too. In one study, for example, CASA Columbia found that 94
percent of primary-care physicians failed to recognize the signs
of risky alcohol use and offer addiction as a possible diagnosis.
All psychologists and physicians, Sheff suggests, should be
trained to recognize the signs of addiction and refer patients to
More psychologists are needed in the drug treatment
workforce as well, says Morgenstern. It’s not realistic or
necessary that all direct treatment providers have PhDs, he says,
but “we need more psychologists in key infrastructure positions.
Right now there are some psychologists who are the directors of
treatment programs, but it’s the exception rather than the rule.”
More broadly, he says, providing evidence-based treatment
means treating addiction as a disease and integrating it into the
health-care system, improving the addiction workforce, and
treating addiction as a chronic rather than an acute illness with
comprehensive long-term care, he says.
“I can tell you that every day I have a family with a young
person who has no place to go,” he says. “There is such a lack
of quality treatment. People suffer and young people are
dying every day because we don’t have high-quality addiction
treatment. We have enough knowledge now that if we put
the resources behind it, we could fashion a workforce and a
treatment system that would do a much better job.” n
The June 2013 special issue of Psychology
of Addictive Behaviors on “Neuroimaging
mechanisms of treatment change for addictive
behaviors” features research by several
psychologists mentioned in this article. Papers
• Jon Morgenstern: “The contributions of
cognitive neuroscience and neuroimaging to
understanding mechanisms of behavior change
• Alan Budney: “A Developmental Perspective
on Neuroeconomic Mechanisms of Contingency
• Sarah Feldstein Ewing: “Integrating Brain
and Behavior: Evaluating Adolescents’ Response
to a Cannabis Intervention”
• Tammy Chung: “White Matter Integrity as a
Link in the Association Between Motivation to
Abstain and Treatment Outcome in Adolescent
Find abstracts at www.apa.org/pubs/journals/
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