The fight against the growing abuse of prescription painkillers and heroin is not robust enough at any level — not federal and state governments’ efforts or those of doctors and users themselves, according to most Americans in a new poll out Tuesday.

Lack of access to care for those with substance abuse issues is a major problem, said 58 percent of those surveyed by the Kaiser Family Foundation. (KHN is an editorially independent program of the Foundation.)

The poll found that Americans had somewhat different views of heroin and prescription drug abuse. More than a third called heroin abuse an extremely serious health problem in the U.S., while just over a quarter of those surveyed said the same about the abuse of strong prescription painkillers. In contrast, fewer than a fifth regarded alcohol abuse in the same way.

The fight against opioid abuse has generated heavy news coverage in recent months, as well as government concerns. President Barack Obama recently proposed adding $1 billion to the federal budget for treatment programs. Yet more than 60 percent of respondents generally faulted federal efforts as too little. Similar shares were dissatisfied with state governments’ actions and those of doctors who prescribe painkillers, the Kaiser poll found.

But more than 70 percent believed drug users themselves aren’t doing enough.

Many Americans have personal experience with the drug abuse epidemic. More than four in 10 of those surveyed said they know someone who has been addicted to painkillers, and one in five said that person was a family member.

Asked about potential policy actions, more than eight in 10 called these steps very or somewhat effective:

• Increasing pain management training for medical students and doctors
• Increasing access to addiction treatment programs
• Increasing public awareness and education programs
• Increasing research about pain and pain management
• Monitoring the habits of doctors who prescribe prescription painkillers

The Kaiser survey also examined Americans’ views on issues involving access to mental health services. About one in five people surveyed said that they or someone in their family once needed mental health treatment but did not get it, for reasons that included affordability and insurance not covering it.

The poll also found that most people are unaware the federal government requires insurance plans to provide mental health benefits and substance abuse treatment under the same rules they apply to other medical services in terms of copays, deductibles and coverage limits. About four in 10 people surveyed knew that applied to health plans and three in 10 knew that for substance abuse treatments.

The poll was conducted April 12-19 among 1,201 adults. The margin of error is +/- 3 percentage points for questions asked of the full sample.