Remarks of ONDCP Director Jim Carroll at "Turning Tide – Improving Access to Treatment for Addictions and Overcoming Equality Obstacles" …


Eisenhower Executive Office Building

11:05 am A.M. East

DIRECTOR CARROLL: Good morning, everyone. I'm so happy to see committed leaders wanting to make sure we're working together to save American lives.

Today, more Americans than ever have needed access to effective addiction treatments through their insurers and health plans.

Insurers, service providers, health systems and employers play a key role in responding to the crisis of dependency.

We know that not dealing with substance use in the workforce is much more expensive than providing access to quality care. Today we have the opportunity to decide how we can better support those in need and save lives.

This cannot be a compromise between doing the right thing and protecting the bottom line – and today we will hear examples where you can do both.

I want to start by sharing the story of a family I met while traveling in the countryside, mom Juli and her son. Juli shared how grateful she was for her family's private insurance.

His son received treatment through three inpatient programs and several outpatient programs. It has been recommended for Suboxone and their insurance covered this essential drug and the other treatment services it received.

This is when he started to shine: this accessible and accessible care, which combined drugs and other services, allowed him to feel in control of his life. The drug helped him to participate successfully in behavioral therapy and to start participating more actively in his family, community and workplace.

Juli acknowledges that access to quality care and assistance in navigating the therapeutic system have been crucial in saving her child's life. She is so grateful for the complete and compassionate assistance her insurer provides.

Juli's son needed more than one episode of treatment to achieve remission and begin the journey to long-term healing.

This series of more or less acute interventions combined with ongoing care coordination and support is no different than what is often necessary to successfully manage other chronic conditions, such as diabetes, hypertension or asthma.

During those years of working to address his substance use disorder, the family health insurer stayed with Juli and his son.

Our nation's dependency crisis has had an impact on so many families like Juli's.

According to the CDC provisional data, approximately 201800 American lives were lost due to a drug overdose in 2018. There are about 186 deaths from overdoses a day.

The impact of this crisis is not just about the number of fatal drug overdoses. The crisis of dependence is putting a strain on health systems, employers, the forces of order, the criminal justice system and the wider community.

As I am sure I need not tell you, health insurers are equally burdened by the fact that the anger of addiction does not diminish.

In 2016, estimates for health care costs for drug use were $ 37 billion.

Employers, insurance companies, hospitals and publicly funded health systems incur higher costs for employees with substance use disorders or SOUTH.

People with SUD are more likely to report poor general health and health conditions that occur simultaneously are exacerbated by their addiction.

People with an untreated SOUTH are more likely to be hospitalized and their average hospitalization period is longer than for people without SOUTH. People with SOUTH also visit the emergency room more often.

Furthermore, the research found that family members of people with active SUD claim high health costs.

The good news that is facing the problem can help.

When an individual begins recovery, his use and health care costs between them and those of their family members fall to levels similar to those of the general population.

A state-level study on Medicaid beneficiaries with SUD found that receiving treatment was associated with annual health savings of $ 2,500 per beneficiary.

Another study found that, on average, people receiving SOUTH treatment cost the healthcare system $ 536 less than people with untreated SOUTH.

The treatment works. Healing is possible.

It must be accessible, and not only through special drug treatment programs, but through primary care, emergency departments, inpatient programs and other facilities.

Patients and their families must be able to access SUD care as easily as they can access any other form of specialized healthcare.

When you concentrate on trying to save a loved one, the last thing you want to consider is the complexity of access to treatment.

Today, unfortunately, the criminal justice approach refers to more people being treated than healthcare professionals.

We need insurers and suppliers to identify people with a substance use disorder and then coordinate their care so that the more they go into treatment, the more they come out in recovery.

The coordination of assistance is essential for complex chronic conditions and all insurers, service providers and health systems can make a significant contribution in this area by offering dependents the same case of management and coordination services they receive people with cancer, HIV or another complex physical condition.

I am pleased to see that the US Preventive Task Force has issued a draft recommendation calling for adult screening for illicit drug use, including the non-medical use of prescription drugs.

This is an essential step not only because we seriously need substance use prevention services, but perhaps even more important because it provides doctors with a mechanism to ask their patients annually for their use of the substances.

Only about 12% of people with a SOUT actually receive treatment. Allow me to repeat it: only 12 percent of people with a substance use disorder receive the care they need. To put it in context, the therapeutic gap is around 18.2 million people.

We seriously need a systematic process in which doctors stop and examine their patients' use of the substances and make course corrections in advance or bring the people in treatment who need treatment before overdosing or suffering further damage.

There is also a knowledge gap of the patient. A whopping 85 percent of people meeting the criteria for the South did not think they needed care. WHO talks about the need for patient education and regular screening.

There are literally millions of Americans who do not realize that they are putting themselves, their families, their collaborators and their communities at risk.

To further complicate people's desire to seek treatment is the stigma that has been attached to the SOUTH for too long.

We must continue to educate the public on the fact that addiction is a chronic disease and not the reflection of a personal or family failure.

Those we serve must understand that addiction can be treated; such recovery is possible.

We need employers, communities, workers and others to understand that – like other chronic diseases – addiction is a medical condition with many contributing factors, not simply a failure of the will.

ONDCP is coordinating federal efforts to counter the illicit use of drugs and non-medical use of prescription drugs.

With our federal partners, we are also working with state, local and tribal governments and the private sector to keep bending the curve on opioid and other drugs.

Today we are contacting you as necessary partners in these critical efforts.

It will take everyone to defeat this epidemic. This is a battle that we must fight on several fronts: in the community, in emergency departments and between health systems and the business community.

That's why we're contacting you to help us ensure that Americans have the coverage and access to the SOUTH care they need.

You are the ones who can deal with these problems and solve them. I know you can.

I have no doubt that many of you may have already made their way. I know some of you will share this topic in a group discussion today.

With your concerted efforts, we will reverse the causes of addiction to devastation, save the lives of our fellow citizens and build more resilient workplaces and communities.

I look forward to working with you on these important issues.

Thank you.

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