Addiction: Closing the Gap between Science and Practice - Implications for Nurse Practitioner Educators

Despite scientific advances in understanding addiction as a brain disease, the public and health professionals alike continue to apply concepts of shame, disgust, low morals, and deficient willpower to the problem of substance use and abuse. Currently in America, 16 percent (40 million) individuals are affected by the disease of addiction. Besides this number, 32 percent (80 million) are considered “at risk” users – with tobacco, alcohol and other drugs – these users threaten the health and safety of all Americans.

According to research done by CASA, risky substance abuse and addiction are America’s “largest preventable and most costly health problems, accounting for one third of hospital inpatient costs, driving crime and lost productivity, and resulting in total costs to government alone of at least $468 billion each year” (p ii). 

Healthcare professionals, including medical doctors, nurse practitioners and others, are woefully unprepared.  We are generally unable to connect what is known about addiction as a disease – and how to intervene  - to daily practice with the healthcare needs of patients.   All patients need knowledgeable practitioners who can implement effective screening, brief intervention, and appropriate referrals.

This presentation will focus on content which will improve the Nurse Practitioner’s knowledge base in addiction medicine:  addiction as a brain disease with clear risk factors, addiction as a frequent co-occuring disease with other health conditions, addiction as a chronic disease, and the common multi-use occurrence of risky use and addiction.  For Nurse Practitioner Educators, teaching strategies for helping students with effective screening and intervention strategies will be presented.

Scant data exists regarding the current substance abuse treatment gap – the number of individuals who are risky users, the addicted – and those who actually get help.  This gap is multifactorial – but it certainly exists partially due to under-training in our medical and nurse practitioner schools.  Initiatives will be presented to improve this training in NP schools, including developing and reaching forward to a national standard of care for risky use and addiction.