Substance abuse in America is more prevalent than you may think, and the numbers of those classified with substance abuse who are actually receiving treatment are unsettlingly low. According to the 2013 National Survey on Drug Use and Health (NSDUH) released by the Substance Abuse and Mental Health Services Administration (SAMHSA), about 22.7 million Americans 12 and older needed treatment for illicit drug or alcohol abuse. That’s about 8.6 percent of the population of persons 12 and older. Of these 22.7 million, only about 2.5 million, or 11 percent, had received treatment in the past year at a specialty facility for their substance dependency or addiction.

By far the biggest reason for this disparity is the widespread belief among addicts that they themselves don’t need treatment. There is, however, a percentage of people who do in fact need treatment, recognize that they do, and then don’t receive treatment. What is keeping these people from receiving the treatment they need for their substance abuse? Read on to see 8 reasons, as reported by the NSDUH.

No health coverage and could not afford cost, 37.3%

Health coverage continues to be the number-one concern for self-identified addicts looking into receiving treatment.

Not ready to stop using, 24.5%

For these people, substance abuse has become a central part of their lifestyle, and they don’t yet feel ready to part ways with their dependency or addiction. This can take on the form of procrastination, fear, complacency, etc.

Did not know where to go for treatment, 9.0%

Many do not know where to turn for addiction recovery, but now there are more treatment options than ever available to those suffering from addiction. From programs of experiential counseling to intensive outpatient treatment to residential care, there is a treatment option for anyone and everyone.

Had health coverage but did not cover treatment or did not cover cost, 8.2%

Some with health coverage still fear the cost of addiction recovery treatment. In these cases, it’s always a great idea to speak with a treatment facility’s financial staff to discuss programs that may very well be compatible with your health coverage.

No transportation/inconvenient, 8.0%

Sometimes the only barrier standing between you and receiving treatment is difficulty getting to the treatment facility of your choice. In these cases, consider confiding in a close and supportive friend or family member your need to receive treatment and asking him or her to help you get there.

Might have negative effect on job, 6.6%

Many fear that receiving addiction recovery treatment will have a negative impact on employment. What many don’t know, however, is that there is legislation in place to help those addicted to legal substances maintain their jobs when going to receive treatment. Another thing to keep in mind is that with the availability of outpatient treatment programs, those seeking recovery from addiction can find treatment options that will work around their schedules.

Could handle the problem without treatment, 6.6%

Some feel that they can handle addiction recovery on their own better than they would in a specialty facility. There is, however, truly no substitute for the support, specialized care, and physical and mental preparation for recovery you receive in a specialized treatment facility.

Did not feel need for treatment at the time, 5.0%

Sometimes those suffering from addiction might feel that they are in a place of control when they begin considering treatment.