When patients fill out an information sheet at a doctor’s office, they are typically asked if they ever had a problem with drugs or alcohol. If you answer “yes,” you probably hope or expect that the doctor will be knowledgeable about the disease of addiction. Many doctors know very little about addiction. They may dislike addicts or prefer not to treat addiction. Some may treat only complications of addiction such as cirrhosis of the liver, without probing underlying issues or referring addicts to addiction specialists. Lack of knowledge about addiction on the part of medical professionals can cause physicians to prescribe dangerous or inappropriate substances, and it can also cause physicians to miss the signs of a drug abuse problem. Millions of alcoholics and addicts seek treatment in clinics, doctors’ offices or emergency rooms every year. This means doctors have a lot of opportunities to steer addicts in the right direction toward help and recovery. The unfortunate truth is that many doctors have had very little education about the disease of addiction, while others may not believe that addiction is actually a disease. In spite of the thorough and diverse training doctors receive, many medical schools have no required courses in addiction. This leaves many doctors unprepared to diagnose or treat people who have had a problem with substance abuse. Not all states require doctors to receive continuing education in the use of narcotics and pain management. In surveys of doctors done by Columbia University’s University Center on Addiction and Substance Abuse, 8 out of 10 doctors believed they were qualified to identify a drug addict, but only 1 out of 100 correctly identified addiction as a possible diagnosis when presented with the case history of a patient with a substance abuse problem. This means that a large number of doctors are seeing addicts on a daily basis and failing to recognize the true nature of their problems. Fortunately, efforts are being made to educate more doctors about substance abuse. Some institutions are establishing programs in which addiction medicine can be chosen as a primary residency. Doctors who specialize in addiction medicine will be able to accurately recognize and diagnose substance abuse and guide addicts to appropriate treatment options.
Getting Past the Prejudice
There is a lot of stigma surrounding drug addicts, and doctors are human beings. Many people, doctors included, believe that addicts are weak, unmotivated individuals who need nothing more than to make better choices. When doctors believe addicts are bad people rather than sick people, they may miss opportunities to steer addicts toward help. Even when doctors are not judgmental toward addicts, not all addicts are ready to get help when a doctor suggests that they do. This can cause frustration for doctors who do recognize a substance abuse problem in a patient, but are faced with hostility and denial when suggesting that the patient get help. Doctors also struggle to treat patients who aren’t completely honest with them. Treating addicts becomes even more complicated and frustrating when a patient has mental health problems. A person that has a problem with anxiety or depression may be using alcohol or street drugs to self-medicate. Physicians are faced with trying to choose medication that can help relieve symptoms without the potential or likelihood of drugs being used abusively. They have to take the time to thoroughly get to know a patient, including mental health problems, lifestyle choices and family influences, in order to choose the right medications and treatment plan. When mental health problems are a factor, specialized treatment from a psychiatrist may be needed. Treatment of addiction usually requires a combination of many approaches including self-help support groups, therapy and possibly medication. Even if the doctor doesn’t treat the patient as if he were a bad person, true recovery is still up to the addict. Addiction has no cure and no quick fix, and patients that have a substance abuse problem have different needs. When doctors lay aside prejudice and take the time to thoroughly learn about the disease of addiction, they are in a unique position to really make a difference in the lives of addicts.