Nearly 21 Million in US Have Substance Use Disorder: Surgeon General's Report

Only one in 10 people getting help for substance use disorder.

ByABC News
November 17, 2016, 3:32 AM

— -- Nearly 21 million people are grappling with substance use disorder, with only one in 10 getting treatment for the condition, according to a lengthy new report released today by the U.S. surgeon general.

Currently, the number of people with a substance use disorder exceeds the number of people diagnosed with cancer -- any kind of cancer, according to the report. This means at least one in seven people will develop a substance use problem at some point during their lives, the report states. And, while approximately 32,744 people died from car accidents in 2014, the report found that approximately 50,000 people died from either an opioid, alcohol or other drug overdose that year.

The massive report is the first time the U.S. surgeon general has released a report on this issue. Similar releases by the U.S. surgeon general on cigarette use and HIV/AIDS were used to galvanize and inform the public on those topics.

In an emotional forward, U.S. Surgeon General Vivek Murthy wrote about nurses at his hospital asking him to step up on fighting addiction when he left to work as surgeon general.

"The nurses had one parting request for me. If you can only do one thing as Surgeon General, they said, please do something about the addiction crisis in America," Murthy wrote. "I have not forgotten their words."

In a summary of the report, Murthy called for more programs and policies, including health coverage, to help treat substance use disorder.

"I recognize there is no single solution. We need more policies and programs that increase access to proven treatment modalities. We need to invest more in expanding the scientific evidence base for prevention, treatment, and recovery," Murthy said. "We also need a cultural shift in how we think about addiction. For far too long, too many in our country have viewed addiction as a moral failing."

The long-term effects of substance use disorder have become more pronounced in recent years as the opioid epidemic has continued to affect large portions of the country.

In 2014, nearly 30,000 people died from an opioid overdose, including heroin or prescription drugs, and another 20,000 people died from overdoses due to alcohol, cocaine or another kind of prescription drug, according to the report.

"These efforts have to start now," Department of Health and Human Services Secretary Sylvia Burwell wrote in a summary of treatment efforts. "Change takes time and long-term commitment, as well as collaboration among key stakeholders."

Dr. Richard Rosenthal, professor of psychiatry at Icahn School of Medicine at Mount Sinai and medical director of the Mount Sinai Behavioral Health System, said the report showed how important it is to have more substance use treatment programs available and to integrate them more with regular medical services.

"It's killing 50,000 a year outright and the information demonstrates clearly the need to invest more dollars into treatment and recovery," Rosenthal told ABC News. Only "one in 10 people get any kind of treatment for their addiction, which is nuts."

Rosenthal pointed out that the Affordable Care Act required insurance plans include coverage for substance use disorders but said more still needed to be done to get addicts into treatment programs.

The report specifically calls for more early intervention programs, screening for substance misuse in healthcare settings and behavioral interventions to help keep people from becoming addicted or from relapsing. The use of medication-based therapies such as methadone to treat opioid abuse is also recommended since scientific data has found maintenance medication can help someone recover from substance use disorder better than abstinence treatment.

However, as the opioid epidemic has progressed, Rosenthal said he's heartened to see more people consider substance use disorder a disease and not just a matter of willpower.

"Rather than a moral failure, it's an illness that requires the same kind of individualized care," said Rosenthal. "This is the first time I've seen convergence between federal, state, local government officials ... and the local public. [It's] because the kids are dying."