Forty million Americans ages twelve and older have an addiction involving nicotine, alcohol, or other drugs, making addiction a disease affecting more Americans than heart conditions, diabetes, or cancer, according to a five-year national study released June 2012 by The National Center on Addiction and Substance Abuse at Columbia University (CASA Columbia). Another 80 million people are at-risk substance users—using tobacco, alcohol, and other drugs in ways that threaten health and safety. The report, Addiction Medicine: Closing the Gap Between Science and Practice, reveals that while seven in ten people with diseases such as hypertension, major depression, and diabetes receive treatment, only about one in ten people who need treatment for addiction involving alcohol or other drugs receive it. Of those who do receive treatment, most do not receive anything that approximates evidence-based care. The CASA Columbia report found that addiction treatment is largely disconnected from mainstream medical practice. while a wide range of evidence-based screening, intervention, treatment, and disease management tools and practices exist, they are rarely employed. The report exposed the fact that most medical professionals who should be providing treatment are not sufficiently trained to diagnose or treat addiction, and that most of those providing addiction treatment are not medical professionals and are not equipped with the knowledge, skills, or credentials necessary to provide the full range of evidence-based services. “This report shows that misperceptions about the disease of addiction are undermining medical care,” said Drew Altman, PhD, president of The Henry J. Kaiser Family Foundation, who chaired the report’s National Advisory Commission. while doctors routinely screen for a broad range of health problems such as high blood pressure or high cholesterol, they rarely screen for risky substance use or signs of addiction, and instead treat a long list of health problems that frequently result from it, including accidents, unintended pregnancies, heart disease, and many other costly conditions, without examining the root cause. This landmark report examines the science of addiction—a complex disease that involves changes in the structure and function of the brain—and the profound gap between what we know about the disease and how to prevent and treat it, versus current health and medical practice. This blog post is an excerpt from The therapist’s Guide to Addiction Medicine – A Handbook for Addiction Counselors and Therapists – by Barry Solof, MD, FASAM; Published by Central Recovery Press (CRP).