I know I haven’t written my website for several weeks. Frankly, I’ve been so depressed over the political situation that I’ve been experiencing writer’s block. I’ve also felt that medical research publications is not foremost on most of our minds – it certainly has not been on mine. But on this rainy day, while house bound and refusing to watch the news, I picked up the January 10 issue of JAMA and found the Surgeon General’s report on alcohol drugs and health. I experienced an immediate urge to share it…
The report actually came out in November 2016. Here are some of the distressing statistics:
Nearly 21 million people in the United States have a substance use disorder and this is comparable with the number of people diagnosed with diabetes and 1.5 times the prevalence of all cancers combined! And this number is actually low because it doesn’t include the millions of people who don’t have a formal diagnosis of the disorder but who misuse substances. One of the most common forms of substance misuse is binge drinking. It’s been found that if individuals are asked to report whether they have binge drank during a previous month more than 66 million people in the US would say yes. Substance misuse and related disorders cause the United States more than $442 billion a year in healthcare, criminal justice and lost productivity. (I also wonder if it impacted voting in our last election…)
The report emphasizes the need to make sure that the medical establishment understands the neurobiological basis for substance use disorders and uses it to aid in prevention, treatment and recovery services. “Addiction is a chronic disease of the brain and not simply a choice or personal failing as it has been viewed by many.” The report sites new evidence that concludes that “substance use disorders result from changes in the brain that occur with repeated use of alcohol or drugs…. Addiction is associated with changes in the basil ganglia, the amygdala and pre-frontal cortex, which collectively affect pleasure (the reward system), learning, stress, decision making, and self control.”
The reports also draws attention to the highly effective impact that prevention or delaying young people from trying substances has in reducing the likelihood of their having a substance use disorder later in life. It has been documented that adolescents who use alcohol before the age of 15 years are four times more likely to develop an alcohol use disorder later in life than those who have their first drink at age 21 years or older.” The report also recommends increased access to treatment and integration of treatment into the traditional medical care system. Currently too few people access the services they need – in fact, only one in ten people with a substance use disorder currently receives treatment.
The Affordable Care Act (ObamaCare) expanded insurance coverage to millions and has made services for substance use disorders an essential health benefit. Additionally the Mental Health Parity and Addiction Equity Act of 2008 mandates that payers treat substance use disorders the same way they treat other medical conditions.
We don’t know what’s going to happen to all this with the new administration.
It almost makes you want to have a drink…