The need for board certified addiction medicine physicians is great. Substance use disorders are a leading healthcare issue in America. Mortality, morbidity and financial costs of substance use disorders are greater than any other disease category (nearly 25 % of all U.S. deaths are attributable to alcohol, tobacco, and other drugs, including certain dependence producing prescription drugs). New drug problems, and new waves of epidemic drug use and consequences are continual. For instance, just as the American methamphetamine epidemic is being addressed, prescription pharmaceuticals have re-emerged as a long dormant killer. The Centers for Disease Control and Prevention reported in 2011 that over 27,000 people died from prescription overdoses in 2007, a number that has risen five-fold since 1990 and has never been higher. Prescription drugs are now involved in more overdose deaths than heroin and cocaine combined, and are the second leading cause of unintentional death in the United States.
Hospital, emergency department, and primary care admission and discharge data show that currently 6 million patients with severe drug dependence obtain health care in one of these three settings, and that the population and patient need will increase 12% by 2020. To meet this need, over 5,000 additional addiction physician specialists must be certified between 2010 and 2020. This does not take into account the additional primary care physicians who will need to be educated about proper prescribing, prevention, screening, and brief intervention, in order to move prevention and care of substance use disorders into mainstream healthcare. Moreover, this projection does not take into account the increase in patient need for care that is expected to occur as a result of the Affordable Care Act.
Scientific knowledge has advanced regarding addiction, substance-related health conditions, the pharmacology of addictive substances, and the pharmacotherapies to treat addiction. Therapies with evidenced-based success are increasingly available to patients (examples include pharmacotherapies – including detoxification protocols – and cognitive behavioral therapies which can be provided individually or in a group setting). Physicians see the benefit of prevention and treatment for their patients and families. The public health mandate is overwhelming. Prisons and hospitals are overcrowded with persons with addictive disorders. Financially, the nation cannot afford to ignore the health care costs of addiction and related illnesses, and the contribution addiction prevention and care will make to reducing these costs. Finally, physicians – particularly younger physicians – are questioning and seeking resolution to the current situation where extraordinary attention, time, care and money are spent on treating the consequences of addiction, rather than treating the primary disease of addiction itself. Physician education, training and certification in addiction medicine will help remedy these problems.