Substance Use Disorder: The Surgeon General’s Report

Meeting Of Support Group Having A Conversation

By Ajay Singh, MBBS, FRCP
November 21, 2016

A quote from Chris Prentiss’s book1, The Alcoholism and Addiction Cure is an appropriate backdrop to the publication this past week on The Surgeon General’s Report on Alcohol, Drugs, and Health.

Writes Prentiss about addiction: “It’s the causes, not the dependent person, that must be corrected. That’s why I see the United States’ War on Drugs as being fought in an unrealistic manner. This war is focused on fighting drug dealers and the use of drugs here and abroad, when the effort should be primarily aimed at treating and curing the causes that compel people to reach for drugs.”

Surgeon General Vice-Admiral Dr. Murthy asks the question: “How we respond to this crisis is a moral test for America.”

In my view the Surgeon General’s Report is a “tipping point” in changing our knowledge and perception about substance abuse.

Time and again the report states “addiction is a health condition, not a moral ailing or character flaw

The full report2 and executive summary3 are available online.

Some Highlights:

  • More than 27 million people in the US reported using illegal drugs or abusing prescription drugs in 2015.
  • There are over 20 million people in the country with substance use disorders, which is approximately the same number of people with diabetes, and 1.5 times the number of people with all cancers combined.
  • Only 1 in 10 people with substance abuse disorders are receiving treatment.
  • In 2014, over 43,000 people died from drug overdose, more than in any previous year on record.
  • Substance abuse must be identified in general health settings, including primary, psychiatry, and emergency care.
  • Effective screening will help create individual treatment plans.
  • Treatment is critical and effective.
  • More than 25 million individuals with a previous substance use disorder are in remission and living healthy, productive lives.
  • Increasing access to medicine—methadone, buprenorphine, and naltrexone—is crucial to fighting the opioid crisis.
  • Substance abuse treatment is not just the work of individual specialists. A mix of caregivers should treat it—social workers, recovery specialists, and nutritionists—just as they do with diabetes or cancer. 


The word “malarkey” came to mind after reading an opinion piece4 by Dr. Manny Alvarez’s about the Surgeon General’s Report. The full definition of the word “malarkey” in the Merriam-Webster dictionary is  “insincere or foolish talk”.

The Opioid Use Disorder Education Program

The Opioid Use Disorder Education Program (OUDEP) is now available from HMS Global Academy. OUDEP is comprised of 3 free online CE/CME courses produced by Harvard Medical School (HMS) with scientific contributions from The National Institute on Drug Abuse (NIDA). These courses are intended for nurses, nurse practitioners, physician assistants, physicians, and other health care providers collaborating to treat patients with substance use disorders.


1Chris Prentiss C: The Alcoholism and Addiction Cure: A Holistic Approach to Total Recovery ISBN 0943015448 Published October 1st 2005 by Power Press (first published January 1st 2005)

2Department of Health and Human Services, Office of the Surgeon General, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: HHS, November 2016.

3Executive Summary

4Alvarez M: Dr. Manny: Surgeon General Murthy leaves legacy of too little, too late.  Accessed Nov 20, 2016

Ajay Singh, MBBS, FRCP

Dr. Ajay K. Singh is the Senior Associate Dean for Global and Continuing Education and Director, Master in Medical Sciences in Clinical Investigation (MMSCI) Program at Harvard Medical School. He is also Director, Continuing Medical Education, Department of Medicine and Renal Division at Brigham and Women’s Hospital in Boston.


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