Every September, the Substance Abuse and Mental Health Services Administration (SAMHSA) sponsors National Recovery Month, an opportunity for people to learn more about substance use disorders (SUD) and celebrate those who are recovering from their disease. As the nation’s prescription and illicit opioid crisis has demonstrated, these disorders are devastating illnesses that can affect anyone. Here are four facts about this serious public health problem:
- Substance use disorders affect more than 20 million people in the United States.
According to SAMHSA, more than 20 million Americans had a SUD involving alcohol, prescription drugs, and/or illicit drugs in 2014. The resulting public health impact is significant: These individuals are more likely to develop chronic conditions, have poorer health outcomes, and interact with the criminal justice system. And the National Institute on Drug Abuse estimates that illicit drug and alcohol abuse account for more than $400 billion annually in costs related to health care, lost work productivity, and crime.
- Substance use disorders are diseases, not moral failings.
These disorders are complex brain diseases that must be treated like any other chronic condition; unfortunately, these conditions are often still viewed as moral failings. As a result, people struggling with dependence on opioids, alcohol, or other addictive substances may be unwilling or unable to ask for help. Even those who speak up often encounter barriers to effective treatment. Eliminating the stigma around SUD and expanding access to treatment requires a change in the national conversation. Thankfully, leaders from across the public health spectrum—including Sylvia Mathews Burwell, secretary of health and human services; Kana Enomoto, SAMSHA’s principal deputy administrator; Michael Botticelli, director of national drug control policy; and U.S. Surgeon General Vivek Murthy—are steering this dialogue, calling for a comprehensive approach to preventing and treating SUD.
- Medication-assisted treatment (MAT) is the most effective therapy for substance use disorders.
Studies have shown that MAT, which pairs medications approved by the Food and Drug Administration (FDA) with behavioral therapy, is more effective in treating SUD than other interventions used to address dependence on prescription opioids, heroin, or alcohol. With MAT, medications—which include methadone, buprenorphine, and naltrexone, among others—help relieve withdrawal symptoms and reduce drug cravings. Some of these drugs also work by blocking euphoric effects. These medications are used in tandem with psychosocial treatments, including health care professional and peer-to-peer counseling, as part of a patient-centered treatment plan.
- Individuals with substance use disorders need more access to effective treatment.
Although MAT has been shown to be more effective in treating SUD than other interventions, it is underutilized. Only 23 percent of publicly funded treatment programs report offering any FDA-approved medications to treat SUD, and fewer than half of private sector treatment programs reported that their physicians prescribed FDA-approved medication. In fact, MAT remains unavailable to most patients, and it is rarely included as part of an individual’s treatment plan, largely because of the limited availability of treatment providers and programs, and public and private payers that restrict access. Fortunately, bipartisan legislation signed by President Barack Obama in July authorizes a host of state grant programs to expand access to this type of treatment, and it permits eligible nurse practitioners and physician assistants—often the only health care providers available in rural and underserved areas—to prescribe buprenorphine.
Substance use disorders have had a devastating impact on communities across the United States. Thankfully, the nation’s leaders—from the medical community to law enforcement to state and federal policymakers—are increasingly working together to ensure that patients and families get the treatment and support they need to live healthier, more productive lives.
Learn how Pew is working to address substance use disorders.
Cynthia Reilly directs The Pew Charitable Trusts’ substance use prevention and treatment initiative.