In Case You Haven't Heard…

Abstract

Mark Weber, whom we have known for our entire career as a master public affairs official in the federal government, is now acting assistant secretary for public affairs (ASPA), the top communications job interfacing with the media and others, at the Department of Health and Human Services (HHS). Weber is a lifelong HHS employee; we first met him when he was launching the Substance Abuse and Mental Health Services Administration (SAMHSA), formerly the Alcohol, Drug Abuse, and Mental Health Administration, which we had also covered for the former Substance Abuse Report. “I was part of the team that rolled out SAMHSA, but little did I know I would soon be communications director there,” he told ADAW last week. Weber has no doubt the Biden team will bring in their own ASPA, but his reflections on how treatment for substance use disorders (SUDs) has changed over his “short lifetime” (we're with him there) are key. “When I first started working at SAMHSA, our challenge was to educate the public and funding officials (Congress) that substance abuse prevention, treatment and mental health services worked,” he told ADAW last week. At the time — the late 1980s and 1990s — there was a “belief that you can't prevent substance abuse and that people who have substance use disorder can't recover, have no hope.” Initially, SAMHSA conducted the studies, took programs to scale and showed they were effective and there was a return on investment. “A major turning point was the National Treatment Evaluation Study, the first major study across publicly funded treatment programs, which showed real impact,” he said. “We have gone from trying to help the public and funding officials understand that these programs are not only effective but there's a return on investment, to achieving equity in the health system.” There is now “equality,” thanks to parity, but actual “equity,” which means treating substance use disorders the same way as any other health condition, is not yet a reality. There would still be specialties, of course, but all integrated within the health care system. “That's what we're moving towards,” said Weber. In addition, he learned early on, from working for 16 years at SAMHSA, that SUDs and mental illness touch on everything else. He values lived experience. “I credit that experience with helping me move into the Office of the Assistant Secretary for Public Affairs,” where he has been in the number‐2 position. “I started at SAMHSA as a bureaucrat and left as an advocate,” he said. Incidentally, Weber went to the border during the Trump administration to talk to the press about the HHS (not Homeland Security or Immigration and Customs Enforcement) arrangements for migrant children. “I've lived in shelters for at least 6 weeks,” he said. “I'm looking forward to continuing to speak from lived experience and going deep on topics.”