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Surgeon General Announces Review of Federal Drug Policies

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The U.S. surgeon general is preparing a first-of-its-kind report “presenting the state of the science on substance use, addiction and health,” the federal government has announced.

The report from Vivek Murthy, the nation’s top public health official, will “outline potential future direction” for drug policies and “educate, encourage and call upon all Americans to take action,” according to a Federal Register notice published on Thursday. It will take a comprehensive look at illegal drugs as well as currently legal substances like alcohol and prescription medications.

According to the notice, signed by Summer King of the Substance Abuse and Mental Health Services Administration, the report will have a broad scope:

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.

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.

Murthy previewed the report during a speech at the Unite to Face Addiction Rally on the National Mall in October.

“It’s time for us to have a conversation in this country that’s based on facts; A conversation that’s based on medicine and science,” he said at the rally, according to a draft of his remarks. “Which is why I’m proud to announce that next year, I will be releasing the first-ever Surgeon General’s Report on substance use, addiction and health. We’re going to look at the best science on everything, from heroin and marijuana, to alcohol and prescription opioids.”

Murthy also used his Instagram account to tease the report.

Surgeon General Vivek Murthy

“We’ll use this report to find a way forward, together,” he said at the really. “Yes, we’ll focus on treatment and recovery. But we’ll also focus on prevention. Because we know that we need a comprehensive approach.”

Murthy made headlines in February when he acknowledged the medical benefits of cannabis. “We have some preliminary data showing that for certain medical conditions and symptoms, that marijuana can be helpful,” he said at the time. “I think that we have to use that data to drive policymaking.”

He later walked back the comments, saying that “while clinical trials for certain components of marijuana appear promising for some medical conditions, 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.”

Murthy isn’t the first surgeon general to wade into the debate about marijuana and drug policy. In 1993, Joycelyn Elders, surgeon general under the Clinton administration, said the U.S. should seriously consider legalizing drugs. “I do feel we’d markedly reduce our crime rate if drugs were legalized,” she said at the time. Since leaving office, Elders has actively campaigned for states to pass medical marijuana laws.

It isn’t clear when the current surgeon general’s new report on substance abuse will be released.

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