The Association of Substance Use Disorder (SUD) Type and Other Factors in SUD Recognition Among U.S. Adults

Approximately 18% of U.S. adults have a substance use disorder (SUD), yet SUD treatment utilization rates remain low. Substance use problem recognition, or one's awareness that their substance use is harmful, is a key precursor to seeking SUD treatment. Despite low treatment utilization prevalence, research on factors that promote substance use problem recognition among those with SUD is limited. Using 2022 National Survey on Drug Use and Health (NSDUH) data and drawing on Andersen's health service utilization model, we examined associations of predisposing, enabling, and need characteristics with substance use problem recognition among adults with one or more SUDs with a focus on the relationships between SUD type(s) and problem recognition. The statistical approach utilized was generalized linear models for a Poisson distribution with a log link function. Compared to having alcohol use disorder-only, having multiple SUDs was associated with a higher likelihood of problem recognition, whereas opioid use disorder-only was significantly associated with a lower likelihood of problem recognition. Findings speak to the need for further efforts to aid in SUD problem recognition.