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Training in addiction medicine should be standardised and scaled up

BMJ 2015; 351 doi: (Published 28 July 2015) Cite this as: BMJ 2015;351:h4027
  1. J Klimas, postdoctoral researcher, Urban Health Research Initiative, BC Centre for Excellence in HIV/AIDS, University of British Columbia, and Department of Medicine, University of British Columbia, St Paul’s Hospital, 608-1081 Burrard St, Vancouver BC V6Z 1Y6, Canada, and School of Medicine and Medical Science, University College Dublin, Dublin 4, Ireland
  1. jan.klimas{at}

Most health systems lack sufficient doctors trained in addiction medicine to reduce the public health consequences of this increasing societal problem, writes J Klimas

Substance use disorders represent a substantial social and public health burden. An estimated 149 million to 271 million people use illicit drugs worldwide,1 and the related physical and psychological morbidity places challenging demands on healthcare systems.2

Addiction science has identified approaches to treat substance use disorders, particularly through early identification and treatment. Most interventions are underused, however.3 4 Adequate diagnosis and treatment by healthcare providers fails partly because of lack of knowledge and accredited training in addiction medicine.5 The public health consequences stemming from high rates of untreated addiction result from a lack of addiction treatment, secondary to a lack of trained physicians. Training doctors better is likely to improve accurate diagnosis and appropriate treatment6; it may also help reduce the public health epidemics that can result from improper prescribing, such as the current epidemic of opioid analgesic dependence in the United States.

Programmes in North America

To this end, new training pathways for diagnosing and treating substance use disorders have begun to emerge internationally.7 The American Board of Addiction Medicine (ABAM) and the ABAM …

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