James S. Brady Press Briefing Room
10:15 A.M. EST
MS. CONWAY: Good morning. Thank you for being here. We come before you bearing good news. For the first time in four years, life expectancy in the United States of America has increased. And for the first time in 29 years, the number of drug overdose deaths has decreased.
This has not happened through coincidence. It’s happened through causation. It’s owing in large part to a whole-of-government approach to treat the whole person, led by President Trump, First Lady Melania Trump, and really, the entire administration.
Nearly 70,000 of our fellow Americans died from an overdose last year, and 48,000 of those involved opioids. About 70 percent of those deaths also involved some type of synthetic opioid, most prominently fentanyl, which could be an instant killer. A couple of tiny grains are a lethal dose.
We’ve met with first responders, parents who have lost children, people in recovery, people who are running recovery centers. We’ve met with mothers whose babies were born chemically dependent. And we certainly have met with health professionals. All of them have shared stories of loss but, increasingly, of courage and recovery.
This is a crisis that we call the “crisis next door,” because we want people to know, from the beginning, that the silence and stigma that it tends to — many people, it prevents them from seeking out the kind of treatment and help that is available to them is a very big priority for us — busting through that stigma and silence.
We also want to make clear, in this crisis next door, that it is indiscriminate. It affects all races, socioeconomic status, gender, age, and certainly other affiliations. If the crisis is indiscriminate, then the response must be indiscriminate.
And that’s why, in addition to everything that the President and the First Lady and the administration have done, I wanted to share with you, as a reflection, what I consider to be the most robust and significant bipartisan accomplishment of the President’s first term: H.R.6, the SUPPORT Act. The President signed it into law following overwhelmingly unanimous support from every Democrat who voted for it in the House and the Senate. This overwhelmingly bipartisan action has led to an increase in the money and awareness on the opioid and poly-drug crisis.
Features of the SUPPORT Act include the CRIB Act, where there is more money and more action for those neonatal abstinence syndrome babies that I mentioned before. Medical professionals tell us it’s best to keep the mother — it’s best for the mother and it’s best for the baby to keep them together. And, increasingly, that is happening.
Also, the nearly $3.7 billion in new grants put forth by the administration have made a real difference in our municipalities. The STOP Act has helped us increase the number of seizures of fentanyl and other synthetic opiates coming through our mail. It’s up to about 38 percent, and we have a goal, if not a mandate, of 100 percent.
Let me go through a couple of the numbers: 4.1 percent overdose death decline overall in our nation. And that is the first time in 29 years — nearly three decades. But in some of the hardest-hit states, we’re off a peak of over 20 percent: 19 percent in Pennsylvania, 22 percent decline over the peak high in Ohio, 11 percent in West Virginia, 14 percent in Minnesota, 7 percent in North Carolina — just to highlight a few of them. Also, the Customs and Border Protection in the last fiscal year increased the seizures of fentanyl by 21 percent.
We also launched a targeted ad campaign geared at youth that was seen by over 1.4 billion views and over 58 percent. In fact, the longer documentary type won an Emmy.
Naloxone prescriptions have increased over 400 percent. Our Surgeon General, in April of 2018, issued the first advisory by a surgeon general in over a decade. And Dr. Adams said at the time: We need to have naloxone more available to our first responders, to our health professionals, to our school systems, libraries, YMCAs and the rest, but also to each and every one of us. The Surgeon General says, if each of us were to carry naloxone on our person, we too can be part of the solution, reversing these overdose deaths by administering this overdose-reversing medication.
Last night, Congress passed a 15-month extension of the current emergency scheduling of fentanyl analogues. This is a critical tool for law enforcement because it allows them to continue to detect, analyze, and handle safely and effectively this very lethal drug.
In our effort to focus on prevention education, treatment and recovery, law enforcement interdiction, I’m also happy to report that we have record back-to-back-to-back-to-back collections on Take Back Day. And I do want to credit our partners, like Google, who have been incredibly helpful to us in raising awareness and action among the public in understanding how to safely and broadly dispose of your unused, unneeded expired drugs.
In addition to Take Back Day, the prescriptions of high-dose opioids have fallen by over 32 percent since the President came into office. If you need the pain medication, it will be there. People are walking around with what’s left from a bottle of 30, 40 pills, and that’s where some of the peril begins.
In addition, we launched FindTreatment.gov — a completely overhauled tool for every American to access so that they can customize finding treatment for their needs. You can customize it by age, by geography, whether you’re veteran, by LGBT, certainly by gender. And this promotes quality over quantity. When you type it in and you customize it, you can find treatment centers that are best for you. Maybe you need to be there for a short amount of time. Maybe you need to be there in-patient, out-patient. Maybe you need to be there a longer amount of time. You can customize that quite confidentially.
From 1999 to 2015, the government reported a 20 percent reduction in our workforce due to opioid and other drug abuse and addiction. A 20 percent decline over 16 years. I’m happy to report that because we’ve invested over $100 million in displaced worker grants across 17 states in the Cherokee Nation, those numbers are moving.
We are trying to treat the whole person, not just check in person. We got you in drug court; we got you in drug treatment. Isn’t that terrific. It’s really terrific if we can them help them acquire employment, education, skills, training, and certainly housing, on the way to full recovery.
There is so much more work to be done. We’re very pleased that the overdose deaths have declined, but 68,000 of our fellow Americans died last year from drug overdose. That’s 68,000 too many. If you look at the Super Bowl this coming Sunday, that number could be represented by every single seat with 3,000 left over at the Super Bowl this coming Sunday — just to give you the actual enormity of the problem.
We will continue to fight this every single day, and we will continue to make the investments of money, of time, of education.
And with that, I’d love to turn this over to Director Jim Carroll of the Office of National Drug Control Policy and then Admiral Giroir, the Assistant Secretary for Health of the United States of America. Thank you very much.
DIRECTOR CARROLL: Thank you, Kellyanne. A couple of years ago, when President Trump and I first talked about me taking the job as the Director of the Office of National Drug Control Policy and serving as his drug czar, he instructed me to be relentless in our efforts to save lives. And that’s exactly what we’ve done to tackle this drug problem here in the United States.
The good news that we’re announcing today is a testament to the President and his leadership on this issue. It’s an example of what can happen when we come together and apply that whole-of-government approach.
The obstacles we face could not be greater, but through our efforts on prevention, treatment and recovery, and reducing availability, we’ve made real progress for the American people — which we not only want to sustain, we want to accelerate.
Kellyanne discussed how we got here and what these numbers mean. Admiral Giroir will discuss the incredible headway we’re making with getting people into treatment.
But I want to highlight the progress that we have made with our international partners and our law enforcement who are critical in reducing the supply of these dangerous drugs.
Back at the G20 Summit in 2018, President Trump raised the issue of fentanyl production with the head of China and demanded a solution. He made it clear that the United States would not tolerate the flow of fentanyl and other deadly synthetic drugs coming into our country.
Because of this, in May 2019, China scheduled fentanyl and other similar analogues, such as controlled substances, which was a historic and significant event.
Last night, the House of the Representatives passed a 15-month extension on the ban in scheduling of fentanyl, but a long-term solution is still needed.
In September of 2019, I led a White House delegation to Beijing to ensure that China was keeping up with their commitment to President Trump. The Chinese government agreed to improve the legal framework, agreed to improve their standards for prosecution for fentanyl-related trafficking, and established law enforcement methods there that were not heard of before.
In every meeting I had with the Chinese, my counterpart said they heard the President loud and clear: that the flow of fentanyl into the United States was not tolerated. Since then, the Chinese officials have invited our U.S. counterparts back there to watch the first-ever prosecutions of Chinese nationals for trafficking drugs into the United States.
This progress, combined with President Trump’s commitment to secure our southwest border — which is critical to stopping the flow of drugs into our country — brings together several lines of effort that will serve to keep Americans safe from the dangers of illicit drugs.
A wall acts as a force multiplier for our Border Patrol agents, and is one of the many tools that we are using to counter drug traffickers.
Taking the steps towards the humanitarian crisis at our southern border has also been critical to keeping those drugs out of the country. The more men and women we have in uniform, the more that we have on line, the more that are stopping these traffickers — the greater chance we have of saving lives.
The Department of Justice has played a critical role in this, as they have been cracking down in unprecedented numbers on drug traffickers.
Under President Trump, the DOJ has ramped up trafficking prosecutions — not only here domestically, but internationally.
Under this administration, the U.S. Treasury Department has made more kingpin designations against operators of distributors in foreign countries.
The High Intensity Drug Trafficking Areas that we fund out of the White House here — which provides assistance to federal, state, and local drug task forces — has received unprecedented funding from this administration, and that is beginning to show and is part of the paradigm shift that we’re seeing.
These HIDTA initiatives, for example, have dismantled 3,000 drug trafficking organizations, they’ve removed $16.5 billion of illicit drugs off our streets, and they have made nearly 99,000 arrests of drug traffickers.
In 2018, we even added, for the first time in 17 years, the first new HIDTA to make sure that we’re tackling this.
The men and women of law enforcement, whether they’re in uniform or not, are playing this vital role and putting their lives on the line every day.
What this shows is the President’s efforts are working and we are saving lives.
Before I turn this over to Admiral Giroir, I want to ask that when you’re reporting on this issue, that when you’re reporting on these numbers, that numbers are really just part of the story. Behind each of these numbers is a person, is a child, is a mom, a dad, someone whose loss has left a great mourning in a family.
I was with three parents yesterday who had lost their child to an overdose. Today, we remember Jason, Amber, and Eddie, and all of the other people that we have lost. And we continue this fight in their honor to make sure that we fulfill the President’s commitment to save American lives.
And with that, I’ll turn it over to my friend, Admiral Giroir.
ASSISTANT SECRETARY GIROIR: Thank you very much, Director Carroll. Again, I’m Brett Giroir. I’m the Assistant Secretary for Health at the Department of Health and Human Services. I’m also Secretary Azar’s principal advisor on opioid policy, and I’ve been that for about two years. And I’m honored to wear the uniform of the U.S. Public Health Service Commissioned Corps.
What we see today is no accident. This is the result of an intentional whole-of-government, whole-of-society approach to overuse — to over- — to opioid use disorders and other substance use disorders.
First of all, we recognize this as the public health emergency as it is. And as such, we have focused on many different areas to yield these results.
First, as Kellyanne said, the number of opioids that have been produced — the total amount of opioids that have been prescribed since January 2017 is reduced by 30 percent nationally. And we have been able to do that while preserving and expanding options for pain control for those who truly are in chronic pain or have debilitating injuries.
Secondly, we’ve approached this as a public health emergency, because addiction — opioid use disorder — is a chronic brain disease. We have unprecedented numbers of individuals who are now receiving treatment. Our estimates are over 1.3 million individuals are now on medication-assisted treatment, and they’re also getting the psycho-behavioral support and wrap-around services that they need.
You heard about naloxone — very, very important because everybody deserves a second chance at life. You have the power. I hope all of you in the media carry naloxone with you. It’s very easy. You can save a life, give a person a second chance.
This has resulted in, as you heard, a 4.1 percent decrease in the number of deaths and a 4.6 percent decrease in the actual overdose age-adjusted mortality rate. Very important.
A couple comments on the overall longevity. I have been shocked. Everyone in the public health community has been shocked that over the three years, previously, our longevity has decreased. That really means that our children and grandchildren will live less long and less quality of lives than we have. This is shocking, and we have not seen this since the height of the AIDS epidemic in the ’90s.
This has been reversed. We’re now on the trajectory of increasing years of longevity, and that’s associated with a number of things. What does that mean? It’s only one-tenth of a year, but that’s 25 million person years we just gained by this increase in longevity. And the good news is the preliminary data from quarter one into quarter two of 2019 is our mortality rates continue to drop.
Now, I want to talk about all the Health and Human Services issues like treatment, like prevention, but I do want to mention the social determinants of health that are very important.
There was a nationwide study in December, published in JAMA, that highlighted what we all know: When an auto plant closes, opioid mortality rate among the young goes up 85 percent. We have to keep our eye on those socioeconomic issues and everything that we’re doing to increase employment, increase opportunity. These all directly affect the rates that we see and that we celebrate today.
And the final thing is, we are not taking our foot off the gas. We understand that this is a dynamic issue — opioid use disorder, other use disorders — and it’s being fueled by transnational cartels. So we are going to keep working together. We work weekly, daily, together across the government to make sure we continue a whole-of-government, whole-of-society approach.
MS. CONWAY: Thank you. Any questions? Kristen?
Q Kellyanne, a couple of questions. How should we think about this moment? Is this, in fact, a turning point? As you point out, the rate is still very high, but do you see this as a turning point? And I have a couple of other ones.
MS. CONWAY: Sure. I’ll have my colleagues speak to that as well, Kristen.
It’s a turning point and we hope it becomes a trend. So what we’re doing is working, and it is a multifaceted approach. So I can’t say it’s just law enforcement and surveillance, or Customs and Border Protection; it’s just a new treatment locator; it’s just Take Back day and more education — that that tiny little bottle that bears a label of the family doc and local pharmacy that was prescribed to help someone could, in fact, be very dangerous in the wrong hands, or even in your own hands, if you’re the prescribe [sic], if you use it for purposes other than why it was prescribed.
So we want to keep and redouble our efforts. We certainly hope that we can count on continued bipartisan action and agreement on this, because as I said earlier and I’ll repeat here: H.R.6 had every single Democratic vote in the House and the Senate, including all the people in the House and the Senate running for President. So there is tremendous agreement and action on this issue because it affects every single district and state.
So we want — we want to see the trend line. We recognize that the mortality rate — excuse me, that the life expectancy is increasing because of strides in the drug space. We still — and
cancer, frankly. We know that suicides and flu — and flu combined with pneumonia — are keeping that rate down among other Americans. But we’re going to continue, and we hope that we have — we have what I call the horizontal and vertical government approach.
Horizontally, it’s across state, federal, and local. And vertically I — you know, I call it in terms of the federal government apparatus. To have 13 or 14 departments and agencies actively engaged on this — ones you would expect, like HHS and FDA and NIH and CDC; SAMHSA certainly; but also Veterans Affairs, Veterans Administration; DHS; State Department has been very helpful; Department of Justice, obviously; but also Department of Labor and Department of Education; and Department of Interior to help with rural and tribal America.
So there’s much more work to be done. But we feel like we have a protocol that’s helped us get to this point of progress.
Q Let me ask you one — if you want to weigh in on that one, I do have one on the coronavirus.
ASSISTANT SECRETARY GIROIR: It is — it absolutely is a turning point, but we have to look at the complexity of the problem. Some states still have increasing rates of death. Most states have decreasing rates of death. We now know that prescription opioid overdoses that caused death are really down tremendously as a result of our work, down 13 percent in 2018, and they continue to decline.
The newest data says cocaine is starting to level off, but we still have issues with fentanyl. It used to be up 30 to 40 percent year over year. Now it’s up under 10 percent, so we’re making progress. But we’re all worried about the next wave, which is evolving, and that is psychostimulants or methamphetamine. Those continue to increase across the nation. They’re being driven all almost entirely by transnational Mexican cartels, and we have been on that problem for about a year right now.
So, yes, we’re at a turning point but this is a dynamic, rapidly evolving crisis.