美国国家公共电台 NPR Surgeon General Murthy Wants America To Face Up To Addiction（在线收听）

Surgeon General Murthy Wants America To Face Up To Addiction

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More people take prescription painkillers in the United States than smoke tobacco. In some states, prescriptions for opioids exceed the number of people. Think about that for a moment. You've got a state. It's got, say, a million people, with more than a million prescriptions for opioids. Now, the surgeon general, Vivek Murthy, is tackling alcohol, drugs and health, looking at the crisis of addiction. And he says attitudes toward addiction need to change drastically.

VIVEK MURTHY: My hope is that this first-ever report on alcohol, drugs and health will help us shift how we think about addiction and how we address substance-use disorders in America. What may surprise people is to know that 20.8 million people in our country are living with a substance-use disorder. This is actually similar to the number of people who have diabetes, and it's one-and-a-half times the total number of people who have all cancers combined. That's pretty extraordinary in terms of the burden of disease that we have with substance-use disorders.

INSKEEP: Do you mean, Surgeon General, 20.8 million people have a substance-abuse disorder now? There may be other people who had it three years ago or will have it next year.

MURTHY: Yeah, so 20.8 million people currently have a substance-use disorder. And the impact that this is having on the health and the well-being of our country as well as on our economy is quite staggering. These substance-use disorders cost us over $420 billion a year. That's billion with a B. But despite how serious this is and how prevalent these disorders are, only 1 in 10 people actually get treatment.

The problem that we have right now is that we're not implementing many of these evidence-based interventions. On the prevention side, for example, we know that we have prevention programs that can return up to $64 for every dollar that's invested in them. Despite that, we're not implementing those programs, and that's part of what I want to change with this report.

INSKEEP: What's an example of a prevention program that you could be using more?

MURTHY: We have a series of these programs, particularly the school-based programs, which involve teaching children about how to manage stress in a healthy way, teaching them about substances, of misuse and also teaching them how to refuse tobacco, alcohol and other illicit substances when they're offered to them. We know, in fact, that if you are exposed to alcohol before the age of 15 that you have a four-times greater risk of developing addiction to alcohol compared to if you take your first drink at the age of 21 or later.

INSKEEP: Why is managing stress part of the program here?

MURTHY: One thing that we - that we know is that, for some people, stress is one of the reasons that they actually turn to substances like alcohol, illicit drugs and prescription painkillers. This is not true for everyone, but it is certainly true for a sizable number of people. And what we need to do is to help people, especially kids at a young age, develop healthy habits for how to manage stress and how to deal with stress.

INSKEEP: I guess if we're talking about tens of millions of Americans with this problem, we're talking about people in every community, whether it's red or blue.

MURTHY: That's absolutely right. You know, substance-use disorders don't discriminate. They affect the rich and the poor. They affect all socioeconomic groups, all ethnic groups. And this is something I saw practicing medicine in Boston for years, where I recognized clearly that people were coming in with substance-use disorders.

Even if that wasn't their primary issue, it was often there behind the scenes. And that's why we are issuing this report - to tell people that this is a public health crisis, but that we do have solutions. And now it's up to us to marshal our resources and our will to ensure that those solutions are implemented for the benefit of our kids and our adults.

INSKEEP: Vivek Murthy is surgeon general of the United States. Thanks very much.

MURTHY: Thanks, Steve. It was good to be with you.