Aiming to repeat the success that the United States had in reducing tobacco use, Surgeon General Vivek Murthy urged the country to take profound actions to combat drug addiction and abuse. In a landmark report, Murthy detailed his ideas for combatting substance abuse, urging Americans to recognize addiction as a chronic illness.
“Stigma has created an added burden of shame that has made people with substance use disorders less likely to come forward and seek help,” Murthy wrote. “It has also made it more challenging to marshal the necessary investments in prevention and treatment. We must help everyone see that addiction is not a character flaw.”
The report did not reveal new findings on the impact of substance abuse or ways to reduce it. But it put a spotlight on the topic in a way that only the surgeon general can. Similarly, former Surgeon General Luther Terry was not the first to acknowledge the hazards of smoking tobacco when he published a ground-breaking report in 1964, but Luther’s report is still one of the most influential reports on tobacco today.
Murthy’s report outlined the numerous consequences associated with alcohol and drug misuse:
The report highlighted a 2005 study published in the Archives of General Psychiatry that concluded more than 14 percent of the population will develop a substance use disorder during their lifetime.
It cited National Survey on Drug Use and Health data that revealed 20.8 million Americans had a substance use disorder in 2015, but only 10 percent of them sought treatment for addiction. Additionally, 40 percent of people with a substance use disorders had a co-occurring mental health disorder, but only 48 percent received treatment for either condition.
In addition to shame and fear associated with stigma, treatment barriers include unaffordable health care, long waiting lists and deficient screening procedures in common health settings, according to the report.
The report wasn’t all doom and gloom, though. It described advances in the field such as increased knowledge on addiction as a disease, the development of effective prevention programs, the expansion of evidence-based treatments and growing criminal justice reform.
Murthy’s goal is to spur the public, policymakers and health care providers to take advantage of the advances in the field and to overcome stigma and other barriers to treatment. The surgeon general hopes the report will generate a national conversation that will lead to more healthy communities.
In the report’s preface, Murthy wrote that the nurses he used to work with implored him to address the addiction epidemic in the United States.
The founder of Doctors for America, a nonprofit comprising 15,000 physicians who advocate for affordable health care, Murthy was confirmed by the U.S. Senate in December of 2014. His confirmation was delayed for more than a year after he was nominated because of opposition from pro-gun lobbyists and senators who believed he was too inexperienced for the position.
With only two years to work before President Barack Obama left office, Murthy made combatting addiction one of his top priorities. He spent nearly half of 2016 traveling the country to discuss the opioid epidemic.
Murthy’s Turn the Tide tour stops spanned the country, including visits to Maryland, Alaska, Ohio and Arizona. He spoke to tribal leaders, addiction specialists, the indigent, local policymakers and individuals in recovery.
Near the end of his tour, the surgeon general wrote a letter to physicians across the country requesting that they sign a pledge to help combat the opioid epidemic. The unprecedented letter was sent to more than 2.3 million doctors. He urged them to learn about treatment for pain, to screen patients for addiction and to remove the stigma associated with the disease.
His report on addiction comes as a new administration prepares to take control of the White House. The attention that the report put on addiction may spur the Donald Trump administration to continue Obama’s fight against addiction.
Trump has promised to fight drug abuse by expanding access to rehab, increasing use of naloxone and supporting criminal justice reforms such as drug courts. Each of those strategies was recommended by the surgeon general’s report. But other Trump strategies, such as building a wall to cut off illicit drug trafficking routes from Mexico, may distract the administration from science-based approaches.
Murthy’s report has achieved its goal of receiving widespread coverage and spurring conversations among public health experts. Time will tell whether it becomes the revolutionary report that Murthy hopes it will be.