American Society of Addiction Medicine
"…addiction is not about drugs, it’s about brains. It is not the substances a person uses that make them an addict; it is not even the quantity or frequency of use. Addiction is about what happens in a person’s brain when they are exposed to rewarding substances or rewarding behaviors, and it is more about reward circuitry in the brain and related brain structures than it is about the external chemicals or behavior that “turn on” that reward circuitry."i
Keith Humphreys, PhD, Professor, Stanford Medical School
"One of the fundamental barriers to providing effective treatment is the fact that addiction is not integrated into medical practice. And a lot of medical people like and want it that way; they do not want to deal with addiction; they do not like to deal with the people and they do not feel effective addressing the problem."ii
Kevin B. Kunz, MD, Former President, American Board of Addiction Medicine (ABAM)
"We want addiction prevention, screening, intervention, and treatment to become routine aspects of medical care, available virtually any place health care is provided."iii
John C. Higgins-Biddle, PhD, Assistant Professor (Retired), Community Medicine and Health Care, University of Connecticut Health Center
"Implementing screening and brief intervention would be a revolution in 21st century medical practice. It would help reduce billions of dollars annually in lost productivity, injury and social costs associated with risky behaviors. It would also encourage those with chronic conditions to get the treatment they need. But medical practices are unlikely to take action without pressure from others who would benefit. The question is, when will society demand this change?"iv
John Rotrosen, MD, Professor, Department of Psychiatry, New York University School of Medicine, VA NY Harbor Healthcare System
"I would define treatment for addiction] the way I would define treatment for any medical problem--good thorough evaluation, intervention tailored for that specific person based on a good assessment, use of a range of tools--behavioral, pharmacological, family and other social support, housing, jobs."v
Jeffrey Samet, MD, Professor of Medicine and Social Behavior, Clinical Addiction Research and Education (CARE) Program, Boston University School of Medicine
"The use of evidence-based approaches in treatment will be driven by policy. We need to use the payment system to drive changes in practice."vi
Brian Hurley, Chair, Physicians-in-training Committee, American Society of Addiction Medicine
"Most doctors do not look at addiction as part of their job. They may assess, but they don’t intervene."vii
Respondent to CASA Columbia’s, Survey of Individuals in Long-Term Recovery
"I was not able to get help until I got myself into the criminal justice system and was then placed into treatment as a condition of parole. I tried many times to get help for my addiction but due to the lack of insurance and money, was denied."viii
Shelly Greenfield, MD, MPH, Chief Academic Officer, McLean Hospital, Professor of Psychiatry, Harvard Medical School, Director, Clinical and Health Services Research and Education Division of Alcohol and Drug Abuse, McLean Hospital
"There is no other comparable example in medicine where you have evidence-based treatments that are not available."ix
Mark Willenbring, MD, Director, Division of Treatment and Recovery, National Institute on Alcohol Abuse and Alcoholism (currently, Associate Professor of Psychiatry, University of Minnesota)
"We are treating these folks with severe and persistent addiction with a time limited-treatment of three or four weeks, maybe six or eight, maybe at the most three months, if you want to include what’s called aftercare. Now, why would we think that treating a chronic disorder for a few weeks would lead to improvement 10 years later or five years later or even a year later? It doesn’t make any sense."x
Michael M. Miller, MD, Past President, American Society of Addiction Medicine
"The effectiveness of addiction treatment is evaluated based on perverted measures of success…you’d never judge the benefits of an antihypertensive medication AFTER the medication had been stopped."xi
Larry M. Gentilello, MD, Trauma Services, Kaiser Permanente Hospital, Sacramento, CA
"If the Joint Commission would require hospitals to report their outcomes on SBIRT, it could do more to medicalize how we deal with risky substance use than all the urging and pleading we’ve undertaken for the past 25 to 30 years."xii
Nora D. Volkow, MD, Director, National Institute on Drug Abuse (NIDA)
"… [addiction] is not simply a disease of the brain, but it is a developmental disorder, and it begins early in life--during adolescence."xiii
Mark S. Gold, MD, University of Florida College of Medicine and McKnight Brain Institute, Departments of Psychiatry, Neuroscience, Anesthesiology, Community Health & Family Medicine, Chairman, Department of Psychiatry
"The notion of critical periods, so integral to the development of language or musical skills, is relevant to the development of addiction as well. It is clear from my work in addiction medicine that use of addictive substances is like a traumatic brain injury to a young person. Any use by young people before brain development is complete equals risky use."xiv
iAmerican Society of Addiction Medicine. (2011). Definition of addiction: Frequently asked questions. [On-line]. Retrieved November 14, 2011 from http://www.asam.org/pdf/Advocacy/20110816_DefofAddiction-FAQs.pdf.
iiHumphreys, K., Ph.D., Professor, Stanford Medical School (personal communication, August 16, 2007).
iiiNational Institute on Drug Abuse. (2009). Program aims to expand physician training to treat drug addiction. NIDA Notes, 22(6), 1.
ivHiggins-Biddle, J. C., PhD, Assistant Professor (Retired), Community Medicine and Health Care, University of Connecticut Health Center (personal communication, February 28, 2012).
vRotrosen, J., Professor, Department of Psychiatry, New York University School of Medicine, VA NY Harbor Healthcare System (personal communication, August 7, 2007).
viSamet, J., MD, Professor of Medicine and Social Behavior, Clinical Addiction Research and Education (CARE) Program, Boston University School of Medicine (personal communication, August 7, 2007).
viiHurley, B., Chair, Physicians-in-training Committee, American Society of Addiction Medicine (personal communication, August 13, 2007).
viiiThe National Center on Addiction and Substance Abuse at Columbia University (CASA Columbia). (2008). CASA Columbia's Survey of Individuals in Long-Term Recovery. New York: CASA Columbia.
ixGreenfield, S., Associate Professor of Psychiatry, Harvard Medical School, Associate Clinical Director, Alcohol and Drug Abuse Treatment Program, McLean Hospital (personal communication, January 18, 2008).
xWillenbring, M. (2009). BHC Journal's interview with Mark Willenbring, M.D., About NESARC. [On-line]. Retrieved February 4, 2009 from http://www.bhcjournal.com/default.aspx?articleId=14186&tabid=252.
xiMiller, M. M., MD., Past President, American Society of Addiction Medicine (personal communication, March 16, 2012).
xiiGentilello,L. M., M.D., Trauma Services, Kaiser Permanente Hospital, Sacramento, CA. (personal communication, March 8, 2012).
xiiiRosack, J. (2004). NIDA, APA collaborate on substance abuse series. [On-line]. Retrieved December 2, 2011 from http://pnhw.psychiatryonline.org/content/39/4/32.1.full.
xivGold, M., MD, University of Florida, College of Medicine and McKnight Brain Institute, Departments of Psychiatry, Neuroscience, Anesthesiology, Community Health & Family Medicine, Chairman, Department of Psychiatry (personal communication, March 19, 2012).