Nearly a quarter of the American population today has reported substance abuse, proving addiction to be a huge public health challenge. Substance Use Disorder (SUD) health care is not only structurally separate from the treatment of other conditions, but socially separate in a country that tends to misunderstand the condition.
Surgeon General Vivek Murthy calls for people to treat addiction like any other medical condition and move forward. Addiction is looked down upon and considered a moral failing instead of a chronic brain disease. There is a dismissive culture that surrounds substance abusers, which sometimes dissuades their decision of getting help. I can see why there is a social stigma on this topic, considering how personal it is. However, I think that this outlook can be improved by looking at this issue with a more open mind. Murthy found that addicts were afraid of losing friends and family or that doctors may treat them differently if they had revealed their SUD. Murthy proposes integrating SUD’s into mainstream health care, harm reduction strategies, and changing discouraging attitudes so people can do what they can to help.
In the Cell Press review article “Addiction: Pulling at the Neural Threads of Social Behaviors”, doctors discuss the biological aspect of addiction and argue that addiction should be treated with a medical approach over a criminal one. From the social disruptiveness drugs can cause to why social stressors can increase susceptibility to drugs, this article thoroughly explains which functional impairments drugs cause the brain to have and how society can change to help decrease those. An example of discouraging social interaction is how the impaired self awareness that addicts have from what the drugs to their brain is frequently interpreted as denial. Similar examples affect the low rates of treatment and dropout rates. The authors propose positive social reinforcers and adding access to treatment for prisoners, considering "80-85% who could benefit from it do not receive it”.
Over 10 million people suffer both an addiction and mental illness, which I believe is substance abuse and half of those who have mental disorders do not receive treatment. According to the review article, only 10% of people who reported they had a SUD received treatment and that fear of social stigma is most likely why. Dr. Murthy has urged over 2.3 million doctors and public health professionals, "“We have to treat with skill, compassion and urgency”.
Primary prevention would be to reduce Adverse Childhood Events, or ACEs. Secondary preventions would be to increase access to health care and increase screening in healthcare settings. Community forums can be created to discuss and stress the medical nature of addiction for a population with certain risk factors. The question I have is: How exactly do we dispel the stigma that surrounds addiction? These prevention strategies have a plan and make sense, but chances are someone will not change just because they are told to. I personally think education and discussion is the solution to increase awareness and understanding for most issues.
Politically speaking with newly elected President Trump, are these addiction treatment efforts never going to be put into place? Trump and a Republican Congress are determined to repeal the Affordable Care Act, which established addiction treatment as a health benefit. The surgeon generals’ reports have never covered drug or alcohol abuse until now, which is why I think this will change the conversation regardless and shed a new perspective in the public health community and the rest of the country.
References:
Schumaker, E. (2016). Surgeon General Vivek Murthy: Addiction Is A Chronic Brain Disease, Not A Moral Failing. The Huffington Post.
Volkow, N., Baler, R., & Goldstein, R. (2011). Addiction: Pulling at the Neural Threads of Social Behaviors.
