Surgeon General’s Report: Why Addiction Research is So Critical
The Surgeon General’s Report on Alcohol, Drugs, and Health, calls for a wholesale change to the way we address substance use and addiction in our country by treating it as a health issue rather than a moral failing. The blueprint set forth in the report is comprehensive and multi-faceted, but the prominent theme that underlies its findings and recommendations is the importance of research in informing addiction policy, prevention and treatment. This recognition of the critical role that research should play in transforming addiction care will have a profound effect on improving access to treatment and reducing the stigma surrounding addiction that has long served as a barrier to effective prevention, treatment and policy.
Under a public health approach, strategies that have proven to be effective in scientific studies are used to address the various individual, environmental and social factors that research has identified as contributing to substance use and addiction.
Brain research in particular has greatly improved our understanding of addiction. First, it helped to identify biological factors that may increase the risk of developing addiction. Second, it helped explain how addictive substances can compromise brain functioning, especially those areas that regulate individuals’ decision making and self-control.
Other research helped identify the genetic, psychological and environmental factors that contribute to addiction and highlighted critical areas of intervention for those who design and implement prevention and treatment strategies.
A better understanding of the disease of addiction, which is gained through research, also helps to dispel longstanding stigma and misconceptions about those who suffer. Addiction has long been thought of as a character flaw or moral failing. Prevention and treatment approaches that were based on this belief proved to be highly unsuccessful, further perpetuating the belief that those with addiction cannot be helped.
Thanks to research, we now understand addiction to be a chronic disease, much like diabetes or hypertension, that can be prevented and treated. But, as the Surgeon General notes, treatments that are evidence-based or “scientifically tested and proven effective” must be adopted. Some of the treatment methods for addiction that are still widely used and preferred by providers, the public and policymakers have not been proven to work and, in fact, often are counterproductive. For example, abstinence-based or medication-free treatment for opioid addiction has an extremely high failure rate and is associated with much higher risk of overdose and death. And despite the fact that science has shown that longer duration treatment or continuing care models are more effective than short-term treatments for addiction, this is not typically reflected in the way that health insurers pay for treatment.
Research has demonstrated that medication assisted treatment (MAT) prescribed by a physician in conjunction with counseling is the most effective, lifesaving, treatment for opioid addiction. Yet misconceptions and stigma about MAT continue to impede its use. Our Center strongly supports the Surgeon General’s recommendation for more widespread adoption of and reimbursement for MAT for the treatment of opioid addiction. In addition, research on treatment efficacy and length of treatment should play a more prominent role in determining how health insurers pay for a range of addiction services.
Our Center has long emphasized the importance of research in addressing addiction. Our mission is to connect science with policy and practice to better the lives of people impacted by substance use and addiction. We promote the use of prevention and treatment methods that are evidence-based, and we make data-driven policy recommendations about ways to reduce substance use and addiction.
We are pleased to see that the Surgeon General’s recommendations recognize the importance of research. Science-based recommendations should continue to guide the ways we prevent and treat addiction with a focus on promoting increased understanding and decreased stigma and suffering. We need to commit the same support and resources for addiction research as we do for other life-threatening medical conditions. A public health epidemic of this magnitude – one that touches every family in the United States – deserves nothing less.
Lindsey Vuolo, JD, MPH
Lindsey is an Associate Director of Health Law and Policy at Center on Addiction