Addiction care has professionalised strongly over the past decades. Yet a persistent problem remains: many doctors, psychiatrists, nurses and psychologists still lack sufficient concrete knowledge of substances, the lived experience of users and the dynamics of recovery. This leads to misunderstandings, late detection, stigma and treatments that connect less well with the reality of clients. The solution does not lie in radical or illegal experiments, but in a systematic strengthening of education and further training. The proposals below build on what already exists in the Netherlands and Belgium and make those practices more structural, deeper and more accessible.
1. Make basic knowledge of substances and addiction compulsory
In most basic training programmes for doctors, psychiatrists, nurses or psychologists, knowledge of substances is still an elective or a limited component. That is no longer tenable. Substance use and addiction occur in almost every care setting: in the emergency department, in general practice, on psychiatric wards, in elderly care and in youth care. Anyone without basic knowledge of effects, risks, withdrawal and the psychosocial context misses crucial signals.
A realistic step is therefore to include a compulsory module of at least 20, 30 hours in all relevant basic programmes. That module must cover not only pharmacology and toxicology, but also subjective experience, the social context and the principles of motivational interviewing. By making this compulsory, a shared language and a minimum competence arise among all care providers. The advantage is clear: faster recognition of problems, less stigmatising attitudes and smoother collaboration between general care and specialised addiction care. Institutions such as Radboudumc, VAD and the Trimbos Institute already have material that can be used immediately. It mainly requires political and educational will to embed this structurally in the curricula.
2. Deploy experiential experts structurally as guest lecturers or co-lecturers
Theory alone is not enough. The subjective experience of substance use, dependence and recovery remains abstract for many professionals. Experiential experts can bridge that gap. When they are structurally deployed as guest lecturers or co-lecturers, students and participants in further training receive not only facts, but also stories, nuances and the human reality.
This has already proved effective on a small scale. In the Addiction Studies minors and in various further training programmes of Tactus, Novadic-Kentron and VAD, experiential experts share their recovery story and reflect together with the group. By making this structural, for example in every module on diagnostics, treatment or recovery, experiential knowledge becomes an equal source of knowledge alongside scientific and professional knowledge. The advantage is twofold: professionals gain more understanding and empathy, and experiential experts obtain a professional, valued role in education. A condition is that they are properly prepared and supported, and that their contribution does not remain limited to “a personal story”, but is methodically linked to the learning material.
3. Make an internship in addiction care compulsory or strongly encourage it
Knowledge without practice remains superficial. For psychiatry residents and for relevant higher professional education programmes (nursing, social work, applied psychology), an internship of at least six to twelve weeks in addiction care should become the standard. At present such an internship is often optional or limited to an elective. By making it compulsory or at least strongly encouraging it with accreditation points and preferential allocation, future professionals gain direct contact with the complexity of detox, outpatient guidance, dual diagnosis and recovery trajectories.
The advantage is substantial. Interns see not only the acute crisis, but also the long haul of recovery, the role of the network and collaboration with experiential experts. They learn to deal with ambivalence, relapse and the limits of treatment. Addiction care institutions already have the infrastructure; it mainly requires better coordination with the training institutes and sufficient supervisory capacity. When this becomes structural, the threshold between “ordinary” psychiatry or somatic care and addiction care decreases considerably.
4. Expand accredited, practice-oriented further training
Further training must become more attractive, accessible and relevant. The combination of e-learning with face-to-face skills training and intervision with experiential experts is the gold standard here. Online modules (such as those of VAD, GGZ Ecademy or Trimbos) can lay the theoretical foundation. This is then followed by one or two days of practising motivational interviewing, dealing with resistance and recognising signals, followed by intervision in which experiential experts also take part.
By firmly accrediting these trajectories for doctors, nurses, psychologists and mental health practice nurses, participation becomes rewarding. The advantage is that professionals not only update their knowledge, but also improve their attitude and skills. Moreover, further training can be offered regionally or digitally, so that the threshold remains low. When employers facilitate these trajectories structurally, for example with study time or reimbursement, a culture of continuous professional development arises instead of incidental courses.
5. Improve financing and recognition of experiential expertise
Without structural financing, the deployment of experiential experts remains vulnerable. In the Netherlands much has already been achieved through the Care Standard on Experiential Expertise and the Professional Competence Profile, but the possibilities for claiming within the Care Performance Model are still limited. In Flanders a clear framework is almost completely lacking. By better recognising experiential expertise as full professionalism, with corresponding job profiles, salary scales and claiming possibilities, they can participate structurally in teams and in education.
The advantage is multiple. Teams become richer through the combination of knowledge sources. Clients feel understood more quickly. And the training programmes gain a constant source of authentic input. This requires political choices: adjustment of financing rules, investment in training trajectories for experiential experts themselves and clear agreements on roles and responsibilities. When this happens, experiential expertise changes from “a nice extra” into an indispensable part of quality care.
6. Encourage exchange between the Netherlands and Belgium
The Netherlands and Flanders each have their strong points. The Netherlands is further advanced in the structural embedding of experiential expertise and in the formalisation of the addiction physician. Flanders has a strongly developed prevention and training offer via VAD and a rich tradition of recovery academies. By developing joint modules, intervision groups, lecturer exchanges and shared e-learnings, both regions can learn from each other.
Concretely this can mean a Dutch-Flemish summer or winter school on dual diagnosis, joint intervision for addiction physicians and psychiatrists, or the sharing of best practices around the deployment of experiential experts in education. The advantage is efficiency (no double work) and enrichment (other perspectives). In addition it strengthens cross-border collaboration in a region where clients already often move back and forth.
In conclusion
These six proposals are not a utopia. They build on existing structures, respect ethical and legal boundaries and are feasible step by step. When basic knowledge becomes compulsory, experiential experts participate structurally, internships become the standard, further training is practice-oriented and accredited, financing is put in order and the border between the Netherlands and Belgium is bridged, a generation of care providers arises that truly understands substances and addiction, not only from the textbooks, but also from the lived experience and the practice of recovery. That benefits the quality of care, the dignity of clients and the job satisfaction of professionals.
