Motivators, Barriers, and Likelihood of Contacting 988 for Substance Use Support: Implications for Marketing, Promotion, and Practice

BACKGROUND: Suicide is a significant public health concern in the U.S. that has been rising steadily over the last 2 decades. Addressing substance use as a form of suicide prevention may help counteract the rising suicide rate, as alcohol and opioids are found in 22% and 20% of individuals who died by suicide, respectively. The Substance Abuse and Mental Health Services Administration envisions crisis response as addressing both substance use and suicide, including through the 988 Suicide and Crisis Lifeline. Unfortunately, few report they would contact 988 if they were experiencing a substance use issue. We sought to explore reasons for, barriers to, and likelihood of contacting 988 for substance use and inform future efforts to increase utilization. METHODS: A survey of 1090 U.S. adults was conducted November 6 to 10, 2025 via the AmeriSpeak Omnibus, a nationally representative bi-monthly multi-client survey using the AmeriSpeak Panel. RESULTS: Only 18% of respondents reported they would contact 988 if they were experiencing substance use issues. No cost (41%), immediate support while on a wait list for treatment (32%), and avoiding stigma (32%) were the most commonly reported motivators for contacting 988 for substance use support. Being advertised as a suicide and crisis lifeline (22%), lack of follow-up (14%), and lack of training among counselors (13%) were reported as barriers. Familiarity with 988 was associated with likelihood of contacting 988 for substance use support for at least 1 listed reason (81% of those extremely/very familiar vs 51% not very/not at all familiar). Responses varied by education, gender, race/ethnicity, and age. CONCLUSION: Findings identified factors that influence the public's likelihood of contacting 988 for substance use support and suggest a need for standardized substance use intervention protocols and targeted messaging tailored to specific audiences.