DPH DIRECTOR PROVIDES TESTIMONY TO CONGRESSIONAL OVERSIGHT COMMITTEE ON THE OPIOID CRISIS

Washington D.C., (May 9, 2019) - Division of Public Health (DPH) Director Dr. Karyl Rattay provided congressional testimony before the United States House Committee on Oversight and Government Reform today regarding the nation's opioid crisis, its impact on Delaware and the Office of National Drug Control Policy's (ONDCP) coordination of a national response. The hearing, "The Trump Administration's Response to the Drug Crisis, Part II," continued the committee's March 7, 2019, examination of coordination of national drug control efforts by ONDCP, including efforts to expand access for treatment of substance use disorder. Dr. Rattay's testimony focused on Delaware's efforts regarding prevention, increasing access to treatment, harm reduction, data and surveillance, and the importance of coordination of resources at the state and federal level.

"I am honored to be asked to provide testimony about the incredible work occurring in Delaware," said Dr. Rattay, who testified on behalf of the Association of State and Territorial Health Officials (ASTHO). "Addiction is a chronic disease. It is extremely complex, and so too is the solution to this epidemic. Preventing and identifying addiction and connecting people to evidence-based comprehensive treatment and recovery services, as well as reducing harm are critical pieces to the multifaceted response required. Collectively, states, territories and local health departments recognize the opioid crisis as a public health emergency."

Dr. Rattay discussed the origins of Delaware's recognition of the opioid epidemic in 2011 when data showed a trend that demonstrated a steady incline of overdose deaths over the previous two decades. In 1990, five Delawareans died from overdoses. In 2017, Delaware experienced the sixth-highest rate of overdose fatalities in the nation and, in 2018, 400 Delawareans died from a drug overdose, according to our state's Division of Forensic Science.

Moreover, the opioid crisis is evolving. In 2009, nearly all of the state's overdose deaths were due to prescription drugs. Now, illicit fentanyl and other synthetic opioids are the major driver of overdose deaths, contributing to 72 percent of the 400 deaths in Delaware this past year.

Dr. Rattay then focused on improvements in access to treatment in Delaware. Delaware has worked tirelessly to increase treatment capacity over the past decade, increasing the number of people receiving OUD treatment by 500 percent from 1,000 in 2006, to 5,000 in 2017. She credits efforts by: the Division of Substance Abuse and Mental Health (DSAMH) through the launch of its START initiative, making real-time, online addiction treatment referrals through the new Delaware Treatment and Referral Network (DTRN) and opening integrated treatment homes for recovering individuals with SUD; the Division of Medicare and Medicaid Assistance (DMMA) for making some medication-assisted treatments (MAT) available without prior authorization since July 1, 2018, removing the copayment for naloxone prescriptions, and paying for certified recovery peer services since 2015; and the Department of Correction for implementing all forms of MAT treatment across its Correctional system.

"It is crucial for federal and state governments, working with local partners, to continue expanding access to evidence-based treatment," said Dr. Rattay. "The ideal treatment system is engaging, comprehensive, coordinated, integrated, high-quality and person-centered. It meets people where they are in their communities, provides an immediate connection to treatment following an overdose, and a warm handoff no matter the setting."

She then discussed the importance of harm reduction through the distribution and availability of naloxone to both the community and first responders. While Delaware now has sustained state funding for naloxone through the Lt. Governor's Behavioral Health Consortium, Dr. Rattay highlighted the importance of sustained federal funding as well.

"We are deeply grateful that Congress has provided additional resources for HRSA, SAMHSA and CDC in the appropriations bills to enhance and bolster the work of state, territorial and local public health agencies. Many of our efforts mentioned today could not have been accomplished without the support of federal grants. Federal funding to public health agencies has been, and remains, critical to our ability to respond effectively to this crisis, to maximize data for our response and to support prevention efforts, such as safer prescribing."

Dr. Rattay then wrapped up her comments with a nod to the efforts of law enforcement, the current work to stand up the nation's first Overdose System of Care in Delaware, and the importance of data and surveillance in monitoring the epidemic and in erasing the stigma that those struggling with substance use disorder often face. She concluded by making a plea for federal leadership, coordination and funding.

"To develop sustainable solutions to this incredibly complex challenge, we must have national leadership that can envision robust and wide-ranging cross-cutting support and coordination involving multiple federal agencies, national organizations, and state and local governments to develop and implement a comprehensive and evidence-based response strategy. The White House Office of National Drug Control Policy (ONDCP) provides this leadership. We are pleased that Congress reauthorized ONDCP last year, and its position should be strengthened, resourced and allowed the expertise to develop robust leadership potential."

A full copy of Dr. Rattay's testimony can be found at: https://oversight.house.gov/legislation/hearings/the-trump-administration-s-response-to-the-drug-crisis-part-ii-0.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person's spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware's citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware's citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.

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