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Secretary Price Announces HHS Strategy for Fighting Opioid Crisis

Thomas E. Price, M.D.
National Rx Drug Abuse and Heroin Summit
April 19, 2017
Atlanta, Georgia

At HHS, we’re ready to fight alongside … the millions of Americans who are trying to find recovery or help their loved ones do so … The Trump Administration is committed to bringing everything the federal government has to bear on this health emergency.

As Prepared for Delivery

Thank you, Hal [Rogers], for that kind introduction. It’s an honor to be here with you all today.

And I know many of you are from out of town, so it’s a privilege to welcome you to the great state of Georgia, and to our great capital city of Atlanta.

I’d like to thank my friend Hal Rogers not just for hosting this annual conference, but for having the vision, courage and leadership to launch this initiative more than a decade ago.

Back in 2003, when Hal first formed Operation UNITE, I think it’s fair to say that most people didn’t think drug addiction was one of America’s top health priorities.

But by the time this summit began in 2012, Hal’s efforts had already proven to be prophetic.

So, on behalf of the Department of Health and Human Services, I want to thank Hal for his leadership and vision on this issue.

I’d also like to thank all of you who are participating in this conference for the incredible work that you’re doing to fight the terrible problem of prescription drug abuse and heroin use in our country.

It’s because of the heroic efforts and dedication of the people in this room — and countless others just like you across America — that I have hope in our ability to overcome the scourge of addiction.

You are on the front lines of this battle. For some, the front lines are in a hospital, a clinic or a research lab. For others, they’re in a state house, a court house or a halfway house. And for far too many, the front lines of this battle run right through their own homes.

That’s what’s so important to understand about this challenge: It knows no bounds. Americans of every creed, color and class are caught up in this crisis. No corner of our country has escaped this scourge. It affects all of us and it’s what brings us all here together for this summit.

Everyone here comes from a wide range of professional and personal backgrounds — a testament to the complexity of this problem and the wide coalition needed to solve it. But you’re united in your pursuit of the same goal: putting an end to the addiction crisis that is ravaging our country.

I’m here to tell you that I share that goal. As long as I have the privilege of serving as Secretary of Health and Human Services, I hope you’ll see the Department as an eager partner in this fight.

Assessing the State of the Epidemic

We need to reckon with the reality of this crisis. Now is not the time for sugarcoating facts or fussing over terminology.

We don’t have time for that. Our fellow Americans who are struggling with addiction today don’t have time for that.

Today, we have people dying from drug overdoses in the middle of funerals for loved ones who just days before died of an overdose. We have unimaginably lethal drugs, like fentanyl and carfentanil, pouring into our communities and instantly becoming best sellers because of their reputation for delivering a high so powerful that it can kill you with just one hit.

So, we must begin with a clear-eyed understanding of the problem of drug addiction and overdose in America today.

The last time I attended this summit was in 2014. Back then, we all thought that prescription drug and heroin abuse and overdose were problems of epidemic proportions. And they were.

I remember listening to one panelist after another as they told harrowing stories of the men and women whose lives had been destroyed by addiction. The numbers took my breath away.

That was tough enough to hear... but then it got worse.

In 2015 alone, 52,000 people died of overdoses in America, the majority of them from opioids. This represents the highest number of overdose deaths ever recorded in our country. Each day we are losing more than 140 Americans to overdoses. Millions more are struggling with opioid addiction.

If those foreboding statistics are all you see, it can easily look like we’re losing this fight. But then you come to an event like this and you don’t see despair or despondency. Instead, you see hope, confidence and ingenuity.

Over the last few years, as the epidemic has worsened, the coalition of individuals, families and institutions committed to solving it has only grown bigger and stronger and bolder.

You all have refused to give up. You have refused to turn your backs on our brothers and sisters. Instead, you have chosen to lift them up — helping them find their own path out of addiction and then helping them live as witnesses to the simple truth that recovery is possible for everyone.  

This is the spirit that will inform our work at HHS: America is not giving up on this fight. Surrender simply isn’t an option.

Just as you’ve done in your own work, we need to spread the good word that recovery is possible, and that everyone, no matter how brokenhearted, has the capacity to recover from addiction.

President Trump's Opioid Commission

This is something that I know President Trump believes very deeply.

When he announced his executive commission on the opioid crisis at the White House last month, he hosted a number of people who have lived at the heart of this crisis, including a woman named Pam Garozzo.

“I am here,” Pam told the group, “because my son is no longer here.”

She showed the president a photograph of her son, whose name is Carlos.

Carlos was wearing a suit in the photo — not his normal attire as a 23-year-old, she said. He was dressed up for that picture because it was taken the day he walked her down the aisle at her wedding.

Carlos had struggled with drugs since he was a teenager. Sometimes, even for long stretches, he would get clean. When he wasn’t using drugs, he could do anything he set his mind to.

He earned a scholarship to a prestigious university and a spot in the engineering program there. He served as a spokesman for others struggling with addiction, and many of Carlos’s friends credited him with helping aid their recoveries.

But Pam said he had a hard time getting the treatment needed to sustain his recovery, even though the family had good insurance.

Twenty days after Carlos walked Pam down the aisle, police officers arrived at her door to deliver the worst news a parent can ever hear: Her son was dead. Her bright young Carlos had been stolen from this Earth by a fentanyl overdose.

Stories like Pam’s break my heart. I know they break the heart of every American who hears them.

At HHS, we’re ready to fight alongside Pam and the millions of Americans who are trying to find recovery or help their loved ones do so.

HHS’s 5 Priorities

Over the course of this conference, you have heard from many of my HHS colleagues about the work they’re doing. But I’d like to take a step back from the details of our work and talk to you about how all the pieces fit together.

The Trump Administration is committed to bringing everything the federal government has to bear on this health emergency. We have identified five specific strategies that HHS will bring to the fight:

  • Improving access to treatment and recovery services;
  • Promoting use of overdose-reversing drugs;
  • Strengthening our understanding of the epidemic through better public health surveillance;
  • Providing support for cutting edge research on pain and addiction; and
  • Advancing better practices for pain management.

Access to Treatment and Recovery Services

As you all know, 90 percent of Americans struggling with addiction are not currently getting treatment. Making sure they get it can make a huge difference. It means more Americans leading healthy, flourishing lives, and fewer moms opening the door to the news Pam got.

That is why I am proud to announce that, this evening, HHS is sending letters to the governors of all 50 states announcing $485 million in grants for their evidence-based prevention and treatment activities.

These state-based grants are funded by the 21st Century Cures Act and distributed through the Substance Abuse and Mental Health Services Administration. They complement the grants we will also be making this year to state and local governments and community organizations under the Comprehensive Addiction and Recovery Act, or CARA. Some of the CARA grants, I am happy to say, will support groups working on recovery efforts.

With these grants, we want to promote evidence-based policies and best practices. But we also recognize that states know best what their communities need, and that they have already been at the forefront of supporting prevention, treatment and recovery.

That’s why these grants are targeted at a wide range of activities beyond typical treatment and prevention programs, such as training for health professionals, technological investments, and support for Prescription Drug Monitoring Programs.

This year’s grants are far from the end of our commitment: There is another half-billion dollars in state grants that will go out next year, based on what we learn from this round about what works best and what communities need.

As part of that assessment process, I plan to travel the country to talk with state, local and community leaders, as well as treatment and recovery specialists and medical providers.

The findings from these visits will also inform the work we do hand-in-hand with the president’s commission, led by Governor Chris Christie.

Opioid Overdose Reversal Drugs

States have also made great strides in expanding access to drugs, like naloxone, which can reverse overdoses, pulling thousands of Americans each year back from the brink.

The state-based grants going out this week can be used to promote the use of these life-saving drugs, and we are committed at HHS — everywhere from FDA to NIH to CMS — to making access to these lifesavers as easy and affordable as possible.

At the same time, we also want to explore new drugs that could save even more lives. With the influx of highly lethal synthetic opioids cutting lives short in communities across America, this work has never been more urgent.

Public Health Surveillance and Research

A key role HHS plays in any epidemic — no less with opioids than with Ebola — is providing public health information and performing cutting-edge research.

As so many of you know, the information we are working with on this issue is, in social science terms, up to date — but for fighting an epidemic, it’s ancient history.

We are committed to securing the very best information we can get about emerging trends in this crisis. Programs like the CDC’s Data-Driven Prevention Initiative and Enhanced State Opioid Overdose Surveillance Program are providing grants and technical assistance to state and local authorities to help them track developments and respond in real time.

We’re also seeing wonderful cooperation between public health authorities and law enforcement. For instance, HHS is working with our colleagues at Customs and Border Protection so that when they intercept shipments of fentanyl headed for a particular city, we can make sure local public health authorities are alerted, too, and prepared for the possibility of a tragic wave of overdoses.

On the research front, while there has been great scientific work in this field, some of it done by people in this room, many questions about this battle remain unanswered.

What new kinds of treatment, both pharmaceutical and otherwise, can help us in our fight? Are there new kinds of painkillers that are less addictive and safer? Can we develop a vaccine for opioid addiction?

Researchers at federal institutions like the National Institute on Drug Abuse and scientists with federal grants across the country are exploring these questions every day.

Pain Management

At the same time, it’s important to be humble about what we can understand about this epidemic. There is no miracle drug that will cure addiction.

To truly stop this crisis, we have to avoid creating dependence in the first place. And that means revisiting and rethinking the revolution in pain management that has taken place over the past several decades, which has done a great deal of good but also had devastating unintended consequences for millions of patients.

I started seeing the first signs of new attitudes toward pain, and an overeagerness to treat it with opioids, as a physician in the 1990s. The concept of pain as a fifth vital sign struck me and many other doctors as nonsensical. A symptom of disease is not a vital sign.

But there was, and still is, a pervasive sense that doctors would be judged in part based on how well patients were satisfied with the pain treatment they got — an issue that patients were being encouraged to make a central medical concern. Sadly, this coupled with a poor appreciation of the risks of opioids led many to prescribe them when they weren’t even needed.

There is no question that this overreach helped create the problem we have today, and that ending this epidemic requires going back to its roots.

Over the past several years, federal authorities like the CDC and CMS, along with private insurers and medical educators, have worked very hard to determine where all this went wrong, so that we can promote safe use of opioids and limit the risk of addiction.

I am so grateful for the work that has been done, but we have much further to go.

A mother named Judy who appeared in a recent CDC advertising campaign drove home the dangers of these drugs so powerfully. She and her husband found a note among the belongings of their son Steve, after his death, that described his experience with opioids.

The note said: “At first, it was a lifeline. Now, it is a noose around my neck.”

No health care system worthy of the name pushes nooses on its patients. Judy’s tragic experience must be part of our past, not our future.

We are committed to going through all of the important work HHS does — in payments, prescribing guidelines, and more — to ensure that we are not pushing doctors toward quick fixes that risk lives. Our goal, in all that we do, should be to promote healthy, evidence-based ways of managing pain and to help providers and patients make responsible choices.

In part, that will happen through the implementation of the National Pain Strategy, led by the Office of the Assistant Secretary for Health and the NIH, and through the Interagency Task Force on Pain Management, which is in the process of being assembled this spring.

Conclusion

As we think about pain, we must not forget the types of pain that can hurt the most but are often the hardest to treat — the pain of loneliness and despair, of feeling unloved or unvalued. The pain of living with a broken heart.

Today’s epidemic is worse than drug crises we’ve seen before. But, at its core, it’s just the latest chapter in the story of the human condition — of man’s fallen nature and our search for meaning and purpose in a broken world.

The problem today isn’t simply that it’s too easy for people to access highly addictive drugs, though this is certainly true.

The deeper problem is that, for many of our fellow citizens, it’s too difficult to access the relationships and institutions — like family, faith, community and work — that make life worth living and the pursuit of happiness possible.

This is a problem that can be difficult to describe, and even harder to solve, but it is impossible to deny.

Across America, the bonds of family, faith, work and community are fraying and fracturing. Detached from these crucial sources of happiness, many are driven to drugs and then caught in cycles of hopelessness and addiction.

Repairing these broken bonds is the key to recovery. That begins by meeting Americans with addiction where they are, while always reminding them of where they’re capable of going.

Addiction isn’t a moral failing, but the addicted person is a moral agent.

He may be enslaved to drugs, but he is not a slave.

He may have lost control of his life, but he has not been robbed of his free will or his God-given ability to bear the greatest burdens in life and come out on the other end stronger for it.

The Apostle Paul writes in his first letter to the Corinthians: “No temptation has overtaken you except what is common to mankind. And God is faithful; he will not let you be tempted beyond what you can bear. But when you are tempted, he will also provide a way out so that you can endure.”

As a nation, we can endure this temptation. But none of us — no person, no family, no community — can do it alone.

It is only with your help that, as a nation, we can find a way out for every American struggling with addiction.

Everyone here is at the top of their professional fields. Gathered in this room, we have some of the world’s most talented scientists, physicians, nurses, lawyers, police officers, first responders, educators, public health officials and recovery advocates.

But each of us is more than what we do every day from 9 to 5 — or, for a lot of you, from 9 to 9 or longer. To defeat this epidemic, we need more than just better professionals — we need braver citizens, stronger families and more loving communities.

I commit to doing my part, as Secretary of HHS, as a physician, and as a member of this Atlanta community, to overcome this challenge, and I invite all of you join me in your own neighborhoods and communities across this great land.

Thank you, and may God bless you and the work you do.

Computed date: 
2017-04-19 21:00:00
Content created by Assistant Secretary for Public Affairs (ASPA)
Content last reviewed on April 19, 2017