Surgeon General Issues Landmark Report on Alcohol, Drugs

AAFP President Praises Report, Highlights Critical Role of Family Physicians

November 22, 2016 03:06 pm Chris Crawford

One in seven people in the United States will develop a substance use disorder at some point in their lifetime -- yet only 10 percent of them will receive treatment.

[Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs and Health]

To bridge this gap, U.S. Surgeon General Vivek Murthy, M.D., M.B.A., released the office's first report dedicated to substance misuse and related disorders: Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs and Health.(addiction.surgeongeneral.gov)

"Alcohol and drug addiction take an enormous toll on individuals, families and communities," Murthy said in a news release.(www.hhs.gov) "Most Americans know someone who has been touched by an alcohol or a drug use disorder. Yet 90 percent of people with a substance use disorder are not getting treatment. That has to change."

The report covers alcohol and illicit and prescription drug misuse and includes chapters on neurobiology, prevention, treatment, recovery, health systems integration and recommendations for the future. The resource's in-depth look at the science of substance use disorders and addiction aims to support a move away from the current social stigma associated with substance misuse in America.

Story highlights
  • U.S. Surgeon General Vivek Murthy, M.D., M.B.A., has released the office's first report dedicated to substance misuse and related disorders.
  • The report covers alcohol and illicit and prescription drug misuse and includes chapters on neurobiology, prevention, treatment, recovery, health systems integration and recommendations for the future.
  • The resource takes an in-depth look at the science of substance use disorders and addiction to support a move away from the current social stigma associated with substance abuse in America.

AAFP President John Meigs, M.D., of Centreville, Ala., told AAFP News this report could very well have the lasting effect that former Surgeon General Luther Terry, M.D.,'s report on smoking and health has had since its release in 1964, when it linked smoking to adverse health effects, including lung cancer and heart disease.

"The use, abuse, misuse, overuse and diversion of prescription drugs, as well as the use and abuse of illicit drugs and alcohol, are major public health challenges," Meigs said. "Almost everyone knows someone or has a friend or family member who has been affected by this epidemic -- my family included.

"I am hopeful this report will help create new opportunities for increased access to effective treatment and prevention strategies, as well as help dispel the shame and misunderstanding that surrounds substance abuse disorders."

Findings From The Report

According to the new report, substance use disorders typically develop over time after repeated episodes of misuse that result in changes to the brain's chemistry.

In 2015, nearly 48 million Americans used an illicit drug or misused a prescription medication, about 67 million reported binge drinking within the past month, and nearly 28 million self-reported driving under the influence within the past year. This large at-risk population of Americans can benefit from appropriate screening, prevention and treatment services, said the report.

Catching substance misuse and abuse at a young age seems to be an especially important factor in helping patients before they're predisposed to lifelong trouble.

"Although substance misuse problems and use disorders may occur at any age, adolescence and young adulthood are particularly critical at-risk periods," Murthy said in the release. "Preventing or even simply delaying young people from trying substances is important to reducing the likelihood of a use disorder later in life."

For example, the report said patients who use alcohol before age 15 are four times more likely to develop an alcohol use disorder later in life compared with those who have their first drink at age 20 or older.

Removing Treatment Gap, Stigma of Substance Abuse

Both the Mental Health Parity and Addiction Equity Act of 2008 and the Patient Protection and Affordable Care Act of 2010 increased access to substance abuse services. However, for a variety of reasons, including stigma, a treatment gap persists.

According to the report, this treatment gap can be attributed to factors such as lack of screening for substance use disorders, fear of shame and discrimination associated with addressing these disorders, lack of access to and costs of care, and fragmentation of services across the health care system. Many people seek or are referred to substance use disorder treatment only after a crisis, such as an overdose, or through involvement with the criminal justice system.

"Families across this country are fighting addiction -- they're fighting an illness, as well as a stigma," said HHS Secretary Sylvia Burwell in the release. "They're doing all they can, and we should do no less.

"At the U.S. Department of Health and Human Services, we have worked hard to make our nation healthier and save lives by increasing access to evidence-based treatment for those who need it. While there's more to do, this historic report provides us guidance and outlines important steps we can take to move forward, build on our progress to address this public health crisis and make a difference for more Americans."

Noting that substance use disorders are a public health problem that requires a public health response, the report recommends taking action by

  • eradicating negative attitudes and changing the way people think about substance use disorders,
  • recognizing substance misuse and intervening early, and
  • expanding access to treatment.

"It's time to change how we view addiction," said Murthy. "Not as a moral failing but as a chronic illness that must be treated with skill, urgency and compassion. The way we address this crisis is a test for America."

Family Physicians' Role

Meigs said family physicians bring a unique perspective to addressing substance use disorders because they are caregivers who treat the whole person.

"We are the specialty that treats people in the context of their family, community and their own unique situation," he explained. "That gives us the opportunity to recognize and hopefully intervene much earlier in this devastating disease."

It has long been known how important treating mental and behavioral health issues is to patients' physical health and well-being, Meigs added. "Screening for and addressing substance abuse is just an extension of that same concept," he said. "We need to work for better access to affordable and effective treatment options.

"I commend the surgeon general for this significant, important and much-needed call to action to address this challenging, growing and devastating epidemic."

Related AAFP News Coverage
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Variety of State Regulations Take Aim at Opioid Abuse

(11/9/2016)

Search and Rescue Campaign Aims to Educate Opioid Prescribers
(10/13/2016)

Robert Graham Center Research
Winning Rural Opioid Fight Depends on Family Physicians

(10/5/2016)

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Additional Resource
Partnership for Drug-Free Kids(www.drugfree.org)