BACKGROUND PRESS CALL
BY SENIOR ADMINISTRATION OFFICIALS
ON THE TRUMP ADMINISTRATION'S EFFORTS
TO CONTINUE COMBATTING THE OPIOID CRISIS
Via Teleconference
9:39 A.M. EDT
MR. CANTRELL: Thank you, Operator. Good morning, everyone. And thank you for joining today's background briefing on the Trump administration's State Opioid Response grants. Today's briefing will be conducted by Senior Counselor Kellyanne Conway and Health and Human Services Secretary Alex Azar.
Opening statements will be on the record. The Q&A section will be on background, attributable to senior administration officials. All information is embargoed until the conclusion of the call.
With that, I will turn it over to Senior Counselor Kellyanne Conway. Excuse me, I will turn it over to HHS Secretary Alex Azar.
SECRETARY AZAR: Thank you all for joining us on this call today. I'm going to begin by laying out what HHS is announcing today and how it fits into our work on the opioid crisis. And then, Kellyanne is going to offer some perspective on how this fits into work elsewhere, across the administration and at the White House.
Today we're announcing that the Trump administration, through HHS, is giving $1.8 billion in funding to continue helping local communities combat our country's opioid crisis. Thanks to the President's leadership and funding he secured from Congress, we are truly headed in the right direction for the first time since this crisis arose.
From 2017 to 2018, we saw a 5 percent decrease in provisional drug overdose death counts -- the first decline in two decades. But we know we have more work to do. More Americans still need treatment. More Americans need support in entering recovery. And more needs to be done to prevent Americans from becoming addicted in the first place.
Today's announcement is part of our commitment to continuing the fight. Today we're announcing two significant sets of grant awards.
First, SAMHSA, the Substance Abuse Mental Health Services Administration, is awarding $932 million in State Opioid Response grants to all 50 states and several territories. This is the second year of these grants made possible by funding secured by President Trump from Congress in 2018.
These grants provide flexible funding for state governments to support prevention, treatment, and recovery services in ways that meet the needs of their states. That can mean everything from expanding the use of medication-assisted treatment in criminal justice settings or in rural areas, be it telemedicine; to youth-focused, community-based prevention efforts; recovery supports, like employment coaching; and support for the distribution of naloxone.
Different states have different needs and different resources of their own. The structure of these grants recognize that.
Starting with the initial grants last year, however, we did impose one requirement: that treatment providers funded by these grants must make available medication-assisted treatment, which is the gold standard of treatment for opioid addiction. I made it clear, from my first day at HHS, that our work combatting the opioid crisis had to follow the best signs possible. And our commitment to MAT is an essential piece of that.
The second set of grants today are under CDC's Overdose Data to Action Grant Program. Nine hundred million dollars will be awarded over three years, with $301 million released now for year one, going to 47 states, Washington, D.C., 16 localities, and two territories.
These grants help state and local governments track overdose data in a timely and comprehensive way, and support the development of strategies to help Americans who suffered an overdose get connected to treatment.
Over the past two years, under President Trump, CDC has dramatically sped up its data reporting. When the President took office, overdose data, nationally, was only published with a 12-month lag. With the help of better reporting from local health departments, we've gotten that down to six months now. That's just one example of the results we've seen under this President.
A year and a half ago, I joined him in Manchester, New Hampshire, to launch his opioid initiative. He called for action, and that's what we've delivered. The President said we would prevent addiction by addressing the problem of overprescribing. Since the President took office, the total amount of opioids prescribed is now down 31 percent.
The President said, quote, "We need treatment by making medically assisted treatment more available and affordable." Our estimates suggest that, in 2016, 921,000 Americans were receiving medication-assisted treatment, the gold standard for treating opioid addiction. In 2019, our estimates suggest we now have 1.27 million Americans receiving this treatment, a 38 percent increase.
The President said, quote, "We're going to make sure our first responders have access to lifesaving overdose-reversing drugs." Since he took office, naloxone prescriptions have risen 378 percent. When the President asked HHS to declare a public health emergency back in 2017, he promised that we'd see more approvals of waivers to help, quote, "unlock treatment for people in need." They'll come, quote, "very, very fast," he said. And since he took office, we've approved 21 states' waivers compared with four under the previous administration.
So we at HHS have delivered what the President called for, and so has the rest of this administration.
To cover work elsewhere, I now want to hand things over to Kellyanne Conway.
MS. CONWAY: Thank you very much, Secretary Azar, for those remarks, and certainly for your leadership on behalf of the President, Vice President, and this administration in all areas of health.
Good morning, and thank you all for being on the call to cover this critical issue and for your interest, generally, in our work to combat the drug supply/drug demand crisis next door that's been roiling our nation.
This announcement today is excellent news. By investing nearly $2 billion in our state and local partners, we are once again supporting those closest to those in need. At the community level, law enforcement, health care providers, mental health professionals, and others access the monies provided by the federal government to bring much-needed relief to our brothers and sisters who are suffering the scourge of misuse disorder and addiction.
As the Secretary remarked, we've seen great progress more recently, under the Trump administration, when it comes to combatting the scourge [of addiction]. More than 700,000 people died from a drug overdose in the eight years from 1999 to 2017 -- 18 years, excuse me. The number of opioid overdose deaths had jumped six-fold over that time.
On average, 130 Americans die every day from an opioid-related overdose. And when you take all drug-related deaths together, you are approximating causes of deaths that go far beyond accidents, gun violence, plane crashes, and the like. So what we're trying to do today is make people aware of both the crisis and the solution.
"Fentanyl" is a word that we've tried to interject into the everyday lexicon as part of our work. Fentanyl caused 32,000 American deaths just last year. The fact that this nation is in such a predicament is because federal policies in our overall healthcare system has failed many Americans who are suffering.
We believe that empowering our state and local leaders has been a linchpin of President Trump's administration, and our response to the opioid and fentanyl crisis is no different.
Under the leadership of the President, Secretary Azar and others across the administration, we are taking unprecedented action to fuel locally led efforts to combat the crisis. The President has witnessed firsthand those who are suffering in the hardest-hit states and is targeting substantial resources to those communities, as well as communities all across this country.
Since no state has been spared and no demographic group has been untouched by the crisis, no state has been spared from the funding resources that we're announcing today, as well.
In President Trump's first two years in office, in 10 states and the District of Columbia with the highest drug-overdose death rates, HHS tripled and DOJ increased by four-fold the number of new state and local partners in which they are investing.
The Trump administration also awarded the highest number of Drug-Free Community Support Program grants in a single year, in the program's two-decade history. These Drug-Free Community grants provided more than $90 million to community coalitions to help prevent substance abuse among youth.
In addition, our public awareness campaign has helped to educate people about the dangers of misusing prescription opioids and other drugs in partnership with the Ad Council and Truth Initiative. One of these campaigns has already reached 58 percent of young adults and generated 1.4 billion views and an Emmy Award to boot.
Last year alone, 113,000 fewer adolescents and 153,000 fewer young adults started misusing prescription painkillers than in 2016. Nearly 60 percent fewer young adults began using heroin in 2018 than 2016.
Central to our effort to stop the flood of fentanyl and other illicit drugs is our unprecedented support for law enforcement and their interdiction efforts. The Department of Homeland Security seized almost 5,000 pounds of fentanyl in fiscal year 2018, totaling 1.2 billion lethal doses. Ladies and gentlemen, that is enough to have killed every American four times.
In March 2018, the Interior Department created a tribal task force specifically to combat the opioid crisis on tribal lands. Since its creation one and a half years ago, the Interior Department’s tribal task force work has led to over 422 arrests, 175 indictments, and seizure of over 4,000 pounds of illegal drugs worth $12 million on the street. This includes over 35,000 fentanyl pills.
Additionally, we have brought kingpin designations against fentanyl traffickers who operate in China, India, the UAE, Mexico, and throughout Southeast Asia, including Vietnam, Thailand, and Singapore. These kingpin designations are the product of interdepartmental work, combining the efforts of DOJ, DHS, the U.S. Attorneys, the intelligence community, and Treasury to stop the handiwork of drug traffickers and to sanction them when we must.
Last fall, the President signed into law the STOP Act, which has empowered our Customs and Border Patrol agents with electronic data to track fentanyl packages. Using this data, Customs and Border Protection agents increased seizures of fentanyl in our mail by over six-fold already, and we’re on our way to 100 percent compliance, ultimately.
We are also bringing new approaches to this fight as well. Last fall, at UNGA, the President launched a global call to action for other nations to join our efforts to stop the flood of illicit drugs into our communities. More than 130 countries have joined us in that effort already.
To build on these efforts, just two weeks ago, the Trump administration released four first-of-their-kind advisories, aimed to help the private sector join with us to disrupt the activities of high-level traffickers in their own private-sector supply chains. These are increasingly being hijacked by fentanyl traffickers, and we are now assisting the private sector to track the money, movement, manufacture, and marketing of these high-level drug traffickers.
We know that, ultimately, this problem hits close to home for many, and locally led efforts are the key to turning the tide against the crisis.
I’d also like to mention that, apart from the independent merit of the State Opioid Response grants being announced today, this is the latest building block in the President’s overall healthcare and health reform agenda. From reforming the way that we treat kidney disease in this country, to increasing price transparency, ending the HIV epidemic by 2030, confronting high drug prices, and of course stopping the surprise billing and allowing health reimbursement arrangements for small businesses, the Trump administration is focused on confronting the healthcare challenges that others have ignored.
This President is determined to improve health outcomes and cure disease, which is precisely the way many people regard healthcare. This is why we have worked so hard over the last two and a half years to confront the scourge of opioid addiction and the overall drug supply/drug demand crisis in this country.
Ladies and gentlemen, addiction is a disease, not a moral failing. Today’s grant announcements will help treat more Americans, offering hope for recovery and lifesaving (inaudible) for so many of our brothers and sisters across this nation. Thank you very much.
MR. CANTRELL: Thank you both. Operator, we will now take some questions.
Q Good morning. My name is Andrew Feinberg. I’m with Breakfast Media. Thank you all for doing this call. My question is for Secretary Azar. Aside from the use of medication-assisted treatment, by what metrics are you using to evaluate whether a grant recipient’s treatment programs are effective?
And is HHS or CMS developing any metrics to measure the effectiveness of treatment programs, considering that there are currently no federal standards to measure whether a given treatment program is effective or not?
SECRETARY AZAR: If I could actually ask, I’d like, because that gets them the particulars of the actual State Opioid Response grant procedures, I’m going to ask [senior administration official] to respond to that question on background. I believe, Austin, should be quoted as a “senior administration official.” Is that the appropriate (inaudible)?
MR. CANTRELL: That’s correct. Yeah.
SENIOR ADMINISTRATION OFFICIAL: Yeah. [Senior administration official], if you don’t mind.
SENIOR ADMINISTRATION OFFICIAL: Thank you. There are a number of metrics that we look at. These include not only the use of evidence-based treatments, medication-assisted treatments, but also retention and treatment. And so it’s not enough to just give a patient medication, but there has to be a connection with counseling staff and other providers in these programs. That’s what retains people in treatment and helps them to recover.
We also look at parameters like increases in employment, increases in stable housing. We look at decreases in emergency department visits and decreases in hospitalizations all as measures of a person regaining their health by having their opioid abuse disorder and other co-occurring disorders treated.
SENIOR ADMINISTRATION OFFICIAL: Thank you very much. Excellent information. I would just add -- it’s [senior administration official]. I would just add very quickly, this is why our opioid cabinet at the White House -- we have 13 or 14 different departments and agencies represented and, really, all the major sub-agencies at HHS, including SAMHSA and CDC and NIH and FDA.
But we also have the Department of Labor; Department of Housing and Urban Development, for example; Department of Interior at the table, because we want to treat the whole person and we think far too often there is a box checked or we’re patting ourselves on the back by just throwing money.
These are people, not problems. And we want to make sure that we’re treating -- a whole-of-government approach is treating the whole person. And that is why we’re working very closely with our partners in these other departments and agencies to avail individuals of housing opportunities, of reskilling, educational, employment opportunities, so that if they are fortunate enough to have come through a drug treatment program or a drug court program, and they come out the other side ready to re-assimilate into society, that they -- if they are able and willing and desirous to work -- to enter a different housing system, to be further educated, or reskilled -- that those opportunities are there.
And I would just give a shout-out to some of the workers from in the private sector, where they -- instead of firing somebody who failed a drug test, for example, an increasing number of employers are asking those employees to immediately enter a drug treatment program -- they keep their job open for them. And then, when they’ve successfully gone through that treatment program and they are cleared for reentry for reemployment, the job is there waiting for them.
It’s quite expensive for some of these employers, but they figure that we’re all worthy of a second chance. And to make that treatment available and to have that job -- which, of course, becomes the main metric of your ability to continue to recover for many Americans -- is critical. And that’s why we work on all of that here at the White House. Thank you.
Q Hello, this is Toby Capion calling from EWTN. My question is: How has faith-based programs helped you implement your programs? And would you consider putting your answer on the record?
SECRETARY AZAR: So, I’m happy to -- this is Secretary Azar -- I’m happy to be on the record. And we obviously encourage faith-based organization participation throughout the states, using the State Opioid Response grants, as well as other programs.
Let me give you one particular example: The NIH HEALing Communities Initiative, which we announced a couple of months ago, this is approximately $400 million in funding to four communities in Kentucky, Ohio, Massachusetts, and New York. And this is based on an insight from Sam Quinones, who wrote the book, “Dreamland,” that where we see the greatest -- the greatest progress against the opioid crisis is when we see an entire community working together. That means employers, the justice system, the court system, mental health, public health, but, very importantly, the faith community, working together to build solutions around people.
And that’s why we selected those communities as we really got a whole-of-community approach in the proposal. And by that, we mean to bring down opioid overdose deaths by 40 percent over the course of three years to show that, with the right community efforts, including the faith community, we can tackle this.
Q Hi, there. This is Sandhya Raman from CQ Roll Call. Thanks so much for doing that call. My question is about: There's been a rise in, kind of, some other types of substances -- meth, cocaine, other drugs -- and if this kind of funding will be available to other types of drugs, or they'll kind of have to look through other funding sources. Thanks.
SECRETARY AZAR: So, this is Secretary Azar. And again, (inaudible) this response to be on the record. So that's actually part of why the CDC's $900 million of funding here is so important. Three hundred million dollars in each of three years to enhance the data reporting systems at the state and local levels, to ensure that we're getting accurate and timely information about drug use, overdose, and overdose deaths.
We have to be constantly monitoring the situation. For instance, we've seen a reduction, recently, in fentanyl analogue overdose deaths, but we have seen increasing utilization of methamphetamine, methamphetamine deaths, and methamphetamine used in association with cocaine and opioids. So that’s an aspect of this crisis that we are tracking very, very closely.
The State Opioid Response monies -- of course, by statute -- may be used for opioid response, but so much of the work that is funded by states under those serves a broader substance use disorder purpose, or enhances the overall systemic capabilities around substance use disorder beyond opioids, even though the money, under the State Opioid Response, of course is for opioid purposes.
Q Hi, this Franco Ordoñez from NPR. Thanks for doing this. I apologize if I missed this earlier, but can you talk about the funding? Where is the money coming from? And was this money not already appropriated by Congress?
SENIOR ADMINISTRATION OFFICIAL: So this is the -- so there are two sources of funding here that are being announced. The first is, the Centers for Disease Control and Prevention, as I just talked about -- $900 million in funding for a three-year cooperative agreement with states, territories, and localities to advance the understanding of opioid overdose epidemic, as well as to scale up prevention and response activities, with $301 million released in the first year.
The second big tranche of money is from SAMHSA, which is awarding $932 million to all 50 states as part of the State Opioid Response grants, which are part of the opioid legislation passed by Congress at the President's request, and, of course, under appropriation by Congress. We can’t spend money that Congress has not appropriated. So this is the actual follow-through and execution (inaudible) money that Congress, at the President’s request, has appropriated.
Q Hello. This is Donna Young, from S&P Global News. I had a question on the President’s health plan. You had said earlier this year that it would be out in September. So could you maybe talk a little bit about the timeline on that? Is it still expected to come out this month? Thank you.
SENIOR ADMINISTRATION OFFICIAL: I’m actually happy to take that. So, in fact, I would encourage you, Donna, to look at a speech that I gave recently -- I think you might have actually been in attendance -- at the Better Medicare Alliance, where I actually laid out what the administration’s and the President’s overall vision is for healthcare, which Kellyanne reflected in her opening comments also, which is a broad approach looking holistically at healthcare for all Americans, instead of just focusing only on the narrower tranche of the Affordable Care Act.
I want to keep focus today, of course, on the very important announcement -- the $1.8 billion of money going out to states and localities to deal with the opioid crisis. But we’d be happy to engage separately with you, Donna, around the President’s broader plans on healthcare.
Thank you.
Q Hi, this is Dan Vergano with Buzzfeed News. I was wondering, you said that you wanted your policies to be guided by the best available science. So I’m wondering why the administration doesn’t support supervising injection facilities, which studies pretty much show are effective at reducing overdoses.
SENIOR ADMINISTRATION OFFICIAL: Actually, they don’t. And it’s for precisely that reason that we do not support them. But let me ask [senior administration official] to give you a more detailed response.
SENIOR ADMINISTRATION OFFICIAL: Thank you very much for the question. Let me first state that the administration supports, broadly, the evidence-based practice of syringe services programs, otherwise known as “comprehensive needle exchange programs,” not only because they reduce Hepatitis C and HIV, but also they’re an on-ramp into long-term recovery and retention and care.
We do not support supervised injection facilities because our review of the science, as well as independent reviews by nongovernmental organizations, do not show convincing evidence that supervised injection facilities are in any way safe, reduce deaths, or reduce any type of infections. And we believe, since the evidence is not there, it is a distraction from evidence-based interventions that actually do reduce death, HIV, HCV, and other complications.
So we support syringe services programs -- comprehensive ones. The evidence does not support the use of supervised injection facilities at this time.
Q Hi. My name is Jacquie Lee, and I’m with Bloomberg Law. I was hoping you could talk a little bit about how much of this money is allocated for faith-based organizations or if they’re included in the groups that get it. And do different states get different amounts? And if so, what are those top five states that are getting the most?
SENIOR ADMINISTRATION OFFICIAL: So the -- this is [senior administration official]. So these, actually, are extremely flexible grants to states. As I mentioned in my opening, different states have different needs. They have different practices that work in their state, that fit their communities. And so there's no allocation to particular providers or entities dictated under that.
Each state really gets to determine how to structure their state opioid program as they see fit and can determine the balance and utilization of faith-based providers and organizations within that.
In terms of the allocation of monies under the CDC grants -- and I'll ask [senior administration official] if there is any more detail on this. But the CDC program, the $900 million, is essentially subject to an application process. And then, based on funding related to that -- I just want to make sure there's not a formulaic distribution, correct? This is [senior administration official].
SENIOR ADMINISTRATION OFFICIAL: So what we did was we allowed states to apply for these grants. There was some formula applied that took into account both population, as well as burden. So all states received a significant amount. We tried to give additional funds for those that had the highest rates of overdoses. And the money goes directly to state health departments, territories, and local health departments.
And as [senior administration official] said, states have flexibility then to determine how it goes to faith-based organizations and other local entities.
SENIOR ADMINISTRATION OFFICIAL: And then in terms of the State Opioid Response grants out of SAMSHA, funding there is distributed by way of a formula that's based on state drug overdose death rate and unmet treatment need for opioid use disorder. Those factors are weighted equally. In addition, there is a statutory 15 percent set aside for the 10 states that are hardest hit by the crisis.
The actual press announcement will have the state-by-state breakdowns in it, so you'll have all of the data there on state distribution.
MR. CANTRELL: Operator, we will now take one last question.
Q Hi, this is Brian Mann, also with NPR. One of things that's happening right now is that there are litigation cases around the U.S. in various jurisdictions that are already providing huge amounts of money, in theory, for opioid treatment. We saw the Johnson & Johnson announcement in Oklahoma; others are pending.
And I'm wondering whether the Trump administration has opinions about how that money can or should best be used. There's a lot of concern that it will be funneled away to projects other than opioids. Does the Trump administration have an opinion about how those kinds of court-produced revenues should be used in this epidemic?
SENIOR ADMINISTRATION OFFICIAL: So, I'm not going to comment, obviously, on any individual piece of litigation, but the Trump administration -- and the President feels quite firmly about this, as do I and the Attorney General -- we believe that for any entities who sold, marketed, or distributed, or in any way brought us into or exacerbated this opioid crisis that has devastated our country, that if there was any improper conduct, there should be full accountability for that.
And the United States has, of course, in the multi-district litigation, has filed a statement of interest and is engaged fully in that effort. We don’t have views, at this point, on the distribution, and I don’t want to comment on how monies secured as a result of that would be utilized because, of course, that could be a subject in the multi-district litigation.
SENIOR ADMINISTRATION OFFICIAL: That’s right. I would just add to that: We don’t want Americans to wait for the appeals process and these monies to get their treatment. That’s why our administration is taking action through the State Opioid Response grants now, getting, literally, today -- well, continuing today.
And I'm sure that there's information available to you. We'd be happy to provide it -- what each state is receiving, obviously. And nobody played favorites here in terms of, "Well, this state has this many deaths." Everybody has been impacted and everybody will receive the money from the federal government. And that is one of the main messages for me and (inaudible).
The other message, of course, is what the Secretary said from the beginning, the President has been saying it, and will probably say it again today in his remarks: The overall decline in drug-related overdose deaths, declining by 5.1 percent -- the first steep decline since 1990 -- is by causation, not by coincidence.
And so this battleship is starting to turn in the right direction. We didn’t get here overnight. We won’t get out of this crisis overnight. But the whole-of-government approach and our main emphasis on prevention, education, treatment and recovery, law enforcement interdiction, is producing dividends, most importantly, for those in need. And we will continue to work on this legacy for the next five and a half years.
As you all know, the First Lady has been incredibly active as well. This is the main public policy issue the President and First Lady tackled together.
Thank you very much for joining us today.
MR. CANTRELL: Thank you, everyone. This will conclude our call. Again, a reminder that opening statements were on the record and, unless otherwise specifically noted, the Q&A section is on background, attributable to a senior administration official.
As always, further questions can be directed to the White House Press Office or HHS. Thank you everyone for joining this morning.
END 10:11 A.M. EDT
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