The CASA Columbia report found that while almost half of Americans say they would go to their healthcare providers if someone close to them needed help for addiction, less than 6 percent of all referrals to addiction treatment come from health professionals. The report also found no clearly delineated, consistent, and regulated national standards that stipulate who may provide addiction treatment in the US; standards vary significantly by state and the source of payment for treatment.

Addiction treatment facilities and programs are not adequately regulated or held accountable for providing treatment consistent with medical standards and proven treatment practices. Most providers of addiction treatment are addiction counselors who are not required to have any medical training. CASA Columbia’s analysis of minimum state requirements found that:

  • Fourteen states do not require all addiction counselors to be licensed or certified;
  • Six states do not mandate any educational degree to become credentialed;
  • Fourteen states require only a high school diploma or GeD;
  • Ten states require an associate’s degree;
  • Six states require a bachelor’s degree; and
  • One state requires a master’s degree.

Physicians and other medical professionals, who make up the smallest share of addiction treatment providers, receive little education in addiction science, prevention, and treatment. In fact, the CASA Columbia report cites other research, which found that, of patients who had visited a general medical provider in the past year, only 29 percent were even asked about alcohol or other drug use. “Right now there are no accepted national standards for providers of addiction treatment,” said Susan Foster, CASA Columbia’s vice president and director of Policy Research and Analysis, who was the principal investigator for the report.

“There simply is no other disease where appropriate medical treatment is not provided by the healthcare system and where patients instead must turn to a broad range of practitioners largely exempt from medical standards. Neglect by the medical profession has resulted in a separate and unrelated system of care that struggles to treat the disease without the resources or knowledge base to keep pace with science and medicine.”

This blog post is an excerpt from The therapist’s Guide to Addiction Medicine – A Handbook for Addiction Counselors and Therapists – by Barry Solof, MD, FASAM; Published by Central Recovery Press (CRP).