Surgeon General Report Could Sway Federal Policy

By Ben Adlin

A top U.S. health official is putting together a first-of-its-kind report on substance abuse that could help set the tone for future policymaking, the federal government announced Thursday.

The report is being prepared by the office of U.S. Surgeon General Vivek Murthy and will examine "the state of the science on substance use, addiction, and health" surrounding both illegal substances and legal drugs such as alcohol and prescription pills.

Reformers are cautiously optimistic. Murthy in February acknowledged the medical benefits of cannabis, adding that “we have to use use that data to drive policymaking.” But he seemed later to backtrack, saying that "neither the FDA nor the Institute of Medicine have found smoked marijuana to meet the standards for safe and effective medicine for any condition to date.”

Intended to be broad and comprehensive, the report will focus on an array of issues surrounding substance abuse, according to a summary in the Federal Register:

Areas of focus in the report may include the history of the prevention, treatment, and recovery fields; components of the substance use continuum (i.e., prevention, treatment, and recovery); epidemiology of substance use, misuse, and substance use disorders; etiology of substance misuse and related disorders; neurobiological base of substance misuse and related disorders; risk and protective factors; application of scientific research in the field, including methods, challenges, and current and future directions; social, economic, and health consequences of substance misuse; co-occurrence of substance use disorders and other diseases and disorders; the state of health care access and coverage as it relates to substance use prevention, treatment, and recovery; integration of substance use disorders, mental health, and physical health care in clinical settings; national, state, and local initiatives to assess and improve the quality of care for substance misuse and related disorders; organization and financing of prevention, treatment, and recovery services within the health care system; ethical, legal, and policy issues; and potential future directions.

Cannabis advocate Tom Angell, who drew attention to Thursday's announcement, noted the surgeon general’s report could be useful if President Barack Obama moves to relax the federal prohibition of cannabis before he leaves office:

The last clause about “ethical, legal and policy issues” is likely to be of most interest to advocates of reforming marijuana laws and ending the broader war on drugs.

Under the Obama administration, federal drug agencies have made a point to talk about addiction as a medical problem, but the drug control budget continues to devote far more resources to arrests, punishment and interdiction than to health strategies like treatment and prevention.

If President Obama intends to bring federal drug polices and budgets into line with his administration’s rhetoric before he leaves office, he could hardly find a better or more effective way to do it than through the nation’s top medical doctor.

A number of other changes are unfolding at the federal level that could sway U.S. policies on cannabis. Among them, the Department of Health and Human Services recently provided guidance to the Drug Enforcement Administration regarding cannabis’s potential reclassification under the Controlled Substances Act. While the advice isn’t yet public, it’s one of the many signs that the government may slowly be opening its mind to at least the medical potential of cannabis.