Physician Understanding and Treatment of Addiction: Have ‘Pseudoaddiction’ and ‘Self-Medication’ led us astray?

U.S. healthcare and psychiatry in particular, lack trained professional workforce, physical infrastructure, and financial support via insurance coverage needed to adequately support addiction treatment. Concepts of ‘pseudoaddiction’ and ‘self-medication’, influential among physicians who treat pain and/or mental illness, frame drug use as being therapeutically beneficial, which is different from, and even opposite to, how drug use is understood in the disease model of addiction. Over-emphasis on the closely-related concepts of ‘Pseudoaddiction’ and ‘self-medication’, especially in regard to patients who suffer addiction at high rates, may have contributed to a medical- psychiatric culture that has been slow to taking clinical responsibility for diagnosing, preventing, and treating addiction as a disease of major public health importance.