Landmark report calls drug addiction as common as diabetes and cancer; KC responds
Fifty years ago, the surgeon general decried the dangers of cigarettes in a landmark report that changed the way the country addressed a tobacco epidemic.
On Thursday, U.S. Surgeon General Vivek H. Murthy released a first-of-its-kind report meant as a similar call to action for another American problem: drug and alcohol addiction.
In the report, called Facing Addiction in America, Murthy discussed the need for laws and programs that explore the science behind addiction and called for a shift away from the idea that addiction is related to “moral failing.”
“We must help everyone see that addiction is not a character flaw — it is a chronic illness that we must approach with the same skill and compassion with which we approach heart disease, diabetes and cancer,” Murthy said in his report.
“How we respond to this crisis is a moral test for America,” he wrote. “Are we a nation willing to take on an epidemic that is causing great human suffering and economic loss?”
According to the 428-page report, 66.7 million people in the U.S. reported binge drinking in the past month, and 27.1 million were abusing illicit or prescription drugs last year. In all, 20.8 million Americans had a substance abuse problem last year. That’s as many as had diabetes and 1 1/2 times as many as had cancer, Murthy points out.
It’s a welcome message for those who have worked to prevent and treat drug and alcohol abuse in Kansas City.
“One thing that I really appreciate in this report is comparison to diabetes and cancer,” said Emily Hage, vice president of development for First Call, an alcohol and drug addiction prevention and recovery organization in Kansas City. “And understanding that addiction is right alongside those things.”
The epidemic has drastic consequences for the country, driving up mortality rates, particularly among middle-aged white Americans, costing the country $400 billion in crime and health resources, and affecting children as young as 12.
The report makes a case for continuing to study the neurological science behind addiction and using it to improve and tailor therapies and treatments to be more effective. It also shows how relapse rates are comparable to other chronic diseases, though stigmas about drug users haven’t inspired communities to invest in long-term solutions.
Local advocates hope that the report might encourage more funding for research and treatment programs for addicts and move away from incarcerating drug users in need of treatment.
“Unfortunately in our society, we primarily treat drug abuse as a crime,” said Alan Flory, executive director of ReDiscover, a nonprofit devoted to mental health and substance abuse services. “There are more people locked up in prisons for illegal drugs and alcohol than there are people in treatment by far.”
Flory said he hopes the surgeon general report will inspire an investment in specific programs that can prevent abuse. For example, Missouri lacks a prescription monitoring system, which allows pharmacists to flag people who might be taking out multiple prescriptions at once. And Congress this year passed the Comprehensive Addiction and Recovery Act of 2016, in part to help combat a growing problem with the abuse of opioids, but lawmakers didn’t fund it.
The rise in those suffering from an opioid addiction is something that Welcome House resident relations manager Micah Haen has seen. The recovering alcoholic now does the intake interviews for the Kansas City living facility for men struggling with addiction.
When he lived in the house two years ago, three out of four residents were recovering from alcohol abuse versus those struggling with opiods and prescription drugs. He says he has watched those numbers flip.
“The disease of addiction does not discriminate,” Haen said. “It’s financial people, businessmen, lawyers. Not necessarily the guy you would expect.”
Flory said he also hopes the report inspires people to broaden their approaches and their minds when it comes to how society views addiction. Some might be surprised to learn, he said, that more people suffer from substance abuse than cancer and diabetes.
“It’s a chronic disease,” Flory said. “People ask and say, ‘What’s your cure rate?’ Wait a minute, you don’t ask those questions about diabetes and asthma.”
Progress, Hage said, relies on more research and efforts to break down stigmas surrounding drug use.
“I think with more of a focus and resources dedicated to more research,” Hage said, “we are going to be able to deal with these disorders more effectively and perhaps more quickly.”
Katy Bergen: 816-234-4120, @KatyBergen
Highlights from the report
Medication myths: 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 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.
TV-style interventions: 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: 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.
Marijuana: The report suggests learning from alcohol and tobacco policies to find out what works to minimize harm as marijuana becomes legal. Voters in eight states have approved adult use of recreational marijuana, and more than two dozen states have medical marijuana laws. The report cites “a growing body of research” suggesting marijuana’s chemicals can help with “pain, nausea, epilepsy, obesity, wasting disease, addiction, autoimmune disorders, and other conditions.”
Surgeon General Vivek H. Murthy supports easing existing barriers to marijuana studies, but said Wednesday that he’s worried the legalization movement is moving faster than research. “Marijuana is in fact addictive,” he said.
The Associated Press
This story was originally published November 17, 2016 at 5:56 PM with the headline "Landmark report calls drug addiction as common as diabetes and cancer; KC responds."