Author: 
General Arthur T. Dean, CADCA Chairman and CEO

CADCA Applauds the Surgeon General’s Release of Facing Addiction in America

The Surgeon General of the United States recently released The Surgeon General’s Report on Alcohol, Drugs, and Health – Facing Addiction in America. This landmark report uniquely describes what we know about substance misuse and how the challenges associated with it can cascade, affecting individuals, families and communities. However, unlike traditional reports, it not only provides facts and details, but is also a call to action. In the words of The Surgeon General, Vice Admiral Vivek K. Murthy, “In this report, we call the country’s attention to the fact that substance use disorders are one of our most underappreciated and under-addressed public health crises.”

Facing Addiction in America finally brings substance use disorders out of the shadows. Here are some facts that you probably know but are worth repeating given this report. In 2015 alone, over 27 million people in our country reported current use of illicit drugs or misuse of prescription drugs. Remarkably, that’s about eight percent of the 325 million people in the U.S. today. Additionally, the report reiterates that over 66 million people (nearly a quarter of the adult and adolescent population) reported binge drinking in the past month.

The report also underscores how substance use disorders place tremendous strain on our infrastructures, including the economy, hours lost on the job and on our healthcare, school and criminal justice systems. Also cited is the fact that alcohol misuse and alcohol use disorders cost our country $249 billion, and illicit drug use and drug use disorders cost us $193 billion.

Even with these realities, as Dr. Murthy affirmed when Facing Addiction in America was released on Nov. 17, 2016, there are, “many sources of hope.” In seven comprehensive chapters, this report takes readers on a journey beginning with the neurobiology of substance use, misuse and addiction. With this foundation established, readers gain insight about innovations in prevention programs and policies; early intervention and treatment and recovery strategies; and health care system services. The report ends by providing a vision for the future.

I strongly urge CADCA coalitions and your partners to review Chapter 3. Prevention Programs and Policies because you will see yourselves in the words – your strategies, programs and – yes – your data! In fact, CADCA was mentioned four separate times, highlighting our role in:

  • Providing technical assistance to coalitions on the science of prevention and the use of evidence-based interventions (EBI)
  • Training local coalitions across the country on implementing laws, particularly the Minimum Legal Drinking Age (MLDA) law
  • Partnering with Mothers Against Drunk Driving (MADD) and federal agencies to develop a manual on how to reduce drinking and driving and underage drinking

I was also pleased to see that our National Leadership Forum was highlighted, providing a short description of how our coalition leaders meet with congressional representatives each year to explore better ways of addressing underage drinking and alcohol and other substance misuse and abuse.

This report legitimizes and lends credibility to our work, affirming that there is, “strong scientific evidence that supports the effectiveness of prevention programs and policies.” There are so many rich take-aways from this chapter such as:

  • Broad brush, foundational concepts (risk and protective factors; universal, selective and indicated interventions; age-specific strategies; and evidence-based policies) that can help you articulate your strategies on the ground
  • Names and descriptions of EBIs that you can incorporate into your planning and implementation
  •  Links to resources if you want to know more

What comes across loud and clear is the fact that the training and technical assistance that CADCA provides to Drug-free Community (DFC) grantees and others is closely aligned with the Surgeon’s General’s report. In our world, we constantly talk about the importance of implementing the Seven Strategies for Community Change, focusing on core competencies and painstakingly completing and revisiting our Logic Models. All of these features are essential to make prevention work on programmatic and policy levels. And now, this important document provides the details on just how successful such efforts actually are.

Interestingly, as I reviewed Chapter 3, I highlighted sections and wrote notes in the margins, identifying ideas that our coalitions address every day. Here are some of them:

  • Prevention is appropriate for all age groups, including children, teens, young adults, adults in the workplace and senior citizens. This is because substances misuse can begin at any age, and problems can follow us throughout our lives. That’s why we should care – that’s why prevention is important.
  • Risk and protective factors can be influenced by programs and policies at multiple levels. Those which address common or overlapping risk and protective factors have the potential to simultaneously prevent substance misuse and undesired outcomes.
  • Interventions which target everyone (universal interventions) are likely to yield the greatest benefits.
  • Likewise, selective interventions are advantageous because they deliver uniquely-tailored prevention services with the goal of reducing specific risk factors. Indicated interventions are important, too for the same reasons, in addition to saving lives downstream.
  • Community-based prevention programs can be effective in helping to address major challenges raised by substance misuse and its consequences. Such programs are often coordinated by local community coalitions composed of representatives from multiple community sectors or organizations.
  • Adaption of EBIs which reflect the needs of diverse communities must be thoughtfully executed to ensure that the original intent of intervention is not lost. Adaptation for some communities is based on target audience input and recommendations.

I think that we can look at Chapter 3 as our movement’s “report card.” It enables us to see how far we have come, and also where we need to go in order to continue achieving success.

We know we have a great formula – creating coalitions which represent our communities’ subtle and not so subtle nuances; conducting needs assessments; enhancing EBIs so they strike a balance between fidelity and resonating with our communities; and planning for long-term sustainability. The challenge is to maintain our never-ending commitment to stay on course as well as evolve and grow as our communities’ needs change.

In closing, this report celebrates wonderful work to date as well as future paths to success for us all. We at CADCA thank you for your hard work and look forward with optimism to 2017 and beyond.