2023 Addiction Medicine Essentials

ALL CLINICIANS HAVE A ROLE

Substance use disorder (SUD) is the nation’s largest preventable health problem, affecting nearly 17% of the 12 and over population. The effects of SUD are broadly destructive and traumatic for individuals and families and devastating for communities. The US expends an estimated $600 billion every year in health and crime-related costs and lost productivity (Healthy People 2020, NIDA InfoFacts). Despite the alarming prevalence and broad impact, according to the 2021 National Survey on Drug Use and Health, only 6% of those classified as having substance use disorder receive treatment. We are all impacted, and clinicians play a critical role in connecting more patients with appropriate treatment services.

In 2021, 29.5 million people were classified as having an alcohol use disorder and 24 million with a drug use disorder (NSDUH, SAMHSA 2021). A staggering 94% of these individuals received no treatment. The wide treatment gap is multifactorial in nature, but physicians and other healthcare providers bear some of the responsibility due to a general lack of knowledge/skills as well as bias and stigma.

ALL healthcare providers can play a role through prevention (safer pain management/opioid prescribing practices, education), identification (screening in the workflow of clinic/ED), treatment (counseling or office-based opioid treatment in a non-addiction setting), and/or referral. It is critical providers confront personal biases and challenge stigmas that are often responsible for suboptimal SUD prevention, identification, and care. Additionally, many individuals with SUDs are hesitant to bring up SUD because they fear judgment or don’t think they need treatment. Providers play a vital role in bridging the gap, establishing patient awareness, and supporting intervention and recovery.

Historically, SUD training has received little attention in medical education. As a result, many healthcare providers feel they don’t possess the knowledge or skills to competently care for patients. Providers are often unfamiliar with available tools and resources and feel ill-equipped. The enormity of the problem and the vast fallout cannot be ignored. Addiction is destroying lives and it is incumbent upon all providers to step up. Fortunately, medical and APP schools are making strides in providing more comprehensive training and clinical exposure to addiction medicine.

Sometimes referral will be indicated. Individuals with moderate and severe SUDs, addiction, and complex co-morbidities often need the care of physicians and advanced practice providers (APP’s) who specialize in addiction – clinicians with advanced training in science-driven and evidence-based treatment. Many patients with less severe illnesses, however, can be identified and treated effectively by non-specialists in a variety of care settings.

The Governor’s Institute is committed to developing and supporting a workforce that is better equipped to meet the needs of patients with SUDs, by offering training and technical assistance that ensures clinicians have the knowledge and skills to provide high-quality, science-based services. We invite you to partner with us by attending our conferences, accessing online CME opportunities, and viewing short clips that address specific substance use content. Let us share our materials and connect you with other addiction medicine providers and resources in your community. And become a member of the NC Chapter of ASAM.

Join the addiction medicine movement in NC and play a role in life-changing lifesaving care!

For additional information please visit addiction-medicine.org or ncsam-asam.org or contact Pollen Williamson at pollen@govinst.org.