Substance Use Disorders
Aside from major a pandemic such as COVID-19, substance use has been recognized as America’s number one “preventable” health problem for nearly two decades. In 2017, when overdose deaths in America reached 70,200 individuals, the total life expectancy rate of American’s dropped by 0.1% due largely to substance use. This was the first lowering of life expectancy in America since the early 1900s. Today, substance use disorders are believed to be impacting 10%-12% of Americans or about 25 million individuals and one in five families (1,2). The U.S. has an existing treatment capacity able to address only about 1 in 10 of those needing care (2,3). Additionally, substance use is significantly correlated to be involved in most major health issues (30-40%), crime and incarceration (60%), homelessness (31%), child abuse (50-80%) (1).
To address America’s evolving problem with substances, from prevention through recreational and prescriptive misuse, dependence, addiction, overdose, harm reduction and recovery, at least 5 times more than the approximately 76,600 current counselors would be needed (4,5). This goal can only be achieved through a sustained growth in the skilled substance use workforce existing within expanded specialized substance treatment, and a much broader and skilled, interdisciplinary workforce that is itself an extension of enhanced and applied substance use awareness and practice in generalized and integrated health practice. All medical care will need the ability to competently address the need for earlier substance use and co-occurring disorder prevention, intervention, treatment and sustained recovery services, i.e. a comprehensive identification of the role of substances at all levels of medical care - and life.
Through national expert leaders and panels (6), workforce development strategic goals, international and national collaborations, counselor competency development and many publications, the Annapolis Coalition has had a longstanding track record in addressing and understanding the substance use workforce. The Coalition maintains a focus on:
- the true magnitude of need for an expanded, skilled, competent workforce to properly prevent, treat substance use and addiction and sustain recovery both through the needs and competencies of specialized professional workers at all levels of care in all disciplines, peer through MD/PhD; and,
- the integration of all substance use and recovery science in a much broader way in all generalized primary and secondary medical care practitioners.
More recently this “workforce development” interest has expanded by assisting in the development of local community led strategies including innovative roles for families and local support workers that can better join the needs of each individual, family and community to best science and practice. Among many specific recommendations, the Coalition’s local “Recruitment and Retention” collaboratives, where “worker” collaborations are designed, are but one example.
- Hoge, M., Stuart, G., Morris, J., Huey,L., Flaherty,M., Paris, M. (2017). Behavioral Health Workforce Development in the United States, in Workforce Development Theory and Practice in Mental Health Sector, Smith, M., & Jury, A. Eds, IGI Global Publications, Hershey, Pa.
- AMA Network Journals. Science/Daily (2015, November). Prevalence of lifetime drug use disorders nearly 10 percent in US, retrieved from http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/jamapsychiatry.2015.2132
- Office of National Drug Control Policy, (2020). National drug control strategy. Retrieved from: https://www.whitehouse.gov/wp-content/uploads/2020/02/2020-NDCS.pdf (White House link is broken.) Can retrieve doc here: https://www.opioidlibrary.org/wp-content/uploads/2020/02/2020-NDCS.pdf
- Hoge, M., Stuart, G., Morris,J., Flaherty,M.,Paris,M. & Goplerud,E.(2013). Mental Health and Addiction Workforce Development: Federal leadership is needed to address the growing crisis, Health Affairs, November, 32.11
- Ryan, O., Murphey, D. & Krom, L. (2012). Vital Signs: Taking the pulse of the addiction treatment workforce, a national report (version 1). Kansas City, MO: Addiction Technology Transfer Center National Office in residence at the University of Missouri-Kansas City.
- Hoge, M., Morris, J., Stuart, G., Flaherty, M., Huey, L., Daniels A., Adams, N. (2007). An Action plan for behavioral health workforce development: a framework for discussion. Substance Abuse and Mental Health Services Administration, Rockville. Available from: http://www.samhsa.gov/workforce/annapolis/workforceaction plan.pdf .