Barriers and Facilitators to Substance Use Disorder Treatment: An Overview of Systematic Reviews

Abstract

objective: This investigation explored the barriers and facilitators to substance use disorder (SUD) treatment in the integrated paradigm. methods: A search technique for barriers and facilitators of SUD treatment was applied to the PubMed and Web of Science databases to identify relevant systematic reviews. The eligibility criteria included systematic review (SR) or SR plus meta-analysis (MA) articles published before the end of 2021, human research, and the English language. Each of the 12 relevant review articles met the inclusion criteria. AMSTAR was utilised to evaluate the methodological quality of the systematic reviews. results: Two authors analysed 12 SR/SR-MA articles to identify barriers or facilitators of SUD treatment. The cumulative summary results of these 12 evaluations revealed that barriers and facilitators may be classified into 3 levels: individual, social and structural. By analysing these review papers, 37 structural barriers, 21 individual barriers and 19 social barriers were uncovered, along with 15 structural facilitators, 9 social facilitators and 3 individual facilitators. conclusions: The majority of barriers indicated in the review articles included in this analysis are structural, as are the majority of facilitators. Consequently, the design of macro models for the treatment of substance use disorders may yield various outcomes and potentially affect society and individual levels.

Examining facilitative services for entry into substance use disorder treatment: A cluster analysis of treatment facilities

“…Despite the benefits of SUD treatment, many individuals face barriers to accessing treatment, furthering their potential exposure to the harmful outcomes related to SUDs. Examples of barriers that individuals may face in accessing SUD treatment include geographic access (e.g., limited or no available treatment programs locally, which could vary by region, state, county, or district), fears about treatment, criminalization of illicit substance use, costs associated with treatment, lack of insurance, transportation, and no current openings in treatment programs [ 4 – 6 ]. National and state-level studies investigating the collection of services offered by substance use treatment organizations that may improve treatment access are limited [ 7 – 9 ].…”

“…To combat structural barriers to treatment (e.g. costs of treatment, lack of transportation to treatment) and improve treatment accessibility, some SUD treatment facilities provide services that facilitate or promote entry into treatment [ 4 , 10 ]. Facilitative factors to entering treatment may include flexible payment options, housing support, transportation assistance, or assistance obtaining social services.…”

“…Socioeconomic factors often hamper one’s access to treatment. A prominent barrier to accessing SUD treatment is the inability to pay for these services, including insurance coverage gaps [ 4 , 11 – 13 ]. The Patient Protection and Affordable Care Act (ACA) boosted insurance coverage rates among people with SUD [ 14 ].…”

“…However, a study that examined SUD treatment access pre-ACA (2009–2013) and post-ACA (2015–2019) did not find a significant increase in treatment entry among adults who have a SUD with a lower socioeconomic status [ 5 ]. Instead, the authors found that while some barriers to accessing treatment increased during the analytical period (e.g., lack of knowledge of available services, perceived stigma, and difficulties accessing appropriate treatment options), there was no significant reduction in insurance-related treatment barriers, highlighting the importance of considering multiple factors to increase SUD treatment access [ 4 , 5 , 15 ].…”

Engagement and response to a psychoeducation program for family members of inpatients undergoing treatment for substance use disorder

“…For example, issues such as domestic violence pose a specific obstacle in the enrollment of parents and tutors of young SUDI, along with a stigmatizing view among family members about mental health treatment (Siljeholm et al, 2022). In this case, family issues and their members have been pointed out as both a source of barriers, as well as facilitating factors for SUD treatment (Farhoudian et al, 2022). Thus, as much as family support intervention is regarded as a basic guideline for addiction treatment, failure to address family issues could result in treatment failure (Acevedo et al, 2020; Alsuwaidi, 2019).…”