Parekh. He previously served as former assistant secretary for health from 2008 to 2015, good you. Ng to guest good morning, pedro. Host the president sent out a talking about the Opioid Crisis this morning, i will be olding a major briefing on the Opioid Crisis, a major problem for our country, at today at 3 00 in new jersey. Stems from his commission that looks at the similar topic ast week putting out calls for him for calling it a National Emergency. Can you tell us what you see but what it events, says about the administrations concerns over the crisis overall . Pedro, thank you. This is a very important issue, oneopioid abuse epidemic is of the most important Public Health issues of our time. So viewers understand, over 30,000 americans die every year twouse of opioid overdoses, million americans are addicted to opioids, affecting young, old, rich, poor, urban, rural, americans. Executive nt issued order creating a Commission GovernorChris Christie has been the interim report just last week, the final report is october. That report by the commission irst and foremost had a recommendation that the president label a National Emergency. Before, been done usually after significant public or th event like hurricane influenza epidemiepidemic. Additional dollars and regulations. The president didnt specify a National Emergency invocation might give, but some way to red it could be get more medicaid dollars or medicaid pay for reatment tmight be way for lo s to better access to locksom, the ante dote. One thing is for certain, this is a good idea because number one, it will raise the nations consciousness about this epidemic. I dont think most americans understand 92 million americans the last year from opioids, astounding from that fact, opioid are not front line treatment for chronic pain or acute pain f. The nations good ence, it will be a thing. Host who is affected most by this crisis . Affected the most . Guest so certainly, if you look regions, phic midwest, the states have highest opioid overdose, individuals uninsured, who are who are unemployed, who have other cooccurring orders, all at higher risk for addiction. Here are essentially two problems in this country, there are too many prescriptions for there is unnecessary prescribing ongoing, too many high of a ns for too dose for too long of a duration is also illicit supply, ot only heroin from mexico, synthetic opioid like fentanyl coming from countries like china. It is a battle on the prevention side. Workingscription opioid with the Healthcare Community of second is illitis supply opioids coming from overseas. This is where we are with the right now. Of course, treatment is critical for the two million americans addicted. Rrently host our guest is here until about f you want to ask the Trump Administration action on the Opioid Crisis, the Opioid Crisis overall. Eastern and central time zone, call 2027488000. Live in pacific time zones, 2027488001. Impacted by the crisis itself, 2027488002. Can also tweet us at cspanwj. Curbing talk about the of the prescription of drugs, that seems to suggest a as the e change as far medical industry or at least the community is concerned. Youto you make that, how do change that attitude . Time it has been a long coming. Physicians, like myself, were introduced to a new class of drugs called opioids and we were told these drug his no addictive properties. Same time, there was Health Care Quality move toment elevate pain as vital sign. To more and more prescribeing and led to cribing, that addiction. What needs to change, culture change among healthcare the ssionals, last year c. D. C. Issued important guidelines for healthcare rofessionals to ensure only prescribing opioids in select cases. Pain. Ly for chronic you should turn to opioids as the first drug there is a lot of needs to be done, most of this education is being voluntarily. What the commission has called for, President Trumps commission, bipartisan call center, we have former governors mandatory alled for prescriber education, before somebody gets a license, license d substance from Drug Enforcement administration, we should have sort of mandatory prescriber education. Epidemic is too large to go any other route. Suppose there be have to be a change of mind when it demanding e patient the drug to manage pain. Guest absolutely. That leads to another important point. We need other options. Opioids cant be the only option. Need to provide patients options to treat chronic pain in a way that is more effective opioids. There are other nonfarm cologic options out there. Need more research, as well, to better identify new chronic treatments. Host so when it comes to the issue again, if you want to talk guest give us a call on the phone lines or tweet your thoughts at cspan wj. Served as former Deputy Assistant secretary of health during the Obama Administration. Did you see this happening as far as this crisis of concern, the obama think administration did in putting some type of stop to it or curb it. O guest i was current Civil Servant throughout and the Obama Administration did a good job of raising the alarm bell. Issued very important guidelines o prescribers, they know when to prescribe opioid, they ways to o identify increase treatment and treatment capacity to states and allow providers to actually provide medication assisted treatment. Forward, move the ball there is a generals report on addiction, as well. Congress, bipartisan action back in december, resident obama signed 21st century bill that poured billion dollars into treatment that is implemented. So there is bipartisan movement forward. Administrationmp thus far is interim commission eport, final report is due in october, but i think the commission is taking some, looking at some right steps, of that is all just a plan and a report. People want action, i must say, i look back at some of my health and human services, taking active role in this crisis, so back in just of l, National Institutes health launched Public Private partnership with industry to number of e medications for addiction treatment, as well as chronic research. The food and trug administration in the last couple weeks, voluntarily asked opioid manufacturer to take a product linked torket, it was Infectious Disease outbreak, which they in fact did. There is an important report highlighting that opioid prescribe suggest coming down, there is sixfold variation between counties across the country. Target prescriber education market. Gencies continue to be front and center and very involved, so im pleased with what the obama did. Istration i think this is a bipartisan issue in congress and so far agency under the Trump Administration are doing a good job. In pennsylvania. Hello, robert, you are on with ahead. St, go caller ive been prescribed years, afor the last 17 few back injuries at work. I dont see the side that is for opioid treatments doing dont see them anything or saying anything to that have eople legitimate pain problems and tried different pain remedys and such and pain and the opioids work in my pain at they keep a manageable level and without he opioids, i could not function, id be bed bound and able to walk 10 or 15 feet, not offer w, youre anything solutions for the people that have a legitimate issue, youre just saying everybody is abusing opioids we need to stop dispensing opioids, so id like know what answers do have you for people who are actually helped by opioids . Guest robert, thank you for the question. Very important question. Developing thein National Pain strategy, when i was back at health and human chronic paintainly is also an important challenge in this country. Solutions are twofold. One, for individuals who are orrectly being prescribed opioids for chronic pain, essentially having that relationship, where both parties understand the benefits, as well as the risk, of opioids for the condition and ailment system critical. The key is to prevents addiction road one moves down that to intervene promptly. I think there are many, many pain americans who chronic is not being addressed by opioids, i think for that population, we need more the public and the private sector, to identify what armacologic could be ons, it helpful. N your case, you tried many different interventions. For others, it is very well trying other therapies, as well. Host oceanside, california, lisa, hello. Caller hi. That i ant to point out i after surgery and i had, believe, opiates, for hand never in the past and i found it to be addictive. Aybe because it was not prescribed too late of a time, my gi system, was gast gastrointestinal gastrointestinal, for those who dont know what i was talking completely shut down and i end up in the hospital when i an opioid. Rescribed was told by a pharmacist, it is now part of their continuing patients are informed of what to do with like that, where there is going to be a gi issue. Guest thank you for the question. Opioidinduced constipation is most well known side effects and you are right, many times now, pharmacists and problems are coprescribing medications to eal with constipation issues that will likely result from opioids. Point,say, also, to your that in fact, i think surgeons dentists are two types of Health Care Professionals where getting is increasingly out, oftentimes after surgery, pioids are prescribed and oftentimes too many opioids are prescribed for too many days and days on opioids, doesnt sound bad, in fact, get five, seven days, seems to weeks, it reach potential addiction. One of the things we need to ork on with Health Care Professionals prescribing medication to ensure they are only an amount that is absolutely necessary and not too much. Course, if there is too much tcan be diverted as something we want to prevent. Rhode island is next. Richard lives there. Hello. Caller hi, how you doing . I have three questions for you. First of all, i think that were problem a ksgiving little bit too late because all of the problems were talking as far as Pain Medicine, has already occurred now. Pharmacys and everyone else that were involved were able to now the government is, you know, putting strict rules in. Really people that are honest, now they need the medication and youre singling problem has and the now become that everybody cant get the Pain Medicine on the so now they have gone to heroin and that is a totally animal now. So the people who are on pain prescribe it or prescribe it properly and they need it. And so the people that you are now picking out are the ones even re going to get stricter laws against them. Host richard, we will leave it there. T point right guest richard, it is an important point that a previous caller made, as well. Americans out there suffering from chronic pain and inariety of ailments who are fact properly being prescribed tried other ave interventions that have not worked and the opioids are their pain at bay and there is a doctorpatient therapeutic relationship there, is ensuring addiction doesnt set in. Hat is tremendous unfortunately that, is not the case for all of the 92 million out there who in a ago, y just a couple weeks utilize used opioids in the last year and i think what we need to here is less single people so just educate americans about benefits and the the potential for addiction and healthcare to essionals, as well, and and the at the doctor patient have the information and the patient have the information they need to prescribe the most therapeutic intervention with the lowest risk for addiction. Host what is the success rate of those overcoming opioid addiction . Guest it takes time. The good part is there is a lot of evidence for what is called medication assisted treatment, partial opioid necessary onjunction with cognitive behavioral therapy. But it is something you have to stick with, a chronic condition, diet or we think of high Blood Pressure is a chronic condition, addiction is a chronic condition and you can relapse if you dont continue to focus on it. Ro, good news, ped dollared if there is evidencebased medicationbased treatment, and Many Americans are on the treatment and opioid addiction. Host washington state, this is kris. Caller hi there. Think one of the problems is that Insurance Companies often othert willing to look at alternatives. Neck problem c from an accident. I have managed to keep pain acupuncture. L from i live in a state, its been 15 since they made insurance pay for it. Once i hit medicare, i found out pocket, out of whereas, i think a lot of people ho get opioids, especially longterm, might get some real elief from alternative medicines and thats something i think that should be encouraged. Perhaps the t reason isnt represented systems, t insurance alternative medicine has companiesand pharmacy certainly do. Thank you. Kris, very important comment that you made. Couldnt agree with you more this is something specific Insurance Companies can do, alternative for chronic pain. For Many Americans, acupuncture, like massage, exercise, physical therapy, could in fact be intervention they need to ackle their chronic pain oftentimes. You have to jump through a lot of hoops to get insurance pay for these. By levelling the playing field, access to the interventions, as easy as paying for medication, could go a long way in better addressing chronic pain. Off twitter says that marijuana is a Good Alternative to opioids, in many cases, any evidence to that claim . Guest there have been increasing number of studies last couple of years hat have looked at states that allow Medicinal Marijuana and ave looked at opioid Overdose Deaths and found in many states, opioid use has been down and Overdose Deaths have been down, that is correlation, not a ausation, we need to do more research on the marijuana side. This is about the public and sector, to identify if fact what trials, in marijuana is doing for chronic pain there is a lot of data Clinical Trial for the f. D. A. To come in and say, yes, marijuana for pain is safe,onic is effective, that clinicians prescribe marijuana can be ensured that it is a pure orm, they know what they are prescribing. I think we have a ways to go, certainly may have a role, but more research. D host kenny from florida. Hey, yeah. When i was in the army, i had a raining accident and hurt my lower back. Was i got out, my pain really bad and actually my drug of choice was crystal meth. I used it for over three years, the only thing to take my pain away. Ive tried opiates, they dont do nothing for me. Gets opiates she and there are days she cant i will put tens units on her. I think she needs surgery, but i dont think her insurance will cover that. Guest first off, thank you for i think it goes to the larger point that were different, our bodies respond differently and for certain ndividuals, pain relieving interventions than others, but i think we have to understand is ongoing that right now with opioid Overdose Deaths and for some individuals, particularly high risk for have se ensuring they alternative means to perhaps treat chronic pain. T is a critical Public Health challenge for our country. Host what is funding or get over hat help to that recovery process, getting over the addiction process, what is available . Guest there are many federal gencies out there, Substance Abuse services has a hotline, resources there. Dollars, federal grants going out to states. Medicaid is very important public insurer perspective of medication treatment, medicare, as well, but less so than medicaid. There are federal providers out there, the va, Indian Health service, the commission called to increase prescribing of medication assisted treatment addiction. Th opioid there are federal resources out there, certainly i think from locality and perspective, there needs to be ore, never quite enough given magnitude of the Public Health challenge and i think the commission referred to several possibilities. Host Bipartisan Policy Center put together recommendations, look at this issue, our guest talked about some of them. Tell us about the development of this. You able to talk about these issues with the commission that enacted . Ident guest yes, we have a Governors Council, five former governors based on their experience with this issue, they wanted to weigh in and they president s commission, chairman chris a istie, they really felt need to address this issue and hey came up with four critical recommendations. Elicit t is again, curb supply. Overdose death over the last deaths ears, heroin increasing by 20 . Indeaths increasing by 72 . Job ed to do a better curbing the numbers and prescribing of opioid by working Health Care Professionals to be sure they are prescribing only when appropriate. We need to have will and in this country to treat two million americans with addiction. Low as 10 ofrts, the two million are currently being treated. Our, we need to get rid of the stigma in this country about americans, educate raise american consciousness. Our Governors Council made for president s commission and i see the governors were the commission incorporate many recommendations in the interim president ion to trump. Host greg from massachusetts, good morning. Aller yes, sir, good morning to you. Really one basic question and i i this is 14 years now ive een in near constant pain and the only thing that would touch this is the oxycontin. I took oxycontin for seven years working. That wore off, i was in massive pain. Happened, my vertebra was broken when i was in the marine corps, i stood underneath a plane and it broke it up. Now, 1048, im 62 next thing you know, im getting and hip and leg everything like crazy. I went through three surgeries acupuncture, spinal station, every drug you can alzheimers, cluding for some reason, but none of them work. Was not addicted to it, i was dependent, but not addicted. They tried to tell me my pain would be brought on by the opiates. Okay. I finally agreed, i quit cold turkey, took six months to get of it, i was in constant pain the whole time. Every y question is, have most of the time you some governor or somebody representing this whole process, thing, we y the same have to make sure were taking care of the people that drug. Mately need the host thank you, caller. Guest thank you for your service. I think this is an overarching theme that we dont need the federal government to eclare a war on opioids, what we need the federal government to do is really battle addiction Overdose Deaths, prevent addiction, as well. Think we want the federal government to get in between the doctor patient we do nship, but i think all need to understand as a addictive t the properties of these types of edications, need to do what we can to prevent addiction and Overdose Deaths and we also need accelerate research into other medications and other opioids, to pharmacologic, for the ones that have pain. He is not id dependant, what is the difference . Greekt dont have e if you a prescription or not taking it as you are supposed to. Clinical and abuse is definition. You go through withdrawal, it interferes with home life, you trouble with the law, go through withdrawal, tol is clinical definitions that differentiate as een abuse, as well misuse. Host one more call from north eric, hi. This is caller this goes out to everybody having a problem with addiction with opioids. Ive been on them myself and had and its ad accident degenerative, nothing can be done about it. Years and really was addicted to them. Is derstand everybody different, but this is going out for people who are addicted to it. You can get off of these, you can get your life back and you is justourself and that what i really wanted to say to you. Cspan, and everyone di ing that is ark addicted to this, i send my love out to you. Guest thank you. So much. Host as far as the Trump Administration going forward, can is the best advice you offer . Guest were waiting for the final report for the president s commission in october. I think it will be continuing agencies, scientific c. D. C. Or f. D. A. Or nih, to move forward. Ensuring public Insurance Programs like medicare and facilitating medication assistive treatment a while, l, for Affordable Care act, repeal and replace, debate we just had a think there ago, i was some concern there that couldg medicaid funds off certainly prevent that. I think it is very important on we continue to focus science, allow scientific agencys to work and see what in october. Ons are ensure we are treating as Many Americans as possible, many opioid Overdose Deaths. Will say, pedro, i think ultimately treatment will be critical to fight this epidemic, that will be prevention will help us beat this epidemic. We will never be able to cspans washington journal, live every day with news and policy issues that impact you. Coming up on wednesday morning, a look at escalating tensions with north korea over it Nuclear Weapons program. The foundation for the defense of democracies. Then, bruce brown on the top administrations crackdown and the potential impact on journalists. Be sure to watch washington journal on wednesday morning. Join the discussion. A look at recent policy in the middle east. Then President Trump talks about the Opioid Crisis and the situation in korea. Later a conversation on oil and Gas Production and government corruption around the world. Car accidents are the leading cause of teen deaths. The results from a new road Safety Assessment will be announced wednesday. The group family career and Community Leaders of america will host the event. A. M. On begins at 9 30 cspan two. The American Enterprise the trumpsays administration is continuing the same strategy be Obama Administration combined to combat terrorism. You can follow both events on cspan. Org or on the free cspan radio app. The 2017 Conference Thursday and friday thursday at 10 a. M. Eastern. A q a about elections happening this year. Plus a look at the 2018 midterm landscape. A friday at 1 00 eastern discussion on standing up for working families and embracing progressive values. How to p. M. A look at win back progressive power through organizing. At 4 00 eastern developing Vision Statements for the kind of society progressives want to see. For thefor coverage 2017 conference on cspan. Now, a debate on the situation in the middle east and the policies of the bush, obama, and from administrations. It includes an author and mr. Yousef. You will hear from former Obama Administration officials and former Navy Intelligence and counterterrorism officials. This is from the Conference Held in pasadena, california