Oct 12 2018
Good afternoon, and thank you for joining us for the 5th Annual Solutions Summit. It’s an honor to host so many talented and dedicated Utahns at this event.
There are few issues more pressing today, or more devastating, than the opioid crisis. And I can think of no better place to discuss this crisis than in Utah – where so many people are passionately and effectively working to address it.
That’s why we convened this summit: to hear from some of the best and brightest warriors in the trenches of this life-and-death fight.
Before we go into today’s panels, I’d like to preface our discussion with some facts and figures about opioids in America, and some thoughts on what it will take to beat this epidemic.
Congress’s Joint Economic Committee has put together a fascinating report on the numbers behind the opioid crisis throughout the country.
Let’s start with this map showing all the counties across the United States.
You’ll see that 40 years ago, only a small handful of counties had opioid-related deaths – counties that were relatively isolated, and which had historically high drug and death rates to begin with.
But in the last 40 years, and over several phases, the rate of opioid overdoses has exploded.
No state has been spared. This plague has spread everywhere; it has reached the proportions of a true epidemic.
Between just 1999 and 2016, the rate of opioid-related deaths quadrupled. The total number was
632,000 – a body count of Americans higher than the Civil War’s.
In 2017 alone, nearly 48,000 Americans died from opioid-related overdoses – a far higher death rate than we have ever experienced from HIV, guns, or car accidents.
This “American carnage” has struck Utah as well: about 6 Utahns die per week from opioid or heroin overdoses. And three rural Utah counties were identified recently by the U.S. Department of Agriculture as being among the most vulnerable nationwide.
Families and communities – in Utah and across the nation – have been robbed of loved ones by these premature and unnecessary deaths.
The stakes are high. It’s going to take our strongest efforts to combat this crisis – or more accurately, these crises.
For when we look at the facts, we see that there is not one single opioid crisis.
There is a rural crisis, and an urban one. There is a crisis hitting poorly educated Americans, and one hitting the highly educated. There’s one that’s hitting adults, and another that’s hitting kids.
And all of these crises take different forms in different parts of the country. In some states the overdoses are caused more by prescription drugs. In others, they are caused more by illegal narcotics. In many cases, deaths are caused by a combination of drugs.
For example, data on opioid overdoses in 2016 shows that while states like Illinois and Wisconsin had primarily heroin-related deaths, states like Utah and Oklahoma had deaths primarily involving prescription opioids.
And as we can see in this chart, prescription opioids have consistently been the biggest problem for our state.
But it’s also notable that in the past few years, the deadliest drivers of the crisis nationally have been fentanyl and heroin, the most common opioids sold on the streets.
From 2015 to 2016, the number of deaths from these drugs more than doubled. And in 2016 alone, fentanyl and heroin were present in more than two thirds of all opioid-related deaths.
At 50 times the strength of heroin, fentanyl is particularly lethal. Mere skin contact with fentanyl is enough to kill you.
Fentanyl also poses special danger because it is incredibly compact, and therefore easy to conceal and tricky to dilute. Trafficked from China, it is most often shipped – rather than smuggled – across our borders through the mail.
In the face of such a complex, multi-faceted, and growing crisis, there will not be just one solution. One-size-fits all policies will not work. We will need many solutions, and they will require all sorts of efforts from a wide breadth of people.
They will require the collaboration of hardworking, innovative individuals in the medical field, law enforcement, government, and our local communities. They will require prevention on the front end, as well as responses to treat those who are already suffering addiction.
And we will need to tailor our solutions at the state and local levels – where we can best address the numerous causes of the crisis, and best reach our children, parents, neighbors, and friends caught in its grip.
We have so far focused on the supply of these drugs. But it is just as crucial to look at the demand for them. Who is overdosing on these drugs? And why are they turning to them in the first place?
The Social Capital Project spearheaded by Congress’s Joint Economic Committee has discovered that there is a strong social component to this crisis.
Our work has found that those who are most vulnerable to opioid addiction are often lonely and cut off from sources of personal fulfillment like family and meaningful work.
Individuals who are divorced or never married make up about 32 percent of the population, but account for an astonishing 71 percent of all opioid deaths.
Similarly, individuals with no more than a high school education are disproportionately likely to die of an opioid overdose.
Single men with only a high school education have an opioid death rate almost three times higher than single women with the same level of education.
Research also shows that those who succumb to opioid addiction usually have other mental health issues like depression or anxiety, or have had prior struggles with drugs or alcohol.
We cannot ignore the fact that there is a profound human element to this crisis. The absence of both purpose and community has led to these tragic “deaths of despair,” as they have been so aptly termed.
And that is precisely why the bulk of our battles must take place in our communities – person to person, eye to eye.
Now, this is not to say that there is no role for the federal government in fighting the opioid crisis.
On the contrary, the Drug Enforcement Agency has already played an important part here in Utah by working with the Attorney General’s Office to prosecute drug cartels and to sponsor “Take Back Days,” during which Utahns can turn in unused prescription drugs.
And Congress should take steps like:
• strengthening our Customs and Border Protection’s authority to discover and destroy packages with illicit drugs;
• establishing a system to stop suspicious orders of opioids from drug manufacturers; and,
• requiring the FDA to update the way it assesses the safety and effectiveness of new drugs.
But just a national, federal, and bureaucratic response will not be enough. Too often federal grant programs have little accountability. And too often they are inflexible and unable to meet the unique needs of states and communities.
No, the real work in solving this crisis will be at the local level. If we are going to halt the spread of opioids, then we need to build more resilient families and communities.
These battles will be won in the offices of governors, sheriffs, and doctors; in hospitals and rehabilitation clinics; and in churches, classrooms, and especially, in living rooms and dinner table conversations around the country.
The struggle against addiction and isolation cannot be won exclusively at the federal level. We can create social capital only at the human level – not simply as fellow taxpayers or citizens, but as fellow human beings.
And on this front, I believe there is reason for hope. Utah’s efforts and results are proof.
While opioid-related deaths rose 10 percent nationwide last year, Utah was only one of 14 states where they fell -- by almost 20 percent, the third year in a row that Utah saw a decline.
For many years, groups like the Utah Coalition for Opioid Overdose Prevention and the Utah Department of Health have worked diligently to combat this crisis.
And since last year, Utah Attorney General Sean Reyes and DEA District Agent Brian Besser have complemented their work by forming the Utah Opioid Task Force.
The Task Force has assembled experts across various fields – medicine, law, treatment, recovery, law enforcement, and business – all united in an effort to save Utahns’ lives.
They have promoted awareness of the perils of opioid dependency, worked with physicians to change prescribing practices, sponsored “Take Back Days,” and successfully prosecuted drug cartels.
Groups like the Utah Support Advocates for Recovery Awareness have also done tremendous work. Mary Jo McMillen founded USARA to open Utah’s first Addiction Recovery Community and Advocacy Organization, and opened Utah’s first peer run Recovery Community Center in 2011.
Jennifer Plumb’s efforts in co-founding Utah Naloxone have yielded great results. This non-profit organization has already saved thousands of lives by distributing kits to administer naloxone, a powerful medication that can reverse opioid overdoses.
And One Voice Recovery, under the leadership of Patrick Rezack (REE-zack), works to remove the stigma surrounding addiction and to empower individuals going through recovery.
These Utahns have already been stepping up to the plate. These groups, and many others, have made a real difference on the ground and in our communities. And I believe there is much we can learn from them today.
The founder of Overdose Awareness Utah, Amber Baum, tragically lost her 22-year old daughter Kenzie to an opioid overdose several years ago. Prompted by her own struggle with this tragedy, and reflecting on her work to address the crisis, she offers us these words:
QUOTE “Overdose deaths are treatable and preventable. The solution is not a ‘one size fits all,’ but together we can figure out how to rescue and heal.
… Remember, too, continuing to love those who are fighting addiction – while not easy – is the best way to help them connect with support and resources. Connected communities allow recovery to happen and become the answer.” END QUOTE.
It is my hope that today’s event will lead to more deeply-connected community efforts to fight – and beat – this modern-day plague.
As prepared for delivery