The [National Survey on Drug Use and Health] is a major task – getting reliable, comparable information is vital to our assessment and policy processes. This monumental effort is absolutely crucial to understanding the challenges we face and knowing how we need to focus our efforts.
As Prepared for Delivery
Good morning everyone. Thank you to Dr. McCance-Katz, assistant secretary for mental health and substance use, for that introduction. You bring a wealth of experience to the issues we’re going to talk about today, and we are tremendously excited for your tenure at SAMHSA. The NSDUH [National Survey on Drug Use and Health] is a major task – getting reliable, comparable information is vital to our assessment and policy processes. This monumental effort is absolutely crucial to understanding the challenges we face and knowing how we need to focus our efforts.
Thanks go to all the hardworking folks at SAMHSA for their dedication to producing this survey every year.
Thanks also to Kana Enomoto, who’s here today, for her work as acting head of SAMHSA during the time this survey was put together; as well as Paolo Del Vecchio, director of SAMHSA’s Center for Mental Health Services; Daryl Kade, director of SAMHSA’s Center for Behavioral Health Statistics and Quality, which oversees this survey; and Kimberly Johnson, director of SAMHSA’s Center for Substance Abuse Treatment.
We also appreciate Rich Baum, the Acting Director of the Office of National Drug Control Policy, for joining us today.
And a special thanks to Emmanuel, Esther, and Zach for participating today to celebrate Recovery Month and share their personal experiences in the struggle with mental illness and substance abuse.
The purpose of our work here today is to shed more sunlight on public health issues and challenges that require sober reflection and honest, candid evaluation and planning.
When our team received a briefing on this from the experts at SAMHSA, it was the first time an HHS Secretary had been briefed in person on this survey in a long time.
That’s not because HHS secretaries are not receiving their share of data briefings. It’s because we are at a most difficult point in this battle against addiction and drug abuse – and we – HHS and the Trump Administration – have chosen to make it a priority.
This survey reflects the urgency we have in two of the clinical priorities we’ve set forth: the opioid crisis and serious mental illness.
There are some good news points – one is that on the opioid crisis. The survey did not show opioid misuse and addiction becoming more common in 2016.
We do know, however, that the number of opioid and overdose deaths continues to skyrocket. As all who toil in this area know, the opioid crisis is a deeply complicated story. But the fact that we are not seeing this scourge spread any further than it has is a real testament to the work of communities across this country.
We’ve seen that positive work in the travel we’ve done across the country to hear from those working on the frontlines.
But we’ve also heard of so much tragedy from communities across the country, because the rates of addiction to heroin and misuse of prescription opioids we’re seeing are incredibly high—and the cost, in terms of lives lost, is still rapidly growing.
For instance, per today’s survey, an estimated 948,000 American adults used heroin in the past year—about 0.4 percent of the population.
That is similar to the numbers we have seen over the past couple years, but it is far higher than any number gathered between 2002 and 2013. We see similar trends for opioids in general. But behind this seemingly stable picture, the situation is worsening, thanks to rising intensity and frequency of misuse and the emergence of illicitly made fentanyl and fentanyl analogs. The opioid crisis, as you all know, is taking a bigger and bigger toll every year—each year, a new unprecedented level of lives lost.
We saw more than 50,000 drug overdose deaths, most of them due to opioids, in 2015—roughly equivalent to the number of Americans lost in the Vietnam War.
Think about that: We are losing a Vietnam War to drug overdose every year.
Preliminary data from the CDC for 2016 suggests that this number rose substantially again last year, likely topping 60,000 – and is on track to continue that heartbreaking trend in 2017.
At HHS, under the Trump Administration, we unveiled a new five-point strategy to tackle this epidemic comprehensively:
- Improving access to prevention, treatment, and recovery services, including the full range of medication-assisted treatments;
- Targeting availability and distribution of overdose-reversing drugs;
- Strengthening our understanding of the crisis through better public health data and reporting—that includes surveys like NSDUH, and support for state data work, like new grants CDC made just this week
- Providing support for cutting edge research on pain and addiction; and
Advancing better practices for pain management. One of the interesting aspects of the survey is that two-thirds of Americans misusing opioids say they did so to treat physical pain. We need to offer them a better option.
Sadly, opioid abuse is not the only serious behavioral health problem facing America. Another is one of our department’s other clinical priorities: serious mental illness.
The overall share of Americans with a serious mental illness—generally meaning schizophrenia, bipolar disorder, or severe depression—has remained steady at around 4 percent of the adult population: 10 million Americans.
One trend and finding in this survey is that the rate of Americans aged 18-25 with a serious mental illness has continued to rise for several years now – and this year exceeds the rates among older Americans for the first time ever.
This is a disturbing trend, one we need to better understand.
Again – the survey found that about one third of Americans with serious mental illness received no treatment in the past year—a number that has been steady for a number of years now. We know how to treat these diseases—failing to provide treatment is a serious indictment of our current policies. It would be like letting one-third of Americans with cancer or heart disease go without treatment.
The good news is there is something being done about it.
Last week, HHS had the honor of holding the first meeting of the Inter-Departmental Serious Mental Illness Coordinating Committee. This committee has an historic opportunity to examine and propose reforms for our policies and practices with regard to serious mental illness.
There are three numbers to keep in mind when thinking about serious mental illness – 10 – 10 – and 10. Ten million, ten years, ten times.
Ten million – 10 million Americans, as today’s survey found, live with serious mental illness in any given year.
Ten years – on average, they live lives 10 years shorter than other Americans—and some estimates find a much larger gap, as big as 25 years.
And 10 times – there are 10 times Mental healthcare – and in particular serious mental illness – has not received the emphasis or resources it needs – and it has been going on for decades.as many Americans with serious mental illness in prison than there are in psychiatric in-patient treatment.
HHS and the Trump Administration are committed to tackling it – and determining what we can do to ensure that Americans with serious mental illness get effective treatment, and that their families and communities have the tools they need to make that happen.
Today’s report underscores the serious challenges we face with the opioid crisis and serious mental illness
The good news is that it is within our power to turn these trends around.
Doing so will enable millions of Americans to live longer, healthier lives, endowed with the kind of purpose and meaning we all want for our children, our neighbors and our fellow Americans.
We are blessed to have so many dedicated and talented folks working to get us moving in the right direction. Thanks to all of them – and thanks to each of you for attending today for your interest and concern about these extremely important public health challenges.