Ago, which specifically mentions oxford house as a good thing and as a way for the future. With that, i call on john kelly to come share with us his knowledge so we can learn more about the disease we have in the road to recovery. [applause] this modern technology stuff jackson is good at adapting. [cheers and applause] we now have coasttocoast operation. Ricky is in the state of washington. [cheers and applause] speaker from massachusetts. We love you, ricky. [laughing] dont make ricky nervous. [inaudible conversations] [inaudible conversations] just to show you how we rebound, here we are. [applause] thank you. Good morning, everybody. Good morning. Delighted to be here. Im one of those phd some new england. I apologize upfront. But im so dependent on powerpoint. I cant speak, i cant even talk without powerpoint. [inaudible conversations] [inaudible conversations] [inaudible conversations] [applause] all right. Lets start over. Im delighted to be here with you all. I was getting worried. I was at, they invited me to come and speak at the call is anonymous World Convention in atlanta a few years ago, and they asked a a couple scientis, speak that research. Ive done research. They said dont bring slides. Dont bring slides to talk. So i was saying to the audience then, i said im so dependent on powerpoint and have to rely on my higher power point to do this talk. I was getting worried there i would have to do the same thing, but anyway, ive got some power now to my powerpoint slide. No, but im really honored, paul, thank you and the committee for inviting me to be with you all. I hope that what a courtesy is the least interesting if not informative and even helpful this morning. So thank you for inviting me. Thank you for having. I hope you have a great conference. [applause] so i think i have to do both of these things. I have to remember, remind me to click these okay, yeah. Looks different on there than here. But anyway, well get through it. If not, ill just tell a couple of jokes. Ive got some good ones. But so what i thought i would do this morning is to talk about longterm recovery, talk about recovery, a National Recovery study that we completed recently, talk about some of the findings from that study. And, what also want to do some context on how we came to this focus on remission and longterm recovery in terms of research. So im going to talk about kind of how we got here in the last 50 years. Ill talk about National Recovery study, and then when we did the National Recovery study ill talk about the prevalence of alcohol and drug problem resolution in the United States. Ill talk about what proportion of those individuals who have resolved a significant drug or alkyl problem identified being in recovery, the predictors of recovering person, what the pathways are that people follow in recovery to achieve recovery. Ill talk about what weve done to estimate the number of recovery attempts it takes before people achieve longterm recovery, stable recovery. And then ill talk about the functioning of people in recovery in the United States, and what happens over time and see if we can identify any milestones of recovery. Okay, that looks like a different slide there. Thats a different slide there. Unfortunately. Thats the wrong slide. Its different than the one on here. Thats the wrong one. All right. Given the time, time scenario here, i i might just have to tk it through. You might just see the slides, unfortunately. [applause] its all right. Im happy im feeling happy. [laughing] im still feeling happy and healthy and terrific. All right. Well, what i can see here, maybe you can gather around here. [laughing] you can see what im seeing, but so what i was going to tell you is this, okay, ive been reflective because its almost 50 years since the declaration of the war on drugs happen in 1970 under nixon. The very nature of that rhetoric implies what . It implies a militaristic identifiable target that we can defeat. As it turns out, although that was the initial stance, to be tough on drugs and tough on crime, weve moved from at that in the last 50 years from a broader approach to quote, unquote, the drug problem. If you look at the laws that have been passed in the last 50 years from the controlled substances act in 1970s to the drug abuse october of 1986, these laws were harsh rhetoric laws designed to be tough on crime, tough on drugs. The results of that, of course, was what . It was actually an increase in the prison population and worked in terms of locking people up. We have about 4. 1 of the worlds population and 25 of the worlds prisoners in the United States. Now, you could say, you could argue and say, yes, but it won the war on drugs. No, unfortunately, it did not. That recognition of the failure of the more punitive stance resulted in the passing of laws to, instead of looking at supply reduction only or more focused on supply reduction on interdiction and supply, was also focusing on demand reduction, demand reduction, recovery. Think of the laws passed in the past 20 years, at Affordable Care act substituted as an essential health benefit, you had to be covered by insurance, exchanges in insurance company, that was a big shift. The comprehensive addiction and recovery act, or cara had been passed. And again, the idea is to focus not just on supply reduction, but also on demand reduction. I had the privilege and honor of being invited to the First Ever National drug policy reform summit held at the white house on december 9th, 2013. And that was under the director of omdcp at the time. And that really was underscoring and making a market shift, National Policy shift away from the rhetoric of the war on drugs towards a broader Public Health approach. So, in some ways, weve kwon from the war on drugs to the war on the war on drugs. But we should also remember that the war on drugs declared in the 1970s also marked the concerted National Effort in terms of forging new ground in terms of treatment and prevention and recovery. And antiabuse of alcoholism and drug abuse 1974. 1972 samsa was founded, as a result, the last 50 years weve learn a lot of addiction and genetics and genomics and just like now, like other complex illnesses and disorders, Substance Abuse disorder is genetic disorder. Thats very clear, thats resulted from the research and funding supporting that research. We also, in terms of cause and controllability, these two factors associated with stigma and discrimination, so pervasive in addiction. We understand from the neuroscien neuroscience findings particularly the last 30 years through brain imaging and neuroscience, and the regulated control for using substances, despite the consequences, the essential feature is theability to regulate those impulses have opinion through our research on neuroscience. We can see much more clearly what happens in the brain in the subcortical areas as well as the cortical areas of the brain. How those are radically impaired as a function of chronic exposure to substances. Weve also had, think about, again, just think about the last 50 years, particularly the last 30 years. Weve seen changes in our clinical approaches. Weve had recognition of the stages of change. Remember the stages of change, pre contemplation, contemplation, decision or preparation, action and maintenance. And then treatments designed to address the notion of ambivalence. This notion of ambivalence, kind of i do and i dont. Its greats im a clinician and its great when people come in and say tell me what to do and im ready to do it. Those are wonderful cases. But most people, 70 of people are coming in because of the police, their spouse, families, schools, i kind of wanted im here, but i dont want to be here, yes, i do, but i dont. What did we use today say . Go back and come back when youre ready. You could be dead by then. So bill miller and kind of the motivational interviewing paradigm which started in the early 90s, it was important because it said look as clinicians we cant just say go back and come back later. If ambivalence is a cardinal feature of addiction, we need to help patients, help them resolve at that ambivalence. So it made it a clinician problem. How do we as clinicians then do Something Different . To really listen, you know, its a good addage on the slide. What people really need is a good listening to, not a good talking to. We used to think a good talking to. But the paradigm what people need is a good listening to. Lets see the world through an accurate empathy and kind of see the world through their eyes. Weve had contingency management, good medications with people with alcohol and ipo use disord opioid use disorder. And what i want to focus on is longterm recovery thats taken shape. The reason why theres been a focus. Weve talked about addiction as a chronic illness for a long time, but have not treated it as such. Weve tended to treat it as a chronic as an acute illness. People like tom mcclellen, chuck obrien, william white, who have had the privilege of working with and publishing several papers and a book on Addiction Recovery management with and bill was really the guy, as some of you know, bill white, he was really kind of the architect of the chronic disease management or chronic Recovery Management paradigm. He provided a lot of the terminology and conceptualization how we address addiction as a chronic illness. And part of the reason for that is the recognition that it takes a long time for people typically to get into remission after they meet criteria for Substance Abuse disorder. It takes about four to five years after the onset of a Substance Abuse disorder before people actually start seeking help. Take the further roughly eight years on average to get one year permission after people start seeking help and roughly four to five treatment episodes in the most severe cases in the clinical population. Whats also noteworthy, however, is even though it takes a long time to get that precious one year of remission, it takes four to five years of continuous remission to be no more likely than anybody else in the general population to meet criteria for Substance Abuse disorder in the next year. In other words, it takes four to five years of continuoouous remission to get below the 15 line. 15 is the annual rate for getting to Substance Abuse disorder. And meeting criteria for Substance Abuse tornado. If youve already had Substance Abuse in order it takes four to five years. What does that suggest, it does in the suggest 30 years of rehab and by graduation. What it suggests is longterm treatment models and Recovery Support structures like houses, like aa, like other mutual help groups. Like longterm clinical Recovery Management paradigms. By the way, all of what ive talked about and paul mentioned this, the Surgeon Generals report i was lucky to be involved in that, honored to be one of the authors on that. Its down loadable for free. Its an easy to read document. Id encourage you to read it, only seven chapters and its got illustrations in there and even i can understand it. The what do we do in this National Recovery study . The reason why we did this is because people like bill white have been talking about for decades, look, weve got libraries on the etiology, libraries full of books like that, libraries how to stabilize people, acutely destabilize people and how much do we know in longterm recovery . Yet, there are millions, tens of millions, it turns out, of people in recovery that we could actually do research on, ask them what helped you . Whats made the difference . What are the things that have done that really, really help . So we conducted this National Recovery study, im sorry you cant see these slides. I spent weeks making them beautiful for you. [laughter] but i tell you what, you can have them. Okay . Ill send them to you. You can yes, you can post them. [applaus [applause] absolutely, well post the slides and you can have them anyway and im happy to send any papers you want on the research, happy to send those as well. So one of the first papers we did from this study, which was one of the reasons for doing it, was to estimate National Recovery, so we had a nationally representative sample, ruffling a sampling of americans who were bench marked through the census and the national representative. And asked them did you used to have a problem with alcohol or drugs and no longer do . We kept it broad like that because we wanted people to selfdefine problem resolution and there was a reason for that because we want today identify also those who identified being in recovery. And what we found was that 9. 1 of the u. S. Population resolved a figure drug or alcohol problem. 23. 25 Million People who have resolved significant drug or alcohol problem in the United States. About 60 , when we look at primary substance, as you might guess, the biggest one, the primary substance of those in recovery is alcohol. And the National Survey of drug use and health just came out this week, 2018, and it was over 20 million cases of Substance Abuse disorder in the United States, 75 of all Substance Abuse cases are alcohol. 20 are other drugs, all other drugs combined. So what we saw was a larger portion, 60 roughly of those in recovery were had their primary substance as alcohol. We had about 10 of cocaine, about 10 methamphetamine, 6 o opioids, 13 cannibus. One of the reasons i wanted to ask that question, did you once have a problem with drugs or alcohol and no longer do . I wanted to estimate the proportion of people actually being in recovery who actually adopted that label and what we found was that roughly half of those who said theyd resolved a significant drug or alcohol problem selfidentified as being in recovery, of adopting that label. What were the results of adopting that label, people whose lives had been more severely impacted by alcohol or drugs were more likely to adopt that label. So, it may serve a selfpreservation, maybe selfpre sserv selfpreservetory, you may keep it here because you dont want to get burned again. The significance to their lives with that identity. Those whose lives severely affected by substances, they were a mixture of people who didnt want to identify with the notion of recovery, they just wanted to leave it in the past and not think about it or not talk about it again. The next thing i want to say is about path ways. What did we find in terms of pathways of recovery . What we found similar to many other studies we have done, looking at pathways to recovery. There are many path ways and all should be celebrated. There are Clinical Pathways and these are more formal treatment and another way is through nonclinical, but service use pathways, aa, na, smart recovery and so on. The third pathway is selfmanagement and people who dont use assistance, but still get into remission. What we found in this study, again, we had a broad base of people who selfidentified as a result of a significant drug or alcohol problem. 54 used an assisted pathway and 46 did not. 46 didnt use any kind of service whatsoever. No treatment, no mutual help, but got in to resolve their problem. And again, when we looked at the predictors of using those different pathways,s a you might guess, the ones that were more severely impacted and affected by addiction tended to use treatment and mutual help groups, and medication. Those who were less severely affected were able to change without those kind of external supports. Of the services that were used by people, the biggest one was mutual help groups like aa and na. About a quarter you had used formal treatment. About 9 medications and other oxford houses and other centers. As a side bar because we just finished a review looking at literature on aa and 12step treatments, because that was the biggest piece of the pie in terms of how people recovered, those who used external services and ill tell you a little about that because theres been a lot of misinformation and misconstrual regarding 12step in media and the press. Were coming out with a systemic review we hope will be published in the next couple of months through the cochran system, the Gold Standard for medical science. What we found in this particular review, 27 studies, very high quality, rigorous, wellcontrolled studies, that interesting 12step facilitation treatment compared to cognitive and motivating did well or slightly better than the more wellestablished treatments. Where it really stood out though was in helping people achieve continue abstinence and achieve remission. 12step facilitation on average, produced about 50 more cases of complete abstinence over three years compared to other wellestablished treatments like cbt and met. Now, the other thing when we looked at the economic studies, there have been four, five economic studies that we included, were included in the report, not only did 12step facilitation actually do better in terms of helping people maintain abstinence over time and remission over time, but it did so at a substantially reduced health care cost, okay . It turns out, over a twoyear period, people who were linked clinically by clinicians to aa and na, but mostly aa, saved about 10,000 over two years in Health Care Costs relative to people who did not receive a linkage and they had one third higher abstinence rate. Now, just taking that alone, translating that into all the people who treated for alcohol use disorder in the United States, roughly one Million People per year, if they were all linked to aa, that would save 15 billion just in Health Care Costs and produce better outcome. [applause] now, that is pretty impressive. Its kind of what we want, right, from a Public Health standpoint is, if we have something, a free ubiquitous and indigenous resource in the communities in which people live, that can mobilize the same kinds of therapeutic mechanisms that are mobilized by formal treatment. That is to say, helping people maintain motivation, selfefficacy and reduce craving, then thats a good thing. In fact, ive referred to aa in groups like the closest thing in Public Health that we have to a free lunch. Think about that, there are millions of people who utilize these resources in the community. And now, the evidence supports the notion that, i think, you all have known for a long time, and many people have known in the literature, its now clarifying that when we actually link patients to these free ubiquitous recovery specific support resources they do better and we save money. Its also been thrown in the oxford house, you may have seen the study by lenny jason, again, a high quality randomized study. Randomizing individuals with a Substance Abuse to go to the house or home to the community and receive treatment. They did a study two years, people who went to oxford house had substantially better Substance Abuse outcomes and 60 asked, over 30 . [applause] the employment rate the employment rate over two years with 76 in the oxford house, 49 in usual. [applause] and the reincarceration rate, criminal justice involvement was twothirds less in the oxford house compared to usual. [applaus [applause] okay. So, know the only did were those clinical and Employment Outcomes better and criminal justice outcomes much better, but it also reduced cost to society of 30,000 per person over that twoyear period. [applaus [applause] so, again, this rise in the community, what we call Recovery Support services, oxford houses, sober living environments, Recovery Community centers, mutual aid groups, recovery high schools, collegiate recovery, emerged and grown and now evaluated are showing very good outcomes. It makes sense when we think about a chronic illness. If we talk about acute illness that could be solved within a 30day period then we wouldnt need all of this. The reality is, people recognize what they need and when its not available, they construct it. Thats what happened with oxford house. All right. People recognized there was a need. It wasnt the government saying we need to create these things, it was people who were suffering, we need more, we need Something Else and this is what happened with mutual aid. This is what happened with oxford home. This is what happened with collegiate recovery. All of these different paradigms. Recovery Community Centers which are growing gangbusters all over the country. Recovery capital in the communities in which people live. Okay, so, let me tell you im going to tell new the time ive got left, i think one of the things im particularly interested in and focused on which is the changes in recovery, what happens in recovery. We had 2000 people in the sample who reported the result of a significant drug or alcohol problem. One of the things were looking at, what happens to quality of life, selfesteem, happiness, distress, and Recovery Capital when they get into recovery, okay . And again and cant see this light unfortunately, but what i can tell or describe it to you is the what we saw was a general linear increase in all of those positive indices with time, particularly in the first five years, okay, when we looked over the 40year period we had people from one week in recovery to 40 years in recovery, right . So we had a lot of people, the 2000 person sample and what we saw was this steep increase in the first five years in selfesteem, happiness, quality of life, Recovery Capital, and a decrease in psychological distress. So thats what you would hope. Thats what we see. But theres some interesting kind of nuances to that story. So first of all let me say that, you know, in keeping with the point i made earlier, remember, i said it takes four to five years before you kind of reach that stable point in remission where youre no more likely than anybody else for criteria in the first year for Substance Abuse disorder. This data showed the same thing, a steep incline for the first five years, trying to get their life on track and get the Recovery Capital and get their life on track. This we see an Inflection Point that happens round about five years. It starts to level off. Still goes up, but the good news is that as people stay in recovery, what it looks like is a psychological distress seems to be people are better able to cope with psychological distress and people continue to accrue Recovery Capital, they get happier, quality of life improved. And selfesteem improves. Whats interesting, it took 15 years before this sample reached the same quality of life as the general population, 15 years, to me, that is way too long. Now, and i think part of the problem here has been our cultural psyche about how we treat addiction. We tend to treat addiction like a burning building. We recognize theres an emergency situation, what do we do . We put out the fire. But what weve failed to do is recognize, yes, we put out the fire, but what about providing the Building Materials that the person can use to rebuild that building or to rebuild that life . And what about most importantly, a Building Permit . So that building can be rebuilt . What happens with people with drug convictions . Is it they cant get a loan, they cant get housing, cant get education, cant get a job because of prior criminal convictions . So they cant get the Building Permit to even rebuild their life. This is something i think that has stymied peoples efforts and it also, it really diminishes hope that people can have a chance at a better life and recovery. One of the things that we notice, also, is the is that these changes in quality of life and Recovery Capital, not the same for all people, so there were different people, particularly those with who had oip opioid and stimulant use disorder. Those using crack cocaine, methamphetamines, cocaine, opioids tended to have a tougher time. They took two to three years in achieving the same level of Recovery Capital as those individuals who had other use disorders, alcohol or cannabis, and the quality of life didnt improve until two or three years into recovery. It didnt get to the same level as though who had cannabis or alcohol use disorders. So what that suggests is that individuals, certainly individuals perhaps more marginalized individuals such as those with opioid abuse disorder need more capital in order to achieve the same quality of life as others. Weve found in the study that people with opioid use disorders and heroin histories in particular have a harder time disclosing the fact that theyre in recovery, compared to people with other Substance Use disorders. What does that mean . It means that theyre feeling a deeper sense of stigma, discrimination and shame. Now, this is pervasive across Substance Abuse disorder, dont get me wrong. Its tough to deal with because were dealing with stigma and discrimination every day, but what we noticed in this study when we looked at primary substance opioids tended people with opioid problems tended to have a tougher time just talking about it and disclosing it to people and that means they dont get as much relief, dont get as much help as maybe others. We need to do more and one of my supervises, valerie at university of delaware, shes doing an intervention to help people talk about this better. So just in closing, because im out of time, but like i said, you can have these slides. Ill be around and moderating the panel right after this on research with a really stellar cast of players, but let me just sum up here. Like i said, remember 9. 1 . 22. 35 million americans have resolving problems. Half identify as being in recovery, half do not. Those who do tend to have more severe histories in terms of their addiction histories and approximately half result of the substance problems without any external assistance, and the quality of life indices, when we look at quality of life over time and recovery, we see general increases, particularly sleep increases in these positive indices in the first five years which then become shallower. Its not the same for everybody. Some people have lower amounts of recovery, access to Recovery Resources and its called Recovery Capital and its important to remember that people need those Building Materials and they need a Building Permit to be able to get started and give them hope. So with that, i think ill leave you alone and ill see you later in a few minutes. But thank you so much. [applause] have a great conference. [applause] dr. Kelly, thank you, thank you very much. Not only first we apologize for not having all the fancy tech stuff that permits power point slides and stuff, but i think that one of the interesting things is, that you showed how the irish are able to adapt to whatever the situation. Yes. Shane is not irish so shes not cheering me. Listen, were going to take a 15 minute break, 10 minute break now, we resume, regain our conference at in 15 minutes. This session is going to be the big conference room, as you look at the numbers in your program, 1, 2, 3, 4, 5, it tells you where the session will be. The big one is always going to be here. See you in 10 minutes. [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations]. [applause] [inaudible conversations] thank you very much. Its a great honor. What a Beautiful Day in the rose garden. Please sit, thank you. To ensure that all resources of the federal government are focused on the arriving sotorm, ive sent vicepresident mike pence to poland in my place. Its something very important for me to be here. The storm looks like it could be a very, very big one, indeed, and mike will be going. Ive just spoken to president duda of poland and expressed to him my warmest wishes and the wishes of the American People. Our highest priority is the safety and security of the people in the path of the hurricane and i will be rescheduling my trip to poland in the near future. Were gathered here in the rose garden to establish the United States space command. Its a big deal. As the newest combatant command, space com will defend americas vital interest in space. The next war fighting domain. And i think thats pretty obvious to everybody. Its all about space. Were joined by vicepresident mike pence, secretary of defense dr. Mark esper, acting director of national intelligence, joe mcguire, acting secretary of the army, acting secretary of the air force matt donovan. General Joseph Dunford and congressman mike turner. Were especially grateful to welcome the new leader of space com, general jay raymond, highly respected man within the military. Joined this afternoon by his wife molly, thank you. Thank you, molly. Congratulations, momly. Thats great. Their wonderful family and several of their friends. General raymond, congratulations, so important. I know hes going to do a fantastic job. Thank you very much. [applaus [applause] the United States combatant commands were developed to join branches of our armed forces in common cause across diverse fields of battle. Each of the United States militaries combatant commands has an area of responsibility from centcom, which overseas our mission in the middle, to our most recent cyber com, which we established just last year to protect americans from the most advanced Cyber Threats and also to create very, very severe and powerful offensive threats should we need them. The dangers to our country constantly evolve and so must we. Now, those who wish to harm the United States, to seek to challenge us in the ultimate high ground of space, its going to be a whole different ball game. Our adversaries are weaponizing earths orbits with new technology targeting american stop lights, critical to orangeses and our way of life at home. Our freedom to operate in space to detecting and destroying any missile launched against the United States. So just as we have recognized land, air sea and cyber as vital war fighting doe mains, we will now treat space as an independent region overseen by a new unified geographic combatant command. The establishment of the 11th combatant command is a landmark moment. This is a landmark day, one that recognizes the centrality of space to Americas National security and defense. Under general raymonds leadership, space com will boldly deter aggression and outpace americas rivals by far. For 35 years, general raymond has led and commanded Space Operations at every level in the u. S. Air force. Molly, i hope youre very proud of him. Ill bet you are. I am, too. Hes a warrior who is integrated Space Capabilities to make our military Even Stronger and to pave the way for a new era of national defense. Hes respected by everybody sitting in front of us, everybody in the military and everybody that knows him. Space com will soon be followed very importantly by the establishment of the United States space force, as the sixth branch of the United States armed forces. And thats really something when you think about it. The space force will organize, train and equip warriors to support space coms mission. With todays actions we open another great chapter in the extraordinary history of the United States military. Space com will ensure that americas dominance in space is never questioned and never threatened because we know the best way to pre victim conflict is to prepare for victory. From our nations first days, americas military blazed the trails and crossed the frontiers that secured our nations future. No adversary on earth will ever match the awesome courage, skill and might of American Armed forces. Today we salute the heroic men and women who will serve in space com and keep americas horizons forever bright and forever free. We have budgets since we came into the administration, since the election, 2016, since january 20th of 2017, we have done things with the military that few people would have thought possible. Budgets of 700 billion, 716 billion and now, 738 billion dollars. Nobody would have thought that that was possible, but we had them approved by republicans and democrats. And that money is now building the most advanced equipment anywhere on earth, equipment that nobody even could have conceived of, even two years ago. Its very necessary and hopefully well never have to use it. I would now like to ask secretary esper to sign documents formally establishing the United States space command. Thank you. [applaus [applause]. [applause] good afternoon, mr. President , thank you for hosting us today. In doing so you honor the airmen, sailors, soldiers and marines that sure our high ground of our nation. On behalf of those men and women wed like to present you with a momento, space command, 2019 on behalf of the space war fighters, thank you on behalf of your leadership. [applaus [applause] thats a big one. Thank you very much. Id know you like to invite chief Master Sergeant roger toberman to the stage to unfurl the flag of the United States space command. Thank you very much. [applause]. [applause] [inaudible conversations] [inaudible conversations] [inaudible conversations] again, were bringing you live coverage of the discussion on the opioid addiction crisis and related issues, thats being hosted by the oxford house here in washington d. C. The next panel focusing on addiction research. Three minutes, three minutes until the restoration of the program. Okay, three minutes, head back in, folks. [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] okay. Were about ready to begin the next session. Come get your seats in the main ballroom. Its the panel on addiction, whats new. In just a second ill read is exactly as jane wrote it. Whats new and news worthy. Get some of the latest information about Addiction Recovery research. Years ago, i kept trying to convince dr. Clark that the best way to have any kind of research is to put a chip in the ear and track people as they come into oxford house and leave oxford house and dr. Clark was then director of csat and used to suggest that my attitude was a bit of republican conservativism and not very american. Hear hear. However, today, as years have passed, i have a thing on my wrist called a fitbit at that keeps track of every step i take. I look at people on this convention and i see a lot of piercing and other things, ears, everywhere else. It seems to me at some point, we need to really become a tracking mechanism for folks who do research so that people will know exactly what happens if you move into an oxford house, get involved in the democracy of a house, learn the kind of selfreliance and selfrespect that comes from oxford house. Youll probably stay clean and sober forever. Now, having said all that, this session has some wonderful experts, from stu gitlow, dr. Clark, kevin sabbat, will, and saber steen. Josh used to be in the Commerce Committee way back in the days i was there. He was called waxmans man and we republicans used to figure out how were going to change what they want. We never succeeded very much and fortunately, he was responsible for helping us get expansion because of the antidrug abuse act of 1988. Okay. With that, let me turn it over to the moderator and john kelly, keep this panel going. [applaus [applause] wonderful, thank you, paul. Hi, everybody, my name is john kelly. Many of you probably saw we on the last talk, if you didnt, im a researcher and clinician from mass General Hospital and Harvard Medical School in boston. Im very happy to be here. Paul has tasked me with a moderator role this morning and i will chime in as well when i feel appropriate, but weve got such an expert, top expert panel here, im just honored to be on the stage with the experts in the field of addiction. So what i thought wed do to begin with, and i want to get your questions. I think, you know, many ways, that you want to get, whats on your mind, you want your questions asked. I want to make sure we leave enough time to get plenty of your thoughts and questions on what is going on what we need to do more research on and the pressing issues youre facing, but what ive suggested to the panel to begin with is for each panel member to come up and talk for five to seven minutes and tell you who they are and give one or two new, new and newsworthy tidbits on research and addiction, and whats new. So why dont we any volunteers to start . Wilson bravely volunteered. Thank you. [applause]. Well, good morning, im wilson, the Deputy Director on the National Institute on drug abuse. National institute on drug abuse is known as nida. We do all sorts of research on drug abuse and drug addiction. We explore how drugs affect the brain and perhaps most relevant to this group, we look at how recovery is affected in brain recovery itself. Weve also done a lot of research to look at how oxford house has impacted lives of team people. We funded work by lenny jason and colleagues to help demonstrate how effective oxford house can be in supporting peoples lives and allowing them to enter recovery for the longterm. Thats really what this is all about. How do we help people, not just save their lives, but turn their lives around and really change their lives in the long haul. Thats what we all hope and thats what our research is all about, both preventing those trajectories and what can we do to help people exit these devastating conditions. I have just a couple of things to share with you this morning after those introductory remarks. First off, i want to remind us, that oxford house is all about housing and housing is essential to recovery. I was really struck when our director, dr. Norville did a series of treatments in baltimore recently. And with discussion with people in treatment, one of the main issues they brought up, how difficult it was to recover without stable housing that provided support for their changing their lives. Most people end up going back to the communities where they came from where the same risks and problems exists for them. Oxford has can provide a respite for that. In addition to the practical issues having a place to live is not a given for people who are early in recovery and beginning to make that transition, thats number one. Housing is essential to the recovery process. Thats something that we know from all of you and much of what we know about the research. Separate, the Opioid Crisis, the focus of my attention actually more than a few years, but weve had extra funding and support to do Additional Research in this area recently. We see Recovery Support as key to these issues. For instance, were doing work how do we engage recovery and support personnel. Hey, are you using substantials . If youre having a problem, how can i get you into treatment. Guess what, its not just the doctors or nurses or Health Practitioners doing that. Its when they engage in Recovery Support is when theyre most promising. Thats some of the models. How do we engage peer support in the Health Care Settings to make that transition. People show up in health care and theyre not quite ready for that transition, so peer support can make a difference in moving people along that trajectory. We also know that helping people enter recovery when they overdose is a key challenge. I kind of thought in my naive way that when you overdose and we have naloxone, were grateful to have a medication that can save peoples lives when they have overdosed that people would want recovery at that moment. Theyd want to enter treatment because they nearly died. No,turns out most people in that setting, mostly are thinking, oh, my god, ive woken up, now im in withdrawal, what i want to do is get high. The next day, there may be an opportunity to reach out to them. Thats what some of our researchers are doing now, can we use peer support to reach out the next day or the day after when people are ready and willing to hear the message of the value of recovery and opportunities for turning their lives around through programs like action ford house and treatment programs that we have. Thats number two. Engaging Research Enterprise addressing the Opioid Crisis right now. The third is the specific Research Study that i read about recently that looked at what happens longterm when we started people on medication. We did a study not too long ago can we use buponorphine. Yes. Researchers did longterm followup, four years later how are people doing, what predicts people be abstinent in recovery four years later . Medications. That didnt stock me, medications can be helpful for peep struggling with opioid use and opioid addiction. Ive identified a couple of key questions i think are important for Recovery Research and we use peer support in engaging persons were in the health care system. Can we use peer support to all people of recently had an overdose . But i bet there are questions you will have to be answered. I dont know, its a oxford house using narcan . Other narcan devices in oxford house . I see a bunch of nodding heads unnumbered please that even if its not for the people in the house, youre going to know a lot of people in the community you will run into people who need the lives saved. Because i cant do Recovery Management and Recovery Support on a deceased person but we can want people of the lives saved. We have the opportunity to help them turn the lights run. Id love to your ideas for Research Ideas that we can help support. What you at the National Institute on drug abuse. We find people like dr. Kelly and other to do research all across the country and we want your ideas. Im not sure whether im allowed to take questions now that i think we are all supposed to speak and then we will definitely turn to you for some observations. Thanks very much. [applause] terrific. Thanks, wilson are just one thing i was about to mention is that dr. Adams was the a Surgeon General is going to be joining us we hope at around 10 30 a. M. I believe so, so we can look forward to that. That should be in about 30 minutes. So when he comes in we weather also give a five five to seven introduction to talk a little bit in the same way. Who wants to go next . Stewart . Thanks. [applause] good morning. Good morning. My name is stu gitlow. Im in rhode island. I have private practice in addictions, and what i would like to focus on is the importance of recovery and the important thing within recovery is its not useful unless you are alive to experience it. The number one leading cause of death among patients in recovery is smoking. Nobody thinks of that. And ill come to these meetings thinking were being successful when i can get into the hotel without coming through a cloud of smoke and vapor. Which at this point i cant do here if were going to get to the point where you all can experience recovery for as long as you possibly can, were going to address smoking. And weve got to start we get that as being the key issue among folks in recovery without talking about heroin, without talking about cocaine, without talking marijuana, and looking at the number one leading cause of mortality. We are here in the middle of what the New York Times and other newspapers address as the the Opioid Crisis. We lost some are between 70 thousand80,000 people last ship as the result of approach. Seems like a lot, except we lost 500,000 due to smoking last year. We lost about 500,000 people youre due to smoking, feature for the past five, ten, 15 years. So its not news. And because its not news because the same thing happens year after year, were essential having this experience where 740 sevens full of people crash everyday around us, and use is about the small car crashed taking place across town. Thats the leading story. Weve got to focus on the 747. Apologies to boeing for example. The key here is to look at where the deaths are actually taking place. Number two, behind cigarette smoking and behind vaping and behind the smoking is alcohol. Still the second leading cause of death among folks with addictive disease. Opioids away in the background. What we need to focus on is still tobacco and alcohol. Tobacco and alcohol. Tobacco and alcohol. I cannot say that enough because thats the key to solving the problem of the mortality rate that we associate with addictive disease. All right. Having said that, since you all expect me to Say Something that opiates, but Say Something about it. The rate of death among people with opiate use disorder is about 15 times higher than it is in the general population. Meaning that i have an expectation among folks come into my office of opioid use disorder, that theyre going to die pretty quickly. What can i do in order to stop that, or at least slow it down . My expectation is that individuals with opiate use disorder, if i have 100 paties and all it to say hi and smile at them in some of this 12step meetings, about five of them will die every year. So of every 100, im going to lose five year if i only use psychotherapy plus 12 step. If i add medication to that, i save four people per year out of those 100. He goes the number of deaths go from five per 100, to one per hundred on medication. Whether its buprenorphine or methadone. For either one of those i save four out of 100 people per year. Then comes the question, and heres the new research, the question is how long do we keep them on medication . The answer, forever. This is an antihypertension for people with hypertensive disease. This is insulin for people with diabetes. Dont come off it. If you come off it even years later, the mortality rate rises from one per 100, to about 1. 7 per hundred. I almost double the death rate by taking somebody off buprenorphine or methadone. So theres no point in taking them off it, unless the only reason for wanting to come off it is i do want to be on anymore. Anymore. No, thats a terrible reason. I do want to be on it anymore. I do want to be on it antihypertensive anymore and by diabetic patients to want to be on the insulin anymore. Tough. Suck it up. Keep taking the medication. Because thats going to make it less likely that you die. Thats a pretty good reason in my book. So the bottom line for this is, take the medication and then do Everything Else that you need to do an do in order to have a good recovery. Quit smoking would be number one. Number two, go to aar na meetings, or the program, do the steps, talk to anybody else in the room. But the key to all of this is to take care of yourself. And the ways of doing that are the same as the are for everybody if youve got a chronic disease, take the medication thats the right one for your chronic Disease State. And if your chronic Disease State involves as it does here a certain way of thinking, then work that through on a daily basis. Focus on it. And everybody here in this room is doing that second piece. To the first piece, take care of yourself, an and addition to tg care of yourself spiritually. Thank you. [applause] terrific. Thanks and kevin, you volunteered next. Thanks. [applause] thank you all so much. My name is kevin is a senior policy advisor in the Obama Administration for two and half years in office of National Drug control policy before that for time and a bush administration. When it was okay to be bipartisan, which i hope we can bring those days back. I dont know what you think but i miss those days. I miss those days a lot. I also want to commend you all for being here because one of my mentors bob dupont talks about the Oxford House Program and 12 steps also as really a modern miracle. It may not be popular on twitter, and if youre on twitter and you look and see what people say about, especially 12step programs, its the very popular. But theres been this very insidious thing that i call a false dichotomy between 12 steps and medicationassisted treatment as if theyre completely incompatible. We know there are many paths to recovery. We know they are compatible, and we want to have a large enough tent to keep people alive and bring everyone in the fall. But you all are the living examples of what is people up here, and its an honor to be up here with giants of the field. Im humbled to be up here, but looks more like a mantle than the panel but i think we will change that next time. With some great women that nixon and be up here. The worlds leading authority on addiction, like doctor evans, doctor harris on and on and on double want to incorporate for next time. But i want to go further with his idea of a false dichotomy. Because will run coming from, and it comes off with stooges said, you know, i cant believe what do just that. The addiction for profit industry, but sadly our country is so good at doing. We look at the alcohol industry. 90,000 People Killed a year. Every doll in alcohol tax causes almost one in social cost. More people in the criminal Justice System today for alcohol related offenses and marijuana, and all other Illegal Drugs combined. Are we having fun yet . Alcohol taxes are onefifth with a worth enduring the korean war. Why . Because we have a massive industry with great lobbyists that sound have a lot more money than oxford house or other recovery groups, and are laughing all the way to the bank. And we look at one of our other favorite industry, the opioid industry. The sackler said they were general to give 10 billion which is onetenth or 100th of the wealth to get people off the backs for the oxycontin mess and the mess from Purdue Pharma at the opioid industry. But that industry come dont worry, theyre still making a ton of money even after the Johnson Johnson lawsuit. We are 50, 40,000 people dead a you from from opioids alone. Im not addiction for profit business. They may look at the biggest one which is by far the biggest one, the 747. We look at the tobacco industry. 450,000 people dead a year for the past 50 years, an industry that lie to the American People for almost a century that said in 1999 tobacco wasnt addictive. They said that in 1999. Not 1899, 1999. If you know about history, tobacco didnt commit people and about 100 to go, thats when the lung cancer incidents happened when big tobacco took over what was before kind of an occasional thing that would use a pipe, did not have all the attitudes in it. But big tobacco came and took a plant tobacco that it been used for thousands of years by many cultures and it was an irritant but it wasnt killing the number of people it kills that were white. Big tobacco took that entered into the deadliest weapon that mankind has ever produced. And now i look around and a wake up and i look at the one that is about to be the fourth one, our friend marijuana. Right . Thats right, thats right. And we look at, and thats what im concerned about. I founded a group called sams, smart approaches to a one that because of a one was killing more people than tobacco but because they were kind of no one else doing it. And i saw a couple of years ago this addiction for profit industry starting up again for marijuana, taking whats called just a plant and by the way, poison ivy is just a plant so dont think just a plant means its okay. Theres a lot of plants you dont want to ingest including hemlock and a lot of other things, right . We see the marijuana plant being used for a long time but now we see an industry around it. And weve seen industry around around hes right. Thank you, Surgeon General jerome adams. Lets thank him actually for his leadership. [applause] im going to shut up any minute. I could go on all day but we are really here to see and hear general adams and then i do want to talk about the great work he did yesterday which was a significant policy development in marijuana from the Surgeon General office, almost in my lifetime, in about 38 years, about two or three years to my lifetime, since 8082 and what happened yesterday was a stored but it just want to finish this thread and introduce the Surgeon General. An industry that took a plant and basically is no modifying it to its benefit, the relies on addiction for profit just like the industry we just talked about, tobacco, alcohol and pharmaceuticals. And what happens when industry takes over something is that more people die. Folks, more people are dying from tobacco and alcohol that heroin, not because the back with more harmful than heroin one to one, if you had a gun to your head and or a violent harewood i would probably smoked spoke a cigarette if i had to choose one, right . Tobacco is much more harmful, much more harmful than heroin. Because it kills ten times as many people. It cost ten times as much money in social cost. When industry takes over produces what we see the Marijuana Industry is producing today, 70 concentrated gummy bears, chocolates, cookies, so to speak we think thats for the occasional adult use. Weve heard that story before. Weve heard it before with the candy cigarettes. Weve heard it before we see alcohol pops. Weve heard before with the formulated opioids the only supposed to be for people pay their severe pain and hospital but in reality the average person was getting 350 350 pils every time they went to the pharmacy. Weve heard this before because this is what our sad history of our country is what we call the addiction for profit industry. We dont want, i do know people to go to prison for a 100 let me be very clear. I dont want to saddle someone with a criminal record for making a mistake and they could hire a good lawyer and because of the color of the skin, they got caught up in the criminal Justice System but to tell me that the answer to that systemic, big problem is to commercialize a new substance of which by the way the research that we talk about when we talk about the harms of marijuana psychosis, mental illness, schizophrenic and reduction in iq, thats done in marijuana that was 10 or less potent. We are only beginning to find out what the 99 potent stuff actually does. When i look at Society Today and i see there are ten times more daily users of marijuana in this country among americans 12 and older, there are 9 million today. There were 901,992. I see an industry that is laughing all the way to the bank and pretending to be social justice advocates while in reality the big secret is the pot and shes basically 99 white rich coming from Corporate America trying to get rich again. I ask all of you to look into who is behind the Marijuana Industry. You do the research. Youll find familiar players. Youll find people like philip morris. Youll find the largest alcohol industry conglomerate Constellation Brands in all big youll find that although because this is a new product line. It may not be, may be made a vehicle to talk about marijuana right now in the midst of the opera crisis in the midst of stimulants is a huge issue coming back and now. In our country every time without opera crisis its been followed by a Statement Crisis and look at the numbers with methamphetamine in Rural America and with cocaine around country and its scary. Soaking liquid the Opioid Crisis look like in the early 2000s when we were getting the precursor. Im worried about that. But lets not take off this benign plant that is not a plant, that has been genetically bred to be a lot more harmful. Ill leave you with this. I someone tell me the other day marijuana wasnt addictive and asked them how they knew that. How, why do you think marijuana is not addictive . The 16 you, that i know marijuana is not addictive because i use it every single day. [laughing] so folks, that is the myth, this information. I want to introduce the Surgeon General and what do thank general adams for the leadership that he of the department of hhs, secretary azar did yesterday by issuing and annuak about it, the first Surgeon General advisory on marijuana since 1982, to what americans especially pregnant women and young people are really all americans that this is a common problem and we may not be come heavy industry influence of lobbyists, which then ends up, but we have truth. With history in a long arc of history they will say what were they thinking . Pot gummy bears. What were they thinking . 99 potency. Just like i say to my parents, smoking on airplanes, what were you thinking . Smoking at the hospital . What were you thinking . Doctors smoking, doctor selling it, advertising it. What was your generation the baby boomers, what in the world were you thinking . Our kids and grandkids are going to say the same thing to us. Surgeon general. [applause] good morning, everyone. Thank you so much for giving me the opportunity to come in and address all of you. I cant tell you how honored i am to be a in front of each and everyone of you. And im going to tell you all a bit of why im honored. But first i got to tell you, kevin gave me a promotion. Im neither a surgeon nor a general. Im actually an anesthesiologist trained in acute and chronic pain management. You know, 25 years ago when i was in medical school they told me opioids were nonaddictive. They told me they were safe. They told me i was a bad doctor if i couldnt prescribe them. So i have lived through this. Ive seen this evolve over the years, and as kevin mentioned, i do want us to have the same play all over again what comes to other dangerous substances. Im not a surgeon and anesthesiologist. Im a a vice admiral in the und states Public Health service commissioned corps. [applause] thank you. Thank you. And Rolling Stone yesterday identified me as the attorney general. Not the attorney general either. If yall have questions for him, please do not give them to me. Please do not give them to me. Surgeon general, not attorney general. But my most important accolade isnt my md, my miles per hour, my vice admiral its vad. Im a dad of the 15, a 13 and nineyearold or any of you who [applause] thank you for that. For the third you in real Life Expectancy expectancy is going down. To put another way, raise your hand if you School Aged Kids those evil raise your hands, we represent the first generation of parents in 50 years who cant look the kids and i right now its how you going to longer life and what im going to live. One of the biggest reasons for that, suicide has now popped into the top ten in terms of causes. Overdoses as you all know is a leading cause of death. Death of despair in many cases start with a common pathway, unrecognized, untreated trauma, Mental Health issues that are against unrecognized and untreated. And then leaving to selfmedication with an array of products. Remember, could be alcohol, could be nicotine, could be marijuana, it could be an array of products. But ultimately then lead to people who are not getting the help that they need to deal with her Substance Use disorders. I want is a first of all congratulations to each and every one of you in this audience for in recovery. Raise your hand if youre in recovery. [applause] now, i also want to ask you to raise your hand if youre in recovery and leave it up. Ill ask another question. Raise your hand if you smoked pot want you were under the age of 25. Hold on, hold on. Im sorry i got to do this. Put your hands down. Ive got to get this on tape. Ive got to get this on tape. Im Surgeon General jerome adams at i am here with recovery audits and going as the audience your question you raise your hand if youre in recovery. Now keep your hand up or raise your hand if you smoked marijuana before the age of 25. See how many hands stayed up . Almost every single one. Its critically important that we know that marijuana has unique impacts on developing brains. They can prime your brain for other addictive substance. Its a couple of many folks pathway to Substance Use disorder. Thank you all for that. Thank you. [applause] so my personal twitter account is at jerome adams indeed get my tweet this morning. I was describing my week. My week on tuesday, my son actually called me from the bathroom at home and said that, though it is time to sell me marijuana. What do i do . Thats tuesday. Wednesday, wednesday my brother went to court for crimes related to his drug use. Trying to get into recovery. His pathway start with unrecognized untreated mental issues that he selfmedicating with marijuana and they went to party and someone gave him a pill. That led to heroin usage. So that was tuesday and wednesday thursday i released a Surgeon General advisory saying i do women in young people should not be using marijuana. Anyone said i was fear mongering. [applause] that this is my lived experience in addition to where the size is taken what you all to understand this is not fear mongering. I hope whatever your feelings are on marijuana and adult usage, ive got some strong feeling about that from a Public Health point of view, i hope we can all agree that no young person, no pregnant women should be using marijuana. [applause] thats really what my advise is all about. Kevin mentioned this and wilson is a peer, and hes the expert in this. But marijuana, 1895, strains of marijuana tested were about 4 thc. Im speaking to a crowd that is very educated, but just who everyone is on same page, thc is a couple of marijuana that causes euphoria, intoxication and causes most of the document harmful effects of marijuana including addiction. 4 in 1995. 2014, the strains that were tested were up to 14 to three times a stronger that was in 2014. The average dispensary now is putting marijuana thats in the 20 thc, so five times more potent than the strains people think of when they think of marijuana. As i said yesterday, im still waiting for the needs to come out but folksy talk about talking about on gma, good morning america, unseen in an npr. Said this yesterday, this aint your mom is marijuana. It aint your mom is marijuana. Were talking 25 stronger thc content or 5 stronger, 25 in platform and then look at oils, waxes, you look at people vaping this and they can get 75, 80, 90 thc delivery to the brain. This is like the difference between the think im okay with you having a 12ounce light beer or a a glass of wine to go to sleep, anything im okay with you drinking a pint of vodka every night to go to sleep. That the difference in policy were talking about and we would have to understand as we are having a conversation about marijuana use, that we recognize we are talking about a fundamentally different product that is particularly dangers to the developing brain. I cant i do want to take up too much time other than to tell you all, my brother, my uncle, many people in my family are walking the same path that you all have walked and venture walking right now. Im not some government talking head who is spouting reefer madness over and over again. Talking about my lived experience, my families lived experience. Im talking of a father whose kid genetically because of my family are at risk for addiction. Im talking about things that i would want any of the parent to know if they wanted to protect their children and im asking you all to help me, again regardless of how you feel about adult years, regardless come help me spread the word that no pregnant women, no young person should be using this, especially potent marijuana because our youth, their future, its too valuable. It is too valuable. We know that when youth use that theyre more likely to drop out of high school, that they seem iq declined in use used cord needed with higher thc content, that Emergency Department admissions have gone up for adolescence, for overdoses of marijuana, for psychosis we know it increases your chance of schizophrenia we know it increases social consequences. I dont want to get too far off the tangent on social justice, but ive been around the country. In many communities we are saying folks are patting themselves on the back for driving down adult arrest rates but theyre not monitoring the fact youth arrest rates are going up because marijuana use has been normalized. In every state is still illegal if youre under the age of 18 to possess marijuana. We are not really solving social justice issues. We are shifting social justice issues. We are still saying this play out among young people. If youre a a racist policies,f you bias, youre still going to racist policies and bias even after you legalistic just shifting them down to 17, 16 a 15 euros for older people. We have to do with the underlying root causes of discrimination when it comes to addressing social justice issues. In every minority community, she unity of color, weve already got a liquor store and a smoke shop. I personally dont see how adding a one dispensary is going to help solve the problems that those communities face. So please, for young people ad for pregnant women, help me spread this message and know that the Surgeon General of the United States, youve got no bigger advocate in washington, d. C. Than the what you do each and every day. And im praying that my brother gets into one of the recovery houses that you all help lift up. We know theres not enough recovery out there. [applause] thank you. I ask that you pray for him and my family, and keep doing what youre doing. Theres not enough treatment. There is not enough recovery out there. We know this, and im leaning into this issue. For anyone who thinks im taking my off the price to know, im widening my aperture and seeing the big picture. We got to stop playing, using a rifle and picking up one part of the problem and watching pop up in another place. We got to look at the big picture, and the big picture starts with prevention. And it leads into educating people about the importance of diagnosing and treating Mental Health issues. And a leads into a discussion about all the different pathways that people in depth needing treatment. Then it involves getting people into treatment and making sure they have access to naloxone because you cant get someone into treatment if theyre different continue to talk about naloxone and then they goes into making sure that treatment is effective and evidencebased and that medication assisted is available to more people. And it leads into recovery because you are not magically fixed after 30 days of treatment. Treatment. Weve got to people understand that recovery is a lifetime. It is a lifetime. And it is a lifestyle. And it requires support, and we need to make sure people can transition successfully from using to treatment to a lifetime of recovery and having the social support that they need to be able to get back and become productive and successful members of society and of their families again. So thank you for letting me read a little bit. I hope you all were patient with me and that is that a passion about these issues. I hope you can give her i hope you can feel it. I hope you understand that im not up here just spouting off because i want, because i want to demonize you all are because i want to hurt peoples access to marijuana. Im here talking because i have lived it. Ive seen it, and i want people to learn from your mistakes. I want people to learn from your successes. I want people to stop stigmatizing people with Substance Use disorder no matter what their substance of choice is. And i want us to make sure our kids have the best chance of a successful future, so thanks again. [applause] thank you so much, Surgeon General. Thanks for coming. Weve got to make more speakers we will have josh up next and then west and then i think will open up to questions from you all. Get your questions ready. Someone got the short straw. I think im just going to come up here. I just want to say how much i appreciate the Surgeon General, a to point out when he put out an advisory on naloxone encouraging people to carry naloxone, had a big impact on naloxone and had a big impact on overdoses. His use of the position has been really remarkable for Public Health. My name is i dont know if this going to work. Hold on. Can you see anything . Okay. My name is josh. Im from Johns Hopkins. Good to see you. Im a professor there. I am so appreciative at the chance to be here with you all and such deep respect for what you do every day to not only help yourself but really to help so many other people in the midst of this crisis. Im going to talk about new research on opioid addiction. The good news and the bad news to im going to talk very briefly mention six study statement published in the last year that i thought you might be interested in. Let me just also say that at Johns Hopkins with a special program called the American Health initiative will be get full scholarships plus 10,000 for people who want to study and get a masters, a Public Health degree in the field of addiction and a few other fields. But if any of you interested you should go to American Health and all the information is there as well as email addresses for how you can find out about the requirements and that sort of thing. You did not have to move to baltimore. You can do it from where you are. So if anybody is interested we love to have you study with us at Johns Hopkins. Real quick, going to talk about three steps of treatments and three studies on harm reduction. First one on treatment was published in september 2019. It is not yet september 2019, but they released the study early. So this study by researchers at our school and elsewhere showed that when people were taking, people with opioid addiction were taking buprenorphine, not on help them with opioid addiction but actually improved care for other illnesses that they had including seizures, depression and other high cholesterol and other illnesses. So that as weve talked about the fact that people with addiction die in many condition, including chronic illnesses can actually having to treatment helps them with those other illnesses and are less likely to die of depression and other illnesses. But then there some bad news, which is a study out of West Virginia showed that fewer than one in ten people who had a nonfatal overdose opioid actually got treated with buprenorphine, fewer than onen ten. So 90 plus people are not getting medications that actually reduce the risk of death by 50 or more. Im not an addiction medicine doctor, im a pediatrician. Wife is an addiction medicine doctor. When we were in medical school i thought she was going to be, i said, why, my girlfriend, shes like a saint. Shes going to take care of patients and offer patients are going to die. In fact, i thought it was hopeless. I thought it was hopeless and thought as a pediatrician id be getting all kinds of present for my patients, okay . Guess i be such a great pediatrician. Fast forward a few years and parents are too busy to get presents to the pediatrician, or are not the good of the pediatrician. My wife helps people, can suppt them in treatment and recovery. She takes people from the brink of death and the break from homelessness, from hiv. She helped them get into treatment. So many of her patients do so well on medications, not on medications, and you come to our house about a holidays and they are so appreciative of what shes done and she gives so much back to them. She is on call for them all the time. And yet so few people have access to that kind of treatment in this country, though that is a recent finding that its not good news. Why is it so few people are able to get medications . Theres another study that just came out about the news Media Coverage of medications and how often it is wrong. Its often wrong because it fails to say very useful, that they reduce death by huge amounts, that they reduce, the chance of dying of chronic illness. And also, more frequently sends the message that being on buprenorphine or methadone stably is a form of addiction. And it is not a form of addiction. Addiction requires, it means someones life is falling away from them. But when people arent treatment even with medications they are getting their life back. Theyre reconnecting with the family, living independently, living in concrete settings. Theyre doing what they want with their life. They are in recovery and remission. That misunderstanding about medication is very prevalent in news media and keep a lot of people getting care that could save their lives. Three new studies on harm reduction. All the studies were published in the last 12 months. This is about naloxone. We heard about how naloxone, the Surgeon General, narcan can say some allies but theres a recent study in pennsylvania that was published that showed save some lives. More than half pharmacies in pennsylvania did not carry naloxone at all. Not only that, only 64 of pharmacists knew that there was a Standing Order that people are just going to get naloxone. A third of them didnt even know how to dispense it. That is a huge risk given how important it is to have a rescue medicine around the people using drugs. So you still need to get the word out, even though pharmacies about naloxone. Heres some more bad news. Syringe Exchange Programs are effective in reducing hiv and actual helping people get into treatment. Thats the good news part of the syringe Exchange Programs. Theres a nida those programs to transition people like and recovery and that has been very successful for places like burlington, vermont. But other places are shutting down Exchange Programs because of misinformation and doing it in a way that is very stigmatizing to the people who are using it. In one Syringe Exchange program and charleston, West Virginia, when they close the Syringe Exchange people start sharing syringe is more and more much more likely to get hiv testing which greatly increases the risk of hiv outbreak. This is what one of the field participants say. Im so worried about contacting hiv its an river i been tested four times this year. I knew a people that have hiv and im afraid im going to contract it. Theres no way to get safe needles. These individuals are using drugs often want to stop, and theyre trying to find a pathway to success. Keeping them alive and healthy until they can do that, until they can make a connection with a peer, thats critical. Unfortunately, a Syringe Service program shuts that, people put more in harms way. Lastly ill just mention briefly, maybe a little bit of good news, as you know fentanyl is the last line that is killing so many americans, more than any other opioid now and its increasingly contaminating cocaine and methamphetamine is so people are dying of fentanyl without knowing its in the drugs theyre using. Theres Research Suggests if you help people test the drugs, they are very interested in knowing whether it contains no. And they may take steps to protect themselves. Theres also research that having those testing strips is an opportunity to make a connection with someone. And even the active starting to test their own drug is a step on the path to get into treatment and recovery. And 90 of people who use drugs intravenously were interested in testing. And the greatest interest was with people who had themselves overdose a witness and overdose. People are really interested in what they can do to keep alive until they are able to get into an effective treatment. So those are my six updates and him looking forward to the rest of the panel. Thank you. Thanks so much last but not least we have dr. Clark. [applause] thank you your pleasure to be here. This is i think my 15th oxford house session, and its always [applause] always a pleasure. I want to talk about Research Less about research per se and more about Substance Abuse without it. But before i start i you all to repeat after me, 263. 263. 263. 263. Ill explain that shortly. But i also want to thank the women in the audience, thickly those who are concerned about the use of marijuana. The data show that pregnant women, once they know that their pregnant, stop using marijuana substantially. In 2018 the prevalence of marijuana use in the first trimester was 10. 5 . By the second trimester it drop to 2. 2 . By the third person, 1. 7 pacific a Public Health messages getting through. Of course should be zero, but the data to show the Public Health message is getting through and women listen. I dont know about the men, but women listen. [laughing] key issue. Youve heard speakers repeat over and over again about the importance of treatment. One of the things that encourages people to get in treatment is the ability to have your treatment records subject to your decision as to who gets it. Thats changing. For the first time in history of the federal rules that protect you and the legislation, the federal government wants to change that. So last week they released two macros. 12 overall liberalize the people who could have access to information, and two, what i call 263 because it is sex 263 of part two, but section 263 is for the first time is saying that if you commit a serious crime that includes violence and child abuse and Drug Trafficking, the court to issue an order to go through your records. Historically, its as if you committed a Violent Crime and child abuse. That he want to include Drug Trafficking. They dont define what Drug Trafficking is. So the question is, anybody here ever bought and sold marijuana or opiates or any other illegal drug . Im not im not so by and large a number of you were involved in Drug Trafficking. So you should be able to go treatment and say i want to stop Drug Trafficking because i need to clean up my act. Well, for the first time the government is saying well, we want to know who you are. That only do we want to know who you are, but we want to know who your providers are and who your friends and relatives are good we want to know if you have committed a serious crime, Drug Trafficking, at or from a Substance Abuse treatment program. These are notice of proposed rulemaking, you have 30 days to respond to the hhs believes reverting to the previous link is missing to reduce Drug Trafficking. So the key issue is if we want to encourage people to go treatment, what we should do is allow them to go treatment talk about the things that cause them to Substance Use disorder associated with the change, there is legislation. To cope with that legislation i a letter from one to states attorney general who favor getting rid of part two, substantial genji. Does anybody know what the states attorney general job is . Anybody . What is it . Prostitution. When they want to get into your personal records, what do you think their purpose is . My job is to prosecute them. Its illegal to use drugs. That makes you an offender so i want to go to find that information out. When your personal information become subject to disclose to anybody and everybody, they can find that information out. The miranda warning says, its against several of self incrimination. Anything say can be used against you. Were discouraging people to go professional treatment encouraging them to go to oxford house, which is a good thing. [applause] house that program . To the extent you been offering is helpful, were changing the rules. I encourage you to understand that my fibers are up, but most important thing is to be aware that we are moving away from the war on drugs to a were on patients. And that i find objectionable. If we want to do with the epidemic of drugs, we have to deal with the people, which allow people to go into treatment and feel comfortable and safe. Again, oxford house does that. Oxford house more than just as housing. Its recovery. And i think i know you mentioned that its important for housing and i agree with you, but its the largeish about oxford house is it facilitates recovery. And it uses the proximity of people who are interested in recovery to achieve that. And it gives them a safe place to be there. So back to the federal rules, the federal rules that you should be aware of this 263. Can i i hear you say that . 263. Make sure you tell people 263. [laughing] not to support 263. Thank you. [applause] thank you. Thanks so much, dr. Clark excellent. Thank you to all Panel Members for that brief synopsis of everybody. Now weve got about 15 minutes left. We have a floor mic here for your questions. Please come up and ask the question. If youd like to just go to the mic and we can hear it, thank you. If you want to address the question to one of the panel, just say which panel member, or otherwise you can address it to everybody on the panel. Thanks. Hello. My name is charles, im a person of recovery. My question is about suboxone, methadone. I was given this inside of an inpatient detox, and on my way out i was offered it to go to the Doctors Clinic and for a fee he would continue to write me this prescription you know, my question about this is, why is this not considered addiction for profit . With the same pharmaceutical companies that are making this [applause] and my, my personal addiction as a young man i smoked marijuana and did cocaine. I got into a car wreck and a group of doctors said you need this and overprescribing oxycontin. Which led to a heroin addiction, which nearly killed me. Ive been sober for a little over two years now. [cheers and applause] because of the 12 steps to collect anonymous and the Recovery Support system that have at oxford house, i declined the offer to go to this Doctors Clinic and take this. I i know that medicallyassisted treatment is a big deal right now within oxford house, but right now what is is a group of doctors once again telling me you need this, and it can be done without that i dont understand why were pushing this and we are not saying were going to do this for x amount of time and were going to work with some sponsor ever going to do these things, instead of saying for the rest of your life were going to keep you on this product. Because its expensive and when mr. Kelly spoke earlier, he said without this were saving 10,000 a person, saving millions saving millions of dollars a person. And when mr. Surgeon general spoke up there, he said 30 years ago they told me opiates were okay. And now theyre telling me that theyre bad. How do we know 30 use a summary is not going to stand up there and say hey, they told me [cheers and applause] hey, they told me methadone was okay, suboxone was okay, and now its not. Thank you for your question. [cheers and applause] i think its a great question, and it boils down to strength of recovery. If you have an incredibly no. [booing] if you have an oppressively good recovery and you are working the program and doing the 12 steps and youre doing commitments and your participating actively, then that can be the means to the end. That can be the means to the recovery. Every person is an individual. We have to look at each person individually, and we have to consider each persons situation individually. But if you look at the general population, if you look at everybody with addictive disease, you guys know as well as i do. How of them are as committed as all of you are . Theres a good portion of them, its not the majority or not as committed, or not it is read every day, who come into my office and when i say to them, are you going to the program, are you working the program, during the steps . Tell me all that does is make me want to use. You know, all i do, or that, im going to the meetings. Really what they mean is there a cross the street. You look over there, there was a meeting going on. Or they sat in back. They arrived late, they left early. They never raised their hand, they never participated. These are the people were coming into my office and to represent the majority of folks who are trying to get into recovery here so when im working with them at a look at the general statistics which you are applying to all group and the statistics tell me that their chances at living are going to double over everybody else, if they stay on the medication. Im going to throughout medication general. But that doesnt mean im not going to look at an individual and safe you are working a good program. Your perfect for us to pay for this medication off. Thats fine taper off. Thats fine but for the general individual where he went to the Detox Program and he tried to insert you really into Outpatient Care that incorporate a medicationassisted treatment, i think its pretty fair way to start. And to think its a pretty fair way to continue for the majority of folks out there. Not to say it applies to each of you individually but it is saint in general the statistics bear that out. [applause] now, we have, i think we have about five minutes left, right . Im from oregon. Anybody here thank you to anybody here have a vape on them . Hold it up. I want to see. I want ask stu, your opinion on vaping is just nicotine kills people more. Smoking is terrible and i got out smoking but i vape. There goes my voice, all the smoking. But i vape never i just wanted to your opinion on this. Im going to answer this from a research perspective. We havent learned enough about vaping. Each device you guys carry this different from one another. How much nicotine doesnt deliver . I do know because theres almost no regulation of these products. One of the things are trying to do is increase research on these to understand who they can benefit. Because certainly helping somebody quit burnt tobacco is a good thing. If the only way you can do that is through a vaporizing device, that seems a very fair tradeoff but we dont have enough research to know who will help, who it will not. Our flavors good for you . Will be some not so good. I really dont want red pepper flavoring being inhaled in my monkey on usher gummi bear or orange flavors are good for teenager on set of these. A lot of things we need to learn about these devices. Safer than smoking at this point . It certainly looks like something that is essentially a steam product that has two other chemicals in it, its a lot safer than a burned product. But not at everybody makes that full transition period some people use it as a crutch to keep smoking longer true. Its a pretty complicated issue. Thank you. [applause] thank you for the question. A few minutes left. My name is luke and ivan im from newton kansas, addicts and recovery. I was opioid addict for four and half years and almost at my life. My question for the gentleman on the far right. Have you yourself personally ever taken methadone . No . How can you push a substance that has a chemical dependency on despite a a person works the program that drug will create a chemical dependency. I know firsthand. [shouting] so the question is, first of all, let me back up. I dont prescribe methadone but ill answer the question. All of these substances that we talk about in here, marijuana, cocaine, methadone, suboxone, vicodin, percocet, all of them carry within the potential of a physiologic dependence. In other words, if i take the drug on a regular basis each day and then suddenly stop, im going to experience withdrawal symptoms. If i take it each day, i will find gradually over the course of the first few weeks that if im taking the same dose, that the effects of the drug gradually diminished to some point where they end up in a baseline. Thats typical. Remember that what were doing with providing suboxone or providing methadone is, and im going to say this to probably your surprise, we are replacing one drug with another. Im not surprised. But remember what were doing, all of us, when you start addictive Substance Use, you are starting it because you are treating an underlying condition. The discomfort that you had originally that led you to find that these drugs made you feel better. Because or anybody out there for used heroin and got hooked on it, there are also some people out there who used heroin and did not get hooked on it. What differentiates those people are the people who got hooked on it, they had addictive disease but they had that before they used the drug. So when we are giving suboxone or methadone, we are giving the drug to treat the underlying disease, the addictive disease. And were doing it with a medication that is less likely to cause harm and is less likely to lead to more bitterly and more talent than the drugs morbidity to treat how they felt. [applause] thank you for the question. One more question. Im chelsea from san antonio, texas. My mom was in a bad car accident and she was like looking come so she got medicaid and her doctors prescribed or vicodin. Towards the end of her life, doctors and medicare did want to pay for her vicodin and so she eventually she resorted to heroin. What are we going to do whenever medicaid stops paying for vicodin are oxycodone or people who are in severe pain . And i have, youd have to answer this question. I wasnt able to get into treatment until cps got into my life. I want to know if you ask for help from doctors, with a report you to cps, like you would get punished for asking for help . Indeed you do and thats one of the problems. People are using treatment as a way to identify people who use and that is not a good thing. This is where, thank you for bring it up. We need your voices in washington dc and your state capital. It may be controversial, i dont mean it in a way of [applause] i dont mean you need to out your fellow meeting members when you are in public or go to the bakery. I am talking about your voices collectively. The great things others have brought up, these are underlying issues lawmakers have no clue about. I worked for both parties. Dealing with 100 issues, staffers dont have a lot of time. Unless its on the front page of the local paper they couldnt care less about a campaign issue, they are not experts on it, you are, and people on this panel are and we need your voices out there, you need to write your legislators, show up in their district offices because right now the impression is half of congress thinks most people dont need healthcare and medicaid provided, Addiction Treatment may be should be involved, maybe it shouldnt. It took our country 150 years to realize the brain was an actual part of the body. In other words healthcare was not just physical health care if you break your elbow but things going on up here and it took a long time because we were anonymous about it. We need your voices. We are out of time but could you just say who you are and ask a question, you might not have time to answer but if we can think about those questions as well, thank you. A heroin and meth addicts for 20 years, i got no treatment or anything. I just asked you guys, not even a question, do you guys reach beyond your cells and talk to people in the field who are out there. Marijuana is described as a horrible thing, to treat a lot of things and epinephrine redefined, it is not an addiction processor and addictive drug and the only difference between the two is you dont control the Marijuana Industry but you do control the heroin industry. Thats what i see. Thank you for the comment. When it comes to mental issues, i greatest a growing number of people being misdiagnosed, mostly as bipolar and being given Prescription Medications that make them crazier than they were, then they appear normal to us, how do we change that and reduce the number of misdiagnoses and increase the educational part through parenting and our School Systems so that people know not to look for things to be wrong but but to change them. Thank you, good question. I am an alcoholic and i first raised my hand after doctor compton had spoken and i was going to thank him for his remarks but then remarked that i had heard him use the word drug and opioid and numerous other words in that category, never so many times and opioids had never once threatened i believe i speak for mister malloy, threatened our lives, bourbon and whiskey threatened our lives. It was never mentioned. I may be answering my question. It is because there is an iaa and you institute does strictly focus on drugs . If not, why is there not a remark about alcohol . Thanks for the question. Last one. I am colleen. I think this is a great opportunity to educate. I dont know why we dont have people who teach us to use no locks own, to make sure it isnt expired, make sure we have enough in the house, get everyone certified to know how to use it, that would be beneficial. Also i havent received a survey being here and there are statistics about drug addicts and daca hall abusers. I have never signed up for a survey or been handed an Anonymous Survey and we have 700 people here. Why dont we have a survey asking the same questions, part of the statistics we hear when we come to these things. Thank you for the questions and thank you for coming, lets think the panel. Have a great conference. [applause] [inaudible conversations] [inaudible conversations] [inaudible conversations] i have been reflecting because its almost 50 years since the declaration of the war on drugs. What was declared then, some of you may remember, nixon standing and declaring the war on drugs and drug abuse as public enemy number one and what i want to tell you today is how we come from the harsh rhetoric and punitive stands of the war on drugs, the nature of that terminology and rhetoric implies a militaristic identifiable target that we can defeat. As it turns out although that was the initial stance, to be tough on drugs, tough on crime, we moved from that in the last 50 years towards growing Public Health approach to, quote, the drug problem. If you look at the laws passed in the last 50 years, the controlled substances act in 1972 antidrug abuse in 1986, they were very harsh rhetoric laws designed to be tough on crime, tough on drugs. The result of that was what . And increase in the prison population. It worked in terms of locking people up, 4. 1 of the worlds population, 25 of prison, you could argue and say it won the war on drugs. Unfortunately it did not. That recognition of failure of the more punitive stands resulted in the passing of laws, instead of looking at supply reduction, more focused on interdiction, also focusing on demand reduction, treatment and recovery. Think about the laws passed in the last 20 years, the Mental Health and addiction equity act, the Affordable Care act, necessitated Substance Abuse disorder included an essential health benefit. It had to be covered by insurance. That was a big share. The comprehensive addiction and recovery act has been passed and again, the idea is to focus not just on supply reduction but demand reduction. I have the privilege and honor of being invited to the First Ever National drug policy reform summit held at the white house december 9, 2014. That was under the director of omb cp at the time and that underscored a market shift, National Policy shift away from the rhetoric of the war on drugs to broader Public Health approach. In some ways we have gone from the war on drugs to the war on the war on drugs. We should also remember the war on drugs when declared in the 70s also marked a National Federal effort forging new ground in terms of treatment and prevention and recovery. The National Institute of alcohol abuse and the National Institute of drug abuse founded in 1974. As a result, of all the research over the last 50 years we learned a lot about addiction both in terms of cause and controllability and genetics and genomics and we understand now that just like other complex illnesses or complex disorders from which people can suffer Substance Abuse disorder is a genetic disorder. That is very clear. It resulted from the research and funding supporting that research. We also in terms of cause and controllability, two factors associated with stigma, we understand from what neuroscience findings in the last 50 years particularly the last 30 years that the controllability, impaired control to regulate impulse to use substances which is essential despite harmful consequences is the cardinal feature of addiction, impaired ability to regulate those impulses clouded by our research on neuroscience. We can see clearly what happens in the brain. In the sub cortical areas of the brain, how those areas are impaired in function of chronic exposure to substances and think about the last 30 years, we have seen changes in our clinical approach, recognition of stages of change, precontemplation, contemplation, decision, preparation, action and maintenance. Then treatments designed to address the notion of ambivalence that people often experience, i do and i dont and it is great when people come into treatment and say i am ready to go, tell me what to do and i will do it. Those are wonderful places to work with because they will do whatever you say but most people are coming in because of their police or their family or sport. I kind of am here but dont want to be here. Yes i do and i dont. So what did we used to say . Go away and come back when you are ready. You could be dead by then. The motivational interviewing paradigms started in the early 90s, very important because it said we cant say go away and come back later. If ambivalence is a cardinal feature of addiction, we need to help patients resolve that ambivalence so it made it a clinician problem. How do we as clinicians do Something Different, to really listen, good adage on the slide talks about what people need is a good listening to. Not so much a good talking to. We used to think people needed a good talking to but instead motivation interviewing and the paradigm says people need a good listening to. Lets help them see the world through their eyes. We had also continuous management, good medications that can help people with alcohol and opioid abuse disorder but what i want to get to is this notion of longterm recovery and the focus on longterm recovery that is taking shape. The reason why, we talked about addiction is a chronic illness but have not treated as such. We treat it as a acute illness. People like tom mcclellan, chuck obrien, william right who had the privilege of working with and publishing several papers and bill was the guy some of you know, the architect of chronic disease and paradigm, it was lovely determination and how you think about addressing addiction as chronic illness. It took a long time, and took four to five years before people start seeking help. It took eight years on average, and started seeking help in the most severe cases. It was a precious one year of remission. It takes 4 to 5 years continuous remission to be no more likely than anyone else in the general population to meet criteria for Substance Abuse disorder. Another were to take four to five years to be no more likely to get below 15 , the annual rate of Substance Abuse disorder. No more likely than anybody else in the following year if you already had Substance Abuse. It does not suggest 30 days of rehab and graduation. The longterm treatment models and Recovery Support like other mutual help groups and management paradigms. All of what i talked about, to be involved in that. It is downloadable for free. Been involved with oxford house. Being employed by fine establishment since february 1993. No small path to be up here and welcome our panelists. Starting with dan from oxford house, state coordinator from oklahoma. [cheers and applause] Curtis Taylor, the alumni and executive director at abc nc North Carolina. [applause] oxford house alumni outreach in florida. We are anxious to hear all your stuff. Jason wilson, oxford house resident and reentry coordinator. Jesse what did i say . Jesse. And and cleveland, oxford alumni. [applause] 3 quarters of oxford house population has done some jail time or prison time. 60 of those in jail or prison are addicted to alcohol and or drugs. Each year thousands of those who are incarcerated reenter society. However, within one year of reentry, half of individuals will commit another crime and head to conviction and reentry into incarceration. The experience of those who enter oxford house following incarceration is usually longterm recovery, in some States Oxford house has developed relationships with programs that permit those leaving incarceration to go straight to oxford house. Others come to oxford house at the recommendation of drug courts and or parole officers. Clients tend to do well if they live in oxford house, not only to such intervention motivate clients to begin to master the recovery process, it also saves taxpayers the cost of incarceration and recidivism. Oxford house residents enter from incarceration or exposed rather than institutional authority. They are elected to leadership positions and undertake shared responsibly for operation of the house. Most residents rise to the occasion. This kind of reallife training is rare for most individuals reentering society. The panel will discuss the need for the post recovery operation, practical ways to facilitate getting individuals leaving incarceration into oxford house and can help clients achieve longterm sobriety and meet expectation of drug courts and how oxford house living facilities facilitate and transition to longterm crime free recovery for most residents. The panelists are all experienced in the field from the inside and outside. Our first speaker will be dan hahn. [applause] my name is dan and i am an alcoholic. Been clean and sober is july 18, 2007. [applause] i was incredibly lucky to stumble into oxford house. Can we agree on that . To talk a little bit about reentry, when you discuss reentry, how i ended up there is constant cycling in and out of the system with a plan to do Something Different and every time back in prison i was able to find recovery in oxford house and i lived in an area years ago we didnt have any direction how to get people out of prison and reentry is not just prison. Reentry is folks reentering society in any capacity from homelessness, whatever area it is. The homeless shelter you have a relationship with, getting people back into society. It takes a village. Takes all of us together to understand there are folks that need our help. Its not because they dont have money or clothes on their back. We dont want them because they dont fit us. We are going to lift them up. That is what my life is centered around, lifting people up and getting them in a position, getting them something they never thought possible. Getting into an environment they can practice recovery right away. That is done by example. Coming out of prison theres a lot of things we dont have. I work in oklahoma today and most of the guys who come out have nothing more than a walmart bag. How do we accept folks like that into oxford house and point them toward success . Realizing most all of us whether we have been incarcerated or not committed felonies whether we were convicted for them or not. Some of us just got caught. It took me 25 years to realize i am not a very good criminal. Through that process oxford house is a prime place to work with drug courts, incarceration, homelessness. What it takes is some basic things. I work a lot in the oxford house community, he doesnt have any money, okay. I teach houses all the time, build your self up some money and hold people accountable. Folks move into our houses. I work with people out of incarceration all the time and i will sit down with them and tell them what they are about to experience. Heres what okay in oxford house and we can agree on this. Perfectly okay to do your score. It is okay. We like that. We would like you to put a money order in the box. We would like you to be employed. We would like you to be employed. We would like you to work a program or recovery of your understanding. Those are nonnegotiable. What i see often, as folks move into our homes are not explained clearly what is expected of them because the people explaining it to them have either not been there or dont understand. Its our job to teach people what it takes to live in oxford house. We deserve a Second Chance and the key component is oxford house is a home for recovery. [applause] reporter we are not there to provide us a place to live, and a program of recovery. Some things folks can do to help reentry in their areas, building relationships with local probation and parole, showing them what it is we do and what we require is not a place to lay your head but to get better. Throughout the drug court, all of those things, and focus on those basic things. And could do the basic things to live in our homes. I dont have a lot more today and i appreciate it, thank you. Thank you. Our next speaker. Critics taylor. Is that a polite way of saying you are not a convict. Man. Having the opportunity, and it is my family. Yes. My name is Curtis Taylor and im a person in longterm recovery. What that means, in 16 years now. I found this thing called recovery and oxford house by gods grace and mercy. Way back in 1996. I had a little more research to do. Did the math earlier this morning, 1996, i have been in sustained recovery all but eight or 9 months. And eight or nine months of that, not engaged fully in recovery. That and in and of itself speaks volumes. Once the oxford think its in your blood, the streets would never be the same. You will never be the same. The last time the disease exhibited itself in my life, or the symptoms of this particular illness. I found myself facing two felony charges. I have been in county jail, grew up in county jail but i have never been in the department of corrections in prison. This time there was no way to avoid a prison sentence. I went to prison. There is more to that story but we dont have time for it. I went into prison and came home may 25, 2004, with absolutely nothing. I didnt even have a change of underwear. I was wearing the white uniform the kitchen workers war. I did not have a change of clothes. Low and behold, Kathleen Gibson, your wonderful chief operating officer from oxford house was in the parking lot, at present that day. I had no idea she knew it was the release date. She had been keeping up with me. I walked over to her truck, what are you doing . Her husband is keith, my husband and i were talking and praying about you and we decided you will come and stay with us a few days. It is going to be all right. [applause] so dan talks about things we dont have coming home from prison. That is a long list. I dont have anything. Fortunately a friend of mine helps support me and provide some of those things. One of the most important things they provided me with was understanding. They werent judging me. They invited me and welcomed me, a convicted felon fresh out of prison into their home and they fed me and clothed me and loved me and i spent a few days or weak out there and then kathleen set me up an interview at oxford house crosslink which had been giving her a fit for 18 months and she was strategically placing me there to help fix it. I went from there, speaking to people about my prison experience and kathleen and i developed a reentry coordinator. We created a position out of thin air and all of a sudden i had a job at oxford house. How about that . [applause] what i need to say is while i was in prison i saw so many people, so many men, so many polaroid pictures of men and children, i couldnt help but think to myself, what is happening with those kids when we are locked up in his cage. So god began instilling my heart with passion. How many thousands upon thousands upon thousands of people coming home from prison every day dont have a Kathleen Gibson in the parking lot . How many of those people never heard of that . It is plain and simple. In 1971, i think it was, this man named richard nixon, declared war. He declared a war on drugs. What he was really doing was declaring a war on people. He was declaring a war on an illness, excuse me, 8 people suffering from an illness and they got together and said i got lets do it like this. We will take Substance Abuse disorder, give them a rope to hang themselves and let them commit various crimes and as soon as they do we are going to jump on them and cuff them and lock them in a cage like an animal. In the meantime we are going to make sure there is no treatment available to these people, no help and to make sure this big moneymaking machine we call mass incarceration, to make sure it continues to be viable we are going to label these folks, call them felons, exconvicts. It is easy to discriminate and judge somebody to justify your discriminatory behavior when you put a label on somebody. Certain news channels you hear the word illegal, things of that nature, to cast these folks into the garbage and forget these are living breathing human beings just like you and i. Let me ask you a question. How many of you have been arrested . [laughter] let me ask you another question. How many have you been to prison . All those hands, right . Let me put my hand up. Now, i am in longterm recovery. Im a business owner, and executive director of alcohol drug counsel of North Carolina. The very first as far as i know, the very first on a national level, paid reentry coordinator for oxford house, the very first. [applause] during my years at oxford house i opened 40 new oxford houses and helped place somewhere around 1000 people. That is just me. All your hands went up. Obviously you are not in prison today, you are not using today, each of you who put your hand up, you have a different story to tell about yourself today. You are doing incredible things in your community. I guarantee not one of us would stand up here, going to prison helped us achieve recovery. May have been an excellent treatment program, i shouldnt go to prison to get good treatment. Locking me up like an animal, caging me up like an animal, taking my dignity and human rights, dressing me in a raggedy orange jumpsuit, making me wear flipflops and stroll buck naked and stripsearched me when i come off the road swinging that while you make millions off the backs of incarcerated americans in any civilized country in the world. 4 of world population, 25 or more of the worlds prison population. It is not hard to see. Richard nixon, he declared a war on drugs. My name is Curtis Taylor and i am officially declaring a war against mass incarceration. [applause] me and my oxford house family declare war against stigma and discrimination, we refuse to watch our brothers and sisters continue to be caged up like wild animals, treated like dogs. A person suffering from Substance Abuse disorder, they need help, they need treatment, detox, residential, inpatient, outpatient, they need oxford house. They need a dog on job. How are you going to call me a convicted felon and then say we cant hire you because you got a felony . My son dont care nothing about me having a felony, he needs something to eat. [applause] addiction can be a real dark place. When i was a little kid some of you probably had the same experience. I remember being afraid of the dark. And the thing i recognize is the second you flipped on the light switch the dark ran away and the light took over. I consider mass incarceration and the way we treat each other as a society as a darkness and im proud to stand up here this morning and say oxford house is that light. Oxford house is that light. To my oxford house family, you know i wouldnt stand here and not remind folks dont you dare look down your nose and judge your brothers and sisters. Dont you dare set up in the house and not answer that telephone. Dont you dare set up in that house and vote now in an interview because he got convicted of a be any we dont know bes in our house, who do you think you are . You might not have got caught but you did plenty. Even if it was driving a 5000 pound vehicle drunk as a skunk, that is a crime so dont get it twisted. You are not better than me, you are not better than anybody and im not better than you. None of us are. We are all imperfect human beings trying to do the best we can on a daily basis. Lets cut out this nonsense, shut down the prison system, close it. [applause] lets take that money and fix these raggedy streets in washington dc. I am sure i am over my time but there is so much more i could say but you know, this reentry thing is powerful, powerful. My life today is dedicated to making sure the next man and the next woman have the same opportunities i have been given because i fully understand if i got everything i deserved i couldnt handle it. I would bust hell wide open a long time ago. I am standing here today. As a result im obligated, i am committed, im dedicated to turn around and make sure i am being a Kathleen Gibson for somebody. Ask yourself who are you being Kathleen Gibson for today . Who are you helping . Who are you making sure has a nice change of clothes and can get a haircut to go to the next job interview, who are you doing that for or are you so caught up on facebook . Worrying about meeting your next baby mama which you dont got time. You know, man, you all look beautiful by the way. Oxford house is an incredible thing. Paul malloy and john fox gave me an opportunity to work with this Incredible Organization for so many years. I thank you for your continued support. As my journey continues. One thing i leave you with. If this convicted felon, i know i have been arrested 60 times in my life, i can remember getting out of county jail in the morning and being back at night. If i can go through all that and on may 11, 2019, graduating at shot university with my bachelors in social work. [applause] if i can become executive director of an agency, if i can most importantly be a father to my beautiful daughter and my wonderful son you can too. [applause] the beauty of oxford house, curtis and i stand on opposite ends of the spectrum in our philosophy what constitutes fair and liberal punishment. The one thing we both agree on is the light of oxford house, i go to house meetings and there are problems, where else in my lifetime have we ever sat at a table and discussed issues in a calm manner, heavy weight issues but no one is getting louder screaming, no one is behaving themselves but oxford house taught me that. We communicate and share ideas. But you have to expect everyones point of view. It is powerful. Our next speaker is Michael Mckeon from our reach florida. [applause] hello, a great honor to speak here, i have been clean and sober since july 15, 2016. I moved into oxford house in mississippi and had a trash bag and that was it. The guys brought me into the house, but early on i started seeing people getting their lives together and getting kids back and college degrees, i saw people get good jobs and getting things back in line and early on i was on the fence about my recovery. I started going to meetings with those guys. And events working with Regional Association and it motivated me so much giving me exactly what i needed. I was formerly known as 155593. [applause] it was a huge fluke how i got into oxford house. The case manager i was working with didnt know where to send me. I was asking about different halfway houses. Those are not for you. Dont go there. One day i was at a Community Work center and she said i heard about this place called oxford house. I dont know what it is so we could do an interview. The guys sitting in their office accepted me. Dont know what i was going to walk into a what to expect but it worked, got in the house, got out of prison and got in. The biggest holdup is the difference case managers transition specialists. If they did, could you imagine the amount of peoples lives we could change if every case manager and specialist new about oxford house. I hope in the future we can really work contracting with docs in all 50 states and having reentry coordinators, people that have stepped up into a leadership role, work with all these people in all these prisons across the country so we could solve this problem. Could you imagine the statistic of individuals reentering, living in oxford house, individuals moving into their grandmas house or moms house or some other place for recidivism. Doctor kelly said the number of recidivism, two thirds less as opposed to a different organization. [applause] i ask you as members of oxford house, the prison reentry, work with the transition specialists, work with the parole probation officers, to find a place to go after they leave prison. Thank you, that is all i have got. [applause] thank you. Our next speaker is reentry coordinator for North Carolina, jesse wilson. A loss of hope in here. Somebody was telling us about the interchange. I am jesse wilson. Since january 21, 2018. In Curtis Taylor, and help people like me, looking back on my life when i was younger man, 809 years old and very mischievous, drinking at 9 years old, started selling drugs at 17, accidental overdose, when i got to prison i was 149407 inmate. That is not who i am today. And i was a drug dealing maniac. And they would let me see my son,. There is a process, they love Curtis Taylor, and now they love me. There was a process, i would see that reentry application. I said the oxford manual. I would be asking about this. And then my phone interview. The longest phone interview was 2 hours long. I let them know you are not talking to somebody behind a desk but i tell them i am a regular guy, wooden brown clothes like you and let him open up to me. It doesnt matter what gang you may claim a what you have done in the past, doesnt matter to me. Gangbanging in prison is real. I want to see her desire to change or willingness to stay clean. I relapsed that day. Who relapsed the day they walked out of prison . It is real. This guy tried to hug me. I was that guy. These guys love me, these guys love me. And back to my real home in oxford house. He got some real steps. I let him know a lot of times, this town is really good. I get real with him, i am real with the guys getting to oxford house. If you do this, the only person he will do it is you. Nobody will do it for you. The thing i am writing down, what youre planning on doing it if you do that you will be held accountable. I give them the run down and tell them what to expect. I have done 130 phones in nine months. I can go hard to this because i relapsed whenever i got out of prison because it doesnt have to happen. Close to 100 people. They were still around. And set them up for success, people got burned, that doesnt mean the third one wont succeed. We were given a chance, lets get back. I went all over the state advocating setting up reentry subcommittees, following up, a voice for themselves. That is what i do. I let them know, i hear the desire, afraid to go back where they came from. The old man told me continue doing what you have always done, continue being what you have always been but on the flipside, if you want to become someone you have never been, doing things he has never done, that is where we come in. Talking about a bag of clothes at a change of underwear. When i got this job i was getting donations putting them in my trunk and taking it all over the state, you wouldnt believe the difference it makes to see somebody. A lot of people told me they dont have a family. They dont have anybody. [applause] this aint a job to me. I get paperwork, but i love what i do, i love what i do. I love doing an interview with somebody and im here to help you. Dont get me wrong, 100 people, it is not just for some people, some people are not for us. It is the truth. We will not waste more time. And somebody in that is going to be. [applause] just being real. Everybody deserves a chance. People change their lives like all of us. [applause] thank you. We will have a special our next speaker is Annie Cleveland from your virginia. [applause] her parents came down here with their daughter. Good morning. My name is Annie Cleveland, i am a woman longterm recovery, havent felt the need to have a mind altering substances april 23, 2015. I am superblessed to be here with all these panelists, really hard to follow so i will tell you a little about myself and what i found works for me. I am one of 13 outreach workers, over 300 strong. I work with 6 different drug courts, in Washington State. One of the biggest things i found is establishing that positive communication. You can be a liaison between the houses in these entities and you are there to change peoples lives. That is one of the main things i do. I sit down with their judges and with my housemates and members and am present, there to support them and not some of the things they need. And our integrity. It helps participants adhere to policies and stipulation that they are trying to complete. Hold each other accountable, lead by example. They love themselves. And leadership for me. And meeting the challenges. And they know they have a better chance of recovery. Making it through a drug court is not an easy task but living with a group of people who understand, and support one another is paramount at best. Grateful to be a Washington State outreach worker and very grateful to reach out between drug court and parole and reentry. [applause] thank you. Our next speaker will be ceo of National Association of drug court professionals, please welcome Mister Carson box. [applause] you know all the other people on the panel but you dont know me. You probably wonder why i am here and how i got involved and everyone has time to tell stories. I will tell short story. Im not in recovery but let me ask you this was how many of you play with matchbox cars when you were little cute you lets give a hand for matchbox cars, love them. I am a long way from playing with matchbox cars. When i was a little kid a friend of mine who grew up with him played matchbox cars. We lived across the street from each other and kind of similar households, similar everything. Im 51 now. He would be 49. My guess is of those 49 years he spent 2025 in prison. I became come later on i became prosecuted and i did one of your lifetime prosecuted. When youre young out of law school, a lot of lawyers going to prosecution because you get court work. And the sp to help start a drug court there. There was a federal court. I started researching what was and it looks like it was helping people. I said sure. Its weird, a lot of my friends after i started doing that i was like i think i want to make this a career. They were like youre crazy. You can go on a practice law. No, i think i want to do this. What a to ask you all fours help. Theres about 4000 treatment courts in the country and so their drug courts which means you might know. When veteran courts court were veterans coming. That in spite of obvious but might also have ptsd or traumatic brain injury. We are moving to place most of the folks in drug court, theyre not in there for like a possession charge. They are in the four charge driven by drugs, because like my friend i grew up with, but before he was arrested, before he was arrested the first time other things happened. My parents woke up in the middle of night and he was in the bedroom rifling through my moms first. Because for those of you who around my age, 25 or 30 years ago, four years ago, and a lot of communities nobody locked the doors. My parents would get mad at us if i had to wash the car and i pull into a certain place and watched it but he didnt leave the keys in the ignition. They got mad because how are you going to find the keys if theyre not indignation . Everybody left their keys indignation and left your doors unlocked. Well, a lot of the things ive dealt with as a prosecutor, episode one thing i need your help with is a lot of folks understand what you all understand. I asked linda people i will talk to people sometimes and i was talking is somebody who worked in our field for a while not too long ago and i said i was in a drug court. Not a single participant in all drug court at a drug charge. Not one person at a drug or alcohol charge and he couldnt understand what i was talking about. I said they are all there because drugs and alcohol are issues that agenda into the Justice System. Its interesting, we had a big conference this summer and last summer. Last summer my sister came to the conference. She was able to come on own. She wanted to see what was i did. My sisters one of those people and maybe your friends or family who does this, one of the people she wants to hug every dolphin or hug a tree. But she heard stories of graduates who stood up in front of people here this one young woman who is a graduate who spoke at a conference and when she talked, she had 18 felonies. These were felonies and she finished drug court and now she runs a treatment facility. My sister, this is where i want to close with the story. My sister afterwards told become she said she liked what he did but she said honestly ill tell you this, not understand the system, i dont know i wouldve given the person another chance. What i need your help on is that a lot of folks dont understand that. They dont understand the folks in drug courts, more of more of these folks are having charges that are not drug and alcohol charges. They are charges within victims but i can tell you when you talk to people in an ugly ask iteration hands, you had to raise your hands are a bunch of stuff you today but i can tell you how to work in the drug courts. A lot of the times victims, if youre in a drug court, if youre paying restitution to folks, those victims are who . Like in my friends case. Hamlet, neighbors, employees and friends. In my friends case was a neighbor and a friend. And its like when karl was talking, people are not disposable. And thats a message that you all can help me with is to get folks to understand that. To get folks to understand theres folks in the system, folks, for example, that are living in the kennedys. If you all are not familiar with drug court, the whole idea is you dont send people to prison. More often than not now folks in drug courts dont have drug charges. They have charges with theirs restitution. They might have long criminal records that are pages and pages long as youre giving them a chance and trying to get them connected to recovery. Its about connecting these folks to recovery. I need you all happy with that. Help with that understand because a lot of folks when you think about people in recovery and think about people finding recovery and to think about people who have charges, they think about just drug or alcohol charges. They dont think about other charges. It doesnt enter their mind. And it needs to enter their mind. I guess ive already said finally once, i will say fight again. A big push people been making miso is we found out theres research out there, and this is, this may i may not surprise you. It looks like giving to bid one state you are in in the United States, that when woman talk be number of folks in prison, that in some states over 50 of the people in state prison are there because they were on probation. The reason most of the folks were revoked is because they had a technical violation. This technical violations, most of them have to do with what . [inaudible] thank you. Whats critical also provokes understand and to push were making is that if you have drug court and what someone has shown you is the basically need more services and higher level of care, why put them in prison . Why not alter them more services and higher level of care . Why are folks, where maybe in some states over 50 of people in prison, people who when the judge first since then, that judge decided youre not a a threat to public safety. You can be out in the commute. Community. What you need is treatment. But when a person relaxes and cant make it, at some point of time that a road that person is sent to prison what theyve done nothing else to show they are a threat to the community. So why . Why not keep them in the community and give them more services and give them that extra step the need . At something working on. Its a heavy lift because you can be talking about 1 million folks then parse it probably should still be in the community receiving treatment, communitybased still in contact with the families and thats a heavy lift. Its a heavy lift to get folks to understand that. A lot of people dont. Im surprised that my sister didnt understand it. My sister has no missed by sometime she didnt understand a lot of the folks come into drug court have more than drug charges. They have more than alcohol charges. I just need you all to keep keeping up the fight, keep doing the good work. The guy i know, i grew up with, somebody told me while i was back on a visit last couple of years, they him and he said do think his wife wouldve been different it back in 25 physical we had a program like that . I said i dont know. I certainly would hope so. Id like to hope so since this is my lights were, that if we had that he would affect a different path our work at my organization is to ensure many people as possible are given the opportunity for that different path. I want to thank you all for what you do anything but interesting questions for me, finally come asked me. I work every day of the year and i love the work you all do. Keep doing what youre doing and i will take this the worst thing of had to do all week is to follow this people on this panel. These are fantastic fantastic people. [applause] so we finished a little earlier, and were going to open it up now for questions. Eq good lineup and please identify yourself with white house of what state you are from and what has. Im britney, houston, texas. In houston were trying to integrate reentry, like really hard right now. We think its a great idea but i think people treat reentry the same way they treat mag and more, whatever its called and theyre scared of the come right . A lot of house a closed off in houston, like know, we dont accept that person like they will the same way they treat mag. Whats a different approach to offer these houses, a reentry person . People are just turn off to that the of reentry. We do have a few reentry Success Stories. Theres one here with us today, and so it works. Its just a lot of houses are close off and it just want to know if theres like a different word we can use been reentry . I i dont know that make sense o you all. Does anybody want to answer that . Weve got several answers for you. Ill take a a stab at it. My first inclination is to grab a baseball bat and start beating the heck out of people. [laughing] i mean, i dont know, man. You saw it. How many people in here, you know, have spent time in concert and the whole room raised their hand. If you went back to those houses, it would be the same result. It sounds like to me its a simple case of people forgetting where they come from, you know. We stumble in recovery. We get haircut, shower and get a cheap bottle of cologne and all of a sudden we forget laying on the prison bunk. We forget when it was time for us to come home, all those prayers and hoping and wishing and god, help me stay clean. God, help you find a job. God, please somebody to welcome me somewhere so i can have a sense of belonging. We forget about all that. We become better, and thats a cygnus in the subject i guess i can really do is keep pushing the message, keep holding up your corner of the world, so to speak, keeping that example. And i suppose whatever, like most states, and a texas, you all are crazy. You eat a lot together so at those events the more you can put a reentry Success Story out in front, maybe make them a keynote for those events, make them come , get them to start te elected to a lot of positions and whatnot and take leadership roles and maybe that will help turn the tide. [applause] one of the things i want to add to that is your asking is there a different name for the period is, oxford house resident. [applause] and didnt want to stop using and stay stopped is our tradition states that her primary purpose is . The easiest way to classify them carefully is they are not different. Did you want to stop using drugs and stay stopped . And they are a member who wants to live in oxford house. Id like to add to that. Not only with reentry a lot of times they will be some houses where someone has an illness or they are gay or something. And i find that houses the seemed operate with a narrow mind, that education will bring it up. And just go there and explain the situation and remind everyone where in recovery. As long as we all start on the same page, we are all in recovery, then we can work miracles from there. But let us the stops the fact that we are house built on recovery and all are welcomed. My name is angie, and from the fort worth, texas, three. I also sit on the fort worth in her chapter Reentry Committee of oxford house. We are having an issue in texas with parole peru oxford houses. We need some help getting our house is approved for parole and probation. What is the essential problem. Was we cant get a houses parole you have any . Maybe one in the fort worth area. Do you know how that spirit two, sorry, two. Do you know how those were approved . By accident. A happy accident. They are saying appear they require a license. Is that accurate . [inaudible] for all houses in texas had to be individually approved, okay . That something each house has to address directly with probation and parole. They will not blanket approve a group of houses. Thats texas rule. If a house once you get approved them to do with individually, every single house. And i think they have a lot of stipulations in place that we need to work on if the want of a Constant Contact in the home, you guys have the obstacles that it would be difficult to overcome because a texas law. Its not your fault at all. Actually hawaii is the same way. What we do with come with we op a new house or we have an existing house and will invite the parole officer to come out and view the property, telephone number. Well call from household have a number and happen to rid come and if it is satisfactory to them, and you know, we fall into certain categories where hey, you dont want next to school or here or there. Thats on parole. Thats not a oxford house. They will approve but they also found, the to just blanket it. But then they had a shotgun approach to their clientele and they had trouble monitoring those people. They limit it to the six houses out of 30 that gilson declines to come and then its easy to manage on their end. So call one of the parole officers and invite them to the house, have a cup of coffee and show them the place. See if that works. Thank you. Good luck. Quinton jackson, austin, texas. My question, i to questions. One for kurtis and other for the gentleman who works for the state. I have three numbers, [inaudible] and also the chapter 11 reentry coordinator. Reentry chairman. With oxford house what i realized is as a reentry chairman with all these different positions if there is no real coordination with other reentry chairman in other cities or anything like that. Could there be more on exactly what our job or what we could be doing . Its just kind of like a position that you have chapter meeting unique to that area, right . Yes. To expand it, help each other out. And then with texas we have a Reentry Division that is part of the board of pardons and parole. Evidently have a presence while youre inside. Theres no presence outside. Whenever you released a give you a packet with a bunch of numbers of homeless shelters and thats it. While the inside to get you Social Security card, idea per certificate and thats it. What is the mission for you in North Carolina can what exactly, what would a state reentry person do so that might could help me whenever i in the capital, whenever i advocate more for reentry and initiatives for people getting out of prison in the state of texas . Thank you. So youre asking what more can you do as a subcommittee . No. With someone who is a reentry coordinator for at a state level, you know, what exactly, i know you kind of mentioned things, meeting with other people or whatever. What exactly is the hard data that you always want hard data, what exactly is the reentry coordinator for the state . So i help assist people transition out of incarceration upon release into an oxford house. The subcommittees we have in North Carolina to help with the placements sometimes. They do help advocate. Me personally, yes, i do work the whole state, but if youre willing, on your own, drive around in advocate, unlike was it earlier, like bring Success Stories with you, just a couple things that weve done in our area is weve got houses that have donated close. People from the houses donate their old close. Of course you dont get donations from everywhere because of bugs, but we started reentry closets for people thats coming out of incarceration with no close. We help with that. My subcommittees, are subcommittees, they do help placements and help guide into the direction of a good house. Stuff like that. Its really all i really got for the subcommittees. I mean, unless you want to start doing presentations on your own, why, shelters were people is getting release two. Thats really one of my main job is making sure somebody has a safe place to transition into, and not a homeless shelter. Kurtis . Im sorry, your name again . Quinton jackson. Quinton, my name is dan. Youre in texas, correct . Yes, sir. The situation that youre ye in, i know that the folks that work for oxford house have worked tirelessly in a lot of your state regional leaders have worked tirelessly trying to get the reentry system polish to where it successful to the houses. The best advice i would have for you to try to answer your question and make a position feel valid, right, is to go out and work with salvation armies, homeless shelters, and focus on people that are starting from zero getting into the houses. Because again, reentry is not just incarceration, okay . Anybody thats need to reenter society, at until texas gets those political things light out to her oxford house is blanket late approved or even multiple houses approved, just focus on helping those that dont have. We just got, i dont know the young lady before our chapter, austin just got tdc approved. I thought he heard courtesy he was the reentry person oxford houses as a whole. No longer. But you come see me after the. Yes, sir. My name is daish on. I from houston, texas, as well. My question is specifically, it was suggested that to help out with the Reentry Program and efforts were doing was to start working with drug court. I did want to know the process do i literally just walk in and say hey, judge, which im willing to do. Good luck with that. [laughing] well, i was in in a point oe county, so i kind of can get through backdoors. But once i made there, who am i looking for and who am i talking to and i can take a. Do you want to it first . First thing i just did, i introduced myself and that i set up conferences. In one of our areas they have a coordinator, and courtney of all the courts. Whether it be Mental Health court, the court, family court. The use of some type of a liaison between the courts that can direct you. And just because i am outreach, we work with a bunch of different counties. I work with six different counties and they have different rules for county. In some counties that authorized me to our life because of hipaa and Different Things like that. Roi. Does that open communication because they would like us to tell them if one of the participant in relapse or if they have moved out of a home are Different Things like that, so we should be able to call and ask hey, what did they really get sanctioned for, and things like that. Thats one of the things that it did. And just being involved. We have compliance officers, so those of the people between the counselors and the Court Liaison system. Just introduce myself and then some of the officers, in some of my counties are actual officers that come by the house and things. Just introducing yourself, and showing up for those events. Celebrating those graduation markers, you know, moving from the different phases just making yourself out there. Im going to give you my email address if he needs is just taken down. First initial last name, cfox allrise. Org. Email me what what i can do is theres a coordinator and ill do an introduction. So email me and ill do an introduction and then follow up and vicious Relationship Building from there. You can email me today or next week or whatever is good for you and i will sure, first initial, last name, so it is cfox allrise. Org. Theyre still spaces or capitals or any thing. My name is bo kelly and im from the state of colorado. I, too, came from reentry. I guess its a really important component for me. I guess now i am an outreach recitative but it been working in reentry since i got out of prison almost a year ago. My guess, somebody can of touched on it, but with such an amazing outreach and reentry team in colorado, but the one thing i find most frustrating is the cooperation and astigmatism we get from the houses. Because i mean, theres this kind of backlash especially from the houses that are already established. They try to separate reentry. I think the guys that were even trying to place and get out of the apartment corrections, with his stigmatism of thats a doc guy, and totally separate about than making the part of the oxford house. I wish you can figure out to combat this problem more because any suggestions you might have, as ive tried a lot of different approaches but yet it seems to be a a constant problem in our area. So youre saying once they get there, they are still a bit ostracized . To some degree. Theres definitely a level of people not wanting to even work with reentry interstate, and then even once they get there, i do want to play somebody who comes out of prison into a house with is already negative feelings or behaviors. We are setting them up for failure at that point. Absolutely. So you yourself having been reentry, tell your story. Tell them about yourself. Be the leader. Thats what i did in my area when i ran into problems like that. I just let them know that it did seven half years of prison, and this is where i met in my recovery. This his oxford house has done r me, and to really just encourage them that it doesnt matter where you come from. It doesnt matter. People get caught and some people dont. Its as simple as that. We are all here as recovering alcoholics and addicts. Usually push yourself and your story and that will touch people. Weve got five minutes. Hello. My name is Peggy Alexander and im from louisville, kentucky. I was one of the many that had their hand race and i am a reentry. I graduated drug court back in 2012 after three and half years, and without that supervision and accountability i was high before the dawn of the next day once those charges were dismissed. Fastforward six and a half years later and i caught my first do some tweaking and i got my first pc in january of 2019. Oxford house help you stay sober. I want to get all gratitude because you all are changing lives. [applause] thank you all. My name is willing to item one willie. I am a reentry chair and i was just wondering if you might have any sources for like federal funding for state funding where were trying to get together a bunch of resources and create a resource list where when these people come into our houses we have them like like a one to t, future food stamps, go here to get your perspective to get, drivers license. Are there any state and federal sources that you might have connections with or links to that might be able to get some of this stuff for these people . None that im going to share. [laughing] no, no listen. Texas, using his Organization Called clean cause, and they have helped us with first months rent. Thats all. As far as federal and state sunday, no, youre on your own on that. I really dont have a clue. Thank you. Sure. One of the things real quick, in North Carolina a lot of the houses and chapters contribute monthly into a fund, we call it the reentry find, and out of that fund we were able to pay the entry fee and a little bit of share for folks coming home. Those guys that dont like the reentry folks coming, they will love that idea. Really quick. Recently the state of Texas Regional associate great a reentry position on the level. By the way, my name is racquel to the question i really want to ask is, people on the panel, is there any experience on reentry on the regional level, and what role that this position can play better to serve the state and stuff like that. We are still trying to figure it out what our current reentry chair has been doing is just kind of like working on her own city and seeing what others are doing. But like what role can the Regional Association play on reentry and working with reentry . Thats, i think kurtis explained really well. Like, he and kathleen kind of creating this position and you kind of, you have to build and network and kind of make your own schedule, your own pace. But you also when you have other team members and you got to focus or you are not overlapping each others work and that you kind of make headway. But do you have any yes. Before i came to florida i was working in louisiana and they recently started a Reentry Association themselves on the past year and half or so. Its been very successful. I would highly recommend that you find some of those people while youre here and talk to them. But its really about getting people to volunteer in their area and meeting as a group bimonthly, and is really hitting all the basis, collectively deciding whats best for the entire state. Thank you. One of the Biggest Challenges is getting the word out. Theres so many people who dont know the oxford house exists or that they have options when come home. And so if are going to be that light that i talked about earlier and run the darkness away, then its up to you and i to volunteer, go inside the facilities, introduce yourself to case managers and superintendents of facilities, and tell them about oxford house. In opportunity that you get, invite these people to see oxford house. Thats the most powerful tool that you have is to bring some into an actual living breathing oxford house. Because once they see that model and here just one or two stories to individuals that live there, they are sold. Thank you. Thats all the time we have. I would like you to thank the panel. Thank you for your participation. [applause] enjoy the rest of the convention. And tonight at the hospitality suite he will be playing jeopardy at 8 00. [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] if you missed any of our live coverage of this event it will be online shortly to you anytime at cspan. Org. Just type oxford house in the video search box. Looking at some of our other like programming today, join us later with journalist and former white house officials examined the relationship between the press and the trump administration. Live Coverage Today at 2 p. M. Eastern on cspan. A little bit later congressional observers talk about the 116th congress and its effectiveness as a lawmaking body. This is another discussion hosted by the American Political Science Association to live coverage at 4 p. M. Eastern also in cspan, online at cspan. Org, or listen live with the free cspan radio app. In the late 1850s americans generally trusted the congressman what they did not trust congress as an institution, nor did congressman trust each other. By 1860, many congressmen congressmen were routinely armed, not because they are eager to kill their opponent but out of fear that opponents might kill them. Professor and author Joanne Freeman will be our guest on in depth sunday from noon to 2 p. M. Eastern. Her latest book is the field of blood. Or other titles include the essential hamilton, hamilton, and affairs of honor. Join our live conversation with your phone calls, tweets and facebook questions. Then at 9 p. M. Eastern on after words in his latest book the moral majority, whether evangelicals are choosing political power over christian values. I think the lesser evil argument is tempting but dangerous point i think it contributes to keeping a system in place that takes accountability out of the system. And i think it also is an easy way to bring in Something Like evangelicalism or any of the faith, and then use that as a way to get votes which seems like about the worst possible way to use faith. Watch booktv every weekend on cspan2. Sunday night on q a, university of Pennsylvania Law School professor amy wax on Free Expression on College Campuses and the conflicts to run an opinion piece she coauthored in the philadelphia inquirer. I i think this is what ruffld a lot of people, that not all cultures are alike. Were trying to tout this code of behavior as being one that was thickly functional and suited to our current technological democratic capitalist society, and comparing it to other cultures which are not as functional. We gave some examples, and that immediately caused a firestorm. Sunday night at 8 p. M. Eastern on cspans q a. Drama 441 days ago intel election 2020. Were joined now by david wasserman, the house editor at the Cook Political Report for a look at the bow for control of house of representatives but start with what the Playing Field looks like right now. Howw. Many seats do republicans need to take back to regain control of the house, and how many seats do you think are in play this cycle . Guest heres the basict math. There are 235 democrats in the house, when hundred 97 republicans. Theres one independent because justin amash decide to leave the Pumpkin Party and goes away on independence day. There are two that republican vacancies both the North Carolina old will b