With more than 20 million Americans in the grip of substance abuse, the U.S. Surgeon General has called on the public and government to take substantive steps in tackling this monster in our midst.
That call came in the form of a first-of-its-kind report — the Surgeon General’s “Report on Alcohol, Drugs and Health” — that relies on current research to give clarity to how America can solve its addiction problem.
And a problem it is.
Some 8 percent of Americans — adults and adolescents — engage in an addiction that significantly impacts their lives.
The most common is alcohol addiction, which affects 16.6 million Americans.
In the area of illegal drugs, heroin dependence is at an all-time high. Since 2000, the number of overdose deaths in the United States attributed to opioids has increased by 200 percent.
Some 78 people die each day in the United States from an opioid overdose.
In fact, Surgeon General Vivek Murthy has said this country is facing a “crisis of addiction,” noting that the addicted population equals the number of Americans battling diabetes. Yet only one in 10 addicted Americans will ever receive treatment.
He placed part of the blame squarely on a false understanding of addiction that has persisted for generations — that people become addicted because of some sort of moral failing, character flaw or sin.
That kind of thinking about alcohol and drug addiction has created barriers for people who, due to the shame attached to the stigma, may refuse to either acknowledge their addiction or to seek treatment.
Addiction can be treated
But there is hope.
The surgeon general’s report noted many advances have been made in the treatment of addiction over the past decades.
For example, there is plenty of scientific evidence to support treatment of addictions using medications such as methadone and buprenorphine. Evidence-based behavioral interventions can be effective as well.
And there is also evidence to support recovery programs such as Alcoholic Anonymous and Narcotics Anonymous that help patients after treatment, although the report emphasized that they “are not the same as treatment.”
be wary of unreliable solutions
On the other hand, the report noted that unscientific approaches to drug and alcohol addiction are still being relied upon.
In particular, the surgeon general questioned the effectiveness of abstinence-only treatments for substance abuse as well as TV-style interventions that focus on aggressively confronting people with their addictions. Neither are evidence-based.
Now the challenge for the country is to make sure those evidence-based treatments are readily accessible and affordable. For the well-being of the country, addiction costs must be covered by health insurance, the surgeon general stressed.
However in the new presidential era, that’s far from guaranteed. The Affordable Care Act, which extended health coverage to millions and established addiction treatment as an essential benefit, may not survive the transition.
Treatment must be available
The bottom line is that it is unacceptable today that only one out of every 10 people addicted to alcohol or drugs gets treatment.
If only one out of every 10 cancer patients received treatment, there would be a huge outcry.
If only one out of every 10 people living with diabetes were treated, we would be outraged.
Yet we stay silent when nine out of every 10 people addicted to alcohol or drugs are left untreated despite the fact that scientifically supported treatments are available.
Why? Ironically, perhaps it’s because the scientific advances that have been made in treating addictions have outpaced the public’s acceptance of the biological causes of addiction.
Consider, for example, a 2006 study that showed 65 percent of people responded that alcoholism was due to “bad character” while only 47 percent said it was due to brain chemistry or genetics.
That belief regarding bad character is untrue and it is unhealthy, the surgeon general informs us.
Addiction services can’t be separated from health services. They are the same.
Addiction is a disease.
It can be treated.