COSSAP National Conference
I am so pleased to join my colleagues today and over 1,200 people from across the country who are working to take on the great challenge of substance use disorders in our nation.
I want to thank Kristen Mahoney, the Acting Director of our Bureau of Justice Assistance, and her outstanding team. In particular, I want to thank Betsi Griffith and Tim Jeffries, who oversee the Comprehensive Opioid, Stimulant and Substance Abuse Program and the substance use disorder portfolio. They have done a terrific job, working with the Institute for Intergovernmental Research, to organize this conference. Thank you both so much.
I also want to give a shout-out to my senior advisor Mariel Lifshitz. Mariel has been indispensable in guiding our work at OJP and making that all-important connection between public health and public safety. Thank you, Mariel.
And a big thanks to all our speakers and panelists, and to the many public safety professionals, substance use and mental health treatment providers, recovery support experts, peers, and other allies in this work who are joining us from every corner of the country. We are so grateful for the essential work you do and we are proud to support you as you tackle the ongoing substance use and polysubstance use crises facing America.
It goes without saying that communities throughout the country are facing extraordinary challenges. We continue to live and labor through a pandemic that has brought us all face to face with pain and loss on a massive scale, and we’ve seen the toll it has taken on individuals, on families and on our systems of care and our systems of justice.
This virtually unprecedented public health crisis has caused major economic and social stress, and sadly, it has been accompanied by a precipitous rise in overdose deaths. More than 93,000 Americans died of an overdose last year, which is heartbreaking. That’s an almost 30 percent increase over the previous year. This dramatic rise was fueled primarily by fatalities from synthetic opioids like fentanyl, but deaths from methamphetamines, psychostimulants, cocaine and prescription pain medications also went up.
What we’re seeing today is not one, but two, national emergencies, each of them claiming hundreds of lives every day, tearing apart families and communities and overtaxing our public health and public safety infrastructure.
Fortunately, we have seen significant progress in our fight against the pandemic, and we now have cause for optimism on that front. The substance use crisis is another matter, and we are now at a point – as if we weren’t there already – where we must take bold, decisive action on all fronts.
The Biden-Harris Administration is doing just that. President Biden made it clear, early on, that addressing the overdose and substance use epidemic is an urgent priority. The American Rescue Plan, which he signed into law in March, appropriated nearly $4 billion to expand access to vital behavioral health services. The Administration has also supported policy and provider flexibilities during the pandemic that have made getting treatment easier – for example, through telehealth.
Importantly, especially for our purposes here, President Biden said that people should not be incarcerated for drug use but should be offered treatment instead. And he has emphasized the need to eradicate racial, gender and economic inequities that exist in the criminal justice system and that impede the road to recovery for many people struggling with substance use and co-occurring issues.
Recently, Secretary Becerra at the Department of Health and Human Services announced a new overdose prevention strategy, which focuses resources on prevention, harm reduction, evidence-based treatment and recovery support. These are four essential pillars of substance use mitigation, and we are working in close coordination and collaboration with HHS leadership to align our efforts, supporting states and meeting the needs of communities both large and small, urban and rural. I am proud that the work we support at OJP, and the programs so many of you run in your communities, center on these elements.
Unfortunately, and too often, the first step toward treatment and recovery is an encounter with the law. It may be a domestic incident that brings police into contact with someone under the influence. Often, it’s an individual in crisis, possibly experiencing an overdose, that draws first responders to the scene. And once in the system, there are any number of intercept points where appropriate intervention and access to treatment resources can turn the tide for those with substance use disorders. The way these encounters are handled, both at the entry point and throughout one’s involvement in the system, can make a huge difference in the outcome.
The challenge, of course, is that police traditionally are generally not trained to respond to an individual’s substance use or mental health needs. Which is why it’s critical that we strengthen the connection between substance use and mental health professionals and law enforcement. Across the Office of Justice Programs, we are investing substantial resources in programs that facilitate these partnerships, and our COSSAP program is a centerpiece of our strategy.
We are supporting hundreds of projects under COSSAP, and those sites are doing some wonderfully innovative things:
- They’re building partnerships between first responders and behavioral health, public health and victim service professionals.
- They’re expanding diversion programs for people who misuse illicit and prescription opioids.
- They’re encouraging cross-system planning and collaboration.
- They’re developing treatment and recovery strategies for those who come into contact with the health care and justice systems.
- And they’re providing support services in rural and tribal communities through technology-assisted treatment and recovery options.
COSSAP is one of our premier investments in addressing substance use disorders, but we have others that hopefully all of you are aware of and take advantage of in your communities. For example, one key to addressing this crisis is preventing prescription drugs from falling into the wrong hands. Nearly every state has an active prescription drug monitoring program, and our Harold Rogers Prescription Drug Monitoring Program is providing critical support.
These systems give prescribers and pharmacists information about a patient's controlled substance prescription history, and they help clinicians distinguish between patients who legitimately need opioids for pain treatment and those who might be looking to misuse or divert these powerful drugs. We’re looking to expand use of these systems. We’re working with our partners at the CDC and other agencies to use open-source solutions to integrate PDMP information with health care IT systems. We’ve awarded a number of grants that connect local, state and national information systems so that jurisdictions can analyze a range of crucial data, across disciplines.
Along those lines, we have a terrific program under the COSSAP umbrella called the Comprehensive Secure and Responsible Drug Disposal Program. This program addresses one of the big drivers of the substance use epidemic: the unused prescription medications that fill America’s medicine cabinets. We’re aligning state and local efforts to dispose of these drugs with the DEA’s National Prescription Drug Take Back Day. Funds support eight sites to purchase drug disposal and collection equipment so they can safely dispose of both prescription medications and controlled substances. On the most recent Take Back Day in October, COSSAP drug disposal grantees collected a total of more than 43 tons of medication for disposal. One grantee, the Wisconsin Department of Justice, led the state’s collection of more than 57,000 pounds of medication – the largest collection in the country this year.
In addition to data sharing and cross-agency partnerships, we have to make sure that people with substance use disorders who come into contact with the justice system get the help they need. We’re supporting drug and veterans treatment courts, as well as mentoring programs for children and youth to keep them from falling deeper into the justice system. Research shows that these programs work. They effectively address substance use disorders, they reduce recidivism and they save taxpayer dollars.
Drug courts and other OJP investments, like our Residential Substance Abuse Treatment program, are helping us get treatment to people who come into contact with the justice system, including those in prisons and jails.
And we are poised to award significant funding this year to help criminal justice officials and mental health providers meet the needs of people with mental illness and co-occurring disorders. A substantial percentage of people in jails have a serious mental illness, and they stay there longer and return more frequently. It’s critical that we address these challenges in the jails setting and at the intercept points that come earlier. And that’s why it’s so encouraging to see innovations in community co-responses to substance use, mental health and other crises. Instead of arrests and jail bookings, communities are getting people the help they need and taking steps toward a more fair and more equitable system of justice, one that does not rely on arrest and incarceration to deal with social and behavioral issues.
I believe that a just society is one in which communities have the appropriate resources to meet the basic needs of individuals without perpetuating longstanding inequities and without aggravating problems like mass incarceration that have, for too long, disproportionately penalized Black and brown communities. Not every emergency call demands the intervention of an armed police officer – and law enforcement cannot, and should not, be expected to handle every crisis encounter alone.
BJA has invested over $164 million though the Justice and Mental Health Collaboration Program to help communities build cross-system interventions where the justice system and the health and social service systems work together. We’re making additional investments this year. For example, we recently created a program called Connect and Protect to help law enforcement and behavioral health partners work together to reform crisis response. We’ll be announcing new funding under this program very soon.
Thank you for the work you do, and thank you for helping to make our communities safer, healthier and stronger.