This year, NATW happens from October 17th to October 23rd. The goal for NATW 2022 is to raise awareness about two important facts related to addiction treatment:
- The need for physicians in training to specialize in addiction treatment
- The gap between the number of people who need addiction treatment and the number of people who receive addiction treatment
Here’s who the sponsors at the ASAM describe NATW 2020:
“A week dedicated to recognizing the critical gap between the number of patients who need addiction treatment and qualified medical professionals available to treat patients using evidence-based approaches.”
The goal of this article is the same as the goals for NATW: raise awareness about addiction, addiction treatment, and the fact that there are more people who need addiction treatment than get addiction treatment, and the fact that right now in the U.S., there are more people who need addiction treatment than there are addiction professionals – especially physicians – trained to treat them.
The Two Treatment Gaps: The Provider Gap and the Treatment-Engagement Gap
We’ll start with that first one: the provider gap.
Here’s the latest data from the ASAM:
- Over 2 million people in the U.S. report opioid addiction
- Only 2% of all providers are trained to provide medications for addiction
- Close to 90% or rural counties in the U.S. do not have sufficient providers to meet the addiction treatment needs of the county residents
- The most recent detailed data we have on the provider gap, from the publication
“Examining Substance Use Disorder Treatment Demand and Provider Capacity in a Changing Health Care System: Final Report” shows the following facts for the period between 2003 and 2013:
- Demand for treatment rose by 14%
- Capacity for treatment rose by 4%
In light of the increase in need for treatment since 2013, caused by the worsening opioid crisis and exacerbated by the mental health stressors associated with COVID-19, we know that in the past five years, demand continues to outpace capacity.
This is our call for any aspiring physicians who may read this article: we encourage you to consider specializing in addiction medicine and addiction treatment. Millions of people need you. You can make a real, positive impact in any location you choose or prefer: rural areas, urban areas, suburban areas, and everywhere in between need your commitment and expertise – and they need it as soon as possible.
That’s the provider gap.
Now let’s look at the treatment engagement gap.
The SUD and AUD Treatment Gap: Facts and Figures
These are the latest statistics on the prevalence and treatment of addiction in the U.S., according to the 2020 National Survey on Drug Use and Health (2020 NSDUH):
- 28 million people ages 18 and over met clinical criteria for alcohol use disorder (AUD), the term mental health and treatment professionals now use instead of alcohol abuse, alcohol addiction, or alcoholism
- Of these 28 million:
- Only 7% received treatment for AUD
- Only 3% received specialized treatment for AUD
- 17 million people ages 18 and over met clinical criteria for substance use disorder (SUD), the term mental health and treatment professionals now use instead of drug abuse or drug addiction
- Of these 17 million:
- Only 14% received treatment for SUD
- Only 2% received specialized treatment for SUD
- Of these 17 million:
- Of these 28 million:
Those numbers illuminate the treatment gap for everyone to see. It’s larger than most of us realize. Here’s another way to present the treatment gap:
- 93% of the people who need help for AUD didn’t get any treatment at all
- 97% of the people who needed help for AUD didn’t get specialized treatment for AUD
- 86% of the people who need help for SUD don’t get the treatment they need
- 98% of the people who needed help for SUD didn’t get specialized treatment for SUD
When we write it that way it’s more effective, and allows us to communicate our primary message more directly: far fewer people receive treatment than need treatment.
The Treatment Gap: Opioids and Opioid Use Disorder (OUD)
One reason awareness weeks like National Addiction Treatment Week are important is because we have the knowledge, skill, and capacity to offer people with AUD, SUD, or both, a wide range of evidence-based, effective treatments. Sometimes the hardest part is getting them on the path to recovery. That takes everyone’s help: peers, family, friends, and community.
Over the past three decades, one way the substance use disorder problem in the U.S. has manifested most obviously is in what we call the opioid epidemic or the opioid crisis. If you’ve never heard of the opioid crisis, it began in the mid-1990s – and due to complex combination of factors – has gotten steadily worse, with a brief exception between 2017 and 2018.
Here are the latest facts and figures related to the opioid crisis in the U.S.:
- Since 1999, almost a million people – 932,000 – in the U.S. have died from a drug overdose
- Around 70% of those deaths were opioid-related
- Between 2019, and 2020:
- Overall opioid-related fatal overdose increased 38%
- Synthetic opioid-related fatal overdose increased by 56%
- Prescription opioid-related fatal overdose increased 17%
Now let’s look at the treatment numbers for people with OUD, and learn if there’s a significant treatment gap.
In the U.S. in 2020:
- 1% of people – around 2.6 million – met clinical criteria for opioid use disorder (OUD)
- Of those 2.6 million, 11% – around 275,000 people – received medication assisted treatment (MAT), which is the most effective evidence-based treatment for opioid use disorder (OUD)
That means there is, indeed, a significant treatment gap for people with OUD: 89 percent of the people who need treatment do not get the best treatment available for OUD. We have the tools and knowledge to help everyone with OUD.
What we need more of is awareness.
How We Can All Help
The way we can help during National Addiction Treatment Week is simple, but it might not be easy. It’s simple because what you need to do is follow the steps we outline below. It might not be easy because not everyone wants to hear about tough topics.
However, in order to heal the addiction crisis in the U.S., we need help.
Here’s what we can all do:
- Tell anyone you know that the disordered use of substances – a.k.a. addiction – is a treatable medical condition
- Tell anyone you know that evidence-based treatment can and does work for millions of people across the U.S. and the world every day
- Inform friends, family, and colleagues that roughly nine out of ten people who need treatment for addiction do not get the treatment they need.
- Tell them the situation is serious in 2021 in the U.S., over 100,000 people died of drug overdose
- Finally, let them know that the sooner a person who needs treatment for addiction, the more likely they are to achieve sustainable, long-term recovery
If we all work together to spread this information, we can reduce the treatment gap, both for medical professionals providing treatment and the people with addiction disorders who need evidence-based treatment right now.