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Preaddiction—A Missing Concept for Treating Substance Use Disorders

Despite decades of federal funding to develop and deliver treatments for individuals with serious addictions, treatment penetration rates are less than 20%.1 Facing a similar situation, the diabetes field increased treatment penetration and impact by identifying and intervening with early-stage diabetes, termed prediabetes. We use this example to illustrate the essential elements of this strategic clinical approach and discuss the changes that will be required within the substance use disorder (SUD) field to implement an analogous strategy. We suggest the DSM-5 diagnostic categories mild to moderate SUD as a starting operational definition for the term preaddiction, a commonly understood, motivating term that could engender broader clinical efforts to effect that strategy.

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