In an article in this week’s Boston Globe by Kevin Cullen the CEO of one of the major Boston area treatment programs cited lack of trained staff as one of the biggest problems with our current system of care. Jonathan Scott, president and chief executive of Victory Programs, stated that “too few hospital staff are trained in addiction”.
It is a little known fact that most of the professional training programs in the greater New England area allow someone to graduate with a Masters in Social Work or a Masters in Counseling degree without ever taking any coursework in assessing and treating addictions and substance use disorders. This is also true for nurses, psychiatrists and doctorate level psychologists. These are the professionals on the front line of treatment services and they are usually unprepared to work with people with substance use disorders.
A person seeking help for such a problem is often mis-diagnosed with depression or anxiety, under treated with an inadequate therapeutic approach or provided with medications (such as highly addictive anti-anxiety medications such as Xanax or Klonopin) that only make the problem worse.
The American Association of Colleges of Nursing provides an extensive list of curricula for nursing education. There is only brief mention of the need to learn screening of alcohol problems within any of these lists. Knowledge of other drug problems and addictions and how to treat them are nowhere to be found.
Of the Boston area MSW programs, none of them offer any specific specialization in substance use disorders and addictions. Any courses that are offered in this area are available as electives and not part of the core curriculum. Only one school, Simmons College, offers a specialization in Mental Health and Addictions. This includes three courses with a substance use and addictions focus, all electives.
The state board that grants license for Counselors (LMHC) , relies on the Commonwealth of Massachusetts Licensure Requirements for Mental Health Counselors. The requirements do not require any training in substance use disorders and addictions. Only the Counseling program at U-Mass Boston requires a course in substance use and addictions as part of its core curriculum. Students may choose between COUNSL 670: Substance Abuse in Modern Society or COUNSL 672: Substance Abuse and the Family.
There are no incentives in the service system to specialize in this area. The professional licensing boards do not require any study or experience in this area and there are no financial incentives for anyone to specialize in this very challenging area. Given the current state of crisis, stipends from the state, to increase the compensation for professionals choosing to specialize in this area would go a long way to filling this gap. Adjustment in licensing requirements would also support more professional specialization in this area. And, the professional schools need to step up, add more curriculum in substance use disorders and addictions and make this topic area part of a core requirement of study.
