The Necessity of Addiction Training

According to the Substance Abuse and Mental Health Services Administration (SAMHSA; 2023), more than 1 in 9 of American adults (11.8 percent) believe they have ever had a problem with alcohol or other drugs of abuse. The sheer pervasiveness of substance use and addictive behaviors in the United States necessitates that all professionals in mental health and medical fields be trained in addiction. Why is this training so important? It's because substance use and addictive behaviors affect multiple aspects of an individual’s life and may result in a person receiving mental health or medical services prior to seeking addiction treatment. If these mental health and medical professionals fail to assess for, or recognize, addiction among their patients, their work will be undermined. Also, the detection of addiction by these professionals can hasten the process of getting an individual into treatment (e.g., a medical doctor makes a referral to a residential treatment facility or the psychologist makes a referral to an intensive outpatient program).

Training in addiction is crucial for professionals in myriad disciplines to ensure thathey provide appropriate and effective services. Consider a counselor who works with a client who meets the criteria for major depressive disorder, but the counselor is unaware of the client’s gambling disorder. How might this affect their work with the client? Or consider a primary care physician whose patient has an array of physical ailments, yet the physician is unaware of the patient’s alcohol use disorder. Or consider a dentist working with a patient with poor dentition, but the dentist is unaware of the patient’s use of methamphetamines. As you can imagine, the efforts of these professionals will be limited by the unrecognized, unaddressed addictive disorder contributing to the issues, and the opportunity to direct the patient to addiction treatment will be missed.

All Mental Health Professionals Should Be Trained in Addictions

Within the field of mental health specifically, it is necessary that professionals in all settings are trained to recognize and respond to addiction, especially since substance intoxication and withdrawal symptoms can mimic mental health symptoms. Consider a client who is hallucinating: It could be a symptom of schizophrenia or a mood disorder with psychotic features, but it could also be the result of LSD intoxication, methamphetamine intoxication, high-potency cannabis intoxication, or alcohol withdrawal. Indeed, the Diagnostic and Statistical Manual of Mental Disorders (APA, 2013) requires the “ruling out” of substance use before assigning a diagnosis for this very reason: The symptoms can mimic each other. It is imperative that all mental health providers know that in some cases, cannabis intoxication can cause paranoia, alcohol withdrawal can cause delusions, opioid withdrawal can cause anxiety and agitation, cocaine intoxication can cause manic behavior, stimulant withdrawal can cause depression, etc. The only way to appropriately assess symptoms and determine if they are substance-induced or stemming from a mental health concern is to be knowledgeable and trained.

In the same way, it is imperative that school counselors are trained in addiction. These counselors must be able to recognize the signs of student substance use (or potentially compulsive behaviors such as gaming, pornography, or gambling). For example, if a student demonstrates changes in behavior (e.g., sleeping during class, tardiness), changes in their attitude (e.g., withdrawn, irritable), changes in their appearance (e.g., weight loss, neglect of personal hygiene), changes in their peer group (e.g., socializing with other students who have used substances), loss of interest in school (e.g., not completing assignments, dropping out of extracurricular activities), or a drop in GPA (Ali et al., 2011), the school counselor must know to assess for the use of substances or engagement in addictive or compulsive behaviors. In this way, school counselors can aid in early intervention and ensure students get the support and services they need quickly.

All Medical Professionals Should be Trained in Addictions

In addition to the field of mental health, the medical field is a prime arena in which patients’ addictive behaviors can be noticed, assessed, and addressed appropriately—perhaps for the first time. Medical professionals in all areas should receive training regarding the physical effects of substance use and addictive behaviors. For example, all medical professionals should know that, in some cases, cocaine use can lead to loss of smell or increased risk of cardiac arrest, alcohol use can lead to liver disease or pancreatitis, cannabis use can lead to cannabinoid hyperemesis syndrome, synthetic cannabinoid use can lead to seizures, MDMA can lead to hyperthermia, etc. Furthermore, given the ongoing opioid epidemic in the United States, it is imperative that all medical professionals consider patients’ addiction history and risk factors for addiction before prescribing opioids or other potentially addictive substances (e.g., prescription stimulants, benzodiazepines). Doctors, dentists, nurses, EMTs, and other medical staff could be among the first professionals to recognize the physical effects of addiction in their patients and provide compassionate guidance for how to receive treatment and support.

Although most mental health and medical training programs do require some degree of addiction training, it must continue to be prioritized and viewed as a necessary component of education in these disciplines. For professionals already working in their respective fields, it is imperative to offer opportunities for continued education related to addiction. In these ways, we can take a multidisciplinary approach to recognizing and responding to addiction in the United States and better support those who struggle with drugs of abuse or addictive or compulsive behaviors.