Boroughs. Tom price wajoined by officials from the Substance Abuse anmental Health Services administration. This is an hour and 40 minutes. Good morning. Each year, samhsa releases findings. Today, samhsas release of results from the 2016 survey. Mccancekatznore toe today to prevent present the key indicato from the report. Today also marks shsas 28 and the oral recovery month observance. 28 recoveryth month observance. You are prevent evidence that treatment works and people do recover. [cheers and applause] recovery month prides an opportunity for us to save those fromubstance abuse and Mental Illness. The hard workates of dedicated professionals in the field, of advocates, of grassroots organizations, and of the mily members and friends who have joined their loved ones on their journeys of recovery. To begin todays program, i am honored to introduce our. Ssistant secretary and is aved her phd gruate of the university of Connecticut School of micine. Mccancekatz has experience in the treatment of those living with mental Abuse Mental Health and Substance Abuse disorders. Over 28 years of clinical expernce in the treatment of mental disorders, Substance Use disorders, and cooccurring issues. Her experience in federal and state agencies as a commission, archer, and educate commission researcher and educator equip her with the expertise need to address Behavioral Health challenges. Please join me in welcomg Education Assistant secretary cekatz. [applause] good morning. It is great to be here. Welcome, everyone, here at the National Press club and ose watching our webcast. I am pleased to join you today, and it is my honor to present data highlights from the survey on drug use and health. It is also my privilege to share the podium with secretary price and our guest speakers. Recovery month is celebrated by countless americans living in loved onesy their and by those who are just embarkingn the joury to regain their health and reclaim their lives. Very seriousaces challenges in Mental Health and Substance Use at this time. Challenge,ry serious we must rise to the occasion and meet the challenges headon with clarity and purpose, coordination of effort, efficiency and strong leadership. We are fortunate to have secretary price, who brings a strong commitment to addressing the seriousness of Mental Illness and the Opioid Crisis. Sworn in as the 23rd secretary of health and Human Services on february 10, 2017. He brings to the department a lifetime of service and dedication to advancing the quality of health care in america, both as a physician and as a policymaker. Trained as an orthopedic surgeon, dr. Price held leadership roles in the atlanta medical community, having served as medical director of the orthopedic clinic at grady memorial hospital, as well as on the faculty emory universitys school of medicine. As wh many physicians and Health Care Providers, dr. Prices experience caring for uniques also gave him a perspective about the impact of Public Policy on the praice of medicine. A goal dr. Price was elected to four terms in the Georgia State senate, following which he was elected t u. S. House of representatives, searching serving georges sixth Congressional District for 12 years. Price has been an advocate for a Health Care System that adhereto affordability,ccessibility, quality, choices innovation, and responsiveness to patient care needs. As secretary, dr. Price remains committed to these principles, administering a we up a wide ay wide array of services and protecting and serving all americans. Please join me in welcoming secretary price. [applause] dr. Price thank you so very much for that kind introduion. Good morning. What a great joy it is to be here with so many dedicated folks to an issue that deserves so much attention for our nation. I want to thank dr. Mccancekatz fothat introduction, and just to commend her for her incredible work as she brings a remarkable wealth of experience to the issues that are of concern to all of you, and to our nation. Toare tremendously excited have you in your tenure at samhsa, so god bless you. Nisda, or the National Survey on drug use and health, is a major task. I dont have to tell most of you that. Getting reliable information is vital to our assessment and policy processes. This effort is absolutely crucial to understanding the challenges we face and knowing how we need to focus our efforts. Thanks go to all of the hardworking folks at samhsa for their dedication in producing the survey every year, and this year is no exception. To connie for her work as acting head of samhsa at the time of the survey, as well as to paolo del vecchio u just kind of like to say that name, dont you . [laughter] dr. Price the director of samhsas center for mental Health Services, daryl kade, the director of samhsas center of Behavioral Health statistics and theity, who oversees survey, and kimberly johnson, thdirector of Substance Abuse treatment area Substance Abuse treatment. To can i just give a special heartfelt thanks to the manual and esther and zach for participating and sharing their story and celebrating recovery month and sharing their personal experiences and struggle with Substance Abuse. The purpose of our work here today is to shed more sunlight on Public Health and the Public Health issues and challenges er reflection sobr and honest evaluation. When our team received this briefing earlier this year on was told it was the first time in years that the hhs secretary have received this briefing in person. Thats not because hhs secretaries dont receive data briefings all the time. It is because we are at the most difficult point in terms of this battle against addiction and drug abuse, and we, at hhs and the Trump Administration, have chosen to make this a priority. It reflects the urgency we have in two of our priority areas, the Opioid Crisis and severe Mental Illness. There are good news points that i would like to share. One is that the Opioid Crisis, the survey did not show that the opioid misuse or addiction has been taking up or is more common than in 2016. The problem is the number of opioid and Overdose Deaths continues to skyrocket. As all who toil in this area, you know well that the Opioid Crisis is a deeply collocated story. The fact that we are not seeing this scorer to a further is a sstament to the courge any further is a testament to the communities around our nation. But we have also heard of so much tragedy as well. The rates of addiction to heroin and misuse of prescription , andds are incredibly high the cost in terms of lives lost is still rapidly growing. Todays survey estimates that 548,000 American Adults use heroine 948,000 American Adults used heroin in the past year. It is significantly higher than the numbers gathered between 2002 and 2013. We see similar trends in the use of opioids, relatively stable now, but so much worse than it was a few years ago. And the situation is worsening significantly, thanks to the rising intensity and frequency of misuse and the emergence of illicitly used fentanyl and fentanyl analogues. The Opioid Crisis is taking a bigger toll on lives across our land. Each year, a new unprecedented total of lives lost. Or a government steps in 2015, and the numbers are no better in 2016, and they are certainly no better this year. That means we are losing a total of more individuals than were lost in the entire vietnam war. Yeare losing every single to drug overdose. Me, to unacceptable to the president , and to every skilled person in this room. To every Single Person in this room. Preliminary data suggest that the number is likely to exceed 60,000 Overdose Deaths in 2016, and the numbers, again, are no better. We have unveiled a new fivepoint strategy to tackle this comprehensively for the american people, on behalf of the american people, improving prevention treatment and recovery, including the full range of medication assisted treatment. The second is making sure that overdose reversing drugs are is omnipresent and available as possible. The third is strengthening our understanding of the crisis andeen Public Health data reporting. That includes things like support for state aid to work like the new grants the cdc put out this week. Fourth is providing support for cuttingedge research on pain and addiction and understanding it. Advancing the way in which we manage pain in this nation. One of the interesting aspects of the survey is that 2 3 of americans misusing opioids said they did so to treat physical pain. We need to offer those folks a better option, a nonopiate option to treating pain. Use and abuse is not the only serious Behavioral Health problem that we have facing america. Another one is one of our departments other priorities, and that is severe Mental Illness. The share of americans with severe Mental Illness, meaning americans with schizophrenia, bipolar disorder, and serious depression, has remained steady at around 4 of the population. One trend in the survey is that the range of americans aged 18 to 25 with a serious Mental Illness has continued to rise for the past couple of years, and this year exceeds the number of Older Americans for the first. Ime ever in taking the survey this is a disturbing trend and one we need to better understand. Again, the survey found that with 1 3 of americans severe Mental Illness received no treatment in the past year, a finding that has been steady for a number of years. We know how to treat these diseases. Failing to provide treatment is a serious indictment of our current policies. It would be like letting 1 3 of americans with cancer or diabetes go without treatment, something none of us would tolerate. The good news is that something can be done. Last week, aged just had the honor of holding the first meeting of the interdepartmental serious Mental Illness coordinating committee. Another committee, but another committee that for the first time is charged with making another report to congress on the just the challenge, but the kinds of solutions we are to be putting forward. To say that, from my standpoint after 12 years in congress and a short time in this position, we have a congress that appears to be receptive to the kinds of needs and resources necessary to make positive changes in the area of serious Mental Illness. There are three numbers i would like you to keep in mind when you are thinking about serious Mental Illness, and they are 10, 10, and 10. 10 million, 10 years, and 10 times. , as todaysmericans survey found, live with serious Mental Illness in any given year. 10 years. On average, they live lives 10 years shorter than the average american population, and some estimates show the gap to the greater. Times and 10 times. There are 10 times more americans with serious Mental Illness in prison and there are are in inpatient psychiatric facilities, a significant indictment. Health care for serious Mental Illness has not received the resources it has needed in the past, and we are intent on turning that around. Hhs and the Trump Administration are committed to tackling it and ensuring what we can do to make sure americans with serious Mental Illness get the treatment they need, and that their families and communities have the tools they need to make that happen. Todays report underscores the challenges we face, and you will hear about that with the upcoming speakers, with the Opioid Crisis and with serious Mental Illness. The good news is it is within our power to turn around these trends and turn these numbers in the right direction. Doing so will enable millions of americans to live longer lives ofn down with the kinds purpose and meaning endowed with the kind of purpose and meaning we all want. We are so blessed to have so many dedicated and talented folks getting us moving in the right direction, and i want to thank each and every one of them and each and everyone one of you for attending today, and for your interest and concern about these extremely important Public Health challenges. Thank you so much. God bless you. [applause] thank you so much, secretary price, for your leadership. It gives me great pleasure to introduce my next speaker, daryl kade. Daryl kade currently serves as the director of Behavioral Health statistics for samhsa within the u. S. Department of health and Human Services. It is the governments lead entity for Behavioral Health statistics. It provides National Leadership and Behavioral Health statistics in the beginning auntie in basiciology, and promotes and applied research and Statistical Methodology and carries out special Data Collection projects. Samhsasonsults secretary for Mental Health Substance Abuse. Please help me welcome barrel to the daryl to the podium. [applause] kade thank you, paolo del vecchio. The survey is an annual survey of the civilian noninstitutionalized population of the United States at age 12 years or older. Hundreds of field interviewers hold facetoface interviews with people throughout the country on sensitive issues. Support, this has been to continued to be the primary source of information on drug use, alcohol abuse, Substance Abuse disorders, and Mental Health issues. One of our strengths is the large nationally representative sample, which allows for the examination of subgroups such as adolescence. Theher strength is stability and the sample and survey design, which allows betiple years of data to combined to examine rare behaviors such as injection and drug use, and to attract and to track trends in those behaviors over time. However, new drugs are introduced into the market, and updates are needed to the questionnaire. To address this need, questions are periodically updated in the survey, which leads to a break in the ability to compare data. In 2015, a number of changes were made to the russian air and to the questionnaire and Data Collection procedures. These data improve the quality of the data collected. As a result, our 2016 first findings report, which is now available on our website, provides longterm trends for heroin use, such as depression, and Mental Health service use. However, it does not have longterm trends for pain relievers, methamphetamines, Substance Use disorders, and treatment. Forward to the 2018 and 2019 surveys, and having a full four years of data points to share with you in the near future that would reestablish trendlines in these areas. Thank you, and i turned the program back to dr. Mccancekatz. She will share major findings from the survey, which are particularly policyroman. Thank you. Policy relevant. Thank you. [applause] while i amkatz happy to have the opportunity to talk to you about the survey, let me just tell you a bit more about it. Every year, the National Survey sda,rug use and health, or n surveys americans about their use of substances and about their difficulties with symptoms of Mental Illness. I want to start by thanking big participants who shared their time with surveyors and at the current and honesty to share Sensitive Information and shed light on these important issues. You also for secretary price mention our leadership at samhsa. I also want to acknowledge our samhsa staff who worked very da every year, and who also work in communities and our state and stakeholders to improve the Behavioral Health of the nation. I do want to recognize all the samhsa. Ho work at i had the opportunity briefly to meet them one by one, and i have been very impressed. Nsda has been completed every year since 1990. We have lots of years of data. Even though the study was redesigned in 2015, there are a number of measures we were able to trend, and they do show. Onsistency from prior years for example, tobacco and alcohol use are trending downward by age group, and Prescription Drug misuse also appears to be modestly decreasing. There but there are also areas of nsduh, and i the bsdyg will share those areas. What we learned in 2016 is that 18. 3 of people over the age of 12 in the United States, or 44. 7 Million People, have Mental Illness, and 23 of those people ve a serious Mental Illness. When i say Mental Illness, i mean people that are diagnosed Mental Illness of such a severity that it impairs activity in their lives. We have another 20 Million People, or 7. 5 of the population, who meet diagnostic criteria for a Substance Abuse disorder, and when we look more closely at that data, we see that 37 of them struggled with illicit drugs, 75 struggle with alcohol, and 12 struggled with both illicit drugs and alcohol. When we look more closely at the illicit substances used by americans, we see that, by far and away, marijuana remains the most frequently used illicit substance in this country, at 13. 9 of our population. After that, psychotherapeutic drugs. Drugs is apeutic category of prescribed medications that have abuse liability. There are four categories of those psychotherapeutic drugs. What you will see in just a moment is that the opioid medications are the majority of the misused psychotherapeutic drugs. Heroin, 948,000 people, or 0. 4 of the population, are currently heroin users. Take a deep look at opioid used in the United States, we of people are continuing to misuse prescription pain relievers. 11. 8 Million People were opioid miss users. That is 4. 4 of our population. 11. 5 million were prescription opioid miss users. Thee look more closely at medications being used by people who engage in this behavior, we see that the majority are misusing hydrocodone, followed by oxycodone, and far fewer misuse prescribed formulations 248,000. Yl, at we see 948,000 heroin users, and 641,000 people report they have misused both heroin and prescription pain medications. But when we look at the adverse outcomes we are seeing from opioids, we can see it is not driven by increases in the numbers of users. What we have shown you here is sduh dataata nis that shows that heroin is flat. For prescription pain relievers, we have seen a small decline in the number of people who are misusing prescription pain relievers. We have about 2. 1 million americans who meet diagnostic criteria for opioid use meet s, and would would need treatment for those disorders. What you see on the right side of the slide is that only 21 obtain treatment for their opioid use disorder. Of those 21 , 37. 5 of people who are heroin users got treatment, versus only 17. 5 of people who were prescription pain reliever addicted. Because is important the other thing we are seeing is the large, stunning increase in deaths related to heroin use. What i am showing you here is tells us that in 2002, we had 4004000 americans that were here 404,000 americans that were heroin users. By 20, that number increases to over 900,000. We see that in 2002, we have just over 2000 deaths, but by 2016, this is estimated data from cdc it looks like they are going to tell us 13,219 abuse. Died of heroin a 230 increase in heroin users over that 2000 22016 time. Over that time. Then, a 600 increase in deaths. Over that time period, a 600 increase in deaths. This underscores the need that we give access to treatment and get people the prescription services, the Treatment Services, and the Recovery Services they need. Fewnow i want to take a minutes to talk about another finding that is very concerning from the National Survey on drug theand health, and that is prevalence of serious Mental Illness in young adults, what what we call transitional age youth age 18 to 8 hadd in 2008, 3. Serious mental on this, but that has risen in 2016 to 5. 9 serious Mental Illness, but that has risen in 2016 to 5. 9 . Just over half of these young adults were able to access treatment. 2 Million People, and just a little over half of them were able to access treatment for their serious Mental Illness. These are the most serious disorders, the ones that affect ones ability to function. Just over half of people in these age groups were able to access the care they needed. Has big consequences, because when people have serious mental disorders, they will have increases in adverse consequences such as suicidality. What we see in the National Survey on drug use and health is, in this age group, the 18 to 25yearolds, we see a significant increase in serious thoughts of suicide, a significant increase of people making a plan to commit suicide, and a statistically significant increase in the number of people who attempted suicide. Why is this happening . The National Survey on drug use and health is a National Survey. We cannot say why this is happening, but one thing we can glean from the survey is that we thatlarge numbers of youth are using illicit substances, 8 million 18 to 25 girls 18 to 25yearolds, 23 of the population. 30 of individuals in that age group engage in engine alcohol use. What i mean is if you are a man, you drink five or more drinks in a session, and if you are a woman, you drink four or more drinks. And 10 of the sage group are what we do of this age group are what we define as heavy alcohol users, people with five or more binges a month. Why is that important . Because we know that Substance Abuse and addiction is highly coordinated with Mental Illness, and we know that these disorders frequently occur. While we dont know for sure that this is what is driving it deservesses, consideration. And we see that for all age groups and individuals with both Substance Use and mental disorders, it is difficult for them to access treatment. We have to do better. This is data that tells us that we are not getting the job done for the people of america. We see that if you have a Substance Use disorder, only 7 of people got Specialty Care that they needed. If you had any mental disorder,. 7 did not receive treatment similar findings for people with cooccurring disorders, for people with serious Mental Illness, as secretary price mentioned, 35 get no treatment. These are people who are terribly impaired by Mental Illness. We have to do better. That are age 12 to 17, we see significant rates of major depression, and 59 of them got no treatment. We use this data to help us plan or programs, and we will be taking a close look at samhsa a close look at this at samhsa. Our chief medical officer is already looking at what we can do for transitional age youth. That is something we can work on over the next be in months, and we will make something public about what we might be able to do to better help americans suffering th theseisorders in that age group and overall. We are very fortunate that appropriationsed in the 21st century cures act that samhsa has gotten out to the states and communities, and we are in the process of ramping up treatment for opioid use disorders. We are also using significant amounts of that funding for prevention interventions and Recovery Services. If you know someone who is a heroin user or you are someone who has a problem, please look to your community for help. We will provide those resources and continue to do what we need to do to help americans with mental and Substance Abuse disorders. A few for your attention, and i will now move to introduce to baum, the acting director of ondcp. They lead and coordinate the development and implementation anassessment of u. S. Drug holocene. Richard baum was named by President Trump as the director in march of 2017. Has dedicated his career to drug and crime policy issues, having served in ars capacities at ondcp for 10 decades. Had the pleasure of working with mr. Baum in the brief period i have worked with m at samhsa. Please welcome richard bomb. Richard baum. [applause]. Baum thank you very much for the kind words. And thank you for all your work. N this survey we could make policy on these important issues without that. This investment is really critical to all the work we do, and we have to keep that going so we can make informed policy decisions. I am going to focus on the drug part of the story, the current overview of all the data, and some of it is concerning, particularly related to marijuana, opioids, and cocaine. The me see that marijuana use has jumped again, and that is a real concern let me say that marijuana use has jumped again, and that is a real concern. In the past month, marijuana use among 18 to 25, this is the highest using cohort it is 20. 8 that reported past month marijuana use. That is the highest rate ever and the past 15 years, yeartoyear changes are modest, but the direction is clear. The good news is, for younger americans, those in the 12 to 17 cohort, their level of marijuana use has not really been increasing. In fact, it is down a little bit. That is wonderful, that todays young people are resisting the pressure to use marijuana, despite all the misinformation about marijuana and all the pressures they face in their young lives. Marijuana really is a concern, and we worry about all the different age cohorts and their use. The futureing survey, which focuses eighth, 10th, and 12 graders, that comes outn december, and we all wi we will also get the statebystate data so we can compare with samhsa, and tt will help take a look at the variation among states. There are some clouds on the. Orizon perception of risk of marijuana has been gradually declining over the past five years, and exposure to Substance Use prevention messages also is , and making sure we have a constent prevention messages critical for our overall efforts and longterm approach on the drug problem. Let me say a few more words about opioids. The survey shows that opioid use but datad flat 2015, from cdc indicates that opioid related Overdose Deaths continue to climb. On one hand, we are making some progress in addressing the epidemic, but has has been the legity of these opioids is very serious, leading to more and more opioid overdoses. What is in todays drug supply is really terrifying, because many of the other drugs also have sent in them. Fentanyl in them. People really dont know the tremdous risk they face when they try a drug or by a drug on the street. We are also seeing counterfeit fentanyl pills that actually have a logo of the manufacturing pill on them, so if you go on the street to bu medication that was previously prescribed to you, it can be deadly, so it is a tremendous risk. Let me turn to cocaine, because really todays surveyhows a growing problem with cocaine in the United States. In 2016, we saw the highest level of past yearocaine use since 2002. The number of past month cocaine users jumped 26 over 2014 levels. A number that we watched very carefully, past year initiation of these substances, is really showing a big jump with cocaine. Past year cocaine and initiates of 2016, americans who tried cocaine for the first time, reached 1. 1 million, a 15 year 2013. 40 more than more americans are seeing cocaine and more americans are trying it. There is little doubt we are seeing this increase in cocaine because of the increased supply coming out of columbia. Colombia produces over 90 of the cocaine consumed in the United States, and production is at record levels. In fact, columbias cocaine production has tripled in the past four years. The wave of cocaine entering columbia from the United States poses a serious threat to our communities. Just to give a number on the production side, colombian cocaine production went from an up toted 235 metric tons 710 metric tons in 2016. 2016. 2013, 710 in that is a real concern. While it is critical that we work and are working on the ioid epidemic, we have to head off at could be called what could become a cocaine epidemic before it takes rt. We are already seeing an increase in Overdose Deaths related to cocaine. A 52 increase since015, and again, that is from the preliminary report. Related000 cocaine fatalities, the highest ever recorded in a single year. It is important to point out that a lot of these fatalities are also related to fentanyl. It is really a concerning number. This is a multifaceted problem that we have to focu on, really the whole poly drug problem the country faces. A lot of the people that are dying from opioids have other drugs in their system as well, when you look at the toxicology reports. Secretary priceaid the president and the administration are working hard to address these threats, including sending funding to the states to address the Opioid Epidemic at a local level. We are looking at ways to target federal prevention efforts going forward. The president s commission on combating drug addition and the Opioid Crisis is working on ways to address the epidemic going forward. We get our final report at the end of october. And we are working to stop the flow of these dangerous drugs at the border, by sea, and by mail. We are working hd to face all the drug threats that face the country, and we are happy to have federal partners working on this. Let talk a bit about recovery. If you asked anyone onstage today, they would agree that recovery is a key part of the solution to this problem. [applause] there are millions of people in recovery today, and they are everywhere, all over the country. They are in your workplace, your schools, your community, your faith community. Look around. They are all among us. The journey may have been through to reclaim their lives has been an incredible compliment, and it is encouraging that they are sharing her story. And they are a critical part of the solution. Some of them are getti trained to be recovery coaches, and others are sharing their story to take those difficult first steps into recovery. Path to no one recovery, because everyone is different. It does not matter how they get there, as long as they get their. It just matters that they have the tools they need. I can tell you that President Trump strongly supports people in recovery. [applause] dir. Baum he has designated ptember as national he wrote the following, solving our drug and alcohol problem requires a strong Public Health response and a strong Public Safety response. During alcohol and Drug Addiction Recovery Month throughout the year, let us remember those whoave briefly conquered their addiction. We also pray for those currently suffering. Tha the let us also family members, friends, and Health Care Providers who provide muchneeded assistance and love to support americans in recovery. President understands the problem, and the whole team and the administration are working together to do everything we can to make re that people in covery get the help they need. We know that people in recovery need sober housing and a place to live, and they need jobs. I will just say that we have people in recovery at our office. We work sidebyside with them. People in recovery me great employees. They deserve a chance. [cheers and applause] dir. Baum so, we will be working t just the rest of the month, but yearround, to get themessage out about incredible Recovery Movement in this country, and talking about what we can do to support the inedible progress already happening. Thank you much. Real pleasure. [applause] mr. Del vecchio thankou so much, acting director baum. Well done. It is a pleasure to have you with us today. Noted in my opening comments, i am in individual recovery from Mental Health and addiction issues. Throughout my personal journey, i am reminded that people like me can and do improve and can and do recover. Yet [applause] mr. Del vecchio mr. Del vecchio mr. Del vecchio yet too many amicans are not getting the mental Health Services they need to reclaim their lives. As assisnt secretary 50 ofkatz said, nrly americans went without the services they needed last year. 35 of alts with serious Mental Illness went without the mental Health Services they needed, and over half of adolescence with major depressive issues went about treatment for depression. Mentalates of serious almost are increasing among young adults, major depressive deficits are increasing among adul and adolescents, we need to learn whats driving this trend. We need to connue ways to explore intervening earlier. I do believe that we can benefit more from closely concerning the play,hat one factoroes and i see a lot of folks here with these. The role that social media may pl in terms of helping influencing those of us with Mental Illness to discuss our symptoms were openly, perhaps being more willing and able to self identify and seek support. Also, others have raised , the social media restrict interpersonal social connection that is also a positive protection factor around these issues . We also need to make sure there is improved and adequate access. At samhsa, we are working hard a improve access to care for number of initiatives, including childrens Mental Health , working with the National Institute of Mental Health. In thehe increase percentage of young adults with seris increase in Mental Illness, we need to with serious Mental Illness, we need in collaborative guidance with shared responsibility with our many partners. Thats why it is encouraging, as the newe noted, about committee that just held its inaugural meeting one week ago today, bringing together not just hhs, but 10 other federal departments to the table with National Experts to focus on solutions. Early engagement in care, care,sing the quality of and expanding communitybased supports are all in focus and within reach. Samhsa has collarated extensively with our colleagues on new programs, addressing First Episode psychosis. As noted in the last three years, we have stood up 228 First Episode psychosis programs around the country. We work closely with our colleagues at the centers for medicare and medicaid services, have collaborated with our colleagues at the department of theice and others to expand assistant outpatnt Treatment Services as well. Potentially, integrated care remas a critical component in improving outcomes for those with Behavioral Health conditions. Family suprt and Greater Community awareness of sues remain keys of focus in better serving individuals trying to sustain recovery before i introduce this years cma this years recovery speakers, i close with my remarks thatoming his world icide prevention day. The World Health Organization estimates that every year, more than 800,000 people across the globe die by suicide. Up to 25 times as many make suicide attempt. Behind these statistics are the individual stories of those who have, for many different reasons, tragically questioned the value of their own lives. Each one of these individuals is part of our community. Some may be well linked, had networks of Family Friends and work colleagues, schoolmates, others may be less wellconnected. Some may be quite isolated. The circumstances, communities have an importt role to play in supporting those who are vulnerable. This years theme for World Suicide Prevention Day is take a minute, chge a life. Of the communities, it is our responsibility to look out for those who are struggling , check in with them, encourage them to get the help they need. Word of a general support and listening in a nonjudgmental way cap take all the difference. Can makall the difference. If we learned from assistant secretary mccancekatz that lands,es of suicide thoughts, and attempts continued toise, particularly for young people. Suicide is an important Public Health problem in the United States, and a tragedy for all of all involved. According to data from cdc, approximately 100 people each day die from suicide in the u. S. Recovery month reminds us that. Here is hope through evidencebased treatment and services, there will continue to be hope for a better tomorrow for the millions of americans who express Behavioral Health conditions. Next, i amonored to introduce you to emmanuel ford, who will be father who will be followed by his mother and caregiver, as eir ford. Emmanuel is a remarkable young man from washington, d. C. D. C. Publicended schools, graduated from the Columbia Heights educational campus. He is a survivor of Adverse Childhood Experiences and suffered from posttraumatic stress disorder, depression, as well as suicidal ideation. He uses his experience and knowledge of integrated systems and care to help other youth achieve success. Passion has found his in assisting others and investing in their Mental Health. He is now a certified youth peer specialist, and a leading advocate for young adults in the city. His efforts began by participating in the Youth Action Research group, whose goal was to identify causes that are meaningful to young people to bring about change in the distri. He also joined the ymca youth and Government Program to create policies that will positively impact the nations capital. In 2016, he implemented a Summer Program for transional youth called yield, Youth Institute for empowering, learning, development, a true leader. Pursuing aly degree in anthropology to better understand the w individuals behave and interact with other cultures. Please join me in welcoming emmanuel. [applause] emanuel thank you very much. Good morning. Good morning anuel i would like to thank samhsa for inviting me here today to share my recover journey. I have never in my life experienced what someone call a normal life. I always knew there was Something Different about me for as long as i can remember. What most people think about households for a child, they think abt having a mother and father, to people i have never had growing up. At the age oseven, my life took a drastic turn. I had to move to one of the worst neighborhoods in the city. I was placed in a home that i thought would be peaceful and loving. Instead it was the opposite. I was abused mentally, physically, and emotionally. The ddest part is i did not tell us all. I suffered every day for most of my childhood in solace. I was taunted by peers for any reason. I did not have a stable home, i had no food, or my biogical parents were not around. I isolated myself and did not let people into my life because i did not trust anyone. As i got older, i thought things would change. I thought the old emerys would nobe an issue for me when i became an adult. Little did i know that theest of my childhood would forever be a part of me. As i got older, i became more angry, more emotional, and unproductive at school. I knew something was not right, but i did notrust people, so i would not find out. I s afraid to be different from most young adults my age. I was afraid of becoming unloved. I hate everything with a slot. Id everying with a smile i withdrew and began using drugs. Negatively about things and dismissed complements stormy as untrue. I left no room for positivity my life, and i resorted to eating to cope with my feeling. I did not see the point of living at all. After one of the lowest points in my life, i was grateful to know i was not alone. The reason i say grateful is becae i needed someone to identify with. I needed to see someone in recovery, too. Th person was my mom, who had a Substance Abuse disorder. After the problems she experienced, that prompted me to seek help for myself and start my own recovery journey. I had the hardest things to do was look in a mirror and acknowledge that my lifeas out of control. Need thisme of you advice. For me to admit that something was wrong was extremely difficult. Gets up, take h medication, and participate in therapy. I saher change, and i wanted to become a part of that, so i put on my big boy pants and started seeing a therapist. After speaking to a therapisti learned i was dealing with ptsd from a childhood and facing anxiety and depssion. Due to the stigma surrounding Behavioral Health issues, i hit my diaosis because i did not think people would understand, but once i realized my peers were suffering too, i had to share my recovery story. To help you avoid facing the same hardships i have experienced it because i didnt know about my Mental Health, and the importance of minding my menl health. Today, i stand before you as a survivor in recovery. Thank you. Thank you very much. And now, i would like to introduc one of e most important people in the world i may be a little biased. Powerful ande most fearless and beautiful women i havever had the in counter of living with my mother. [applause] good morning. I am the proud mother and also want to say thk you. Samhsa has been so supportive. So i have three beautiful children as apparently wanted to provide a safe and stable environment for my children. Instead i abandon them leaving them to raise themselves and sadly, they are all victims of my experience. Periodically, i would return home, saying that everything would be ok. Without any notice, they would wake up and i would begun. It wasnt until years later that they shared with me that they never gave up hope that one day i woulreturn for good. And in and out of prison, i was finally in front of a judge who rognized my behavior. He ordered me into tatment. There that i received my diagnosis. Wasund out tt i fourthyear generation of mentally notice Mental Illness. I was told with medication, peers support and therapy that i could finally live a life of recovery from my Mental Illness and Substance Abuse disorder. At the treatment, i was able to elpport a manual emmanu with his challenges. He needed a parental fure with his life. He was highly able to open up and share, that every time i left, i took a part of him with me. One of my first steps toward supporting him throughis recovery was allowing him and his siblings to share with me how my negative behavior pacted their lives needless to say, it was the hardest thing i ever did. I knew they needed to share that with me. Who told me how he was affected. I got mad and wanted to know why this was happening. I enrolled in college. [laughter] [applause] it was there that i lened trauma care and learned techniques and tools of wellness. I was so excited. I would come home and share it. He began to apply the tools that i shared with him to his life and it helped him with his healing process. Continues to use those tools to maintain his overall wellness. One of my greatest achievement in life is that today i have a wonderful relationship with all of my children. I have the opportunity to see him through his journey. I have been in recovery for all lost 11 years. [cheers and applause] i have watched him grointo a responsible and positive male figure, an advocate for change. Not just for oneself, but feathers. I continue to support him as he continues to be an example of support and recovery. For use and our community. Thank you. [applause] youth and our community. Ank you. [applause] outstanding. Your stories are a testament to the strength and resiliency of individuals who experience Mental Health and addiction. I have the honor of introducing you to dr. Ken johnson. He leaves the centers activities to promote highquality aected Substance Abuse treatment and recovery seices. Her extensive experience in treatment and educator and contributions to the health field ensures that the centers sograms support samsha mission. Please join me in welcoming dr. Kym johnson. Quite you all get to catch your breath after that story. Now i have to talk. To express our gratitude to you, your crucial support in evidencebased proams and practices that save lives improve public self Public Health and safety. Colleaguecall out my fran harding. The data that we ha on alcohol, the reduction of alcohol use, tobacco use, marijuana use, it is not a magic thing that happens. It is because of the hard work of the leadership in that community. Thank you. [applause] for millions of voices raised across the country, we know that Substance Abuse disorrs are among the tghest as they tear apart over families and communities. I want to begin by quoting two of my fellow mainers. People recover every day. They get well and they go on to do incredible things in our communities. The power of possibility of people in recovery is a myth. Is immense. At collective belief in the power possibility is fundamental to our success, including our couryss success success in addressing the health issues. We have come together to conquer challenges. As data from Scientific Research continues to identify the biological, psychosocial, and environmental factors, we already have sufficient data to help shape our response to our current crises. Is causedat addiction by accommodation of properties of the drug, exposure, dose and duration, and indidual factors relad to genetics, early exposure and in by mental risk. , the physicale and Emotional Trauma can contribute to the disease progression. We know that scientifically validated medications ar necessary in sustaible recovery pen and bavioral intervention, including things like cognitive behavioral therapies, motivational incentives and recovery coaching can improve outcomes. We know that medications can reduce overdoses and save lives. We dont know yet, but we are learning that programs like anchor more and anchor ed in rhode island and the safe Stations Program in maryland are anding us to reach out engage peopl in care early on before they have to overdose. Goodies fory over two decades, the center has played a vital role in the sustained treatment for americans o are now living healthy and productive lives, supporting their families, builng the communities, and contributed to the wellbeing of our whole couny. Andrams are Community Based the focus is competence of Substance Abuse screening and intervention and recery services for all people and improving the quality of care. In collaboration with the center, and substae abuse with the mental Health Services to cover Mental Illness. Such as hiv and hepatitis. In 2016, legislation coupled with state leadership contributed in the opioid disorder crisis. It includes the rapid growth in the number of Healthcare Providers that can treat opioi abuse disorders with medication through our intensive training and certification processes. Population targeted efforts, like our expansion of programs from for pregnant and , response withn datadriven, targeted response with populations with the greatest unmet needs. Performance Outcome Measures indicate programs are improving health, public sety and social outcomes. They are increasing access to housing, employment and the lives of people with Substance Abuse disorders. Still, we remain acutely aware of how much we have yet to accomplish. With this in mind, it has investigated to benchmark motor the datadriven programs. The framework has been used in success in other national and international programs. Were working with public and private partners to advance and accelerate our efforts to reduce Substance Abuse disorders across the countr has reinforced and expanded our understanding that the key foci of our Public Health efforts must be in early and encumbrances screening, engageme in treatment for fore in worth disorders those with disorders. So now, you had a moment to catch your breath. Introducerivilege to mr. Zachary talbot. A noalbot has faced disorder while he s in grad school. He is paying for the support and assistance he has received on ma fronts. He has opened to opioid Treatment Programs in georgia d north carolina. He currently serves on the credentialing committee and bordering boarding directors and the board of directors of the Southeastern Institute on chemical dependency. Mr. Talbot, your Proof Positive that people recover and do incredible things in their communities. Yourou so much hein aatn yfos amie to prevent and overcome these Chronic Health conditions. [applause] hello, my name is zach talbot. As Program Georgia director of an opioid Treatment Program. I was born in knoxville, tennessee in eastern tennessee and grew up in a small, southern anymore so small about 30 minutes south of knoxville in an affluent community. I came from an upper middleclass, churchgoing family. We prioritized family, faith, and education. I went on to graduate with my bachelors degree from the university of tennessee in. Noxville during my time as a graduate student in the social work program, ironically enough, i was prescribed opioid pain kneeations for some minor and back pains. It was as if i had never lived before. Something almost immediately changed in me and a dependence turned addiction to opioids began to engulf my life. Not long before i was academically dismissed, i was a user. R, daily, iv heroin i can vividly recall going into the bathroom in graduate school and shooting up in between classes to ward off withdrawal symptoms. For a long time, prior to my academic dismissal that led to a downward spiral, i was a high functioning addict. I wasnt one of them. I came from a good family, from good southern stock, they would say. We were people of faith, Community Leaders and role models. But i am here to tell you today that opioid addiction does not discriminate and knows no byndaries by class or race, gender or sexual orientation, by religion or level of education. Not even a half decade into the new millennium, i was living in hellalth that began in a that began in aprilinduced heaven. Hell that began in a pillinduced heaven. Being a graduate student never really truly left me. Of basic andred tired, i began to research my best chance of success. I would to credible sources, something been into me during my time in college, to see what i should do if and when i was ready. I kept coming back over and over to this thing called medicationassisted treatment. Like some in the other people, at the time, i was hesitant, thinking i would be trading the witch for the devil or potentially leave potentially ending up in a worse addiction. But i was desperate. So i called the Opioid Treatment Centers near me only to find there was a wait list. I drove two hours in one direction and enrolled in a Treatment Program in georgia. It was the best decision i ever made. I found i was not only stabilized with a medication that allowed me to live a normal life again, allowed me to rake those chains and that cycle of living to avoid withdrawals, but i was met with compassionate Treatment Professionals and that counseling was an even more important priority than the medication i was receiving. Backld zach quickly came and i once against or to dreaming again and reevaluating my life goals. I stopped living to avoid withdrawals. I was breaking the chains that had bound me. They, you are looking at true face of medicationassisted having become medicationassisted recovery. [applause] i did not trade one addiction for another, of but i traded dysfunction first ability and misery for hope. I got my life back. I became involved in Patient Advocacy in treatment. The zach that was a graduate student in critical social work was back. Opioidsince opened two. Reatment programs i have studied and worked to drugve certification as a and alcohol abuse counselor. All the work i am now doing was made possible because of metafiction medicationassisted treatment. Methadone combined with quality life. Ling saved my since those early days in maintenance treatment, i am someone who has been able to slowly taper down my dosage while working on relapse prevention and coping skills and counseling. But i recognize that is not possible for everyone. Just like any other chronic disease, like diabetes or hypertension, different people need different amounts of medication for different periods of time. Medication. Definite and that is ok. [applause] what matters is someones life and their quality of life, not whether or not they happen to take a legal medication or for how long they might need to take it. During this only. During this Opioid Crisis, we have the obligation to offer all options, be they abstinencebased or the use of medications, inhouse or outpatient, shortterm or extending for months or years or even indefinitely. We have to support all the medications at our disposal to combat the so beard crisis. Combat this Opioid Crisis. We must support the use of naloxone for overdose reversal, so people like me can stay alive long enough until we get the help, the evidencebased help that we need. We have to train first responders, teachers, counselors, and family and friends of those who are at risk of opioid addiction had to use naloxone. And we have to recognize that some people need more than one dose. And for some people, it will take more than one overdose before they are ready for treatment. We have to be ok with that and do what is necessary to keep people alive while supporting treatments proven by Research Going toce if we are turn this ob or crisis around. I am living proof there is hope after opioid addiction. You are looking at the true face of this epidemic, the true face of one of the lucky ones who happened to stumble into a Treatment Center that prioritized signs and research over stigma and fear. Along with of that, my own dedication to the hard work of recovery, i am here to speak with you today. My recovery means everything to me. Recovery, i likely would not have my life. Myersonally want to extend heartfelt thanks to all of our leaders who are here today. And to President Trump for his convening the Opioid Commission as they continue working to bring to the publics eye help and help get it will take all of us working together to turn this epidemic around. Thank you. [applause] thank you so much, zach. Fortunate for you sharing your remarkable journey, your recovery with us, for your advocacy efforts, for your giving back to the communities, and also being a social worker. [laughter] before i open the floor to questions, i want to ask that we thank all of our speakers one more time. Please join me in a round of applause. [applause] we are going to move to questions. Credentialed with press. Seeing none from media, i will open the floor to see if there are others. Yes, maam. First of all, i wanted to to everyoneratitude who shared. One of the things we have been concerned about is we are talking a lot about the Opioid Crisis, rightfully so. I am appreciative. Balms comments. There is it must talk about alcohol. Im curious as to what the panel thinks as to alcohols role in his current epidemic. So alcohol is our biggest drug of abuse. If you look at how many people and if you look at deaths is stillo alcohol, it higher than Overdose Deaths, if you include all the deaths. We know that is a critical issue. We know we have done a really good job with adolescents. What we are seeing is young adults starting and they start pretty heavily. That is the target we have to do about prevention. Ist particular age group highest users for everything. We need to do more targeting and treatment for that age group. A lot of times, they dont think they have a problem. They are in a social environment where the use is the norm. We have to address that. Powell. Me is joe i am a young person in longterm recovery. [laughter] my question again this year, thereike last year, house been any progress on Data Recovery in the survey . Im glad you asked that. We just received omb clearance to add recovery questions to our 2018 survey. [applause] it is a start and we are looking forward to the data. Yes, sir. My name is ryan hampton, a person in longterm recovery. Thank you for your upbeat recognition of recovery during your remarks. Need to do isp challenge the barriers, housing, education, employment. Why in the interim report from the Opioid Commission that your offices staffing, why did it fail to mention the importance of recovery in solving the crisis . We have to fund and not just talk about the entire continuum, which includes Recovery Support services. Thank you. Thank you for the question and your kind comments. Let me answer the question directly. Enter a report that just came out a few weeks ago is only the very first piece of what the commission is working on. They are planning a ,omprehensive final report probably out at the end of october. I am confident it will include Strong Language and recommendations related to recovery. Dcp, we aref on committed to addressing and removing obstacles to full recovery to the millions of americans who are trying to get their lives back. Peopleid in my remarks, in recovery are doing what we want them to do. They are going through treatment. They are reclaiming their lives. So when people have taken these really difficult steps and changed their lives, we have to make it easier for them, not harder for them. Understand. We have had an awful lot of conversations about employment and the challenges that people face in the active use of using drugs. These obstacles should be removed. We want people back in the workplace. We want them back in the community. And we are committed to understand those obstacles and would ask rachel to try to understand the obstacles, the laws, the regulations, state and federal, that we can address. Because we are with you 100 . My name is Lauren Mcneil come a person in longterm recovery and i am from new york state. I would like to say for salah that this has been powerful today. Everyone who spoke has been so, so powerful. There is a story in the data, which i appreciated so much. When we look at young people in the numbers of young people that i thoughtijuana the ford family was excellent because they talked about things that are related to asus. If we look at what we have done around cigarettes, i think we really have to look at prevention and getting the message out just getting the of asis, how it is connected to longterm outcomes. When we look at cigarettes, look at what is happening with that, the number of people that are not smoking now, i think there is a lot that we can do with that. If we are going to turn this around, we have to focus. It is wonderful for treatment. But we have to focus on having we have to put ourselves out of business, as we used to say. [laughter] thank you. [applause] please. E front, my name is George Otoole from her ride on from rhode island. My question is this. People coming out of incarceration with Substance Abuse disorders and the lack of programs for reintegration is a problem in this country. I know we deal with it in rhode island. Is there anything we can do as a Community Around the country to come together and try to provide the services that are desperately needed, housing. How to balance a checkbook. I spent 20 years of my life and cars rated. When i came out of incarceration, i finally found recovery. Had support. Who many people dont have that support. I going to the prisons today and try to bring hope of recovery to these people. Im allowed into the same prison i spent 20 years of my life in and i bring hope to these people and try to show them ways. The problem is, when they leave incarceration, there is nothing there for them. There is nothing. And there is nothing but stigma. This is where we need to come together. I am a manager of a program called anchor ed. I provide. Recovery support services in all rhode island Emergency Rooms for anyone who comes in for opioid overdose. But the great number of people that are coming in that we see are for alcohol use its incredible. Last week alone, my recovery coaches responded to 111 calls in the Emergency Rooms in rhode island Emergency Rooms in rhode island. I think it was 69 of them were on call responses. That really needs to get some attention as well. George, can i respond to you . Commissioner for returning citizen affairs. First of all, we are aware that there is a disconnection. The sea and our organization and the mayor and the commissioners that work with reentry, we are trying to bridge the gap for Behavioral Health. Judge did not realize that i had that problem and new with the behavior was, we came up with a program. We are trying to create something where we can talk about when they get diagnosed in jail its ok and you how you need support on you come home. I worked in a gel for a couple of years here in d. C. They are diagnosed. But when they leave, there is a disconnection. We are try to bring the peer mentor program. So when they come out, they have a network and support you in and its ok to take medication. Medication cap me out of jail medication kept me out of jail. George and i have worked together. I am from rhode island as well. Ofas the medical director the State Hospital in rhode island for a couple of years. Saw. S what i not a single admission to the rhode island State Hospital for people with severe mental occurred except for people that had criminal charges, people that were coming to us from jails, sometimes even from prison for assessment, competency evaluation and treatment. Thats just wrong. Thats just wrong. And having observed that, one of the things that will be a will be tor samhsa work, to do exactly what you are talking about, george, to make those connections for people. What i would like to see his programs that help us divert people away from the Justice System and get them the care and Recovery Services that they need. [applause] we at samhsa, one of the first things i was given the opportunity to do was give recommendations about our 2019 budget. I recommended increases to our justice and juvenile justice intervention programs, significant increases and funding, so we will have more programs through the country that will help us to understand better how to help people and to get and disseminate that information out to states and so they can get that information to their people and get programs in place and help people. We will have more for more resources to help with Assertive Community Treatment Programs, to help people stay away from the Justice System. And we will be providing more , toices, working with cms collaboratively provide services, people coming out so they can get the resources they need. One of the things that the assistant secretary requires is that we, for the first time, congress has said the assistant secretary must work with other agencies. Mentionedretary price answer part interdepartmental committee. Ther and education and that eight and the dod the v. A. And the dod. So we look at our programs and see how we can better help people. Thanks for asking, george. [applause] we have time only for one more question. Jason robertson in los angeles. I want to thank everybody, especially the fords and mr. Talbot, for your individual stories. Thank you samhsa. The selfhelpe, and Recovery Exchange in los angeles. One of the things you mentioned was evps . Selfhelp support groups are an evidencebased practice that are greatly underutilized by our systems of care. When we talk about how to use evps, is there an effort to increase our connection for systems of care with selfhelp support groups that are based . Ty second, in l. A. County, we had a great difficulty with rolling out evps. One of the things that happened is a vps became Profit Centers for large agencies and became incredibly expensive to rollout and difficult to adhere to fidelity as more people were using them. So how do we address those things . Thank you for that question. It is a tall order. Evidencebased practices, we have the information that we need. We know what we need to do. Too often, they are not used by many types of programs. That we canhings is within federal agencies, to provide some oversight and guidance to states and communities about evidencebased practices and how they need to be used. One of the other things that we need to do is we need to work with our insurers so they understand what our evidencebased practices within Behavioral Health and pay for this treatments. [applause] if you can get paid for what you are doing, you dont do it. So we will be working with cms. And we will be working with insurers to make them better aware of the evidencebased and what is called parity. Are people who have Behavioral Health issues are entitled to the same types of treatments they would get worried a medical illness. Behavioral health is different from physical illnesses. So one of our jobs is to make it clear what that evidencebased is and that parity requires the fees and services be compensated so people can get the care they need. [applause] thank you all for joining today. I want to say special thank you to all the staff who but this event together. [applause] you tolose, i want invite a want to invite you to visit samhsa. Gov. You will find access to all of our data resources, educational resources, outreach material, information about treatment, treatment locations as well as crisis hotline. That concludes todays press event. Thank you for joining us. Thank you for your passion, your energy. Happy recovery month. [applause] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap. Org] which is responsible for its caption content and accuracy. Visit ncicap. Org] tonight on qnb, founder and ceo of open the books on how taxpayers dollars are spent and the need for government transparency. Veterans affairs, we audited their check books for the past for years the past four years. Died waitingterans to see a doctor. V. A. Had 20 haverford 20foot Christmas Trees costing as much as a car. Sculptures for 700,000. V. A. Center in a that serves blind veterans. This is the type of waste that is in our government. Tonight at 8 00 eastern on cspans q and a. And johnjohn Kasich Hickenlooper outline their proposal to fix the nations system. Are this event was cohosted by the American Enterprise institute and center for american progress. It also includes policy experts who talk about ways to stabilize the individual health insurance