US Surgeon General: Addiction An Illness, Not A Moral Failing

Apr 28, 2016

Dr. Vivek Murthy is not only one of the youngest people ever named the U.S. Surgeon General, the 38-year-old also is the first person of Indian descent to hold the post.

But there’s one more thing: he's a Floridian.

His experiences growing up in Miami, where his father ran a medical clinic and he attended Palmetto High School, shaped his life as a physician and public health advocate.

Health News Florida recently sat down with Murthy at the annual Association of Health Care Journalists conference, and discussed some key issues he says are a focus of his time as Surgeon General: addiction, heroin abuse and HIV infections.  He also gave a keynote address at the conference in Cleveland, Ohio:

Specifically, he said he wants to help change the way people look at addiction. It's a chronic illness, not a moral failing, he said.

Here are some highlights of the conversation: 

HNF: In the past two years, Florida has led the nation in new HIV infections. Your hometown – Miami – has reported numbers greater than nearly all states across the nation.

However, the Florida Department of Health recently revised its numbers downward, saying some of the infections were being counted incorrectly. Critics are challenging the new numbers. I’m wondering how can regular Floridians interpret these changing number in relation to how serious a problem HIV is in our state?

Murthy: HIV is an issue that is near and dear to my heart because it's actually how I began my career in public health, working on HIV. Growing up in Miami, even when I was younger, we knew HIV was a problem and we were one of the communities where HIV was being discussed first.

Now, we do know that HIV is still spreading. It’s spreading through sexual contact and it's also spreading through IV drug use, as we saw in other states last year.  And this to me, highlights the importance of ensuring that people know that it's still important to use safe sex practices and it's also important that we address IV drug use in America.

One of the things we know is that the heroin crisis that we have is in part being driven by the prescription drug crisis. We know that 80 percent of people who use heroin began by misusing prescription opioids.

Surgeon General Dr. Vivek Murthy spoke at the 2016 Association of Health Care Journalists conference in Cleveland, Ohio.
Credit Deborah Crowe/Association of Health Care Journalists

HNF: Heroin addiction and overdose deaths have become a major national crisis – from Florida to places like Detroit. The health department director there says the problem is decades old, but it’s only now catching the public’s attention because, he said, “White people are dying.” What responsibility do you have in helping combat this problem not only in the more affluent suburbs around the country, but in poorer communities where opioid addiction and death has lingered for years?

VM: You’re right, there are communities that have been dealing with heroin issues for decades. Part of the problem is that 20 or 30 years ago, when we thought about addiction broadly, we thought of it as a problem that certain people faced and certain communities dealt with.  We thought of it, quite frankly, as a moral failing, as a bad choice…

And that’s why, as we face trying to address the prescription opioid addiction crisis, the heroin crisis, we have to ensure that we are not only changing prescribing practices, getting medication-assisted treatments to people, getting (opiod overdose antidote) Nalaxone in the hand of first responders, we also have to ensure that we are changing the way that our country thinks about addiction.

We have to be sure that people see it for what it is, which is a chronic illness, that we have to treat it with the same urgency and the same skill the same compassion we would diabetes or heart disease.

Because the truth is that we shouldn’t treat addiction any differently and the fact that we are late to the game in catching up with that mindset, the fact that we didn’t recognize that 20, 30 years ago – that addiction was a chronic illness in the country -- has meant that many people have gone without treatment who could have lived fulfilling lives and contributed to society and otherwise were consigned to very difficult situations and in some cases, illness and death.

Later this year, one of the initiatives that I will taking on is actually the creation of the first ever Surgeon General’s Report on Substance Use, Addiction and Health…It’s there not only to bring together the best science and how to prevent and treat substance abuse disorders, but it’s also there to move the country toward a new way of thinking about addiction.

The hope is that if we can do that, we can support more treatment efforts, we can support more investment in prevention. And we can ultimately get our community and our country healthier.

Mary Shedden reports for WUSF in Tampa. WUSF is part of Health News Florida, which receives support from the Corporation for Public Broadcasting.