Despite the high prevalence of addiction and substance use disorders in the United States, the number of physicians adopting evidence-based substance use disorder interventions in their clinical practice remains low. A team of investigators, including University of Colorado Department of Medicine faculty member Jarratt Pytell, MD, MHS, aimed to find out why.
Through a systematic review of 283 previous studies published between 1960 and 2021, the team found that the most common reasons given by physicians to explain their reluctance were a lack of institutional support, knowledge, skill, and cognitive capacity.
The resulting research article, “Physician Reluctance to Intervene in Addiction,” was published July 17 in the JAMA Network Open, and it was highlighted in a National Institutes of Health news release. The study was funded by the National Institute on Drug Abuse.
“We have a lot of evidence-based interventions that are not being delivered by physicians. We wanted to understand what factors make physicians reluctant to address addiction in their clinics,” says Pytell, an internal medicine and addiction medicine physician and assistant professor in the CU Division of General Internal Medicine. “Across the board, a lack of institutional support was the most commonly cited reason in the studies we reviewed.”
We recently spoke with Pytell to discuss this research, its findings, and what he thinks needs to change to improve patient care for people with addiction and substance use disorders.
This interview has been edited for length and clarity.