According to the American Society of Addiction Medicine (ASAM), there is 3,000 board certified addiction medicine doctors in the U.S. The Substance Abuse and Mental Health Services Administration (SAMHSA) says there are 21 million adults with substance use disorder. While the volume of addicted people is rising, the number of doctors to treat them is already operating at a deficit. This disparity is not expected to correct itself anytime soon.
Addiction medicine has all the elements of a popular television reality show:
- The frustration of families as they deal with the possible ruination of their loved one’s life;
- The struggles of a patient caught up in the throes of a devastating illness;
- The dismay felt by physicians when a patient relapses.
But for the nation’s addiction medicine physicians, this is not TV; it is their job.
With the nation in the grip of widespread addiction, more physicians trained in addiction medicine are sorely needed. What is working in addiction medicine really like? This article explores a day in the life of a physician specializing in addiction medicine.
Critical Need for Addiction Medicine Clinicians
The shortage of doctors trained in addiction medicine means that primary care or emergency room physicians often take up the slack when diagnosing and treating patients. In some instances, these physicians may not be trained in the latest addiction medicine techniques.
Addiction medicine physicians combine their training across the disciplines of internal medicine, mental health counseling, psychology, public health, social work, and more to help patients recover. These cases have typically very complex underpinnings crossing bio-psycho-social lines, while also affecting the families of those addicted.
With 21 million adults with substance use disorder and only 3,000 board-certified clinicians, the shortage of addiction medicine doctors is severe.
According to the Addiction Medicine Foundation, these physicians offer patients evidence-based treatment to include:
- Screening, brief intervention, and referral to a treatment provider or center.
- Behavioral interventions.
- FDA-sanctioned drug therapies.
- Therapeutic support groups or one-on-one counseling.
A typical day consists of seeing new and existing clients, conducting comprehensive evaluations, developing treatment plans, and monitoring existing plans. The American Medical Association (AMA) shadowed an addiction medicine physician who stated that the two most difficult parts of the job were getting insurance companies to provide coverage for needed patient treatment, and for the patient to accept their diagnosis.
Doctorly suggests: “Because of the complex nature of addiction and the various medical and psychological issues that could present alongside addiction, addiction medicine physicians are able to offer nuanced treatment of patients.”
Some of the types of nuanced treatment that the addiction medicine physician could prescribe include:
- Detox centers to break the cycle of patient addiction.
- Treatment of withdrawal symptoms, which could include seizures, vomiting, nausea, or other symptoms up to a respiratory or cardiac arrest.
- Physical or mental therapies to rehabilitate the patient.
- Acute interventions to save the patient from an overdose.
- Protocols for harm reduction to reduce the risk of relapse.
- Treatment of diseases acquired as a result of drug or alcohol addiction.
A day in the life of an addiction medicine physician depends upon their treatment facility. For example, they could work in a long-term care facility, a hospital ER, a psychiatric facility, or residential rehab. The addiction medicine physician could work solo, or, more typically, as part of a multi-disciplinary team.
No matter where care is provided, it is very clear that the US is in desperate need of more addiction medicine physicians to help stem the tide of substance use disorders as quickly as possible.
