Addiction Medicine: Closing the Gap between Science and Practice

4.7

4.8

5.4

6.6

9.2

9.4

18.0

27.9

41.1

53.6

Cancer

Asthma

Diabetes

Smoking

Heart Disease

Obesity

Depression

Addiction-Alcohol

Addiction-Prescription Drugs

Addiction-Illicit Drugs

* Among those who responded "somewhat less or much less likely".

Source: CASA Columbia National Addiction Belief and Attitude

Survey (NABAS), 2008.

P E R C E N T

Figure 7.N

Participants Reporting They Would Be Less Likely*

to Hire a Qualified Candidate in Recovery

from/Treated for Each Condition:

for obesity or heart disease and about five
percent said the same for diabetes, asthma or
cancer.* 117 (Figure 7.N)

Another study found that 43 percent of the
public would be less likely to vote for a
gubernatorial candidate who was in recovery
from addiction involving alcohol or other drugs
(excluding nicotine).^118

Discrimination against those with addiction is
manifested on the governmental and institutional
levels as well. Insurance companies generally
provide less coverage for addiction treatment
services than for other medical services.^119
Although the passage of the Paul Wellstone and
Pete Domenici Mental Health Parity and
Addiction Equity Act (MHPAEA) of 2008, and
the subsequent 2010 Patient Protection and
Affordable Care Act, were significant
breakthroughs, the laws contain exemptions and
loopholes that may continue to limit access to
addiction treatment.† 120

* The stigma associated with addiction is

compounded by its high rate of co-occurrence with
mental illness.
† For example, MHPAEA does not require health

insurance plans to offer coverage for mental health or
addiction treatment services, employers with fewer
than 50 employees are not covered by the law, and if
the projected cost increase is too high for health

Perhaps because of the lingering view that

addiction results from lack of will power or self

control that can be remedied with a simple

change of mind, stigma and

discrimination against addicted

individuals are all too common.

Recent research finds that people

with addiction are seen as more

blameworthy and dangerous

compared to individuals with a

“mental” illness, and those with

a “mental” illness are viewed

more negatively than those with

a “physical” illness.

Consequently, those with

addiction are avoided more and

helped less.^121 Research also

indicates that enhancing the

public’s understanding of

addiction or mental health

disorders as having a

neurobiological basis relates to

increased public support for providing treatment

services to individuals with these conditions, but

has not yet translated into less of a stigma or

discrimination associated with these

conditions.^122

Privacy Concerns .......................................................................................................

Because of negative public attitudes toward

addiction and the consequent potential for

stigma and discrimination, prospective patients

for addiction treatment may have concerns about

the extent to which their identity and the details

of their treatment will stay private and

confidential.^123

Prospective patients sometimes believe that

providers violate patients’ confidentiality.^124

insurance plans (more than two percent in the first

year and more than one percent in subsequent years),

then insurance companies may request an exemption

from the law. Under the ACA, mental health and

addiction treatment services must be offered in

individual and small group health plans as part of

essential health benefits, but the scope of these

benefits will likely vary by state. See Chapter VIII

for a more complete discussion of health insurance

coverage for addiction prevention and treatment

services.