…to the point where, even when they recognize a patient’s SUD — which doesn’t always happen — doctors still may fail to treat it.

It’s something we’ve encountered repeatedly over the years. That’s why I found this particular study fascinating. It’s a wide-ranging  examination of the barriers that physicians themselves identify as reasons for their reluctance to deal with substance use disorders and the patients who have them. Here’s a link to the article:

Physicians Cite Barriers in Addiction Care: Study Reveals

The study covered research involving some 67,000 physicians. Here, according to respondents, is what stands in the way:

Lack of knowledge, especially when it comes to treatment, and particularly where drugs other than alcohol were involved. I can see how that would be a barrier during a decades-long opioid epidemic, but shouldn’t we have addressed the issue by now? I mean, seriously.

Lack of institutional support— I suppose, reimbursement for time spent delivering care? Or, given that many docs work in institutional settings, that the organizations that employ them don’t emphasize identification and treatment of SUDs?

Lack of skills— As in,”I don’t know how to deal with drug users, so it’s easier to avoid the issue.” That I can understand, as SUD clients can be difficult to manage. But that’s also true for a bunch of other illnesses, and somehow we manage to overcome it, for the good of the patient.

Lack of available brainpower— an odd turn of phrase, but I think it means the physician feels as if they’re just too busy with more important tasks.

Lack of expectations of benefit– I’m guessing that translates to the familiar “what’s the use? It won’t do any good.” You hear that a lot, especially from primary care docs, ER staff, and others on the front lines, who may see a lot of relapse.

And of course, SUD treatment has traditionally been burdened with social stigma. As one private practitioner put it: “look, nobody wants those people in their waiting room. They just make my other patients uncomfortable. We’re certainly not going to do anything to encourage them to come see us.”

I like to think we’ve come quite a ways in terms of reducing that stigma over the past decades. Clearly not far enough, however.