Current Data on the Addiction Treatment Gap in America

Drug and alcohol addiction is at the level of an official Public Health Emergency, yet only a small percentage of addicts receive effective treatment. This situation is known as the Treatment Gap. The gap is large, and too many people are falling through it.

Just how broad is this gap, and how do we close it?

Defining the Treatment Gap

The National Institute on Drug Abuse, the leading federal research institute for data on drug addiction and treatment, defines the Treatment Gap as the difference between the number of Americans who need treatment and the number of Americans who receive treatment. At the time of a NIDA publication, at least 21 million Americans needed treatment. (That figure is per 2011 data. The number of addicted Americans is likely much higher now).

Of those 21 million addicted, only about 2 million received treatment the year of the report. What’s more, some experts believe that a higher number of people become addicted to drugs each year than get help—suggesting that treatment is not keeping up with the levels of increase. Though the numbers have changed since 2011, the disparity between those who need treatment (a considerable number) and those who receive it (a small fraction of that number) undoubtedly remains the same or is worsening.

Another aspect of the Treatment Gap is that many addicts seek treatment but don’t receive it for various reasons. The disparity here is also extreme—the number of struggling addicts actively seeking treatment is much larger than the total number of addicts who receive treatment.

Sadly, though there are effective treatment methods available, very few of those who struggle with addiction receive treatment.

The Cost of the Treatment Gap

To be blunt—the “Treatment Gap” is a gaping hole. None of this data makes for a pretty picture, and in fact, the situation is grim and difficult to digest. Most of us would prefer not to think about it. However, as a society, we must, because at the other end of data collections and systematic analyses are real lives, real suffering. And too many lives are being lost to addiction. According to the National Institute on Drug Abuse, in collaboration with the Centers for Disease Control and Prevention, tens of thousands of Americans die from drug overdoses each year. In 2019, NIDA reported 70,630 overdose deaths, including deaths from illicit drugs and prescription opioids. The death toll for 2019 is almost double the 38,329 people who lost their lives from drug overdoses in 2010.

But fatal overdoses are not the only harm caused by the treatment gap. The collateral damage from the Treatment Gap is considerable not only for the addicts but their families and society as well.

For the drug addict, addiction can translate into lost careers, accidents, health problems such as infections related to injections, incarceration and mental crises—to name a few items on the long list of possible harms.

For families, addiction gives rise to broken relationships, in-utero exposure (causing problems for baby), poor parenting and devastating financial losses.

There is also damage to every community and a substantial financial cost brought on by addiction in America. According to NIDA, substance abuse costs the nation over $600 billion annually.

The cost of the Treatment Gap is high, and those in the gap are at increased risk. But in one way or another, the gap impacts each of us, whether we have blinders on or not.

Why not invest in closing the Treatment Gap?

To say that it would be the right thing to do is a considerable understatement, especially considering further statistical data:

Statistical Data on America’s Addiction Treatment Gap

Annual reports released by the National Survey on Drug Use and Health provide valuable information on the state and scope of drug and alcohol misuse in the United States. Such information is insightful when analyzing the type and magnitude of actions needed if we are to begin to find real solutions to the drug crisis.

According to the 2019 National Survey on Drug Use and Health, only 4.2 million Americans received addiction treatment. These findings determined that these 4.2 million Americans represent only about 12 percent of the total population of Americans who need substance abuse treatment.

The 2019 NSDUH also records the percentage of addicts who feel they need (or do not need) treatment. Surprisingly, about 95% of Americans struggling with substance abuse report they do not require treatment. That makes closing the treatment gap more challenging.

Overcoming the Treatment Gap—Solutions to Drug Addiction

There is plenty that society could do to diminish the Treatment Gap. Redirecting resources from criminalization towards more practical and humane solutions, such as drug education and accessibility to treatment, would go a long way. But even before we could do this, more individuals would have to be made aware of the gravity of the situation called the Treatment Gap. As a society, we must stop cringing when we hear the words “drug addict” and look at the problem directly and compassionately.

But even now, with the number of treatment centers that are accessible, we can do more to get these centers operating at full capacity and helping more individuals.

It starts with deciding to help one addict – maybe someone you know. Overcoming opioid addiction is difficult. Withdrawal can be painful and highly uncomfortable without the right help to get through it. Many addicts can’t face the withdrawal symptoms and therefore say they don’t need treatment. There is also a stigma attached to drug addiction that makes discourse on the topic uncomfortable. But no matter what an addict is saying or manifesting, no one wants to be addicted.

Whether addicts perceive that they need treatment or if it would help, anyone struggling with an addiction to drugs or alcohol needs assistance. When addiction is in full gear, the individual cannot break free from the habit independently. Their drug use or drinking will continue, progressively worsening, until some form of intervention occurs, and they are brought to realize the need for change. Once this happens, help becomes possible, and treatment should be immediately presented as a solution.

Doctors Lipari, Park-Lee, and Van Horn say it best in an article for the Substance Abuse and Mental Health Services Administration: “The substance use recovery process is highly personal and occurs via many pathways. For many Americans, this recovery process includes access to and use of substance use treatment at specialty facilities. Having access to substance use treatment and supportive services to address various needs associated with substance use disorders is critical for those who are in need of treatment.”

If you know anyone who needs help with a drug problem, please help them find a qualified drug and alcohol addiction treatment center. Do it as soon as possible because left untreated, addiction only gets worse. It never “gets better” without intervention and treatment.

Sources:

• https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-do-we-get-more-substance-abusing-people-treatment
• https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates
• https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/drug-addiction-treatment-worth-its-cost
• https://www.samhsa.gov/data/sites/default/files/reports/rpt29393/2019NSDUHFFRPDFWHTML/2019NSDUHFFR1PDFW090120.pdf
• https://www.samhsa.gov/data/sites/default/files/report_2716/ShortReport-2716.html

Reviewed and Edited by Claire Pinelli, ICAADC, CCS, LADC, MCAP RAS, LCDC-i