Surgeon General Releases Comprehensive Addiction Report

Spilled wine and pillsUnited States Surgeon General Vivek Murthy has released the first comprehensive report on addiction in America. In 1964, the surgeon general at the time released a report on the perils of tobacco use that spurred a national fight against smoking. Murthy hopes the new report will have a similar effect for substance abuse, especially in light of the rising rates of opioid abuse and overdose.

According to the report, 27 million people abused prescription or illicit drugs in 2015. Binge drinking was even more prevalent, with more than 66 million Americans reporting binge drinking in the past month.

Understanding Addiction in America

The report provides a comprehensive overview of addiction in America, treatment rates, barriers to treatment, and risk factors for addiction. Some key points from the report include:

  • Addiction is linked to child abuse and neglect, costs the health care system billions of dollars, and decreases productivity. Alcohol abuse is estimated to cost the economy $249 billion annually, with illicit drug use costing an annual $193 billion.
  • Substance abuse treatment continues to be stigmatized, with addiction considered separate from other health issues. About 10% of people who abuse drugs or alcohol receive specialized treatment. About 40% of people who abuse drugs or alcohol have a co-occurring mental health condition, but less than half receive treatment for either diagnosis.
  • Forty percent of people who report having a substance abuse problem say they are not yet ready to quit.

The report provides evidence showing addiction is a chronic neurological condition, not a failure of morality or willpower. Relapse is common, but treatment can reduce relapse rates and help people who relapse achieve sobriety again.

Fighting an Addiction Epidemic

Opioids are a leading cause of addiction, and deaths due to prescription and illicit opioid use reached a record high in 2014. Children are not immune to the epidemic. Some even gain access to drugs and medications through their parents’ medicine cabinets. From 1997-2012, opioid-related hospitalizations of children more than doubled.

Schools across the nation are fighting back with a specialized program designed to prevent abuse of opioids. The program, which was developed at Cornell University, targets children as early as fourth grade. As part of the program, pharmacists educate students about the risk of prescription drugs, which some students may mistakenly believe are safer than illegal drugs.

The surgeon general’s report highlights stigma as one of the main reasons people with an addiction do not seek help. Murthy calls on physicians and the general population to change the way they think about addiction, as this may be an effective way to make people more comfortable asking for help.

The Political Battle Over Addiction Treatment

The incoming presidential administration has not yet laid out a comprehensive plan for fighting addiction. Because Murthy is only halfway through his four-year term, he could continue to advocate for fighting addiction in the new administration.

Eliminating or rolling back the Affordable Care Act (ACA) has been a centerpiece of Republican policy goals since the law went into effect. A Republican administration would have the support of Congress to gut the law. This could further reduce access to treatment, because the ACA mandates insurance coverage for mental health and substance abuse conditions. Prior to the law, many insurers did not provide such coverage.

References:

  1. Facing addiction in America: The Surgeon General’s report on alcohol, drugs, and health. (2016, November 17). Retrieved from https://addiction.surgeongeneral.gov/
  2. Kenen, J. (2016, November 17). Surgeon general ramps up addiction battle. Retrieved from http://www.politico.com/story/2016/11/surgeon-general-addiction-drugs-231532
  3. Whalen, J. (2016, November 11). Schools step up efforts to fight opioid abuse. Retrieved from http://www.wsj.com/articles/schools-step-up-efforts-to-fight-opioid-abuse-1478899399

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  • Tommy

    Tommy

    November 22nd, 2016 at 11:29 AM

    With this new addiction problem it almost feels like whatever we do, whatever measures are put in place, it starts to feel like it is all too little too late.
    The tide of this addiction and abuse has gotten so strong that it is going to take something miraculous to stop it from growing at this point.
    That is pretty terrifying.

  • Silver D

    Silver D

    November 22nd, 2016 at 11:56 AM

    U fortunately, the premise here is that the Affordable Care Act actually provides useful addiction treatment, the fact that most treatment centers do not furthers the misinformation on the epidemic and treatment. As it is, most Treatment Centers use 12 Step and AA as their foundation, even though 12 Step and AA have been shown to have about a 5-10% effectiveness rate. Thus, promoting the options rather than forcing tax payers to pay for something that arguably can even make addiction work is counterproductive at best: 10 Major Alternatives to AA
    (circa 2016)
    Free Self-Help
    hamsnetwork.org
    smartrecovery.org
    sossobriety.org
    womenforsobriety.org (includes men for sobriety)
    lifering.org
    moderation.org
    reddit.com (entirely online)

    Help involving paid professionals
    rational.org
    sinclairmethod.com (for alcohol)*
    ibogainealliance.org (for opiates)**

    Sinclair method and Ibogaine use medication to rewire the addiction pathways in the brain
    *most doctors can prescribe the medication Naltrexone, but Goodmancenter.com is a treatment center specifically
    based on the Sinclair method.
    **aftercare is recommended, such as genesisiboganiecenter.com, holistichousevegas.com, and medicineheartrecovery.com

  • Lila

    Lila

    November 22nd, 2016 at 2:05 PM

    The coverage on most plans is laughable at best. It is either very limited in the number of days that you can have access to treatment or it is such a high deductible to be met before they start paying that it still puts many things in the mental health care categories far out of reach for thousands who need it.

  • Silver D

    Silver D

    November 27th, 2016 at 1:04 PM

    Again, since 12 Step-based drug treatment programs are not effective, that sufferers are having to pay out of pocket makes it so much worse of a problem. Again, what needs to be given more media attention is the alternatives to AA and 12 Step.

  • Wallace

    Wallace

    November 23rd, 2016 at 9:26 AM

    The hardest part is being a by stander and wanting to help someone who is totally just not ready yet to help themselves.

  • Silver D.

    Silver D.

    November 24th, 2016 at 9:49 AM

    If there were not so many illegal drugs, and there was better knowledge on how to use drugs safely, users would not be so often put in a position of total abstinence or excessive use. This is the strength of HARM reduction (ideas totally opposite to written text of AA). If people saw that they could learn to moderate, they would be more willing to do so. AA, as the major treatment ideology, says that it is even useful for people to slip further and further into a living hell because it is imagined by AA ideology that living in hell motivates people to want to quit.

  • Bessie

    Bessie

    November 25th, 2016 at 7:23 AM

    so you believe that there does not have to be a rock bottom for people to want to change? just that there needs to be more education? but how does that alone help someone who has an addictive personality break free and use only moderately? for many addicts it has to be all or nothing, there is no in between

  • Izzy

    Izzy

    November 26th, 2016 at 8:49 AM

    This has been happening right in front of us for years now and we now decide that addiction is a political issue? Come on, it is much more serious than that and has been for a very long time!

  • melanie

    melanie

    November 26th, 2016 at 10:54 AM

    There are many providers who have been predicting this for years and no one wanted to listen

  • Silver D.

    Silver D.

    November 26th, 2016 at 1:30 PM

    My comment is based on my participation in the wider Recovery community that explores the alternatives to AA and 12 Step. For people thoroughly familiar with both 12 Step practice and the alternatives, the idea that there is an “addictive personality” is more specific to AA than to other treatments. In short, I’m saying that the premise of your query is flawed because you assume that what AA says about “addicts” specific to the very early members of AA, is true for anyone who finds themselves abusing substances at a particular point in their lives.

    I would have less problem with AA and 12 Step being the dominant method of treatment if only the personality type for which the original AA groups were designed participated in AA. I think it is possible that this very specific personality type is gong to have the best results in AA. However, because of the popularity of AA, people that bear little or anything in common with the personality outlined by Bill W. as the “alcoholic” personality are told that they will do best in AA. For example, people who are more likely to be victim than abuser in personal relationships tend to not do as well as those that are abusive, as the wife beater is probably going to be happier in AA than is the wife who was beaten by her husband. AA ideology says that all alcoholics have the same kind of all or nothing thinking and basically the same attitude towards drugs. If one is familiar with the other treatments, one knows that this isn’t true.

    Indeed, if AA would list the 10 major alternatives to AA, some of which teach moderation and some of which also teach total abstinence, in its meetings as a supplement to the “How It Works” readings, I would have a lot less problems with AA. See my earlier post for a list of these alternatives.

  • Ted

    Ted

    November 27th, 2016 at 1:34 PM

    It floors me that this is actually the first comprehensive report on addiction in America??
    How is that possible??

  • Silver D

    Silver D

    November 28th, 2016 at 9:28 AM

    Ted, I’m not quite sure what you mean by “comprehensive”? I would say that the Surgeon General’s report isn’t that comprehensive either. He ignores a great deal of data. Also again, the bulk of what he says isn’t new. It is the general stance on anyone who leans towards AA treatment but doesn’t know that much about how AA truly works.

  • Ted

    Ted

    November 28th, 2016 at 2:59 PM

    I was just going by the title of the article. I don’t view it as comprehensive at all, especially when this has been going on for such a long time and at an alarming speed and yet we are just now starting to talk about it?

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