An NPR investigation published August 6 found that most US clinicians actively avoid providing addiction treatment, and that the majority do not offer the medications shown to work for alcohol and opioid use disorder.
That has a direct bearing on how anyone should approach an addiction treatment search. It means the question is not only whether a provider is available, but whether that provider will treat the condition at all.
What the Reporting Found
NPR addiction correspondent Brian Mann reviewed existing research and interviewed more than a dozen medical experts over several weeks.
Alcohol and street drugs including fentanyl are causing more than 250,000 deaths a year in the United States, according to federal data cited in the report.
Against that, new federal data indicated that in 2025, more than 80 percent of people with substance use disorders received no help at all for their addiction.
Dr. Bobby Mukkamala of the American Medical Association described the shortfall on both sides of the encounter, saying too few physicians treat substance use disorder and too few patients receive evidence-based treatment.
Why Clinicians Step Back From Addiction Treatment
The explanation experts offered NPR was consistent, and it is historical rather than clinical. Substance use disorders are now classified as treatable illnesses.
For decades before that, addiction was widely treated as a moral failing or a criminal matter, and many forms of addiction still involve illegal drugs.
Research indicates that history produced fear and hostility in the general public, and surveys of medical professionals show the same stigma inside the health system.
Robert DeForde of Shatterproof, an organization that works to persuade clinicians to treat opioid addiction, described two overlapping problems.
Some clinicians do not want these patients in their practices, and some do not believe the FDA-approved medications will actually help. DeForde is in recovery himself and said he has encountered that bias from his own doctors.
The Medications in Question
The evidence base here is not new or contested. For alcohol use disorder, FDA-approved medications include naltrexone, acamprosate, and disulfiram.
For opioid use disorder, they include buprenorphine, methadone, and naltrexone. Both sets have decades of evidence behind them for reducing cravings and, in the case of opioid medications, preventing fatal overdose.
Research also indicates these treatments carry relatively low risk of misuse by patients, which undercuts one common reason for withholding them.
Dr. Judy Chertok, who treats patients and researches addiction care at the University of Pennsylvania, told NPR the effect of wider prescribing would be “transformative.”
The Training Gap Underneath It
The structural finding may matter more than the attitudinal one. Experts told NPR that decades after the opioid crisis began, most US medical and nursing schools still do not teach addiction care as a core, normalized part of practice.
The practical consequence is that new clinicians continue to enter the field without the skills or the confidence to treat these patients, which means the gap does not close on its own as older cohorts retire. Efforts to change this exist, but the people interviewed described progress as slow.
What This Means for Addiction Treatment Seekers
The useful takeaway is not discouraging, though it is worth stating plainly. Effective addiction treatment exists and is often not offered, which means where you go and what you ask for changes the outcome more than it should.
If a clinician declines to discuss medication or dismisses the request, that is a reason to seek a second opinion rather than a verdict on whether treatment could help. Addiction medicine is a recognized subspecialty, and providers who practice it are identifiable.
Finding the Right Rehab
A few questions separate programs and prescribers who deliver this care from those who only refer out. Ask directly whether the program prescribes medication for alcohol or opioid use disorder on site, and which medications.
Ask whether medication continues after discharge or ends with the program. Ask whether any clinician on staff holds addiction medicine or addiction psychiatry credentials.
Ask what your insurance covers before admission. Ask how co-occurring mental health treatment is handled, since untreated anxiety or depression is a common reason people leave care early.
Rehab.com’s directory lets you compare verified treatment centers by location, level of care, insurance accepted, and the services each facility reports offering. For free and confidential help finding treatment, call
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