Seeking help for substance use disorders is a complex process that involves individual, clinical, social, economic, cultural, and, sometimes, legal determinants. We found that greater severity of substance use severity as measured by dependence rather than abuse and having received previous SUD treatment markedly increase the likelihood of seeking treatment for a new SUD. Past treatment of psychiatric disorders modestly increased treatment of alcohol abuse. Early age of SUD onset, belonging to an earlier birth cohort, and receiving higher education all decreased the probability of SUD treatment contact. Psychiatric comorbidity operated in a more complex manner with some disorders increasing and other decreasing the probability of treatment-seeking. Given the high rates of SUD, their substantial toll on the individual and society, and the importance of external rather than internal motivators for treatment, these patterns suggest the need for innovative approaches to increase timely access to care for individuals with SUD.
