It was a long time coming. The Surgeon General’s Report on tobacco, HIV, AIDs, mental health, and physical activity changed national habits and policy, and saved millions of lives. Now the Surgeon General’s Report on Addiction calls for a culture of change for what has been the #1 health issue in America for almost two decades. Over 500,000 people have died from overdoses since 2000.
The Parity Act was passed in 2009 to insure that mental health and addiction would be covered by insurance the same as physical illnesses, but policy about what coverage for addiction would look like has yet to be established eight years later. Now, with the Surgeon General’s Report, steps can be taken to set guidelines for care and get appropriate coverage for people who need it.
The landmark report released November 17 by U.S. Surgeon General Vivek Murthy places drug and alcohol addiction alongside smoking, AIDS and other public health crises of the past half-century, calling the current epidemic “a moral test for America.” “The reason I’m issuing this report is I want to call our country to action around what has become a pressing public health issue,” Murthy said in an interview.
“I want our country to understand the magnitude of this crisis. I’m not sure everyone does.” The report calls for a cultural change to increasing overdose epidemic that has killed more than 500,000 Americans since 2000, and it presents evidence that addiction is a treatable brain disease, with new therapies under development. In 2015, the report notes, substance-abuse disorders affected 20.8 million people in the United States — as many as those with diabetes and 150 percent of the total with cancer. Yet, Murthy said, only one in 10 people receives treatment.
“We would never tolerate a situation where only one in 10 people with cancer or diabetes gets treatment, and yet we do that with substance-abuse disorders,” he said.
The Associated Press reviewed the report ahead of its official release. Here’s a look at what’s in it and some of the AP early reaction:
The surgeon general’s report refutes abstinence-only philosophies as unscientific and supports medications such as buprenorphine and methadone that are used to treat opioid addition. That may annoy supporters of traditional 12-step programs who see medications as substituting one addiction for another. Medication-assisted treatment (MAT) for opioid addiction can take time. “One study suggested that individuals who receive MAT for fewer than 3 years are more likely to relapse than those who are in treatment for 3 or more years,” the report states.
Staged interventions, like those depicted on TV, may backfire. Planned surprise confrontations “have not been demonstrated to be an effective way to engage people in treatment,” the report says. The trouble with the approach? According to the surgeon general’s report, it can heighten resistance and attack the self-worth of the addict.
Alcoholics Anonymous was founded in 1935 because mainstream medicine wasn’t treating alcohol disorders. That started a legacy of separating addiction treatment from the rest of medicine. The report makes room for AA and other recovery support services, noting they don’t require health insurance and are free, but it also says they “are not the same as treatment and have only recently been included as part of the health care system.” AA gets praise for adaptability. American Indians, for instance, have incorporated Native spirituality and allowed families to attend meetings. Research shows AA to be “an effective recovery resource,” the report concludes.
HIGHER ALCOHOL TAXES
Alcohol tax policies get a nod in a section on evidence-based prevention: “Higher alcohol taxes have also been shown to reduce alcohol consumption.” Other policies suggested by research include limiting the density of stores selling alcohol, banning Sunday sales and holding bars liable for serving minors.
ROR analysis coming soon.
Reach Out Recovery By Leslie Glass