In keeping with prior US studies (Olfson et al., 1998; Wang et al., 2005), the rates of treatment-seeking were low for the first several years after onset of the disorder for all SUDs. A novel finding of our study was that time to first treatment contact varied substantially across SUD diagnoses in the year after diagnosis and over the lifetime of the individual. There was a lower probability of treatment, regardless of the timeframe considered, for drug dependence followed by alcohol dependence, drug abuse, and alcohol abuse. This ordering is consistent with the extent of their overall impact on quality of life and daily function (Compton et al., 2007; Hasin et al., 2007; Rubio et al., 2014). Symptoms of withdrawal, which are common to dependence but not of abuse criteria (Compton et al., 2007; Hasin et al., 2007; Hedden and Gfroerer, 2011), may also lead to greater perceived need among individuals with substance dependence than abuse and motivate greater treatment-seeking behavior. As compared to individuals with abuse, those with dependence might also experience greater social pressure to seek treatment exerted by family, economic realities, or legally-related consequences of their behavior.
