Surgeon General’s Report: Facing Addiction in America
The Surgeon General’s Report on Alcohol, Drugs, and Health
The Centers for Disease Control and Prevention (CDC) summarizes strength of evidence as:
- “Well-supported”: when evidence is derived from multiple controlled trials or large-scale population studies;
- “Supported”: when evidence is derived from rigorous but fewer or smaller trials; and
- “Promising”: when evidence is derived from a practical or clinical sense and is widely practiced.
This is exactly the kind of evidence they did NOT find for the recommendations in the CDC opioid prescribing guideline.
As yet, insufficient evidence exists of the effects of state policies to reduce inappropriate prescribing of opioid pain medications.
Yet, they are recklessly forging ahead with national generic restrictions on opioid pain relievers. This constitutes experimenting on pain patients without any evidence of benefit.
Well-supported scientific evidence shows that addiction to alcohol or drugs is a chronic brain disease that has potential for recurrence and recovery.
Well-supported evidence shows that the addiction process involves a three-stage cycle: binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation.
This cycle becomes more severe as a person continues substance use and it produces dramatic changes in brain function that reduce a person’s ability to control their substance use.
Well-supported scientific evidence shows that disruptions in three areas of the brain are particularly important in the onset, development, and maintenance of substance use disorders: the basal ganglia, the extended amygdala, and the prefrontal cortex.
Well-supported scientific evidence shows that medications can be effective in treating serious substance use disorders, but they are under-used.
The U.S/ Food and Drug Administration (FDA) has approved three medications to treat alcohol use disorders and three others to treat opioid use disorders. However, an insufficient number of existing treatment programs or practicing physicians offer these medications.
They complain about the scourge of opioid addiction but are doing nothing to treat it.
Funds for addiction treatment are still very limited and are often spent on fancy expensive “recovery clinics” offering only 12-step treatment which is freely available for the public through AA.
Remission from substance use disorders—the reduction of key symptoms below the diagnostic threshold—is more common than most people realize.
“Supported” scientific evidence indicates that approximately 50 percent of adults who once met diagnostic criteria for a substance use disorder—or about 25 million people—are currently in stable remission (1 year or longer).
Even so, remission from a substance use disorder can take several years and multiple episodes of treatment, RSS, and/or mutual aid.
Well-supported evidence shows that the current substance use disorder workforce does not have the capacity to meet the existing need for integrated health care, and the current general health care workforce is undertrained to deal with substance use-related problems.
Health care now requires a new, larger, more diverse workforce with the skills to prevent, identify, and treat substance use disorders, providing “personalized care” through integrated care delivery.
Here they recommend personalized care for addiction, but they dictate a single standard of treatment for pain.
This push to use generic dosages for ALL patients with all different types and causes of pain is unheard of in other medical disciplines.