Barriers to Treatment of Substance Abuse in a Rural Population of India

Abstract

Background: In spite of having strong religious and cultural influences, substance abuse among adult population is very high in Punjab, a north Indian state of India in the border of Pakistan. A large majority of individuals with alcohol and substance dependence do not seek treatment. The primary objective of the study was to evaluate the barriers for which people in general population having alcohol and substance dependence do not seek treatment. There is paucity of data in India regarding barriers in treatment of substance abuse. Therefore, it was very tempting to evaluate these barriers. Method: Data was collected from the rural population of a randomly selected village by directly going to their home. Substance dependence was diagnosed by DSM-IVTR criteria in 412 persons and was assessed by Barriers to Treatment Inventory scale (BTI). Results: Among all the barriers ‘time conflict’ predominated in the study population by 51.2% followed by two other barriers ‘absence of problem’ (48.8%) and ‘fear to treatment’ (40.3%). Admission difficulty and poor treatment availability were relatively less prominent barriers. Female substance dependents had major problem with privacy (87.5%), fear to treatment (75%) and absence of problem (75%). Conclusion: This study shows that there are several barriers, certain beliefs, social influences and obligations in the population for which people can’t take treatment. Social stereotypes and fear to treatment due to poor health services add further vulnerability. Minimization of the barriers should be done by changes in education, screening, outreach, detection, and referral patterns in alcohol & substance abuse treatment delivery systems.