MICHEL MARTIN, HOST:
When a public health crisis hits the U.S., doctors and nurses are almost always on the front lines, but NPR has found something very different is happening with the epidemic of illnesses caused by addiction. Research shows even as deaths soared, most clinicians are still actively avoiding treating people who are grappling with alcohol and street drug use. NPR addiction correspondent Brian Mann is with us now to tell us more about this. Good morning, Brian.
BRIAN MANN, BYLINE: Hi, Michel.
MARTIN: You spent weeks researching this story. What did you find?
MANN: You know, addiction, Michel, is one of the most common illnesses in the U.S., and alcohol and street drugs like fentanyl - they're causing more than 250,000 deaths a year. That's according to federal data. But NPR reviewed research and interviewed more than a dozen medical experts, and we found many doctors still resist or avoid helping these patients. Dr. Bobby Mukkamala is with the American Medical Association.
BOBBY MUKKAMALA: There are too few physicians that are treating substance use disorder and too few patients that kind of receive that evidence-based treatment.
MANN: New federal data found that in 2025, more than 80% of people with substance use disorders didn't receive any help at all for their addiction, and without care, a lot of those people are getting really sick, and they're dying.
MARTIN: Why aren't more doctors and nurses participating in this kind of care?
MANN: There's consensus this is one legacy of America's long drug war. Substance use disorders are now considered treatable illnesses. But for decades, addiction was seen by many as a moral or criminal issue. Many forms of addiction still involve illegal drugs, and research shows that led to fear and hostility in the general public, and the same stigma turns up in surveys of medical professionals. Robert DeForde is with a group called Shatterproof that works to convince clinicians to treat opioid addiction
ROBERT DEFORDE: Persistent stigma, right? They don't want these people around them. They don't think that the drugs that we have that are FDA-approved medications are really going to actually help the patient. That is what I would say is a fatal flaw in our system.
MANN: And DeForde himself is in recovery from addiction. He says he's experienced this kind of medical bias from his own doctors.
MARTIN: What should doctors and other clinicians be doing differently?
MANN: Well, the science on this is clear. As DeForde mentioned, there are really good prescription medications for treating the deadliest forms of addiction. That's alcohol and opioids. They've been shown for decades to be highly effective at reducing cravings and preventing overdoses. Research shows these treatments are fairly low risk for misuse by patients, but the vast majority of clinicians simply don't offer them. Dr. Judy Chertok, who treats patients and researches addiction care at the University of Pennsylvania, told me if more health workers did offer these treatments in doctors' offices and clinics and hospitals, it would save a lot of lives.
JUDY CHERTOK: I do think the impact would be transformative. We have tremendous opportunities to intervene.
MANN: Instead, many addiction patients are being turned away with very little treatment or no care at all.
MARTIN: Is there any effort to change this?
MANN: Absolutely. But most people I interviewed say progress is slow. And they point, Michel, to one fact that they describe as troubling - decades after the opioid crisis erupted, most medical and nursing schools in the U.S. still don't teach addiction care as a core, normalized part of medical practice. Experts told me that needs to change, but for now, we're training another generation of clinicians, many without the skills and the confidence they need to treat these addiction patients.
MARTIN: That is NPR addiction correspondent Brian Mann. More of his reporting on this story later on All Things Considered. Brian, thank you.
Thank you. Transcript provided by NPR, Copyright NPR.
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