Barriers in access to substance use treatment for rural adolescents

The increasing prevalence of substance use disorder (SUD) is a major public health crisis in the Unites States. Adolescence is an ideal period for early intervention to reduce the risk of SUDs in adulthood, as research has shown that up to 60% of adult SUD could have been avoided by early intervention in youth. Prior research has typically focused on urban metropolitan areas when describing adolescent substance use. However while the data is varied, several studies have shown that the prevalence of rural adolescent substance use is equal or greater than that of their urban peers, particularly alcohol, tobacco, and prescription drug use, and begin use at an earlier age. There are several methods of treatment for adolescent substance use and SUD, centered on evidence-based practices, which have been shown to be moderately effective at reducing substance use. Despite the existence of these treatment strategies, substantial disparities exists with respect to the number of adolescents who could potentially benefit and the number who actually enroll in treatment. It has been estimated that 90% of adolescents in need of treatment are not able to succeed in receiving it. This highlights the importance of understanding the circumstances in which youth initiate drug use and the unique barriers they must overcome to receive treatment when these behaviors develop into a pattern that impacts daily life. With this information, interventions can be targeted to reduce the magnitude of the most significant barriers in order to increase treatment utilization, especially in rural areas where adolescents face unique challenges to treatment access as a consequence of their remote locations. A literature review was conducted and found the major barriers in access to substance use treatment for adolescents to be a lack of available treatment programs, lack of treatment options including medication treatment, lack of perceived need or motivation for treatment, social stigma, socioeconomic status (SES), familial relationships, and referral services. These studies were all conducted in the United States and published from 2011-2020. The aim of this thesis is to propose a protocol for the completion of a systematic review to determine which barriers exist to adolescents receiving substance use treatment and to examine them in the context of rurality. Healthcare decisions and policy are informed by the best available evidence from systematic research and incorporated into evidence-based practices. A systematic review will summarize the findings of all relevant studies thereby making the key information more accessible to decision makers, including clinicians and policy makers, in order for substance use treatment to become more accessible to adolescents