49 Million Need Help, Only 13 Million Get It

Matt shares findings from a comprehensive National Institutes of Health study revealing why doctors struggle to treat addiction effectively and the alarming gap between those who need help and those who receive it.

• 81% of doctors cite lack of institutional support as the main barrier to treating addiction
• 74% of physicians acknowledge insufficient skill sets for addiction treatment
• 66% of studies identified negative social stigma as a significant deterrent
• 56% of doctors fear damaging patient relationships by addressing addiction
• In 2022, 49 million Americans had substance use disorders, but only 13 million received treatment
• Of 9 million people with opioid use disorder, only 25% received medication-assisted treatment
• Treatment demand significantly exceeds available capacity across the country
• Political solutions and policy changes have often fallen short of addressing core issues

If you or someone you know needs help with addiction, call or text 988, visit findtreatment.gov, or call 800-662-4357. Join our free family support meetings Mondays and Thursdays at 8pm Eastern, and our new trauma-focused family meetings Wednesdays at 8pm Eastern. Register at interventiononcall.com or contact Matt directly at matt@partywreckers.com.

Chapters

• 0:00 Welcome to the Party Wreckers
• 1:47 Doctors' Barriers to Treating Addiction
• 6:13 Stigma and Patient Relationship Concerns
• 9:07 Treatment Demand Exceeds Capacity
• 15:13 Finding Solutions and Getting Help
• 25:31 Free Family Support Resources

Transcript

Speaker 1: 0:00

Welcome to the Party Wreckers podcast, hosted by seasoned addiction interventionist, Matt Brown. This is a podcast for families or individuals with loved ones who are struggling with addiction or alcoholism. Perhaps they are reluctant to get the help that they need. We are here to educate and entertain you while removing the fear from the conversation. Stick with us and we will get you through it. Welcome the original party wrecker, Matt Brown.

Speaker 2: 0:51

What is up everyone? Welcome. Welcome to another episode. My name is Matt Brown. I am an interventionist and have been for about the last 21 years. I'm also a family coach and I'm glad you're here, if you found this podcast, if this is your first time here.

Speaker 2: 1:09

The purpose of what I do here is I want to make the conversation that you're having with your loved one around addiction a little bit easier. I think so many families get scared to try to have this conversation because, if your loved one is anything like I was, we don't make it easy on you. We sure are going to make you pay when you want to bring up our addiction or our drinking problem, because that addiction really wants to protect itself. And so I think a family properly armed with the right information, with the right attitude and certainly an abundance of love and concern, is a very well-equipped family to have this conversation. Today I want to talk about something that I found. It's an article from the National Institute on Drug Abuse. The study was done by the National Institutes on Health and this article came out in July of last year, 2024. And it was interesting to me because this article focuses on the well, the title of the article. It says Doctors Reluctant to Treat Addiction Most Commonly Report Lack of Institutional Support as a Barrier. So this article is about or this study was about doctors reporting what was preventing them from successfully engaging with their addicted clients. And the interesting thing about this article and forgive me if you hear some papers rustling I want to make sure that I'm taking a lot of the data that I have here and reporting it accurately, because there's a lot.

Speaker 2: 2:47

This study compiles 283 previous studies done between, I want to say, 1960 and 2022. So about 61 years. I'm sure the math doesn't add up there, but it's about 61 years worth of studies. Now, 97% of those studies were done after the year 2000. So most of those have happened in the last 25 years.

Speaker 2: 3:13

Now, of those studies, there was about 66,732 doctors that participated or contributed to the cumulative knowledge that was gained from these studies, and so the sample size is probably one of the biggest that I've seen and certainly over the longest duration that I've seen, and so I found it pretty fascinating because it really highlights where I think we're going wrong, not just in the medical field but in addiction treatment as a whole. Now, the biggest contributing factor that doctors reported over those 61 years was lack of institutional support. Now institutional support refers to factors like support from a physician's institution or employer, say a hospital or a practice group. Insufficient resources, such as staff training, challenges in organizational culture and competing demands. This reason for reluctance was cited in 81% of the studies reviewed. Now the second most cited reason was insufficient skill.

Speaker 2: 4:29

So doctors are you know and I got to say I'm glad that they were willing to say this, but they were able to say that 75% of the doctors, 74% of the doctors, said that they didn't have the sufficient skill to be able to treat addiction. Lack of cognitive capacity to manage a certain level of care 74%, and inadequate knowledge 72%. So skill and knowledge really kind of ranked up there with each other. But this issue around institutional support I think really highlights why there are so many treatment centers in the private sector, outside of what Medicare and Medicaid provide, outside of what hospitals provide, this lack of institutional support Either they didn't have the personnel, they didn't have the resources and, quite frankly, they're not getting the reimbursements that they would get from other medical conditions, and so they naturally kind of punt this to the private sector and you get a lot of these quite frankly good and some not so good treatment providers that are out there providing nothing but addiction treatment, but addiction treatment. And I think when families are looking at, hey, I need to get my loved one some help, I think the first maybe not some more, but historically the first place people looked was to their doctor, maybe to a therapist, maybe to a psychiatrist, maybe to a clergyman, but most typically it was a medical doctor that somebody would go to. And when you have 81% of these doctors saying that they just don't have the support that they need to be able to adequately treat addiction and 74 to 72% of them say they don't even have the right knowledge or the right skill set to be able to do this, it really highlights where I think as an industry, a medical industry, we are falling short in terms of providing doctors the right knowledge, the right skill set and the right support to be able to treat addiction.

Speaker 2: 6:43

Now, around 66% of these studies out of the 61 years, 66% of the studies cited negative social influence or beliefs about community acceptance of addiction care. So this highlights something different, and I think we see a lot of this as a society these days, and that is just the stigma that surrounds addiction. Most people don't look at this as a medical issue these days. They look at it as an issue of poor character, lack of self-will, poor choices. Constantly on the family support calls that we do every Monday and Thursday, we regularly get questions asked to the interventionist at an intervention on call. You know, is addiction a choice or is it a disease? And when you have families that are asking this. It also sounds like doctors are struggling with this in some way as well when they say 66% of the studies cited negative social influences or negative stigma around addiction and addiction treatment. That's telling.

Speaker 2: 7:56

56% of the studies cited fear of harming the patient-physician relationship as deterrents for physicians to intervene on addiction. So 56% of the studies said that the doctors were afraid of losing a patient or that the patient wouldn't engage with them going forward if they address the underlying addiction. And so you guys, as families, are not the only ones worried about damaging a relationship when it comes to your loved one. Doctors are worried about it as well. Loved one Doctors are worried about it as well, and I don't know if that's. It doesn't say that that's necessarily financially motivated, but it removes the ability from or at least they're worried that it would remove the ability for a doctor to continue to treat the patient if they were to address the addiction. Families worry about this too. How many of you listening to this who have an addicted loved one can think of a time in the past, or even recently, where you wanted to address this but you were worried about upsetting your loved one? You were worried about what it might do to your relationship and it was just easier to not talk about the elephant in the room and maybe look for a better opportunity down the line than address it right in the moment. And doctors are struggling with the same thing, according to these studies. According to at least 56% of the studies, the doctors were reporting that they were worried about losing their patient if they address the addiction.

Speaker 2: 9:28

It also goes on to say that reimbursement concerns for the cost of delivering addiction interventions were also observed. So insurance just isn't paying what hospitals and other people in private practice are hoping to recoup. People in private practice are hoping to recoup, and so it's just not a profitable. What's the word I'm looking for? Medical practice you have different specialties, I guess was the word I was looking for. It's not something that insurance was reimbursing hospitals as well for, and so, as you guys are depending on insurance to go into the private sector and contract with treatment providers, a lot of times insurance companies will tie the hands of even private treatment providers who bill insurance in terms of the number of days they're willing to authorize, in terms of the amount of reimbursement on a daily rate that they're willing to authorize, and I think a lot of times we think, well, I've got insurance, it should cover this, and honestly it should, especially given the premiums that a lot of us are paying. But the insurance industry being what it is, they want to make as much money as possible. I mean, that's their business model, and so I think, as an industry, we've got to try to work with legislators.

Speaker 2: 10:59

Say what you will about Obamacare Some people are for it, some people were against it. What it did establish was parity, which is treating addiction like any other medical illness. For those of you who tried to get your loved one treatment before 2013, 2014, insurance companies could deny treatment for addiction because it was a pre-existing condition pre-existing condition and so they could deny it, or it was just not covered under the policy. Now we're not seeing that. We're seeing that it's being treated like any other medical condition, but they're finding other ways to limit access to treatment. And along those lines, let me just read another. This is a really important statistic and I don't want to get this wrong. I'll just read what it says here Despite effective interventions for treating substance use disorders, including medications, behavioral therapies, adoption of these practices remains low and demand exceeds treatment capacity.

Speaker 2: 12:05

Now these are the statistics that are going to kind of blow everybody away. I think Now these are the statistics that are going to kind of blow everybody away. I think In 2022, nearly 49 million people in the US had at least one substance use disorder. 49 million. Of that 49 million, only 13 million people. Residential treatment that's inpatient. Residential treatment that's outpatient, that's medication assistant treatment going to the methadone clinic getting suboxone. That includes any form of treatment. So you have 49 million people. About 25% of those people were able to get help. 13 million More than 9 million adults needed treatment for opioid use disorder in 2022, but fewer than half around 46% received any form of treatment and only 25% received medication for opioid use disorder. So 9 million people needed treatment for opioid use disorder and I think, in large part just based on the evidence that I've seen and the experience that I had that was largely fentanyl, of course, some prescription drug use abuse, but 25% at the bare minimum. At the bare minimum where doctors were prescribing a medication to help with cravings, only about 25% of those people got help.

Speaker 2: 13:34

Now, in recent years, buprenorphine was only allowed to be prescribed by a certain. You had to have a certain license to be able to prescribe buprenorphine, which is Suboxone, subutex, a lot of the anti-craving medications that are out there. Right recently, the, the, the laws changed and any medical doctor with a an FDA license well, that's not the right oh, what's it? It's the oh. Who issues the licenses? I can't remember, but if you had a license to prescribe medications, you could prescribe buprenorphine Even then. Now there's greater access to that medication. Only about 25% of those 9 million people were able to get it.

Speaker 2: 14:21

Now, because of the kind of work I do, I also see that a lot of people are reluctant to get help. I'm not going to sit here and say that every one of those 9 million people were banging down the door of their doctor to try to get help, or banging down the door of a treatment center to try to get help, or those 49 million people were all clamoring like, hey, help me, I'm addicted and I need some help. Here. I think anybody listening to this podcast, especially from the vantage point of you know do I need to do an intervention for my loved one? You're wrestling with this idea that, hey, my loved one doesn't really want help, they don't really want to change yet, and so I think in large part that 49 million I shouldn't say in large part. Some of that, a good percentage of that 49 million were people who had not yet become willing to get help. Even then, the demand for help far outweighed the ability to provide that help. Again, this is just a lack of services. I don't want to make this political. Oftentimes it's an easy finger to point. But I'll look at where I live.

Speaker 2: 15:33

In my home state of Oregon, when recreational use of marijuana was passed in the middle 20-teens, one of the things that was promised to those of us here in this state was that with the tax revenue from the sale of recreational marijuana, that they were going to create more treatment opportunities. That has not happened happened. And then, of course, you have brilliant ideas like the decriminalization of drug possession. In theory it's not a bad idea I shouldn't say it sarcastically like that. In theory it's not a bad idea, because I don't think that drug addiction should be criminalized. But here in Oregon the idea was hey, we're going to write you a ticket if we catch you in possession under a certain weight or a certain amount of substance, and you either have an opportunity to pay a $100 fine the first time or you can go get an assessment to see if you meet criteria to go into a treatment program. Now, on the second time you get a ticket there's no more $100. Fine, you're going to get that assessment and they're going to see if they can get you help.

Speaker 2: 16:51

I called about a year into this, after the legislation had passed. I called Oregon Department of Health and I said hey, I've worked in a couple of other different states where I've helped train people to go in and assess people and help motivate people to get help. I would love to be a part of training the teams that are doing these assessments. And the gentleman that I spoke with at Oregon Department of Health was very open and he said you know we don't have anybody doing those assessments yet. I said no, wait a minute, it's been a year. What's going on? And he's like we just haven't been able to get the infrastructure in place to be able to do this. And so what was happening is law enforcement was writing all these tickets. I'm sure some people would have opted to go and get help, and it wasn't available. There was nobody doing the assessments. Now, since then, they've changed the law, it's been recriminalized now and they're handling it a different way, because the way that they tried to roll it out just didn't work and it was putting law enforcement at a real disadvantage disadvantage, I know I'm deviating a little bit from the medical component of this, but I really just want to highlight the fact that the demand outweighs the ability to provide at this point.

Speaker 2: 18:11

So many families will reach out and say I don't know where to find my loved one help. Families will reach out and say I don't know where to find my loved one help, especially families who have loved ones that are on Medicaid or Medicare. How do I find a treatment facility that doesn't have a waiting list, that doesn't have? You know, sometimes there is a backlog of people waiting to get in. I know, if I'm working with a family here in Oregon and their loved one has Medicaid, I'm able to help them, but sometimes it's not going to be like the same day of the intervention.

Speaker 2: 18:44

There's several different hoops to jump through In some states. Other states work this way as well. Where you get the person to agree to go and get help, the first step is they have to go and get assessed. The person will do the assessment and say okay, you meet criteria to go into an inpatient program or you meet criteria to go into an outpatient program. Here are your options and this you know. Of these options, the earliest we might be able to get you in is three weeks from now. Well, now we've got to tread water for the next three weeks to try to get this person and keep this person motivated to continue to get help. That shouldn't be the hardest part of this process. The hardest part shouldn't be how can I get my loved one help? We have the ability to provide good quality addiction treatment and mental health treatment. We've got qualified therapists.

Speaker 2: 19:44

It baffles me that in 2025, we are still struggling to combat this problem. The war on drugs was started in 1972 by Richard Nixon and it's been a war that we've been losing ever since and we've been playing catch up. And until we. I think part of the problem is we're looking at this from a supply side issue. If you just look at it from a supply and demand, we look at this from a supply side solution. We've got to stem the flow of drugs into the United States. We've got to stem the sale of drugs within the United States. We've got to work on getting dealers off the streets. We've got to work on enforcing laws or implementing new laws that are going to make drugs more difficult to get a hold of. Well, I think we all know, from prohibition on, we've learned that as long as there's a demand, there's going to be a supply.

Speaker 2: 20:46

If we can give families what they need to be able to have different kinds of conversations with their loved ones, and not put it on police, not put it on schools, programs like the DARE program, which was ridiculous, this whole idea of just say no. You know, nancy Reagan, if I could have just said no, I would have. You know, it sounds like a great idea, but I, you know, just say no is not an option for most of us. You know, I wanted to say no so many times and couldn't. Um, we've got to find a way to provide better care and more readily available care to people who need it.

Speaker 2: 21:33

I guess my challenge to everybody listening to this today would be reach out. If you have a doctor, find out I mean, just be curious. Find out what they know. Find out what kind of education they have when they went through medical school on addiction. Find out if they're doing anything in terms of of continuing education on addiction or or addiction treatment. If you're a medical provider and you're listening to this podcast, I would be interested, if you wouldn't mind and we can do this completely discreetly, of course I would be curious to know what is the biggest barrier that you have experienced in being able to provide good quality care, as far as addiction goes, to your patients. That will never get shared on the podcast, certainly not with anybody's identity.

Speaker 2: 22:26

I would be interested, just for my own edification, to learn what some of the challenges are today. If you feel like these numbers line up with what you're experiencing in your practice, or if you feel like, hey, this is not what I'm experiencing, here's actually what I'm able to see and I feel like I'm actually able to provide quite well for my patients, I would love to hear that. If you feel like you have a limited access in your state, especially if you're here in Oregon, reach out to your local legislators. Find out why we have such an abysmal recovery rate when it comes to availability and quality of care in addiction treatment. Why are these doctors finding it so difficult to get the institutional support that they need, to get the training and the education that they need to be able to treat something that's killing tens of thousands of people every year.

Speaker 2: 23:26

Anyways, I'll get off my soapbox. I found this article to be completely interesting and I thought I would just share it today. There's a couple of other things that I want to share, because I think that this is something that's lacking as well. The last paragraph of this article says if you or someone you know is struggling or in crisis, help is available. Call or text 988. Until I read this article I've been doing this work for over 20 years I didn't know that there was a three-digit number that you can call, kind of like 911. It's 988. But you can call and talk to somebody, or text and talk to somebody to try to find help. Somebody or text and talk to somebody to try to find help.

Speaker 2: 24:07

There's a website, 988lifelineorg, where you can go. Findtreatmentgov is a website where you can go and actually find treatment programs. Again, it doesn't mean that there's going to be an abundance of treatment programs. It doesn't mean they're not going to have a waiting list, but hey, there's a website out there where you can go and find treatment, especially if you're limited in your resources in terms of having insurance private insurance or state-funded insurance like Medicaid you have a website you can go to and find treatment findtreatmentorg, or you can call 800-662-4357. I will put all of this information in the show notes so that you don't have to remember it just from listening here.

Speaker 2: 24:51

Thank you guys for listening. I appreciate you tuning in for another episode. My name is Matt Brown. If you need help or want to reach out, you can find me at matt at partyrecordscom. You can email me directly. I would love to hear from you. You can book a private session with me at interventiononcallcom, with myself or with another of the amazing providers that we have on the site.

Speaker 2: 25:16

Every Monday and Thursday at 8 pm Eastern we have a free family support group for families who have loved ones in active addiction. Starting this Wednesday that would be May 14th we have Jason Chain, who is an amazing man. He's very knowledgeable when it comes to trauma and addiction. He's going to be doing a free family meeting every Wednesday night now at eight o'clock Eastern for trauma in those that are addicted in their families. So we know that addiction is a family disease and it has to be treated on a family level. Family members experience trauma when their loved ones are going through this and Jason is a really. He's generously given some time to come on every week and talk with families about how trauma has impacted those of us that struggle with addiction and our families. So you can register for any of those family meetings. Like I said, they're completely free. You can register for any of them at interventiononcallcom. Again, you can reach out to me at mattatpartyrecordscom. I look forward to hearing from you. I hope your loved one gets sober and stays sober. Thank you.

Speaker 1: 26:38

Thanks again for listening to the Party Wreckers. If you liked what you heard, please leave us a rating and a review. This helps us get the word out to more people, to learn more or to ask us a question we can answer in a future episode. Please visit us at PartyWreckerscom and remember don't enable addiction ever.