More than 70 percent of US adults feel the healthcare system is failing to meet their needs in at least one way, according to Harris Poll data reported by TIME magazine in 2023. “More than half of the roughly 2,500 US adults who took the survey graded the US healthcare system a ‘C’ or below. When asked about factors that prevent people in the US from getting care, cost was the most common criticism, followed by the system’s focus on profits, inaccessibility of insurance coverage, and confusion around what is covered by insurance.”
The grade slips to “F” when it comes to substance use and mental healthcare.
“A staggering 43 percent of US adults who say they needed substance use or mental healthcare in the past 12 months did not receive that care, and numerous barriers to access stand between them and needed treatment,” according to a 2022 national survey of more than 2,000 U.S. adults conducted online by The Harris Poll on behalf of the National Council for Mental Wellbeing.
“Substance use and mental health challenges and barriers to access are enacting a crushing toll on those who seek treatment and cannot get it. The COVID-19 pandemic led to increased substance use and mental health challenges for people of all ages and all backgrounds, yet too many people are not getting the care they need. It is not enough to acknowledge the problem. We must break down these barriers,” commented National Council for Mental Wellbeing President and CEO Chuck Ingoglia.
Addiction treatment is still the poor cousin of American medicine in general and psychiatry in particular, although the US has seen multiple deadly waves of drug overdose deaths.
“The first wave of the long-running and devastating opioid epidemic began with the abuse of prescription painkillers (early 2000s),” reported NPR this month. “The second wave involved an increase in heroin use, starting around 2010. The third wave began when powerful synthetic opioids like fentanyl started appearing in the supply around 2015.” Now experts are observing a fourth phase of the deadly epidemic as illicit stimulants mixed with fentanyl have become the most common drugs found in fentanyl-related overdoses.
HEALTHCARE SYSTEM NEGLECTS ADDICTION TREATMENT
In a recent Family Workshop presentation, Blanchard founder and CEO Ward Blanchard called the US healthcare system “broken” with a shortage of addiction professionals and a distinct lack of supervision. “Most people become licensed professional counselors (LPCs) without ever having taken a substance use class.”
“Addiction became a recognized physician specialty eligible for board certification only in 1991,” wrote McNeely, Schatz, Olfson, et al. in Psychiatric Service three years ago. “According to the Association of American Medical Colleges, [fewer than] 2,500 physicians nationwide are certified in addiction medicine, and only approximately 2,000 are certified in addiction psychiatry. By contrast, 22,500 cardiologists practice in the United States—nearly five times the number of addiction physicians.”
The average medical school curriculum dedicates only a few hours to addiction—during four years of training. “Barely half of the approximately 10,000 residency programs nationwide require curricular content on addiction prevention and treatment, and in many of these programs, addiction content is provided for only 4–12 hours over several years of training,” wrote McNeely, Schatz, Olfson, et al. “With historically limited curricular training, the medical faculty and supervising physicians of today’s trainees are ill-equipped to oversee the scale and complexity of care necessary to appropriately respond to today’s opioid epidemic.”
With neglect like that, it’s a small wonder that there is little interest in addiction psychiatry. “Some individual psychiatrists are wonderful but psychiatry as a whole got worse,” Blanchard told the webinar. “Substance misuse is the only condition where the healthcare system throws it at the family’s feet and says ‘You figure it out.’ There is no other disease where they would do it like that. This status quo is unacceptable.”
STIGMA STILL WIDESPREAD
Since few medical providers are exposed to effective addiction treatment and successful patient outcomes, there are misperceptions that substance use disorder cannot be treated successfully. “This sets up a confrontational situation that pits provider against patient (especially in high-acuity settings such as hospitals and emergency departments), with some providers considering patients with opioid use disorder an unnecessary burden and labeling them as ‘drug seeking’ or ‘addicts who will be back again,’” wrote McNeely, Schatz, Olfson, et al.
The Blanchard Institute has been trying to improve the situation. “Right from the start, we wanted it to be a community resource, a teaching site, and general wellness center as well,” says Blanchard. Hosting events like the annual Recovery Awareness Day, empowering families, engaging alumni as “change agents,” working closely with referring professionals, and providing gender-specific recovery residences make Blanchard a modern, evidence-based treatment program that treats clients holistically.
The Blanchard Institute cultivates a safe, comfortable environment for clients and their families across North Carolina. Our recovery management and alumni program support a life-long recovery. Your journey to recovery doesn’t end with day or outpatient treatment, once you’re with Blanchard, we’re always there for you.
Our admissions process is discrete, confidential, and non-invasive. Our mission is to provide support for every person who reaches out to us. Call us at (704) 368-0776 —our experienced admissions specialists will guide you through the process and treat you with the dignity and compassion you deserve.