-i-Accompanying Statement by
Drew E. Altman, PhD, Chair, The CASA Columbia
National Advisory Commission on Addiction Treatment
In homes, doctors’ offices, hospitals, schools,
prisons, jails and communities across America,
misperceptions about addiction are undermining
medical care. Although advances in
neuroscience, brain imaging and behavioral
research clearly show that addiction is a
complex brain disease, today the disease of
addiction is still often misunderstood as a moral
failing, a lack of willpower, a subject of shame
and disgust. Addiction affects 16 percent of
Americans ages 12 and older--40 million people.
That is more than the number of people with
heart disease (27 million), diabetes (26 million)
or cancer (19 million). Another 32 percent of
the population (80 million) uses tobacco, alcohol
and other drugs in risky ways that threaten
health and safety.Like other public health and medical problems,
we understand the risk factors for addiction. We
have effective ways of screening for risky use
and intervening. While as of now there is no
cure for addiction, there are effective
psychosocial and pharmaceutical treatments and
methods of managing the disease. But as this
landmark report by CASA Columbia shows in
sharp detail, this is where the comparison with
other health conditions ends. Unlike other
diseases, we do little to effectively prevent and
reduce risky use and the vast majority of people
in need of addiction treatment do not receive
anything that approximates evidence-based care.The medical system, which is dedicated to
alleviating suffering and treating disease, largely
has been disengaged from these serious health
care problems. The consequences of this
inattention are profound. America’s failure to
prevent risky use and effectively treat addiction
results in an enormous array of health and social
problems such as accidents, homicides and
suicides, child neglect and abuse, family
dysfunction and unplanned pregnancies. CASA
Columbia estimates that risky substance use and