Factors associated with not ready to stop using substances among adults with an unmet treatment need: findings from the National Survey of Drug Use and Health 2015-2019

Background: 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. Objectives: 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. Methods: 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 (N = 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. Results: 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). Conclusion: 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.