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This article is part of a larger treatment system study entitled Women and Men in Swedish Alcohol and Drug Treatment carried out in Stockholm County. The goal is to analyse and describe the reasons people have for not entering the health-based addiction treatment system in Stockholm County. The following questions were raised: What reasons for not seeking treatment did the patients have prior to treatment entry? What are the differences between females and males and alcohol and drug abusers with regard to reasons for not seeking help? The material analysed consists of 942 face-to-face interviews with patients entering alcohol and drug treatment units. The analysis is based on nine items about various things that might get in the way of people getting help for an alcohol or drug problem. The majority of the patients (90 %) endorsed at least one of the statements. The three most prevalent reasons for not entering treatment among the patients were that they did not want to stop drinking or using drugs; they were concerned about what others would think; and thought they could handle their problem themselves. Approximately half of the respondents agreed with each of these items. Forty-four per cent did not think their problem was that serious, and therefore had not sought treatment earlier. Treatment scepticism constituted a barrier for 36 per cent of the respondents that did not think treatment would help them. Responsibilities at work are not considered an important barrier to entering treatment as only 22 per cent agreed with this statement. However, when focusing on those who had a job nearly 45 per cent of the respondents agreed with the statement. Thirty-one per cent of the respondents did not enter treatment since they felt they had too many responsibilities at home. Only 7 per cent indicated the reason for not seeking treatment as there was nobody to take care of their children (among those who had children). A present threat to abusers with children seems to be fear of losing custody of their children. Nearly 30 per cent considered this a reason for not entering treatment. The females support five out of nine statements to a significantly greater extent than the men do and also support three of the four remaining statements to a greater extent than the males, although not to a significant degree. There is no doubt that women experience more home- and child-related barriers to entering treatment. The only difference between alcohol and drug abusers was that alcohol abusers reported unwillingness to stop usage more frequently as a reason for not entering treatment than the drug abusers.

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