At Senate Finance Hearing, Portman Discusses Youth Addiction Crisis, Touts Telehealth

Press Release

During a Senate Finance Committee hearing earlier today, U.S. Senator Rob Portman (R-OH) discussed the surge in drug use and overdose deaths, specifically among teens and young adults. Portman pointed out that the proliferation of synthetic opioids, such as fentanyl, bears much of the responsibility. In December, Portman toured the border at Nogales, Arizona, to see firsthand the challenges Customs and Border Protection officials face with increased and more sophisticated efforts to smuggle illegal and deadly drugs such as fentanyl into the United States. The most recent CDC data shows that from April 2020 to April 2021, drug overdose deaths in the United States rose to a record more than 100,000, with fentanyl accounting for well over half that number.

In addition, Portman touted the effectiveness of telehealth in combating addiction and other mental health issues. Over the past year, Portman has led efforts to ensure telehealth is available to individuals on Medicare and Medicaid.

Senator Portman: "I appreciate the testimony and the fact that you all are in the trenches every day doing great work with our young people. Doctor Hoover, you talked about telehealth, and I just want to be sure that we're also focused on broader behavioral health, and specifically substance abuse. It seems to me that telehealth is one of the few silver linings in an otherwise dark cloud of COVID with regard to substance abuse treatment, that there has been some real improvements. Would you agree with that?"

Dr. Sharon Hoover, Ph.D.: I would agree with that. I mean, certainly the opioid crisis has brought attention and has been exacerbated during COVID. So the funding provided by the federal government to states and communities to support the opioid crisis has been tremendous and certainly there's been an improvement in care. Tele-mental health has improved that as well

Senator Portman: "This is why we've got to continue the reimbursement under Medicare and Medicaid, Medicaid particularly for substance abuse. At a time when we had 100,000 drug overdose deaths in the period from April 2020 to April 2021. So during one year, a record level. That was a 28.5 percent increase in overdose deaths, really heartbreaking because we had made great progress in 2018, 2019. Now we're unfortunately seeing more and more people dying of overdose deaths. The reporting we have about young people, because that's the topic today, shows that we have seen anywhere from an increase of three times higher the number of overdose deaths to 13 times higher in 2021 compared to the numbers we had from 2019. And by the way, dramatic increases among black youth in terms of overdoses, particularly concerning.

"Ohio State has done a report recently looking at it from a different perspective, they said how many years have been lost? Their analysis is that, beyond the numbers we already know, the loss of years lived for more than 21,000 young people who they tested from overdoses show that adolescents and teenagers, ages 10 to 19, lost cumulatively 200,000 years of life. And when they expanded the study to include 10 to 24 year olds, it grew to more than 1 million years lost. So it's a shocking way to look at it. But think of all that lost potential and all that God-given potential being ruined. So this is a huge reason that we need to figure out as a Congress how to get back on this issue. And deadly fentanyl is killing, we think, about two thirds of these kids. So this is synthetic opioids streaming across the border. We've done a lot more in terms of the prevention side and the treatment and recovery side, but obviously not enough. And what we see in Ohio is that this deadly fentanyl is often masked as other substances, so it looks like a pain medication or anxiety medication or ADHD medication. And we've had parents approach me in Ohio and talk to me about this issue because they believe that their son or daughter died of an unintentional overdose by being deceived about what was in a pill.

"So, Dr. Hoover, talk to us a little about that, and anybody else jump in? What do you think the reasons are for this big jump in overdose deaths? And how much of it do you think is attributable to these cartels putting fentanyl into other medications?"

Dr. Hoover: So I'll jump in quickly and defer to Dr. Benton on the kind of impact of drugs and the medical side of this, but certainly in terms of the comorbid mental health issues, we know that the substance use issues we're seeing increase in young people are likely very related to their increase in depression, anxiety and post-traumatic stress. Not only are we seeing increases in that pre-pandemic, but we're seeing real exponential growth in that in the context of COVID. We know when that happens, we see increases in substance use, and so it's not surprising when you give those really tragic numbers. I'll defer my time over to Dr. Benton with respect to that.

Senator Portman: "You're talking about self-medication because of other behavioral health or mental health challenges?"

Dr. Hoover: "That's a piece of it, absolutely. That self-medication to address anxiety, depression, trauma, and just to really cope with some of the isolation and loneliness that our children have experienced over the last couple of years."

Senator Portman: "Dr. Benton, can you talk a little bit about that synthetic opioid issue with Fentanyl getting into other medications?"

Dr. Tami D. Benton, MD, FAACAP, FAAP: "Yeah. So what I can say is that we are seeing increases in utilization across the country and unfortunately, I have to say that in many mental health programs there's not the robust substance use and addiction treatments that we'd like to see. And a major focus of expansion of resources and treatment for young people needs to focus on increasing the integration of substance use and mental health treatment services. We know that for young people with any mental health condition, the comorbid use of substances only makes the outcomes worse. And the substance use is associated with worse outcomes, including suicide and other impulsive behaviors that land young people in bad situations and so that has to be a focus. Right now, they run almost as two separate systems in some ways and that really needs to be a focus of our efforts going forward if we're going to address the substance related morbidities that we're seeing right now."

Senator Portman: "Okay. I think my time has expired, but Trace, I'd love to hear from you on this if you have a minute, Mr. Chairman, if Trace has any thoughts."

Mr. Trace Terrell: "Yeah, I would love to. Thank you, Senator. I think when we talk about all these statistics, it's really alarming. But I also think that there is a beacon of hope. Since YouthLine's inception we've experienced an annual increase in contact volume of about 15 percent annually, with an additional increase of 3 to 5 percent since the COVID-19 pandemic. And obviously, while that proves that there is a need for mental health care. There's also so many teens reaching out for help and I think that is really inspiring and I think it shows the resilience of teens in regard to mental health challenges and substance use challenges. And so I think if we can really ensure that the people reaching out for help are able to receive help, we will get really far on this issue."

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