The Surgeon General’s Report on Addiction: A Scientific Call for Hearts and Minds

Hollywood launch signifies culture change as important as policy change

Several hard-fought decades of advocacy, research and experience paid off this week when the first-ever U.S. Surgeon General's report on addiction was released. At once, the report validated years of work and ignited fresh hope that America's attitudes and approach to substance use may finally turn the proverbial corner.

"This is our moment," said my colleague, William Moyers, vice president of Public Affairs and Community Relations for the Hazelden Betty Ford Foundation. For 20 years, he has used his own personal recovery journey to demonstrate that addiction is best addressed as a health problem, rather than a personal or moral shortcoming.

Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs and Health provides a comprehensive summary of where the nation stands in confronting the problems of substance use, and where we need to go if we are ever to minimize the enormous human and economic costs associated with it.

It's a scientific document designed to be a catalyst for winning hearts and minds.

"The best of movements are powered by compassion and love," said Surgeon General Dr. Vivek Murthy. He, along with William and other leaders from around the country, spoke at a Los Angeles event—broadcast live online Nov. 17 to a nationwide audience—that served to amplify the report's release.

The Epicenter of Popular Culture

The setting was fitting—The Studios at Paramount in Hollywood. It signified that progress in the fight against addiction requires more than making a strong scientific appeal to policymakers back in Washington, D.C. In the end, it requires penetrating the cultural mainstream to fundamentally shift public attitudes about substance use problems and the people who experience them.

It helps when the scientific standard bearer is the Surgeon General. The iconic, uniformed public figure has a medical bully pulpit that gained cultural significance in 1964, when the first Surgeon General’s Report on Smoking and Health was issued—a report, by the way, that sparked 50+ years of public health progress.

It also helps when the Surgeon General partners with a hip, media-savvy nonprofit like Facing Addiction, which was responsible for the movie-studio glitz of the launch party. It helps, too, getting Dr. Oz to promote "Facing Addiction Over Dinner" the same night, as a way to encourage families to discuss the topic over their evening meal. It also helps to film celebrities and other bigwigs immediately after the report's unveiling for a 30-minute program—"Listen: Facing Addiction in America"—airing the very next night on several national television stations, including MTV, Comedy Central and VH1.

A Social Cause with Momentum

Real progress on addiction, as Dr. Murthy implied, requires a movement. And, indeed, one is afoot.

It started 15 years ago, when my colleague William and a small group of others launched what has become known as the New Recovery Advocacy Movement. I consider myself part of that movement, and am proud that my organization—the Hazelden Betty Ford Foundation and our Institute for Recovery Advocacy—has played a leading role. Thanks to an infusion of young leaders and the urgent, tragic need presented by the nation's opioid epidemic, our movement has picked up tremendous steam in just the past three years.

Now, Dr. Murthy's report legitimizes the movement—both scientifically and culturally—and also becomes a pinnacle piece of it, providing a new and lasting source of fuel for historic change.

The Surgeon General's Report on Alcohol, Drugs and Health

A full video recording of "Facing Addiction in America: A National Summit with the Surgeon General," held in Los Angeles to amplify the release of Dr. Vivek Murthy's long-awaited, groundbreaking report on addiction. Our own William Moyers is introduced at the 2:25:20 mark.

The reality is that even before the Surgeon General’s report, we knew a lot about what works, in terms of preventing substance use problems, treating addiction, and supporting people’s long-term recovery.

Unfortunately, comprehensive solutions have long been obscured by the pervasive shadow of negative perceptions, with misunderstanding and stigma subtly holding back progress. The result has been widespread marginalization of a very serious and common health condition. You can see it in our government policies and budgets. In our insurance policies. In our medical school priorities. In our criminal justice and education systems. And on and on. 

As a nation, we have failed to acknowledge the massive scope of the problem, failed to accept the science that tells us it is a preventable and treatable health issue, and failed to make needed investments of time, energy, money and political will.

Given the facts—one in seven Americans develops a substance use disorder at some point in their lives; $442 billion in annual costs; and a robust body of research on effective solutions—there is no explanation for this failure, other than entrenched stigma that says people with substance use problems just aren’t worth it.

Dr. Murthy noted that the number of Americans with substance use disorders is similar to the number suffering from diabetes, and 1.5 times the number who have cancer, yet only 10 percent of those who need addiction treatment receive it.

“In this report we call the country’s attention to the fact that substance use disorders are in fact one of our most under-appreciated and under-addressed public health crises,” he said. “Imagine how our country would react if only one in 10 people with cancer could actually get treatment, if only one in 10 people with diabetes could access treatment. We wouldn’t tolerate that. And we shouldn’t tolerate it for substance use either.”

William Moyers, Vice President Pubic Affairs Hazelden Betty Ford Foundation
William Moyers

Some progress is under way, but huge access and funding issues remain. Let’s also not forget that our healthcare system has proven woefully unequipped to address the opioid overdose epidemic, which takes 29,000 lives a year and ruins many more.

Sadly, we’ve also grown comfortable with the individual and family devastation caused by alcohol, which contributes to 88,000 deaths per year and accounts for well over half of all substance-related costs.

Clearly, there is so much more we can and need to do. 

Dr. Murthy’s report consolidates a substantial and growing body of research on neurobiology, prevention, treatment, recovery, and health system integration. The report doesn’t contain any quick fixes or cures. Instead, it recommends the only practical solution—a difficult, but comprehensive, all-in public health approach, with notable emphasis on long-neglected priorities like prevention, recovery support and medical education.

As much as it can, the report provides a go-to source of truth on the subject matter, and it is now an invaluable resource for all of us committed to progress.

Dr. Connie Weisner and William Moyers
Dr. Connie Weisner and William Moyers

Though the word “historic” gets thrown around rather loosely, the Surgeon General’s Report on Alcohol, Drugs and Health fits the bill. It articulates the truth about substance use problems and solutions, and puts an official stamp on the message of our recovery advocacy movement. It gives us the opportunity, moving forward as a nation, to cement in the public consciousness the reality that substance use disorder is a chronic illness which can be prevented, overcome by individuals, and addressed as a community and nation with appropriate healthcare and community support systems.

That is a message that actually dates back to Hazelden’s first two presidents, Patrick Butler and Dan Anderson, who were among the earliest modern advocates, singing a similar tune from the 1950s through the 1980s.

As I’ve studied history in recent years, I sometimes wondered if the message could ever reach a game-changing threshold of cultural relevance. Thanks to the Surgeon General’s report and a growing collection of cultural influencers like hip hop artist Macklemore and many others, I think we are much closer. And now it’s up to us to take the message to the people with even more vigor than ever before. To win hearts and minds.

To not just influence the culture, but to become a significant part of it.  

Jeremiah Gardner, Mgr of Public Affairs and AdvocacyJeremiah Gardner, manager of public affairs and advocacy at the Hazelden Betty Ford Foundation, is a person in long-term recovery with a master's degree in addiction studies and a background in journalism, public affairs, business and music.

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