Paramedics wheeled Jean Descamps into Providence Milwaukie Hospital on a cold December night in 2023. He was barely conscious and covered in his own waste. Hours later, staff wanted him gone. One worker on the ward told police it was not really a medical problem. He called the 26 year old a malingerer. Descamps died from a drug overdose soon after leaving the building. His death, first reported by NPR, is an extreme example of a pattern researchers have quietly documented for years. Doctors call it physician reluctance to treat addiction, and it plays out inside the very system meant to save lives.

A System Failing Millions

Addiction affects more than 40 million people in the United States, according to the latest federal data. Yet more than 80 percent of people who need help receive no medical treatment of any kind. Alcohol and drug related disorders kill more than 250,000 people every year. A separate national review found overdose deaths reached 107,941 in a single year, 2022. Almost 46.3 million Americans reported a past year substance use disorder. Only 6.3 percent of them received any form of treatment. That adds up to an estimated economic cost of 442 billion dollars a year. This data helps explain why physician reluctance to treat addiction shows up so consistently across specialties and countries.

Why Physician Reluctance to Treat Addiction Persists

A systematic review published in JAMA Network Open analysed 283 studies covering 66,732 physicians. It found consistent barriers standing between patients and care. Researchers cited a lack of institutional support in 81.2 percent of relevant studies. A shortage of skill followed at 73.9 percent. Limited cognitive capacity followed at 73.5 percent, and gaps in knowledge came in at 71.9 percent. Doctors avoiding addiction care was rarely about indifference, researchers found. More often it came down to training, workload and systems that never supported the intervention in the first place.

Dr Beth Meyerson is an addiction care expert at the University of Arizona College of Nursing. She said the avoidance often starts at the level of the family doctor. If I’m at my own general practitioner, she said, and it’s suddenly clear I’m addicted to an opioid, my doctor will likely send me somewhere else. Yet the same doctor would treat diabetes or another chronic condition without a second thought, she said.

Stigma Still Shapes Treatment

Bias compounds the shortfall. A 2020 study in the Annals of Internal Medicine found only one in five American physicians expressed interest in treating a patient with opioid use disorder. The advocacy group Shatterproof surveyed clinicians in 2024 and found 43 percent of healthcare professionals believed medications for opioid use disorder simply substitute one drug for another. Evidence shows treatments such as buprenorphine are rarely misused. This pattern of doctors avoiding addiction care, even for patients they already treat for other conditions, appears in specialty after specialty.

Dr Judy Chertok treats addiction patients and teaches medicine at the University of Pennsylvania. She said she has heard colleagues talk about people with addiction in ways they would never tolerate toward any other patient group. Dr Bobby Mukkamala led the American Medical Association until June 2026. He acknowledged that stigma still shapes physician decisions. There’s an emotional response from within, he said, that makes doctors say they are just not comfortable with it. That, he said, is the stigma.

A Preventable Death

Back in Oregon, the consequences of that reluctance played out in real time. Bodycam footage released by the Milwaukie Police Department shows officers challenging hospital staff over the decision to discharge Descamps. Officers then wheeled his limp body into a dark car park in a wheelchair. He can’t be on his own, one officer said. Why is he being released? We have no place to take him. A bus station is fine, a hospital worker replied.

Descamps died a short time later. A local prosecutor investigated and found hospital staff had not carried out a toxicology test before releasing him. The Oregon Health Authority published a follow up review in February 2024. It found the hospital was still discharging vulnerable patients without proper safeguards, and it warned that a similar event could happen again. Nobody recorded any disciplinary action against the hospital or its staff.

Closing the Gap Before It Costs Another Life

Researchers behind the JAMA review argue the fix lies less with individual doctors and more with the institutions around them. Staffing, training budgets and reimbursement rules all make addiction care harder to deliver than other chronic disease management. Dr Nora Volkow heads the National Institute on Drug Addiction. She has asked what models researchers could develop to actually change the culture of medicine itself.

A separate analysis by the Centers for Disease Control and Prevention found more than two thirds of Americans who died from an overdose in 2024 had at least one potential opportunity for intervention beforehand. Most medical and nursing schools in the United States still do not teach addiction care as a core part of training. That gap carries a real toll on young people and families. Until it closes, cases like that of Jean Descamps will remain less an exception than a warning of what continued physician reluctance to treat addiction can cost.

Source: dbrecoveryresources