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Alcohol, Drug Misuse are “major public health challenges”: Surgeon General on the Addiction Crisis in the US

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Last year, 27 million people reported either the use of illegal drugs or the misuse of prescription drugs.Over 66 million people reported binge drinking in the past month. These two key findings are the beginning of Surgeon General Vivek Murthy’s lengthy and historic report on the addiction crisis in the United States. These findings, along with many others presented in the report, support the Surgeon General’s contention that “Alcohol and drug misuse and related disorders are major public health challenges that are taking an enormous toll on individuals, families, and society.” The report also highlights the yearly economic impact of substance and alcohol abuse as reaching a combined total of $442 billion. Clearly, substance and alcohol abuse is not only a personal or mental issue but a crisis that affects the nation. Never before has issues related to substance abuse and addiction been treated to such a full line of inquiry by a federal office, and the insights are both enlightening and sobering. The report includes an overview of substance abuse around the country, the neurobiology of substance abuse and addiction, the efficacy of prevention programs, and the reasons for hope and optimism when it comes to intervention programs and recovery. It is worth checking out the report in its entirety, which you can find on the Surgeon General website here. If you want just the highlights, read on.

The Purpose and Approach of the Surgeon General Report

The aim of this report from the Surgeon General is to review what is known about substance and alcohol abuse, how this relates to health and healthcare, and how “we can use that knowledge to address substance misuse and related health consequences.” The first step of the report, then, is to lay a foundation of not only why substance abuse is a problem within the United States but what happens within the brain of someone who is addicted to drugs or alcohol. In this way, the report makes it clear that addiction is a mental disorder and a health condition, rather than a character flaw or failure of character. This approach sets up those looking to treat their addiction for success.

The Surgeon General on the Addiction Crisis: Key Insights

There recently released report from the Surgeon General is a large, research-heavy work discussing the prevention, treatment, recovery and health care systems related to addiction, alcoholism and drug use. These findings can be separated into five major areas, each of which have key insights presented below. The Neurobiology of Substance Use, Misuse, and Addiction

  • Addiction to alcohol or drugs has been scientifically shown to be a chronic brain disease, with the potential of both recurrence and recovery
  • Addiction is a three-stage cycle: binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation.
  • Research shows that the negative effects of drug use on the brain continue long after the use of the substance stops.
  • Addictive drugs have a particularly negative impact on the adolescent brain

Prevention Programs and Policies

  • Scientific evidence supports predictors and risk factors for substance abuse that should be taken into consideration
  • It is never too early, nor too late, to prevent the abuse of substances and the problems related to substance misuse
  • Community efforts to bring preventative measures to scale have been shown to be effective in preventing substance abuse

Intervention, Treatment, and Management of Substance Abuse Disorders

  • It is not only possible but entirely effective, to treat substance abuse and addiction disorders.
  • Recurrence rates for those with substance use disorders are no higher than those with other chronic diseases (such as diabetes and hypertension)
  • Very few people who suffer from substance abuse or alcoholism receive specialty treatment; however, there is a current shift toward integrating addiction treatment into general health care practice.
  • Behavioral therapies are effective in treating substance abuse and addiction
  • The goals of treating substance abuse and addiction are the same as other chronic illnesses: reduce key symptoms, improve health status, and reduce the likelihood of recurrence.

Recovery & The Path to Wellness

  • Recovery involves a positive change in the whole person
  • Full remission from substance abuse or addiction disorder can take years and multiple programs of treatment
  • Support groups and organizations are a crucial aspect of recovering from substance abuse or addiction
  • Scientific evidence points to the effectiveness of recovery programs, recovery housing, and drug-focused mutual aid groups

Health Care Systems and Substance Use Disorders

  • It is important to bring together the treatment of substance abuse and mental health services
  • Many individuals suffering from substance abuse or addiction do not seek out specialty treatment
  • Health care requires a renewed commitment to integrating treatment for substance abuse and addiction into the general health care setting.
  • The Affordable Care Act (ACA) has increased the insurance coverage for substance use disorder services

Final Thoughts: There is Hope for Addressing Addiction in the US

The report form the Surgeon General, as summarized above, makes it clear that alcohol and drug abuse is a serious and pervasive issue in the United States. However, the report also highlights several reasons for hope and optimism in the face of this crisis. These include, but are certainly not limited to:

  • Research on alcohol and drug misuse has lead to one major conclusion: addiction is not only a chronic disease, but entirely treatable
  • Recent years have seen a decrease in the stigma and moral judgment associated with addiction and drug abuse
  • Effective treatment options and support services (such as Alcoholics Anonymous) have become increasingly available
  • Health care reform is now aimed at including the treatment of addiction and substance misuse in general public health

These recent developments have opened up the door for those suffering from addiction to seek out the treatment they need. As the report concludes, “These changes are leading to a new landscape of care for alcohol and drug misuse problems … and to new hope for millions of people who suffer from them.”