Surgeon General's Report: An Essential Tool for Addressing Substance Use Disorders

April 2, 2018
H. Westley Clark MD, JD, MPH, DFASAM
Dean's Executive Professor
Public Health Program
Santa Clara University

I spent 16 years as the Director of the Center for SubstanceAbuse Treatment trying to elevate the discourse about substance use, misuse and dependence.  It was not until I retired, that the discourse about addiction was joined by the Office of our Nation’s doctor, the Surgeon General. 

In November of 2016, The Surgeon General’s Office released the groundbreaking document, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health (SG Report). This document, which was the first from a Surgeon General, thoroughly outlined the neurobiological underpinnings of substance use, misuse and dependence, as well as effective, evidence-based treatment and prevention strategies for facing addiction in America. Please join Dr. Clark on the 

 webinar!

This SG Report proposes a comprehensive and widely-applicable framework for addressing substance use, misuse, and dependence in America. The document, which is based on concrete, empirical research, was also written so that anyone, not just experts in the field, can use this framework to address the myriad of substances, which affect the lives of people experiencing substance use. The creation of this document was a major achievement for the field of addiction science, and the addiction community as a whole. 

However, it is in the dissemination and use of this document that is the herculean feat.

Timeless relevance  

This report functions as a complement to the current efforts to address the opioid crisis in America. The SG Report reminds those interested in prevention and treatment of the complexity of substance use disorders and of the multitude of factors that have to be taken into consideration when addressing either a single substance or the larger mixed substance use pattern with which people present. It is also a useful tool to address the common co-occurring disorders of addiction, such as anxiety and depression.  

Though the SG Report was published nearly a year and a half ago, its timeless relevance is slowly being appreciated seen via discussions in journal articles, blog posts, and presentations across the country. People are actively discussing the Report’s focus on putting addictions into a broader context and ending the stigma surrounding them. While medications are an essential component of treatment strategies for some psychoactive substances, such as alcohol, opioids, and tobacco, they are not currently FDA approved for other substances such as marijuana, methamphetamines or cocaine.   

The SG Report is reader friendly, broken down into key chapters that can be used to inform patients, patient families, people in recovery and professionals alike. Wherever you are in the community, it is helpful to have resources that can be used to explain the addiction phenomenon, as many people just want the problem of addiction to simply go away.

One agenda: To inform 

We all know that it takes much more than a wish to understand and to address America’s contemporary substance use problem. And, we know that there are volumes of materials that can be used to communicate information about addiction in America, but in this one report, broken down into seven digestible chapters, the reader has enough information to recognize that prevention works, treatment can be successful and that recovery happens.

With the imprimatur of the Office of the Surgeon General, the public is reassured that care has been taken to offer unbiased, carefully researched information. The only agenda being that people be informed. Because effective approaches to addictions require a whole systems approach, it is important that a dialogue be fostered that includes the broader health care delivery system, as well as the community.

Advancing treatment and reducing stigma 

Others recognize the implications of the report from perspectives unique to their understanding of addiction. For example, in an article in the Journal of Humanistic Psychology, the following comment was noteworthy:

““This Report will undoubtedly shape the direction of research and practice in the addictions field for years to come”[1] I

In another setting, an expert in integrative health and recovery discussed the potential of the SG report in helping advance the treatment of substance use disorder, as well as reducing stigma. [2].

While we are facing an opioid crisis, we also are seeing an increase in stimulants and may see an increase demand for marijuana services. It is important to be prepared with a comprehensive overview of addiction. It is also important to recognize the interrelationship between psychoactive substances and their impact on individuals.

Those on the front line need to find some time to learn more about the SG Report. Whether you are a family member, a person who worries about the misuse alcohol, opioids, stimulants or other substances, a therapist, a primary care physician, a religious leader, a specialist or a policy maker, the SG report has important information for you. We can’t wait another 16 years.

About our guest blogger:

Dr. Clark is currently the Dean’s Executive Professor of Public Health at Santa Clara University in Santa Clara California. He is formerly the Director of the Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Service, where he led the agency’s national effort to provide effective and accessible treatment to all Americans with addictive disorders.

He recently contributed to the US Surgeon General’s Report on Alcohol, Drug Abuse and Health as a Section Editor for Treatment. He is a member of the Board of Directors of the non-profit Felton Institute, a family service agency in San Francisco. He is on the Board of Directors of Faces and Voices of Recovery, a group that advocates for the needs of people in recovery from addiction. He is also on the Board of Directors of the Pacific Institute for Research and Evaluation.

He has received numerous awards for his contributions to the field of substance abuse treatment, including the 2015 Lisa Mojer-Torres Award from Faces and Voices of Recovery, the 2015 James Ralph Memorial Award for Outstanding Public Service from the Black Psychiatrist of America, and the 2015 Annual Award from the American Society of Addiction Medicine. Other awards include the 2008 John P. McGovern Award from the American Society of Addiction Medicine, the U.S. Department of Health and Human Services Secretary’s Award for Distinguished Service, and the Vernelle Fox Award from the California Society of Addiction Medicine.

Dr. Clark received a B.A. in Chemistry from Wayne State University in Detroit, Michigan. He completed his MD and MPH at the University of Michigan, Ann Arbor, where he completed a Psychiatric Residency at University Hospital, Neuropsychiatric Institute. He obtained his JD from Harvard University Law School, and completed a two-year Substance Abuse Fellowship at the DVAMC-SF. Dr. Clark received his board certification from the American Board of Psychiatry and Neurology in Psychiatry. He is a Distinguished Fellow of the American Society of Addiction Medicine. He is ABAM certified in Addiction Medicine. Dr. Clark is licensed to practice medicine in California, Maryland, Massachusetts and Michigan. He is also a member of the Washington, D.C., Bar.

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[1] Ciovacco, L. A., & Hughes, S. (2017). Sanity of Addiction: Contemplative and Humanistic Reflections on the Surgeon General’s Report on Drugs. Journal of Humanistic Psychology. doi:10.1177/0022167817740464

[2] The Surgeon General's Report on Addiction: A Call To Action (Duluth). (2017, June 21). Retrieved from https://minnesotarecovery.org/events/surgeon-generals-report-addiction-call-action-duluth/