-iii-This report focuses long overdue attention on the
disease of addiction. It clarifies the important
difference between this disease and risky use of
addictive substances; identifies the human and
economic costs of our current approach to these
health problems; and documents the breadth of
available knowledge on how to prevent risky use
and treat addiction.
As our nation struggles to reduce skyrocketing
health care costs, there are few targets for cost
savings that are as straightforward as preventing
and treating risky substance use and addiction.
This report shows that modest public health
interventions and relatively inexpensive
addiction therapies, compared with other
medical treatments, would reduce this burden
significantly.
The report calls for modernizing addiction
treatment--to harness the scientific knowledge
we have acquired to prevent risky use and treat
this disease. This report is a call to action. Like
the Flexner Report a century ago, it shines a
bright light on the problem and offers a roadmap
for action. Addiction Medicine: Closing the Gap
between Science and Practice represents more
than five years of intensive research, and draws
on policy and treatment research conducted by
CASA Columbia over two decades and on a
wide body of scientific, clinical and policy
research conducted by others. This major
undertaking was the result of the work of a large
team of dedicated individuals and institutions
and was conducted with the able advice and
counsel of The CASA Columbia National
Advisory Commission on Addiction Treatment
which I had the privilege to chair. The
Commission includes an impressive group of
individuals knowledgeable about the many
aspects of substance use and addiction in
America today. We are grateful for their expert
assistance.
The project was made possible by the generous
financial support of The Annenberg Foundation;
The Diana, Princess of Wales Memorial Fund
and The Franklin Mint; The New York
Community Trust; and the Adrian and Jessie
Archbold Charitable Trust.
Peter D. Hart Research Associates conducted the
National Addiction Belief and Attitude Survey
for this report; Survey Research Laboratory
(SRL) of the University of Illinois at Chicago
administered the survey of New York State
addiction treatment providers. We are grateful
to Karen Carpenter-Palumbo, former director of
the New York State Office of Alcoholism and
Substance Abuse Services (OASAS) for helping
to make the New York State survey possible.We thank the following organizations which
generously helped connect CASA Columbia
with treatment providers who participated in a
national online survey of members of
professional associations involved in addiction
care: The American Academy of Addiction
Psychiatry (AAAP); the American Association
for the Treatment of Opioid Dependence
(AATOD); the American Psychological
Association (APA); the American Society of
Addiction Medicine (ASAM); the Association
for the Treatment of Tobacco Use and
Dependence (ATTUD); NAADAC, the
Association for Addiction Professionals; the
National Association of Addiction Treatment
Providers (NAATP); the National Association of
County Behavioral Health and Developmental
Disability Directors (NACBHDD); the National
Council for Community Behavioral Healthcare
(National Council); the State Associations of
Addiction Services (SAAS); and Treatment
Communities of America (TCA). Also, we
thank the following organizations for connecting
us with individuals in long-term recovery for
CASA Columbia’s online survey of this
population: Hazelden, Freedom Institute, Faces
and Voices of Recovery, Betty Ford Center,
National Council on Alcoholism and Drug
Dependence, Inc. (NCADD), Trea tment
Communities of America (TCA), Alcoholism
and Substance Abuse Providers of New York
State, Inc. (ASAP) and an anonymous treatment
program alumni group. Finally, we are grateful
to the 176 key informants who shared their
insight and recommendations.Susan E. Foster, MSW, CASA Columbia’s Vice
President and Director of Policy Research and
Analysis, was the principal investigator and staff
director for this effort. The senior research