At HHS and across the Trump administration, we know that prevention is an essential part of addressing substance abuse in our country. We especially recognize the importance of community-level expertise in achieving prevention. It takes hard work from partners like you to ensure that every American knows about the risks and harms of substance use disorders.
As Prepared for Delivery
Thank you, Assistant Secretary McCance-Katz, for that introduction, and thank you for the work you are doing at SAMHSA.
It is a pleasure to be here today, at SAMHSA’s 15th annual Prevention Day, to discuss such an important topic: the role that substance abuse prevention plays in our mission at HHS to improve the health and well-being of every American.
I want to begin by thanking everyone who’s come from around Washington and across the country for this event. The work you do to prevent substance abuse is vital to the health and well-being of all Americans.
Whether you are a mental health professional, a community leader, a physician, an activist, or just someone who’s gotten involved because of the experience you or a loved one has had with substance abuse, I want to thank you for the work you do.
You are on the frontlines of our country’s battle against substance abuse, and you are doing life-altering, life-saving work.
At HHS and across the Trump administration, we know that prevention is an essential part of addressing substance abuse in our country.
We especially recognize the importance of community-level expertise in achieving prevention. It takes hard work from partners like you to ensure that every American knows about the risks and harms of substance use disorders.
Substance abuse has touched all of our lives in some way, and it takes a collective effort to make the positive impact we all want to see in our communities.
We certainly cannot do it alone from Washington, and I know all of you recognize that. We’re grateful especially for the partnerships that many of you have forged: from the criminal justice system to faith communities, schools, housing organizations, and so many other community-level organizations.
I hope today’s gathering is an important chance to build on those partnerships and forge new connections.
From the federal level, we are committed to ensuring that all community members—first responders, physicians, families, and everybody else—have the tools they need to prevent substance abuse.
That’s why, last year, under Dr. McCance-Katz, SAMHSA reconfigured its training approach to be more locally focused. Training is now more available to all providers and communities, rather than just focusing on SAMHSA grantees.
SAMHSA has made similar changes to how it provides Technical Assistance, or TA, to communities. Grantees know their programs and their needs best, so we have given them more ability to request the TA services they actually want, rather than having their options dictated by what the federal government or contractors have available. Local expertise and experience now helps define the services we provide.
SAMHSA has also developed a Strategic Prevention Framework, which prevention professionals use as a guide to plan, implement, and evaluate prevention practices and programs.
This framework involves five steps—don’t worry, I’m not going to walk through all of them—and two guiding principles, which I am going to touch on.
The first is “Cultural Competence,” which highlights the importance of effectively interacting with Americans from all sectors of society and all walks of life.
Substance abuse does not discriminate, and it is crucial that our prevention services don’t either.
The second principle is “Sustainability,” which emphasizes understanding how we can achieve and maintain long-term results.
I want to mention what the principle of sustainability looks like when it comes to combating our country’s opioids crisis in particular.
Taking on our country’s epidemic of opioid addiction and overdose is a priority for all of us here at SAMHSA, at HHS, and throughout the Trump administration.
We are well aware that opioid addiction is not the only substance abuse challenge our country faces, but the scale of this crisis has helped drive innovation in all of our substance abuse work and has brought a refreshing bipartisan focus to the broader area.
The President laid out a three-point opioid initiative last year, focused on cutting drug supply, providing treatment to those struggling with addiction, and, most relevant to all of you, preventing opioid abuse in the first place.
We’ve supported prevention efforts through funding in programs like SAMHSA’s State Opioid Response grants, which have provided historic levels of support for combating the opioid crisis.
We also know that the majority of Americans who use heroin got started by misusing a prescription opioid, so it’s clear that improving pain management, reducing inappropriate opioid prescribing, and ensuring safe disposal of unused opioids will be effective prevention tools.
Already since the President took office, the amount of prescription opioids dispensed monthly has dropped more than 20 percent, thanks to the promotion of more appropriate prescribing practices and more awareness about the risks of prescription opioids.
The good news is that we believe prevention efforts are working. SAMHSA’s 2017 National Survey on Drug Use and Health showed that the number of heroin initiates dropped significantly from 2016 to 2017, while prescription opioid misuse has dropped two years in a row.
The opioid crisis has also driven some important thinking at HHS about how substance-abuse prevention can be built right into our health and human services systems.
I’ll mention two potential ways to do that. One is thinking about how screening for and preventing substance abuse can be integrated into the way we pay for healthcare services.
The grants that HHS provides to local communities can be invaluable, but by far the most money we push out the door every year is through our payment systems in Medicare and Medicaid.
We want our healthcare programs to support Americans in staying healthy, rather than paying for the much-more-expensive treatment needed when they’re sick.
We all know addiction is a disease, and preventing it is just as important a goal as staving off any physical illness.
One example of innovation in this space is a payment model launched last year by the Center for Medicare and Medicaid Innovation, called the Integrated Care for Kids, or InCK, Model.
We know we need to do a better job of identifying and screening for potential mental health and substance use issues among our kids. We need to address the challenges they or their families are facing, before more serious issues develop.
Under the InCK model, when mental and behavioral health challenges arise, there is a full set of crisis services available to handle the needs of kids and their families.
The best part about innovative payment models like this is that we test them rigorously: States apply for funding, and then we assess whether the model as implemented really does achieve goals like preventing substance abuse.
The second area for innovation I want to mention also involves doing a better job of providing young Americans with the mental health services they need.
Through the school safety commission established by President Trump, we have been able to learn about how communities around the country have built more positive environments for their children and integrated mental health services right into schools.
Last year, SAMHSA announced new resources within its Mental Health Technology Transfer Centers that will help enable these efforts, and we look forward to helping local communities expand mental-health services right in schools.
That new effort is just one more example of how we are focused on ensuring that all of the work we do, all of the science and evidence we put out, is about supporting you in your communities.
Know that SAMHSA, and all of HHS, wants to assist your work in every way we can.
Engage with us, and let us know how we can be more helpful. I hope today’s meeting was helpful in this respect.
Collaboration is essential, because we at HHS cannot accomplish our mission without you.
So thank you again for your hard work.
Every day, you are helping to tackle one of America’s toughest health challenges, and improving the health and well-being of your communities.
Thank you for having me here today, and I’ll now turn it back over to Dr. McCance-Katz.
