Addiction Medicine: Closing the Gap between Science and Practice

60.1

39.9

11.7 11.6 10.4

Mutual Support

Program

Hospital Visit Residential

Rehab Clinic

Prescription

Medication

Outpatient

Treatment

P E R C E N T

Source: CASA Columbia National Addiction Belief and Attitude

Survey (NABAS), 2008.

Figure 5.C

Public Perceptions of the Types of Interventions

that Constitute Treatment

82.5 79.9 73.6 73.1

Alcohol Prescription Drugs Illicit Drugs Tobacco

P E R C E N T

Source: CASA Columbia National Addiction Belief and Attitude

Survey (NABAS), 2008.

Figure 5.D

Percent of Public Agreeing that

Addiction Treatment Is Somewhat/Very Effective,

by Substance Involved

Perceptions of the Types of Interventions that Constitute Treatment ........................

Although a wide range of psychosocial and
pharmaceutical therapies are available to
treat addiction, 60.1 percent of respondents to
the NABAS spontaneously offered mutual
support programs such as AA or NA as a
“treatment” intervention when asked what
kinds of treatment come to mind when they
think about treatment for addiction. This is
despite the fact that a mutual support
program, while a very helpful resource to
many individuals with addiction, is not an
evidence-based treatment for the disease.
Forty percent (39.9 percent) mentioned a
hospital visit, 11.7 percent mentioned residential
rehabilitation clinics and 10.4 percent mentioned
outpatient treatment as what comes to mind
when they think of addiction treatment (although
these are treatment venues, not treatments
approaches). Although only 11.6 percent
mentioned the utilization of prescription
medications for treating addiction (Figure 5.C),
a separate question found that 54.7 percent of
respondents (46.8 percent of those with a history
of addiction) stated that it is good that there are
medicines to treat addiction because addiction is
a medical condition that medicine can help.
Perhaps reflective of a lack of knowledge about
effective treatment for addiction, 38.3 percent of
respondents (48.6 percent of those with a
history of addiction) indicated it is not good
news that there are medicines to treat
addiction because treating addiction with
medication only serves to replace one
addiction with another.^429

Some individuals with addiction may not
access appropriate treatment because of the
belief that the use of pharmaceutical
treatments, such as methadone, to treat
addiction is contrary to the abstinence-based
perspectives of addiction treatment espoused
by many mutual support/12-step programs. A
recent study found that adherence to such
beliefs leads many heroin users to underutilize
methadone maintenance therapy despite their
knowledge of its effectiveness.^430

Perceptions of the Effectiveness of Treatment ..........................................................

Despite respondents’ limited awareness of

effective science-based treatments for addiction,

the majority of respondents to the NABAS

reported believing that if a person admits to

having a problem and wants to get better,

addiction treatment is somewhat or very

effective:* approximately eight in 10 indicated

that treatment for addiction involving alcohol

(82.5 percent) or prescription drugs (79.9

percent) is effective, and about three quarters

indicated that treatment for addiction involving

illicit drugs (73.6 percent) and tobacco (73.1

percent) is effective.^431 (Figure 5.D)

* It is important to note, however, that a significant

proportion of the public defines treatment in a way

that is not consistent with the science of best

practices in treatment.