How Will the New Surgeon General Handle the Addiction Crisis?

Acting Surgeon General, Rear Admiral Sylvia Trent-Adams
Acting Surgeon General, Rear Admiral Sylvia Trent-Adams

The Trump administration appointed a new surgeon general on Friday. Obama administration holdover Vivek H. Murthy was asked to resign and was replaced by his deputy, Rear Admiral Sylvia Trent-Adams.

The move was somewhat unexpected, according to the New York Times, “employees at the Department of Health and Human Services privately expressed surprise at his sudden departure.” Dr. Murthy’s wife, Alice Chen, even suggested that her husband had refused to resign and was fired.

Although not unprecedented, it is unusual to terminate a surgeon general’s four-year term early. Dr Murthy was not on friendly terms with America’s gun lobby—for years he promoted the idea that gun violence should be classified as a public health threat. And he was a staunch supporter of the Affordable Care Act (ACA), also known as Obamacare. Both stances cannot have endeared him to President Donald Trump.  

Perhaps, his biggest accomplishment was putting together a comprehensive report on addiction, issued in November 2016. Facing Addiction in America is not a comfortable read, stating bluntly that “the United States has a serious substance misuse problem.”

It was the first-ever surgeon general’s report on alcohol, drugs, and health, indicating how serious the addiction epidemic in the United States has become. In its scope, the report tried to emulate the 1988 landmark report by Surgeon General C. Everett Koop which asserted that nicotine has an addictiveness similar to that of heroin or cocaine. Smoking declined dramatically in the US, following the Koop report.

What happens now to Dr. Murthy’s appeal “to all Americans to change the way we address substance misuse and substance use disorders in our society” is unclear. Rear Admiral Sylvia Trent-Adams is not a physician and will be acting surgeon general for now. It is very possible that President Trump will nominate a different replacement for that position in the near future.

In March, President Trump asked New Jersey Governor Chris Christie to take on an advisory role to help figure out ways his administration can fight the opioid epidemic. Not much has happened since. The White House page of the Office of National Drug Control Policy is still without content, some observers fear, Trump might abolish the office of the “drug czar” entirely.

Meanwhile, the uncertainty about the future of the American healthcare system continues after the Republican reform bill to replace the ACA failed to receive enough support in Congress. While a clear strategy of the federal government to combat the addiction crisis is missing, the drug overdose deaths numbers continue to climb. Drug misuse now kills 144 Americans every day and the nation urgently needs a plan to tackle this epidemic.

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