Surgeon General’s Report on Alcohol/Drugs Offers Fodder for Serious Change

(Winter 2016) Should employers even bother offering second chances to drug-free policy violators? Does treatment really work? Do parents have any influence on whether their kids will experiment with drugs? What needs to happen for our society to get a grip on the drug epidemic that is crushing families, the U.S. workforce and even our economy? What should schools be doing? Faith-based organizations? Law enforcement? Public officials and legislators? People who care about someone who’s addicted?

“Americans are being urged to change how we as a society address alcohol and drug misuse and substance abuse disorders.”

In a landmark report issued this November by the U.S. Department of Health & Human Services, U.S. Surgeon General Dr. Vivek Murthy laid out all the current literature about substance abuse and related disorders, and offers researched-based recommendations for preventing and treating this public health threat.

Like other public health issues including cancer, diabetes, obesity and motor vehicle injuries, the research around alcohol and drug misuse and addiction has dramatically increased over the years. And just as experts have used research to create programs and policies that lowered the prevalence of smoking, we have increasing amounts of data around substance base that can help guide our behaviors and decisions – legislatively, in treatment centers, at home with our children and even at work — regarding alcohol and other drug issues.

The comprehensive report, “Facing Addiction in America,” addresses

• The role the brain plays in addiction.
• How to prevent and treat substance abuse.
• What an addict needs to sustain recovery.
• What our healthcare system needs to do to get better treatment outcomes.
• Recommendations for how the U.S. can create an “equitable and effective, science-based public health approach” to tackling this issue.

The report also reminds readers that while this public health issue is devastating and pervasive (more people suffer from substance use disorders than cancer!), the stigma and shame surrounding substance use disorders are debilitating.  One in seven people are expected to develop a substance abuse disorder in their lifetime, yet the extreme misunderstanding surrounding this disease makes it one of the least treated medical conditions. Only one in ten people who suffer, get help.

With the wealth of research available, it’s not necessary to fly by the seat of our pants when making alcohol and drug-related decisions. Credible research exists and can be used to guide behavior and decisions.

Parents
Avoid basing alcohol-related parenting decisions on intuition or how you were raised. (e.g., “My parents let me drink when I was young and I turned out OK.”) A lot of research has been published recently around what parents can do to help prevent substance abuse disorders with their children. For example, we now know that kids who  drink before the age of 15 are five times more likely to develop an alcohol use disorder later in life, compared to those who have their first drink at 21 or older. Seek counsel from organizations and individuals who understand the research and how it can be used to parent drug-free kids.

Taxpayers
Insist that any money spent in your school and community to prevent alcohol and other drug use among students be based on or modeled after evidence-based research. For too long schools have floundered over their role and, like parents, have often selected programs and approaches that “feel” right instead of those based on research. Again, seek counsel from preventionists who know the research and best practices tied to that information.

Employers
Treatment is effective, so consider this when making policy decisions around corrective action for a positive test. Talk to your assistance providers and specifically ask what treatment methods they use and if these approaches are supported by current research. For example, research supports treating heroin and prescription pain med abuse with medication.  According to the research compiled in the report (and contrary to public opinion), “Abundant scientific data show that long-term use of maintenance medications successfully reduces substance use, risk of relapse and overdose, associated criminal behavior, and transmission or infectious disease, as well as helps patients return to a healthy, functional life.”

The General Public
If you care about someone with a substance abuse disorder, you know the symptoms can be ugly, embarrassing, frustrating and painful. A major dynamic this new report reminds us of is that there are scientific, neurological facts that can offer an explanation for these symptoms. While substance abusers and addicts, of course, need to be held accountable for their behavior, the research can be helpful to understand what they need from a medical perspective to improve their health. We now know that substance use disorders change circuitry in the brain and directly affect one’s ability to make decisions, respond to stress and control impulses. “Understanding this transformation in the brain,” the report said, “is critical to understanding why addiction is a health condition, not a moral failing or character flaw.”

While shining a spotlight on the prevalence and challenges related to this public health issue, the Surgeon General also shared that this is a time of “great hope and opportunity” to prevent and treat substance use disorders:

• The increase in research has fostered an increase in overall understanding.
• We now know the types of policies and programs that are effective.
• Health care reform efforts, according to the report, “are creating new opportunities to increase access to prevention and treatment services to improve public health.”

By the numbers …

• The number of people living with substance abuse disorder is 1.5 times the combined number of people with any type of cancer.
• Substance abuse disorders cost $420 billion in healthcare costs, costs to criminal justice and economic productivity
• More people die from overdoses than car crashes.
• 1 in 10 drivers reports driving under the influence of alcohol and/or other drugs.
• 2 – 5% of the U.S. population is suffering from health consequence related to their moms misusing substances during pregnancy.
• Nearly 25% of adults and adolescents reported binge drinking in the past month.
• Between 40 – 70% of a person’s risk for developing substance abuse disorder is genetic.

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