SAMHSA Prioritizes 5 Areas of Focus for Strategic Initiatives

Miriam E. Delphin-Rittmon, PhD, assistant secretary for mental health and substance use in the US Department of Health and Human Services (HHS) and the administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA) walked Rx Summit attendees through a variety of the administration’s key priorities for addressing the nation’s addiction crisis on Tuesday morning in Atlanta, Georgia.

With more than 40 million Americans having a substance use disorder (SUD) and nearly 53 million having a mental illness of any kind, SAMHSA has identified 5 areas of focus for its strategic initatives, Dr Delphin-Rittmon said:

• Enhancing access to suicide prevention and crisis care
• Promoting children’s and youth behavioral health
• Integrating primary and behavioral healthcare
• Using performance measures, data, and evaluation
• Preventing overdoses

After leveling off from 2017 to 2019, overdose deaths across the US have begun rapidly increasing again with the onset of the COVID-19 pandemic, driven largely by the emergence of illicit fentanyl, Dr Delphin-Rittmon noted. In 2020, of the drug overdose deaths involving illicitly manufactured fentanyl, 40% did not involve any other substances. Stimulants combined with fentanyl accounted for 42% of such deaths.

Primary prevention, harm reduction, evidence-based treatment, and recovery support are the 4 pillars of HHS’s overdose prevention strategy. One data-driven program having success on the prevention front, Dr Delphin-Rittmon said, is the Strategic Prevention Framework for Prescription Drugs (SPF-Rx) grant program. In fiscal year 2020, the program’s grantees implemented 396 prevention strategies, including helplines, collaborations with medical boards to develop policies related to prescription drug monitoring program use, youth education, recreational events, and screening and prevention programs.

Harm reduction initiatives, meanwhile, have been concentrated in 4 areas:

• Research and demonstrations, such as the provision of fentanyl testing strips
• Integrated evidence-based harm reduction, with harm reduction technical assistance from the Centers for Disease Control and Prevention and SAMHSA
• Sustainable funding, including harm reduction grants from SAMHSA
• Stigma reduction, such as CDC’s Stop Overdose campaign

SAMHSA expects to award $30 million through its first harm reduction grant program this year, Dr Delphin-Rittmon said.

Dr Delphin-Rittmon identified SAMHSA’s State Opioid Response grant program as an example of the administration’s whole-person approach to SUD treatment. Since 2019, programs funded by such grants have served more than 296,000 clients. Among those clients, there was a 26.3% increase in those who reported no alcohol or illegal drug-related health, behavioral, or social consequences within the prior 30 days. Clients also reported fewer suicide attempts, as well as lower rates of depression and troubles controlling violent behavior.

Dr Delphin-Rittmon pointed to the upcoming launch of the 988 crisis hotline as a tool that will connect more individuals with mental health needs to appropriate care while also easing burdens on law enforcement and emergency departments. She also highlighted the success of the Certified Community Behavioral Health Clinics program. There are now more than 430 CCBHCs across the US.

Dr Delphin-Rittmon concluded by pointing attendees to SAMHSA’s Evidence-Based Practices Resource Center and emphasized that the administration’s programs and grants provide for treatment or intervention at all points along the continuum of care and lifespan.

Reference

Delphin-Rittmon M. Plenary. Presented at: Rx and Illicit Drug Summit; April 18-21, 2022; Atlanta, Georgia.