U.S. Assistant Secretary of State Kirsten Madison Opening Remarks for the ISSUP Conference


U.S. Assistant Secretary of State Kirsten Madison

 Opening Remarks (As Prepared) for the International Society of Drug Use Professionals (ISSUP) Fourth Annual Workshop

Nairobi, Kenya, December 10, 2018


Thank you for the kind introduction and thank you to NACADA for hosting us here in sunny Nairobi.  A workshop of this magnitude is no small task; we are grateful for Kenya’s leadership in organizing this truly global conference and to ISSUP and the African Union for your tireless efforts to make ISSUP-4 a reality.  It is a pleasure to be here with Cabinet Secretary Dr. Matiang’i, and colleagues from the United Nations, Colombo Plan, and the Organization of American States.  We’re also joined by participants from more than 80 countries, including more than 40 African states; all of whom have dedicated their professional lives to preventing and treating those with substance use disorders.

Coming from the United States, where we are suffering through a drug-use epidemic of unprecedented scale, these issues could not be more relevant.

Last year, more than 70,000 people died from drug overdose in my country.  And sadly, we are far from alone in facing this tragedy:  according to the latest United Nations World Drug Report, 450,000 people died due to drug use in 2015.  To put that number in perspective, it is one of every ten people in the city of Nairobi, or enough people to fill this convention hall nearly 100 times.  And that was in one year.

The Report also indicates that 275 million people, more than 5% of the global population, used a drug at least once in 2016.  While the use and overdose figures alone are staggering, countless more families, friends, and communities affected around the globe each day.  Moreover, we know that drug use produces serious implications for public health, security, economic productivity, and families and communities.

But there is good news too:  We know substance use disorder is a disease from which people can recover.  More than 70 years of scientific research shows that prevention and treatment can work.  This powerful truth is what brings us here this week, and what motivates us daily.

ISSUP brings together many disciplines – health workers, educators, administrators, academics and researchers, trainers of the next generation of nurses, doctors, and leaders; or, like me, you are in government to implement the best possible policies and programs for the communities we serve.  It is when we combine all our skills, experiences, and knowledge that we can tackle this challenge in a meaningful and lasting way.

We come to Nairobi to exchange expertise, conduct and engage in training, and network with peers who grapple with and solve similar challenges around the world.

The United States is proud to support these efforts.  Reducing demand for drugs is an essential component of a comprehensive approach to combatting the crisis.  I am pleased my team at the U.S. Department of State has been able to partner with so many people here to take a truly crucial step – creating specialized, universally applicable, evidence-based training programs for preventing and treating those with substance use disorders.

We follow a framework to advance a sustainable, evidence-based public health approach to drug use, which aims to generate systematic and generational change.

The cornerstone of our global drug demand interventions is a workforce trained in evidence-based curricula. Recognizing both the challenge – and the necessity – of translating science into practice, our aim is to “unlock” the science into step-by-step training modules.  We then work with partners, including the UN Office on Drugs and Crime, or UNODC, the Colombo Plan, national governments, universities, and NGOs to conduct trainings for prevention and treatment practitioners.  These training events ensure that those who work directly with clients have what they need to provide the best possible care.  We are thrilled to support nine training sessions this week on prevention, treatment, working with adolescents, working with families, building drug free community coalitions, and developing drug free workplace programs.

In addition to developing the workforce, at the macro level it is critical to professionalize service systems, to ensure successful and consistent treatment outcomes.  We support credentialing of practitioners to ensure that treatment provided is in line with the international treatment standards.  This week, 45 additional practitioners will sit for credentialing exams.

Additionally, through a partnership with UNODC, we support a quality assurance system to enable national governments to evaluate and rate treatment centers within their country and develop recommendations to improve the quality of care.  The program is complementary to an effort currently underway by the Organization of American States in the Western Hemisphere.

Connecting the prevention and treatment workforce, academia, and policymakers is another component in our strategic approach to drug demand reduction.  ISSUP – as you all know well – serves as a convening forum for all drug prevention, treatment, and recovery professionals to 1) share the latest research and best practices, 2) connect members of the demand reduction community around the global, and 3) advocate for effective, evidence-based drug policy at the local, national, and international levels.

We also encourage participation in other networks, such as the International Consortium of Universities for Drug Demand Reduction.  With membership of over 130 universities around the world, ICUDDR works to expand drug prevention and treatment training within their communities and to integrate drug prevention and treatment materials into existing university programs.  We see a future where, for instance, an aspiring teacher learns prevention as part of their study program, and aspiring medical professionals receive training on drug use disorders as part of their education.  Furthermore, we support the development of community coalitions to drive prevention and treatment activities.

Across all aspects of our work, interventions must be tailored for populations with specific clinical needs.  These include children, people in rural areas, and individuals currently in recovery.  In partnership with the Organization of American States, this year we supported a new 2-day course to provide policymakers an overview on alternatives to incarceration.  This course brings together policymakers to review options for such alternatives, and allows for action planning on improving systems of care.

This week you will be surrounded by the experts in the field — I encourage you to get to know one another and share your experiences.

And, when you get home, look for opportunities to further promote and professionalize the prevention and treatment workforce in your communities and countries.

On behalf of the U.S. Government, I want you to know how proud we are to partner with all of you, with this cause, and to support the work you do. We look forward to continuing the robust drug demand reduction partnerships we have built around the world to tackle this challenge.


Thank you for your time, energy, and passion.

Fact Sheet on Drug Demand Reduction