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Adm. Brett Giroir is focused on addressing the opioid crisis
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“Prehab,” not rehab, may be key to opioid crisis

SALT LAKE CITY — A top Trump administration health official says our best hope for curbing the opioid crisis may lie in the concept of “prehab,” or helping people avoid addiction in the first place, rather than rehabilitation after the fact.

Adm. Brett Giroir, Assistant Health Secretary, visited Utah’s Morning News on Friday to talk about what the White House is doing to fight the opioid epidemic. His visit coincides with a healthcare innovation symposium hosted by the Kem Gardner Policy Institute and the Hatch Center.

“The opioid crisis is truly the most important and challenging public health crisis of our time,” Giroir told KSL Newsradio. “Last year, in the country, we had over 72,000 people die of drug overdoses. And the great majority of those were from opioids like heroin or fentanyl.”

Giroir acknowledged that part of what’s challenging is how potent the drugs on the black market have become.

“Fentanyl is a very, very potent drug that is usually used only in intensive care units or in an operating room, but we are really seeing the illegal import of fentanyl, primarily from China, that gets into the drug supplies. So it is a very powerful opioid, about 1,000 times more powerful than some of the ones that you might get in a pill, and 100 times more than morphine or heroin,” Giroir says. “When someone takes that either accidentally or on purpose, it’s very, very high risk, and we see so many deaths from that.”

Giroir says Utah is no exception, with 662 overdose deaths in the last 12 months, and the majority again related to opioids.

“Even one death is too many,” Giroir says.

However, Utah is making progress. Nationwide, the rate of overdose deaths increased more than 7 percent in the last year, but Utah’s overdose death rate dropped over 12 percent. He called Utah a leader in the fight against the epidemic. One reason for that is the availability of Naloxone at any pharmacy in the state.

“There’s a standing order for that, which is just wonderful,” Giroir says, praising the effort to make Naloxone accessible. “If there’s anyone that you know, yourself or anyone who’s at risk of having an opioid overdose – if they’re on chronic opioids, if they have a problem with substance use disorder. Even if they’re on small amounts of opioids over taking other drugs — this is really a life-saving thing. It’s very easy to administer, and – you know, it doesn’t cure the disease of addiction, but it gives a person a second chance at life.”

Giroir says sometimes, that second chance is critical in terms of getting someone channeled into a rehabilitation or recovery program that helps them beat the addiction. But he says opioids aren’t the only problem – pointing to increased rates of alcoholism and teen suicide as indicators that we need to focus on the health of the society as a whole.

“We always talk about rehab. How about prehab?” he asks. “That’s why community empowerment, education, self-esteem, communication – all the things that build our communities are so important.”