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.”
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."