Addiction Medicine: Closing the Gap between Science and Practice

26.8 24.1

9.9

3.7

27.3 26.1

13.7

6.5

College/Bachelor's

Degree

Master's Degree Medical Degree Doctoral Degree

P E R C E N T

* Among those who responded that the educational qualification is "very

important".

Source: Casa Columbia Survey of New York State Addiction Treatment

Providers, 2009.

Figure 10.A

New York State Addiction Treatment Providers' Beliefs

about the Importance of the Following Provider

Educational Qualifications*

Director

Staff

Addiction treatment services primarily are
provided through community-based treatment
programs that were established in the 1970s and
1980s before the medical model gained support
and changes in the financial structure led to
increasing demands for accountability and
efficiency.^149 The treatment provider workforce,
although frequently highly dedicated, is
composed primarily of certified alcoholism and
substance abuse counselors (CASACs)--a
profession for which a college degree typically
is not required* and in which counselors receive
limited on-the-job training in evidence-based
practices.^150

The result is that much of the current treatment
provider workforce is not equipped to provide
consistent evidence-based treatment, including
administering and monitoring medication
protocols, implementing complex psychosocial
interventions, addressing co-occurring health
conditions or responding to medical
problems that may arise among
individuals undergoing addiction
treatment.^151

CASA Columbia’s survey of addiction
treatment providers in New York State
provides a case in point. It found that
37.2 percent of staff providers do not
have a bachelor’s degree† and only
67.5 percent of program directors and
35.0 percent of staff providers have a
graduate degree of any type.^152

Further, most treatment providers see
the current state of affairs with regard
to the staffing of treatment programs as
reasonable. When asked which type of
professional they think is best qualified to
provide addiction treatment services, nearly
three quarters of respondents to CASA
Columbia’s New York survey (71.3 percent of
program directors and 72.6 percent of staff

• See Chapter IX for specific credentialing

requirements.
† 29.9 percent had some college or an associate’s

degree, 6.6 percent had only a high school degree or
GED and 0.7 percent did not complete high school or
have a GED.

providers) said substance abuse counselors

(CASACs); 16.3 percent of directors and 17.8

percent of staff providers said social workers,

7.5 percent of directors and 6.7 percent of staff

providers said psychologists and only 1.3

percent of directors and 1.5 percent of staff

providers said physicians.^153

Only 9.9 percent of program directors and 13.7

percent of staff providers indicated that a

medical degree is a “very important”

qualification for treatment providers to have; 3.7

percent of directors and 6.5 percent of staff

providers thought that way about a doctoral

degree. A quarter (24.1 percent of directors and

26.1 percent of staff providers) felt that a

master’s degree was a very important

qualification, and about a quarter (26.8 percent

of directors and 27.3 percent of staff providers)

felt that way about a college/bachelor’s

degree.^154 (Figure 10.A)

In contrast, the majority of treatment providers

in CASA Columbia’s survey (61.4 percent of

program directors and 76.3 percent of staff

providers) thought that personal experience with

addiction is an important qualification for