A growing misconception threatens mental health progress: the belief that any provider can treat substance use disorder. Effective addiction care requires specialized expertise and a workforce to match.
Terrence D. Walton
Executive Director and Chief Executive Officer, NAADAC
If we are serious about improving mental health in America, we must be serious about improving access to substance use and co-occurring mental disorder treatment.
A growing misconception threatens that goal: the belief that substance use disorder (SUD) is a byproduct of other mental health conditions or just another diagnosis that every provider can treat. This assumption has led some policymakers, insurers, and consumers to conclude that mental health or primary care providers can help people move from crippling addiction to lasting recovery.
That may be true in some cases, but far too often, it is not.
The case for specialized addiction care
SUD is not just another condition on the list of disorders. It is a complex, chronic condition that often intertwines with other health challenges, yet takes on a life of its own. Effective treatment and prevention require professionals with specialized training, experience, and an in-depth understanding of addiction, prevention, treatment, and recovery. Without that expertise, many individuals — and the families and communities who love them — are left without a real pathway to sustained recovery.
There is broad agreement that the nation needs more behavioral healthcare. The question is whether policymakers will strengthen the workforce required to deliver it. That includes recognizing and supporting the distinct and essential role of the addiction counselor, while also advancing integrated mental health and primary care.
A workforce under strain
Today, that workforce is under significant strain. More than 160 million Americans live in areas with shortages of behavioral health professionals, and only a fraction of individuals with substance use disorder receive specialized treatment each year. High turnover, low reimbursement, and persistent stigma continue to drive experienced professionals out of the field.
Stigma remains one of the most overlooked barriers to access. It discourages individuals from seeking care and diminishes the perceived value of addiction treatment and the professionals who provide it. This stigma shows up in policy decisions, insurance design, and workforce investment, often leaving services underfunded and inaccessible.
A critical policy moment
We are at a critical policy moment. The administration’s Great American Recovery Initiative signals a welcome commitment to addressing addiction through prevention, treatment, and recovery support, but that progress must be matched by sustained investment. Proposed cuts to Medicaid and related services threaten access to care for millions of Americans, particularly in states and communities that rely heavily on federal support.
Ongoing debates around mental health and SUD parity will shape whether coverage for addiction and mental healthcare is ever truly comparable to physical healthcare. Parity must be enforced and strengthened so individuals can access timely, appropriate, and comprehensive services.
We have made meaningful progress in reducing overdose deaths, but the work is not over. Maintaining that progress will require continued partnership across federal, state, local, and private sectors, along with sustained investment in a qualified and credentialed behavioral health workforce.
America does not need a narrower definition of mental healthcare. It needs one that addresses addiction, supports the professionals who treat it, and ensures that people have access to the care they need to heal and thrive.
