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Hospital-Based Addiction Medicine Healthcare Providers

High Demand, Short Supply

Braithwaite, Vivian BKin; Nolan, Seonaid MD

doi: 10.1097/ADM.0000000000000488

Substance use disorders account for a significant burden of disease and place an enormous strain on the health care system in the United States and beyond. Despite death tolls climbing, a myriad of evidence-based medications exist to effectively treat many substance use disorders including nicotine, alcohol, and opioid use disorders. To date, hospitals have largely been overlooked as a setting ripe for the delivery of specialized addiction care. This occurs despite a high lifetime prevalence of a substance use disorder (50%) occurring among hospitalized individuals. A potential barrier to this is the lack of addiction medicine training that currently exists in undergraduate and graduate medical education. Consequently, a paucity of existing physicians report feeling competent to adequately screen for, diagnose or treat substance use disorders. Given the prevalence, cost and potentially lethal consequences of substance use disorders, a critical need exists to improve its identification and evidence-based management in hospital settings.

British Columbia Centre on Substance Use (VB, SN); Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada (SN).

Send correspondence to Seonaid Nolan, MD, Assistant Professor, University of British Columbia, Clinician Scientist, British Columbia Centre on Substance Use, 553B–1081 Burrard St. Vancouver, BC, Canada V6Z 1Y6. E-mail:

Received 26 July, 2018

Accepted 18 November, 2018

The authors have no conflicts of interest to disclose.

© 2019 American Society of Addiction Medicine