What the New Surgeon General Report Means for Addiction

In the wake of what many are calling the last significant act as President Barack Obama’s Surgeon General, Dr. Vivek Murthy recently released a landmark report on alcohol, drugs, and health to serve as a guide to a national addiction recovery effort. The report places emphasis on a major cultural shift needed in the way Americans view drug and alcohol addiction. But what does the vision for the future of addiction and individuals in recovery now look like for America?

Dr. Murthy’s 400-page report, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health, details the toll addiction takes on the nation. A staggering 78 people die each day from an opioid overdose and 20 million have a substance use disorder. The report explains how implementing several integral steps can offer real hope for recovery.

“I am calling for a cultural shift in how we think about addiction, recognizing that it is not a moral failing or evidence of a character flaw but a chronic disease of the brain that deserves our compassion and care,” Dr. Murthy said.

Dr. Murthy and other policymakers created the report in the hopes that it will impact the fight against addiction in the same way the 1964 Surgeon General’s report on smoking and tobacco changed the nation’s attitudes toward the life-threatening habit. With plans to also handle the epidemic head-on but with compassion and care, Dr. Murthy provided a detailed strategy for tackling the problem. Here are some highlights of his plan for combatting addiction in America:

Addressing both substance misuse and substance use disorders requires the implementation of effective strategies. Some of the strategies Dr. Murthy suggests include:

• Expanding access to effective, evidence-based treatments
• Broader prevention programs and policies
• Education, regular monitoring, and even modest legal sanctions

Highly effective community-based prevention programs and policies should be widely implemented. Prevention programs and interventions can have a strong impact and be cost-effective. However, this is only the case if evidence-based components are used and if those components are delivered in a coordinated and consistent fashion throughout the at-risk period. Parents, schools, healthcare systems, faith communities, and social service organizations, Dr. Murthy suggests, should be involved in delivering comprehensive prevention programs. To be effective, prevention programs and policies should also be designed to address the common risk and protective factors that influence the most common health threats affecting young people.

Full integration of continuing care services for substance use disorders in conjunction with the rest of healthcare could significantly improve the quality, effectiveness, and safety of all healthcare. As Dr. Murthy points out, the goals of substance use disorder treatment are very similar to the treatment goals for other chronic illnesses. The goals are to eliminate or reduce the primary symptoms (substance use), improve general health, and increase the motivation of patients and their families to manage threats of relapse. With comprehensive continuing care, recovery is an achievable outcome: More than 25 million individuals with a previous substance use disorder are estimated to be in remission.

Coordination and implementation of recent health reform and parity laws will help ensure increased access to services for people with substance use disorders. Dr. Murthy suggests enhanced federal communication will help increase public understanding of each individual’s rights to appropriate care and services for substance use disorders. This communication he believes could help eliminate confusion among patients, providers, and insurers. But, more will be needed to extend the reach of treatment and thereby reduce the prevalence, severity, and costs associated with substance use disorders.

Future research is needed to guide the new public health approach to substance misuse and substance use disorders. This research should build upon our existing knowledge base to:

• Inform the development of prevention and treatment strategies that more directly target brain circuit abnormalities that underlie substance use disorders
• Identify which prevention and treatment interventions are most effective for which patients (personalizing medicine)
• Clarify how the brain and body regain function and recover after chronic drug exposure
• Inform the development of evidence-based strategies for supporting recovery

Dr. Murthy also contends in his report that changes need to be made on an individual level to help effectively treat addiction. He calls for people to be more vocal on issues related to addiction as well as be more supportive of individuals in recovery. Some of his callouts from his list of suggestions:

• Reach out, if you think you have a problem. Breaking the silence and isolation around addiction related issues is crucial for encouraging individuals and families to seek help openly.
• Be supportive (not judgmental) if a loved one has a problem. Recognizing that substance use disorders are medical conditions and not moral failings can help remove negative attitudes. It can also help promote open and healthy discussion between individuals with substance use disorders and their loved ones, as well as with their healthcare professionals.
• Show support for people in recovery. Extending kindness to people with substance use disorders and those in recovery can provide added encouragement to help them realize and maintain their recovery. It also will encourage others to seek out treatment when they need it.
• Advocate for the changes needed in your community. Many challenges need to be addressed to support a public health-based approach to substance misuse and related disorders. Everyone can play an important role in advocating for needs of an addicted person, the needs of their loved ones, and the needs of their community.
• Parents, talk to your children about alcohol and drugs. Parents need to become informed, from reliable sources, about substances to which their children could be exposed. Parents also need to educate themselves on substance use disorders and talk openly with their children about the risks of addiction.

Although Dr. Murthy applauded the ongoing shift in an array of public policies that emphasize public health rather than law enforcement, the report is intended to prompt Congress to maintain and expand access to treatment under the Affordable Care Act.

Both timely and valuable, Dr. Murthy’s report reiterates the need for addiction to be fought at every level of society and government. Without it, the epidemic is certain to escalate.