Transcripts For CSPAN2 Opioid Epidemic 20170901 : comparemel

china t was legal to manufacture fentanyl up until early march. fortunately our state department and others, you heard from omdc earlier helped to change that so we can get cooperation to reduce the flow t hasn't reduced yet but we have a ways to go. fentanyl is 50 times more powerful than heroin. one gram is like 50 grams of heroin. it can be shipped in the mail. shipped in commercial carriers. fancy way of fedex, dhs, not postal service but other ways you ship packages across borders. it is shipped directly to the states or it is shipped to the canada and mexico. "the wall street journal," you know they're all about business, reminds us this is a business. the raw products cost about $1000 for fentanyl can be sold on the streets in the u.s. for about a million dollars. that's pretty big profit margin and that motivates a lot of behavior. so i think as much as we can focus on the supply we better do something to help people in recovery so there is less of a demand for these products. i want to end by emphasizing that our department of health and human services in the federal government under dr. price's leadership has laid out five main priorities. new approaches to pain. if a key driver was excess prescribing of opioids, can't we do a better job not using opioids to treat pain? yes, we can. the second approach is improving prevention, treatment and recovery services. what can we do to focus on the addictive process itself and eliminating it. the third will be, can we save lives more readily providing naloxone, that is the antidote. i wonder how many recovery houses have naloxone in their facilities. i hope you all do. not that the residents you all in recovery necessarily will have a problem but it might happen but you will know people that do. you will have friend that have an overdose, having this life-saving medication readily available is a key part of saving livings so then people can make the gradual steps towards recovery. the fourth area is to improve our data. we talk about how many death west have in the u.s. from the overdose. my latest data is from 2015. where are we? this is now september of 2017. don't you think we could have numbers from 2016 by now? don't you think we could no more about this? we would mike to speed up the process. finally i'm pleased research is being supported. i'm thrilled with the treatments we have. i'm thrilled with the recovery support services we have. we need more of them. we need it know how timely meant them as efficiently and effectively as possible but frankly we need better treatments. i'm kind of pleased with the medications we have treating heroin, fentanyl opioid disorders in general. we have medications that can be helpful. but they don't help everybody. many, many people fail on the medication so can't we do a better job? i hope you are research into the basic mechanisms what explains these conditions and how we treat them better will lead us to transformations so we don't have to see some tens of thousands of people dying every year. thanks very much. [applause] >> thank you, dr. compton. we'll move directly on to dr. clark. [applause] >> thank you. it's a pleasure to be here again at the house. it has been a honk time, last year. so, i appreciate this audience and we're going to be talking again later. so i don't have any slides but i have slide later. so both dr. gitlow and dr. compton addressed a host of issues associated with the epidemic that we've been discussing. so i would like to take a slightly different perspective. i want to point out there is an issue called the social determinants of health that gets forgotten. there is also an issue of how do we adequately treat pain. dr. compton made reference to that, but that's a large issue because indeed, it affects people's desire to use opioids with. we brought in a whole host of people who were not previously using opioids. we have to keep in mind as dr. compton points out and dr. gitlow, we have 69 million people that are binge drinkers. 65 million people cigarette smokers. 22 people marijuana users. 4.2 million people who miss use pain relievers. not the largest group of individuals. so dr. gitlow's point is well-taken. we have to deal with the fact that our society embraces use of psycho active substances. how it should be administered, what we should do, that is another matter. with regard to prescription drugs, we have, according to the household survey date from 2015, i agree with dr. compton it is outdated data, ostensibly within the next two weeks we will hear 2016. 95 million past users of pain relievers but only 12.8% past year admitted to misuse. we have to deal with the issue -- anybody here have any pain? anybody here want to enjoy that pain? so unless you're into s and m -- [laughter] there are people, you know, psychiatrists, we meet all sorts of individual i don't want to dismiss their predilections and i had yo sin crow sis, if we don't deal with chronic pain, chronic, non-cancer pain we won't deal with the issue. i know dr. compton's institute, nih, has a working group trying to come up with non-psychoactive substances that help treat pain, that resulting in strategies. the cdc has come up with guide lines to treat pain. the fact is we don't know how to treat non-chronic pain adequately. take motrin. motrin hurts you if you take too much. take tylenol or acetaminophen. acetaminophen hurts you if you take too much. don't take opioids. the fact is i can't stand the things but i'm not a proponent of people suffering. in the discussion there is mistrust and distrust of consumers. pill mills, though are responsible consumers. you show up, i got a pain in my pinky, they give all the pills in the world. that is not a responsible consumer. that is not a responsible prescriber. there are mistrust and diss trust as consumer. my fear we go from one end of the pendulum to the other end and single out the consumer as the bad guy. we have prescription drug monitoring programs. we have people wanting access. they want to put you on registries. they want access to your information. they want all they can get and your phone is doing half of that with your gps but they all want they can get from you. vilifying the consumer is not a solution to this problem. we have people who are exploiting the vulnerable, the business misery. dr. compton made reference to indiana. it was a matter of opioids and benzodiazepine, but methaphetamines. i looked at jail in the community who was being arrested for what. that information was public. i looked at jail records. a bunch of folks arrested for methaphetamine. they were not injecting methaphetamine and smoked heroin? anyone know how you do that? the combo? you inject the combo. when we focus on one substance alone as dr. gitlow is pointing out, we ignore a larger issue. social determinants of health. if they are being abused physically, if they are abused psychologically, if they have no solutions they tend to use whatever makes them feel better. we need solutions. and i'm going to turn to some of the themes that surface at oxford house because i see in oxford house some of the solutions. you may have seen from your materials over the years themes like accountability, responsibility, integrity, honesty, community, support, respect. these are themes that make for a good dr. patient relationship, a good community relationship. we can deal with those things. employers mindful and respectful of employees, not let me see if i can get the next 26 hours out of you. when you look at mine workers, look at the pain that -- they don't have cancer pain but hunched over for long years. they come out, all they have got is pain. we're surprised if they use opioids. how did that happen? factory work, anybody work at a factory? i worked in a factory when i was college. i was one of those relief people. after eight hours my mind was numb. i was only doing it twice a week. i asked myself, could i do this every day of the week? basically what they were interested in was the assembly line, not me. so, my point to you is oxford house offers some solutions. wilson, there are some solutions. the solutions in the principles of oxford house, accountability and responsibility. the patient needs to be responsible. the patient needs to be accountable, but so does the doctor, so does the hospital, so does the drug company. the system needs to be accountable. honesty, the doctors need it tell patients about them. [applause] they were giving out pills not alternative solutions. alternative solutions costs $500, the pill is $5. what do you think the insurance company is going to do? right. so i'm going to wind up with the notion of gratitude, because the principles of oxford house function well if our larger community adopts those principles. that way when someone is quote, backisliding, as dr. compton points out you should have naloxone in your facilities because people crash and burn. this is not a perfect disease and the efforts are not always flawless but if you have a environment where people get support and people have opportunities and if they follow the basic tenets they have recovery on the horizon, then i think we can deal with chronic pain, if we have an honest society that recognizes that we put people in grueling environments, that they need relief, but they don't necessarily need to be drugged for relief. so your principles should be incorporated in the larger theme of what we're going to do. there is not another pill necessarily. not another big brother surveillance civil necessarily but a society that treats each other with respect and with dignity, that holds people to accountability and responsibility, and that diffuses to every participant in that society, then we have our solution. thank you. [applause] >> dr. major. [applause] >> good morning. how are you all doing? i got some bad news for you. i have a power point. [laughter] might take a second or two to put it up there on the screen. i don't have a prompter. i will look over here i think when i present. let's see. i'm john major, with harry s. truman college, part of the city colleges of chicago. i don't have a prompter. i don't have my glasses. i will be looking at my notes, so bear with me. what constitutes a crisis number of things come to mind, what are the prevalence rates? i would like to go into detail on statistics and data discussed from dr. carr and dr. compton. this comes from smsa has on the website from the national survey on drug use and health. this is data that was presented about one year ago today, reflecting 2015 data. i got a bunch of slides. i'm not going to be terribly technical. so if you bear with me i will try to get through this as quick as i can. in terms of prevalence rates there is a lot of drug use going on and it is very comprehensive report from the survey that crassfied psychotherapeutic drugs into four categories. we're talking about prescription drugs that are painkillers, known as analgesics, things that make us not feel the pain. we have tranquilizers or things that calm us down, we know stimulants are, things that put a people to our step, adderall, ritalin, and sedatives to help us go to sleep. if you look at the chart there, it is surprising. almost 45% of people in the united states are estimated for using these drugs. you might be thinking, oh, my gosh, this is an epidemic? maybe they don't use the drugs like some of the people in attendance today. they throw away drugs or give them back to the pharmacy after done or take them as prescribed. the situation here is misuse of prescription drugs. the numbers are much smaller but still very significant. at least 7% of folks in the united states are estimated for misusing your prescription drugs. you see on the chart those frequently misused prescription drug in that category of psychotherapeutic drugs, pain relievers or analgesics. it doesn't get any bert. when you look at people using other drugs, alcohol included, tobacco, stimulants, folks who use heroin have a high frequency of misusing prescription drugs. can you guess which of the four categories they tend to misuse more? painkillers, right. analgesics, about the same rate. so there is a lost drug use going on. and in terms of meeting diagnostic criteria for a opioid use disorder, you see the bar charts there, very top it is alcohol. like dr. gitlow said, we have a big problem with smoking and drinking. but today we're talking about opioids. if you look down, you see a little sliver, .6, why are we talking about heroin? that is small number. that translates to 591,000 criteria. diagnostic criteria for opioid use disorder by way of heroin. but what is even more alarming, three times the rate more for other opioids. that is the thing i'm really going to be focusing today. so there is all kinds of opioid use. we seem to focus a lot on heroin but a lot it going on with other prescription opioid use that is being misused. this bar chart shows mission of drug use, people might be initiating or starting with prescription drugs, most of them being analgesics or painkillers. there is a lot of accessibility, probably explains the prevalence of use of these drugs. i would like to introduce some data produced a couple years ago when one of the most respected addiction researchers gave testimony to the united states senate focusing on america's addiction to heroin and prescription drugs. she wented very compelling and very scary data. this chart chose the increase in prescription drugs have been assigned in the last 20 years or so and folks, that is in the millions. now i don't have my glasses on. i can't see that far but i think 74 million prescriptions were assigned in '91. 20 years later, nearly tripled. see the green line corresponding to specific opioid drugs that were prescribed. so this is a very serious problem. this graph here seems a little complicated but it is pretty simple. from the. of 2009 to 2011, a three-year period, they showed trends of drug use across four, four opioids. i think one category is other opioids. oxycontin, oxycodone and other hydrocodone and heroin. percentage of people reported they used opioids to get high the past 30 days. if you go to the far left it is about 10% of people surveyed that yeah, i used heroin to get high in the last 30 days. then it gets to be 50% of those folks or more reporting that they're using prescription drugs. you see there are changes when you go from the left to the right. we're talking about trends of drug use. dr. volkow says, in her interpretation of the data, and i quote, the emergence of chemical tolerance toward prescribed opioids prescribed in smaller number of cases with difficulty of obtaining many of these medications legally may explain transition of use of heroin, which is cheaper and some communities easier to obtain than prescription drugs. that is the concern of a lot of researchers. they're getting ahold of prescription drugs. they're hard to come by because they're expensive. go into the communities to get the dope because it is cheaper. when i read this, something stuck out it me. first, look at this line. chemical tolerance towards prescribed opioids. have you ever once heard anybody talk about the chemical tolerance toward heroin? other things that speak out to me. things like perhaps in a smaller number of cases. in other words, dr. volkow is very smart, she is a researcher that had to be very careful when we term data. we have to be cautious. we have to use conservative language but she makes a point that these things are leading to transition to abuse. i come across a couple studies where the data suggests that people are using prescription drugs, therefore, it leads them to using heroin. then they typically over-d, overdose. now when i look at the numbers on this graph, it shows changes over time. in other words trends. but nowhere in this report that i came across did it make reference to these changes being significant and that is very important because in research when we talk about statistics when we find something that is significant that means that it is due to something other than chance. it is not a chance occurrence. often times we make attribution, has to do with independent variable or whatever it is we're looking at. at least when i look at this chart, this to me shows normal trends across time. there is no rhyme or reason for the changes of frequencies. now i have highlighted and probably from where you're sitting it might be difficult to see, two sets of data points that kind ever suggest that support the notion of a switch from prescription drugs to heroin. if you look at the turquois-colored graph toward the bottom you see from one time point there is a slight increase in heroin use. and that corresponds to the other lines above it. decreases in opioids. and you see that in the second highlighted column to the right. the idea is, people are increasing their heroin use because they're getting less access or they're decreasing their use of prescription drugs. that is pretty interesting. now, dr. volkow also says, if you read this on the website, heroin abuse like prescription opioid abuse is dangerous both because of the drugs addictiveness and the high-risk of overdosing. that is great. she is saying prescription drug abuse and heroin abuse are both dangerous. they're both highly addictive. but then we read in the case of heroin now i include the emphasis on the slide, the danger is compounded by the lack of control over the purity of the drug injected and its possible contamination with other drugs. that's true. we know in recent years they're mixing the dope with fentanyl. people are dropping left and right. it is horrible. when i read this, let's say i'm a u.s. senator, not so adept looking at research stuff, i want to walk away with the idea heroin is worse for you. the danger is even more. but what about the dangers of prescription opioids? that doesn't really seem to ring very loud to me when i read research articles. and i think this is something that we as researchers need to do. dr. clark talked about accountability. researchers are a little bit behind the curve but i think we'll continue to be accountable showing dangers of this epemin i can or this crisis that we have. i like to draw your attention to the graph. i get rid of it very quickly. you can see at least there are seven points to look at where you can draw conclusions. now the only basis i could see supports a claim of a switch from prescription drug use to heroin are those two i showed but you can look at other sets like these two. it shows when people increase the heroin use they're also increasing their prescription opioid use. in other words it suggests polysubstance uses going on. there are three data points show the opposite effect. you could actually draw the conclusion that prescription drugs are plentiful. because of that, i'm going to reduce my heroin use. so us researchers have to be very careful interpreting these data points. now if you look to the screen again, look at gold line, essentially shows that an increase in heroin overdoses by 50% in the 10-year period. that is alarming. we definitely have a problem. so, i'm sorry, i don't have my glasses. so in conclusion, you know, when you can read we're seeing increase in number of people who are dying from overdoses, predominantly abusive prescribed opioid analgesics. researchers are coming around. we're starting to see this stuff. this disturbing trend growing from the commercial market. prescription opioids like other priored medications present health risks but they're also clinical allies. clinical allies? that's interesting. one thing in the testimony is the fact that over 13,000 people died from opioid drugs, prescription opioid drugs but it is not considered an overdose. this is referred to unintentional death. if you die by heroin you have an overdose. if you die by prescription opioids it is unintentional death. now these drugs are clinical allies. we have to be very careful. i think there is something to it because if you go to one of the first charts i showed you, a lot of people are using these drugs and they don't have a problem. they are not that 7% of people who misuse them, develop a opioid use disorder. even if we go with that, more prescriptions going out and more people have access to it, you might make the argument this might be the gateway maybe overtime people will become more addicted to this stuff. what about people in 12-step recovery? it is interesting about giving them prescription drugs for any reason because we know they tend to misuse prescribed drugs, right? but people i know, this is where the experience comes in for this, facts and experience, i know a lot of people in 12-step recovery and their pain is real and some researchers say, pain management, not just for non-addicted populations but it is important for people that have opioid use disorder or other type of addictive disorders and it kind of bothers me that i know some people, because i used to be a clinician, they would drug seek. oh, i'm in pain. how will we distinguish what is legit and what is not? but what disturbs me these days, my friends in 12-step program, i'm a recovering addict, i don't want the effect of psychoactive drugs. their physicians are telling them this is non-narcotic, this is non-addictive. this is just a muscle relaxant. john, i felt i was high, if i relapse, what the heck? these physicians need to be very careful, not just read pamphlets saying it is non-narcotic when it can trigger a craving process for people in recovery. let me talk very briefly about diversion. diversion is the act of sharing, selling or illicitly using substances. this is not just mere misuse of prescribed drugs. we're talking about getting drugs on the black market, selling them, not just using them against doctors orders. three drugs in particular have become of interest to researchers are medication specific treatment drugs. drugs used to help people get off opioids. meth known and naloxone. what reason study about receiving methadone and syboxi, those receiving it were twice as more likely to engage in diversion practices. another study found there sin creased risk of overdose among people engaged in diversion practices. that is kind of cool. it is not like lethal overdose. it is like playing russian roulette without spinning the chamber. the closer you get to the non-rogual overdose the more closer you get to overdose. we're talking about medications, treatment types of medications, they kneel this is positive thing. majority of people in the study said they were morally right to do so, and they could do so without getting detected. lastly death rates, i'm running out of time. i had 15 minutes. i tried to prepare for 15 minutes. i will try to wrap up as soon as i can. thank you for the indulgence. this came out from colleagues at johns hopkins university school of public health. this recently came out. there is two lines, the broken line, the bottom line, showing trend in lethal overdoses due to methadone. the top line, lethal overdoses in relation to prescribed medications but they're not really defined what prescribed medications we're talking about. the prescribed opioids. this is very alarming because we go from the bottom line, in terms of methadone overdoses, 1999, 784 deaths. and by 2014, it gets up to 3, 400. now some people will say, around 2007, 2008, there were regulations implemented to regulate methadone, to decrease the rate of overdoses due to methadone. some researchers are saying wow, we're showing decreases in the death rates of methadone in authority, two, three-year period. there is some truth to that but look over the course of 15 years, 784, to 300, that is six-inch dagger in somebody's back, pulling it out one inch, saying hey, we made a difference. [applause] now come to the other prescribed opioids. it is off the hook. we're talking about, i can't read numbers from there. somebody read that for me. what is it, 14,838 over 14-year period? good news, only 300% increase. not 400% like methadone but the numbers are very high. if you look at the highlighted 2010 that is the same level if not a little bit higher than 2014 and those rates are very comparable with what dr. volkow presented. so there is a lot of consistency across researchers looking at this epidemic. so if you look at numbers from this report from 2014 from colleagues, you see a lot of deaths due to opioids. not just the heroin. methadone, medication assisted treatment. it is used a lot more as a medication-assisted treatment. if you add up numbers, looking 18,000 people dying from opioids. this is 2014. if you take methadone, sorry, if you take heroin out of equation, that is a huge number. a lot more people are dying not from heroin but by prescribed opioid medications. one more study, almost done here, one year later, here are the rates. i will show you the rates of heroin overdoses and prescription opioid not including methadone. the number for heroin went up by 25% in one year. that is very alarming. and by over 30% for prescription opioids. so this is what's going on. this is what the numbers tell us. but when we turn on the tv or go to "people" magazine, it is the heroin crisis. no mention about how people are dropping like flies due to prescribed opioids, not just for pain but for those to treat opioid use disorders. we don't anything about the unintentional death rates of these taking. we're starting to find that out about methadone but about sabtoxin a good friend of mine, andy chapman, explained what i was presenting. first thing out of his mind, he is not academic, like normal people out here, first thing out of his mind, john, you have data, why aren't you reporting death rates on prescribes drugs? that remains to be seen. in conclusion, there is a greater access to greater use of opioids particular prescribed opioid medications. medications used to treat this problem are being misused. it is being diverted. death rates continue to increase but we continue to promote these medications. now, you know, i'm not a real doctor like dr. gitlow here, he is md, i'm a phd. i tell my students i play one in the classroom but in my crowd adhere to certain ethics code, american psychological association code of ethics and it is pretty similar across all professions actually but there is a thing called beneficence. that we do good. but couple that with non-malfeasance. do no harm. if i went with the idea that medication assisted therapies are beneficial, but i'm not a believer, i am not a believer, some cases it can work but if you institutionalize it can go awry, say for argument these things provide benefit, we must embrace it without doing harm. i don't think there is risk of harm. i know there is harm. the numbers don't lie. people are dying from the medications we prescribe them. like we've been saying since the '80s, silence equals death. we need to talk about this and us researchers need to be a lot more accountable how medication-assisted treatments not just show risk but death and show harm and if we kind of have that we might be in a better position. lastly, athedra, '90s, dietary supplements with ephedra. the fda says it might cause harm. the harm it causes pales to the comparison of harm we know going on with prescription medication. that is all i have. thank you for the indulgence. [applause] >> good morning, everybody. >> good morning. >> my name is lori holtzclaw, regional manager for oxford houses of mississippi. >> [applause] >> so i am not a doctor. nor a researcher. but what i am going to speak to you about today is my experience. so dr. clark mentioned something about, you know, we need a solution and what i believe is that the solution starts right here with everybody in this room. [applause] so, you know, there is a little quote, a saying, be the change that you want to see in the world, and that is what i strive to do every day, i strive to be the change i want to see in the world of the people that i love the most which is, you know, alcoholics and addicts. people that are trying so hard to change their life. so i am, i am an addict. i'm an opioid addict. i was addicted to prescription medication, oxycontin, heroin, anything like that, and then i have also been on medically-assisted treatment which did not work for me. i'm not saying it doesn't work for anybody, it just did not work for me. my addiction brought me to homelessness and incarceration. and you know, i lost everything. as everyone knows in this room, it brought me to incomprehensible demoralization and i was unable to make decisions, you know, i couldn't put two thoughts together. my first seven months of recovery, i would say sobriety, i spent in jail. and when i got out of jail, i was very fortunate to move into an oxford house. so one of the things that i have learned over the last 10 years to be open-minded to different forms of recovery and that's where a lot of change is coming in. so, you know, there is all types of different, 12 step recovery is not the only recovery out there. there is all types of different recovery out there. that is one of the things i want to focus on today is us as individuals as a whole to focus on other ways and paths to recovery. they have this new thing called refuge recovery. has anyone heard of that? >> yes. >> and then they have smart recovery, which is, it's a also a newer form of recovery. they have the 12-step programs. they have faith based programs. and then of course medically-assisted treatment. so, all those different, you know, those are just some of them. there are probably more out there. there are some examples of them, but all those different forms of recovery, you know, can all lead to the same results, and that's, abstinence from opioids, abstinence from amphetamines, abstinence from any drug that is out there. so, you know, another thing i want to -- i want to speak to you guys as individuals. like give yourself the time in oxford house. i was in oxford house for seven years. i know that is a really long time, but i know me. you know what i mean? and you know you? and you know that it es going to take more than three, six, nine, one year of recovery for you to change and stay sober for the rest of your life. i took that time for me and it was important. you know, i made sure that i was stable and that i wasn't moving in with somebody that i could make everything work for myself. that's one of the biggest things we focus on in oxford house is being self-supporting. that is not just for oxford house. that is for you as an individual to be self-supporting, self-staining, not have the system take care of you with food stamps. there are things to help you with tools. then i'm going to close with this. the, the other part of is giving back and, one of the biggest ways that i gave back before i started working for oxford house, i did service work was opening houses. that is one of the most rewarding things that you can ever do is to provide six, eight, 10, 12 bed for people that need it. you know, we have 110 houses in the state of louisiana. we have 20 in mississippi. those are houses i'm directly, regional manager over. [applause] we don't have a lot of staff down there. so we truly depend on the people that live in the houses to open these houses, to make sure they get all the furniture an stuff like that. but gives you a sense of purpose and we have to have a sense of purpose to stay sober. we can't just flail, we can't just work all the time. we can't flail around and not have something that is going to give us, you know, a sense of, that we're changing the world. so, you know, i just, you know, i want you all to take this back to your houses and to the, to the chapters and stuff like that. you know, you can make a difference in the opioid crisis today. you can be an example to your best friend that is still out there, your sister, your mother, your child. you know, all of these people, everybody's different, everybody's family members are different but i know that, you know, we can be an example of what recovery looks like. and all that comes from, within an being the change that you want to see in the world, so thank you. [applause] >> how y'all doing? >> all right. >> what's up, family! let's do, a lot of people poured heart out up here. do me a favor, part of the thing would be cool if you did, just do one thing, take like 10 seconds, take a deep breath. take a deep breath. let that thing out, and be grateful. you know. [applause] be grateful we made it. because all the graphs and stuff, that gets me depressed, you know? i'd like to see a graph on you, you know? you are, everybody in this room is 100% successful today, 100%. [cheers and applause] 100%. everybody, you know the little thing, i don't know why i'm saying it, the thing on the pill bottle saying alcohol may intensify this effect? do not operate machinery? but anyway, i will get back to this. the what was chilling me up here, we were talking about perfect storm. what created the perfect storm of opioid disaster is what is going on, and it is not just opioids. alcohol has been a disaster for thousands of years, but opioids, the world population, the population of the world, this is simple math, it doubles every 25 years. 25 years ago we had 3. something billion people. now we have 7 point -- better buy some real estate. the world population doubles, which means the problems double. you know. that's scary. and so i'm sitting here looking, everybody here has put together a lot of work to get here. a lot of people put together a lot of work to put this on. for 42 years oxford house put forward a lot of work, to maybe sure everybody here has a house to go to, a safe place. there is system of operations. there has been untold volunteers, chapter, housing services, house presidents, house secretary, all of that for 42 years, i'll thinking it just kind of dawned on me. we've been creating the perfect storm to combat this. this is the perfect storm to move forward, that self--runs, self-finance, democratically-run system of operations that is catching everybody's attention. this is the perfect storm. this is one of the greatest solutions on the planet today, you're a part of that. please give yourself a round of applause for that. [applause] that is kind of mind-boggling. one of reasons, i can qualify myself, you see these beautiful cities, portland, oregon, is a beautiful city, a beautiful city. anybody here from oregon? [cheering] i ran those streets in portland, oregon, when i was coherent. portland, oregon changes after about 10 p.m. it's a different city. it is a different city most people don't see. all the things that are going on, there is a lot -- and i saw a little bit when we had our world convention there. you know going down the beautiful parks and things. well if you look in the corners, if you look in the shadows, it's there, you know. and it comes out after 10:00 p.m. you know, it is a whole different world. so, it is always been there. and what, i guess when -- there is famous saying when the teacher or when the student is ready, the teacher will appear, there is also good recovery in portland, oregon, and we've all been in the shadows, things like that. it has always been there, the opioid crisis. i was a product of the opioid crisis alchohol may intensify this effect. i was a product of that in the entire '80s. many jails and many institutions. i was, probably write a few of my family here have been the ones they gave up on. how cool is that, that we were the hardest cases, and we're here together, working together, common of purpose. [applause] that is amazing. i would love to see a graph on that. but, there is the anonymity factor and things like that and that's great but, the cool thing about oxford house is that we're different in that we motivate, we're not only, we hold each other accountable, you know, and they were talking about the first one said, said you need somebody, who is the house managers? you give an addict, alcoholic some authority over you twice? you know. you ever had a piece of that? that's a mess. we do this. we vote excruciatingly democrat. we vote who comes in and we vote who can go out. to motivate, the motivation and support of oxford house has been unparalleled. yes he, we have accountability. yes we have some consequence, you don't pay your rent, you might not live here. but the power of the group has been exponential in my recovery. by the grace of god, if march makes it, and i make it there, 20 years. i'm frikin' 20ers -- 20 years. [applause] sounds weird saying it. i am 20 years off that crap. that is what it is. we're kind of people, lori and me giggling about that, we might get in trouble later, we're kind ever giggling, we're the kind of people, somebody says, man, johnny, johnny od'd, in our addiction, any way. johnny od'd, he got the dope from ploko. we are going, we got to go to ploko's house. it will not happen to me. that is the kind of disease we have. we immediately want to know where the hell ploko is. that is crazy. that is frikin' craziness. you know one foot in the grave constantly. everybody is giggling, they know exactly what i'm talking about. [laughter]. >> help me find him. >> help me. yeah. what i've learned up in the most valuable in my recovery, i should never ever, say, anymore, i got this. i got this. i got it. you know. i ain't got nothing. i ain't got nothing. what i say now, we got this. we got this, right? we going to do this together. okay? talents! i will end with this, i will shut up. i don't have graphs and things like that. i just got, i'm so great every time my butt wakes up in the morning i'm not in jail. i got a license with my picture on it, you know? [laughter] i got a credit card with my name on it. it is awesome. [cheering] but what i found is, and i see it a lot, you know, people move in. they want -- kind of like smoking cigarettes. you talk to people that smoke, you go out there people smoking cigarettes, man i wish i could quit. if i could do it over -- they want to quit. they don't want that but they just, is so familiar, that they keep going and keep going. i smoked for 32 years. camel filters. you would think they buy me a hat? hell no. [laughter]. that is a lot of frikin' money, man. and, moving into oxford house, moving in with our family. we do this together. i look at you now. i'm looking at you, i am looking at the perfect storm, the perfect storm. and we, the only way we're going to move forward, when you give the person the option either to succeed or die, you're probably going to succeed, if those are the only two options. in 1519, got a story, got a story. in 1519 cortez took his soldiers over to the yucatan peninsula to get, to rape, pillage and plunder, and the soldiers were like, they were, i don't know that is a long ocean ride from wherever cortez lived. and, and the warriors, they were like, yeah, we're tired. we're tired. he is like, get off the ship and burn your boats. burn your frikin' boats. you ain't got an option. you have no backdoor. the only way we're going to do this together if we all burn our boats. we have got no other option. we don't have a backdoor. we've got to move forward, and we've got to do it together. that is what i got for you, man. thank god you're here. [cheers and applause] >> we have flo stein coming up. we'll have a couple minutes over. i want to take time to point out, we talked about two things. the importance recognizing your strength lies in one another and our perfect storm. of course we have the perfect storm. that was last week down in houston. and i do want all of us to keep in mind the fact that our folks down there in houston, our peers in houston, don't have the ability right now to rely on their group the way they have been, right. their access to their peers, their access to their groups, their access to methadone and what happens to be they're taking, all has been cut off for many of them. so our hearts and thoughts go out to all of our peers in houston. we'll open our doors to them so we can help them out the best we can. >> amen. [applause] >> hi, you guys. i am going to change everything i was going to do, and that is what we do in the state. we, okay, this house going, we'll take it from there. i want to thank all of you for inviting me today and those of you who did because i see this as my personal withdrawal program. i just retired one month ago from 30 years in my job. and -- [applause] and you were so nice to invite me back. and to keep going, even though i'm no longer the state substance abuse director. but what's great about this panel is, these are all the people who are part of the solution. when dr. clark was at smsa, he called me up to the meeting. there is spike in methadone deaths. something is happening along the appalachian mountains. you better get up here. . . it was gone for a while and now we have the physicians and other health practitioners really helping us, so i'm proud to say that i just checked with kathleen and it's not fair kathleen lives in north carolina , but we don't care up we want her and we are keeping her. we had 239 houses as of today meaning we started-- [applause]. >> we started building those houses the day paul was talking about the requirement and block grant and revolving loan fund and we are one of those dates that still has revolving loan fund. we keep having to add money to it, but that's okay. it means we are hoping more and more houses, but i want to talk about how oxford house is part of the solution particularly in our state and i hope it will be true in other states. kathleen and tony are on our advisory council. curtis was actually appointed by our secretary to our opioid study task force, so he was not only representing oxford house, but voice of recovery and actually worked a lot on issues stigma and the biggest part of stigma having to try to talk to treatment providers, so that's a particular problem of airfield where we have a lot of different beliefs and we hold them very strongly, but we have to learn to work together, so i really appreciate what oxford house has done particularly in the last two years with leadership at the state level on all of our groups , so our chief justice who was the 0.8 of the group and now our attorney general has taken it up. big deal for the state to try to figure out how to improve the health of their citizens and our governor, governor cooper, is now on the president's opioid task force. we will be working hard to implement some of our strategic plans. i like what paul said this morning and one thing that's important that organization and house is one of those important organizations as you have to have a story. there has to be a saga, there has to be a leader and everyone has to repeat the story over and over again because that's how you build the momentum and i think oxford house is one of those great organizations. i also say what oxford house has done in north carolina to respond to needs of our state. we have oxford women and children, oxford reentry, oxford veterans and our newest homes are on college campuses and we are looking forward to oxford house being part of the solution on the opioid crisis and it is an issue with medication and oxford house and i think you all are working on it. i know your position is that each house decides for itself with the state needs to do or know or referring agencies which houses can accept someone like that and which ones can't. and what are you doing to improve your education to be watching for those assigned and symptoms? there are overdoses in houses. we've had a number of those last year in north carolina. we mention the infectious disease and i read a story last week of increasing amount of syphilis in places where it's been thought to have been completely eradicated, but it's from that needle sharing behavior, so challenges for you all in the house is not to mention that as we read medication assistance treatment, a new kind of provider that might be out there. people who don't know about you, so losing some of the primary care clinics and we talk about oxford house, they don't think about people's housing. they should because it has to be everyone's issue, food, shelter and a meaningful life, but that is a new group for you to talk to. i also want to introduce rob ravel morrison who is right there. rob is the executive director of the national association of alcohol and drug authorities. until 30 days ago i was the public policy chair, but now i'm nothing. [laughter] >> i'm glad rob is here because when i was asked to do this panel the first person i called his rob. i said, what is our most recent report on what all the states are doing to respond to this opioid issue and they have reports and that's what they track and that's what they provide assistance with. so with providing direct hands-on assistance to the state to implement something the-- that you have to help us do, there is a lot of money out there that congress provided and it's almost too much money to be absorbed quickly. gave me a lot of ideas. it would be a terrible happening if that money gets out there and nothing changes like nothing changes on the grass. more people are arrested than ever, which is one of our most typical solutions for this kind of problem. we got to make it work and we need you to work with us like our oxford house of north carolina to make it happen. i have all these other pages that are not going to talk about, but i do want to say that you are the solution. what y'all said is true. the first oxford house conference i came to, i think, in new orleans where i got the shingles or i was in texas. i forget where it was. i thought i have never seen this many people in recovery in one place in my life and it was a tiny little group and look at you now, so congratulations. [cheers and applause] [applause]. >> thank you so much to our panelists today and thank you all for coming to see us. i will see you guys this afternoon. [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] >> as you heard this conference taking about a 15 minute or so break in the next section will be on the role of the oxford house handling person's release from prison who have drug or alcohol addictions and working with them to avoid committing crimes are coming up this afternoon there will be presentations about acute care and long-term recovery and training programs for medical students working with drug abuse patient. again, about a 15 minute break and during the break we will show your remarks from acting director of the white house office of national drug control policy from a short time ago. [applause]. >> thank you so much. it's great to be here in as paul said oxford house is new to me. i did in this field a long time i went to ask paul how many drug houses have you known before started in the 40 ministration with bob dupont? >> we did not know bob until later because the ford administration was kind of quiet about the whole thing and then we began to doubt other because of the crack is there a link-- academic scare the hell out of everyone and i for chile was not able to get to all the crack users and say use canadian instead. [applause]. >> i went to want to say is that what paul has been doing is every four years, eight years a new crowd comes to town and powers always hear. he comes in, talks to people, educates us and brings us up to speed and really what he is built, what you have built is incredible. it's amazing. every administration comes to know the work of oxford house i can tell you this administration we want to do everything we can to support you and paula right here is a living legend. you guys are so lucky to stand up. stand up for paul. [cheers and applause] [cheers and applause] >> so, thank you for everything you do. i just want to say a word about, paul mentioned the office where i'm serving as acting drug czar, pretty good title. i like it. was created in 1988 at the end of that reagan administration. since then there's been a white house drug czar and those of us who-- i'm a career official. president trump asked me to serve as director in march and i'm thrilled and honored to serve and how they have a permanent replacement down the road at some point, but we are about 80 people, almost all career step, very commission focused, worked to represent the entire anti- drug community to rally the company behind what needs to be done to address this terrible problem of addiction in the country. oxford house is a critical factor and we are glad to have the partnership with you. i went to introduce my prop-- colleagues. stand up. [applause]. >> peter and june and myself are here for the long haul. it's not a stepping stone for us. we have been here, june and i have been here over two decades and we are committed to partner with you and keep building oxford house and building other sober housing opportunities so people have a place to live, so thank you so much. [cheers and applause] >> i would like to say good morning to kathleen gibson, your seo zero and james from the oxford house board of directors and i'm pleased that sander could be here as well. welcome to dc. it's wonderful to join you on the first day of the 19th annual oxford house worldwide convention and it's inspiring to see a model that-- that has flourished since 1975. for 42 years you have been helping people across the country and across the world maintain their recovery, live healthier and more productive lives and i cannot tell you how important it is and now more than ever with so many people struggling with drugs and the drug supply being so dangerous and so lethal, how important it is to have a place for people to have a sober recovery, a place to live, a community of friends, something to pull their lives together not just be drug and alcohol free, but to strive and pursue their dreams. it's such an important institution. anything we can do to support partner, we want to do. paul has already been to try for a couple times and he's always welcome. we want to do what we can to do more states supporting the revolving fund and we want to build up the whole oxford house community. [cheers and applause] >> there's 2200 houses and more than 10000 people living in these houses at a time. your impact is significant. [cheers and applause] >> a round of applause for yourself. [applause]. >> since becoming active director in march i have had the pleasure of meeting with people in recovery around the country and i have got to travel and it's been a great honor for me. people don't necessarily know my name, but they know that title drugs are and they are happy to share their stories and i sat down with people across the country and heard about their journey. two topics come up all the time in these conversations. one it's related to recovery housing, finding a safe place to live to allow people to continue recovery and also stable employment. those are a couple things i want to dwell on today. it's reassuring to know that oxford house is there to provide a structure, accountability and housing for individuals who want to stop using and maintain recovery and it's a hope in this administration that each person who was to stop their drug and alcohol use find recovery and each one who once to stop their use is welcome regardless of their recovery pathway they follow in whether or not it includes medication. there is no one path to recovery. it doesn't matter how someone gets into recovery as long as i get there. [applause]. >> we support people having every tool available to them including options like medicated assisted treatment. it's an important drug policy to work to ensure medicated-- medication assisted treatment is available to people who want to use it. i know some are wary of the treatment and believe medication recovery is not really recovery, but what i believe that evidence shows and what experience shows that it really helps stabilize people to get counseling and work towards recovery. [applause]. >> some applause for matt. i have to say we have our message and our beliefs, but we are able to listen and hear other views and have dialogue. i like it to be a conversation and hear other people's thoughts, but as many of you know there are three fda approved medications for treating opioid abuse. we look at the evidence and i think we find in a lot of people do pretty well on the medications and also helps reduce overdose death and the spread of infection and disease from injection. at the bottom line is and métis can be part of the solution that's right it's important oxford house changes policy and the more inclusive by admitting people. this is something we talked about, paul. i commend paul for bringing up this subject and working it into the oxford model. of those whose houses have accepted individuals using this to keep the recovery is encouraging and i encourage you to think about something to add to your house as well. [applause]. >> let me move on to talk about employment because it's interesting when i traveled around talking to people and giving talks on drug stuff and a lot of people asked me about employment and jobs in my first thought is i am drug czar, not housing czar one of you give ben carson a call. when i talk with people the employment issue is really central to people's recovery and so i started talking about it more and asking about it more and thinking about what else we can do in government to promote options for better employment for people in recovery. i understand this is something oxford house works with as well. i was in vermont a few weeks ago working with people to address the opioid crisis. i met a woman named hillary-- >> the prior session when a little long so we will give another maybe two minutes or so when we look forward to getting this one started at 11:20 a.m., so if you have folks and friends who wanted to be in this room and they are still in the hall, we need to get everyone in so we can give all of our speakers respect. thank you. [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] >> good morning again, everyone. my watch says 1120, so we are going to go ahead and get started. my name is curtis taylor and i'm a long-term recovery and what that means for me as i have not used alcohol or other drugs in almost 15 years now. [cheers and applause] >> please understand that's strictly by god's grace and mercy. like marty walker i take no credit what so ever for all the good things god is doing in my life today. this particular panel is what my passion is. my life at this moment is dedicated to what we call reentry. in other words, i'm dedicated to helping men and women transition from incarceration in a successful manner such that they never ever, ever go back to prison. that's where my heart is and actually, by god's grace and mercy again that's what i get paid to do today. imagine that. so, over three quarters of the oxford house population has done some jail or prison time. how many people in here have been to jail or prison? wow. i think only the senators aid has not. [laughter] >> thank you for stopping me, lord. in america today ought proximally 60% of those in jail or in prison are addicted to alcohol or some other drug. each year thousands of those who are incarcerated reenter society within one year of reentryabout half of those individuals will commit another crime and beheaded right back to conviction and reentry into incarceration. those who enter in oxford house following incarceration tended to master long-term recovery and crime free behavior. in some states, oxford house has developed relationships with reentry programs permitting those leaving incarceration to go straight to an oxford house appeared this panel will discuss how and to encourage this. oxford house residents become-- who come to an oxford house from the carson tatian-- and carson tatian-- they are elected to leadership positions and they undertake shared response ability for the operation of the house. most residents rise to the occasion. this kind of real-life training is rare for most individuals reentering society. this panel will discuss the need for post incarceration recovery opportunity, the value of oxford house as a transitional residence and practical ways to facilitate getting individuals leaving incarceration into an oxford house. our first panel member this morning and before i introduce her i want to make sure everyone has silenced their cell phone. everyone has had that last minute discussion they need to have, so we can all show together each panel member the utmost respect today. our first panel member is stacy hatfield who is oxford house outreach in washington state. [cheers and applause] >> my name is stacy hatfield. i'm a woman in long-term recovery and what that means for me as i have had not used since september 21, 2006. [cheers and applause] >> i live in spokane, washington, so i will explain a bit about what we do for reentry in washington state. i would like to start off by saying that in the early 2000's this great guy named tony perkins started the incarceration committee and we are a little bit more politically correct today and we caught-- it the reentry program. he started this off of wanting to get people out of prison and into oxford house. when it first started in washington, it started off with a 500-dollar to get them into a house and that would be their application fee towards their des or whatever house they were in and that sometimes happen, but for the most part i will talk about program we have called the voucher program. in washington state we have this excellent relationship with washington department of corrections and they see that moving into an oxford house is more beneficial if they can get them into oxford house then housing them for $150 a day, so they will pay $500 a month for the first three months they move into an oxford house. we have a pretty large reentry program. almost all 254 of our houses are preapproved addresses. most houses participate, not all houses do. for the most part they do, so in my area the houses that participate we have a reentry chairperson and she will get all of the applications coming to our area in eastern washington. so, she will get these applications, regular application and about five more pages of the questions. a lot of the questions on the interview and maybe other questions on their turkey then they send that seven-page application to her and she will go over those and do phone interviews with a counselor present, with the inmate and herself. so, she will do those interviews and ask all kinds of questions just like we do a house interview, so for most of the houses that participate in our reentry program, they are okay knowing she does a thorough interview and not we have talked to the counselor and we know what kind of programming they are doing inside and we know what infractions they have so we are not sending someone to just a preapproved address or someone who just wants to get out of jail, prison or just get some place to live. she does that pretty well and most of the houses will accept her acceptance and they will be interview upon the person getting to the house. somehow said she will actually take all of the paperwork that she will fill out and go to the house and kind of do an interview in place of that person. so that the house will want to accept them that way. sometimes if that doesn't always work, they get there in the house doesn't like that person then they will stay there until the interview at another house because they have been accepted by the reentry program, so they are accepted into the oxford house system in their house just may change. really does that happen, but on occasion there will be something , maybe they know the guy from something or there is some kind of reason to transfer that person. mostly, that's about all i would say. these guys will go into more detail about it, but i just wanted to explain the voucher program mostly for us. we are blessed to have this and we have a pretty large turnout. it feels our houses-- it fills our houses. that's about it,. [applause]. >> stacy is being modest. what we need to embrace and acknowledges the fact that every single reentry program for oxford house in america is modeled after washington the state. [cheers and applause] >> the only thing we cannot model is that voucher program. [laughter] >> they hurt-- hold pretty tight to those pursestrings in other states. so, i was joking with our next presenter about some of the language that we used to define ourselves or talk about this reentry thing, this criminal justice initiative type thing and in a way some of it is funny because i know this next presenter, there's no judgment in his heart. he means no harm whatsoever. he's only went in to help people, but it the end of the day i've got a lot of titles, none of them is ex- offender. my name is not ex- offender. as a matter of fact, i offend people everyday. [laughter] >> i wondered if you all are going to get that. but, today i'm a homeowner, a father, a businessman, business owner, outreach worker, brother, basketball coach, son. [applause]. >> that's who and what i am today. my past will not dictate my present nor my future. there is no limit to where god can take me and where god can take you, so with that i'm going to give you mr. ivory wilson who has a lot of alphabet behind his name. i'm not even going to try to decipher those, but he's a very important gentlemen and the program manager at the office of behavioral health in the department of health and human services in louisiana. [cheers and applause] >> i don't know if i should run out of the nearest exit or if curtis just set me up. like ernest-- curtis mentioned my name is ivory wilson. we have been contracting with oxford house for probably post- katrina-- pre-katrina rather so maybe 15 plus years. first off i went to give a disclaimer. curtis mentioned initially a lot of times we operate as state agencies in silos and there is this antiquated in our language that was being used to describe people who are incarcerated. so, i apologize for the language if it's offensive, there is no intent. i fraction of an occasional law new orleans growing up and i just never got caught. so, that being said, i will kind of go over some of these objectives about reentry program, which totally align with the objectives that you all have outlined within the oxford house. the primary objective is to show the need for post- incarceration opportunities. i was getting to data information ladder-- later describing some of the barriers that prevent individuals from maintaining absence drug and alcohol and also staying out of institutions to prevent them from being incarcerated. a second object should-- objective is transition of residence and i heard laurie mentioned that she has been with oxford house for seven years. sounds like she got happy with the place, but i can see why. i've been coming to these conferences for the past five years and it continues to impress me. i enjoy them. i don't think we do in up with oxford house in our state, but i will get into information later how we attempt to meet the needs of oxford house in our state. the next one of course is transitioning individuals who are free from institutions. was a better way to describe that besides using that nasty old word? >> returning citizens. >> returning citizens. >> formally incarcerated returning citizens. >> new neighbor. so, i'm taking all these points and i promise i won't use this crazy language moving forward. got to forgive me for that. kind of give you a backdrop on oxford house in louisiana. we are not as large as washington or north carolina, but we have 110 houses. 69 men's houses, 25 women's houses. one particular house i'm fond of because i manage the tennis contract, temporary assistance for needy family. we have a total of six facilities statewide. we had to discuss with lori and i think marty at the time that if you implement that into the continuum of care treatment in louisiana so now, we have 16 women and children's homes equating to a total 809 beds. i can't even explain how that fits in the continuum of care in our state especially since both states are going to reduction. i can't even impress upon you how important those beds are in continuum of care. there are 509 men's beds and a breakdown again of how many total women's beds we have and the total number of women and children's beds. this is some of the data lori gave to me prior to the conference, some of the oxford house data. it appears 90% of oxford house residence were involved with the department of correction at some point time. once you see these shocking numbers from louisiana in terms of prison incarceration rates it's probably more than 90%. may be underestimated. the average incarceration time has been 16 months and of the total number of individuals that actually took the survey within the state of louisiana, 81% or 444 residence actually took the survey which attributed to this data. i kind of give you an idea what we are doing in louisiana. there's a new federal program called louisiana justice reinvent package. there's a lot of language that i'm not even really interested in, but it's important to why we are addressing that. louisiana justice reinvestment task force is a bipartisan group of private law enforcement, core practitioners, community what members, legislators, state organizations, department of children and family services, department of education and other groups as well as correctional facilities interested in changing and impacting the criminal justice system in louisiana. post- katrina we have probably 4.8 million people in the state of louisiana, probably the size of metropolitan dallas is. not a lot of people in the state of louisiana. this number will shock you. i hope you have something to keep you call before you started looking at these numbers. 2016 louisiana has total prison population 39867 people. imagine that. 4.6 million people in the whole state and we have almost 40000 people incarcerated at. that's shocking. the next slide says 84% of individuals incarcerated in louisiana are under the influence of some type of illness or substance at the time they committed their crime. as i mentioned earlier i've never been incarcerated, but i have friends that i have grown up with who are doing life in prison. have a brother doing life in prison and all under the influence of drugs or something at the time they were incarcerated-- offended. i visited the program statewide conducting presentation on the service our office offers to prevent people from going back to prison and also talking to family members who have been incarcerated and they agree the national averages somewhere around 70 or 79. in louisiana we always do it big we exceeded that number. of those individuals incarcerated, 44% have what we call disorders that exceeds the 30% which is the national average, so again we show up in louisiana. this is even more shocking, the amount of money we spend is a state. office of behavioral health operates within a budget of approximately $385 million with money going to interject healthcare-- indigent healthcare the little less than $400 million, state and federal funds including kirk look at what the state of louisiana department of corrections and public safety office spent on the budget. i wasn't the smartest dude and math growing up in $700 million on keeping people incarcerated. you have a situation with the das office, prosecutors, judges going around saying we have to be tougher on crime and a lock them up. of the department of justice released a data report i think 2015, may the 2016th indicating less than 35% of individuals incarcerated word therefore violent or heinous crimes. they are writing this platform and that's why it's important once you have regained your status in society it's important you register to vote. you can make an impact on the laws that affect people who are not only in your situation because they get up and they ran 10 rave about how bad people are and i can tell you how may times those same-- i think we are still on c-span, so i should watch it. some people may be listening. i can't tell you how may times we get these calls from political people wanting us to help get one of their constituents and treatment and it's our priority to get everyone in need help and treatment. some of the same lawmakers who added to this enormous amount of money we spend on criminal justice system-- i'm just going to get away from that topic. stay out of trouble with that. louisiana leads the nation in free world in a imprisonment at a rate nearly double the national average, higher than the second and third highest state sunoco home in alabama. anyone from oklahoma? we are beating you on that. [laughter] >> you may have more houses, but we beat you in locking people up. next bullet. louisiana sends people to prison for nonviolent offenses at 1.5, three times that of neighboring states with a growing number of inmates serving long sentences. i get into information a little later about this. there was a study done and they examined the incarceration time frame for individuals in cook county, joliet area. we have a guy who came in similar charges in both states and these two guys, one of louisiana was similar charges, possession of crack cocaine, paraphernalia, all of that step and this guy louisiana incarcerated for three years on that charge. guy in cook county, illinois, to have, three months. it's disparaging, but i will give you information showing the department of corrections is committed to changing the dynamic. here's our objective of the louisiana department of correction initiative. primary objective is to inform, educate and reeducate offenders on the rate of services offered. we are established in a new position within our office through federal grants that we have received and we will have individual-- it will be in the oxford house contract, also. don't get stuck on the name because they may change it tomorrow. that person will connect individuals released from reentry facilities to until health and housing services. that means when these guys are released a lot of times they go to the highest concentration areas, high prevalence for criminality and was they are released in those communities we want to connect them to the services they need to prevent them from being incarcerated again. we hope to identify those individuals at risk for relapse and connect them to services. the big program i was talking about called the louisiana prison reentry initiative. i sit on the behavioral health subcommittee that the glory, he said on one of the committee; right? in a nutshell, the department correction was awarded this huge amount of money to try to reform criminal justice in louisiana. partnered with different agencies, state agencies, universities to establish a mechanism by way of identifying what are the barriers preventing individuals being released to becoming engaged in society, to prevent them from going back to institutions and also looking at ways to enhance the current system of reform. let's see. that's really not the greatest important part. i will get to the really good news. criminal justice liaison, and there-- it includes criminal justice liaison position who will work with the department corrections. the goal of this position is to link individuals released from institutions, returning citizens, neighbors, friends, release reentry program, statewide oxford house services reducing recidivism in prison incarceration rates. for a long time we were not happy with the amount of money we were giving oxford house. through katrina unfortunately we lost that fun. with and talking to kathleen and paul and everyone else about getting you more money. [applause]. >> proud to say jason and lori gave me a ride last night. they were likely have potential people for that position, but you ain't signed a contract yet. it's a difficult in our state. i take full culpability for that new contract process you can probably give a flying crap about, but in our state it's a new process. it's all kind of snakes and turns. we are just getting to maneuver it. we can reassure you the services provided you will be reimbursed on. contract is not signed yet. i talked to leeann earlier about that. we will take care of you. the role of liaison i gave you a couple of those, but establish and maintain relationship with staff and criminal justice sites , now a lot of these responsibilities we just help transition the liaison person. some of you may not agree or conform with the oxford house model, but it's really going to get it where it fits your needs in louisiana. maintains regular communication with staff and criminal justice and substance abuse treatment facilities so forth and so on. of the responsibilities for new position will entail, so some of the key barriers we face in louisiana are probably some of the same barriers every other state in america faces. inadequate housing including houses. meeting with doc staff on a regularly basis. one of the biggest issues we have is that the size inadequate housing is there is a problem with a sensitive population of focus and people don't like to talk about it, but a lot of these guys have similar issues, substance abuse disorders, mental abuse. they also need adequate housing. substance abuse disorder like i mentioned earlier at least 88% of the individuals-- 84% of the individuals in louisiana incarcerated have substance abuse issues and that contributes to recidivism. mental health issues, low education, employment issues as well as previous sentencing guidelines. i don't know how i'm doing on time. >> you are good. >> all right. some of the legislation has been passed in the state and i talk to you earlier about even though we have the most locked up state in america and the world we are making attempts especially with the previous legislation. they pass more legislation in this past session than any time in history a louisiana to prevent these judges and das from key-- giving people who have sicknesses and illnesses excessive amounts of time and sentences work first of all, senate bill 220, revises-- [inaudible] >> that equates to starting in november, individuals given excessive sentences especially with mental health and substance abuse disorders, i'm not quite certain to the mechanism to use to determine how much time they will roll back, but in a nutshell individuals with substance abuse or mental health disorders they will evaluate their charges together with the da and the judges and that they will roll back a certain percentage of that time. i can't remember how much they said. so, a lot of these guys that have been locked up will get some time roll back and that's good news especially for individuals with substance abuse disorders. senate bill 221, distinguish weapon offenses. senate bill 139 will streamline and simplify release processes. expand eligibility for programs proven to reduce recidivism. i think by your slogan here it's evidence -based reflecting oxford house. the department of correction carinae can tell you how many times with the presentations, training, whatever the case may be. i come up with these slides and data and you don't want to hear from all of that. where's the girl from oxford house? [cheers and applause] >> all those letters behind my name does it mean a being of hills to the department corrections, which is good. i spoke with one of the deputy secretaries probably before she went out on medical leave and they're looking at at ways to use that prison welfare fund to help individuals released into their respective society and transitioning to an oxford house they are looking at paying up to maybe two weeks of that first i guess move-in fee and things that they need to sustain themselves. not a bunch of money. it's not like millions of dollars, but it is something, so that's good news. [applause]. >> they also looking at senate bill 249 telling criminal justice financial obligation-- in other words you have people gathering that have been locked up together and so they don't have a lot of resources or family members and they expect them to pay these probation fees. finally, legislature woke up and said that this not make sense. the guy gets out of jail and you expect him to pay these probation fees and the next thing they going to do is what? was the first thing they going to do? violate, real find. i mean, it's logical from my standpoint and i ain't even been locked up. so, they struck down as the tickler bill were proposing to increase the probation fee. go figure that. these are some of the additional programs which this first when senate bill 16 ensures most people sentenced to life including juveniles receive an opportunity for. in louisiana life means life. that means you die there. there's no going home. there's a huge graveyard where they bury you in a wooden box made by individuals incarcerated they rolling back starting november these life sentences. i'm not sure the mechanism they are using. they use these terms as long as the person is not the worst of the worst. i don't get that. anyone who can be really military-- rehabilitated will not be considered. largely the data suggest most of these people are not violent people and that's also good news. people under drugs at the time that killer rape someone is a serious act and if not downgraded at all or downplayed, but you bring in the fact of the person under the influence of some type of volatile chemical and it weighs the fact in their decision-making process so they look at things. let's see. just look at ones that are more important. this is pretty good right here. house bill 519, streamline the process of individuals released so that way they can reestablish occupational licenses. if you a truck driver before, or whatever the case may be they going to help expedite the process to require your license and get back in fully employed and that's a good one. 680, you've got these cats that get locked up and they have kids not the fact they have responsibilities, but when they get out the cost constantly rices. they did wrong. they committed a crime and i get all that, but when he gets out of jail and he has this child support pay, he's going to reoffend. one of the ideas they talking about in that bill is to suspend the payments while they incarcerated. not remove their responsibility, but at least while they are in-- incarcerated. copy to set them up with classes to get them gainfully employed so when they get out they can pay. this also applies to individuals released, neighbors, friends, new citizens will lifted the ban on applying for staff benefits and that's important. as lori mentioned earlier, it's not a situation you want to have sustain you for life, but when you get out of institutions i don't think a lot of you-- i mean, you need a helping hand when you get out. so, they going to open up the ability for those guys to apply for snap and tanf benefits, so that's good. these are some services we have in our office, oxford house and substance abuse treatment prevention programs with individuals released, compulsive gambling services and so forth. there's a huge initiative. we applied through the conference of addiction recovery act awarded nationwide. we received funding in the form of the sdr grant. target response to opioid and heroin epidemic. our state will receive approximately $8.1 million for two years. some of the money will go-- we have allocated a certain amount two usc, huge initiative to collaborate with the department of corrections. we will establish one female and one male facility in a pilot's effort to get individuals addicted to heroin and prescription opioids, they going to set up a program in which these individuals probably nine months to a year once they in the process of being released from the reentry programs they will get involved in programs-- let's see. collaborate with the department of probation and parole to collect and analyze data so forth and so on. also pure support model which is important to helping individuals transition back into society. that's important that we are in for-- embarking upon to help change the climate and environment of the incarceration in our state. with that said, i had a brother that was a chronic alcoholic and he moved into a new housing area , been addicted to alcohol for roughly 40 years of his life and he had fell down a flight of stairs took you lived in a housing project. broke his neck assist-- sir came to his injuries. this thing about being able to connect with people who have chemical dependencies, everyone has one in their family. i lost my brother and it was difficult. oxford house is a great organization. if i could have gotten him into one of those programs are probably would have saved his life. with the work we are doing in our state and everyone is doing nationwide to enhance the services that we provide for individuals with chemical and substance abuse disorders and restore them back to their best individual functioning level, so thank you for your time. [applause]. >> let's have another round of applause for mr. ivory wilson. [cheers and applause] >> i think it's always incredible to me when state staff gets behind our organization in the way they do and they embrace your journey in my journey in the way they do, so thank you so much, ivory. next up we have mr. dan hawn who is the oxford house state coordinator for oklahoma. [cheers and applause] >> good morning, afternoon everyone. my name is dan and i'm an alcoholic and also a drug addict. i will do the best i can today. my head will be bobbing a lot because i have to see that powerpoint, but i'm going to do a powerpoint and talk a little bit about what we do in oklahoma it's pretty special because it's all by the resident. the residence-- our state is in a serious budget crunch like everyone else. department of corrections is upside down and it's really tough. through education we have our residents supporting this movement with reentry and we are having really good outcomes. .. educating doc has been very. we have a limited resources and unfortunately with the department of mental health we have a good support for outreach in oklahoma and we recently added two new outreach workers. i share a common bond with curtis and i get to practice my passion now. we get to work on reentry and what i love and the reason being is that i walked out in 2003 and nowhere to go and i will never forget that feeling. later on i ended up in an oxford health and how it felt. later on, it was after i re- offended. presentations to administration, no disrespect to the people returning to society but we much rather talk to the administration because they're the most effective at spreading the word. we don't have an opportunity to always speak to the turnover, people are moving around and we want to really get involved with the administration and let them know about our program and how it works. partners in that ties in with the caseworkers and the parole and probation officers, taking time to build relationships locally with those offices and having contacts that understand what we are about. informing them is one of our big barriers that we had in our cities in oklahoma and it's our zero-tolerance policy. they say what will be do with them and if you evict him and so we work through those barriers about what the options are gone to the point with our houses that we are able to basically have the ability through blessing of the parole officer say, hey, to avoid being in trouble this is where you will need to be tomorrow morning for you are evicted. we have those things in place. verifying applicant publication which is sex offenders, arsonists, that type of thing that our area participate in upholding. we really work hard at that and educating doc so they know where they are sending people and what it is about. and then how to apply. what we have done is we have a state website in oklahoma and in the coming months will create, were looking at different websites of return to society or something like that and we look at different options and will create a separate website exclusively for reentry. you go to the oxford house okay and you download the form which is again the washington form and it's changed a little bit but you download that form -- the caseworker doesn't work and they provided to the person returning to society and they fill it out and we have a regent map that shows what outreach workers in that region and the e-mail those applications directly to us. that form is transmitted by us to the specific houses that are the stopping point for reentry. oklahoma right now has three soon to be for with a fifth being a woman's house coming really soon. depending on where the vacancies are that is a worthy application goes. we do let them know that they will be transferring soon upon arriving because we guarantee them a spot so we succeed with this in the metropolitan areas because we always have some bed space. normally were able to put them where they have contacts and where their employment lineups are. so, the process of acceptance is really smooth. this is an oxford house in oklahoma and have a laserjet printer that the chapter brought for them to save money on printing costs because we go through a lot of applications. were soon to go digital with all of that and put it in their meeting room which is on the later slide. this is one of the things that we asked them to provide which is a crc card which shows what they been incarcerated for and we asked them to provide that with their application. when that comes in you can't see it but it's clearly all the charges are related to drug offenses. then we use that washington application to get the information we are looking for. there is their meeting right there. this is at one of the houses in oklahoma city. at their business meeting on sunday night at 7:00 the applications are passed around and voted on at that point. they go right back to that the pewter and there is a pre- done acceptance letter on there that they forward back to the originating e-mail letting them know if they were accepted or denied into the oklahoma reentry program. this works the same at all of the houses. these particular houses are able to process these applications rather quickly and have no vacancy problems ever. the new member needs we get guys off the bus and they have nothing. they donav

Related Keywords

Louisiana , United States , Alabama , Portland , Oregon , North Carolina , Texas , Philadelphia , Pennsylvania , Washington , Vermont , Illinois , Whitehouse , District Of Columbia , Togo , Truman College , Mississippi , Mexico , Oklahoma , New Orleans , Cook County , Compton , Chile , Houston , Dallas , Chicago , Turkey , Joliet , America , American , Kathleen Gibson , Dan Hawn , Andy Chapman , Flo Stein , States Kathleen , Marty Walker , Curtis Taylor ,