Why physicians are unprepared to treat patients who have alcohol- and drug-related disorders

Most primary care physician do not feel competent to treat alcohol- and dru g-related disorders. Physicians generally do not like to work with patients with these dis orders and do not find treating them rewarding. Despite lar ge numbers of such patients, tile diagnosis and treatment of alcohol- and d rug-related disorders are generally considered peripheral to or outside med ical matters and ultimately outside medical education. There is substantial evidence that physicians fail even to identify: a large percentage of pati ents with these disorders. Essential role models are lacking for future physicians to develop the atti tudes and training they need to adequately approach addiction as a treatabl e medical illness. Faculty development programs in addictive disorders are needed to overcome the stigma, poor attitudes, and deficient skill among ph ysicians who provide education and leadership for medical students and resi dents. The lack of parity with other medical disorders gives reimbursement and education for addiction disorders low priority. Medical students and ph ysicians can also be consumers and patients with addiction problems. Their attitudes and abilities to learn about alcohol- and drug related disorders are impaired without interventions. Curricula lack sufficient instruction a nd experiences in addiction medicine throughout all years of medical educat ion. Programs that have successfully changed students' attitudes and skills for treatment of addicted patients continue to he exceptional and limited in focus rather than the general practice in U.S. medical schools. The authors review the findings of the literature on these problems, discus s the barriers to educational reform. and propose recommendations for devel oping an effective medical school curriculum about alcohol- and drug-relate d disorders.