Why People With Cannabis Problems Avoid Treatment in Sweden | Research

The takeaway

Privacy concerns and poor availability were the biggest barriers to seeking addiction treatment across alcohol, cannabis, and gambling users, while stigma specifically deterred people from social services.

Addiction treatment professionals, policymakers, and anyone interested in barriers to seeking help

Privacy concern and stigma were the top barriers across all groups

What the researchers found

Cannabis users shared similar treatment barriers with alcohol and gambling users, including privacy concerns, stigma, and fear of consequences. However, different groups described different aspects of these barriers: cannabis users emphasized fear of legal consequences, while all groups reported stigma as the top barrier to social services.

Why it matters

The treatment gap for addiction is one of the largest in healthcare. Understanding why people avoid help, and whether the barriers differ by substance, is critical for designing systems that actually reach the people who need them.

The numbers in context

51 cannabis users, 207 alcohol users, and 37 gamblers surveyed. Five general barrier themes and three social-services-specific barrier themes emerged from interviews.

How the study worked

Mixed methods study combining surveys (Barriers to Treatment Inventory) from 295 participants (207 alcohol, 51 cannabis, 37 gambling) with 17 semi-structured interviews. Quantitative and qualitative data were analyzed in parallel and then integrated.

What this study cannot tell us

Small cannabis subsample (n=51) limits the power to detect group differences. Participants were recruited through online platforms, which may not represent those with the most severe barriers. The study is specific to Sweden's unique care system.

How to read the evidence

Mixed-methods design provides both breadth and depth, but small cannabis subsample and Swedish-specific context limit generalizability.

When this study was published

2024 study

The bigger picture

Sweden has a multi-provider addiction care system with both healthcare and social services. The finding that stigma, fear of consequences, and lack of knowledge about available services cut across substance types suggests systemic barriers rather than substance-specific ones.

Questions still open

Would reducing the role of social services in addiction care reduce stigma-related barriers? How do these barriers compare in countries where cannabis is legal vs. illegal?

Common questions

Do cannabis users face different barriers to treatment than alcohol users?

Broadly, no. The main barriers (privacy, stigma, poor availability) were similar across groups, though cannabis users placed more emphasis on fear of legal consequences.

What stops people from seeking addiction help through social services?

Stigma was the biggest barrier, followed by not knowing what services exist and fear of consequences like losing custody or employment.

Read the original research

A mixed method study exploring similarities and differences in general and social services-specific barriers to treatment-seeking among individuals with a problematic use of alcohol, cannabis, or gambling.

BMC health services research, 24(1), 970

View on PubMed ↗Publisher’s paper ↗

Citation

Schettini, Greta; Lindner, Philip; Ekström, Veronica; Johansson, Magnus. (2024). A mixed method study exploring similarities and differences in general and social services-specific barriers to treatment-seeking among individuals with a problematic use of alcohol, cannabis, or gambling.. BMC health services research, 24(1), 970. https://doi.org/10.1186/s12913-024-11304-5