the white racial/ethnic group, have a higher education, earn $35,000 or more annually, live in an urban setting and have health insurance. In contrast, individuals with AUD with mood or anxiety comorbidity were more likely to be female, earn less than $20,000 and to have other psychiatric and substance disorder comorbidity. These differences in predisposing (gender, race/ethnicity), enabling (insurance, income, urbanicity), and need factors (type of AUD, other comorbid conditions) suggest different patterns of treatment seeking behavior and different barriers to treatment [20]. Individuals with lower income and no health insurance as well as those who live in rural areas face a greater number of barriers to substance disorder services and other health services. Indeed, we found a larger number of barriers among the comorbid group. However, the association of comorbidity with perceived unmet need persisted in the adjusted model controlling for socio-demographic and clinical characteristics. It is possible that the persisting difference among the AUD groups with and without comorbidity is due to unmeasured differences between the two groups in severity or impairment in functioning.
