Addiction medicine: closing the gap between science and practice.

CASA Columbia’s new five year national study reveals 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, including pharmaceutical and psychosocial therapies and other medical care. 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 we know about the disease and how to prevent and treat it versus current health and medical practice. Highlights from the report: • Forty million Americans ages 12 and older (16 percent) have the disease of addiction involving nicotine, alcohol or other drugs, a disease affecting more Americans than heart conditions, diabetes or cancer; another 80 million people are risky substance users – using tobacco, alcohol and other drugs in ways that threaten health and safety. • 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 while the number receiving treatment for nicotine is not even known. • Addiction treatment facilities and programs are not adequately regulated or held accountable for providing treatment consistent with medical standards and proven treatment practices. • In 2010 only $28 billion was spent to treat the 40 million people with addiction. In comparison, the United States spent: $44 billion to treat diabetes which affects 26 million people; $87 billion to treat cancer which affects 19 million people; $107 billion to treat heart conditions which affect 27 million people