Kolmac Outpatient Recovery Centers

The alcohol and drug treatment community received a parting gift from the outgoing Obama administration this month in the form of the newly released “Surgeon General’s Report on Alcohol, Drugs, and Health.” Here are some of my thoughts about the Surgeon General’s Alcohol and Drug Report.

  1. It is groundbreaking. This is the first surgeon general’s report to address substance use disorders and their relationship to other health issues. It argues for addictions to be approached as a public health rather than a moral matter.
  2. It is comprehensive. The report combines information found in a textbook with a call to action; the full report weighs in at 428 pages. An accompanying executive summary is 36 pages. The topics include neurobiology, prevention, treatment, recovery, and healthcare systems.
  3. It is well done. The list of contributors and reviewers reads like a Who’s Who of addiction experts. Graphics are used to make complex neurobiological topics comprehensible.
  4. It emphasizes evidence over ideology and politics. It does not shy away from addressing controversial issues such as buprenorphine for opioid addicts, cannabis, and needle exchange. References to scholarly research are extensive
  5. It is in line with Kolmac practices. In recommending a broad level of psychosocial interventions, supported by medication and integrated into both recovery support and general medical communities, the report does not present any significant idea with which I would disagree.

One of the big questions is what the impact of the Surgeon General’s Alcohol and Drug Report will be, particularly with the upcoming change of administrations. Those of us in the field hope it will contribute to efforts aimed at de-stigmatizing addiction, efforts that have at times faced difficulty gaining traction among policy makers and the general population. Will a balance be struck between holding people accountable for their behavior and maintaining a compassionate awareness of the need for treatment, rather than shifting to a primarily moral and punitive approach?

The report is already being compared to the landmark 1964 Surgeon General’s Report on Smoking. That report generated immediate excitement, was the subject of leading news stories and led to relevant legislation. It accelerated a change in the way tobacco was regarded and helped reduce the use of tobacco and combat the diseases associated with smoking. I believe that the current report will not achieve that historic impact, but it is nevertheless welcome.

In a future article, I will focus on some of the particular points of the new Surgeon General’s Alcohol and Drug Report.

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