Year of Publication



Public Health

Date Available


Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Sarah Wackerbarth

Committee Member

Dr. Rachel Hogg-Graham

Committee Member

Dr. Jayani Jayawardhana



Nationally representative data have indicated that less than one in ten individuals with a substance use disorder (SUD) have received recent treatment, suggesting a need for research to examine potential barriers to SUD services. Although research has been conducted to identify some barriers to treatment, there is little research focused on gender differences. To address this gap in research, the present study aimed to examine gender differences in barriers to entering SUD treatment, as well as differences in factors that may impact decisions to enter treatment.


Participants (N = 62) were recruited from the community as part of a state-funded study in Kentucky and asked to complete an online screener to determine eligibility. Eligibility included individuals (1) who self-reported drug use and had recently considered treatment but not enrolled; or (2) who dropped out of a SUD treatment program in the past 12 months. Eligible individuals were invited to complete a confidential phone interview focused on substance use history, mental health, history of trauma, and barriers to entering SUD treatment. Bivariate analyses were conducted using chi-square and t-tests.


Women were more likely than men to identify stigma (60.0% vs. 22.2%, p=0.003), unreasonable requirements for entry (54.3% vs. 25.9%, p=0.025), and lack of trauma-informed care (60.0% vs. 33.3%, p=0.037) as notable barriers. Significant differences were also observed on several factors that may impact treatment needs. One difference included that women were disproportionately affected by interpersonal victimization as compared to men including ever being physically assaulted/attacked by someone (88.6% vs. 55.6%, p=0.003). However, men indicated earlier initiation of substance use compared to women (13.4 vs. 15.0, p=0.037).


Findings highlight the unique experiences faced by men and women entering substance use treatment. These findings indicate the need for increased awareness on treatment barriers, as well as adjusting treatment entry requirements and incorporating trauma-informed therapy. In order to better understand the barriers faced when entering treatment by men and women, it is critical for substance use programs to use data to modify their programs.

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