Columbia University think tank reports doctors aren't trained to treat addiction - 44% get sent to AA by the Criminal Justice System

Report shows disconnect between addiction science, treatment

Columbia University think tank reports doctors aren't trained to treat addiction
By Jaclyn Cosgrove | Published: June 26, 2012

Although scientific research shows that addiction is a complex brain disease, many people still misunderstand it as a moral failure or lack of willpower, according to a report released Tuesday.

The report from the National Center on Addiction and Substance Abuse at Columbia University states that U.S. doctors are unprepared to intervene or treat addiction, even though there have been significant advances in the science regarding the disease.

These issues further exacerbate a problem that costs Oklahoma an estimated $7.2 billion per year, according to data from the National Association of State Alcohol and Drug Abuse Directors, which tracks substance abuse trends.

“I think that the real important finding here that hasn't been made clear before is the vast disconnect between what we know about addiction and how to prevent and treat it ... and how the medical profession has largely neglected addressing this disease for a variety of reasons,” said Susan Foster, vice president and director of policy research at the National Center on Addiction and Substance Abuse.

The think tank's 586-page report outlines the many gaps that exist within the realm of addiction.

Addiction affects 16 percent of Americans age 12 and older, which is about 40 million people, according to the report. That number is higher than the number of people affected by heart disease (27 million), diabetes (26 million) or cancer (19 million), according to the report.

An additional 80 million people are “risky users,” using tobacco, alcohol and other drugs in ways that threaten health and safety.

Blame isn't the point

Unlike other diseases and medical conditions, little is done to prevent risky use of substances, and most people who need treatment don't receive anything that would be defined as evidence-based care, according to the report.

Instead, if people go to see their primary care physician, they're sent to a support group, such as Alcoholics Anonymous or Narcotics Anonymous.

“If you went into a doctor's office and said, ‘I have heart disease or diabetes,' there's not a doctor that says, ‘I don't treat that, but there's a group that meets down the street three times a week,'” Foster said.

However, for a variety of reasons, many doctors aren't prepared to treat addiction, Foster said. For one, medical schools don't generally cover addiction thoroughly in their classes. Secondly, there aren't a set of nationally accepted standards for how doctors should treat addiction, she said.

Although almost half of Americans say they would go to their health care providers if someone close to them needed addiction treatment, less than 6 percent of all referrals to addiction treatment come from health professionals.

“Forty-four percent come from the criminal justice system, which tells you about our failure to treat this problem until it emerges into serious social consequences,” Foster said.

Foster said there are also huge gaps in insurance coverage. For example, some insurance providers structure their addiction treatment coverage on an acute care model. This means someone might be able to get one round of treatment covered. This model fails to see addiction as the chronic disease that it is.

Depression was once thought to be a character flaw because it was understood to be a chemical imbalance. Other diseases like cancer carried similar stigma, Foster said.

She said it's important to not get hung up on who is to blame for the disconnect between the science of addiction and the medical practices around it.

“I think the point here is not to go back and dig up who's to blame,” Foster said. “The point is to move forward and make sure people get the care they need.”

Source:http://newsok.com/report-shows-disconnect-between-addiction-science-trea...

The National Center on Addiction and Substance Abuse (CASA) report "Addiction Medicine: Closing the Gap between Science and Practice" can be downloaded at http://www.casacolumbia.org/templates/NewsRoom.aspx?articleid=678&zoneid=51

"June 26, 2012
New report, Addiction Medicine: Closing the Gap between Science and Practice, reveals addiction treatment neglected by the U.S. medical system and a lack of national treatment standards to assure quality care for those with the disease of addiction."

Comments

JR Harris's picture

A Rigorously Honest Report of the news by Jaclyn Cosgrove on AA and NA, "Jaclyn Cosgrove writes about health, medicine and fitness, among other things. She graduated from Oklahoma State University with a news-editorial and broadcast production degree. "

http://newsok.com/more/Jaclyn%20Cosgrove

We need more people like this to analyze the issues.

"Tradition 10 - Alcoholics Anonymous has no opinion on outside issues; hence the AA name ought never be drawn into public controversy." Please follow orders from the Interchurch Center if you are an AA member and don't comment.

“If you went into a doctor's office and said, ‘I have heart disease or diabetes,' there's not a doctor that says, ‘I don't treat that, but there's a group that meets down the street three times a week."

Well what have we here? Someone who actually "gets it". It does not matter if you do not have a problem with the "higher power" concept or if your group is just a bunch of kind old ladies. You do not send a person to a group of people "hanging out" to solve mental, emotional and behavioral problems.
The results speak for themselves.

avogadno's picture

That's very true msa, and a point that often goes overlooked. Perhaps it is because many doctors, counselors, etc think that AA is a group of people trading ideas about dealing with cravings and stuff like that. In the groups that I went to practical shares about how to stay sober were actually off limits and outside issue. Ridiculous, as this was the pretense thatI had joined the program. Not to talk with strangers about my spiritual life and religious practices. One (besides fear) of the reasons I stuck around and kept trying new meetings was because I kept thinking that I would find the group that would actually give me constructive advice.

Pro Empowerment!
Truth about AA: http://orange-papers.org/menu1.html
Expose AA: http://www.expaa.org/

Clara's picture

Wow, we often had discussions just like that. What it was like, what we did and the outcome... People could toss in something about where they were and have a brainstorm, a la SMART. Perhaps some doctors and counselors feel that way because it is what they experienced or heard from patients.

Remember Christopher Stevens when you vote.

becket's picture

So is your point that all doctors should be trained to treat patients who are complaining of substance dependence? If so, what should these doctors' training consist of? What sort of curriculum would you suggest to enable the doctors to be of maximum assistance to the dependent patient, considering the physical, mental and emotional aspects of substance abuse?

“The essence of the independent mind lies not in what it thinks, but in how it thinks.”
― Christopher Hitchens, Letters to a Young Contrarian

alkieanon's picture

"... the medical profession has largely neglected addressing this disease ..."

JR Harris's picture

I see you haven't gotten it YET. Voodoo magic chanting rituals are not the answer, it doesn't "work" on a "disease" in case your wondering.

"The report from the National Center on Addiction and Substance Abuse at Columbia University states that U.S. doctors are unprepared to intervene or treat addiction, even though there have been significant advances in the science regarding the disease."

"Tradition 10 - Alcoholics Anonymous has no opinion on outside issues; hence the AA name ought never be drawn into public controversy." Please follow orders from the Interchurch Center if you are an AA member and don't comment.

JR Harris's picture

Who would you believe about the percentage of court mandated people to AA? An anonymous and easily faked triennial survey from AAWS at the Interchurch Center, or the report from the National Center on Addiction and Substance Abuse at Columbia University?

By they way, the newest triennial survey is very late, they must be trying to "fudge" the number again.

1968 - First triennial survey in U.S. and Canada
At the 28th International Congress on Alcohol and Alcoholism, held in late summer 1968 in Washington, D.C., A.A. chairman Dr. John L. Norris reports on the findings of the first survey of members from all states and provinces. Sixty percent of the 11,355 men and women who responded at 466 meetings in 1968 reported that they had gone without a drink for a year or more. The survey, which will be taken every three years, also finds that 41 percent of members said they had not drunk alcohol since their first A.A. meeting.
http://www.aa.org/aatimeline/timeline_h5.php?lang=_en

"Tradition 10 - Alcoholics Anonymous has no opinion on outside issues; hence the AA name ought never be drawn into public controversy." Please follow orders from the Interchurch Center if you are an AA member and don't comment.

becket's picture

If you believe someone is lying or cooking the books, why don't you take your research capabilities and do your own survey? Yes, that would mean you'd have to get up out of your armchair, but it might just be worth it.

“The essence of the independent mind lies not in what it thinks, but in how it thinks.”
― Christopher Hitchens, Letters to a Young Contrarian

among doctors, scientists, and researchers....many do not support the concept and this produces an obvious (or not so obvious) intellectual conflict in the field of research.

Thomas S. Szasz first wrote "The Ethics of Addictions" back in the early 1970's and soon thereafter his book "Ceremonial Chemistry- The Ritual Persecution of Drugs, Addicts, and Pushers". Szasz is probably one of, if not, the forerunner in the case against the "medical model" followed by many more including Ty Colbert, Stanton Peele, Jeffrey Schaler and a whole host of Szaszian followers in varies disciplines including medicine, law, anthropology, etc.
Thats right! Anthropology! check out John Rush's "Clinical Anthropology" as a replacement for the medical model on many issues that are more of the mind than the body.

We have to scratch this whole goofy system and start over. Let those who want to sit in church basements drinking bad coffee and eating stale cookies do so if they so choose....but forcing people into practices of cult like voodoo for non existent "diseases" ....we should be calling upon the forces of the Secular Coalition of America to help us with this battle.
www.secular.org

Anthro

becket's picture

"the 'disease' concept is still highly refuted . . . "
"...but forcing people into practices of cult like voodoo for non existent 'diseases' . . . "

Please explain this discrepancy. Your conclusions as a doctor, scientist and/or researcher are of some interest here.

If no man or woman were ever again mandated to attend AA or NA, would that satisfy you? Under those circumstances it would likely be nearly all voluntary attendees, and you could get back to living your life without concern over people being coerced into attending.

“The essence of the independent mind lies not in what it thinks, but in how it thinks.”
― Christopher Hitchens, Letters to a Young Contrarian

I am a researcher and I am simply providing you with the final conclusions of some of the most brilliant minds of the 21st century.

www.szasz.com

Anthro

rainbow's picture

Thank you Anthro. I like. I like. Good cause. This is odd. I just had one of those a-ha moments... The day I walked out of AA for good, a gal came up to me afterwards and asked me What was I going to do now that I was leaving? In hindsight, it would have been the most perfect moment to have said, "Woo-hooo!! I'm going to Disneyland!!! " Then I'd drive off into the sunset! Down the ocean highway! With the wind of freedom blowing through my hair! Instead, however, I quickly replied, "I'm going to become an activist, that's what!" I said it kind of in a kidding manner, but I see now what the mind can really DO. What I tell myself, and what I CALL myself, truly can & does indeed manifest.

Hi everybody. My name is rainbow, and I'm an activist. ; )

~~~~~~~~~~~~~~~~~~~~~~~~~

People attended AA on a voluntary basis ONLY and if you heard the old timers in the 1980's they began blaming the court system for some of their woes. A few home groups refused to sign court slips. Many people left the centrally located clubhouses (usually in or within a few mile of a downtown area) and started opening up clubhouses in the burbs. This was all part of an attempt to shake off some of the low lifes sent by the court system.
You have to remember that people are and should be free to associate among whomever they choose in a free society and in the beginning of AA people did just that.
However, the bedfellowship with the medical industry and the roots of religion created an alliance that was bound to bring trouble. The third component, the court system, was and is a disaster for AA.
This is one of the main reasons AA is imploding. People should NEVER, I repeat NEVER be forced to associate with anyone or any group in a free society. Mandating people into the cult sowed the seeds of destruction....thank goodness.
We need to see the destruction of AA. It is an idea whose time has come.

Anthro

live_free_or_die's picture

There was the so called "white" flight to the burbs, now I am hearing, for the first time, there was also a "drunk flight" to the burbs as well?

Alcoholics Anonymous: MyNotGodHasItCovered®
http://www.expaa.org/
http://bereanresearch.com/
http://badrecovery.blogspot.com/
NOT AA:
Rational Recovery, SOS, HAMS
http://alcoholabusesolutions.com/