Addiction and Drug Use

Number of Providers per 1,000 Adults with Addictions
Jeff Zornitsky / Advocates for Human Potential

This story was provided to Sound Medicine by Stateline, an initiative of the Pew Charitable Trusts.

The number of people with insurance coverage for alcohol and drug abuse disorders is about to explode at a time there’s already a severe shortage of trained behavioral health professionals in many states.

Until now, there’s been no data on just how severe the shortage is and where it’s most dire.  Jeff Zornitsky of the health care consulting firm Advocates for Human Potential (AHP) has developed the first measurement of how many behavioral health professionals are available to treat millions of adults with a substance use disorder, or SUD, in all 50 states.

Zornitsky’s “provider availability index” – the number of psychiatrists, psychologists, counselors and social workers available to treat every 1,000 people with SUD – ranges from a high of 70 in Vermont to a low of 11 in Nevada. Nationally, the average is 32 behavioral health specialists for every 1,000 people afflicted with the disorder.  No one has determined what the ideal number of providers should be, but experts agree the current workforce is inadequate in most parts of the country.

“Right now we’re in a severe workforce crisis,” said Becky Vaughn, addictions director for the industry organization National Council for Behavioral Health.  The shortage has consequences, she said. “When people need help for addictions, they need it right away. There’s no such thing as a waiting list. If you put someone on a waiting list, you won’t be able to find them the next day.”

The shortage of specialists threatens to stall a national movement to bring the prevention and treatment of SUD into the mainstream of American medicine at a time when millions of people with addictions have a greater ability to pay for treatment thanks to insurance.

Shane Avery practices family medicine in Scott County, Ind. In December, a patient came to his office who was pregnant, and an injection drug user.

After running some routine tests, Avery found out that she was positive for HIV. She was the second case he had seen in just a few weeks.

"Right then, I kind of realized, 'Wow, are we on the tip of something?' " Avery says. "But you just put it away. ... It's statistically an oddity when you're just one little doctor, you know?"

Founded by two men in Akron, Ohio, in 1935, Alcoholics Anonymous has since spread around the world as a leading community-based method of overcoming alcohol dependence and abuse. Many people swear by the 12-step method, which has become the basis of programs to treat the abuse of drugs, gambling, eating disorders and other compulsive behaviors.

When you ask people what impacts health you'll get a lot of different answers: Access to good health care and preventative services, personal behavior, exposure to germs or pollution and stress. But if you dig a little deeper you'll find a clear dividing line, and it boils down to one word: money.

The Kids Are Alright: Risky Teen Behaviors On The Decline

Feb 13, 2015
a group of teenagers lying in a big clump
Son of Groucho via Flickr https://creativecommons.org/licenses/by/2.0/

Maybe it's time to give teenagers some credit: Recent data shows rates of teen pregnancy and abortion are at historic lows, and teens are drinking less and taking fewer hard drugs. However, marijuana use among teens is up. Sound Medicine's Barbara Lewis spoke with Dr. Theresa Rorhr-Kirchgraber, professor of clinical medicine and pediatrics at the IU School of Medicine, about the good news. 

Senegal is full of tourist attractions: sandy beaches, historic buildings, religious sites. But when historian Donna Patterson visits, she heads to the drugstore.

New numbers released by the federal government reveal a continuing upward trend in drug overdose deaths, with 43,982 deaths in 2013 from both prescription medications and illegal drugs combined. Deaths involving prescription opioids increased 1 percent from 2012, while heroin-related deaths rose a staggering 39 percent.  However, almost twice as many people died from prescription opioid overdoses (16,235) as from heroin (8,257).

Vermont Gov. Peter Shumlin attracted national attention last January when he devoted his entire State of the State address to Vermont's opiate addiction problem.

For the first time, he said, the number of people seeking drug addiction treatment had surpassed those getting help for alcoholism, and many had nowhere to go.

Ramunas Geciauskas/Flickr.com

At Harvard University’s Beth Israel Deaconess Medical Center in Boston, mental health patients are given access to their therapists' notes, as part of their innovative Open Notes program. Dr. Michael Kahn, a psychiatrist at Beth Israel wrote about why the program was launched in a recent JAMA article. Here, he reflects on what clinicians are learning from it. 

Opioid Prescriptions Can Go Missing Between Hospital and Nursing Home

Dec 8, 2014

Madison, Wisconsin - Better communication between hospital and nursing home can thwart people determined to steal opioid prescriptions.

Pages