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Surgeon General’s Report: Substance Abuse Continues to Grow in America

by Derek Gilna

A new report from the federal government documents what many already know: that the problem of substance abuse addiction continues to expand, now affecting an estimated 20.8 million Americans. That’s more than the total number of people in the U.S. with cancer.

Prisoners at the local, state and federal levels also suffer unacceptably high levels of substance abuse, the report noted.

Published in November 2016, “Facing Addiction: The Surgeon General’s Report on Alcohol, Drugs and Health,” is the first study from the office of the nation’s top healthcare professional to address what then-Surgeon General Dr. Vivek H. Murthy called a “crisis of addiction.” Dr. Murthy left office in April 2017 after being asked to resign by the Trump administration.

Incorporating research from the Centers for Disease Control and the Substance Abuse and Mental Health Administration, the Surgeon General’s report found that only 10% of those suffering from addiction – about 2.2 million people – actually receive treatment. Yet 1 in 7 Americans, over 45 million people, will face addiction during their lifetimes.

The report added that 78 people die each day in the United States from opiod overdoses alone – a death every 19 minutes, nearly quadruple the number in 1999. The economic impact of drug and alcohol abuse and addiction totals $442 billion annually – almost $200 billion more than the economic cost of diabetes, though that disease affects a similar number of people.

At least one lawmaker, U.S. Senator Edward J. Markey, called the report a “missed opportunity,” because the opioid epidemic demands “a far more detailed discussion.”

“The deaths caused by prescription drugs, heroin and fentanyl [a synthetic opioid] overdoses are growing exponentially every year, yet this report fails to provide any detailed road map for how best to curb opioid addiction,” Markey said in a statement.

The low rate at which addiction is treated – what the report calls a “treatment gap” – is especially urgent since research has found that every $1 invested in viable substance abuse treatment saves $4 in health care costs and $7 in criminal justice costs. The Surgeon General recommended a shift in public policy to remove the stigma from addiction and focus more resources on treatment than punishment – creating more patients and fewer prisoners.

“We have to recognize [addiction] isn’t evidence of a character flaw or a moral failing,” Murthy stated. “It’s a chronic disease of the brain that deserves the same compassion that any other chronic illness does, like diabetes or heart disease.”

In addition to more substance abuse treatment, the report also calls for more prevention, noting that early alcohol and drug use significantly increases the risk of developing an addiction problem later in life. It noted that those who start drinking before age 15 are four times more likely to become addicted later in life than those who start at 20 or later. Trying an illicit drug before age 13 raises the risk of addiction to 70 percent, from 27 percent for those whose first use occurs after age 17.

The majority of alcohol and drug users do not develop addiction problem in part because, as the report notes, 40 to 70 percent of the risk is due to genetic factors. That those factors are unknown until an addiction problem develops, though, makes treatment and prevention efforts even more urgent.

Prisoners are not exempt from these issues, of course, and substance abuse in correctional facilities is a common problem; an estimated 80% of prisoners had an alcohol or drug problem prior to their incarceration, and drugs are just as prevalent in prisons as they are outside.

For those whose only crime is using illegal drugs, the Surgeon General’s report calls for the criminal justice system to engage “in efforts to place non-violent drug offenders in treatment instead of jail, to improve the delivery of evidence-based treatment for incarcerated persons, and to coordinate care in the community when inmates are released.”

On August 10, 2017, President Trump declared the opioid crisis a national emergency under the National Emergencies Act.

“We’re going to spend a lot of time, a lot of effort and a lot of money on the opioid crisis,” Trump stated. “It is a serious problem the likes of which we have never had.”

Meanwhile, pharmaceutical companies that produce narcotics, such as OxyContin, have been criticized for helping to fuel the opioid epidemic. Two states, Mississippi and Ohio, filed lawsuits against pharma companies earlier this year, accusing them of “engaging in a sustained marketing campaign to downplay the addiction risks of the prescription opioid drugs they sell and [exaggerating] the benefits of their use for health problems such as chronic pain,” according to an NPR news report. 


Sources: The New York Times, NPR, USA Today,,,, CNN

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