Surgeon general issues landmark report on alcohol, drugs and health

recommends actions we can take to prevent and treat these conditions, and promote recovery.

One in seven people in the U.S. is expected to develop a substance use disorder at some point in their lives. Yet only 1 in 10 receives treatment. Among other things, the report shows that substance use disorders typically develop over time following repeated episodes of misuse that result in changes to the brain circuitry.

The Report makes clear that substance misuse – which includes use of a substance in any way that can cause harm to oneself or others – is an underappreciated but critical public health challenge that can lead to substance use disorders, such as addiction. In 2015, nearly 48 million Americans used an illicit drug or misused a prescription medication, approximately 67 million reported binge drinking in the past month, and nearly 28 million self-reported

driving under the influence in the past year. This large, atrisk population of Americans can benefit from appropriate screening, prevention, and treatment services.

“Although substance misuse problems and use disorders may occur at any age, adolescence and young adulthood are particularly critical at-risk periods,” Dr. Murthy said. “Preventing or even simply delaying young people from trying substances is important to reducing the likelihood of a use disorder later in life.”

For example, people who use alcohol before the age of 15 are four times more likely to develop an alcohol use

disorder later in life compared to those who have their first drink at age 20 or older.

One of the findings of this report is that substance use disorder treatment in the United States remains largely separate from the rest of health care and serves only a fraction of those in need of treatment.

The Mental Health Parity and Addiction Equity Act of 2008 and the Affordable Care Act in 2010 have increased access to these services, making it possible for more people to get the treatment and support services they need to get and stay well. Yet for a variety of reasons, including stigma, a treatment gap remains.

This treatment gap can also be attributed to factors, including lack of screening for use disorders, fear of shame and discrimination associated with addressing substance use disorders, lack of access to and costs of care, and fragmentation of services in our health care system. Additionally, many people seek or are referred to substance use disorder treatment only after a crisis, such as an overdose, or through involvement with the criminal justice system.

“Families across this country are fighting addiction -they’re fighting an illness, as well as a stigma. They’re doing all they can, and

we should do no less. At the U.S. Department of Health and Human Services, we have worked hard to make our nation healthier and save lives by increasing access to evidencebased treatment for those who need it,” said HHS Secretary Sylvia M. Burwell. “While there’s more to do, this historic report provides us guidance and outlines important steps we can take to move forward, build on our progress to address this public health crisis, and make a difference for more Americans.”

The report identifies substance use disorders as a public health problem that requires a public health solution.

It recommends taking action by eradicating negative attitudes and changing the way people think about substance use disorders; recognizing substance misuse and intervening early; and expanding access to treatment.

“It’s time to change how we view addiction,” said Dr. Murthy. “Not as a moral failing but as a chronic illness that must be treated with skill, urgency and compassion. The way we address this crisis is a test for America.”

If you or someone you know is struggling with a substance use disorder, call 1-800-662-HELP or visit samhsa.gov/find-help.