Addiction is often classified, in the treatment and recovery industry, as a lack of control to resist a substance. Even through negative consequences, the addiction continues. Despite the medical community’s acceptance of addiction as a disease, substance abuse doesn’t seem to be a high healthcare priority. Unlike other debilitating illnesses, substance abuse has been historically viewed as a behavioral or a moral failing. Also, unlike other illnesses, it’s often treated as a crime and punishment issue rather than a medical issue.
Yet, perhaps the biggest reason it’s not a priority is that it’s so hard to detect the signs of addiction. Unlike other illnesses, those who suffer from it often don’t realize they have it. And if they do, denial plays a large role in stopping them from getting the help they need. Thoughts like, “I don’t have a problem,” or “it’s just a phase,” may prolong their addiction.
Plus, once you get beyond the realm of chemical addiction, psychological dependencies on things like sex, shopping, and gambling are even more difficult to identify. For psychological disorders, doctors use the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM does not include every known addiction and, as in the case of shopping addiction, some addictions are lumped into larger categories, like behavioral addictions, without accurate definitions of specific disorders. Some doctors feel that DSM-5, the most recent edition of this guide, is deeply flawed and it has lead to some controversy.
Missing the Signs of Addiction
A study conducted in 2000 surveyed the occurrence of addiction and abuse, and how often they go undetected. Among non-pediatrician primary care physicians, “the vast majority (94%)…failed to diagnose substance abuse when presented with early symptoms.” About 41% of pediatricians also misdiagnosed or failed to diagnose abuse/addiction under similar conditions, even when presented with classic descriptions of teen substance abuse.
As of 2013, DSM-5 was released creating changes in the way psychological disorders are diagnosed. Some psychologists claim that loosening the definitions of these disorders has created a wave of misdiagnosis.
Why So Many Cases Go Undiagnosed
Although the study took place over a decade ago, many of its findings hold true today. There are various reasons why substance abuse goes undetected, and responsibility falls on both patients and their doctors. With regards to doctors, many are skeptical about the effectiveness of addiction treatment or simply don’t think diagnosing would be worth the patient’s time or money. They are also cynical about their patients’ honesty, with 58% avoiding the topic of drug use because they believe their patients would lie about it. As many as 85% of patients admitted to lying to their doctors.
Doctors are Busy
It’s a common occurrence in today’s medical office to wait thirty minutes in a waiting room, talk to a nurse or physician’s assistant for ten minutes, and see your doctor for five. The regulatory requirements put on doctors often requires them to spend more time doing paper work and less time in the exam room talking to patients. Because of this, patients may feel rushed or that there isn’t enough time to talk about what’s bothering them.
Patients Aren’t Honest with Doctors
Again, according to the survey mentioned above, 85% of patients admitted to lying to their doctors. Why? Why go to the doctor and give him false information or omit important information. There are a number of different reasons a patient might not be forthcoming with their doctors.
For one, it’s an awkward social situation to walk into a professional office and talk to a stranger about intimate personal details. Patients may rather tell white lies or leave out details than face embarrassment. According to a 2015 survey, fear of being judged was one of the top reasons, patients lied to doctors. Add to that the stigma often associated with substance abuse and addiction and it stands to reason why doctors might lack the necessary information for an accurate addiction diagnosis.
Patients may also see their doctors as the ultimate experts, not needing complete information to give them the answers they need. A patient may assume a doctor will know, after an examination or lab work, what is wrong with them. That frees them to leave out embarrassing admissions. In reality, diagnosis is like finding a needle in a haystack without complete information, despite years of medical school and modern technology.
On the other end of the spectrum, more patients are starting to lose trust in their doctors. Because they believe doctors are pill pushers looking to make money or too busy to listen, they choose not to trust them with information, which makes it difficult for doctors to properly treat them.
Patients Aren’t Honest With Themselves
People lie when they are afraid of telling the truth. They are afraid of what will happen if they are honest about their addiction. But the first person they lie to isn’t their doctor, it’s themselves, which makes it difficult to detect substance abuse. You’ve heard it before that the first step in overcoming addiction is admitting you have a problem. First and foremost, that would mean being honest with yourself, rather than staying in denial.
They may also fear addiction treatment and the prospect of getting sober. Detox and withdrawal are incredibly uncomfortable at best. Admitting you have an addiction means opening up the possibility of a difficult road to recovery.
Another major reason why patients lie has to do with the stigma of addiction. They are ashamed of being labeled a junkie, a criminal, an alcoholic, etc. They immediately assume they will be judged if they admit the truth. Or worse, they are paranoid about facing legal consequences.
Obviously, everyone has his or her own individual responsibility. However, we cannot ignore the social stigma of drug use and addiction. Unless they are comfortable with the truth, they cannot express the truth to medical professionals or counselors. Without that honest self-examination, they will continue down the road of substance abuse toward the terrible end of addiction.
Finding the Right Addiction Treatment
If you or a loved one is potentially suffering from a substance abuse problems it’s important to get the help you need as soon as possible. You can call the Drug Treatment Center Finder 24-hour hotline for an immediate consultation at 855-619-8070. Since detecting and diagnosing substance abuse can be a challenge, it may be up to you to make the first step. Talk to someone today about your experiences with substance abuse and find the right next step towards recovery.