Substance Abuse Treatment: Where Are We?

Because the opioid epidemic is such a critical issue to both our nation and our industry, the Cordant news section is launching its first-ever series to look more in-depth at substance use disorder and its treatment options. This first article introduces this complex problem. Later articles will highlight the different types of treatment and the availability of funding for these interventions.

The statistics continue to be grim: By one estimate, 17,536 Americans died in 2015 from overdoses involving prescription and illicit opioids. Physicians and public health leaders largely agree that addiction is a disease that usually requires medical help. But public health agencies estimate that 80%–90% of those who need substance use disorder treatment do not receive it.

There are two major reasons why people go without care. The first is simply that not enough treatment is available, given the numbers who need it. The second is that many people have no access to what care is available. In fact, more than half the counties in the United States have no physicians approved to prescribe medication-assisted therapy, and these same (often rural) counties often have few mental and behavioral health professionals. This fatal combination leaves many Americans with no realistic options for treatment.

To address the epidemic, Congress last July passed the Comprehensive Addiction and Recovery (CARA) Act, the first major federal addiction legislation in 40 years. The CARA act authorizes the Department of Justice and the Department of Health and Human Services to award grants that support such actions as additional treatment programs and improved PDMPs to help monitor and track prescription drug diversion and to help at-risk individuals access services. Funding for these efforts depends on Congressional approval of the act’s inclusion in the federal budget.

Next up:

  • The evidence for medication-assisted therapy.
  • The history and support for abstinence-based therapy.
  • The challenge of funding substance abuse programs.