World leading addiction experts highlight fundamental cause of poor addiction care

published on October 22, 2013

Patient populations and health care system suffer from lack of addiction medicine training

Vancouver, BC [October 22, 2013] North America’s leading addiction experts point to a lack of physician education in Addiction Medicine as a key contributor to high rates of untreated addiction and related harms.

In an article published in the October 23/30 issue of the Journal of the American Medical Association (JAMA), three of North America’s top experts in Addiction Medicine explore why the medical education system fails to train physicians in addiction medicine despite the enormous burden of disease attributable to addiction.

In British Columbia, particularly in areas like the Downtown Eastside, high rates of untreated alcohol and drug addiction have been a longstanding almost intractable problem. The subsequent health and social concerns, including poor mental health and high rates of homelessness have recently resulted in calls from the Vancouver Police Department and the City of Vancouver to improve the health system’s response. The JAMA article published today highlights a key explanation as to why the problems of untreated addiction have been so difficult to address and calls for more physician education training to properly treat patients suffering from addiction disorders.

The article was authored by Dr. Evan Wood, professor of medicine at the University of British Columbia where he holds a Canada Research Chair in Inner City Medicine; Dr. Jeffrey Samet, President of the American Board of Addiction Medicine (ABAM) Professor of Medicine, Boston University School of Medicine; and Dr. Nora Volkow, Director of the U.S. National Institute on Drug Abuse (NIDA) one of the U.S. National Institutes of Health.

“There is a remarkable gap between the science of addiction medicine and the care patients actually receive,” says Dr. Wood. “In British Columbia, for instance, our traditional failure to invest in training of Addiction Medicine physicians has meant there is simply an extremely limited number of physicians trained to deliver evidence-based care.”

The authors point to recent reports that have found most treatment for addiction in both the U.S. and Canada has been provided by “unskilled laypersons,” who although supportive, do not have the medical training required to effectively provide the latest evidence-based care. The authors further say that exciting new addiction treatments are often not utilized because of the lack of physicians to prescribe them.

“Fortunately, in British Columbia, we are addressing this problem by very recently establishing a comprehensive training approach,” notes Dr. Wood in reference to the St. Paul’s Hospital Goldcorp Fellowship in Addiction Medicine and related physician training activities being developed at UBC. “These programs are a critical first step toward turning the tide.”

The Fellowship is a partnership among St. Paul’s Hospital, St. Paul’s Hospital Foundation, the BC Centre for Excellence in HIV/AIDS, and the University of British Columbia, and was made possible through a $3 million donation by Goldcorp Inc. in 2012. The program recently received accreditation by the American Board of Addiction Medicine and is seeking to make British Columbia a world leader in addiction medicine education.

“Despite the availability of these evidence-based prevention and treatment strategies, only a small fraction of individuals receive prevention or treatment consistent with scientific knowledge about what works,” says Dr. Samet.

“Through the increased incorporation of addiction medicine into medical training, patients will be better served and the quality chasm in treating substance use disorders will be narrowed,” adds Dr. Volkow.”Given the proper training, tools, and resources, physicians can be the first line of defense against substance abuse and addiction, identifying drug use early, preventing its escalation to abuse and addiction, and referring patients in need to treatment.”

The St. Paul’s Hospital Goldcorp Addiction Medicine Fellowship will provide fellowships over the next five years to more than 20 B.C. physicians from a variety of specialized backgrounds, including Family Practice. The first group of St. Paul’s Hospital Goldcorp Fellows in Addiction Medicine began training on July 1, 2013.