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Key Points
- A JAMA Network Open study found that 28.4% of therapy patients stopped after three sessions or fewer. The authors link early dropout directly to depression relapse and persistent untreated illness.
- Patients with any prior mental health encounter were significantly more likely to stay in therapy, pointing to familiarity with care as a protective factor, not willpower.
- SAMHSA opened National Recovery Month 2026 with panels on peer support specialists, chronic disease frameworks for addiction, and community reintegration after institutional settings.
- Peer support specialists complete formal training and, in most states, earn state certification. They model stability in early recovery but are an adjunct to physician and licensed therapist care, not a replacement.
- A 2023 study found that people with opioid use disorder who received buprenorphine after surviving a nonfatal overdose had a 62% lower risk of dying from a subsequent overdose. Most patients still do not receive it.
Addiction News Weekly Episode 1.16
In This Episode
- More Than a Quarter of Therapy Patients Quit Within Three Sessions
- SAMHSA Opens National Recovery Month With a Focus on Peer Support
- Dr. Sylvie Stacy on Peer Specialists and the Evidence Behind Them
- NPR Revisits Clinician Reluctance to Treat Addiction
Episode Transcript
Welcome to Addiction News Weekly by Rehab.com where we break down the biggest stories in addiction, recovery, and public health. September is National Recovery Month, so this week we’re covering what actually keeps people in treatment. We have a new JAMA study on how many people quit therapy almost immediately, what the federal government is pointing at as the thing that helps people stay in recovery, and NPR going back on the air to answer listeners who pushed back on its reporting about doctors who would rather not treat addiction at all.
More Than a Quarter of Therapy Patients Quit Within Three Sessions
We start with a study published in JAMA Network Open that followed 40,732 patients who started individual psychotherapy.1 Of those, 28.4% stopped after three sessions or fewer.
That is 11,571 people who got through the door and then did not come back. The researchers pulled electronic health record data from 2008 through 2022 across two academic medical centers, six community hospitals, and their affiliated outpatient networks in Massachusetts. The authors describe early dropout as a significant public health problem, citing its links to depression relapse and illness that persists.
The same pattern that ends therapy early tends to also end addiction treatment early, and untreated depression is a recognized driver of both first-time substance use and relapse. When someone stops after two sessions and the depression comes back, alcohol and other substances are available to manage symptoms in the absence of medical treatment. Receiving a therapy referral during or shortly after a hospital stay predicted higher odds of dropping out. The authors read that as a systems problem rather than patient failure.
A referral handed to someone at discharge while they are still recovering and juggling follow-up appointments does not have as much of a foundation underneath it. Their proposed fix is making the first contact happen before the patient leaves the building. The study also found that patients who were not white or non-Hispanic dropped out at higher rates, which is a retention gap in the system rather than anything about the people within it.
One note on the limits: the researchers built prediction models and their accuracy was modest, so this is not a tool for identifying who exactly will leave. The strongest protective factor was having had any prior mental health encounter at all, even something brief like a group session or a psychiatric evaluation. Knowing what to expect appears to make continuing care easier.
SAMHSA Opens National Recovery Month With a Focus on Peer Support
SAMHSA opened National Recovery Month last Thursday with an event at Health and Human Services Headquarters in Washington.2 Recovery Month has run every September since 1989. This year’s kickoff was not a single announcement but a series of panels. The first was on peer support. Others covered treating addiction as a chronic disease, recovery-friendly workplaces, and helping people transition back into their communities after leaving institutional settings.
Dr. Sylvie Stacy on Peer Specialists and the Evidence Behind Them
Here is Rehab.com Medical Officer Dr. Sylvie Stacy with her take on the event.
There’s a lot we could talk about relating to National Recovery Month, but one topic that I feel like I’ve been hearing a ton about recently is peer support specialists, so I’d like to focus on that. When we talk about peer support specialists, we are talking about people who have personal lived experience with substance use disorders. So they’ve walked that road, but it’s different from an informal chat with someone and it’s different from a 12-step program sponsor.
A peer support specialist has completed formal training and in most states they’ve actually earned a certification. Many facilities and programs are now embedding these directly into their treatment teams, but their function is really distinct and separate from therapy. A peer specialist isn’t analyzing trauma or running an intensive psychotherapy group. They’re modeling stability and they’re helping patients handle the challenges of early recovery.
That distinction ties back to the findings on therapy dropouts discussed a few minutes ago. In that study, the main factor that kept people in the room was prior exposure to care, simply knowing what to expect. Walking into an addiction clinic for the first time can be really disorienting and intimidating for people. In my own practice, I know I’ve had patients almost freeze up during an intake because they’re afraid of being judged or they’re overwhelmed by all the paperwork or all the clinical jargon that they’re hearing. Having a peer specialist step in and be able to tell them, I have sat in that chair, I felt that same anxiety, and here’s what the next week or two weeks or two months is actually going to look like, that really diffuses a lot of the fear and anxiety. And establishing that rapport can happen really fast.
The evidence behind peer support is really promising, particularly around patient engagement and retention in treatment. Right now, it doesn’t carry the same weight that we see for the evidence for medications for substance use disorders like opioid and alcohol use disorders. And a peer support specialist doesn’t formally teach therapeutic principles that form the foundation of evidence-based psychotherapy. So a peer specialist isn’t a substitute for a physician or for a licensed therapist, but it is an adjunct support. For anyone who is looking into a certain treatment program or adjusting their own practice or even budgeting money for a program, you’ll want to think about how peer specialists will interact with patients, how they’ll coordinate with the medical and therapy teams, and very importantly, if and how that peer connection will continue after the patient is discharged.
NPR Revisits Clinician Reluctance to Treat Addiction
Two weeks ago, we covered NPR’s reporting on how often clinicians are reluctant to treat patients with alcohol and drug use disorders.3 That story drew a large response, including criticism, and on August 28, NPR went back on the air to answer it.6 One listener who identified herself as a nurse practitioner said it was unfair to describe medical professionals as treating these patients with suspicion or hostility. Others asked whether the medications actually work and whether overwhelmed emergency rooms are being held at an unreasonable standard. Correspondent Brian Mann took those questions on air.
On the evidence for stigma, Mann pointed to decades of surveys. NPR cited a study from 2000 that found a third of nurses and one in five doctors viewed addiction as a moral or spiritual issue rather than a treatable disease,4 and a 2021 study describing the same pattern as explicit discrimination.5 On emergency room capacity, Mann put the question to Dr. Itay Danovich of the American Society of Addiction Medicine, who said hospital staff should bring the same standard of care they would to a heart attack or car crash. That means stabilizing the patient, starting treatment, and linking them to continuing care. He called all three achievable while acknowledging it is harder in places without enough trained or willing clinicians.
On whether the medications work, NPR cited a 2023 study finding that patients with opioid addiction who were prescribed buprenorphine after an overdose had a 62% lower chance of later dying from another overdose.7 Doctors interviewed by NPR said buprenorphine and naltrexone are no more difficult to prescribe than other common medications. Most patients still never receive them.
Conclusion
This week we asked, what really keeps people in treatment? The three answers we got are knowing what to expect before you walk in, having someone alongside you who has lived experience with the process, and having a clinician willing to prescribe the treatment that works. A doctor’s personal discomfort is not a verdict on whether treatment would work for you. If a clinician declines to discuss medication or waves off the question, that is reason to get a second opinion. Ask any program directly whether it prescribes buprenorphine, methadone, or naltrexone, and how it handles the handoff from an emergency visit or detox into ongoing care.
If you or someone you love is looking for treatment, Rehab.com lists thousands of verified centers across the country, and free confidential support is available anytime through the SAMHSA National Helpline at 1-800-662-4357. And if you are in crisis, you can call or text 988 at any time. Those are the top stories in the news. For more, visit Rehab.com. We will be back next week. I’m Kay, and thank you for listening.
Sources in This Episode
- Substance Abuse and Mental Health Services Administration. National Recovery Month. SAMHSA. September 2026. Accessed September 15, 2026. https://www.samhsa.gov/recovery-month
- Mann B. Most U.S. doctors avoid treating patients with addiction, leaving millions vulnerable. NPR. August 6, 2026. Accessed September 15, 2026. https://www.wunc.org/2026-08-06/most-u-s-doctors-avoid-treating-patients-with-addiction-leaving-millions-vulnerable
- Mann B; Summers J, host. A conversation about doctors, addiction patients and stigma. NPR. August 28, 2026. Accessed September 15, 2026. https://www.npr.org/2026/08/28/nx-s1-5945729/a-conversation-about-doctors-addiction-patients-and-stigma
- Samples H, Williams AR, Crystal S, Olfson M. Buprenorphine after nonfatal opioid overdose: reduced mortality risk in Medicare disability beneficiaries. Am J Prev Med. 2023. doi:10.1016/j.amepre.2023.01.037
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