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Why Doctors Don’t Treat Addiction

Physician training in drug and alcohol abuse is almost nonexistent. New hospital addiction residencies will help.

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Mutual distrust between doctors and addicts.
Photo via thinkstockphotos

By Dirk Hanson

06/15/11

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What doctors don’t know about addiction could fill a book. A textbook, actually. If there is one thing most workers in the field of addiction treatment can agree upon, it is that doctors are inadequately trained to deal with addicted patients. The American Board of Addiction Medicine (A.B.A.M.) knows this is true, and will shortly begin training about 20 doctors in the first 10 accredited residency programs in the board’s history. The A.B.A.M. began operation in 2007, and currently has 2,500 certified addiction physicians. Dr. Kevin Kunz, the board’s president, said it was really quite simple--physician training in addiction medicine is almost nonexistent. “We think that medicine and the nation are now ready to address the primary care of addiction and not just the consequences,” he said.

The first residence programs will take place at St. Luke’s-Roosevelt Hospital in New York, and also at the Boston Medical Center, where researchers earlier reported that national “education on addiction is inadequate during medical training, resulting in suboptimal medical care for those at risk.” Joseph Califano Jr. of Columbia University’s National Center on Addiction and Substance Abuse told a conference: “Although doctors and nurses have the best opportunity to intervene with alcoholics and substance abusers, our research indicates they are woefully inadequate at even diagnosing someone with this disease." Surveys conducted by the center showed that 90% of primary care doctors fail to offer a diagnosis of addiction even in patients clearly displaying classic hallmarks of the condition.

To be fair, however, the plight of doctors in this regard is not to be underestimated. Dr. Catherine D. DeAngelis, editor-in-chief of the Journal of the American Medical Association, told the New York Times that “caring for patients with substance abuse is one of the most difficult things I have ever had to deal with as a doctor.... When the ailment in question carries a substantial behavioral component, like substance abuse, physicians get frustrated and don’t do as well.”

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