Surgeon General’s Report Summary — Chapter 7

Chapter 7, the last chapter, is devoted to the Surgeon General’s call to action. There are many things we as individuals can do, not only individually, but also as a community, and country. This is our opportunity to rise and meet the challenge of facing addiction together, as one.

It is time to change how we as a society address alcohol and drug misuse and substance use disorders. A national opioid overdose epidemic has captured the attention of the public as well as federal, state, local, and tribal leaders across the country. Ongoing efforts to reform health care and criminal justice systems are creating new opportunities to increase access to prevention and treatment services. Health care reform and parity laws are providing significant opportunities and incentives to address substance misuse and related disorders more effectively in diverse health care settings. At the same time, many states are making changes to drug policies, ranging from mandating use of prescription drug monitoring programs (PDMPs) to eliminating mandatory minimum drug sentences. These changes represent new opportunities to create policies and practices that are more evidence-informed to address health and social problems related to substance misuse. Pg. 7–2

Change the Way We View Addiction

Five decades ago, basic, pharmacological, epidemiological, clinical, and implementation research played important roles in informing a skeptical public about the harms of cigarette smoking and creating new and better prevention and treatment options. Similarly, research reviewed in this Report should eliminate many of the long-held, but incorrect, stereotypes about substance misuse and substance use disorders, such as that alcohol and drug problems are the product of faulty character or willful rejection of social norms. Pg. 7–6 to 7–7

Recommendations for Participants

Because of past stigma and discrimination, many individuals are afraid to speak up about having an alcohol or substance use disorder. But, thanks to the advent of online support and advocacy groups, that fear is starting to fade. However, we are only at the beginning.

Changing the culture is an essential piece of lasting reforms, creating a society in which:

• People who need help feel comfortable seeking it;
• There is “no wrong door” for accessing health services;
• Communities are willing to invest in prevention services, knowing that such investment pays off over the long term, with wide-ranging benefits for everyone;
• Health care professionals treat substance use disorders with the same level of compassion and care as they would any other chronic disease, such as diabetes or heart disease;
• People are celebrated for their efforts to get well and for their steps in recovery; and
• Everyone knows that their care and support can make a meaningful difference in someone’s recovery.
• Pg. 7–8

Everyone has a role to play in addressing substance misuse and substance use disorders and in changing the conversation around substance use, to improve the health, safety, and well-being of individuals and communities across our nation. 7–8

There are many things we as individuals, communities, and groups can do to affect change. Listed below are various groups, with suggestions on where to start. Please note that this is only a highlight of the information provided. If you would like to read more about each suggestion, please see the chapter link at the end of this post.

Individuals and Families

• Reach out, if you think you have a problem
• Be supportive (not judgmental) if a loved one has a problem
• Show support toward people in recovery
• Advocate for the changes needed in your community
• Parents, talk to your children about alcohol and drugs
• Pg. 7–8 to 7–9

Educators and Academic Institutions

• Implement evidence-based prevention interventions
• Provide treatment and recovery supports
• Teach accurate, up-to-date scientific information about alcohol and drugs and about substance use disorders as medical conditions
• Enhance training of health care professionals
• Pg. 7–9 to 7–10

Health Care Professionals and Professional Associations

• Address substance use-related health issues with the same sensitivity and care as any other chronic health condition
• Support high-quality care for substance use disorders
• Pg. 7–11

Health Care Systems

• Promote primary prevention
• Promote use of evidence-based treatments
• Promote effective integration of prevention and treatment services
• Work with payors to develop and implement comprehensive billing models
• Implement health information technologies to promote efficiency and high-quality care
• Pg. 7–11 to 7–12

Communities

• Build awareness of substance use as a public health problem
• Invest in evidence-based prevention interventions and recovery supports
• Implement interventions to reduce harms associated with alcohol and drug misuse
• Pg. 7–12 to 7–13

Private Sector: Industry and Commerce

• Promote only responsible, safe use of legal substances, by adults
• Support youth substance use prevention
• Continue to collaborate with the federal initiative to reduce prescription opioid- and heroin-related overdose, death, and dependence
• Pg. 7–13

Federal, State, Local, and Tribal Governments

• Provide leadership, guidance, and vision in supporting a science-based approach to addressing substance use-related health issues
• Improve coordination between social service systems and the health care system to address the social and environmental factors that contribute to the risk for substance use disorders
• Implement criminal justice reforms to transition to a less punitive and more health-focused approach
• Facilitate research on Schedule I substances — (i.e. — marijuana)
• Pg. 7–14 to 7–15

Researchers

• Conduct research that focuses on implementable, sustainable solutions to address high-priority substance use issues
• Consider how scientific research can inform public policy
• Promote rigorous evaluation of programs and policies
• Pg. 7–15 to 7–16

Conclusion

This Report is a call to all Americans to change the way we address substance misuse and substance use disorders in our society. Past approaches to these issues have been rooted in misconceptions and prejudice and have resulted in a lack of preventive care; diagnoses that are made too late or never; and poor access to treatment and recovery support services, which exacerbated health disparities and deprived countless individuals, families, and communities of healthy outcomes and quality of life. Now is the time to acknowledge that these disorders must be addressed with compassion and as preventable and treatable medical conditions.

By adopting an evidence-based public health approach, we have the opportunity as a nation to take effective steps to prevent and treat substance use-related issues. Such an approach can prevent the initiation of substance use or escalation from use to a disorder, and thus it can reduce the number of people affected by these conditions; it can shorten the duration of illness for individuals who already have a disorder; and it can reduce the number of substance use-related deaths. A public health approach will also reduce collateral damage created by substance misuse, such as infectious disease transmission and motor vehicle crashes. Thus, promoting much wider adoption of appropriate evidence-based prevention, treatment, and recovery strategies needs to be a top public health priority.

Making this change will require a major cultural shift in the way Americans think about, talk about, look at, and act toward people with substance use disorders. Negative public attitudes about substance misuse and use disorders can be entrenched, but it is possible to change social viewpoints. This has been done many times in the past: For example, cancer and HIV used to be surrounded by fear and judgment, but they are now regarded by most Americans as medical conditions like many others. This has helped to make people comfortable talking about their concerns with their health care professionals, widening access to prevention and treatment. We can similarly change our attitudes toward substance use disorders if we come together as a society with the resolve to do so. With the moral case so strongly aligned with the economic case, and supported by all the available science, now is the time to make this change for the health and well-being of all Americans. Pg. 7–16 to 7–17

To view the PDF file of this chapter, please follow this link: https://addiction.surgeongeneral.gov/chapter-7-vision-for-the-future.pdf

Originally published at www.mysoberashes.com on July 19, 2017.