Why the surgeon general’s report is the go-to resource

When the U.S. surgeon general issues a report on substance use, healthcare officials and the medical community are bound to take it seriously. “Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health,” released Nov. 17, is focused on the most science-based aspects of addiction. But it’s meant for real people, easily readable and searchable.

“Above all, we can never forget that the faces of substance use disorders are real people. They are a beloved family member, a friend, a colleague, and ourselves,” wrote Vivek H. Murthy, MD, surgeon general, and vice admiral with the U.S. Public Health Service, in a preface to the report.

This isn’t expected to be a case of a report that comes out and is put on the shelf, forever to be forgotten. Murthy, who has two more years remaining in his tenure as surgeon general, intends to roll out facets of the report over time to audiences such as community organizations and state leaders, says H. Westley Clark, MD, dean’s executive professor of public health at Santa Clara University. One of the lead science editors of the report, Clark talked to sister publication Addiction Professional this week about the document, referring to it as one that “people can digest and use as a springboard for action.”

With a change of administration, it will be particularly important for the country to have a single scientific document about substance use disorders, says Clark.

“The surgeon general can’t dictate to the public health community or other groups,” he says. “But the office can use moral suasion, science, evidence and reasonable logic.”

Treatment

There isn’t one approach to treatment, as the report makes clear.

“Personalized medicine doesn’t work that way,” Clark says. “The cookie-cutter approach is the easy way out—you offer one thing, and if it doesn’t work, you blame the patient.”

The White House has made significant advances on addressing substance use disorders as the opioid epidemic increased in intensity over the past eight years. For example, Michael Botticelli, heading the Office of National Drug Control Policy, has tirelessly campaigned for medication-assisted treatment (MAT) for opioid use disorders.

The report states that although substance use disorders often are not treated and covered by insurance to the same degree as other chronic illnesses, evidence-based treatments are available. These include behavioral interventions, medications and social support services.

Additionally, the report includes statistics on the prevalence and demographics of substance use, on the clear adverse effects of substance use on health, and on the economic costs. There are chapters on neurobiology, prevention, early intervention and treatment, recovery and wellness, and healthcare systems.

Alcoholics Anonymous (AA) and other 12-Step mutual support groups are also covered. The report summarizes research showing that AA is effective. But mutual support groups are listed in the recovery, not treatment, section.

Letter to Trump

On Nov. 18, four healthcare leaders sent an open letter to President-Elect Trump, calling on him to address addiction as a public health crisis and to help eradicate the stigma associated with it. Linda Rosenberg, president and CEO of the National Council for Behavioral Health; former congressman Patrick J. Kennedy; television host Mehmet Oz, MD; and Marla Weston, PhD, RN, CEO of the American Nurses Assn., together signed the letter, which cites the surgeon general’s report.

The letter states, “While science tells us how to solve this problem, we need you and other elected officials to help marshal the resources to take on this public health crisis. We applaud the attention you placed on the issue of prescription drug abuse during your campaign for president, and appreciate you stating your commitment to making this a part of your health care policy agenda. And, now it's time for action. As our president, you can help address addiction in American communities by calling for the strengthening of prevention programs and increasing access to treatment.”

For the full letter to the president-elect, click here.