Addiction Medicine: Closing the Gap between Science and Practice

65.7

60.0

50.1 47.1

17.3 21.1

29.7

20.8

8.8

14.6 17.6

22.7

4.0 1.5 0.8 3.5

Illicit Drugs Alcohol Tobacco Prescription Drugs

P E R C E N T

Source: CASA Columbia National Addiction Belief and Attitude Survey (NABAS), 2008.

Figure 5.B

Public Perceptions of the Goals of Treatment

Complete

Abstinence

Goal Set by

Patient

Reduced Use

Fewer Negative

Consequences

percent), cocaine (76.0 percent) or

methamphetamine (73.9 percent) indicates

that the user has a serious problem and

should seek treatment.

 42.5 percent thought that any misuse of a
controlled prescription drug is a serious
problem requiring treatment; 29.6 percent
thought that daily or more than daily misuse
of these drugs is serious enough to require
treatment.

 35.8 percent felt that any use of marijuana
indicates that the user has a serious problem
and should seek treatment; the same amount
(35.9 percent) thought that daily or more
than daily use of marijuana is a serious
problem that requires treatment.

 78.0 percent reported
that alcohol use is a
serious problem
requiring treatment if
it occurs daily or
more than daily; 6.8
percent reported that
any drinking is a
serious problem
requiring
treatment.^427

 49.5 percent felt that
smoking was a
serious problem
requiring treatment if
it occurred on a daily or more than daily
basis; 24.3 percent reported that any
smoking is a serious problem requiring
treatment.

Perceptions of the Goals of Treatment .......................................................................

From a medical perspective, the goal of
addiction treatment would be to restore and
maintain health and eliminate or reduce risky
behavior that threatens health and safety. Most
respondents to the NABAS* indicated that

• In the NABAS survey, respondents were asked

which of the following they thought should be the
main treatment goal for someone with addiction

complete abstinence should be the main goal of

treatment for individuals with addiction

involving illicit drugs (65.7 percent), alcohol

(60.0 percent), tobacco (50.1 percent) or

controlled prescription drugs (47.1 percent).

Whereas the next most common response for the

goal of addiction treatment was that the goal

should be set by the patient, a small but

significant proportion indicated that reduced use

should be the primary goal; this was particularly

true for addiction involving prescription drugs,†

tobacco and alcohol, but less so for addiction

involving illicit drugs. A focus solely on

reducing the negative consequences of substance

use (the “harm reduction” approach) rather than

reducing or eliminating use was endorsed by

fewer than five percent of the respondents as a

main goal of treatment.^428 (Figure 5.B)

involving tobacco, alcohol, illicit drugs and

prescription drugs: complete abstinence, reduced

use, fewer negative consequences from use, or that

the goal should be set by the patient.

† For prescription drugs, reduced use was a more

common response (22.7 percent) than that the goal

should be set by the patient (20.8 percent).