Samenvatting
De meeste mensen met cannabisafhankelijkheid zoeken geen hulp. Een ‘behandelkloof’ ontstaat als niet-hulpzoekers niet spontaan herstellen en ernstige klinische kenmerken hebben. Het is onbekend in hoeverre hier sprake van is. Ook is er nauwelijks iets bekend over de redenen om al dan niet hulp te zoeken. In dit onderzoek werden 70 cannabisafhankelijke patiënten in de verslavingszorg vergeleken met 241 cannabisafhankelijke gebruikers uit de algemene bevolking die geen hulp hadden gezocht. Redenen om al dan niet hulp te zoeken werden vastgesteld bij alle 70 patiënten en bij 160 van de 241 cannabisafhankelijke gebruikers die zeiden in geval van cannabisproblemen geen hulp te zullen zoeken. Vergeleken met niet-hulpzoekers rapporteerden patiënten meer afhankelijkheidscriteria, meer cannabisgebruik, meer psychische problemen en meer beperkingen in het functioneren als gevolg van lichamelijke en/of psychische problemen. Patiënten ervoeren vaker dan niet-hulpzoekers een tekort aan sociale steun, ondanks dat zij vaker steun van vrienden of familie kregen, die ook vaker aandrongen om hulp te zoeken. Geestelijke gezondheidsproblemen en hinder in het functioneren waren de meestgenoemde redenen om hulp te zoeken. De belangrijkste motieven om geen hulp te zoeken waren: zelf willen stoppen, liever stoppen met hulp van familie of vrienden en behandeling voor cannabisproblematiek niet nodig vinden. Al met al lijkt de ‘behandelkloof’ mee te vallen, want vergeleken met patiënten in de verslavingszorg hebben niet-hulpzoekers met cannabisafhankelijkheid minder ernstige klinische kenmerken en vinden ze hulp vaak onnodig. Behandeling lijkt vaak onnodig voor niet-hulpzoekers, hoewel sommigen baat zouden kunnen hebben bij laagdrempelige interventies die rekening houden met de behoefte zelf te stoppen en met ondersteuning door familie of vrienden. Dergelijke interventies zouden daarnaast doorverwijzing van degenen met ernstige problemen kunnen faciliteren.
Abstract
The majority of cannabis dependent people do not seek professional treatment. Whether this indicates a ‘treatment gap’ depends on clinical characteristics of dependence in absence of treatment. In addition, motives for (not) seeking treatment are largely unknown. The current study compares 70 cannabis dependent patients with 241 non-treatment seeking cannabis dependent community subjects. Treatment facilitators were assessed in the 70 patients and barriers in 160 of the 241 dependent non-treatment seekers, who precluded to seek treatment. Compared to non-treatment seekers, patients reported more symptoms of dependence, more cannabis use, more mental health problems and more functional impairments due to physical and/or psychological problems. Patients also more often perceived lack of social support, while they received more support from family or friends, who also more often pressured to seek treatment. Patients reported mental health problems and functional impairment as facilitators to seek treatment. Cannabis dependent ‘precluders’ reported desire for self-reliance, preference for informal help from family or friends, and absent treatment need as their main reasons not to seek treatment. Non-treatment seekers showed better clinical characteristics compared with patients, and often deemed treatment unnecessary, suggestive of a limited ‘treatment gap’. While indeed treatment may often be unnecessary when it is not sought, some may still benefit from low threshold interventions, which should consider the desire for self-reliance and the preference for informal help, and would allow referral of severe cases to more intensive interventions. Reprinted from Drug and Alcohol Dependence, 133(2), van der Pol P, Liebregts N, de Graaf R, Korf DJ, van den Brink W, van Laar M, Facilitators and barriers in treatment seeking for cannabis dependence, 776–80, Copyright (2013), with permission from Elsevier.
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van der Pol, P., Liebregts, N., de Graaf, R. et al. Wel of geen hulp zoeken voor cannabisafhankelijkheid?. Verslav 11, 103–115 (2015). https://doi.org/10.1007/s12501-015-0016-z
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DOI: https://doi.org/10.1007/s12501-015-0016-z