Dive into our witness testimony as well. Since 1999 more than 700,000 people have died from a Drug Overdose in the United States. Increased opioid addiction and the production of deadly synthetic opioids have exasperated americans staggering death rate. In 2017 more than 70,000 people died from Drug Overdoses making it the leading cause of death in the United States. Of those 60 involved prescription opioids such as fentanyl. American. Up better against the Opioid Epidemic in 2018 when more than 10 Million People aged 12 or older abuse to opioids. 2 Million People suffered from an opioid use disorder and on average 130 americans die each day from an opioid overdose. We know the untimely death from widespread abuse of prescription and nonprescription opioids but they know from our familys neighbors and friends of the Opioid Crisis is not over. We must continue contending with this crisis. That being said we have made Great Strides in the past three years to help combat this crippling epidemic. Congress has passed t landmark legislation directed at combating the Opioid Crisis. Most of sadly the conference of addiction and recovery act and the 21st century cure at also known as the cures act both of which i proudly supported were signed into law in 2016. Combine these two bills provided over 1 billion in funding to combat the opioid t crisis. With an emphasis on increasing drug abuse prevention and treatment programs for two yeart Later Congress passed the bipartisan support for patients and communities act which is the most conference of antidrug addiction legislation in modern history. We crafted a support act to address every element of the Opioid Epidemic for manufacturers and distributors prescribers to users to First Responders and recovery professionals the date congress has dedicated nearly 11 billion to tackle the Opioid Crisis with the largest portion of that hunting granted to the department of health and Human Services. Today well hear from the administration and the executive Branch Members that shape e and execute the Government Strategy for combating the opene guide epidemic. The office of National Drug control policy and the department of justice the Drug Enforcement administration and the department of health and Human Services. This hearing is especially important when we think about the oversight role we have in congress and executive branch are distributing the funding we provided them to tackle the Opioid Crisis. That said the federal government is one aspect of combating this epidemic. We do not stand alone. Curbing the Opioid Crisis relies on widescale integrated solutions from all impacted. Today during the hearing we will have the opportunity to hear from key components of the private sector including the Health Care DistributionAlliance National committee of Pharmacists Association community antidrug coalition of america and drug policy from the rand corp. But together we anticipate a close and cooperative review of ourio collective effort to curb the supply of illicit opioids and unnecessary prescription opiates to approve access to evidencebased prevention treatment and Recovery Services for opioid use disorder to identify future needs of federal state and local levels and to develop sophisticated and tailored solutions for this destructive and deadly crisis. Before he turned to our Ranking Membere and witnesses i like to take a moment to remind us all that americas drug abuse problem did not begin with opioid misuse and will not and with the Opioid Crisis. In my home state of iowa amphetamine abuse has remained persistent problem. Nationwide in 2017 was 1 Million People have a methamphetamine use disorder and that has been reportedly clinically significant impairment including help albums disability and failure to meet responsibilities at work or school or home as a result of their drug abuse. This number significantly is higher than the 684,000 people who reported having methamphetamine use disorder a n 2016. Ed in 2016 alone my home state of iowa reported over 1500 confirmed child abuse reports relating to methamphetamine notches in theth home but foundn the childs body. Ultimately americans suffering from drug dependency. I loved ones are dying from drug abuse at alarming rates. Opioids are a priority today but methamphetamine and other dangerous substances have been attacking our urban arra committees and should and will be addressed going forward. Thank you and now ill turn to Ranking Member feinstein for her Opening Statementnt. Thanks very much madam chairman. I think her Opening Statement dovetails each other and i suspect it will dovetail with every member of the committee thinks. The question is what to do about it. Just last year overdoses created 48,000 deaths. To meet that number is stunning. In 2015 Life Expectancy in the United States has fallen for the third year largely due to opioid related Overdose Deaths in the economic costs are just unbelievable, 700 billion a year. One of the reasons that grew so much im told is a lack of education among medical professionals which has led to overprescribing. We saw in many cases pharmacies where pill mills with churning out of millions of pills to smaller communities regardless of the medical necessity. It opioids manufactures and distributors i believe had a responsibility to identify and report the suspicious t orders t they did not. This problem was compounded by inadequate responses from the federal, state and local governments. The Trump Administration declared the Opioid Epidemic a Public Health emergency in 2017 but has only used three of the 17 authorities triggered by that declaration, limiting its effect. The office of National Drug control policy failed to issue National Drug control strategies in 2017 and 2018. Its 2019 strategy did not include concrete goals for fiveyear projections for programs and Budget Priorities both of which are required by law. According to the october 2019 department of justice ig report the Justice Department and dea did not initially use all of their existing authorities and resources. Reduced quotas for opioids or whole registrants adequately accountable to the result was an Opioid Epidemic that evolved from Prescription Drugs to heroin and ultimately to fentanyl. There is little question in my mind that the initial response to the opioid situation was ineffective. How do we get back on track . I very much believe any solution must include a whole of government approach and we have got to use all available resources. The comprehensive addiction and recovery act enacted in 2016 laid the foundation for this approach. Another bill, the support act was signed into law last year. It builds on the 2016 legislation by authorizing critical agencies as well as prevention, Treatment Recovery and enforcement programs and expanding research. This act alsoer included a provision called the using data to prevent opioid diversion. This part of the law is designed to ensure that opioid manufactures andha distributors are held criminally and civilly liable for identifying and reporting suspicious orders of opioids. I happen to be the one that offered that and im very much concerned that it has never been really enforced. Today i am introducing new legislation to strengthen this laww and the legislation will requirean data on all controlled substances to be reported, not just opioids, in order to better identify suspicious orders. It will also require pharmacies to report all transfers of controlled substances to the dea each month. There is so much to do. The federal government has begun to do this. Ondcp is establish a number of interagency working groups including the national oil opioids in synthetic cord nation group to monitor emerging trends in data. The Justice Department created the opioid enforcement anden prevention efforts division and thats an opioid fraud and abuse detection unit under a new initiative, focused on disrupting the on line sale of illicit drugs. For its part dea has increased its tactical diversion squad, enforcement and administrative actions against negligent distributors and manufacturers. As a result of these efforts for the First Time Since 1990 Prescription Drug related Overdose Deaths decreased. Thats really good news. There are things that we can do to save lives and reduce addiction. The centers for Disease Control and prevention have warned us a fourth wave of Drug Overdose epidemic is upon us. Most of those suffering from addiction they tell us use more than just opioids. In u 2018, cocaine, methamphetamine and benzodiazepines were present in nearly 60 of all opioid related Overdose Deaths. That is a stunning figure to me. We have got to take a good look at it and see what we need to do i would encourage her Witnesses Today to comment on this and if you have a solution or a thought i think wed be very interested in hearing them. Our country has beenay ravaged y an addiction epidemic and it costs tens of thousands of lives every year. Failure should not be an option. This is an important hearing and i so look forward to hearing from her witnesses hopefully with new ideas and constructive thoughts of thank you very much madam i chairwoman. Thank you Ranking Member and i recognize senator durbin for open opening comments as well. Thank you bed and chair for this m hearing. I called senator graham several weeks ago and asked him to consider this and i think a menu for making am possible today. I would like to state again with already ben stated we are in the Worst Epidemic in the United States losing 130 people each day. Small or suburb to wealthy to escape this drug epidemic. Its not the first epidemic in our history. The crackcocaine epidemic showed that we learned we cannot incarcerate our way out of this addiction crisis. In the prevention, intervention and treatment on the front end not just prosecution on the backend. Theres a growing bipartisan consensus that harsh prison sentences for lowlevel drug offenders have not only failed to stop drug addiction but if created many unjust and disastrous outcomes. Im proud of those committees spearheading the first atbat to right these wrongs. Now we need to make sure that the f combat current drugs on te market and the spread of synthetic fentanyl analogs that we do not impede Scientific Research that can save people who overdose on these drugs and we do not criminalize any harmless substances in the process. Let me ask you to consider just this fact. A recent study of fentanyl overdoses in massachusetts from 2014 to 2016 found that 83 of patients required more than two miloxone doses. Why . Because naloxone no longer Strong Enough to stop an overdose. Researchers have not yet identified an antidote that is. Many researchers believe a more powerful antidote may include the drug fentanyl. Thats why proposing legislation that will allowha truly harmful analogues to be added to schedule one but not at the expense of facilitating Vital Research to discover lifesaving antidote. Unfortunately there isnt an effort to bypass this conversation about the Research Aspects of the help hope hume returned to be the second pointed like to make is this. We can learn an c important lesn from the 1990 Tobacco Settlement agreement. The msa was a landmark 246 billion settlement to hold big tobacco responsible for hooking americans a nicotine and contributing to millions of deaths. I might add that they are at it again with vaping readonly of the dollars paid under that settlement were devoted to Public Health harms of nicotine addiction. 8 . Most of the money was spent on unrelated itemsic like stadiums. Many states cities and counties have sued theds opiate industry is a large there mass of lawsuit underway in cleveland today that could produce a large settlement. I think its critical that a substantial portion of the settlement be dedicated tos funding opioid addiction. The third is this. It was in june of 2016 in his hearing room at this very table that i learned the first time from acting director of the Drug Enforcement administration revealed on theor record it was actually the dea that approved the animal of opioids to be produced in the United States. Opioid addiction starts with prescription painkillers made by pharmaceutical companies, regulated by the Drug Enforcement administration however the Inspector General of the department of justice recently found that i quote dea was slow to respond to the dramatic increase in opioid abuse and needs to fully utilize its regulatory enforcement resource. Forhi years dea permitted, dea permitted pharma to produce enormous evergrowing amounts of opioid pills each year even though dea had the ability to set quotas limiting that protection. Foretim example and 2017 the drg Enforcement Administration of the government of the United States of america allowed pharma to produce 13 billion opioid doses to be put on the market. How much would that be . It would be a threeweek prescription for every adult in america approved by the Drug Enforcement administration. For years have been calling on them to set lower quotas. Mr. Senator kennedy of louisiana and i joined in a bipartisan effort to reform the law and require the Drug Enforcement administration to suggest opioid quotas to reflect whats happening in america. Madam chair im sure you are well aware of the county in your state, we county on the border of iowa and illinois. Lee county iowa averaged 45 opioid pills per person for nearly a decade dispensed by one pharmacy in that county. 45 opioid pills per person for every person living in that county for 10co years. Harden county illinois by the least populated counties in my state of 4300 people, between 2006 in 2012, 2. 7 million opioids were shipped to a single pharmacy in harden county enough to provide every resident with 90 painkiller pills a year. The Drug Enforcement administration is supposed to monitor p this so they are provg massive production on the front end and no monitoring on the backend as we see in these areas Rural Counties being swamped with opioids. For years have been calling on them to lower quotas and now they have the legislative authority and no excuses. Im concerned that dea has not taken this as seriously as a should and i will ask questions when we reach that point. Well dea his lowered the indefensible quotas of recent years dea has proposed 20 quotas do not take p into account drug addiction overdoses and deaths. In other words the former production quotas dont look at the reality of the worst drug epidemic going on in america today. There will be some questions on that. Look forward to working with myn colleagues in continuing on a bipartisan w basis to deal with this. Thank you madam chair. Opioids and synthetic Coronation Group of the office of National Drug control policy. In this capacity mr. Chester leads interagency efforts to reduce the availability of heroin fentanyl and synthetic drugs in the United States by disrupting his global applied chain. We also have ms. Miss amanda luscombe. She is director of ovoid enforcement prevention efforts for the United States department of justice. This system is responsible for odaining Department Strategic response to the Opioid Crisis including all investigative and efforts. They also have mr.