Top Reasons for Not Getting Alcohol or Drug Treatment

Lack of Motivation to Quit and Health Coverage Are the Top Reasons for Not Receiving Needed Alcohol or Drug Treatment

An estimated 20.5 million people needed but did not receive alcohol or drug treatment in the past year, according to data from the 2010 National Household Survey on Drug Use and Health (NSDUH). The primary reason for not receiving treatment among those who were classified as needing—and felt they needed—treatment was not being ready to stop using alcohol or illicit drugs (40.2%). The second most commonly cited reason for not receiving treatment was having no health coverage and not being able to afford the cost (32.9%). People in need of alcohol treatment were more likely than those in need of drug treatment to cite not being ready to stop using (45.1% vs. 30.7%; data not shown), while those needing drug treatment were more likely to cite not having health coverage and could not afford the cost (41.8% vs. 30.9%; data not shown). Other reasons given were not knowing where to go for treatment, thinking that going to treatment might have a negative effect on their job or social relationships, or thinking that they could handle the problem without treatment (see figure below).

(N=an estimated 1,341,000 U.S. residents ages 12 and older classified as needing and perceiving a need for—but not receiving—treatment)

  • Not Ready to Stop Using 40.2%
  • No Health Coverage and Could Not Afford Cost 32.9%
  • Might Have Negative Effect on Job 11.5%
  • Might Cause Neighbors/Community to Have Negative Opinion 11.3%
  • Could Handle the Problem Without Treatment 9.9%
  • Did Not Know Where to Go for Treatment 9.3%
  • Did Not Feel Need for Treatment at the Time 7.8%
  • Did Not Want Others to Find Out 6.8%
  • No Transportation/Inconvenient 6.3%


My Last Cup

Australia New Zealand L58

No longer a slave to the poker machines

For finally, I have broken their wicked spell

And each time temptation tries to lure me back

I just remember ‘my living hell.’

The tangled web of lies, ‘constant’ and ugly deceit

Sleepless nights of ‘frantic worry’

‘No food left to eat.’

The fear of opening up my mail box to find another

‘I can’t pay it bill’

Eventually they stole it all

No longer giving me ‘that thrill.’

The tormented thoughts of ‘self hatred’

Of the longing to ‘simply die’

Empty, guilt filled nights

‘No tears left to cry.’

‘Yes’, in the beginning the pokies helped me feel

‘Exhilarated, happy, content and alive’

The ‘sounds of lights, the free spins’

‘So much pleasure’ I derived.

The atmosphere ‘most welcoming’

Giving me a sense of security, comfort

I felt a ‘warmth all around’

And as the coffee, cakes and biscuits flowed

I felt ‘so safe and sound.’

The endless ‘jackpots’ and ‘giveaways’

I actually believed I had the ‘Midas touch’

But in the end I lost all sense of reality

And ‘my self, pretty much.’

And all of my old friendships

I had pushed aside ‘long ago’

I think to myself…‘if only’ I knew back then

‘What today I now know.’

I remember clearly that day

When I finally reached into ‘my last cup’

‘I looked down and saw it bare’

And I realised in that moment

‘What I needed, I would never find it there.’


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Top Posts March ’08

Recovery from Compulsive Gambling

Author shares his journey of recovery from compulsive gambling

Gambling Looking back on it, Bill Lee, author of Born to Lose: Memoirs of a Compulsive Gambler, realizes that his gambling addiction began in the third grade when he would wager his cherished baseball card collection in “pitch the card” contests during recess. Soon he was pitching pennies and nickels against other kids on the playground. By age 10, he was playing blackjack and poker and finding other creative ways to gamble.

He recalls: “When it was raining outside, the window in my classroom served as a game of chance, as my classmates and I picked individual droplets and wagered on their race to the bottom of the pane.”

After decades of accumulating and losing small fortunes, Lee forfeited everything he owned at a blackjack table when his winning streak spiraled into a devastating loss.¿ By that time his marriage had failed, his teenage son had run away from home, and his thoughts were suicidal. Lee’s journey of recovery has been a fragile but hopeful one, with Gamblers Anonymous (GA) at its core.

Lee’s experience underscores the progressive nature of compulsive gambling–a treatable addiction characterized by increasing preoccupation with gambling, a need to bet more money more frequently, restlessness or irritability when attempting to stop, and loss of control manifested by continuation of the gambling behavior in spite of mounting, serious, negative consequences.

According to the National Council on Problem Gambling (NCPG), 2 million (1 percent) U.S. adults are estimated to meet the criteria for pathological, or compulsive, gambling in a given year.

Another 4-8 million (2-3 percent) are considered “problem gamblers,” meaning they do not meet the full diagnostic criteria for pathological gambling, but they are experiencing problems due to their gambling behavior. Only two states (Hawaii and Utah) do not have legalized gambling.

Gaming is the fastest growing industry in the United States, and gambling is the fastest growing addiction. No longer just a problem for male adults, now youth, the elderly, and women are being affected in record numbers. For every compulsive gambler, it is estimated that five others are affected by the addiction. In his book, Lee stresses the importance of Gam-Anon, a mutual-support group for the loved ones of addicted gamblers.

“Gam-Anon members sometimes envy spouses of addicts in other fellowships whose drug of choice is alcohol, food, or sex,” writes Lee. “At least with those addictions, the healing can begin as soon as the addiction is in remission; whereas in gambling, the financial damage can last a lifetime and beyond.”

Pokies 44 According to GA, once a gambling addict, always a gambling addict. “The first bet to a problem gambler is like the first small drink to an alcoholic. Sooner or later he or she falls back into the same old destructive pattern,” their Web site states. In GA, members work the Twelve Steps of Alcoholics Anonymous (AA) that have been revised to reflect an addiction to gambling. Like AA, GA is a microcosm of our society. Young and old, rich and poor, professionals and blue-collar, men and women of a variety of ethnic and religious backgrounds gather to listen to and support their fellow members. In describing his own GA group, Lee writes: “Everyone present has bounced a check, faced bankruptcy, and at least contemplated suicide. More than half are recovering from multiple addictions. A few proclaim that gambling is harder to kick than heroin and crack.”

Like alcoholism, compulsive gambling can be thought of as a “family disease.” Lee traces the addiction back at least three generations in his own family, and he writes poignantly about the effects his obsessive gambling had on his own son. But, like alcoholism, the disease cycle can be interrupted when compulsive gamblers take an honest look at their destructive behaviors and get the help they so desperately need.

To learn more about compulsive gambling and recovery for individuals contact GA at For information on National Council on Problem Gambling, visit or for family and friends of problem gamblers see Gam-Anon at

Alive & Free is a health column that provides information to help prevent substance abuse problems and address such problems. It is created by Hazelden.

See also;

Signs of Compulsive Debting

Signs of Compulsive Debting

1. Being unclear about your financial situation. Not knowing account balances, monthly expenses, loan interest rates, fees, fines, or contractual obligations.

2. Frequently “borrowing” items such as books, pens, or small amounts of money from friends and others, and failing to return them.

3. Poor saving habits. Not planning for taxes, retirement or other not-recurring but predictable items, and then feeling surprised when they come due; a “live for today, don’t worry about tomorrow” attitude.”

4. Compulsive shopping: Being unable to pass up a “good deal”; making impulsive purchases; leaving price tags on clothes so they can be returned; not using items you’ve purchased.

5. Difficulty in meeting basic financial or personal obligations, and/or an inordinate sense of accomplishment when such obligations are met.

6. A different feeling when buying things on credit than when paying cash, a feeling of being in the club, of being accepted, of being grown up.

7. Living in chaos and drama around money: Using one credit card to pay another; bouncing checks; always having a financial crises to contend with.

8. A tendency to live on the edge: Living paycheck to paycheck; taking risks with health and car insurance coverage; writing checks hoping money will appear to cover them.

9. Unwarranted inhibition and embarrassment in what should be a normal discussion of money.

10. Overworking or under earning: Working extra hours to earn money to pay creditors; using time inefficiently; taking jobs below your skill and education level.

11. An unwillingness to care for and value yourself: Living in self-imposed deprivation; denying your basic needs in order to pay your creditors.

12. A feeling or hope that someone will take care of you if necessary, so that you won’t really get into serious financial trouble, that there will always be someone you can turn to.

Debtors Anonymous

              How to Get Out of Debt, Stay Out of Debt and Live Prosperously*: *(Based on the Proven Principles and Techniques of Debtors Anonymous)
by Jerrold Mundis

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Recovery from Debt

The Tools for Recovery of Debtors Anonymous

Action is the magic word. We have found the following actions essential to our recovery.


We practice abstinence by not incurring unsecured debt one day at a time. Unsecured debt is any debt that is not backed up by some form of collateral, such as a car, house, etc.


We attend meetings at which we can share our experience, strength and hope with one another. Unless we give to newcomers what we have received from D.A. we cannot keep it ourselves.


We practice anonymity, which allows us freedom of expression by assuring us that what we say at meetings or to other D.A. members at any time will not be repeated.

The Telephone

We maintain constant contact with other D.A. members by exchanging telephone numbers. We make a point of talking to other D.A. members before and after taking difficult steps in our recovery.


Many of us find it extremely helpful to select a sponsor. A sponsor is an abstinent member of D.A. who is usually more experienced in working the Twelve Steps. The sponsor aids us in implementing our action plan and in working the Steps.

A.A. Literature

We study the literature of Alcoholics Anonymous to strengthen our understanding of compulsive disease. We can identify with many of the situations described therein by substituting the words “compulsive debt” for “alcohol.”


We maintain awareness of the danger of compulsive debt by taking note of bank, loan company and credit-card advertising and by reading news accounts of its effects.

Debtors Anonymous

          Addiction & Recovery for Dummies
by Brian F., PhD Shaw, Paul, PhD Ritvo, Jane, D.Phil Irvine

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