Narcotics control examining heroin and Prescription Drug abuse. This is an hour and 45 minutes. Come to order, i would like to welcome our distinguished witnesses, and they will be introduced shortly. Recent recently, the media has chronicles a resurgence of heroin abuse in the United States and actually more heroin being moved into the country. According to a 2012 national survey, 666,000 americans reported using heroin during the previous year. That number has steadily grown over the past several years. So this begs the question why are more people using heroin and this is the Senate Caucus on International Drug control, but the reason to control it is to keep it out of our country and to do those things which prevent opiate use, not to enable it, but one answer according to the experts may be the countrys addiction and use of prescription pain medications, a report released by the Substance Abuse and Mental Health services that people who use prescript n prescription thats an amazing thing to me. Furthermore, four out of every five heroin abusers in much the same way as heroin, the lesson here is that rather than thinking of two separate addictions, prescription pain medications, and heroin, we should realize that were facing a much larger opiate addiction epidemic that includes both, so the strategy to treat the number of overdoses, but the first and most important strategy is to prevent drug abuse before it starts and this means educating communities and youths about the dangers. Now some communities already do this through the federal Drug Free Communities Program prescribed and dispensed only for legitimate medical purposes. State based Prescription Drug monitoring programs, along with mandatory checks of electronic databases can help doctors and pharmacists identify drug abusers. Since requiring mandatory checks, new york has seen a 75 decrease in doctor shopping and significant reduction and pain reliever prescription so drug take back programs can also help redu reduce opiod abuse, to get them out of medicine cabinets where young people obtain these drugs. The deas Heroin Signature Program in 2012, determined that 90 of wholesale heroin seizures were able to be traced from mexico or south america, dea also reports that the mexican based drug cartel is expanding its market eastward and producing and selling heroin and its more pure, its in the brown or the white heroin, between 2008 and 2013, heroin seizures along the southwest border increased nearly four fold. From 559 kilograms, to 2196. The second key strategy in this fight is successful treatment, which often ud assisted therapies using drugs like methadone and im going to have trouble with this one, bupenorphine. Thank you, sirs. Unfortunately, in 2012, 2. 5 Million People in our country were addicted to these opiods, where only 351 ,000 received these methadons or these bupenorphine to treat their addictions, that means the rest arent receiving treatment. Finally the third strategy is to release Overdose Deaths, in 2010, the latest year for which data is available, the centers for Disease Control and prevention reported more than 19,500 unintentional opiod Overdose Deaths. Theres steps that can be taken, there are drugs that immediately reverse these overdoses, and 18 states including california have taken actions to improve access to these drugs, i think we need to find a way to make these drugs more available to properly administer to individuals, including first responders. I think we have an interesting hearing, i do want to point out, if you look over at those charts, you see the rate of opiod sales, Overdose Deaths and treatment between 1989 19992010. The green is treatment admissions, the red are deaths, and the blue are sales. And as you can see, theyre all going up in this country, i theys a good chart that really discusses what were about. The other quick point is that heroin abuse increases as access to prescription painkillers decrease. Now thats a brand new thing for me, and thats what this other chart shows. So i would hope that some of you in your testimony would remark on this. And now i would like to recognize the distinguished vice chairman who you certainly can i would like to defer to senator put on your microphone. I would like to defer to senator mcconnell and thank him for his interest in this issue. And i thank you as well, sir. Thank you. Thank you, senator feinstein, senator grassley, for the opportunity to be here today to testify on the scourge of heroin abuse that is devastating as senator feinstein indicated, too many families and children across america, particularly in my home state of kentucky. It will be many places in america, but it happens to be in Northern Kentucky. In Northern Kentucky area of suburban cincinnati is the center of culture arts and american history. Its the home to the cincinnati Northern Kentucky international airport, and the gateway to the bluegrass state from the north. Residents of the three counties up there, kenton, boon and campbell, the area we referred to as Northern Kentucky. Live in a time of great opportunity. They have the benefit of living in a major metropolitan area of more than 2 Million People, with all the liveability and charm of a small town. They can take advantage of the Cultural Amenities like the cincinnati zoo and botanical gardens. They can take in a Cincinnati Reds game or a Cincinnati Bengals nfl game, or the cincinnati art museum. And over 25,000 acres of parkland give free reign to relaxation and Northern Kentucky offers all of that, and yet this Proud Community is also settled with the terrible distinction of being the very epicenter, the very epicenter of heroin addiction in kentucky and in the nation. They believe that the problem started because of prescription pain pill abuse, as senator feinstein was pointing out, kentucky has the third highest Drug Overdose mentality in our country. These pain pills are expensive, they cost between 60 and 100. Compared to a bag of heroin at just 10 a bag. I discussed a relationship between prescription painkiller abuse and the growing heroin threat with leading agencies responsible for curbing these threats, as we all Work Together to fight this epidemic, i want to highlight for the drug caucus some hard but true facts about the extent of heroin abuse in Northern Kentucky and i would like to credit the Northern Kentucky chamber of commerce for the data. The fact that these numbers come from the chamber of commerce and not a Law Enforcement or Public Health agency demonstrates how pervasive the threat to the community is. These in 2012, heroin Overdose Deaths in the three county more than 75 . 75 in 2012, while the number of heroin overdose cases by just august of 2013 had already doubled the number in all of 2012. Rates of accuse hepatitis c infections in Northern Kentucky are double the state wide rate and 24 times the national rate. 24 times. The national rate. Public Health Officials attribute the regions high infection rate to the regions high level of heroin use. Whats more, the Northern Kentucky health reported that for every one death, theres one new case of hepatitis c that incurs a lifetime cost of 64,500. The smallest among us are not spared from the scourge. Sadly, newborn babies are born with drug withdrawal syndrome. Each case is heartbreaking and not only costly in human terms but fiscally as well, incurring an average hospital cost of 14,257. Law enforcement is on the front lines of this battle to protect kentucky families. According to the Northern Kentucky drug strike force, the number of court cases for heroin possession and trafficking has increased by 500 from 2008 to 2012. In the three counties i mentioned, and is expected to double again in 2013. To put this in perspective, the three counties of Northern Kentucky area contained 60 of my states heroin prosecutions in 2011 even though they are home to less than 10 of the states population. Let me add here that its fitting you are holding this hearing during National Police week. When thousands of Police Officers from across the country visit the nations capital. We owe these officers our profound thanks and gratitude for risking their lives to combat the drug problem. And the many ancillary violent and property crimes driven by the growing trend. Clearly, the troubling facts ive just related show Northern Kentucky has a serious, serious heroin abuse problem. Its a major problem not for a few, but for the entire region. And while Northern Kentucky may be ground zero in my state, the problem of heroin abuse is spreading like a cancer across the bluegrass state where were losing close to 100 fellow kentuckians a month. A month to drug related deaths. We only have 4 Million People in the whole state. This is more lives loss than fatal car crashes. This march, i held a 90minute listening session in that area of our state to hear from those closest to the problem how federal resources could best be devoted to fixing it. As ive said in boone county, one of the three counties i referred to, there are great heroes in this tragic story such as the medical professionals who save lives, the Business Leaders who raise money for prevention and awareness efforts, the prosecutors and dedicated investigators who take drugs off the streets, and the recovered addicts themselves who find the courage to live despite their addiction. I heard from informed kentuckians in the medical, Public Health and Law Enforcement fields and in the business community. And in particular, i want to point out one brave young man patrick kenyan who had been ensnared by heroin and saw his friends use it and overdosed. It took repeated attempts for him to break his addiction. But he said proudly in the listening session, he was four years and ten months clean. I cant stress enough how helpful it was to hear about this issue from so many thoughtful perspectives. Thats why im pleased you are holding this hearing today. Let me just report briefly three takeaways from the listening session i held several months ago. First is noted, its clear that the increase in heroin addiction is tied to our fight against Prescription Drug abuse which is largely driven by the abuse of prescription painkillers. Second, while kentucky is making progress with greater education and more aggressive prosecutions and enhanced Regulatory Authority at the state level, we need a combination of both treatment and incarceration to be part of the solution. Lastly, the heroin trade is no respecter of borders, which is why multijurisdictional and multiagency Law Enforcement efforts, such as in my state, the appalachian high intensity Drug Trafficking area are so crucial. In this area of finite federal resources, we must use these inner Agency Partnerships to the best extent to maximize our return from federal dollars we spend to combat the epidemic. My friend, executive director, of appalachian hida never fails to remind his Law Enforcement partners that theres no limit to what we can accomplish when no one cares who gets the credit. The very same credo must also guide our efforts at the federal level. So senator feinstein, senator grassley, let me return to the picture i painted of a Northern Kentucky ripe with promise and yet beset, beset by heroin abuse. Thankfully, the ending to the story has yet to be written. Thats why im here today to share with you the gravity of the heroin threat to my constituents and to pledge work with all the stake holders to save lives in kentucky from this terrible growing threat. With the efficient leveraging of federal resources and authorities using best practices learned from both the Law Enforcement and correction agencies as well as the medical and Public Health communities, we can and will eliminate the shadow of this terrible heroin epidemic from robust. Communities all across america like Northern Kentucky. Thank you very much. Thank you very much, senator mcconnell. Senator grassley, you havent made your statement and then senator klobuchar would also like to make an opening statement. I think since you described the situation very well, im going to start out at the middle of my statement and refer to something that you and i learned about the existence of a database by doctors maintained by purdue pharmaceuticals. Purdue markets oxycontin, one of the most abused prescription opiates. The database allegedly contained information about doctors who engaged in reckless prescribing practices. During my investigation revealed many state medical boards as well as the center for medicare and Medicaid Services didnt know about this database. We encourage these organizations as well as dea to contact purdue about it. As a result, the information is now in the hands of authorities who could take action against irresponsible doctors. The purpose of this hearing is to learn more about what else is being done to combat this epidemic and what role congress can make. A multifacetted approach makes common sense. Prevention effort through which doctors and the public are educated about the dangerousness of opioids and other addictive drugs should be a part of that solution. This is why the mixed signals, the Obama Administration sends to young people about marijuana use are also damaging. Young people and all those looking to climb up the ladder of opportunity in america dont need another pathway to addiction. But that is what i think that what the president has said provides by failing to enforce federal laws and dismiss marijuana use as just another bad habit. Treatment for those who have become addicted is also a part of the solution, as well. A drug called moloxone has shown effectiveness in countererring the effects of heroin overdoses. Of course, we cant arrest our way out of this crisis, but we can and must maintain the current Law Enforcement tools to go after those who are trafficking heroin into our nation and our communities. Unfortunately, sentencing reform bills that are now before congress does just the opposite. The proposed smarter sentencing act proposed out of the judiciary cuts the minimum sentencing for those who manufacture, import and distribute heroin and do that by cutting them in half. These are penalties for dealers, not for users. In the midst of an epidemic, my opinion, this makes no sense. Federal prosecutors themselves wrote that the Current System of penalties is a cornerstone of their ability to, quote, infiltrate and dismantle large scale Drug Trafficking organizations and to make violent armed career criminals to get them off the street, end of quote. I dont want to remove this cornerstone, at least of all at this particular time. Thank the witnesses for being here and im going to put my entire statement in the record in place of what i just said. Please do, and thank you very much, senator grassley. Senator klobuchar. First, id like to thank you, senator feinstein and also senator grassley for holding this important hearing, for inviting me to participate. Just yesterday afternoon, i was with president clinton at Johns Hopkins where the Clinton HealthMatters Initiative held a very Important Forum on this very topic with the focus on Prescription Drug addiction and some discussion about heroin. I was on a panel with commissioner hamberg and the former representative Patrick Kennedy that followed president clintons speech. And he is really taking this issue on, which i thought was a positive. And he has a lot of energy, as you know. Id say i start with Prescription Drugs because when i look at the facts on heroin, the fact that while the vast majority of Prescription Drug users do not start to use heroin, Something Like 97 of them, in fact, 4 out of 5 heroin users today std