By Toni Clarke
The U.S. Surgeon General issued a call to action on Thursday to end what he said was a public health crisis of drug and alcohol addiction that is both underappreciated and undertreated.
Dr. Vivek Murthy issued the first-ever Surgeon General's report on substance abuse and said he hopes it will galvanize work on the issue the way a similar report 50 years ago sparked decades of effort to combat smoking.
U.S. deaths from drug overdoses hit a record in 2014, increasing 6.5 percent to 47,055, propelled by prescription painkiller and heroin abuse, according to the Centers for Disease Control and Prevention.
"The most important thing is, we have to change attitudes towards addiction and get people into treatment," Murthy said in an interview. "Addiction is a disease of the brain," he added, "not a character flaw."
The report comes amid a broader government effort to address addiction, in particular opioid painkiller abuse. President Barack Obama has requested an additional $1.1 billion to help address the problem. Opioids include oxycodone, hydrocodone, fentanyl and morphine and are sold under such brand names as OxyContin, Percocet, Vicodin and Actiq.
In 2015 more than 27 million people in the United States reported using illegal drugs or misusing prescription drugs. More than 66 million people, or nearly a quarter of all adolescents and adults, reported binge drinking within the previous month.
The estimated annual economic impact of drug abuse is $193 billion, the report states, while the estimated economic impact of alcohol abuse is $249 billion. Every dollar invested in treatment saves $4 in healthcare costs and lost productivity and $7 in criminal justice costs, Murthy added.
The report urges a holistic approach to battling the addiction epidemic that should involve policy makers, regulators, scientists, families, schools and local communities.
The goal is to increase access to existing treatment programs, which Murthy said have been shown to reduce the risk of relapse, while at the same time expand new and more effective programs.
Murthy stressed the importance of intervening early through school programs to discourage early access to alcohol. If a person has their first drink before the age of 15, their likelihood of developing an alcohol problem is four times greater than if the first drink is taken after the age of 21, Murthy said.
The model Murthy hopes to follow is the 1964 Surgeon General's report on tobacco. At that time 42 percent of the population smoked but few recognized the danger.
"That Surgeon General's report catalyzed a half century of work on tobacco control and now the smoking rate is less than 17 percent," he said.
Under pressure from lawmakers the Food and Drug Administration agreed earlier this year to reform its process for approving opioids. In March it added new warnings to short-acting opioids to bring information about addiction and abuse in line with that of long-acting pills. Short-acting pills account for 90 percent of prescribed opioids.
Murthy's report urges more investment in research and new types of treatment programs. But he said that shouldn't prevent people from acting to increase access to existing programs.
"We can't afford not to invest in treatment because we are going to pay a lot more later," he said.