40 million Americans ages 12 and over meet the clinical criteria for addiction involving nicotine, alcohol or other drugs. That is more than the number of people with heart conditions, diabetes or cancer. Meanwhile, another 80 million Americans fall into the category of risky substance users, defined as those who are not addicted, but use tobacco, alcohol and other drugs in ways that threaten public health and safety.
This 5-year study found that, despite the prevalence of addiction, the enormity of its consequences, the availability of effective solutions and the evidence that addiction is a disease, both screening and early intervention for risky substance use are rare. Misunderstandings about the nature of addiction and the best ways to address it, as well as the disconnection of addiction medicine from mainstream medical practice, have undermined effective addiction treatment. Additional key findings include the following:
This report relied on various research methodologies, including a review of more than 7,000 publications, analyses of 5 national data sets, and interviews with 176 leading experts in a broad range of fields. Several surveys were conducted, including a national survey of 1,303 adults about their attitudes and beliefs related to addiction and its treatment, an online survey of 1,142 members of professional associations involved in addiction care, and an online survey of 360 individuals with a history of addiction. Analyses of licensing and certification requirements for treatment as well as a case study of addiction treatment in New York State and New York City provided further data.