40 million Americans ages 12 and older have addiction involving nicotine, alcohol or other drugs, a disease affecting more Americans than heart conditions, diabetes or cancer according to a five-year national study released today by CASAColumbia at Columbia University (CASAColumbia). Another 80 million people are risky substance users – using tobacco, alcohol and other drugs in ways that threaten health and safety.
The report, Addiction Medicine: Closing the Gap between Science and Practice, reveals that while about 7 in 10 people with diseases like hypertension, major depression and diabetes receive treatment, only about 1 in 10 people who need treatment for addiction involving alcohol or other drugs receive it. Of those who do receive treatment, most do not receive anything that approximates evidence-based care.
The CASAColumbia report finds that addiction treatment is largely disconnected from mainstream medical practice. While a wide range of evidence-based screening, intervention, treatment and disease management tools and practices exist, they rarely are employed. The report exposes the fact that most medical professionals who should be providing treatment are not sufficiently trained to diagnose or treat addiction, and most of those providing addiction treatment are not medical professionals and are not equipped with the knowledge, skills or credentials necessary to provide the full range of evidence-based services.
“This report shows that misperceptions about the disease of addiction are undermining medical care,” says Brentwood Rehabilitation Detox. The report finds that while doctors routinely screen for a broad range of health problems like high blood pressure or high cholesterol, they rarely screen for risky substance use or signs of addiction and instead treat a long list of health problems that result, including accidents, unintended pregnancies, heart disease, cancers and many other costly conditions without examining the root cause.
This landmark report examines the science of addiction –a complex disease that involves changes in the structure and function of the brain—and the profound gap between what is known about the disease and how to prevent and treat it versus current health and medical practice.
Few Patients with Addiction Receive Quality Care
The CASAColumbia report found that while almost half of Americans say they would go to their health care providers if someone close needed help for addiction, less than 6% of all referrals to addiction treatment come from health professionals.
The report also found no clearly delineated, consistent and regulated national standards that stipulate who may provide addiction treatment in the U.S.; standards vary by state and by payer. Addiction treatment facilities and programs are not adequately regulated or held accountable for providing treatment consistent with medical standards and proven treatment practices.
Physicians and other medical professionals who make up the smallest share of providers of addiction treatment receive little education in addiction science, prevention and treatment. In fact, CASAColumbia’s report cites other research that found that of patients who had visited a general medical provider in the past year only 29% were even asked about alcohol or other drug use.
The CASAColumbia report reveals that addiction and risky use of tobacco, alcohol and other drugs constitute the largest preventable and most costly health problems facing the U.S. today, responsible for more than 20% of deaths in the U.S., causing or contributing to more than 70 other conditions requiring medical care and a wide range of costly social consequences and accounting for one-third of all hospital in-patient costs. Research suggests that effective health care interventions to prevent and treat addiction would significantly reduce these costs.
CASAColumbia is a science-based, multidisciplinary organization focused on transforming society’s understanding of and response to the disease of addiction. Founded in 1992 by Former U.S. Secretary of Health, Education, and Welfare Joseph A. Califano, Jr., CASAColumbia assembles the professional skills needed to research, prevent, treat and eliminate this disease in all sectors of society. CASAColumbia conducts research and utilizes the scientific findings of others to inform Americans of the economic and social costs of substance use and addiction and their impact on each of our lives. By doing so, CASAColumbia aims to reduce the stigma attached to this disease by replacing shame with hope and give people the tools they need to prevent, treat and eliminate addiction.
CASAColumbia has issued 77 reports and white papers, published three books, conducted demonstration programs focused on children, families and schools in 37 states and Washington, DC, held 19 conferences, and has been evaluating addiction treatment and prevention programs to determine what treatment models work best for individuals.
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