gender perspective, men tend to delay treatment demand due to a low awareness of the illness, as well as a low perception of substance abuse-related problems. In contrast, stigmatization, in terms of shame and lack of family support, are relevant reasons for treatment delay among women. We found low levels of social awareness about drug abuse as a chronic illness. The only way to change the attitude of treatment avoidance among patients is to raise the level of awareness on this issue. Furthermore, raising awareness would curtail social stigmatization, feelings of shame, and the lack of social and family support.

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