Social Workers in the Substance Abuse Treatment Field: A Snapshot of Service Activities

TLDR: The results of the PRN survey indicate a need to further assess social workers' role in substance abuse services and to identify training opportunities for the profession.

Abstract: The impact of substance abuse on society is wide ranging and costly. According to a Robert Wood Johnson Foundation (RWJF, 2001) report, substance abuse, including tobacco use, is the cause of more deaths, illnesses, and disabilities than any other preventable health condition. This same report indicates that approximately 25 percent of the more than 2 million deaths each year in the United States are attributable to alcohol, illicit drugs, or tobacco. The Department of Health and Human Services (HHS) estimates that drug and alcohol abuse contribute to more than 120,000 deaths in the United States each year (HHS, 2002). According to Healthy People 2010 (HHS, 2000), alcohol and illicit drug use are associated with a wide range of health and social welfare problems, including child and spousal abuse, sexually transmitted diseases, teenage pregnancy, school failure, motor vehicle crashes, low worker productivity, increasing health care costs, and homelessness. Furthermore, long-term heavy alcohol use can lead to heart disease, cancer, liver disease, pancreatitis, and fetal alcohol syndrome (HHS, 2000). In 1995 the cost of alcohol and drug abuse to society was conservatively estimated at more than $275 billion per year (RWJE 2001). These figures reflect costs associated with illness, deaths, medical care, crime, other related costs (for example, motor vehicle crashes), and special conditions related to substance abuse (for example, HIV/AIDS attributable to substance abuse). According to a Substance Abuse and Mental Health Services Administration (SAMHSA) report, it is estimated that 18 to 26 million Americans were in need of substance abuse treatment in 2002 (SAMHSA, 2003). The 2002 National Survey on Drug Use and Health estimated that 22 million people age 12 or older were classified with substance abuse or dependence, supporting the need for substance abuse treatment in the United States. Estimates from SAMHSA indicate that the need for substance abuse services for individuals with an illicit drug problem are increasing (SAMHSA, 2002a). Furthermore, abuse of alcohol and drugs (both legal and illicit) affects nearly 17 percent of adults age 60 or older (SAMHSA, 2002b). Although the need for treatment is documented, it is estimated that only 3 million people actually received substance abuse treatment in 2002 (SAMHSA, 2003). Literature Review: The Role of Social Workers A Bureau of Labor Statistics (BLS) report indicates that there were 477,000 social work positions in 2002 (BLS, 2004). Of these positions, 95,000 were in mental health and substance abuse. A 1993 HHS report suggested that only 6 percent of all staff in substance abuse treatment programs in the United States were social workers at the master's level or higher. According to the BLS report, employment of social workers is expected to increase faster than the average for all occupations through 2012, and employment of social workers in substance abuse settings will grow rapidly between 2002 and 2012 (BLS).This projected increase is due to a variety of factors, including placement of substance abusers, particularly abusers of illicit drugs, into substance abuse treatment programs instead of into the criminal justice system; recognition of the need to provide substance abuse treatment in the United States; and increased comorbidity of substance abuse disorders with other problems (for example, mental health disorders, HIV/AIDS and other sexually transmitted diseases, child welfare cases). For instance, Hall and colleagues (2000) found that at least half of all hospitalized patients in urban areas have substance abuse--related problems. Often, social workers are the first service providers to come in contact with substance abusers in the various service delivery systems, including child welfare, employee assistance programs, hospitals, schools, programs for elderly people, and community-based services. Social workers often provide key assessment and referral services in an array of health and mental health care settings (Hall et al. …