Inadequate Integration
of Addiction Care into Mainstream Medical Practice
Addiction prevention and treatment are for the most part removed from routine medical practice.
Ponder the lost opportunity to identify and intervene earlier in addiction.
80% of Americans visited at least one physician or other health care professional in the past year
More than 2/3 of people with addiction are estimated to be in contact with a primary or emergency care physician about twice a year.
Yet most physicians and other health professionals do not identify or diagnose addiction; focus only on the secondary and tertiary complications of addiction; and do not know what to do with patients who present with identifiable and treatable signs and symptoms
→ This allows a public health epidemic to advance unchecked.
Physicians and Other Health Professional Should Be on the Front Line Addressing this Disease
and “Most People in Need of Treatment Do Not Receive It
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 – the number receiving treatment for nicotine is not even known.
Forty million Americans ages 12 and older (16 percent) have the disease of addiction involving nicotine, alcohol or other drugs.
Addiction affects 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.
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 affects 27 million people.
→ The people who need treatment don’t come to traditional addiction treatment providers. They are in general healthcare settings.
→ Not only do the addiction and mental health fields need to integrate better, but also behavioral health needs to integrate better with general healthcare.
→ Addiction treatment providers should establish an office or presence in the general health centers and emergency departments –
maybe even in shopping malls!
→ With the ACA and healthcare reform and new financing models of Accountable Care Organization (ACOs), Medical and Health Homes population-based care and financing will increase dramatically.
→ If the ACA really works, there will be millions more clients eligible for definitive addiction treatment who now are not covered by insurance or public funding.
Most Referrals to Publicly Funded Treatment Come from the Criminal Justice System
Only 5.7% of referrals to publicly funded treatment come from a health care provider.
In contrast, a full 44.3% are referrals are from the criminal justice system.
Thus addiction is addressed only at the point when it causes profound social consequences.
→ These discrepancies in referral patterns underline the need to expand outreach and integration with general healthcare settings.
→ Increase and improve dialogue between treatment providers and Justice services to move beyond compliance and doing time
to doing treatment that translates into the outcomes everyone wants: decreased legal recidivism;
increased public safety; safety for children and families;
and accountable self change that lasts way beyond the time when the mandating agency now orders compliance.
© 2012 – David Mee-Lee, M.D. | 5221 Sigstrom Drive | Carson City | NV | 89706