Why People With Cannabis Problems Avoid Treatment in Sweden

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.

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.

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.

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.

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.