JUANA SUMMERS, HOST:
This month, NPR reported on doctors and nurses who are reluctant to treat patients struggling with alcohol and drug addiction. In response, we got a lot of good questions from listeners; also, some criticism. NPR's Brian Mann reported the story, and he is here to answer some of those questions. Hi, Brian.
BRIAN MANN, BYLINE: Hi, Juana.
SUMMERS: Brian, for starters, just tell us about this story and also the stakes involved.
MANN: Well, the stakes are super high. Addiction is one of the most common and dangerous illnesses in the U.S., but research shows 80% of people with substance use disorders don't get treatment for their addiction. And my story focused on a case involving a 26-year-old man named Jean Descamps. He was discharged from a hospital emergency room in Oregon in 2023 even though local police were really concerned about his condition. And he then died of an overdose from drugs already in his system. And that case, Juana, sadly isn't unique. Roughly a quarter million people in the U.S. die every year from alcohol and opioids, and researchers say many of those deaths are preventable.
SUMMERS: I want to turn now to those audience questions that we mentioned. Your story talked about addiction treatment medications, and some people I understand were skeptical about these drugs. What are they? And also, do they really work?
MANN: So medications like buprenorphine, methadone, and naltrexone reduce cravings for alcohol and opioids, and data shows they're really effective. One study published in 2023 found that when patients addicted to opioids were prescribed buprenorphine after an overdose, their chance of later dying from a future overdose dropped 62%. That's really huge. And I spoke about this with Dr. Judy Chertok. She treats patients with addiction in Philadelphia. And she told me she was shocked to learn how well these medications work.
JUDY CHERTOK: It was unbelievable to have a tool to address something that I had inappropriately deemed difficult to treat or untreatable.
MANN: And these medications have been available for decades. Doctors say buprenorphine and naltrexone, in particular, are no more challenging to prescribe than other common medications. But again, most patients just never get them.
SUMMERS: OK. I want to talk about why, because your story pointed to stigma among healthcare workers, but one person who identified herself as a nurse practitioner wrote to us at NPR to say that it's not fair to say medical professionals treat addiction patients with suspicion or hostility. So help us unpack this. Like, what is the evidence that the stigma is real?
MANN: So surveys of doctors and nurses for decades have shown persistent, widespread stigma. One study in 2000 found a third of nurses and 1 in 5 doctors view addiction as a moral or spiritual issue, not a treatable disease. Jump forward to 2021. Another study described this pattern as explicit discrimination. So this problem is really well documented.
SUMMERS: Brian, if we can, I want to turn now to emergency rooms. One person wrote that critics are asking too much of the nurses and doctors and ERs that, as we know, are often understaffed and overwhelmed. Is addiction care actually possible in ER settings?
MANN: I put this question to Dr. Itai Danovitch. He's with the American Society of Addiction Medicine. And Juana, he says, yes, hospital staff should be trained to treat people with substance use disorders with the same kind of care they bring to other patients after, say, a heart attack or a car crash.
ITAI DANOVITCH: They have to stabilize them. They have to initiate treatments, and they have to link them to continuing care. Otherwise, that person is going to be right back there. And these are all doable.
MANN: And this can be challenging in places where there aren't enough doctors who are trained and willing to treat addiction. But even then, Danovitch says hospitals should be offering more of their patients those proven medications.
SUMMERS: And last thing, Brian, and this is something I'm personally very curious about. A lot of people asked if this problem with addiction treatment is really different from what many Americans face when they're just trying to find generally good, affordable healthcare.
MANN: Yeah, it's a great question. Doctors, researchers and government officials I interviewed say addiction is different. Care is much harder to get, and that's true for people living on the streets - right? - who are often severely ill. But it's also true for the tens of millions of Americans with treatable addiction who have homes and jobs. And often these people have health insurance, but right now, they go to their doctors or local clinics, and they just aren't getting help.
SUMMERS: That was NPR's Brian Mann. You can read and hear Brian's full report right now on our website. That's npr.org. Brian, thank you.
MANN: Thanks, Juana. Transcript provided by NPR, Copyright NPR.
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