Addiction Medicine: Closing the Gap between Science and Practice

77.2 73.2 71.2

10.9

Hypertension¹ Diabetes² Major

Depression³

Addiction³

(excluding

Nicotine*)

P E R C E N T

Figure 7.A

Individuals with Select Medical Conditions

Who Receive Treatment

(^1) Ages 18 and older; Ostchega, Y., Yoon, S.S., Hughes, J. & Louis, T.
(2008).
(^2) All ages; Centers for Disease Control and Prevention. (2011).
(^3) Ages 12 and older; CASA Columbia analysis of The National Survey
on Drug Use and Health(NSDUH), 2010

• Due to data limitations.

Most People in Need of Treatment Do Not Receive It ....................................................

In 2010, 15.9 percent of the U.S. population
ages 12 and older--40.3 million people--met
diagnostic criteria for addiction.* Although
some treatment providers are beginning to
address the disease of addiction
comprehensively, including all involved
substances, no single national data source exists
to compare the proportion of the population in
need of addiction treatment† involving any
addictive substance (including nicotine) to the
proportion that receives such treatment. CASA
Columbia’s analysis of the treatment gap in the
following discussion, therefore, is based on
available data and limited to the 9.1 percent
(23.2 million) whose addiction involves alcohol
or other drugs excluding nicotine.‡ 9

CASA Columbia’s analysis indicates that only
one in 10 (10.9 percent, 2.5 million) of those in
need of addiction treatment (excluding nicotine)
receive it, leaving a treatment gap of 20.7
million individuals. The proportion of
individuals in need of addiction treatment who
actually receive it has changed little since 2002,
when 9.8 percent of those in need received it.^10
This is in stark contrast to the much smaller

• Those meeting criteria for addiction include

individuals who met the Nicotine Dependence
Syndrome Scale (NDSS) criteria for past month
nicotine dependence, or the DSM-IV clinical
diagnostic criteria for past year alcohol and/or other
drug abuse or dependence. This estimate excludes
the institutionalized population, for which rates of
addiction are higher.
† Those in need of treatment are defined not only as

those who met DSM-IV diagnostic criteria for past
year alcohol and/or other drug abuse or dependence,
but also those who have received formal treatment
for addiction involving alcohol and/or other drugs in
the past year. Due to data limitations, individuals in
need of treatment for addiction involving nicotine are
not included in this analysis.
‡ Another nine percent (22.9 million) of the

population has addiction involving nicotine; 2.7
percent of the population (7.0 million) has addiction
involving multiple substances, including alcohol,
illicit drugs, controlled prescription drugs and/or
nicotine.

treatment gaps that exist for other major health

conditions including hypertension, diabetes and

major depression.§ 11

(Figure 7.A)

§ For this comparison, CASA Columbia examined the

referenced national survey data to determine the

proportion of the population with each disease--those

with diagnosed or undiagnosed hypertension (59.3

million); those with diagnosed or undiagnosed

diabetes (25.8 million); those who met clinical

criteria for a major depressive episode in the past

year and/or received professional treatment (saw a

doctor, received medication, some combination

thereof) (22.4 million); and those who met clinical

criteria for addiction involving alcohol or other drugs

excluding nicotine in the past year and/or received

professional treatment for alcohol and/or other drugs

in the past year (23.2 million)--who received

treatment.