Resolutions: Nation’s #1 Preventable Health Problem
By Dr. James Palermo // December 30, 2012
BREVARD COUNTY, FLORIDA–The results of a recently reported study , titled “Addiction Medicine: Closing the Gap Between Science and Practice,” by the National Center on Addiction and Substance Abuse (CASA) at Columbia University reveals that about 40 million U.S. residents—or 16 percent of residents ages 12 and up—are addicted to nicotine, alcohol, or other drugs.
The study also suggests that 80 million Americans–32 percent of the population– can be classified as “risky” substance users, individuals who use substances in a manner detrimental to their health and safety.
Despite the prevalence of this dangerous behavior in our society, adequate treatment is not readily available, and only about one in 10 people who need treatment for their addiction actually gets it. In comparison, about 70% of individuals with hypertension, major depression, or diabetes receive needed treatment.
Treatment for addiction is traditionally “disconnected from mainstream medicine,” according to a Columbia University news release reporting on the study, and most health care providers are not trained to diagnose or treat addiction. As a result, less than 6 percent of referrals to treatment facilities for substance abuse come from health professionals.
“Right now there are no accepted national standards for providers of addiction treatment,” said Susan Foster, CASA Columbia’s Vice President and Director of Policy Research and Analysis, who was the principal investigator for the report. “There simply is no other disease where appropriate medical treatment is not provided by the health care system and where patients instead must turn to a broad range of practitioners largely exempt from medical standards. Neglect by the medical profession has resulted in a separate and unrelated system of care that struggles to treat the disease without the resources or knowledge base to keep pace with science and medicine.”
Primary care screening for a variety of health problems, such as high blood pressure, high cholesterol, diabetes and certain tumor markers are routine, but patients are rarely routinely screened for substance abuse.
Instead of efforts to preemptively change destructive behavior, patients end up being treated for the fallout of the addiction — injuries, unintended pregnancies, heart disease and cancers, said Drew Altman, chairman of the report’s National Advisory Commission and president of the Henry J. Kaiser Family Foundation, a nonprofit health-policy analysis organization.
Professional and financial resources devoted to addiction-treatment are limited in many states despite CASA’s findings that addiction and risky use of tobacco, alcohol, and other substances represent the largest preventable health problem in the United States. Specifically, they found that addiction and risky substance use:
- Account for more than 20% of U.S. deaths;
- Contribute to more than 70 other conditions that require medical care; and
- Account for one-third of overall hospital inpatient costs.
The United States also spends significantly less on addiction treatment than on treatment for other conditions. For example, the country spent $44 billion on 26 million diabetes patients and $107 billion on 27 million heart disease patients, but only $28 billion on 40 million patients with addiction.
Current funding, intervention and treatment approaches must be comprehensively changed to bring practice in line with the scientific evidence and with the standard of care for other public health and medical conditions. “It is time for health care practice to catch up with the science. Failure to do so causes untold human suffering and is a wasteful misuse of taxpayer dollars,” noted Director Foster.