The Washington Post recently called attention to a terrible but widespread phenomenon: the fact that “most doctors fail to identify or diagnose substance abuse.” Moreover, even when addiction or substance abuse is recognized in a patient, physicians often have no idea what to do about it. Why? Because of the 985,375 practicing U.S. physicians, only 1,200 are trained in addiction medicine. This disconnect contributes greatly to the disturbing statistic that only ten percent of the millions who need substance abuse treatment actually receive it.
Luckily, new training curricula are being introduced across the country to remedy this knowledge gap, offering residencies in addiction medicine to physicians who are specializing in other areas. Getting physicians involved in the screening and early intervention process will be key to helping more people get help. After all, many folks don’t get treatment simply because they don’t think they need it; there’s an old saying that addiction is the only disease that tricks you into thinking you’re not sick.
I applaud programs that teach doctors how to identify and deal with substance abuse in their patients—and increased funding for these initiatives is crucial. Historically, addiction treatment has been outside the realm of mainstream medical care. But with health care reform, there’s a greater emphasis on treating substance abuse within the medical community; we will see more and more trained specialists, plus all doctors will receive basic training in addiction treatment. Like other chronic diseases – cancer or diabetes, for example – addiction should be one of the many bases covered in a medical school’s core curriculum.
What Jeffrey Samet says is in the Post article is absolutely true: “If you don’t address drug or alcohol abuse, you can’t begin to control a patient’s diabetes.” When someone comes into the hospital with a bleeding ulcer caused by their excessive drinking, you can’t just treat that ulcer and ignore the underlying issue. Addiction treatment benefits the entire medical field, and we need more doctors on the case. We need a workforce that understands the importance of treating this disease. Physical and mental health professionals alike must understand that while it’s difficult to help a patient address drug or alcohol problems, it’s still essential. Effective care can save that person’s life.
Deni Carise, Ph.D.
Chief Clinical Officer