PD Editorial: Addiction is a disease, and it can be treated

About 21 million Americans have substance abuse disorders. They are addicted to drugs or alcohol, and their addiction is destroying their lives. Along the way, they drag down their families and place a tremendous burden on society.

U.S. Surgeon General Vivek Murthy recently issued a groundbreaking report on substance abuse in America that could change the conversation around addiction.

In some regards, the report contains little that is truly new. Horror stories of people whose lives and the lives of their families are ruined by addiction are common in the media. The need for evidence-based treatment is well established in the academic literature.

What makes the report so important is that brings together the data and a strategy for going forward into one readable report that contains information for researchers, lawmakers and the public.

The Centers for Disease Control and Prevention report that, in 2014, the most recent year for which data is available, California had 4,521 overdose deaths. The opioid epidemic has hit localities hard. Here in Sonoma County, the rate of overdose deaths and emergency room visits exceeds statewide rates.

Nor is it just hard drugs that are problematic. About one-fifth of Americans binge drink. Substance abuse costs the United States more than $420 billion per year.

A popular view of addiction, especially among people who have no firsthand experience with it, is that it is a personal failing. The addict chose to start taking drugs or drinking too much. Personal suffering is punishment.

The surgeon general, backed by overwhelming medical research, rejected that notion. “Research on alcohol and drug use, and addiction, has led to an increase of knowledge and to one clear conclusion: Addiction to alcohol or drugs is a chronic but treatable brain disease that requires medical intervention, not moral judgment,” the report states.

In some ways, this moment is like 1964. That year, the surgeon general issued the first comprehensive government report on the dangers of smoking. Like the current report, it offered a path forward to lead to a healthier America. Five decades later, smoking rates have plummeted.

Like other diseases, treatments exist for addiction. Access to them is the biggest challenge.

One key to better access is better health insurance. The Affordable Care Act requires that insurance companies that participate in the exchanges provide mental and behavioral health parity. In other words, health insurance may no longer just pay for diseases of the body but also for diseases of the mind. Addiction, depression, etc. would be covered just as well as diabetes and pneumonia.

Republicans in Congress and President-elect Donald Trump, should make sure that remains true. If they make good on their promise to repeal Obamacare, whatever replaces it should include a parity requirement. Often, people who suffer from addiction are among the least able to pay for help. Insurance they purchase should cover that expense to help them recover and return to a healthful, productive life.

Yet the outline of a Republican plan released by House Speaker Paul Ryan doesn’t even mention treating addiction and mental health.

When it comes to addiction, the real moral failing will be society’s if America disregards the surgeon general’s warning and fails to confront this public health crisis.