Millions of U.S. citizens have substance abuse disorders, but only a small percentage receive treatment each year, a recent Pew Charitable Trusts report revealed.

More than 21 million people faced substance abuse issues in 2013, but only 18 percent of those received treatment.

The self-perception that care was not necessary was the primary cause for failing to receive treatment, though lack of insurance and high cost of treatment also played a role.

Self-help groups were the most common form of assistance, followed by outpatient and inpatient care programs, private doctors, emergency rooms, and prisons or jails.

“These disorders often result in not only serious harm to the health of the individuals, but also enormous financial and social consequences that go beyond the health care system – including the loss of economic productivity due to withdrawal from the workforce and increased rates of crime, disability and death,” the report said.

An estimated 8 million children live in homes with a parent who has a substance abuse problem, “a contributing factor in one-third to two-thirds of [Child Protective Services] cases,” Pew said.

In addition, nearly two-thirds of persons in correctional facilities have substance abuse problems.

Through the Door,”’s documentary on faith and prisons, featured several interviewees who emphasized the connection between substance abuse and incarceration.

“If you had to choose one element of why people are in prison at the rates they’re in today, drug addiction, drug abuse is it,” said William Gupton, assistant commissioner of rehabilitative services for the Tennessee Department of Correction.

“The majority of our clients are people who have substance abuse problems,” said Anthony Metcalf of Churches Embracing Offenders, an Indiana re-entry program for nonviolent offenders. “But again, that goes back to the majority of crimes committed are substance related.”

Vernon Pittman, a retired Texas prison warden, affirmed Metcalf’s assessment, while Teresa McBean, pastor of Northstar Community Church in Richmond, Virginia, shared that 85 percent of people in prison have an addictive process.

The complete Pew Charitable Trusts report is available here.

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