It usually comes back to the assumption that another problem ‘underlies’ addiction, and therefore will respond to treatment with the “right” drug, if we can figure out what it is.
This isn’t a problem a physician can deal with comfortably in the context of a 12-15 minute office visit.
Would you respond to this information with a concerted effort at self-examination and profound behavior change?
Might be that clinicians can teach patients to activate their own body’s placebo response, in order to feel better.
It’s hard to accept that what began in an effort to help people in pain has turned into this unholy mess.
I’ve come to view it more as a tool for harm reduction than a path to long term recovery, with some notable exceptions.
As any case manager knows, making a referral can be a challenge, since many fall by the wayside during transition to another provider, different therapist, etc.
Despite the collateral damage, Big Pharma seems determined to preserve the market for its products, through sophisticated lobbying.