Surgeon General report: A call to action on addiction

In November 2016, the U.S. Surgeon General for the first time issued a report on alcohol, drugs, and health – calling addiction, “one of America’s most pressing public health issues.”

The report, likened to a Surgeon General report on the dangers of smoking issued 50 years ago, was meant as a call to action. The “report aims to shift the way our society thinks about substance misuse and substance use disorders,” reads the report’s executive summary from the U.S. Department of Health and Human Services, Office of the Surgeon General, titled “Facing Addiction in America.”

The report also reviews information about substance use and discusses how that can be used to address the issue.

According to the report:

• Nearly 21 million Americans – more than the number of people who have all cancers combined – suffer from substance use disorders

• 90 percent of people with substance use disorders are not getting treatment

• Substance use disorder treatment is largely separate from the rest of health care

• Changes are needed

Daniel Graubert, M.D., addiction medicine physician at ROAD to a Better Life in New Hampshire, and president of the Northern New England Society of Addiction Medicine, said the report is significant because it’s a formal acknowledgment of the scope of the problem. “It’s coming from high up and it’s a pretty rigorous examination of the scientific evidence about addiction, including alcohol,” he said. “It’s certainly a move in the right direction.”

Although addiction is a more complicated issue than tobacco use, Graubert said, the importance of this report is in attracting attention, gaining momentum, and having a document from a national office that can be referenced. “What remains to be seen, is what happens to this? It got a little flurry of publicity but beyond that I haven’t seen much,” he said.

The report also stressed that addiction is perceived as a disease not as a moral shortcoming or failure, Graubert said. “Unfortunately, a lot of people still see it that way,” he said.

It also discussed medication-assisted treatment as well as other aspects of prevention. “I think prevention is something that hasn’t received enough attention,” he said.

Graubert said prevention is important because addiction is not occurring in isolation. “The fact is that addiction is more present when there is comorbid psychological illness, PTSD, and abuse,” he said. “The treatment of that is crucial. Treating it is one part, preventing it is the other part.”

Many dealing with substance use or addiction issues are directed toward treatment with an addiction counselor, Graubert said. “While I think that is helpful, a lot of them have a real need for general therapy for other issues: traumas, mood disorders, personality disorders,” he said. “They are able to get a one-sided approach, but I don’t think that’s enough. I hope going forward, we have a more cohesive mental health approach for folks dealing with addiction.”

He also stressed that physicians are often blamed for many of the addiction issues facing this country because they prescribe medications that can become addictive. “You can prescribe all you want, that doesn’t inherently cause addiction,” he said. Ultimately, the hopelessness that people feel is what needs to be addressed, he said.

To read the report, visit the Surgeon General’s website.