Jerome Adams on Navigating a Nation’s Health: From Opioid Crisis to Pandemic Preparedness

The former Surgeon General reflects on his tenure, the enduring challenges facing American public health, and the path forward.

In the ever-shifting landscape of public health, few figures have navigated the complex currents of national well-being with the directness and candor of Dr. Jerome Adams. As the 20th U.S. Surgeon General, appointed by President Donald Trump in 2017, Adams took the helm during a period marked by escalating public health crises, from the devastating opioid epidemic to the unprecedented global challenge of the COVID-19 pandemic. His tenure, which concluded in January 2021, was a testament to his commitment to a pragmatic, evidence-based approach, often grounded in a deeply personal understanding of community health and the social determinants that shape it.

In a comprehensive interview with Margaret Brennan on “Face the Nation,” a portion of which aired on August 10, 2025, Dr. Adams offered a reflective yet forward-looking perspective on his time in office. He delved into the persistent issues that continue to plague the nation’s health, the lessons learned from managing national health emergencies, and the critical steps required to build a more resilient and equitable public health infrastructure for the future.

Context & Background

Dr. Jerome Adams was no stranger to the complexities of public health when he assumed the role of Surgeon General. His career began in emergency medicine, where he witnessed firsthand the impact of health disparities and the often-overlooked social factors that contribute to illness and injury. Prior to his federal appointment, Adams served as the Indiana State Health Commissioner, a position that provided him with invaluable experience in addressing state-level public health challenges, including chronic diseases, infectious outbreaks, and substance abuse.

His appointment as Surgeon General placed him at the forefront of national health policy and communication. The Surgeon General is often referred to as “America’s Doctor” and serves as the nation’s leading spokesperson on matters of public health. This role involves issuing Surgeon General’s Reports on critical health issues, advising the President and the Secretary of Health and Human Services, and engaging with the public to promote health and prevent disease. Adams’ tenure was characterized by a focus on several key areas, including the opioid crisis, the nation’s mental health, and the promotion of a healthier lifestyle through initiatives like the “Community Health and Opioid Prevention” program.

The opioid crisis, in particular, was a defining challenge of his early years as Surgeon General. The nation was grappling with an epidemic of opioid addiction and overdose deaths, which had reached alarming levels. Adams made it a priority to raise awareness, advocate for evidence-based treatment, and promote harm reduction strategies, such as the wider availability of naloxone, an opioid overdose reversal medication. His approach often involved meeting people where they are, acknowledging the diverse challenges faced by different communities, and fostering collaborative solutions that involved healthcare providers, law enforcement, and community leaders.

As the world entered the COVID-19 pandemic in 2020, Adams’ role became even more critical and challenging. He was tasked with communicating complex scientific information to a public often grappling with fear and uncertainty, while simultaneously advising the administration on public health strategies to contain the virus. This period tested the limits of public health infrastructure, highlighted existing inequities, and underscored the importance of clear, consistent, and trustworthy public health messaging.

In-Depth Analysis

During his interview, Dr. Adams offered a nuanced perspective on the enduring challenges that continue to shape American public health. He spoke extensively about the lessons learned from the COVID-19 pandemic, emphasizing the need for a robust and adaptable public health system that can withstand unexpected shocks. A central theme of his commentary was the critical importance of building trust and fostering effective communication between public health officials and the communities they serve. He acknowledged that the pandemic exposed and exacerbated existing disparities in healthcare access, quality, and outcomes, making it imperative to address the social determinants of health.

Adams highlighted that his experience as Surgeon General reinforced his belief that public health is inherently linked to social justice. He discussed how factors such as poverty, lack of access to education, housing insecurity, and systemic racism disproportionately impact the health of certain populations. “We cannot talk about health without talking about health equity,” he stated, underscoring the need for policies and programs that actively work to dismantle these barriers.

A significant portion of the discussion revolved around the opioid crisis, an issue that Adams remained deeply committed to throughout his tenure. He reiterated the importance of a multi-faceted approach that includes prevention, treatment, and harm reduction. He emphasized that viewing addiction solely as a moral failing rather than a treatable disease had been a significant impediment to progress. His advocacy for broader access to medication-assisted treatment (MAT) and the destigmatization of addiction was a cornerstone of his efforts.

Adams also spoke about the challenges of communicating public health guidance in an increasingly polarized environment. He acknowledged the difficulties in cutting through misinformation and disinformation, which often hindered public health efforts during the pandemic. His approach to communication emphasized clarity, empathy, and a commitment to providing evidence-based information in an accessible manner. He recognized that building trust requires transparency and a willingness to engage with communities on their terms.

Furthermore, Dr. Adams touched upon the critical need for sustained investment in public health infrastructure. He noted that the nation’s public health systems had been underfunded for decades, leaving them ill-equipped to handle major health crises. He advocated for increased funding for public health workforce development, disease surveillance, laboratory capacity, and community-based health initiatives. This investment, he argued, is not merely an expenditure but a crucial investment in national security and economic stability.

The conversation also touched on the mental health crisis, another area of significant concern for the former Surgeon General. He highlighted the growing prevalence of anxiety, depression, and other mental health conditions, particularly among young people, and stressed the need for greater access to mental healthcare services, improved mental health literacy, and the integration of mental health support into primary care settings.

Pros and Cons

Dr. Adams’ tenure as Surgeon General, like any public health leadership role, was marked by both significant achievements and considerable challenges. His proactive approach to public health issues, coupled with his ability to connect with diverse communities, were widely recognized strengths.

Pros:

• Opioid Crisis Advocacy: Dr. Adams was a vocal and consistent advocate for addressing the opioid crisis. He championed harm reduction strategies, expanded access to naloxone, and worked to destigmatize addiction, contributing to a national conversation and increased awareness of this critical issue.
• Focus on Health Equity: He consistently highlighted the importance of health equity and the social determinants of health, recognizing that disparities in health outcomes are rooted in broader societal inequities. This focus brought greater attention to vulnerable populations and the need for targeted interventions.
• Clear Communication Style: Adams was known for his ability to communicate complex public health information in an understandable and relatable manner. He often employed analogies and personal anecdotes to connect with the public, fostering a sense of shared responsibility for health.
• Emphasis on Prevention: Throughout his tenure, he emphasized the importance of preventive health measures, promoting healthy lifestyles, and encouraging individuals to take an active role in managing their well-being.
• Community Engagement: His commitment to engaging directly with communities, listening to their concerns, and collaborating on solutions was a significant asset in building trust and implementing effective public health strategies.

Cons:

• Navigating Political Polarization: Serving during a highly polarized political climate, particularly during the COVID-19 pandemic, presented immense challenges. Public health guidance sometimes became politicized, making it difficult to maintain consistent messaging and public adherence.
• Limited Authority: As Surgeon General, his role is largely advisory and communicative, meaning he had limited direct authority to implement broad policy changes without the support of Congress and the executive branch.
• Resource Constraints: The nation’s public health infrastructure, while recognized as needing improvement, often faced resource constraints, which could limit the scope and impact of initiatives.
• Battling Misinformation: The proliferation of misinformation and disinformation, especially online, posed a significant obstacle to public health efforts, making it challenging to ensure the public received accurate and reliable information.

Key Takeaways

• Trust is Paramount: Building and maintaining public trust is the bedrock of effective public health. Clear, consistent, and empathetic communication is essential, especially during times of crisis.
• Health Equity is Non-Negotiable: Addressing health disparities and the social determinants of health is not just a matter of fairness but a fundamental necessity for improving the overall health of the nation.
• Invest in Public Health Infrastructure: Sustained and increased investment in public health systems, workforce, and research is crucial for preparedness and response to current and future health challenges.
• A Multi-Pronged Approach is Key: Complex health issues like the opioid crisis require comprehensive strategies that encompass prevention, treatment, harm reduction, and community support.
• Collaboration is Essential: Public health is a shared responsibility. Effective solutions require collaboration among government agencies, healthcare providers, community organizations, and the public.

Future Outlook

Looking ahead, Dr. Adams’ reflections offer a critical roadmap for the future of American public health. The challenges he navigated – the opioid epidemic, mental health crises, and pandemic preparedness – are not static; they are dynamic and evolving. The lessons learned from the COVID-19 pandemic, in particular, underscore the urgent need for a paradigm shift in how the nation approaches public health.

Adams’ emphasis on building trust and fostering effective communication suggests a future where public health agencies prioritize transparency and community engagement. This will likely involve a greater investment in public health communication professionals and a willingness to adapt messaging strategies to meet the diverse needs of various populations. The ongoing battle against misinformation will require innovative approaches, including media literacy education and strategic partnerships with trusted community voices.

The call for increased investment in public health infrastructure is likely to be a recurring theme in policy discussions. This investment must go beyond immediate crisis response and focus on strengthening core public health capacities such as data collection and analysis, disease surveillance, laboratory testing, and the public health workforce. A well-funded and modern public health system is a prerequisite for effectively addressing future health threats and promoting long-term population health.

Furthermore, the renewed focus on health equity will continue to shape public health initiatives. Future efforts will need to go beyond identifying disparities to actively implementing policies and programs that dismantle systemic barriers to health. This could include investments in affordable housing, access to quality education and healthy food, and reforms in criminal justice and healthcare systems that disproportionately affect marginalized communities.

The integration of mental health services with primary care and the expansion of mental health support for youth are also likely to be key areas of focus. Addressing the mental health crisis requires a societal commitment to destigmatization and the provision of accessible, affordable, and comprehensive mental healthcare.

Ultimately, the future of American public health will depend on its ability to adapt, innovate, and prioritize the well-being of all its citizens. Dr. Adams’ insights provide a valuable framework for navigating these complex challenges, emphasizing that a healthy nation is a resilient nation, built on a foundation of trust, equity, and collective action.

Call to Action

Dr. Jerome Adams’ tenure as Surgeon General served as a stark reminder of the critical role public health plays in the fabric of American society. His insights from navigating the opioid crisis to confronting a global pandemic offer valuable lessons for us all. As individuals, communities, and as a nation, there are concrete steps we can take to build a healthier future:

• Engage with Public Health Information: Make a conscious effort to seek out credible sources of health information and to be critical consumers of media. Support and share accurate public health messaging within your own networks.
• Prioritize Your Health and Well-being: Take proactive steps to manage your physical and mental health. This includes adopting healthy lifestyle habits, seeking regular medical care, and being aware of mental health resources available to you.
• Advocate for Stronger Public Health Systems: Contact your elected officials and advocate for increased funding and robust support for public health infrastructure, research, and workforce development.
• Champion Health Equity: Educate yourself and others about health disparities and the social determinants of health. Support initiatives and policies that aim to create a more equitable healthcare system and address the root causes of poor health.
• Foster Community Support: Be an active participant in your community. Support local public health initiatives, volunteer your time, and offer support to friends, family, and neighbors who may be struggling.
• Combat Stigma: Whether it’s addiction, mental health challenges, or other health conditions, work to reduce stigma through open conversations and by treating all individuals with empathy and respect.

The path to a healthier America is a shared one. By embracing the lessons learned and committing to collective action, we can build a future where public health is prioritized, equitable, and effective for all.