The U.S. Surgeon General recently published a landmark report on alcohol, drugs and health.
According to the report, almost 21 million people in America have a substance use disorder involving alcohol or drugs. This is similar to the number of people in our country with diabetes and is higher than the total number of Americans suffering from all cancers combined. Despite the scope of the problem, the report notes that only 1 in 10 people with a substance use disorder ever receives treatment.
A key part of the report is the scientific evidence that shows that addiction is a chronic brain disease. The onset, development and maintenance of substance use disorders are influenced by disruptions in several areas of the brain. Adolescence is identified as a critical period of risk for substance use and addiction. It is well known that addictive substances, including alcohol and marijuana, have especially harmful effects on the adolescent brain.
The process of addiction involves a three-stage cycle, binge/intoxication, withdrawal and preoccupation/anticipation. After intoxication, the period of withdrawal may be accompanied by irritability and depression. A period of abstinence, in turn, leads to a stage at which the addicted individual becomes preoccupied with seeking the substance again. The cycle may repeat over the course of months or weeks, or even daily.
There is well-supported evidence that prevention programs targeting at risk youths and adults may reduce drinking and the harms associated with alcohol misuse.
It is known that the treatment of substance use disorders is at least as effective as the treatment of other chronic health conditions, like diabetes, asthma or high blood pressure. Unfortunately, less than 1 in 10 people with a substance use disorder receive any form of treatment.
The goals of treating a substance use disorder are to reduce key symptoms to non-problematic levels and to improve health and functional status. Treatment may include medications, behavioral therapies and recovery support services.
There is good evidence that recovery from a substance use disorder is possible. In fact, over half of people with a substance use disorder, 25 million people, are in stable remission. There is well-supported scientific evidence demonstrating the effectiveness of 12-step programs while other recovery programs also show promise.
If you or someone you love is struggling with an addiction to alcohol or drugs, the Surgeon General’s Report is a message of hope. The details of the report, including links to treatment resources, can be found at https://addiction.surgeongeneral.gov.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.