May 12, 2025 • 27 mins
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Matt shares findings from a comprehensive National Institutes of Health study revealing why doctors struggle to treat addiction effectively and the alarming gap between those who need help and those who receive it.
• 81% of doctors cite lack of institutional support as the main barrier to treating addiction
• 74% of physicians acknowledge insufficient skill sets for addiction treatment
• 66% of studies identified negative social stigma as a significant deterrent
• 56% of doctors fear damaging patient relationships by addressing addiction
• In 2022, 49 million Americans had substance use disorders, but only 13 million received treatment
• Of 9 million people with opioid use disorder, only 25% received medication-assisted treatment
• Treatment demand significantly exceeds available capacity across the country
• Political solutions and policy changes have often fallen short of addressing core issues
If you or someone you know needs help with addiction, call or text 988, visit findtreatment.gov, or call 800-662-4357. Join our free family support meetings Mondays and Thursdays at 8pm Eastern, and our new trauma-focused family meetings Wednesdays at 8pm Eastern. Register at interventiononcall.com or contact Matt directly at matt@partywreckers.com.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to the Party Wreckers podcast, hosted by
seasoned addictioninterventionist, Matt Brown.
This is a podcast for familiesor individuals with loved ones
who are struggling withaddiction or alcoholism.
(00:22):
Perhaps they are reluctant toget the help that they need.
We are here to educate andentertain you while removing the
fear from the conversation.
Stick with us and we will getyou through it.
Welcome the original partywrecker, Matt Brown.
Speaker 2 (00:51):
What is up everyone?
Welcome.
Welcome to another episode.
My name is Matt Brown.
I am an interventionist andhave been for about the last 21
years.
I'm also a family coach and I'mglad you're here, if you found
this podcast, if this is yourfirst time here.
The purpose of what I do here isI want to make the conversation
(01:13):
that you're having with yourloved one around addiction a
little bit easier.
I think so many families getscared to try to have this
conversation because, if yourloved one is anything like I was
, we don't make it easy on you.
We sure are going to make youpay when you want to bring up
our addiction or our drinkingproblem, because that addiction
really wants to protect itself.
(01:34):
And so I think a familyproperly armed with the right
information, with the rightattitude and certainly an
abundance of love and concern,is a very well-equipped family
to have this conversation.
Today I want to talk aboutsomething that I found.
It's an article from theNational Institute on Drug Abuse
(01:56):
.
The study was done by theNational Institutes on Health
and this article came out inJuly of last year, 2024.
And it was interesting to mebecause this article focuses on
the well, the title of thearticle.
It says Doctors Reluctant toTreat Addiction Most Commonly
(02:17):
Report Lack of InstitutionalSupport as a Barrier.
So this article is about orthis study was about doctors
reporting what was preventingthem from successfully engaging
with their addicted clients.
And the interesting thing aboutthis article and forgive me if
you hear some papers rustling Iwant to make sure that I'm
(02:40):
taking a lot of the data that Ihave here and reporting it
accurately, because there's alot.
This study compiles 283 previousstudies done between, I want to
say, 1960 and 2022.
So about 61 years.
I'm sure the math doesn't addup there, but it's about 61
(03:03):
years worth of studies.
Now, 97% of those studies weredone after the year 2000.
So most of those have happenedin the last 25 years.
Now, of those studies, there wasabout 66,732 doctors that
participated or contributed tothe cumulative knowledge that
was gained from these studies,and so the sample size is
(03:28):
probably one of the biggest thatI've seen and certainly over
the longest duration that I'veseen, and so I found it pretty
fascinating because it reallyhighlights where I think we're
going wrong, not just in themedical field but in addiction
treatment as a whole.
Now, the biggest contributingfactor that doctors reported
(03:53):
over those 61 years was lack ofinstitutional support.
Now institutional supportrefers to factors like support
from a physician's institutionor employer, say a hospital or a
practice group.
Insufficient resources, such asstaff training, challenges in
(04:14):
organizational culture andcompeting demands.
This reason for reluctance wascited in 81% of the studies
reviewed.
Now the second most citedreason was insufficient skill.
So doctors are you know and Igot to say I'm glad that they
(04:34):
were willing to say this, butthey were able to say that 75%
of the doctors, 74% of thedoctors, said that they didn't
have the sufficient skill to beable to treat addiction.
Lack of cognitive capacity tomanage a certain level of care
74%, and inadequate knowledge72%.
So skill and knowledge reallykind of ranked up there with
(04:55):
each other.
But this issue aroundinstitutional support I think
really highlights why there areso many treatment centers in the
private sector, outside of whatMedicare and Medicaid provide,
outside of what hospitalsprovide, this lack of
institutional support Eitherthey didn't have the personnel,
(05:16):
they didn't have the resourcesand, quite frankly, they're not
getting the reimbursements thatthey would get from other
medical conditions, and so theynaturally kind of punt this to
the private sector and you get alot of these quite frankly good
and some not so good treatmentproviders that are out there
(05:39):
providing nothing but addictiontreatment, but addiction
treatment.
And I think when families arelooking at, hey, I need to get
my loved one some help, I thinkthe first maybe not some more,
but historically the first placepeople looked was to their
doctor, maybe to a therapist,maybe to a psychiatrist, maybe
(06:02):
to a clergyman, but mosttypically it was a medical
doctor that somebody would go to.
And when you have 81% of thesedoctors saying that they just
don't have the support that theyneed to be able to adequately
treat addiction and 74 to 72% ofthem say they don't even have
the right knowledge or the rightskill set to be able to do this
(06:23):
, it really highlights where Ithink as an industry, a medical
industry, we are falling shortin terms of providing doctors
the right knowledge, the rightskill set and the right support
to be able to treat addiction.
Now, around 66% of these studiesout of the 61 years, 66% of the
(06:47):
studies cited negative socialinfluence or beliefs about
community acceptance ofaddiction care.
So this highlights somethingdifferent, and I think we see a
lot of this as a society thesedays, and that is just the
stigma that surrounds addiction.
Most people don't look at thisas a medical issue these days.
(07:09):
They look at it as an issue ofpoor character, lack of
self-will, poor choices.
Constantly on the familysupport calls that we do every
Monday and Thursday, weregularly get questions asked to
the interventionist at anintervention on call.
You know, is addiction a choiceor is it a disease?
(07:29):
And when you have families thatare asking this.
It also sounds like doctors arestruggling with this in some
way as well when they say 66% ofthe studies cited negative
social influences or negativestigma around addiction and
addiction treatment.
(07:56):
That's telling.
56% of the studies cited fear ofharming the patient-physician
relationship as deterrents forphysicians to intervene on
addiction.
So 56% of the studies said thatthe doctors were afraid of
losing a patient or that thepatient wouldn't engage with
them going forward if theyaddress the underlying addiction
(08:18):
.
And so you guys, as families,are not the only ones worried
about damaging a relationshipwhen it comes to your loved one.
Doctors are worried about it aswell.
Loved one Doctors are worriedabout it as well, and I don't
know if that's.
It doesn't say that that'snecessarily financially
motivated, but it removes theability from or at least they're
worried that it would removethe ability for a doctor to
(08:39):
continue to treat the patient ifthey were to address the
addiction.
Families worry about this too.
How many of you listening tothis who have an addicted loved
one can think of a time in thepast, or even recently, where
you wanted to address this butyou were worried about upsetting
(09:01):
your loved one?
You were worried about what itmight do to your relationship
and it was just easier to nottalk about the elephant in the
room and maybe look for a betteropportunity down the line than
address it right in the moment.
And doctors are struggling withthe same thing, according to
these studies.
According to at least 56% ofthe studies, the doctors were
(09:22):
reporting that they were worriedabout losing their patient if
they address the addiction.
It also goes on to say thatreimbursement concerns for the
cost of delivering addictioninterventions were also observed
.
So insurance just isn't payingwhat hospitals and other people
(09:45):
in private practice are hopingto recoup.
People in private practice arehoping to recoup, and so it's
just not a profitable.
What's the word I'm looking for?
Medical practice you havedifferent specialties, I guess
was the word I was looking for.
It's not something thatinsurance was reimbursing
(10:06):
hospitals as well for, and so,as you guys are depending on
insurance to go into the privatesector and contract with
treatment providers, a lot oftimes insurance companies will
tie the hands of even privatetreatment providers who bill
insurance in terms of the numberof days they're willing to
authorize, in terms of theamount of reimbursement on a
(10:28):
daily rate that they're willingto authorize, and I think a lot
of times we think, well, I'vegot insurance, it should cover
this, and honestly it should,especially given the premiums
that a lot of us are paying.
But the insurance industrybeing what it is, they want to
make as much money as possible.
I mean, that's their businessmodel, and so I think, as an
(10:52):
industry, we've got to try towork with legislators.
Say what you will aboutObamacare Some people are for it
, some people were against it.
What it did establish wasparity, which is treating
addiction like any other medicalillness.
For those of you who tried toget your loved one treatment
(11:14):
before 2013, 2014, insurancecompanies could deny treatment
for addiction because it was apre-existing condition
pre-existing condition and sothey could deny it, or it was
just not covered under thepolicy.
Now we're not seeing that.
(11:36):
We're seeing that it's beingtreated like any other medical
condition, but they're findingother ways to limit access to
treatment.
And along those lines, let mejust read another.
This is a really importantstatistic and I don't want to
get this wrong.
I'll just read what it sayshere Despite effective
interventions for treatingsubstance use disorders,
(11:56):
including medications,behavioral therapies, adoption
of these practices remains lowand demand exceeds treatment
capacity.
Now these are the statisticsthat are going to kind of blow
everybody away.
I think Now these are thestatistics that are going to
kind of blow everybody away.
I think In 2022, nearly 49million people in the US had at
least one substance use disorder.
49 million.
(12:17):
Of that 49 million, only 13million people.
Residential treatment that'sinpatient.
Residential treatment that'soutpatient, that's medication
assistant treatment going to themethadone clinic getting
suboxone.
That includes any form oftreatment.
(12:39):
So you have 49 million people.
About 25% of those people wereable to get help.
13 million More than 9 millionadults needed treatment for
opioid use disorder in 2022, butfewer than half around 46%
received any form of treatmentand only 25% received medication
(13:00):
for opioid use disorder.
So 9 million people neededtreatment for opioid use
disorder and I think, in largepart just based on the evidence
that I've seen and theexperience that I had that was
largely fentanyl, of course,some prescription drug use abuse
(13:21):
, but 25% at the bare minimum.
At the bare minimum wheredoctors were prescribing a
medication to help with cravings, only about 25% of those people
got help.
Now, in recent years,buprenorphine was only allowed
to be prescribed by a certain.
(13:42):
You had to have a certainlicense to be able to prescribe
buprenorphine, which is Suboxone, subutex, a lot of the
anti-craving medications thatare out there.
Right recently, the, the, thelaws changed and any medical
doctor with a an FDA licensewell, that's not the right oh,
(14:04):
what's it?
It's the oh.
Who issues the licenses?
I can't remember, but if youhad a license to prescribe
medications, you could prescribebuprenorphine Even then.
Now there's greater access tothat medication.
Only about 25% of those 9million people were able to get
it.
Now, because of the kind of workI do, I also see that a lot of
(14:25):
people are reluctant to get help.
I'm not going to sit here andsay that every one of those 9
million people were banging downthe door of their doctor to try
to get help, or banging downthe door of a treatment center
to try to get help, or those 49million people were all
clamoring like, hey, help me,I'm addicted and I need some
help.
(14:46):
Here.
I think anybody listening tothis podcast, especially from
the vantage point of you know doI need to do an intervention
for my loved one?
You're wrestling with this ideathat, hey, my loved one doesn't
really want help, they don'treally want to change yet, and
so I think in large part that 49million I shouldn't say in
large part.
Some of that, a good percentageof that 49 million were people
(15:11):
who had not yet become willingto get help.
Even then, the demand for helpfar outweighed the ability to
provide that help.
Again, this is just a lack ofservices.
I don't want to make thispolitical.
Oftentimes it's an easy fingerto point.
(15:32):
But I'll look at where I live.
In my home state of Oregon, whenrecreational use of marijuana
was passed in the middle20-teens, one of the things that
was promised to those of ushere in this state was that with
the tax revenue from the saleof recreational marijuana, that
they were going to create moretreatment opportunities.
That has not happened happened.
(16:01):
And then, of course, you havebrilliant ideas like the
decriminalization of drugpossession.
In theory it's not a bad idea Ishouldn't say it sarcastically
like that.
In theory it's not a bad idea,because I don't think that drug
addiction should be criminalized.
But here in Oregon the idea washey, we're going to write you a
ticket if we catch you inpossession under a certain
weight or a certain amount ofsubstance, and you either have
(16:37):
an opportunity to pay a $100fine the first time or you can
go get an assessment to see ifyou meet criteria to go into a
treatment program.
Now, on the second time you geta ticket there's no more $100.
Fine, you're going to get thatassessment and they're going to
see if they can get you help.
I called about a year into this,after the legislation had
passed.
I called Oregon Department ofHealth and I said hey, I've
worked in a couple of otherdifferent states where I've
(16:58):
helped train people to go in andassess people and help motivate
people to get help.
I would love to be a part oftraining the teams that are
doing these assessments.
And the gentleman that I spokewith at Oregon Department of
Health was very open and he saidyou know we don't have anybody
doing those assessments yet.
I said no, wait a minute, it'sbeen a year.
(17:20):
What's going on?
And he's like we just haven'tbeen able to get the
infrastructure in place to beable to do this.
And so what was happening islaw enforcement was writing all
these tickets.
I'm sure some people would haveopted to go and get help, and
it wasn't available.
There was nobody doing theassessments.
Now, since then, they'vechanged the law, it's been
(17:50):
recriminalized now and they'rehandling it a different way,
because the way that they triedto roll it out just didn't work
and it was putting lawenforcement at a real
disadvantage disadvantage, Iknow I'm deviating a little bit
from the medical component ofthis, but I really just want to
highlight the fact that thedemand outweighs the ability to
provide at this point.
(18:11):
So many families will reach outand say I don't know where to
find my loved one help.
Families will reach out and sayI don't know where to find my
loved one help, especiallyfamilies who have loved ones
that are on Medicaid or Medicare.
How do I find a treatmentfacility that doesn't have a
waiting list, that doesn't have?
You know, sometimes there is abacklog of people waiting to get
(18:32):
in.
I know, if I'm working with afamily here in Oregon and their
loved one has Medicaid, I'm ableto help them, but sometimes
it's not going to be like thesame day of the intervention.
There's several different hoopsto jump through In some states.
Other states work this way aswell.
Where you get the person toagree to go and get help, the
(18:54):
first step is they have to goand get assessed.
The person will do theassessment and say okay, you
meet criteria to go into aninpatient program or you meet
criteria to go into anoutpatient program.
Here are your options and thisyou know.
Of these options, the earliestwe might be able to get you in
is three weeks from now.
Well, now we've got to treadwater for the next three weeks
(19:17):
to try to get this person andkeep this person motivated to
continue to get help.
That shouldn't be the hardestpart of this process.
The hardest part shouldn't behow can I get my loved one help?
We have the ability to providegood quality addiction treatment
(19:38):
and mental health treatment.
We've got qualified therapists.
It baffles me that in 2025, weare still struggling to combat
this problem.
The war on drugs was started in1972 by Richard Nixon and it's
been a war that we've beenlosing ever since and we've been
(20:00):
playing catch up.
And until we.
I think part of the problem iswe're looking at this from a
supply side issue.
If you just look at it from asupply and demand, we look at
this from a supply side solution.
We've got to stem the flow ofdrugs into the United States.
(20:21):
We've got to stem the sale ofdrugs within the United States.
We've got to work on gettingdealers off the streets.
We've got to work on enforcinglaws or implementing new laws
that are going to make drugsmore difficult to get a hold of.
Well, I think we all know, fromprohibition on, we've learned
that as long as there's a demand, there's going to be a supply.
(20:46):
If we can give families whatthey need to be able to have
different kinds of conversationswith their loved ones, and not
put it on police, not put it onschools, programs like the DARE
program, which was ridiculous,this whole idea of just say no.
You know, nancy Reagan, if Icould have just said no, I would
(21:06):
have.
You know, it sounds like agreat idea, but I, you know,
just say no is not an option formost of us.
You know, I wanted to say no somany times and couldn't.
Um, we've got to find a way toprovide better care and more
(21:28):
readily available care to peoplewho need it.
I guess my challenge toeverybody listening to this
today would be reach out.
If you have a doctor, find outI mean, just be curious.
Find out what they know.
Find out what kind of educationthey have when they went
through medical school onaddiction.
Find out if they're doinganything in terms of of
(21:50):
continuing education onaddiction or or addiction
treatment.
If you're a medical providerand you're listening to this
podcast, I would be interested,if you wouldn't mind and we can
do this completely discreetly,of course I would be curious to
know what is the biggest barrierthat you have experienced in
(22:11):
being able to provide goodquality care, as far as
addiction goes, to your patients.
That will never get shared onthe podcast, certainly not with
anybody's identity.
I would be interested, just formy own edification, to learn
what some of the challenges aretoday.
(22:31):
If you feel like these numbersline up with what you're
experiencing in your practice,or if you feel like, hey, this
is not what I'm experiencing,here's actually what I'm able to
see and I feel like I'mactually able to provide quite
well for my patients, I wouldlove to hear that.
If you feel like you have alimited access in your state,
(22:53):
especially if you're here inOregon, reach out to your local
legislators.
Find out why we have such anabysmal recovery rate when it
comes to availability andquality of care in addiction
treatment.
Why are these doctors findingit so difficult to get the
institutional support that theyneed, to get the training and
(23:15):
the education that they need tobe able to treat something
that's killing tens of thousandsof people every year.
Anyways, I'll get off my soapbox.
I found this article to becompletely interesting and I
thought I would just share ittoday.
There's a couple of otherthings that I want to share,
(23:36):
because I think that this issomething that's lacking as well
.
The last paragraph of thisarticle says if you or someone
you know is struggling or incrisis, help is available.
Call or text 988.
Until I read this article I'vebeen doing this work for over 20
years I didn't know that therewas a three-digit number that
you can call, kind of like 911.
(23:57):
It's 988.
But you can call and talk tosomebody, or text and talk to
somebody to try to find help.
Somebody or text and talk tosomebody to try to find help.
There's a website,988lifelineorg, where you can go
.
Findtreatmentgov is a websitewhere you can go and actually
find treatment programs.
(24:18):
Again, it doesn't mean thatthere's going to be an abundance
of treatment programs.
It doesn't mean they're notgoing to have a waiting list,
but hey, there's a website outthere where you can go and find
treatment, especially if you'relimited in your resources in
terms of having insuranceprivate insurance or
state-funded insurance likeMedicaid you have a website you
can go to and find treatmentfindtreatmentorg, or you can
(24:40):
call 800-662-4357.
I will put all of thisinformation in the show notes so
that you don't have to rememberit just from listening here.
Thank you guys for listening.
I appreciate you tuning in foranother episode.
My name is Matt Brown.
If you need help or want toreach out, you can find me at
(25:01):
matt at partyrecordscom.
You can email me directly.
I would love to hear from you.
You can book a private sessionwith me at interventiononcallcom
, with myself or with another ofthe amazing providers that we
have on the site.
Every Monday and Thursday at 8pm Eastern we have a free family
(25:22):
support group for families whohave loved ones in active
addiction.
Starting this Wednesday thatwould be May 14th we have Jason
Chain, who is an amazing man.
He's very knowledgeable when itcomes to trauma and addiction.
He's going to be doing a freefamily meeting every Wednesday
(25:47):
night now at eight o'clockEastern for trauma in those that
are addicted in their families.
So we know that addiction is afamily disease and it has to be
treated on a family level.
Family members experiencetrauma when their loved ones are
going through this and Jason isa really.
He's generously given some timeto come on every week and talk
(26:09):
with families about how traumahas impacted those of us that
struggle with addiction and ourfamilies.
So you can register for any ofthose family meetings.
Like I said, they're completelyfree.
You can register for any ofthem at interventiononcallcom.
Again, you can reach out to meat mattatpartyrecordscom.
I look forward to hearing fromyou.
(26:30):
I hope your loved one getssober and stays sober.
Thank you.
Speaker 1 (26:38):
Thanks again for listening to the Party Wreckers.
If you liked what you heard,please leave us a rating and a
review.
This helps us get the word outto more people, to learn more or
to ask us a question we cananswer in a future episode.
Please visit us atPartyWreckerscom and remember
(27:05):
don't enable addiction ever.
Welcome to the Party Wreckers podcast, hosted by
seasoned addictioninterventionist, Matt Brown.
This is a podcast for familiesor individuals with loved ones
who are struggling withaddiction or alcoholism.
(00:22):
Perhaps they are reluctant toget the help that they need.
We are here to educate andentertain you while removing the
fear from the conversation.
Stick with us and we will getyou through it.
Welcome the original partywrecker, Matt Brown.
Speaker 2 (00:51):
What is up everyone?
Welcome.
Welcome to another episode.
My name is Matt Brown.
I am an interventionist andhave been for about the last 21
years.
I'm also a family coach and I'mglad you're here, if you found
this podcast, if this is yourfirst time here.
The purpose of what I do here isI want to make the conversation
(01:13):
that you're having with yourloved one around addiction a
little bit easier.
I think so many families getscared to try to have this
conversation because, if yourloved one is anything like I was
, we don't make it easy on you.
We sure are going to make youpay when you want to bring up
our addiction or our drinkingproblem, because that addiction
really wants to protect itself.
(01:34):
And so I think a familyproperly armed with the right
information, with the rightattitude and certainly an
abundance of love and concern,is a very well-equipped family
to have this conversation.
Today I want to talk aboutsomething that I found.
It's an article from theNational Institute on Drug Abuse
(01:56):
.
The study was done by theNational Institutes on Health
and this article came out inJuly of last year, 2024.
And it was interesting to mebecause this article focuses on
the well, the title of thearticle.
It says Doctors Reluctant toTreat Addiction Most Commonly
(02:17):
Report Lack of InstitutionalSupport as a Barrier.
So this article is about orthis study was about doctors
reporting what was preventingthem from successfully engaging
with their addicted clients.
And the interesting thing aboutthis article and forgive me if
you hear some papers rustling Iwant to make sure that I'm
(02:40):
taking a lot of the data that Ihave here and reporting it
accurately, because there's alot.
This study compiles 283 previousstudies done between, I want to
say, 1960 and 2022.
So about 61 years.
I'm sure the math doesn't addup there, but it's about 61
(03:03):
years worth of studies.
Now, 97% of those studies weredone after the year 2000.
So most of those have happenedin the last 25 years.
Now, of those studies, there wasabout 66,732 doctors that
participated or contributed tothe cumulative knowledge that
was gained from these studies,and so the sample size is
(03:28):
probably one of the biggest thatI've seen and certainly over
the longest duration that I'veseen, and so I found it pretty
fascinating because it reallyhighlights where I think we're
going wrong, not just in themedical field but in addiction
treatment as a whole.
Now, the biggest contributingfactor that doctors reported
(03:53):
over those 61 years was lack ofinstitutional support.
Now institutional supportrefers to factors like support
from a physician's institutionor employer, say a hospital or a
practice group.
Insufficient resources, such asstaff training, challenges in
(04:14):
organizational culture andcompeting demands.
This reason for reluctance wascited in 81% of the studies
reviewed.
Now the second most citedreason was insufficient skill.
So doctors are you know and Igot to say I'm glad that they
(04:34):
were willing to say this, butthey were able to say that 75%
of the doctors, 74% of thedoctors, said that they didn't
have the sufficient skill to beable to treat addiction.
Lack of cognitive capacity tomanage a certain level of care
74%, and inadequate knowledge72%.
So skill and knowledge reallykind of ranked up there with
(04:55):
each other.
But this issue aroundinstitutional support I think
really highlights why there areso many treatment centers in the
private sector, outside of whatMedicare and Medicaid provide,
outside of what hospitalsprovide, this lack of
institutional support Eitherthey didn't have the personnel,
(05:16):
they didn't have the resourcesand, quite frankly, they're not
getting the reimbursements thatthey would get from other
medical conditions, and so theynaturally kind of punt this to
the private sector and you get alot of these quite frankly good
and some not so good treatmentproviders that are out there
(05:39):
providing nothing but addictiontreatment, but addiction
treatment.
And I think when families arelooking at, hey, I need to get
my loved one some help, I thinkthe first maybe not some more,
but historically the first placepeople looked was to their
doctor, maybe to a therapist,maybe to a psychiatrist, maybe
(06:02):
to a clergyman, but mosttypically it was a medical
doctor that somebody would go to.
And when you have 81% of thesedoctors saying that they just
don't have the support that theyneed to be able to adequately
treat addiction and 74 to 72% ofthem say they don't even have
the right knowledge or the rightskill set to be able to do this
(06:23):
, it really highlights where Ithink as an industry, a medical
industry, we are falling shortin terms of providing doctors
the right knowledge, the rightskill set and the right support
to be able to treat addiction.
Now, around 66% of these studiesout of the 61 years, 66% of the
(06:47):
studies cited negative socialinfluence or beliefs about
community acceptance ofaddiction care.
So this highlights somethingdifferent, and I think we see a
lot of this as a society thesedays, and that is just the
stigma that surrounds addiction.
Most people don't look at thisas a medical issue these days.
(07:09):
They look at it as an issue ofpoor character, lack of
self-will, poor choices.
Constantly on the familysupport calls that we do every
Monday and Thursday, weregularly get questions asked to
the interventionist at anintervention on call.
You know, is addiction a choiceor is it a disease?
(07:29):
And when you have families thatare asking this.
It also sounds like doctors arestruggling with this in some
way as well when they say 66% ofthe studies cited negative
social influences or negativestigma around addiction and
addiction treatment.
(07:56):
That's telling.
56% of the studies cited fear ofharming the patient-physician
relationship as deterrents forphysicians to intervene on
addiction.
So 56% of the studies said thatthe doctors were afraid of
losing a patient or that thepatient wouldn't engage with
them going forward if theyaddress the underlying addiction
(08:18):
.
And so you guys, as families,are not the only ones worried
about damaging a relationshipwhen it comes to your loved one.
Doctors are worried about it aswell.
Loved one Doctors are worriedabout it as well, and I don't
know if that's.
It doesn't say that that'snecessarily financially
motivated, but it removes theability from or at least they're
worried that it would removethe ability for a doctor to
(08:39):
continue to treat the patient ifthey were to address the
addiction.
Families worry about this too.
How many of you listening tothis who have an addicted loved
one can think of a time in thepast, or even recently, where
you wanted to address this butyou were worried about upsetting
(09:01):
your loved one?
You were worried about what itmight do to your relationship
and it was just easier to nottalk about the elephant in the
room and maybe look for a betteropportunity down the line than
address it right in the moment.
And doctors are struggling withthe same thing, according to
these studies.
According to at least 56% ofthe studies, the doctors were
(09:22):
reporting that they were worriedabout losing their patient if
they address the addiction.
It also goes on to say thatreimbursement concerns for the
cost of delivering addictioninterventions were also observed
.
So insurance just isn't payingwhat hospitals and other people
(09:45):
in private practice are hopingto recoup.
People in private practice arehoping to recoup, and so it's
just not a profitable.
What's the word I'm looking for?
Medical practice you havedifferent specialties, I guess
was the word I was looking for.
It's not something thatinsurance was reimbursing
(10:06):
hospitals as well for, and so,as you guys are depending on
insurance to go into the privatesector and contract with
treatment providers, a lot oftimes insurance companies will
tie the hands of even privatetreatment providers who bill
insurance in terms of the numberof days they're willing to
authorize, in terms of theamount of reimbursement on a
(10:28):
daily rate that they're willingto authorize, and I think a lot
of times we think, well, I'vegot insurance, it should cover
this, and honestly it should,especially given the premiums
that a lot of us are paying.
But the insurance industrybeing what it is, they want to
make as much money as possible.
I mean, that's their businessmodel, and so I think, as an
(10:52):
industry, we've got to try towork with legislators.
Say what you will aboutObamacare Some people are for it
, some people were against it.
What it did establish wasparity, which is treating
addiction like any other medicalillness.
For those of you who tried toget your loved one treatment
(11:14):
before 2013, 2014, insurancecompanies could deny treatment
for addiction because it was apre-existing condition
pre-existing condition and sothey could deny it, or it was
just not covered under thepolicy.
Now we're not seeing that.
(11:36):
We're seeing that it's beingtreated like any other medical
condition, but they're findingother ways to limit access to
treatment.
And along those lines, let mejust read another.
This is a really importantstatistic and I don't want to
get this wrong.
I'll just read what it sayshere Despite effective
interventions for treatingsubstance use disorders,
(11:56):
including medications,behavioral therapies, adoption
of these practices remains lowand demand exceeds treatment
capacity.
Now these are the statisticsthat are going to kind of blow
everybody away.
I think Now these are thestatistics that are going to
kind of blow everybody away.
I think In 2022, nearly 49million people in the US had at
least one substance use disorder.
49 million.
(12:17):
Of that 49 million, only 13million people.
Residential treatment that'sinpatient.
Residential treatment that'soutpatient, that's medication
assistant treatment going to themethadone clinic getting
suboxone.
That includes any form oftreatment.
(12:39):
So you have 49 million people.
About 25% of those people wereable to get help.
13 million More than 9 millionadults needed treatment for
opioid use disorder in 2022, butfewer than half around 46%
received any form of treatmentand only 25% received medication
(13:00):
for opioid use disorder.
So 9 million people neededtreatment for opioid use
disorder and I think, in largepart just based on the evidence
that I've seen and theexperience that I had that was
largely fentanyl, of course,some prescription drug use abuse
(13:21):
, but 25% at the bare minimum.
At the bare minimum wheredoctors were prescribing a
medication to help with cravings, only about 25% of those people
got help.
Now, in recent years,buprenorphine was only allowed
to be prescribed by a certain.
(13:42):
You had to have a certainlicense to be able to prescribe
buprenorphine, which is Suboxone, subutex, a lot of the
anti-craving medications thatare out there.
Right recently, the, the, thelaws changed and any medical
doctor with a an FDA licensewell, that's not the right oh,
(14:04):
what's it?
It's the oh.
Who issues the licenses?
I can't remember, but if youhad a license to prescribe
medications, you could prescribebuprenorphine Even then.
Now there's greater access tothat medication.
Only about 25% of those 9million people were able to get
it.
Now, because of the kind of workI do, I also see that a lot of
(14:25):
people are reluctant to get help.
I'm not going to sit here andsay that every one of those 9
million people were banging downthe door of their doctor to try
to get help, or banging downthe door of a treatment center
to try to get help, or those 49million people were all
clamoring like, hey, help me,I'm addicted and I need some
help.
(14:46):
Here.
I think anybody listening tothis podcast, especially from
the vantage point of you know doI need to do an intervention
for my loved one?
You're wrestling with this ideathat, hey, my loved one doesn't
really want help, they don'treally want to change yet, and
so I think in large part that 49million I shouldn't say in
large part.
Some of that, a good percentageof that 49 million were people
(15:11):
who had not yet become willingto get help.
Even then, the demand for helpfar outweighed the ability to
provide that help.
Again, this is just a lack ofservices.
I don't want to make thispolitical.
Oftentimes it's an easy fingerto point.
(15:32):
But I'll look at where I live.
In my home state of Oregon, whenrecreational use of marijuana
was passed in the middle20-teens, one of the things that
was promised to those of ushere in this state was that with
the tax revenue from the saleof recreational marijuana, that
they were going to create moretreatment opportunities.
That has not happened happened.
(16:01):
And then, of course, you havebrilliant ideas like the
decriminalization of drugpossession.
In theory it's not a bad idea Ishouldn't say it sarcastically
like that.
In theory it's not a bad idea,because I don't think that drug
addiction should be criminalized.
But here in Oregon the idea washey, we're going to write you a
ticket if we catch you inpossession under a certain
weight or a certain amount ofsubstance, and you either have
(16:37):
an opportunity to pay a $100fine the first time or you can
go get an assessment to see ifyou meet criteria to go into a
treatment program.
Now, on the second time you geta ticket there's no more $100.
Fine, you're going to get thatassessment and they're going to
see if they can get you help.
I called about a year into this,after the legislation had
passed.
I called Oregon Department ofHealth and I said hey, I've
worked in a couple of otherdifferent states where I've
(16:58):
helped train people to go in andassess people and help motivate
people to get help.
I would love to be a part oftraining the teams that are
doing these assessments.
And the gentleman that I spokewith at Oregon Department of
Health was very open and he saidyou know we don't have anybody
doing those assessments yet.
I said no, wait a minute, it'sbeen a year.
(17:20):
What's going on?
And he's like we just haven'tbeen able to get the
infrastructure in place to beable to do this.
And so what was happening islaw enforcement was writing all
these tickets.
I'm sure some people would haveopted to go and get help, and
it wasn't available.
There was nobody doing theassessments.
Now, since then, they'vechanged the law, it's been
(17:50):
recriminalized now and they'rehandling it a different way,
because the way that they triedto roll it out just didn't work
and it was putting lawenforcement at a real
disadvantage disadvantage, Iknow I'm deviating a little bit
from the medical component ofthis, but I really just want to
highlight the fact that thedemand outweighs the ability to
provide at this point.
(18:11):
So many families will reach outand say I don't know where to
find my loved one help.
Families will reach out and sayI don't know where to find my
loved one help, especiallyfamilies who have loved ones
that are on Medicaid or Medicare.
How do I find a treatmentfacility that doesn't have a
waiting list, that doesn't have?
You know, sometimes there is abacklog of people waiting to get
(18:32):
in.
I know, if I'm working with afamily here in Oregon and their
loved one has Medicaid, I'm ableto help them, but sometimes
it's not going to be like thesame day of the intervention.
There's several different hoopsto jump through In some states.
Other states work this way aswell.
Where you get the person toagree to go and get help, the
(18:54):
first step is they have to goand get assessed.
The person will do theassessment and say okay, you
meet criteria to go into aninpatient program or you meet
criteria to go into anoutpatient program.
Here are your options and thisyou know.
Of these options, the earliestwe might be able to get you in
is three weeks from now.
Well, now we've got to treadwater for the next three weeks
(19:17):
to try to get this person andkeep this person motivated to
continue to get help.
That shouldn't be the hardestpart of this process.
The hardest part shouldn't behow can I get my loved one help?
We have the ability to providegood quality addiction treatment
(19:38):
and mental health treatment.
We've got qualified therapists.
It baffles me that in 2025, weare still struggling to combat
this problem.
The war on drugs was started in1972 by Richard Nixon and it's
been a war that we've beenlosing ever since and we've been
(20:00):
playing catch up.
And until we.
I think part of the problem iswe're looking at this from a
supply side issue.
If you just look at it from asupply and demand, we look at
this from a supply side solution.
We've got to stem the flow ofdrugs into the United States.
(20:21):
We've got to stem the sale ofdrugs within the United States.
We've got to work on gettingdealers off the streets.
We've got to work on enforcinglaws or implementing new laws
that are going to make drugsmore difficult to get a hold of.
Well, I think we all know, fromprohibition on, we've learned
that as long as there's a demand, there's going to be a supply.
(20:46):
If we can give families whatthey need to be able to have
different kinds of conversationswith their loved ones, and not
put it on police, not put it onschools, programs like the DARE
program, which was ridiculous,this whole idea of just say no.
You know, nancy Reagan, if Icould have just said no, I would
(21:06):
have.
You know, it sounds like agreat idea, but I, you know,
just say no is not an option formost of us.
You know, I wanted to say no somany times and couldn't.
Um, we've got to find a way toprovide better care and more
(21:28):
readily available care to peoplewho need it.
I guess my challenge toeverybody listening to this
today would be reach out.
If you have a doctor, find outI mean, just be curious.
Find out what they know.
Find out what kind of educationthey have when they went
through medical school onaddiction.
Find out if they're doinganything in terms of of
(21:50):
continuing education onaddiction or or addiction
treatment.
If you're a medical providerand you're listening to this
podcast, I would be interested,if you wouldn't mind and we can
do this completely discreetly,of course I would be curious to
know what is the biggest barrierthat you have experienced in
(22:11):
being able to provide goodquality care, as far as
addiction goes, to your patients.
That will never get shared onthe podcast, certainly not with
anybody's identity.
I would be interested, just formy own edification, to learn
what some of the challenges aretoday.
(22:31):
If you feel like these numbersline up with what you're
experiencing in your practice,or if you feel like, hey, this
is not what I'm experiencing,here's actually what I'm able to
see and I feel like I'mactually able to provide quite
well for my patients, I wouldlove to hear that.
If you feel like you have alimited access in your state,
(22:53):
especially if you're here inOregon, reach out to your local
legislators.
Find out why we have such anabysmal recovery rate when it
comes to availability andquality of care in addiction
treatment.
Why are these doctors findingit so difficult to get the
institutional support that theyneed, to get the training and
(23:15):
the education that they need tobe able to treat something
that's killing tens of thousandsof people every year.
Anyways, I'll get off my soapbox.
I found this article to becompletely interesting and I
thought I would just share ittoday.
There's a couple of otherthings that I want to share,
(23:36):
because I think that this issomething that's lacking as well
.
The last paragraph of thisarticle says if you or someone
you know is struggling or incrisis, help is available.
Call or text 988.
Until I read this article I'vebeen doing this work for over 20
years I didn't know that therewas a three-digit number that
you can call, kind of like 911.
(23:57):
It's 988.
But you can call and talk tosomebody, or text and talk to
somebody to try to find help.
Somebody or text and talk tosomebody to try to find help.
There's a website,988lifelineorg, where you can go
.
Findtreatmentgov is a websitewhere you can go and actually
find treatment programs.
(24:18):
Again, it doesn't mean thatthere's going to be an abundance
of treatment programs.
It doesn't mean they're notgoing to have a waiting list,
but hey, there's a website outthere where you can go and find
treatment, especially if you'relimited in your resources in
terms of having insuranceprivate insurance or
state-funded insurance likeMedicaid you have a website you
can go to and find treatmentfindtreatmentorg, or you can
(24:40):
call 800-662-4357.
I will put all of thisinformation in the show notes so
that you don't have to rememberit just from listening here.
Thank you guys for listening.
I appreciate you tuning in foranother episode.
My name is Matt Brown.
If you need help or want toreach out, you can find me at
(25:01):
matt at partyrecordscom.
You can email me directly.
I would love to hear from you.
You can book a private sessionwith me at interventiononcallcom
, with myself or with another ofthe amazing providers that we
have on the site.
Every Monday and Thursday at 8pm Eastern we have a free family
(25:22):
support group for families whohave loved ones in active
addiction.
Starting this Wednesday thatwould be May 14th we have Jason
Chain, who is an amazing man.
He's very knowledgeable when itcomes to trauma and addiction.
He's going to be doing a freefamily meeting every Wednesday
(25:47):
night now at eight o'clockEastern for trauma in those that
are addicted in their families.
So we know that addiction is afamily disease and it has to be
treated on a family level.
Family members experiencetrauma when their loved ones are
going through this and Jason isa really.
He's generously given some timeto come on every week and talk
(26:09):
with families about how traumahas impacted those of us that
struggle with addiction and ourfamilies.
So you can register for any ofthose family meetings.
Like I said, they're completelyfree.
You can register for any ofthem at interventiononcallcom.
Again, you can reach out to meat mattatpartyrecordscom.
I look forward to hearing fromyou.
(26:30):
I hope your loved one getssober and stays sober.
Thank you.
Speaker 1 (26:38):
Thanks again for listening to the Party Wreckers.
If you liked what you heard,please leave us a rating and a
review.
This helps us get the word outto more people, to learn more or
to ask us a question we cananswer in a future episode.
Please visit us atPartyWreckerscom and remember
(27:05):
don't enable addiction ever.
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