This transcript is taken from a Stand in the Gap Today broadcast which originally aired on Jan. 3, 2020. To listen to the program, please click HERE.
Keith Wiebe: Today, we talk about a couple of topics that are extremely important. I’m going to pose a question for you. Just how serious are the opioid crisis, the mental health crisis, and the HIV crisis, and how great the impact do they have even on Christians and Christian families. And perhaps most important of all, what is the solution? How should we as faith-based, gospel-based people be involved in this solution? You’re listening to Stand in the Gap today. I’m your host, Keith Wiebe, joined by cohost, Pastor Gary Dull, and our very special guest today, a good friend of many years, is Shannon Royce.
Shannon is the director of the Center for Faith and Opportunity Initiatives at the U.S. Department of Health and Human Services. In leading that center, Shannon’s words are that she sees her role as one of service and stewardship carrying out the vision of the administration [inaudible 00:01:01] she serves. She received her law degree from George Washington University School of Law. She is married, has two grown sons, and enjoys running half marathons just for fun. Now our topic today is one that’s perhaps we rather not talk about. It can be uncomfortable, it can be messy, and it’s perhaps one that you at first blush will think, “Well, that doesn’t really affect me, after all I’m a Christian.”
We’re going to discuss three problems that are very critical in our culture, our audience listening in the main from a biblical world view perspective. We’ll certainly agree that these are indeed serious societal issues, but they may tend to think that those of us in our faith Christian community are not directly affected. I believe our broadcast today is going to show otherwise. We live in a broken world, a world broken by sin. We live in, as a result of that, a broken culture, brokenness that needs the love, compassion and mercy that a biblical world view the [inaudible 00:02:12] of us. I’m going to urge you to listen closely.
Our discussion, as I said, will be a bit at times perhaps unpleasant, perhaps difficult to receive it here, but it’s also factual. It’s a data-driven perspective on three tragic trends that affect us all, and for which we each have responsibility. In fact, it may surprise you even to learn just where opioid addiction usually begins. But this discussion is also driven by a hope, hope that comes from God who envelops us with His love, mercy and grace. You’ll want to stay tuned for the entire program. We’ll discuss the problems as they present themselves in the lives of people who are often much like each us.
You’ll learn about what is now being called an addiction epidemic. But as I said before, we will also offer hope, hope that even new medical advances and the new government initiative by the Trump administration will offer to those who are already ensnared by this addiction epidemic. Shannon, thank you very much. Well, thank you. It’s a busy time of year. You’ve taken time out of a busy schedule. I’d like to ask you, first of all, tell us why in the Department of Health and Human Services, is there a Faith-Based Office? Describe its purpose for us.
Shannon Royce: Right question … I keep wanting to call you Dr. Wavy. I’m going to have to practice that. Keith
Keith Wiebe: Yeah, you’re going to have to work on that.
Shannon Royce: The Faith-Based Office originated in the Bush administration, so our office dates back to 2001, was created under the Bush administration, continued under the Obama administration, and now continued again through the Trump administration. The role of our office is to connect faith and community partners at the grassroots level to the work of health and human services and to support and encourage and engage those faith and community partners in the efforts from the department.
Gary Dull: Shannon, it’s a delight to have you with us and it’s interesting that we’re talking about this Faith-Based Office because back in ’01 and whenever it was, ’02, I was actually involved in some of the initial discussions with that, going to Washington, D.C. and discussing some things with Vice President Cheney and a few others, and so it’s interesting to see that that is continuing and I trust that it’s continuing well. But as it relates to what is currently going on, what does the fact that there’s a Faith-Based Office in the Department of Health and Human Services say about the importance of faith in the Trump administration?
Shannon Royce: Well, I think this has been a key priority to President Trump. He’s made very clear from the beginning that he supports a religious expression in everyday life, he supports faith-based engagement in everyday life, and he recognizes the unique contribution and the essential contribution of faith-based folks in meeting the needs of the daily lives of people living in our communities. Each of the three issues we will talk about today, the addiction crisis, the mental health concerns, and the HIV initiative are all areas where the faith community can make such a significant contribution.
Keith Wiebe: Shannon, in the department, HHS, do you find that there are a pretty good number of people that would approach this from a faith-based perspective, perhaps even with a biblical worldview?
Shannon Royce: Well, I think what you’ll find is, at HHS, you have folks who take a very scientific approach in our research, in development of new programs, in figuring out what our key … not cures, but key treatment protocols to use in people’s lives. So it’s there a very scientifically-driven evaluations that are done, but there is an understanding and recognition of the contribution that the faith-based community makes in line with those scientific realities that we deal with. So we do the both end.
Keith Wiebe: Now I think that’s one of the things, Shannon, that all of us here at Stand in the Gap appreciate about this current administration, the Trump administration, that there is a recognition of the value of faith-based solutions, and I appreciate that. Gary was mentioning his connection to the Faith-Based Office. My daughter, Elizabeth, served in the White House Faith-Based Office for several years as a presidential appointee, part of the Bush administration, and I grew to have a deep appreciation to have that role in our government.
I appreciate it on the two fronts that you have alluded to, and one that we’ll talk about a great deal here in just a few moments, and that is approaching some of this from the scientific perspective, looking at the conditions that exist, things that people are experiencing and how can we extend a hand to them, reach out to them, reach them where they are and really be a special help to them. Well, we’re glad to have you back, and appreciate again you tuning in to Stand in the Gap today. I mentioned at the front of the broadcast that we would be talking about the opioid crisis.
There are no communities in our country that have not been affected by it. I have conducted funerals as a pastor of those who were victims themselves of that opioid crisis. In fact, the community where I live a couple of years ago proportionately had one of the highest rates of overdose deaths from opioids of any place in the country, and the State of West Virginia where I live, the problem of excessive prescription drugs has been alarming. So Shannon, I want us to talk about just this opioid crisis. Just how serious is it? What does your understanding and research show?
Shannon Royce: Yes sir. Thank you for that. Keith, it really is a very significant crisis. To use the word crisis, I think sometimes we can use that too often when you look at what happened with opioids, it’s appropriate to call it a crisis. The crisis really started, as you mentioned, with an over prescription of opioids. We would have kids go in to have their wisdom teeth removed and they’d be given opioids by their dentist, or you’d have the high school jock who gets a knee injury or the cheerleader who takes a spill, or the deacon or pastor who has to have surgery and as a result is placed on opioids.
The crisis really started with an over prescription of opioids and then people who were predisposed to struggle with this, and you don’t know it unless you know it, right? There’s no reason if you’ve never taken opioids in your life to know that you might have a predisposition to addiction, and that is really how the foothold started. It moved from there into what we considered the second wave, and that was those who had been addicted to the prescription opioids they were on. Their doctor starts cutting back, and they have an addiction problem and many of them then moved to the street to buy cheaper alternatives, heroin or fentanyl, which was the second and third wave, which is why we call this an addiction crisis, not just an opioid crisis.
Then we are more recently seeing an increase of methamphetamines that’s being deemed the fourth wave. All that bad news. Let me tell you a little bit of good news because we have to remember that we’re making progress, and we have seen a decrease in opioid deaths of 5.1% over this last year for the first time in many years. We’re seeing a turn and that’s really encouraging. We’re seeing more people involved in treatment and that’s encouraging. We’re seeing the overdose reversing drug Narcan be distributed widely so that if someone is in an overdose status, you give them a shot of Narcan and they immediately will wake up. They call it the Lazarus drug. Interestingly, for those of us from a biblical worldview, it’s called the Lazarus drug because it literally brings people back from the dead. The crisis has been taking up to 130 people a day, so this really has been a significant challenge for our nation.
Keith Wiebe: That is incredible, Shannon. Just a very quick follow up. It starts with prescriptions drugs. Has there been any evidence that doctors are somewhat culpable in this over prescribing or even using it for extra money themselves? Or am I going down a track that’s really not there?
Shannon Royce: Yes sir. I think that it started with a misunderstanding about the addictive nature of opioids. So the companies, manufacturers creating this, you’ve seen lawsuits all over the nation against the manufacturers addressing this because they did not tell doctors just how addictive these products were. So yes, doctors were over prescribing but they didn’t understand just the serious nature of the addictive quality of opioids. So the good news again is we are seeing significant cutbacks where doctors are being more careful in their prescribing behaviors and that has been helpful, one of the factors that has really contributed to the turn that we’ve seen.
Gary Dull: Shannon, this is interesting that we’re discussing this crisis of opioids because I deal with rheumatoid arthritis, and they diagnosed me with that. They put me on opioids, and I realized to the degree that they were basically taking over my life when for a period of time I actually left my medicine back at the house when I was going on a trip, and I realized how much of a negative effect they had on me, and I want to tell you, I weaned myself off of them. So it’s a very serious thing and I’ve had that personal experience with them and it’s a terrible thing to have to go through. But we hear about this so often, and yet it is also a matter within the faith-based community. My question to you is how great is the effect of opioids on a faith-based community?
Shannon Royce: Well, we don’t have separate studies specifically on the faith-based community, Gary. But I mentioned to you in our pre-conversation, I’m a Southern Baptist preacher’s kid, so I grew up in the church and I’m old enough now to have lived through a number of these historic transitions we’ve been through. The reality that I have seen over the years is that people in the faith community struggle with the very same things quite often as the wider culture. We just often don’t talk about it very freely in our faith communities, and so I’m grateful that you just acknowledge what you said, that you realized that opioids were a struggle for you and you had to move away from them.
Many people don’t realize that in time and actually do become addicted. It really is a significant struggle. My particular concern, honestly, to transition just a little bit into an issue that we touched on yesterday is our kids. Because what we know from the research is that by the time our kids are seniors in high school, 17, 18 years old, almost 70% of them will have tried alcohol, half of them will have taken an illegal drug, and nearly 40% of them will have smoked a cigarette. 20% of them will have used a prescription medication for a nonmedical purpose. Now, there are a lot of reasons why kids, why adolescents will experiment with this kind of thing.
Frankly, we know that they’re biologically wired to seek new things and to try to be independent from their parents and carve out their own identity. All of that is just a normal transition of going through the teen years. The challenge is when they choose unhealthy ways to walk through those things, and we see that just in those statistics I just mentioned. We have a real problem right now with vaping of e-cigarettes. We have five million kids right now using e-cigarettes, and that has increased from 11% to 25% in just three years. One part of an e-cigarette is equivalent to an entire pack of cigarettes. So this is scary. I mean, this is why we’re talking about the addiction epidemic because there are many things. Opioids, cigarettes, alcohol, e-cigarettes. I mean, we’re seeing a struggle with addiction in many areas.
Gary Dull: Just to jump in here, if I may for a moment. Keith and Shannon, I think it’s very important that we as pastors encourage the parents within our churches to become educated and informed on these things so that they can more adequately communicate the
to serve it to their children.
Shannon Royce: No question. The e-cig pods, many kids do not even understand that they have nicotine. There had been many, many of them in candy flavors and fruit flavors. Just yesterday, the FDA announced new rules that’s removing all of those flavored products, the fruit and candy flavored products off the market, and that hopefully will really help. But yes, parents need to understand the challenges that their kids are confronting and really engage their kids on these questions.
Keith Wiebe: Do you have any thoughts or experience from your perspective on a good way for churches to be responding to the opioid crisis, the e-cig crisis that is out there? Even in terms of public discussions or what kind of an atmosphere do we need within our churches? I guess I look at this as a pastor, and I know Gary does too. How do we give spiritual leadership from your perspective that we can encourage our people to be handling this with their kids?
Shannon Royce: Right. Absolutely. That’s a great question, Keith. I really think the most important thing that pastors can do is just talk about it, incorporate it in the messages that they do just as a regular part of what they talk about. When they talk about struggles from some biblical story, use it as an example, a current cultural example of the kind of struggles that people can have. We created an opioid practical toolkit to help faith communities know just how to talk about these things, and that’s a toolkit that’s in its fourth iteration at this point. We continue to tweak it and make it more informed to make it stronger so that it helps faith communities, helps pastors know exactly what they can do to engage.
Keith Wiebe: Shannon, when we come back, let’s be sure to tell our folks how they can get that toolkit. That sounds like a very valuable resource. I want to move to the second area that I brought up at the beginning of the broadcast, the mental illness portion of this addiction epidemic that we’re facing. Shannon, talk to us for just a moment about the mental health crisis and about how that presents itself even perhaps in our Christian families and our churches.
Shannon Royce: Absolutely. Thank you for that, Keith. Well, let’s just be practical and talk about some statistics. The Centers for Disease Control says that in a class of 25 kids, and that’s whether that’s a school class or a Sunday school class, in this class of 25 kids, two children will have been diagnosed with ADHD, attention deficit disorder, one child will have been diagnosed with a behavior problem, one child will have been diagnosed with anxiety. In a single grade of 100 children, three of those children will have been diagnosed with depression, and this is children from the age of three to 17.
It’s increased among children living below 100% of the federal poverty levels, so those living at lower incomes. More than one in five, 22% have a behavioral mental health or developmental disorder. So this is really a significant issue touching our school children as well as our church children. And of that, according to SAMHSA, the Substance Abuse and Mental Health Services Administration, they oversee all of our opioid work and our mental health work, we know that 50% of people with a defined diagnosed mental illness onset happened before the age of 15. 50%. An onset happens 75% of the time before the age of 25, so this is touching many families both in the church and out of the church. Really a significant concern.
Gary Dull: I think that is a significant concern, I’m sure. Let me just drop back a little bit if you don’t mind. Shannon, you talk about ADHD, anxiety, depression in the lives of these young people. What really is the source of that in the lives of so many young people? I mean, I think that often when we think of people having those particular syndromes or whatever you want to call them, that it’s normally seen in the lives of older people even I would say teenagers on up. But what you’re saying here is that a lot of our younger children have these issues as well. What is the cause of them, do you think?
Shannon Royce: No, I think it’s complicated and it depends on the diagnosis, and in some cases, I believe in a full picture perspective in dealing with these issues. There’s a biological piece, there’s a psychological piece, there’s an environmental piece, there’s a spiritual piece. We’re holistic people and there are different parts of us touched by brokenness. So for some diagnoses like schizophrenia or bipolar disorder or major depression, there tends to be a very, very strong biological piece, and for other conditions, it might be less strong. So you really can’t speak in general terms about causation. You have to look at each of the conditions.
One of the major concerns that I have is that, when we’re dealing with our children, we’re seeing youth suicide rates just skyrocketing. So death by suicide for children 10 to 24 years old has increased 56% between 2007 and 2017, and the youngest group, they’re the 10 to 14 year olds, that rate has nearly tripled to about 500 suicide deaths in 2017. 500 10 to 14 year olds took their own lives in 2017. That should shake us up, and if you’ve ever as a pastor performed a memorial service for a young person who has died by suicide, that is a particularly a heartbreaking experience and one that touches all of our faith communities.
Gary Dull: Well, it certainly does. I’m certain that as we are discussing here today, Shannon, that there are pastors all across the nation, we’re on over 430 radio stations. We probably have pastors all across the nation who are saying, “Number one, how can I identify this particular crisis in my church? And secondly, how can I deal with it?” I’m asking that question even personally. Of course, I pastor a church, and recently in our Christian Education Department, we were talking about dealing with this matter of ADHD, particularly within younger classes of our ministry. We’re trying to build a program whereby we might be able to deal with this from the biblical perspective. But talk to our pastors out there. How can they really identify this crisis that is in their church and what specifically can they do about it?
Shannon Royce: Let’s talk about two practical things that I think could be helpful to pastors. The first is, if you don’t think it’s in your church, this is what I tell pastors all the time when they say, “Oh, I don’t have any of that in my church.” If you don’t think it’s in your church, what I encourage pastors to do is the next time you do a congregational prayer, and most pastors in our faith communities will do a congregational prayer where you pray for the sick and you pray for those who are hospitalized and those who are grieving the loss of a loved one, just throw into that congregational prayer something simple like, “And God, we lift up those who are struggling with depression or anxiety and pray that you will minister to them and help them to know that you love them and that we are here to support them.”
Just throw that into your congregational prayer and watch what happens over the month to follow, because you will have people come out of the woodwork to you at the door, leaving the church, calling your office, sending you an email and letting you know that, “Yes, this is touching our family, and I’m so grateful that you mentioned it.” So that’s the first thing I would say to pastors, that the most important thing you can do is open the door to let people know it’s okay to come to you, that you are there to support them and love them and walk with them.
But I think the second thing that is so important for pastors, and it’s something we’re working on here in our office, is to understand that that a family doesn’t expect a pastor to be able to diagnose or treat a chronic health condition. I went through cancer treatment not quite 14 years ago now, and when I was diagnosed with lymphoma, I did not expect my pastor to diagnose or put me on a treatment protocol to treat that lymphoma. But what I did expect … and we reached out to our pastor and had dinner with him and his wife. What my husband and I did expect was that they would love us and support us and pray for us as we walked through a very challenging season in our lives. The same holds true for those touched by mental illness in your churches.
There’s no expectation you will be able to diagnose that or provide a treatment protocol for that. But you can love that family, you can support that family, you can be a listening ear and a supportive, encouraging word to them when they’re struggling with whatever condition their family is touched by, and we try to help pastors understand you need to know your limits, know what you can do. You can provide support and care and love and prayers. Know what you can’t do. You can’t diagnose and treat chronic health conditions like serious mental illness. So those are some of the things that we’ve been working on in our office to help educate pastors. We’ve done a number of webinars addressing different mental health concerns and conditions so that pastors are better educated and know when it’s time to refer out to a medical professional.
Gary Dull: I know this may be backing up just a little bit, but just for the sake of the discussion, how would you define mental illness? Simply because of the fact that so often when people hear that phrase, number one, it scares them. Number two, they don’t have any understanding as to what it really is. So how would you as a Christian from the biblical perspective, define mental illness?
Shannon Royce: Well, I think mental illness is a complex area, Gary, and so you have different conditions that would be deemed mental illness. You have your more serious mental illness that tends to have that very strong biological piece, and those are the conditions like schizophrenia and bipolar disorder, major depression that would be deemed serious mental illness. Those tend to be very biologically-driven and quite often will require medication as a part of a treatment protocol, and then there are other conditions that are also forms of mental illness like eating disorders or borderline personality disorder, various behavioral disorders.
It’s complicated. It’s all in what’s called the DSM-5 which is the [inaudible 00:29:07] if you will, for the medical community when it comes to mental health concerns, and [inaudible 00:29:14] from a biblical worldview may look at some of those things in the DSM-5 and not agree at all that those are medical conditions. That’s too long of a conversation for us to have today.
Gary Dull: I appreciate you talking about there briefly. I certainly do because that’s clarifies it as well.
Keith Wiebe: We are talking today on our broadcast about an addiction epidemic that is taking place in our culture. It’s involves opioid use, it involves mental illness as we were just discussing, and as we’re going to pick up and discuss for a few minutes, it also involves the HIV crisis. Shannon, you have used the term several times. You’ve begun an answer by saying, “Well, this is a complex thing.” Some of these things also get somewhat messy, messy for individuals, messy for families, messy for churches, but folks that’s the nature of the broken world in which we live in and doesn’t the gospel address itself to people whose lives are messy because of sin. Shannon, I like to begin this last segment by asking you first of all to tell us where folks can go to access the toolkit that you talked about earlier and also how HHS makes available to them some other resources and where they can go to get that, and then I want us to move into a discussion about the HIV crisis.
Shannon Royce: Yes sir. Happy to do that. If anyone wants to receive a copy of the toolkit I mentioned, the practical toolkit, on engaging concerning opioids or other addiction struggles or wants the new toolkit that we are about to launch just in the next few weeks, a new faith and community roadmap to recovery support, helping people coming out of these various conditions, get back to work so they have that purpose and meaning of work that God intends for us to have purpose and meaning in our lives, they can reach out to our office by simply emailing us at partnerships, partnerships with an S, @hhs.gov, and we have webinars on each of these subjects we’ve been discussing that’ll help educate you. We have these toolkits available, we have lots of resources that would help equip the folks listening on the program today.
Keith Wiebe: Thanks Shannon. That is great. Very helpful. I would encourage you, if you’re listening to this, and I’m sure that what we have talked about today has really struck some hearts. Shannon, talk to us a little bit about the HIV crisis, but maybe it would be good to lead on that answer with the initiative that the Trump administration has been advancing to deal with this.
Shannon Royce: Last year during the President’s State of the Union Address, he announced a new initiative, new HIV initiative with the goal to cut new HIV infections by at least 90% in the next 10 years. This is really a critical goal and a critical, achievable, measurable goal for us because the reality is we have everything we need in terms of medications, both treatment and prevention, to address HIV and eliminate it from our national discussion and our national concerns, and so we have been working on this initiative as a department to encourage people to be tested, to encourage them if they are HIV positive, to be in treatment and if they’re HIV negative, to take preventative medications so that they will be safe.
Keith Wiebe: I know that your department, you’ve done a lot of research. Where is HIV showing up? We have been guilty probably in the Christian community maybe of too long, assuming that it’s just one particular lifestyle that is afflicted by this. What is your reach, your show? Where are you finding this to be presenting itself?
Shannon Royce: Sure. Well, we certainly know that HIV is transmitted through intimate contact. That certainly is something that we know historically. But I think you’re right. We have tended to think of this as a condition only touching folks from certain communities, and sadly that is not the case. It is a widespread and we’re particularly seeing a connection to the addiction crisis. It’s one of the reasons we’ve seen such significant increase of HIV in recent years. We have 34 states that report monthly overdose deaths by drug, and that also ties in that of the 40,000 new HIV infections that we’ve seen in recent years, many of those are associated with injecting drugs.
What we’re finding is we thought it was just … Many in the faith community thought it was just a particular population, but we are seeing many heterosexual women particularly who are being diagnosed as HIV positive. So that means either that their partner has been unfaithful or it means that there has been some connection to drug paraphernalia that has exposed that individual. So it is much more widespread, and again, touching faith communities in a way that maybe faith communities have not understood before. We had one particular city, Keith, Austin, Indiana, which is in Scott County, Indiana.
We’re in a town of just 2,500 people. 210 of them were diagnosed with HIV, and this was from sharing or reusing dirty needles, cotton and cookers from using illegal drugs. So when our office spoke to the public health folks there in Austin, Indiana about this hotspot and how the church engaged and were responding to this, they acknowledge that the churches probably would not have touched the issue of HIV because it tends to be cloaked in secrecy and quiet and nobody talks about it misunderstanding. But because of the crisis in their community with 210 people being diagnosed with HIV, the churches had to talk about it and engage.
This is an issue we really are encouraging the faith community to begin to have conversation about, particularly because of the 48 counties and seven states with the highest number of new HIV diagnoses, they’re in the South Eastern part of the United States, which tends to be a part of the United States with the highest concentration of houses of worship.
Keith Wiebe: Yeah. The Bible Belt typically seem to be there. Shannon listening to this, thinking about the problem of transmission of HIV through the use of needles, injections, that kind of thing, the problem also through intimate contact, and I wondered, do you think that our young people in this sexually charged climate, and I’m not going to give you much time to respond to this, I can tell by watching the clock, but in this sexually charged climate in which we live, in which being sexually active is considered almost a rite of passage, do they really understand that the risk that they take when they’re involved with people and they have no idea what their previous experience may have been?
Shannon Royce: Right. No, I think this is a real significant concern. It Is for me as a mother. I was raised, as I mentioned, in a Southern Baptist church and we of course were taught abstinence and we should teach abstinence, abstinence before marriage, faithfulness in marriage. That’s a terrific thing to be teaching in our faith communities. But in the little focus group that we did have 10 pastors in rural Mississippi, the beginning of the focus group, they came in arms crossed, a little uncomfortable talking about this, and by the end of … and agreed that abstinence is what we teach, and it should be. But agreed that into broken world we live in, many people are having encounters outside of biblical teaching that are leading them exposed.
Keith Wiebe: Folks, let’s be faithful and pray together. I’ve taken us to the ends of the broadcast and ran past the time to have Gary lead in prayer. But I think we can all agree that it’s God’s people, there is a tremendous [inaudible 00:38:35]