Study Shows Gap Between Addiction Science and Treatment

We know more than ever before about the disease of addiction through medical research, science, and factual, evidence-based studies. According to an extensive, five-year study by CASAColumbia, however, when it comes to actual treatment for the disease of addiction, that science is largely ignored. The study shows a significant gap between the evidence and practice of addiction medicine.

Addiction Medicine: Closing the Gap Between Science and Practice was published by The National Center on Addiction and Substance Abuse at Columbia University (CASAColumbia) in July of 2012. The report details the results of the nationwide survey that took an in-depth look at how medical knowledge of the disease of addiction is actually used in the treatment of addiction, as well as public perceptions regarding addiction and the costs of addiction to society as a whole. The results are shocking.

science and addiction

“No National Treatment Standards to Assure Quality Care”

The report finds that most of the addiction treatment centers do not make sufficient use of medical knowledge in the care they provide. Most of the people who are providing addiction treatment are not medical professionals, and they are not trained on evidence-based methods of diagnosing and treating addiction. In short,, we have vast knowledge and research on treating the disease of addiction from a medical perspective that is not being used where it’s needed most.

The report also examines the varying state requirements for people who treat addiction or provide addiction counseling. Most aren’t required to have any medical training, and some states don’t even require any type of advanced education degree or certification.

“Few Patients with Addiction Receive Quality Care”

In addition, doctors and medical professionals should be properly trained on how to prevent, diagnose, and treat addiction, but the report finds that most aren’t. It was found that only 29 percent of doctors even asked about alcohol or drug use during routine medical screenings. Out of people in treatment centers for addiction, only 6 percent were referred there by a doctor.

When you consider how many people in the country are affected by addiction, it gives an even clearer picture of just how little is done to prevent, diagnose, and treat addiction from a medical standpoint. It’s estimated that 40 million Americans – or 16 percent of the country – have the disease of addiction, and another 80 million Americans – or 32 percent of the country – use tobacco, alcohol, and other drugs in a risky or unsafe manner. Only 1 out of 10 of people who need addiction treatment actually receive it.

“The Most Costly Health Problems Facing the U.S. Today”

The disease of addiction is estimated to be responsible for 20 percent of deaths in the U.S., as well as one-third of hospital inpatient costs. Addiction contributes to more than 70 conditions that require medical care. The report finds that addiction is the most costly – and the most preventable – public health issue today. Of local, state, and federal government spending on addiction, 95 percent goes to paying for the consequences of addiction, while only 2 percent of spending goes to preventing and treating addiction.


CASAColumbia’s report also lists a number of recommendations to improve addiction treatment in the country. It says much more needs to be done to modernize addiction treatment, so that it incorporates all the scientific findings and medical research we have on the disease of addiction, which clearly show that addiction involves changes in the structure and function of the brain, and thus requires medical treatment. It also recommends that national treatment standards for addiction treatment be implemented.

CASAColumbia also calls for greater public education on the disease of addiction in order to help reduce the social stigma and misconceptions associated with addiction. It believes that one of the reasons addiction treatment is so insufficient is that many people attribute addiction to a person’s poor decision-making or lack of willpower, rather than a disease of the brain. The report also finds that more emphasis needs to be placed on preventing addiction, as well as treating addiction as a chronic disease that requires long-term care rather than an acute condition.

This report is of incredible importance to advancing and improving addiction treatment, and it remains to be seen what types of positive changes it can inspire the medical community, the addiction treatment community, and the public at large.


  1. says

    I am a woman in long term recovery who works with people in this crisis everyday. I am not academic and do not possess any licenses, nor do I wish to based on the evidence. I however come to the table with 30 years of experiential knowledge having battled with my disease of addiction. With that said, maybe just maybe science has it backwards! Yes, it helps to have evidence that addiction changes the molecular structure of the brain, but at the grassroots level this disconnect is really between treating people like people rather than putting them into a science jar or attaching a diagnoses which puts them in a box. The scientists cannot help the trauma that people have gone through that causes them to want to numb themselves. The scientists are not holding these peoples hands who are terrified and ashamed and guilt ridden! The person, using me as an example, doesn’t care what science has to say. Some of us just look for a quick fix to feel better! Instant gratification is the problem and the doctors and pharmaceutical companies and quite frankly scientists have capitalized on this fact! The medical community is the leading contributor to the problem by placing labels on people which have caused these people to become dependent on medications rather than holistic approaches to this disorder. People are multidimensional mind, body, spirit. We have spent the last 20 years focusing on the body, lets spend research dollars focusing on the other components of the human being! Let us focus on training people on trauma informed care, let’s support the holistic community and pursue faith based organizations for the spiritual components. Let us look at building up peer centered organizations. Let us upon our hearts and our minds and actually listen to the people that are suffering, including their family members. Let us get to a practical multi faceted approach as this problem. Let us utilize a team approach for the individual and their family . It is quite infuriating for society, science, government, and the medical community to look down from their perch at us, when all we want is understanding about how to stop doing the things that are destroying our lives. Most of us don’t want to be medicated we want to be understood and loved! Most of us just need to be taught that the trauma we suffered does not have to happen again and that we can pick up and start again. Most of us have to be taught that it is okay to not be okay with feelings that are intolerable. Most of us have to be taught that the pain of our feelings won’t kill us! Most of us have to be taught that we don’t have to be afraid of what others think of us. In the meantime I pray that the medical community can hear this!! Peace

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