Chapter VII
The Addiction Treatment Gap
In spite of the facts that 15.9 percent of the U.S.
population ages 12 and older report meeting
clinical criteria for addiction and that evidence-
based interventions and treatments are widely
available, research clearly indicates that only a
small fraction of those in need of addiction
treatment receives it and, of those who do, few
receive evidence-based care. Determining the
exact size and shape of the addiction treatment
gap in this country is impossible due to
significant data limitations;* however, 89.1
percent of those who meet criteria for addiction
involving alcohol and drugs other than nicotine
report receiving no treatment† at all.‡ 1* There are no national data on the total number of
people who receive treatment for the disease. Rather,
existing data on addiction treatment exclude
addiction involving nicotine, and data on the types of
services offered and venues in which they are
provided are available only for providers that receive
public funds. Because some addiction treatment
providers accept both public and private funding, the
available data on providers serving publicly-funded
patients also include an unidentifiable number of
patients who receive private funding.
† For the purposes of the present analyses, treatment
includes: (1) services received at non-intensive or
intensive non-residential settings (including alcohol
or other drug rehabilitation facilities, mental health
centers or facilities or doctors’ or mental health
professionals’ private offices); and (2) short- or long-
term residential settings (including alcohol or other
drug rehabilitation facilities, hospital or mental health
centers or facilities) in the past 12 months.
Detoxification, services received in an emergency
department or in prison or jail settings, mutual
support programs, peer counseling and other support
services (including religious-based counseling) are
excluded from these analyses.
‡ While 31.7 percent of the U.S. population ages 12
and older engage in risky use but do not meet criteria
for addiction, there has been no attempt to document
nationally the proportion of this population that
receives evidence-based screening and brief
interventions, leaving the size of the intervention gap
for risky users unknown. Therefore, this chapter
focuses exclusively on the treatment gap for
individuals with addiction.