If you are like many still recovering from the national tragedy on November 8 that resulted in the impending presidency of Donald J. Trump, you may have missed the release of the first Surgeon General’s report on substance use and misuse titled: Facing Addiction in America.
Released by U.S. Surgeon General Dr. Vivek H. Murthy, the report provides definitive evidence supporting the view long held by the social work profession that addiction is not a matter of moral deficiency but a consequence of neurological functioning impacting our brains. So even if your first drink is a matter of choice, your addiction may well be beyond your ability to control. That says much about how we should respond to addictions. Locking people up will do little to control the problem. Prevention and treatment will do more to reduce dependency on mood-altering substances.
Given the devastating effect last month’s election had on progressives, we may very well see a spike in substance use. Even in the absence of new instances, Americans have significant incidences of substance use, misuse and substance use disorder. More than 27 million Americans reported use of illicit drugs or misuse of prescription drugs in 2015 and more than 66 million Americans—a quarter of the American adult and adolescent population—reported binge drinking in the last month. The estimated economic costs are $249 million for alcohol misuse and $193 million for illicit drug use. It is estimated that 40 percent of people who misuse substances also suffer from a mental health disorder. Just 10 percent of affected people are receiving specialty treatment for substance use.
America’s newspapers have been filled with articles about the devastation opioid misuse is inflicting on individuals, families and communities across a wide swath of the nation. Drug overdose is now the leading cause of accidental death in the United States accounting for 47,055 fatalities in 2014. Of those deaths, 18,893 were attributed to pain medication misuse and another 10,574 were due to heroin overdoses. White women are now the most likely victims of drug overdoses. Congress responded rather decisively passing the Comprehensive Addiction and Recovery Act earlier this year and signed into law by President Barack Obama on July 22, 2016. Congress authorized $181 million annually to address the opioid epidemic well short of the $1.1 billion requested by the President. However, those funds must be appropriated annually during the budget process which means they are not guaranteed. An ambitious budget by the incoming Trump administration of more tax cuts, increased military spending, and huge investments in infrastructure could crowd out proposed funding levels.
Republicans in their zeal to humiliate President Obama by repealing his signature legislative accomplishment, the Affordable Care Act which they derisively named Obamacare, may be doing irreparable harm to efforts to quell the opioid epidemic. The ACA provides extensive resources for addiction treatment. There is a theory that says Republicans will not repeal and replace Obamacare—just rename it. They plan to pass legislation immediately designed to cripple and eventually dismantle the Affordable Care Act. However, that bill would delay significant changes probably until after the 2018 election when it would be revisited with a couple of slight tweaks and renamed Trumpcare. In the meantime, millions worry about losing their healthcare because of these mostly political shenanigans.
Social workers and other helping professionals cannot take our eyes off the ball on the need for action on addiction as Republicans with control of all the levers of government are poised to continue their efforts to rollback New Deal policies and eviscerate the social safety net. They see a minimal role for the federal government in addressing Americans’ health and mental health needs. Much like the groundbreaking 1999 report on mental health produced by Surgeon General David Satcher, Facing Addiction in America presents a compelling argument for the need to expand resources to address substance abuse and mental health. These are certainly times that will try our souls. We must be up for the challenge.
Written By Charles E. Lewis Jr., Ph.D
Social Workers Facing Growing Addiction Crisis was originally published @ Charles Lewis – Congressional Research Institute for Social Work and Policy and has been syndicated with permission.