​U.S. deaths related to drug and alcohol misuse have surged in recent years, almost entirely because of opioid misuse, according to a comprehensive report released by the U.S. Surgeon General on November 17, 2016. While the report found no significant change in statistics related to alcohol, cocaine, and hallucinogen consumption between 2002 and 2014, prescription opioid and heroin overdoses increased substantially during that time frame. The Surgeon General called for a public-health-based approach that shifts focus away from "negative attitudes" about the dangers of drugs and toward medically based treatment options. "Historically," the report said, "our society has treated addiction and misuse of alcohol and drugs as symptoms of moral weakness or as a willful rejection of societal norms, and these problems have been addressed primarily through the criminal justice system." The U.S. healthcare system has not given substance use disorders the amount of attention given to other health concerns that affect similar numbers of people, the report noted. More than 40% of people with a substance abuse disorder also have a mental health condition, and only 48% of those people receive treatment for either. Factors causing this gap include limitations in access to care, fear of judgment or discrimination, and lack of accurate screening tools, the report said. A November 19, 2016, editorial in the Washington Post addressed the report and asked questions regarding how the incoming administration will address addiction treatment.

HRC Recommends: Risk managers should encourage a patient-centered approach to identifying and treating substance abuse disorders and ensure that staff are trained in assessing patients' behavioral health needs and providing or arranging for appropriate treatment. Complete history taking is an important part of the assessment process. For example, taking a complete history may reveal that the patient is taking psychiatric medications that should be continued while he or she is in the hospital. Only when a patient's behavioral health needs are assessed and identified can a treatment plan be developed to address the whole patient.