Transcripts For CSPAN2 Senators Hassan Portman And Manchin On Opioid Addiction Abuse 20171019

Hello, everyone. Good morning. Im a congressional reporter with the post. Im joined now by two senators who b have seen their States Affected by the Opioid Crisis and are working to find solutions. Please join me in welcoming senator Maggie Hassan, senator rob portman. [applause] we also send a joe manchin whos hoping to join us today. Wait a little bit, perhaps it will be joining us a a little later but were just delighted to have two leaders in this sphere who have been working every day. Senator Maggie Hassan is in her first term representing New Hampshire. Her efforts to combat opioid abuse did not start in january. During her four years as governor, she worked across party lines. To secure funding come to strengthen treatment, recovery and Law Enforcement efforts in her state, New Hampshire increase penalties for that no distribution, begin investigating Overdose Deaths is homicide. Expanded the states Prescription Drug monitoring system. Shes a member of the committee on health, education, labor and pensions. Typical spots of multiple bills to address the epidemic. Senator rob portman of ohio, delighted to have you here. Senator portman is in his second term representing ohio. Hes a former director of the office of management and budget, former u. S. Trade representative is 115th congress is foremostt experts on fiscal and trade matters but also had a long interest in combating drug abuse dating back to his days as a house member turkey established and that the Drug Coalition in some town of cincinnati. He is author of the comprehensive addiction and recovery act, one of the first major reform of federal addiction policy into decades which was signed into law last year and is chairman of the Senate Permanent subcommittee on investigations where he has done some significant intensive oversight on the response to the epidemic. Thank you for being with us today. And for those watching i want to invite you to please tweet your questions at best. Were collecting them under the hashtag postlive. Will be delighted to answer those. Let me start with, you know, as a member of the post, when we have an investigation thats had an impact as assault on sunday, its important to address that. And i want to ask you both, but we learned through this investigation, most of us, a lot of us, that congress acted last year passing a bill that keeps figures of the d, took pauls way that they need to combat this epidemic. Both of you are authors of legislation that ends to stop the epidemic and help its victims. When did you learn about the effects of this particular bill . And whats your reaction to knowing that you may have come in your case, senator portman, you are in congress when it happened, that you may have played a part in supporting a bill that may have exacerbated the crisis . Just the people understand, this is a bill that passed by unanimous consent, republicans and democrats alike. Anyone send a quick stop the bill but it seems there was not an understanding of what the impacts of this bill would be. Senator portman, i would ask you to start. Thanks to the poster i i thk thats true, i assume if not almost of my colleagues, its a complicated issue, opioids, and it requires a comprehensive response. Obviously thats why the comprehensive Addiction Recovery act last year was landmark legislation because it covers the whole gamut. Some of the legislation we can in a conference with the house. In the Prescription Drug which is why we have reintroduced legislation thats a little stronger than our original push that got knocked out in the house on Prescription Drug monitoring. Maggie is a cosponsor of that bill. Amy klobuchar and i are the coauthors. I think on this particular one, i mean, i frankly asked my office did we hear from anybody . The answer was no. The irony is that it actually passed the Judiciary Committee, im not on the Judiciary Committee but it went to the Judiciary Committee at the same as the comprehensive addiction and recovery act. A lot of the focus is probably on the Opioid Crisis and the prevention, education, treatment and recovery, and narcan, which is the miracle drug that reverses the effects of overdoses, the focus is on the comprehensive addiction and recovery act and that made them one of the reasons it slipped through because apparently it was unanimous consent in committee, unanimous consent on the floor. What thats when it issues we now we look at, examined that. Did look this morning at what the dea Enforcement Actions were around that time, they were significantly reduced before the legislation was passed. So that was actually already a pullback of Enforcement Actions but again, its a very complicated issue. There is no silver bullet. Theres a one way to address this issue that will solve the crisis. Because it is a crisis. A i just got to meet the family coming out who we saw here. Maggie and i, ive met with probably 1000 attics, recovering addicts in the last couple of years alone. I focus a lot on the issue but everybody has. I think you have to start with the Drug Companies coming up with a nonaddictive pain medication. There was a task forcen recently established under the comprehensive addiction and recovery act by the administration. In fact, applications are being accepted now for people to be on the task force we need to push the Drug Companies to come up with nonaddictive alternative. Its crazy we are using opioids for things like extracting they just doesnt make any sense. The Distribution Network which was aic focus of the story is a huge part of it. The Prescription Drug monitoring act that again i encouraged members to cosponsor lets get the darn thing passed requested seven Prescription Drug Monitoring Program that holds the pharmacies and the doctors responsible on the prescription side to stop the overprescribing. Also car states too get involved with the interstate compact so that your interoperability. People get the prescription and the nay to West Virginia, kentucky, indiana, kentucky is a roast get another prescription filled it with got to stop that. And then obviously on the treatment and recovery side, narcan and the enforcement side. We have another bill, maggie and i, a bipartisan bill that deals with how do you keep the Illegal Drugs getting back in. I want to talk about the stop act later. Senator hassan, let me ask you, what your reaction to these revelations . You had some tough questions for the dea. You would expect the agency thats enforcing these laws to speak up whenn congress is about to act to take tools out of the toolbox. Whats your reaction to what happened . First of all, as is true with rob, i have been meeting with an hearing from families, people of struggle with addiction, people of lost people do addiction ever since i got into office, but particularly over the last three to four years in New Hampshire the epidemic has to spread like wildfire. Part of what we see in the story that you are broke is the structural underpinnings of this epidemic. And while it is very true that weve been focus on prevention, treatment, recovery, Law Enforcement. One of the other things i did as governor was republican colleagues in the legislature stand at that medicaid expansis of people could actually get treatment. Its a critical part of the Affordable Care act that also requires private insurers to cover substance misuse disorder. So while we been focus on what i would call getting resources to the frontoc lines, and we need o do much, much more on that, the structural underpinnings of this epidemic are much harder to crack because of the various forces involved. I along with w senator mccaskill and senator manchin, the bill that we filed yesterday to repeal the law the passed by unanimous consent now that we understand what the impact really has been. At the end of the day i think one of the things that its been a real challenge here is that there are all these structural component. There is a pharmaceutical industry that encourages doctors to treat pain as a vital sign and use opioids aggressively. There are doctors who obviously, the vast majority of them trained to help people alleviate pain, save lives. So they were i think somewhat resistant to the beginning to think that they had a role in this. So changing prescribing roles is difficult. We have Drug Companies making enormous amounts of money on these drugs here and then we have an epidemic in which the people are suffering from the disease are stigmatized. And i really do think if this weref an epidemic that did not carry the stigma that Substance Use disorder b does, we might he gotten at the structural issues sooner. So we sawr. A lot of work to do and we still have to push incredibly hard in addition to asking and encouraging and providing incentives for Drug Companies to find nonaddictive pain relief. Well also have a medical Device Industry that actually does have some nonaddictive alternatives for pain treatment but they cant get coverage defense of medicare and medicaid for c tho. So theres a lot of work to do. I just will also just say how grateful i am not only from a te family we just heard from but throughout my state, throughout robs state, threat the country, people suffering from addiction and the families has to do. Parents have begun to write breathtakingly difficult obituaries about their children. They have brought attention to this by being willing to stand up and talk about their pain, their suffering and this disease, and thats whats going to make a difference ultimately thats how were going to be the same. We are joined by senator joe manchin. Hey, joe. How are you doing . The drive was horrible. Thanks, senator. Im sorry. Three is always, its great to have awa treo with us. Ill give a brief introduction to g senator manchin whos represented West Virginia and the senate since 2010 beckys work tirelessly to bring attention to the toll of the Opioid Crisis in the state will be for the national dimensions of the epidemic became known. Among the efforts hes been involved in, he was a leader in the effort to get hydrocodone rescheduled, very powerful speakers like a dan from schedule the schedule to. Thats meant quite a dramatic decrease in the number of prescription for that particular drug. Hes cosponsored a number of bills related to the crisis. He was scope and the Prescription Drug abuse caucus, and he talks about this almost every single day. Lets be honest, every single day youre talking to get stitches, talking about this issue. Thanks for joining us. Senator, i know you saw the report we ha in the paper on sunday. Thank you. That we did with 60 minutes. You have spoken out about it. You called for representative marino to withdraw his name. Let me ask you this though because i gave senator portman a bit of a hard time before you showed up, but you were in the senate last you would a bill passed by unanimoushe consent. What was your reaction when you learn as the author of the number of bills that address this epidemic that you may let a bill through that may have made it worse . We were incensed because and look at the whole timeline 2014, congressman mirena put a piece of legislation in the house that that a great resistance from the dea and doj saying it would harm their ability to do the job theyre supposed to do. They went reback, reshuffled more, hired people in the dea which is mr. Barber, was able to write and smooth it over. It went through. No objections whatsoever from the house in 2015. Came over to the senate. They came into the senate and to work on the language some work to make smoother. There were no objections. They use means basically comes out of the committee, the sign committee at theres no one, if were not on these committee and our staff is not integral involvement we rely on the agency. The dea at the doj said we think this will not harm them whatsoever. We sought to make sure the patients that are in severe pain, endoflife, cancer, is going to get what they want. We never intended to remove them from photos never intended to be a wholesale market to open up the floodgates because in West Virginia the floodgates are already open. I had one little town, 392 people, 9 million bills in one pharmacy. You tell me something was up flag and why it should have been flagged . Everybody is at fault. How do you stop it . Used topically getting the enforcement people back to do their job. Do you stop them y from going fm the dea, the people that know what to look for and how to investigate, how to prosecute and doj, and prevent them from going into the pharmaceutical Industry Business within the same week and get a big paycheck. With be clear this is not a partisan failure. This is republicans and democrats, cosponsored he has much problems in ohio as i do and maggie in New Hampshire. This is democrats, republicans, independent it doesnt give unto you are it will get you. We keep our mouth shut because of something members we afraid to embarrass anybody. Embarrass ourselves. Every Family Member i know and that he would end his audience probably know somebody that has been affected. Before moveon and want to ask one last question to each of you. What needs to be done to fix this . Should this bill be repealed or at least the provision in question here . Which is support, would you all support that . What are willing to do to make sure that happens. First of all, weve already cosponsored it with Claire Mccaskill right now, and im sure it will be a bipartisan effort know no antenna for the. I was happy to see this morning that the Judiciary Committee agreed to hold a hearing and thats the first step toward addressing theth issue. Its got to be reexamined and will be. I think it will be i partisan, as joe says. That hearing will take place soon as i understand it, and again, when a look at the date ofof this morning, enforcements were already down before the legislation passed. So its a deeper problem than just the standard of proof which is whathe changed. There needs to be, this was in the obama administration, that any new administration but the same career people there who need to be given the tools to do their job. Two routes point, it seems there was this concerted effort by the industry terrazzo point to get the dea to work quote with them or pigments of law judge who you all cited in the report, i read some of his article yesterday and he said the language is to bet makes it impossible. And so now that weve got a judge in charge of interpreting the law saying the language, whatever it was intended to do, this just the people, this is the person whose job it is to interpret and say what they do and what they dont say. As you learned in your hearing in the h. E. L. P. Committee yesterday, the dea takes a different you even this was the industry. When asked the industry whether the judge was wrong who said the law made it impossible to really bring Enforcement Actions, to send shipmentsos of opioids, the judge said it was asked the industry about yesterday and they said the judge was wrong and they were not misleading the public we gotda some work to do. The phrase, the substitute a minute was substantial immediate threat. Change everything. Well, senator portman, i want to follow up with you. You chair and oversight committee, the permanent subcommittee on investigations. Do you see some opportunities, i know youve done a lot of work on opioids, do you see any opportunities on this particular issue just have been or are there other committees looking at this . Theyve artie made a decision, thick of the jurisdiction but sometimes we managed to pride those committees to be more aggressive and weve done a lot in this area. So it would not be an appropriate lets see what the Judiciary Committee does. I think this move pretty quickly. There are other things to do, too, and addition to this obviously. And i dont know if lets move on. One thing thats out there i think were all at least some of them and what isnt that the White House Commission looking at this. Have been looted look at this a number of months. They are due to put out a final report is the end of the month. But we alreadye know, theyve made interim recommendations in july, what of which was to declare a National Emergency. That something that got a lot of attention at the time. Hasnt happened yet. Weve heard the president earlier this week sort of indicate that may be happening soon can we talk about that declaration of a National Emergency . What does it mean, what doesnt mean, how important is it . Sort of shorthand for other things that need to be done. Weve been waiting for details on what the president and the commission actually mean. Because joe knows as former governor like me, the type of emergency you declare matters in terms of what resources you then can actually deploy. And so we been waiting for details from the white house. It was very disappointing that the president the president said were going to declare a National Emergency, which i soon then, then really garner some resources because all they care act really, care and cures really helped us get some resources out in the field, they are not nearly enough. And we talked to the commission about the distribution formula. New hampshire is one of the highest per capita rates of the death from overdoses in the country but we only got 3 million of the money, of the 500 million. But at the end of the day this administration has said that he cares a lot about this and then has not followed through and we are losing people everyday. If i may say, in my state i am the highest, ive more deaths per capita than any state and its affected every area of my state. West virginia, the coalfields most direly got hit hard. I go around and being governor, former governor and i my position use senate and seeing the devastation thats gone on, first of all we were all in denial thinking that if you are addicted you are a criminal, well put you away. We did that. For 20, 30 just that we never could anybody. So now we understand and those who are not naysayers or deniers that addiction is an illness, and you list each treatment. If you dont have Treatment Centers, forget about it. We are starting in West Virginia we have to start preks was education in schools what this has done. We have no place to take the children. We take them out of a drug infested home. We have people talking about orphanages again to try to get them out ofng a drug infested hell. How do you clean the person of if you dont have Treatment Center so i introduced the called lifeboat. One penny per milligram for every milligram they produce of opioids in the United States of america. That produces 1. 5 2 billion. One penny, and theyre not going to be able to pass that through. But he says it will be attacks increased its not. Its a treatment and we can start putting these Treatment Centers andrt helping people. Secondly, we can get people in the workforce. Im down to 2 because freaking skip out of the workforce. You either have addiction, you have incarceration or a record, conviction, or you have lack of skill sets or accommodation. A combination that i can tell you if your addicted you will end up with a criminal record, probably large day. We have no way to get the backing because we put them in jail. If its not a a Violent Crime r sexual crime, the person goes through one year of treatment and passes, when your mentoring, helping other people,to they out to have a right to go back joe simpson judge into thick and other onetime expunged. I want to ask you because you been outspoken and saying its not just about the regulations, its about the funding. Youve worked to try to get the funding in place. Some of that was that in cara, another bill passed last year but you said the order be done. How does declare anon emergency help, or is the bigger issue Getting Congress to act appropriating money to actually get people to help they need . I think its both. Whats happened in the last year and half is really positive peer congress did pass the legislation it took us four years to get the support for the quick conferences in d. C. , brought best practice from around the country. The First Time Congress has acted to Fund Recovery programs. To the point maggie and joe made, this is not going to be solved with only one approach. Its going to be multifaceted. It has to include in my view not just treatment of longterm recovery. Thats what this legislation does pick as maggie said it does provide grants to the states. We overfunded it this year and that was a really good sign. My concern was were not going to provide enough funding. We founded more than was authorized. We will take some more. And we need more. And i was the last year and now we passed the cures act also. Cheers is different because it sends money trucker to the state. Cara can go, if you have three grandson about that were announced to service providers, but cures goes directly to states. Its a half a billion dollars a year. Thats for this year and next year, but enough to be that. So we will have to be sure we get the 500 billion a get in this fiscal year, get as much as we can because the crisis is i getting better. Its getting worse. Then we got to be sure whether longerterm strategy. Some of us of a the work about o cut it out how to get something that is more permanent so states can plan but all that would be needed. The commission i think that a good interim report. I had testified before, talk to them. I spoke to governor christie over the weekend again about final reporter i think he is passionate about it, committed to. He is the chair of the commission as you know. Actually the report was due on october 1 right. They asked for an extension. Thats fine. I just want to make sure that you meet the end of the month the deadline. Governor christie may come thats his intention . And again his passion about this. Hes got a personal commitment to this, but i got to tell you, i dont think a National Emergency is as important as sort of what results in terms of congress. Because the administration can appropriate money. What they could do and this is positive, ive met with the president person on this very issue, is they can declare an emergency that requires all the agencies to work better together. I mentioned the task force and coming up with new nonaddictive pain medication. If the agencies arewi all told e cop, this is an epidemic, which it is, this is a National Emergency, and will make a difference. Thats good, but congress has to also view this as an emergency. That requires us to do a better job of providing some longerterm funding. Not just funding. Its not a metaphorober and mont the issue. Its a metaphor and what works. What cara did is what treatments work better than others . The need for longerterm, all the research we did, the need for us to deal with this issue at every level. Well talk about the stop act in a second help but there are more people died in ohio today, i do think the same is true with your state from fentanyl pen from heroin. The note is a synthetic form of opioids, coming in from china molted. Thats an outrage. Unbelievably the stop act which maggie and i have worked on for about a year now has been stuck in congress. Before we move on to the stop act i do want to save, we have a couple questions come in from abuse that i want to get to eventually get absolutely lets talk about the stop act, senator hassan. Fentanyl is as were going every day is in accord with powerful drug thats, you know, its killed people. Its affected innumerable lives and we have this problem that is simply coming through the mail from overseas. Talk about the problem and what the stop act in New Hampshire 70 or so of our Overdose Deaths are a result of fentanyl overdoses. It is 50 times more powerful than heroin. With both led ten deaths from carfentanil which is 100 times more powerful than fentanyl and was really intended only to tranquilize large elephants. So these drugs are synthetic. The profit margin because theyre easy to make him you dont have to grow a plant as a precursor here, are huge and flooding particularly rule areas of our country. I do just want to add one other thing to the overall picture here of what we need to do. The last thing we should be doing is destabilizing and repealing our health care in this country in terms of making sure that there is treatment accessible to people who need it. So in the snakes while we talk about the stop act, which is critically important to getting updated so that we can go after these fentanyl producers and dealers, we cant ignore the fact that an integrated Healthcare System that treats Behavioral Health and Substance Abuse disorder is an absolutely essential piece of this. And if we repeal the Affordable Care act, if we cut medicaid substantially, if we fail to invest in longterm treatment and that the bride of modalities for people, we will not turn the tide on this thing and beat it. Senator portman, quickly, i mean, the stop act seems like a nobrainer, that we would want a to crack down on Something Like this. Why is it so difficult for congress to act to change the law to keep these very powerful drug honestly, i can tell you the recent but its a mystery to me. Because heres whats going on. This is a shock when people find out. Fentanyl which is again killing more people inn our state than heroin now is coming into the u. S. Mail. This is i coming overland from mexico like heroin. Its not even coming from a country next to us. It is coming mostly from china. They choose the is no because the u. S. Mail system does not require that packages that information for Law Enforcement to stop this poisoning if your fedex, ups, dhl, yet to provide as data that says this is where tom, this of arsenic, this is where its going. Ive been to the screening, ive seen them do. They go in there with customs and Border Protection people, and dea and dea a strong supportive of our benefits and theyre able to identify this package. Its like finding a a needle ia haystack. As as a result you get a package the size of that clock that could at 100,000 doses in it. Three flakes of the stuff can kill you. This is incredibly powerful, incredibly cheap. And at a minimum we have been giving our Law Enforcement officials the ability to find his packages and stop them. Thats not again i thought the onlyha solution because that wil increase the cost and get all the less on the street but we still have to do with the broader issue. That is a nobrainer. I want you to feel this is a question from a pr, jazmine asked on twitter, to what extent is harsher punishments for fentanyl a solution to the broader crisis . I know there f are bills out there, senator feinstein i know has one that are involved in i find with anything that works and is more effective. Unless we do something, the Chinese Government and they get serious about shutting this think out, we all know where its coming from. They know where its coming from. He until this administration gets a series in treating of c think we do and all the pressure we can put sanctions and we can tell them pastors can will not let them keep telling americans. They got to know the sisters and were not standing for and we will not tolerate it. We can shut everything down. We can try to stop the flood, if you will, but unless the Chinese Government is real and get real about this and sincere, knowing that we are sincere, and that were going to do everything we can to sanctions and trade agreements, and if you think we put pressure on them, if theres no quid pro quo offense to those, the money keeps pouring in, they will keep doing it. Those two indictments this week of a chinese nationals as traffickers was significant because thats the first time that Jessica Barth has taken that step. If they dont they dont issue those indictments lightly. Is moving in the right direction, just to slow. There is a criminal justice aspect to this sender to mention i you been outspoken in saying you cant incarcerate your way out of this problem senator manchin. You have to treat this as the illness that it is. Theres another interesting question coming to us from a viewer, victoria on twitter ask what do senators think about establishing Safe Injection Sites to help curb the crisis . In other words, giving addicts a place where they can go and be monitored while the use . Weve heard about other harm reduction, Risk Reduction strategies like needle exchange, et cetera. Is this something thats worth exploring . Let me talk about methadone and some boxing there with certain to recommend this is how you should bring them down. With other people is actually not. Im an addict. You are just stringing me out. Everyone has a different approach. I can just delegate we have places in West Virginia Treatment Centers called recovery points. Recovery. Takes an absolutely clean slate and goes with it. These are all run by severe addicts, people almost bottomed out and theyre all working and running these recovery points. They do not tolerate methadone. They did not tolerate any of that. They have a 68 basically to rate. But the really work with these people and they monitor. They are on 24 7, minimum of 12 months. Thats what it takes when youre been addicted to the point americas addicted and West Virginia has been addicted. Im not knowledgeable enough to say bring them down. Senator hassan, i would give you the last word. I will say that what we know is different people need different kinds of treatments. We also know that theres the e sector set of medical problems like pepsi and cardiac problems that come from hpsci we need to be smart. We need to treat this as the disease it is people also need to all people accountable which is what Drug Court Programs with Treatment Options are so important. Weve got a lot of work to do. Again were losing people everyday to this horrible disease. Senator portman, i will actually give you the last word. Look, i dont disagree. I think again going back to the Drug Companies at the need to come up with nonaddictive pain medication we also need better medication. This is what cara try to end set of eyes to some funding to come up with other Treatment Options. Joe has talked about methadone. I for the same thing from a lot of addicts. I think maggie is right that it needs to be customized to the person or vivitrol is that after which blocks the grading as opposed to continuing the effects of an opioid. Thats been very successful for some people but is incredible to me we dont have more options after the people to look at that are not addictive option to get people to the difficult period of recovery. I think that again if you look at this in a broad sense weve got to go back to the core. Had we stop people from over prescribing, bobby for the five addicts start on Prescription Drugs and how to come up nonaddictive medications and then at the other end had to come up with better therapies. If its really an epidemic which i believe it is, and if we have a National Emergency that will be part of the focus. Very briefly. If that wasnt for the Washington Post article what you wante done, i called all my stuff, i knew right then that congressman marino was not to be the drugs are. No one in West Virginia would delete after reading that article and also you all collaborate with 60 missy would be fighting for them. It was not personal against him. The position hes taken an abuse so involved was the wrong person. I applaudud the president for moving as quickly as a movie in a different direction. I think the white house is sincere about this. Now its time to take action and want to thank you all because if you have not done that this would still be simmering. We appreciate the kind words but thank you for joining us today. Thank all the senators for joining us. They can for them. [applause] when you get a chance, thank First Responders. Senator hassan makes a tremendous point. Thank the First Responders who are on a a daily basis of bondg to people in crisis. And were going to move onto the next portion of our program. If you will bear with us for just a moment. Thanks again. [applause] its so great to see all of you here. Im one of our on error reporters and then joined by the team that made this story happen. Its great to have you guys on stage to get you from your person. Lenny bernstein, health and misreported at the Washington Post. Scott, pesky reporter at the Washington Post and iver, produce at 60