Transcripts For CSPAN Key Capitol Hill Hearings 20160331

Coming up today, the brookings is tuition here in washington will host the turkish president for an address on the challenges facing his country, as it approaches its 100th anniversary in 2033. Live coverage at 12 30 eastern. We also have road to the white house coverage. Cruz and former republican candidate Carly Fiorina will be in appleton, wisconsin talking and meeting with voters at a pizza store. At 4 00, a panel looking at the opportunities and risks of network smartphones. Analysts predict that domain will double in size by the year 2020. That is a nearly 2 trillion market. That is from the Atlantic Council starting at 4 00. This week, we are featuring programs on the situation of the Current Supreme Court vacancy. An apparent impasse between democrats, the white house, and republicans over the next Supreme Court justice, we look at what todays leaders have said in the past considering the nomination and confirming process of individuals to the Supreme Court. Confirmation hearings, no matter how long, fruitful, or thorough, can alone provide a sufficient basis for determining if a nominee merits a seat on our Supreme Court. Thoughtful senator should realize any benefits of barring an ideological opponent the outweigh not likely to the damage done to the courts institutional standing. It even goes on, ideological opposition to a nominee from one end of the political spectrum is likely to help generate similar opposition to their nominations from the opposite end. Some of the programs featured this week on cspan. Tonight on cspan, the Supreme Court cases that shaped our history come to life in landmark cases. Our series explores real life stories and constitutional dramas behind some of the most significant decisions in u. S. History. This ismargo said different, the constitution is a political document. But it is also a law. If it is a law, we have the courts to tell us what it means. Ultimate antipresident ial case, exactly what you do not want to do. Who should make the decisions about the case. The Supreme Court said it should make the decisions about the case. Tonight, we look at the case changed the working conditions in the United States regarding the 14th amendment. Tonight, the growing problem of addiction to prescription painkillers and heroine. The drugs are known as opioids, and according to the National Institute of health, more than 2 million americans are addicted to them. Nih says the number of Overdose Deaths have quadrupled in the u. S. Since 1999. Deaths have quadrupled in the u. S. Since 1999. Hours, weext three will take a look at the problem and what congress and the executive branch are trying to do about it. We start with a visit president obama made to West Virginia last fall. That state has the highest rate of Overdose Deaths in the nation. Office, icame into started studying this issue. Of, lets call it opioids. And i was stunned by the specifics. More americans now die every year from Drug Overdoses and they do from Motor Vehicle crashes. More than they do from car accidents. The majority of those overdoses involve legal, Prescription Drugs. In 2013 alone, overdoses from prescription pain medications killed more than 16,000 americans. One year. Ont know what to tell you as is a terrible toll. The numbers are big, but behind those numbers are incredible pain for families. Thisvirginia understands better than anybody, because the state is home to the highest rate of Overdose Deaths in the nation. Addiction is not new. 99, sales of89, pain medications have skyrocketed by 300 . Million 259 prescriptions were written for these drugs, which is more than enough to give every american adult their own bottle of pills. Their use has increased, so has the misuse. Some folks are prescribed these medications are good reasons, that they become addicted because they are so powerful. At the same time, we have seen a dramatic rise in the use of heroin, which belongs to the same class of drugs as painkillers. The class of drugs known as opioids. Heroin, four in five new heroin users, started out by misusing Prescription Drugs. Then they switched to hair when. Heroin. This really is a gateway Prescription Drugs become a gateway to haieroin. Relatedber of heroin deaths in america nearly quadrupled. Although the number of heroin related overdoses is still far exceeded by the number of legal Prescription Drugs. Lives, crisis is taking it is destroying families, it is share it is chattering communities and that is something about Substance Abuse it doesnt discriminate. From celebrities to College Students to soccer moms, to innercity kids. White, black, hispanic, young, old, rich, poor, urban, suburban, men and women. It can happen to a coal miner, a construction worker, a cop who took a painkiller for a workrelated injury, it could happen to the doctor who writes the prescription. Have ishe problems we too many families suffer in silence, feeling like they were the only once struggling to help a loved one. And lets face it, there is still fear and shame and stigma that too often surround Substance Abuse, and often prevents people from seeking the help they deserve. When people throw around words like junkie, nobody wants to be labeled in that way. Is tof our goal here replace those words with words like father, or daughter, or son, friend, sister. Then you understand there is a Human Element behind this. This could happen to any of us, in any of our families. Would we replace a word like junkie with recovery coaches, specialists like jordan . Epidemicfight this without eliminating stigma. Thats one of the reasons im so proud of michael, who is the first person in the job of dealing with drugs in america who actually knows what it is like to recover from addiction. He shares his own story as a way to encourage others to get the help they need before its too late. My problem is that there are elected officials in the state who have told their stories about what is happening in her family, and to themselves, in order for us to start lowering keep peopledes that from getting help. Ive made this a priority for my administration. We are not new to this. In 2010, we released our First National drug control strategy. We followed that up in 2011, with the Prescription Drug abuse prevention plan. We are implement and this plans, we are partnering with communities to prevent drug use, reduce Overdose Deaths, help people get treatment. And under the Affordable Care act, more health plans have to cover Substance Abuse disorders. Congress wouldnt invest in things like state Overdose Prevention programs, preparing more First Responders to save more lives and expanding medication assisted treatment programs. We have to make those investments, rather than spending billions of dollars, taxpayer dollars, on long prison sentences for nonviolent drug offenders. We could save money and get Better Outcomes by getting treatment to those who need it. [applause] and we can use some of the savings to make sure that Law Enforcement has the resources to go after the hardened criminals who are bringing hard drugs like heroin into our country. With no other disease do we expect people to wait until they are a danger to themselves or others to self diagnose and seek treatment. Every other disease you have a broken leg, diabetes, some sort of sickness, we understand that we have to get you help. We also understand, when it comes to other diseases, that if we dont give you help and let you suffer, other people could get sick. This is an illness, and we have to treat it as such. We have to change our mindset. [applause] this is one of the reasons the dea the cleared a national Prescription Drug takeback day, a day when americans can safely of conveniently dispose expired and unwanted Prescription Drugs in their community. Most young people will begin misusing Prescription Drugs when they get them from mom or dads medicine cabinet. And today, we are also announcing new actions. First, we are ensuring that federal agencies training federal Health Care Providers who prescribe opioids. Its a commonsense idea that you are already implementing in West Virginia. Congress should follow that lead and make this a national priority, and we work forward to looking with governors in the medical community as well. Second, and joe and i were talking on the flight over, there is evidence that shows medicaidassisted treatment, if done properly in combination with behavioral therapy and other support and counseling and 12 Step Programs and things like that, can work, and can be an effective strategy to support recovery. But it cant adjust be replacing one drug with another. It has to be part of the package. We are going to identify any exist thatat still are keeping us from creating more of these Treatment Facilities, and incorporating them into our federal programs. Private sector partners are helping out to help fight this epidemic as well, and it want to give them some credit. More than 40 medical groups, from the American Medical Association to the american dental association, are committing to concrete actions, and we need to work with the medical community, because they are the front lines on prescribing this stuff, and there has got to be a sense of responsibility and ownership and accountability there. We have to expand prescriber training. Naloxone. The use of i want to make sure i was browsing that right. Naloxone. This is something that they First Responders have it can often save, quickly, the lives of somebody who is having an overdose. We want to make sure that First Responders have a supply of this. We want to make sure we are getting more physicians certified to provide medication assisted treatment. We then have broadcasters providing airtime for education and awareness, and groups like the nba have committed to running psas about drug abuse. Thats just an example of some of the private sector partnerships we are forging. The point is and i will end with this we all have a role to play. They people like jordan, remind us, these are our kids, not somebody elses kids, our kids. Not somebody elses neighborhood, its our neighborhood. And they deserve every chance. We have got to make sure we are doing right by them. We are taking this seriously, and the goal today is to shine a spotlight on this and make sure we walk out of here, all of us, committed, whether we are a safe leader, an elected official, in Law Enforcement, a private citizen, a business, we all have a role to play. You understand that here in West Virginia and we want to make sure the whole country understands how urgent this problem is. Host after president obamas remarks, he sat down for a discussion with people personally affected by drug addiction. One of them was kerry dixon, whose son is in prison, where he is undergoing treatment for opioid addiction. I spoke this morning to a good friend of mine who was calling me to wish me well today, to encourage me in this endeavor, and this friend of mine lost her daughter to an a half years ago to drugs. I dont take this charge as being here lightly. I realize that i am here to represent families, and i am grateful for the opportunity. Do want to say that as i am speaking to you, i am sharing my story, timesharing the stories of so many other family members that are in this community and in the nation that has this issue. And this also is important to know for the sake of time, ill try to make this concise this is the tip of the iceberg of what families experience and endure when they love someone with an addiction. We raise our children in loving homes; we teach them morals and values; we teach them the difference between right and wrong. We wonder what is happening in the great start slipping, when things that used to be enjoyable for our loved ones no longer interest them. As to the cause of the personality changes that we see in our loved ones. Were shocked when we hear of that first dui. We are fearful when our loved ones are taken to jail for the first time. Embarrassed when holidays approach, and family members are coming in from out of towns, and loved ones cant interact because they are under the influence of drugs. We dread the next phone call. We cant sleep because we havent received a phone call. We dont take vacations for fear of the next crisis. We come back from vacation because there is a crisis. Bute sad and angry, most importantly, sentimental items are missing from our homes, only to find out that they are at upon shop or in the hands of drug dealers. Relieved when our loved ones acknowledge that they have a serious problem, and understand they need help, and we are devastated when we help them seek treatment only to find out that there is a monthlong wait, or that there is no insurance coverage, or that there is a big requirement for money up front for treatment. And uncomfortable when someone asks us about our loved ones, and we are even more sad when they ask about every other member of our family, and dont mention our loved ones. We neglect our marriages. We neglect other children in our homes, who are thriving. Because all of our attention is focused on addiction and Substance Abuse. We disagree endlessly about the right way to handle this problem. And after experiencing years of turmoil, we rest better at night when our loved ones are incarcerated, because the place you never dreamed your loved one would ever see, a jail or prison, is safer than them being on the street, interacting with drug dealers pushing a needle into their arms. The ones who are fortunate, we layaway get night and we plan our loved ones funeral. The ones who arent fortunate, actually do plan the funeral in reality. This is where addiction has taken us. This is where Substance Abuse has taken us. All that being said, there is hope. Thats probably the most important thing to remember here. , to people inful recovery helping others. We are grateful to the mayor, who has so tirelessly and endlessly spearheaded programs to help our community recover. Made itue, whos possible for people to receive treatment in our communities. Important,cation is and i was fortunate enough to find a group developed by a man named ed hughes. Its a sevenweek series that provides education and support for family members, for those who care about those with an addiction. Program, week of the we get to speak to people in recovery. They speak to our group of people, and it inspires us, because we know that recovery is possible, that it can happen. For too long, we have been silenced, and i think this is going to answer your question as parents and family members, because of the stigma and this of this disease, we have been silent, and i think that is holding us back. We need to open our voices so that people dont feel ashamed. This is a disease that is a sickness. But education, educating ourselves as much as we can, and speaking out to raise awareness, is i think critical in this situation. Im almost finished. People in 12 Step Recovery groups and different groups rely on a higher power. In myperson of faith, faith has helped me navigate this journey that we have been on. I just want to share with you a verse that i hold dear for my own family member, who is sick, but also offer to others. Jeremiah 2911. The plans to prosper you, to give you hope in the future. I believe that every person in the throes of an addiction and Substance Abuse needs hope in the future, and i believe this for their families as well. Thank you so much. [applause] host opioid drug abuse was also a topic on the campaign trail. New hampshire is the first in the nations primary state, and Overdose Deaths in that state have doubled in the last two years. Days before the New Hampshire primary, texas senator ted cruz spoke about his sisters addiction and her overdose death. The senator was introduced at the event by a recovering crack addict. Witell, that all sounded really great is chief bartlett here . Hey, chief. In putting this deal together, all that sounded great, but chief bartlett said to me i lived in florida for 26 years, in New Hampshire in the 1980s, and when i called him up to put this together, he said, you know, i used to be an undercover drug agent in manchester. Were you living here in the 1980s . I think i know you. [laughter] all that sounded really good, but what it was was someone trying to woefully get their way s any recovering alcoholic or addict will tell you, if they have read their 12step program carefully, we never quite finish anything. We get tight at all the wrong times. I used to do that. I was born in massachusetts, not far from here, in the central part of massachusetts, a little town called charlton. I went to the hospital when i was five. When i came out of the hospital, im having a hard time today. Most of my family was gone. Our store was gone, our home was gone, we got wiped out in a flood. Luckily, my mother had taken my siblings out, but i lost my dad and my grandparents and my uncle. We didnt have a home anymore. The Grocery Store was gone, and we were behind the dam that broke. That was 1955. I think stuff like that i have come to realize, ive been able to get myself away from crack cocaine for about nine years now. [applause] and i had a hard struggle with that. For about 25 years of my life. Was anf these things, i irregular but constant user, and i would mess up my life and never finish anything, as the book said. I dont know how my mother did it; we ended up moving to florida, my grandfather built a home in florida, and she took us away from all my dads relatives, just wanted to escape. I dont know how my mother didnt become an alcoholic, didnt become a drug addict, and i dont know how she did that. She is still alive, got lesser, at 94. God bless her, at 94. She lost everything she knew in her life. She grew up in a small town in massachusetts, 2000 people, 3000 people. 15 minutes after she walked out of her house, every piece of silverware, every picture, they found her mom eight miles away, two weeks later, because her diamond ring cop the sunlight in the mud. Caught the sunlight in the mud. I have come to believe from being heavily involved in going to meetings, people get damaged a lot when theyre children. I call it abandonment issues. I dont know if its an orphanage or molestation or i think it does something that allows ive come to believe in recovery. My recovery is all about spiritual recovery. I recovery is about the way bill w. Wrote about in his group; what i have to do to stay sober every day. Its that i have to have a relationship with god. I work very hard to have that relationship. The big book says that i can stay sober, subject to the my spiritualof condition. I have been a master of the universe. I was 32 years old and i was a master of the universe. Ask me and i would have told you. And i went to a meeting with a couple lawyers in boston on the top floor of one of the 8th st. Nce room and 60 stat they laid out some white powder that i never seen before. I never became addicted to anything, but i snorted this and i think it was the first time i was instantly addicted to cocaine. It ruined my life. A number of months after that ined, i got involved was all of a sudden hanging around the wrong people. I was very happened, close to senators and governors and lieutenant governors, treasurers of campaigns, i was in the white house at 26, i had coached basketball in duke by the time i was 23. I had all these Different Things that i had done, that people would work a lifetime for, and i never appreciated them, because part of having the damage that occurs to people that go through these abandonment issues is you live a life in low selfesteem. You cover it up with a false ego. To relatees it hard to people, and people cant relate to you. Of the characteristics you tend to have friendships with the opposite sex. You are supposed to have friends of members of the same sex, but people that are in the program of recovery, before they recovered, they traditionally had relationships with members of the opposite sex. They couldnt get along with members of their own sex. And this is the spiritual disease at the big book talks about. That the big book talks about. And it is that. And i recognize, in getting sober, luke, its also in matthew a house divided against itself cannot stand. When you get sober, you cast the demon out. That demon is searching for food and drink, finding none, it comes back to inhabit its old haunts. Finding them swept and clean, it brings back seven demons stronger than itself. If you believe like i have come to believe through this program were thery that w battlefield, those of us that are damaged goods are the battlefield, because the devil did not want to lose me. Demonsants to send seven stronger than the last one to come get me; so i have to be very vigilant. It, and i use of this event is just one example, is that i have become so vigilant that i have learned its not a fake word. I have learned how to practice safe. I was really good at practicing basketball. I was really good at practicing the p f and practicing drums practicing the pno is practicing drums. I never thought about practicing faith. You have to get better at it. When you get better, you get new words for what that means. The big tells me in step 11 that i will learn to have a sixth sense that will guide me, if i can stay in the present. Imagine this. I was a master of the universe. At one time i was worth 11 million or 12 billion, and in homeless,ary, i was penniless, clothesless, everythingless. Some guy came over and picked me up in the middle of the night. He was a short control guy at the Mayport Naval base. I guess he mustve had a room for rent advertised, and i knew i had to get out of this place where it was, and i just had to get out, and this angel picked me up in the middle of the night. I have nothing to do; i only had the clothes on my back. I had nothing else. Words incomprehensibly demoralized. The people that you know that are drug addicts, that are incomprehensibly demoralized. I was sitting on a bus stop bench, and the lady looked at me and said, im going to a meeting; you need to go to one. Fare and i went with her to the meeting, and i never left for seven or nine months. I really, really didnt leave. I was afraid to leave. And the third day i was there, somebody spoke at a saturday night meeting and i have us virtual experience with hers time since i could remember. I didnt feel alone anymore. And read the bigo book, and i realized it was a certain, five word sentence in the big book, and it was the only choice in the entire first 164 pages. It said, god either is or is not. Id done isnt. How did that work out for me . Or 1983 ofrom 1982 being arrested, when i started hanging around the wrong people and i ended up in some sort of reverse drug sting. I wasnt even in the state when it occurred, but i have been around these people and i had gotten a few ounces of pot. I was the guy that made the news. I was such a mess that when they came and got me three days later they did a choke of me on saturday light five saturday night live. When youre at home really depressed and see saturday night live to pick you up and they do and i gotyou arrested for trying to buy crack, for a parking ticket in San Francisco. Its easier to get a ticket for solicitation than a speeding ticket in florida. Thats San Francisco, i guess. I got a parking ticket in San Francisco for solicitation. Through all the terrible things that drug addicts go through, that behavior that we have. Here i am trying to get sober, totally lost and out of it. Gave me an immense amount of talent and i miss used it and misused it and misused it. Sudden you are standing with nothing. You start thinking about everything you did, you want to care yourself. If you start thinking about how bleak your future looked, there was no way anybody would let me work anymore or anything, youd want to kill yourself. I read a book called the and jesus commands us to stay in the present. I learned if i prayed all day long, if i prayed as unceasingly as they tell me to do, i couldnt think at the same time and pray and have fear at the same time and i couldnt pray and regret my life at the same time. I started to actually get intuition. I stopped being woeful, i just allowed my life to go wherever it took me. Because i went so deep in the woods it took a long time for me to come out of them. Did finally get hired by a real estate agent, a really big firm that used to represent me. But i was blessed to get it. It took a long time. I had an angel that took care of me for a number of years and helped me get back on my fee. God didnt want me to get back, feet until he knew i was humble enough. I wasnt easy to humble. He already learned that because it took 25 years of humbling and then have nothing. I am so blessed that i did. Putting this conference together turned out to be a miracle. I wrote them a note, saying god has gotten it taken care of. I go to Church Sunday and say do . What do you want us to 15 minutes with that call. They say we would love to put on this event. So that was just a blessing. Was getting sober i had no money and as long as i was doing the right thing people in my aa club would come and give me five dollars, comment give me three dollars. They allowed me to come in to his place and have dinner and lunch. I would ride the bus or my bicycle. Three months sober, the most important day of my life. Somebody let me use the bicycle. Thats how i learned to be last. That was the happiest moment of my life. Three days, three months of walking. I thought i was off to the races. That is how much i had to fall in order to rise again. About 18 months ago, and i dont know if senator cruz has been ready to come in or not. I will quickly move ahead. I was very blessed. I started praying about how could i not leave my daughters this country that i dont recognize. Allow med if you could to use the talent that you gave me that i have destroyed, that i didnt use properly, that i didnt use to your benefit, let me have one shot, let me help my kids so i can look them in the eye and say i tried. Somewhere in march i turn on the tv and senator ted cruz is announcing i called a guy that i knew was an acquaintance,. Guy named rick tyler i knew him to be a godly and humble man. I knew if i called rick he would tell me what i should do. A fundraiser is tomorrow, we went and i met senator cruz. I met his wife, and met all the people around him. Im have let me help they have let me in to help them. Me despiteelcomed my past. Hings in and im so grateful to senator ted cruz. [applause] thank you for that powerful testimony. Thank you for the powerful testimony. It is a journey every one of us understands. Every one of us has seen people we love stumble and fall. Hopefully we have seen people pick themselves up again and turn around. You know this topic, drug and alcohol drug and alcohol addiction is an epidemic in this country. Its destroying lives. Its destroying lives nationwide. Weree year 2014 there 47,055 drug Overdose Deaths. People than were killed in car accidents. You see a terrible accident on the freeway and think about the people that lost their lives, every one those of which could have been and should have been prevented. ,n New Hampshire in particular it is reeling from this plague. New hampshire in particular is. Eeing the ravages of heroine New Hampshire in 2015 had nearly 400 drug Overdose Deaths. There was a 17 increase from 2014. An 2014 represented a 73 increase from 2013. That doesnt bring it as real as the rather stunning stat that 48 of the people in new knowhire personally someone who has abused heroin in the last five years. One in two people in the state abusingly know someone heroin and adults under 35, it is 60 . Nearly two thirds of adults under 35 know someone who has abused heroin in the last five years. That is stunning. It is stunning and heartbreaking. And it is something that is destroying lives. Topic that itthis is something i know something about in my family as well. And i will share two stories,. Tories of addiction one that ended well and one that did not. , mary, was nine years older than i. The daughter of my father from his first marriage. And when she was a little girl my parent a little girl her parents divorced. She lived with her mom during. He year she lived with me and my other half sister during the summertime. As her baby brother i would play with her, she would let me pull on her hair. Pull on her hair nonstop. She was a beautiful woman. She was very smart, very charming. Talks about the consequences of abandonment, the consequences of a family breaking up. Miriam herb whole life was angry. She never forget my dad for miriam,g her mother her whole life was angry. She never forgive my dad her mother. For divorcing her mother. She stroked her whole life with drug and alcohol abuse. A teenager she partied hard. I remember as a little kid she would steal money from me. I would save money from my allowance and she would steal toey to go out and use it buy alcohol, buy drugs. She ended up marrying a man who had been in and out of prison. Who ended up mistreating her pretty significantly. Joey. D a son, my nephew pretty soon miriam was a single mom. Was in a car accident and had a back injury. And she got addicted to painkillers. The painkillers spiraled down from there. She herself went to jail. Offenses,be petty thinks like shoplifting. I remember talking to her when she was in jail, crying how hard it was, how horrible the people were in their to her. I remember when i was in the 20s and in my late miriam took a serious turn for the worse. She had gone mad of jail and had gotten with a guy that was a more serious drug addict than she. And they were living in a crack house. I remember my dad flew up from texas. Was up in philadelphia. My father and i drove up, i was in dcf time. Time. Ve d. C. At the we drove up to try to get my sister out of the crack house. Me tooker my dad and our watches and rings and wallets and left them behind. We didnt know if we were going to be robbed or shot or what was going to happen. And i remember pulling her out of there and we took her to a dennys not too far away. Of us sat down with her there for four or five hours. Trying to pull her back. But she wouldnt listen. She kept going on and on. She was angry. She said, daddy you missed my swim meet when i was in high school. And i remember telling her, miriam, you have a son. A sixth grader, he needs you. But she didnt want to listen. She wasnt prepared to change the path she was on. And she wouldnt change. So i ended up, i just started a law firm, i was a brandnew lawyer. Loans butn of student i ended up taking a 20,000 cash advance on a credit card, and using that money to put my school,n a boarding valley forge military academy. They took him in. It was actually a wonderful environment for my nephew, having some structure, having some order, having some discipline, having some basic stability. By the end of that year in school miriam had come back to him. She was out of the crack house, she was still struggling with but itd alcohol abuse, was not as bad as it has been. She was able to care for joey again. And then a few years ago miriam died of an overdose. Joey, her son, found her in her bed. The coroner ruled it asks said corn ruled it orner ruled it accidental. These tragedies are hopping all are happening all over this country. With peril and sometimes people make decisions bound and determined to destroy themselves. As a family you wonder if i could have done more, was there a way to pull her back, was there a way to change the path she was on. There are other journeys that have happier endings. Journeys like the one paul briefly described. That journey was my fathers journey. Which occurred when i was a little boy. That is one of the reasons his first family broke up. My mother was not a christian. Were living up in the time up at the time in calvary. My dad went down to texas and decided he didnt want to be married. Be he decided he didnt want to be a dad to his son anymore. My mom was a single mom raising me. And a friend invited my father to a bible study. Reason my dad came to the bible study. At the end they were taking Prayer Requests and they were praying. Indeed one of the women described how her son beat her to get money to buy drugs. What struck my father was the had what aing there scripture calls a piece to the path of understanding. He couldnt understand it, it made no sense to him but he knew he wanted it. So he left that bible study. Leaving the folks hosting it gave him a little pamphlet. I suspect a lot of you have read the four spiritual laws. They said read this and come back next week. He did and he came back. The asked him, did you read pamphlet. He said he yes, but it cant be that simple. Thats too easy. It cant be that simple. So he began asking questions. The folks hosting the bible study were fairly new christians. They said tell you what, tomorrow our pastors coming over to the house. Would you be willing to come by and ask him the questions. He said, sure. Next day he went by the house at about 7 00 and my dad spent fourrs hours arguing with the pastor. He was young, he was brilliant, he was an atheist. He was convinced he knew everything. Withe argued and argued the pastor. Finally at 11 00 at night my dad said, what about the man into tibet who has never heard of jesus . Pastor brother wiley didnt take that date. That bait. He said, i dont know about the man in to that. Jesus, ve heard of i dont know about the man in to tibet, but you have heard of jesus. Its your excuse whats your excuse . Fellas april 15, 1975. That wasmonth my april 15, 1975. Airport, hethe bought a ticket and he flew back to my mother and me. It turned his life around. My father hasnt had a drink in 40 years. [applause] everyone of us who has dealt has dealt demons are with loved ones grappling these demons, everyone of us understands these are personal there is no uniform solution that fixes it all. It is certainly not going to be washington, d. C. That steps in and solve these problems. Its going to be friends and families, churches and charities, loved ones, Treatment Centers, people working. People working to help those struggling to overcome drug addiction. Is a disease,ion it is a vicious disease. There are so many working in the field. Helping people get that monkey off their back. Helping people overcome that addiction. Faith and relationship with god can be a powerful element. The church plays such an important role. Aayou look at the history of we were80 years ago facing an epidemic of alcoholism. Doctors had given up. Alcoholics were put in asylums to die. The northeast was a battleground for this devastating disease. The founders of aa were from the neighboring state of vermont. When they formed aa there were no government grants. There were no nonprofits working to help alcoholics. The program was so successful at the time that wealthy donors often wrote checks to undermine aa. Turned down the money to not coupt the organization. Today they take no money from outside a prices enterprises or sources. And a program of person helping person to find god, there understanding and relying on ,hat higher power to guide life and protecting the program as it still works today. Those programs are more and more of the need, helping people get back on their feet. Not everyone is going to be of us can makeh a difference. The Senate Judiciary ittee to combat opioid addiction. We will hear from michael, the director of the White House Office on the National Drug control policy. I have a question for you, i have a personal friend i am a personal friend of your speaker. Point the senator was making, and i do agreed with agree with what senator durbin said. If we focused on the prescribed , then i think we are going to see an increased uptake in heroin abuse. In North Carolina it was a matter of state policy, we did a number of things crack down on drug shopping. There is almost a direct correlation between the reduction in those prescribed opioids and an increase in heroin at buse heroin abuse. I am also struck by the fact that there are great disparities between overdoses and death. I was shocked to know hours had still a but it is fraction of a state that has 1. 5 Million People versus a state that has 10 Million People. What risk to be run of federal policy, potentially hampering what you think and your Senate Leader needs to do to address to theseat are unique things that have disproportionate problems . That is a great question. Cant to you why some states are being hit harder than others. This im being convinced of, i dont think we would have the ifoine problem in america the didnt start people out with opiates that are sold at overthecounter drug stores. Is the irrational exuberance around painkillers is matched by the crisis. Convinced if we went back to the old policies on pain medicine, if someone has chronic pain treated and treated hard. But dont pass the stuff out as if it is not a problem. Had a reporter come into my office and she just tunnel. Ery for carpal i asked how many ox ease she got. She said 80. Took, shew many she said half of one. So there are 79 andahalf left behind. Comes by, she is a sophomore in college but she had four molars pulled out. They gave her ox see gave her oxy. I asked her how many she took, she said none, so there is 40 more. There is no question when we resistant, folks went to your heroin because it is cheaper and easier to get. We cannot loose side of the fact that we are having this problem prior to the invention of oxycontin. To the to go back source. The senator from illinois said i remember when the fda fda do notro approve this drug is into two. His drug 11 to two there is a correlation if you talk to folks or addicts, and 90 of the time folks say to me i got an a car accident, i got surgery, this happened to me. Senator sheen wanted to add something. I did. Everybody talked about the fda, pharma, and the role of Prescription Drugs. But we cannot talked about medical school and doctors. We understand medical schools dont have courses on prescribing medication, on recognizing drug abuse. It seems we have to get attention from medical schools who are turning out doctors doing these practices without the history of what has been raised at this hearing. Amen. I agree with senator shaheen on this. We have to engage the medical community. But for example, in New Hampshire, back when i was attorney general, i was fighting for prescription monitoring. Our state was late to the game. When we look at this data, in giving physicians the information and thats one of the piece of this bill, to support prescription monitoring programs. Physicians that want to do the right thing, that gives them the data to understand if someone is dr. Shopping. It gives us the focus to know if a particular doctor is actually exceeding his her bounce because its focusing on them. His her bounds so its focusing on them. Samsung will tell you some of the work they have done nationally. 4 out of 5 people started by overusing or misusing Prescription Drugs. To your point that you raised in your opening, with the patient survey, we are encouraging reimbursement based on how satisfied people are with pain. That has to be addressed as well. I know that cms is looking at this. It has to be a priority. This was brought to our attention from doctors concerned that, if they are worried about an addiction issue, they are being judged on a survey how does your pain satisfaction . That has to be addressed as well. Senator portman and then senator klobuchar. I dont disagree with the comments made here. We not only have the drug monitoring programs, which were incentivized. And how the states will respond to this legislation, it does not mandate the states to do this, it just provides incentives. Every state will be a little different. Some states have done cutting edge work and should be the laboratories of democracy. But we are hoping with this prescription monitoring, across state lines. We may have a great program, in southern ohio, West Virginia or kentucky. You dont know if someone has a prescription filled in ohio without having infrastructure. That is something the federal government can exclusively do. We have legislation on that. Second, the jug takeback the drug takeback program. Taking those drugs off the shelves. The final things is, having talked to hundreds of people who are recovering, who have been addicts because of Prescription Drugs, i understand that very well, including the athlete i talked about earlier. There are a lot of talked to that went straight to heroin. Holly is an example of that, as we will hear from her mom. I think now, because heroin is so plentiful. I was just with the fbi in ohio yesterday talking about this drug cartels from mexico are in ohio, illinois, in our states. Because its plentiful and cheap, its not just about Prescription Drugs anymore. It has been a gateway for a lot of people. But now there is a problem we have directly with heroin, even first use. In the days when we worked on this issue of cocaine and marijuana in the 1990s, heroine was not a first use drug. He was one you used after other gateway drugs typically. With people as young as 13, 14, 15 years old are using heroin today. This legislation is comprehensive. It deals with the prescription site and the heroin issue, which we sadly have to confront perhaps because of this onslaught from the overuse of pain medication. But how the heroin is upon us. Going back to the earlier observation about 30 doctors prescribing in pain connect pain clinics, things that are not needed that end up on the street and sold. Can. What are we doing working with the medical societies and medical professionals . They are the for these prescrip. What we doing to clean this up and hold those accountable in a public way . A fundamental problem is thinking about 750 million prescriptions annually in the u. S. , which actually leads to an enormous amount of diversion. Tons, its clearly telling us we are overprescribing medication. Its not just drug doctors, which are actually very few, but the practices we have in order to treat pain in this country. That leads to addiction and overdose. Is there a conversation with the medical profession about this. One thing we have done as part of West Virginia, we have worked with matter Major Medical societies and trained half a million of their physicians on safe and effective opioid prescribing. It is not enough for my perspective. When we look at the data, we are 10 years into this epidemic. I dont think it is too much to ask medical professionals and medical societies to purport a minimal amount education as it relates to save and effective opioid prescribing. I also want to include, many of the guidelines currently available for physicians about the use of prescription opioids has been developed by the pharmaceutical industry. There is a direct conflict. The National Institute of health has coordinated with many to generate a curriculum for not just medical students and physicians, but also nurses, pharmacists, and dentist for the proper management of pain and use of prescription opioids. There is interest, and we worked with different medical agencies for development of guidelines for the better management of pain. Senator sessions. Sen. Session thank you. This is very important. I know senator durbin is correct on those points hes made. Pain physicians are concerned about this. They know people complaining about pain. Many of them have other sources, other doctors giving them pain pills. Things such as allowing a position to check a physician to check that if other doctors are providing the same relief. Do you agree that could be helpful . And does it provide good doctors an opportunity to push back and not overprescribing . Yeah, i think this is the main goal of drug monitoring programs that are easy to use, that are interoperable across state lines. Physicians can have good Accurate Information about how many prescriptions one of their clients can get. Its a prime part of our strategy. We have seen the work in many states that have implement it. Sen. Session dea has great power, it seems to me. You can monitor the number of prescriptions coming from a certain position, can you not . Senator, those are state programs. We support all are state partners and the National Association sen. Session but if you have information a physician is prescribing extraordinary amounts, you can interview them and examined the records. You dont need a search warrant. You can just ask for their records. And a drug store or pharmacist, you can also examine their records, is that correct . That is correct. Investigation insert in a number of different ways. Patterns of oversubscribed patterns of overprescribing can lead to an investigation. Sen. Session if a doctor is clearly abusing, weve had doctors and pharmacists. Dea and the local police chief signed a one page memorandum that nobody would have a plea bargain on Prescription Drug until they were told where it came from. It came from a limited number of sources. That particular drug was virtually eliminated in alabama for a while. If somebody goes to jail, that sends a message to the other doctors and pharmacists, does it not . Certainly it does. Sen. Session i think that is important. Looking at the reports from the new england journal of medicine, they conclude there is no consistent evidence of an association between the implementation of policies related to prescription opioids increases in the rates of heroin deaths. Alternatively, heroin market forces, including increased accessibility, reduced crime, and high purity of heroin appeared to be the major drivers of the recent increase in rates of heroin use. Do you agree with that . Senator, we are focused both on the prescription sen. Session no, do you agree with that or not . Its not an yes or no answer. Sen. Session well it is. You are used to be what is called the drug czar. Do you believe high purity and accessibility of heroin are the major drivers of the recent increase in heroin use . This study was undertaken for a question that i had about what we were hearing about, does reduced availability drive people to heroin . There has been folks that have said, if you clamp down on heroin sen. Session the question is as i ask it. I would agree that the availability of cheap and pure heroine in the u. S. As well as untreated addictions has significantly increased heroin use rights in the u. S. Sen. Session i think that is a good answer, mr. Chairman. And lack of enforcement at the border is a big part of that. 1970s, i was assisting a u. S. Attorney. I was given 17 heroin cases to prosecute. They didnt trust me for anything bigger. It was almost all coming from turkey. The president was very aggressive in that. I give him credit. I came back in 1981 as a u. S. Attorney. We went several years before we saw a heroin case. Supply is important. We can impact supply. Heroin is lowprice and high purity on the streets, is dangerous. Prosecutions are critical to this. People need to go to jail who are pushing this kind of addictive power into our community, destroying lives anf fd families. Mr. Chairman, its a very important hearing. Thank you. We can do better about Prescription Drugs. Taxpayers are paying on their medicaid, medicare bills. Their insurance rates are higher because of overdoses and over prescription of drugs. Its an important issue. Thank you for your leadership. Host 2 months later, the full Senate Consider Legislation that would authorize the federal government to issue grants for drug addiction prevention and treatment programs. Senator shaking from New Hampshire offered an amendment that would upright would provided 600 million for the programs. On very gooding legislation with the Company Since it addiction and recovery act. Unless we provide the resources to make these programs work, its like giving a drowning person a life preserver that has no air in it. It doesnt make a difference. We are losing 47,000 people a year. 120 people a day from overdoses. Our Law Enforcement needs additional funding. The Substance Abuse treatment folks need additional support. What might emergency supplemental amendment would do is support the programs that are in the kennel legislation. Its about equally divided between support for Law Enforcement and support for treatment. It helps with Prescription Drug monitoring, with education, with recovery. It is the kind of support we need to provide if were going to make a difference in this epidemic that we are facing. I would urge my colleagues not just to support the underlying legislation. Thats good, we should support it. But unless we provided the funding, we will not have done what we need to to accomplish real change, to keep people from dying. I would urge all of my colleagues to support it is amendment. Mr. President. The senator from wyoming. Pending amendment offered by the senator from New Hampshire topopriates 600 million on of the 571 provided in the bill as reported by the Judiciary Committee over the 20162020 period. Unlike the underlying bill which requires appropriators to provide authorized funding within the Discretionary Spending caps, the shaking amendment would designate you spend in the shaheen amendment would designate new spending. The bill provides 300 million to the Substance Abuse and Mental Health Services Administration for Substance Abuse treatment to address the heroin and opioid traces. Opioid crisis. While we agree this epidemic must be addressed, i believe the underlying bipartisan bill provides a better framework to tackle the problem. It provides the comprehensive pacifics evidencebased approach to help americans combat this. In the meantime, the Senate Appropriations committee shepherded resources to deal with problem in the consolidated appropriate bill signed into law late last year. Nearly 600 million was included to help states and communities address the problem. The appropriators working with authorized inside the framework of the bill. The senators time has expired. Ask the pending amendment offered by the senator from New Hampshire would cause the aggregate level of Budget Authority for fiscal year 2016 is established in the most recently agreed to concurrent legislation on the budget to be exceeded, therefore i raise the point of order under section 311 2a under the congressional budget act of 1974. Sen. Shaheen i would point out, despite what the honorable chairman of the Budget Committee said, the fact is that the emergency supplemental funding amendment we introduced is very specific about where the funding goes. It goes to programs that are addressed and improved. The Substance Abuse prevention and treatment block grants go to the state to be distributed. Funding to Law Enforcement through the grants that are very to specific in how they can be used to fight heroin and opioid abuse. Like my colleague, i am disappointed, not surprised, but disappointed. I very much appreciate those people that voted for this stepment, who were willing forward and say, if we are going to address this problem, weve got to provide the resources that communities and states need to fight this addiction. Have, foron that i those that did not vote to support this amendment is how many more people have to die before we are willing to provide the resources that are needed to fight this epidemic . 47,000 peoplein 2014. In New Hampshire, were losing more than a person a day. In 2015, we lost over 400 people to Overdose Deaths from opioid and heroin. 3 times as many people as we lost in traffic accidents. So how many communities will continue to be ravaged because we are not willing to commit the resources to tackle this pandemic . And what do we tell the families of those people who have overdosed . What do we tell the parents of young people like courtney griffin, whose father testified at a hearing we had last fall in New Hampshire. He talked about the difficulties of getting courtney treatment before she overdosed and died. I met a man at a Treatment Center in lebanon, New Hampshire. A man in recovery who had been in and out of prison. I thought he put it really well. About 35,000sts a year to keep somebody in prison. Wouldnt it make more sense to put dollars into treatment, because its a whole lot less expensive to provide the funding usingat people who are opioids and heroin, who are Substance Abusers, than to put them in jail. So mr. President , to all of my colleagues, i am disappointed, but i an not defeated. That fact is, this is coming back. It will come back in the appropriations process and it will come back at every opportunity. Because i am not going to quit on this families in New Hampshire that need help. Im not going to quit on the Treatment Professionals that are trying to revive treatment for those in need. Im not going to quit on the Law Enforcement, the Police Officers and sheriffs and all of those in Law Enforcement in New Hampshire trying to put pushers behind bars and trying to get people off the streets into treatment. And i hope at some point the rest of the members of this body are willing to take up this cause and provide the resources that people need. I will tell you, its certainly worth it to address the 47,000 people who we lost. We were willing to put 5. 4 billion into fighting ebola, and we lost one person in america. We were willing to put 2 billion into fighting swine flu, and we lost about 12,000 people in the swine flu epidemic. We have not been willing to put funding in to address the thousands, tens of thousands that we are losing each year in this country. We are going to keep at it. We are going to fighting until we get the resources that families and communities need to fight this scourge. Mr. President , i healed to my colleague i yield to my colleague from maine, who has been a real leader in trying to address this issue. Mr. President. The senator from maine. Mr. President , i rise in disappointment, surprise, and some confusion that we have this bill. We spend a week. I went to the Judiciary Committee. It came out unanimously. There is tremendous interest in this subject. When i talked about it at home, i said to my people in maine, this is something we will be able to do because every member of this body is being affected by this tragedy engulfing our country. This is something we can do together. And indeed, we have done a lot together. We have a good bill. We passed good amendments. This is important work, but it has to be funded. The old saying in maine and i suspect everywhere else, put your money where your mouth is. I was on a teleconference with folks in maine two hours ago talking about this. One of the chiefs of police said, its time to move from talking about being interested in this to investing in it. We cannot solve this problem without money. It would be nice if we could. There is a drastic and dramatic shortage of Treatment Facilities in this country. The only way we can do it is to pay for it. We had a point of order on the budget. I have to tell you, im confused because i stood here less than three months ago when we passed 680 billionll and of tax expenditures. Where was the point of order then . It wasnt funded, a dime of it wasnt funded. Maybe there was a point of order, but it was overwritten so fast that none of us noticed it. It was the speed of light. So my mother used to say, we strain at nats and swallow camels. We swallowed 680 billion, and entirely unfunded tax extenders are, and we cant solve it and bring it into our hearts to save lives for one 1000 of that amount. One oion, one 1000 ne thousandth of what we had. I am confused by thsi. I dont understand it. The way, 47,000 people that sounds like a lot. Heres what really sounds like a lot. Since this debate started at 2 00 this afternoon, 10 people have died. 10 people had died in the last 2 hours. 47,000 people is 5 people every hour 24 hours a day, 365 days a year. We are not talking about obstructions here. Were talking about lives. When i consider one of the most Serious Problems i have ever seen in my state. And we talk about ebola, isis, all of these challenges that we have. And yet this is something that is killing five people an hour. And we are not willing to put the funds in to do it. Its a false promise. I believe this bill is going to do a lot of good. But its not going to meet the promise we are making to the American People by all this drama about drug abuse. That we are going to do something about it. But were not going to do enough about it. Because in order to deal with this problem, and this is true everywhere, its going to take money to provide treatment for people that need it. When someone is ready to change their life and ready to try to defeat this awful disease, and they cant find anyplace to give them treatment. I was at a detox center in portland just last week. They are turning away 100 people a month from a detox center. Not even a Treatment Center, but a detox center. Because they dont have the beds. Im delighted we are working on this this. Im delighted we are passing it. There is a lot of good in it. And it is in fact bipartisan. But to venture to the edge of this problem and step away because we are not willing to pay for what, in my mind, is one of the most serious emergencies weve faced since ive been in public life, is disappointing, a great missed opportunity for the country. I join my colleagues in regretting the decision that was just made. I think it was an opportunity where we could have spoken as one, to realistically, realistically attack this scourge that is devastating our people. We are losing lives. We are squandering treasure. And were breaking hearts. And the only way we can solve this problem, or at least make a dent in it, is to provide the wherewithal to the programs throughout the country that are struggling manfully and mightily to confront the problem and defeat it. Thank you mr. President. Senator from ohio. Thank you. If my colleague from nevada will let me speak to the comments about the legislation before us, which is legislation to address this horrible problem in overstates problem in all of our states. About 100 people will die today from overdoses. Thats just the tip of the iceberg. There are so many other life that are being ruined, families torn apart and communities devastated. This legislation was drafted by senator whitehouse, myself, other members of this body over the last few years, including 5 summits in this congress to bring in experts on prevention, education, treatment, and recovery. Dealing with Law Enforcements side and the importance of having narcan available, also getting Prescription Drugs off bathroom shelves. It is a comprehensive approach. I disagree with my coauthor from rhode island insane that if we could in saying that with we could pass this bill, there would be no funding. We have had huge increases in funding for opioid addictions. Senator whitehouse and myself is that funding was consistent. The Judiciary Committee worked hard to drop legislation to draft legislation to get this within a fiscal year. There would be funding to get this legislation. However, as my colleagues know, this is an authorization bill. It directs how funding will be spent, its not a spending bill. Having said all that, as senator shaheen knows, i supported her efforts to add Additional Resources over and because i believe this is an urgent problem and it rises to the level of being an emergency. , anda fiscal conservative that means it is not paid for by offsetting other programs. We have done this with Health Care Emergencies when we have Something Like the ebola crisis. I think this is a crisis. Im a cosponsor of senator shaheens amendment. I do not support the efforts of some who say there is no money in here. This is an authorization bill, the First Step Towards getting the money in the future. That is the point. Drug the author of the Free Community built. 1. 9 million has been spent, creating coalitions in just about every state represented in this body. Was that a spending bill . No. It was an authorization bill. Evidencebased practices we knew would work. , andis what this is specifically directed to the beingof Treatment Centers built, Detox Centers not having room for somewhere to go. These are real problems in our community. That is what this legislation is by anto address, not just appropriation for one year, but by changing the law for the future. The nextthis right, in 19 years, we will spend even more than we have spent on the drugFree Community at. It will be over 2 billion that would not have otherwise gone out. Just as senator whitehouse said he supports this bill because it based, because we took the time and effort to make sure it will be money well spent , this bill is important. I appreciate the support of my leagues, senators sicking senator shaheen, senator king. It is the right thing to do at a time when we face a crisis. Will support additional spending because i think it is so critical. Lets not go forward with this sense that somehow this does not matter. This does matter in a very big way. This is a necessary first step. In terms of this year, because we increased funding dramatically at the end of this fiscal year, not one penny has been appropriated. There has been no outlay. I believe everything we could get done this year would be funding that we could use for these important programs just in the next seven months of this fiscal year. Certainly, we should, right now, as i have done and others are doing, go to the appropriations with regards say, to next fiscal year, lets make sure we have the bill funded. At a minimum, lets get this done. On ais an opportunity bipartisan basis to help people who are crying for help. Communities that need our help, families that are being broken apart. I appreciate the fact that senator shaheen made her best effort today. She was right, in my view. Lets also continue to Work Together to get this legislation passed. Istever funding we can add great, but lets get this bill passed to ensure we are increasing funding to those who need it most. I appreciate my colleague in about a. I yield back nevada. I yield back. The senator from rhode island. I would like to end this conversation on a happy note. That is to express my appreciation to senator portman for his cooperation to get this where it is now. I would like to express my appreciation for publicly pledging to work as hard as we can together to get funding for and through the appropriations process that is underway right now. I believe we missed a opportunity because senator shaheens would have flooded more money into the solution of this problem. A week after voting not to add 600 million to the legislation, the Senate Passed the comprehensive addiction and recovery act by 941. The bill authorizes grants to states for treatment and education program. Of apands the availability drug that can block the effects of opioids and prevent overdoses and strengthens Prescription Drug monitoring programs. Companion legislation has been introduced in the house. House Oversight Committee held a hearing on opioid abuse. We will hear from elijah cummings, who asked whether Drug Companies promote over prescription so they will make more money. We will hear a discussion about whether marijuana is a gateway drug. Record thento the baltimore sun, the effects of opioid over prescription. Explains one reason we are seeing such a huge increase in heroin overdoses is because legal painkillers are being overprescribed. She says, once a patient is hooked, he or she often turns to street drugs, which can be easier and less expensive to acquire. Everyone else said that this morning. I want to be clear. I not trying to blame the doctors. Or, do you agree one reason we are seeing an uptick is because of the abuse of opioids . Yes. Oped says with only 5 of the world population, we are consuming over 80 of the worlds painkillers. Oped explains Drug Companies are actively promoting this problem. Prescriptions for opioids have been traditionally limited to cancer pain. But in the mid1990s, Drug Companies began marketing these pills as a solution to a plethora of ailments. Expand theforts to market, producers understated and willfully ignored the powerfully Addictive Properties of their drugs. It sounds like Drug Companies are almost like drug pushers. Cites several examples. Oxycontin by of perdue was the most aggressive marketing of a schedule 2 drug ever undertaken by a pharmaceutical company. This is a big business. How in the world do we combat this massive and aggressive effort by Drug Companies . You know, when they are making billions . Go ahead. Congressman, thank you for asking that question. I appreciate your saying that. Doctors want to do the right thing. When we talk to our communities, when we ask our youth in schools it heroin is good or bad, they will say it is bad, but we have a culture of access. We have this expectation there should be a pill prescribed for every pain. We have to make sure doctors get the resources they need, including Prescription Drug monitoring programs and guidelines for prescribing. We also need the resources when we are in the e. R. We need the resources to connect patients to treatment. Otherwise, we feel frustrated knowing that our patients need care but we cannot deliver. You talked about guidance you sent out. Include using painkillers that are not so addictive or not addictive at all . Yes. Our guidelines include three things. First is the necessity of prescribing naloxone with any opioids. The second is to be careful about the opioid medications, knowing they are not first line medications. They should only be prescribed for severe pain. The third is the danger of benzodiazapene. Profit. Ys this is about perdue achieved its place on the list of wealthiest families. 14 billion. That is appaling. I call that blood money. People are dying, bigtime. Want to go back to something you can answer this. Yesterday i was talking to a reporter. Concerneding, are you that, with even more money being requested for treatment, because there are so many more people heroin,into opioids and that money would be spread so thin it would not have the kind of impact you are hoping for . Your point, i think we need to have a comprehensive response. We need to rein in prescribing behavior. The centers for Disease Control put out recommendations last week that follow the guidance dr. Wen put out. That is a significant driver to the problem. We know that, despite our efforts, we have too many people overdosing because they cannot access treatment programs when they needed treatment programs. This is why i think the president has put forward a significant proposal to expand treatment capacity in the United States. I hear this wherever i go. I did a town hall in toledo, ohio. Thingd the sheriff one the federal government should be doing to address the opioid epidemic. He said, we need more treatment capacity. We are arresting too many people who have not been able to access treatment. We carefully look at how many people need treatment and try to adjust the proposal to focus on making sure that as many people as possible have access when they need it. One more question. Dr. Wen, what happened . In other words, this was not a problem, not as much of a problem. Then something happened. Can you tell me what happened . The numbers the gentleman cited, and i realize people are moving from the opioids to heroin. What happened with regard to opioids to get so many people on them that they moved to heroin. My understanding is there was aggressive marketing by drug ispanies so the pain scale something that is up during the course of a hospital stay. The goal should be appropriate treatment. But an expectation is placed on patients and doctors. Doctors are put in a hard place of satisfying those requirements. Doctors have a tough time. In other words, the patient keeps coming in, and the pain be a 2, being the mildest the patient has a 2. Then he or she comes in and does not tell the truth and says i am at a 9. Is that the kind of thing that happens . That definitely happens. Doctors feel they have to get zero,tients pain to which includes overprescribing painkillers in order to do so. Would you like to Say Something . I agree we set up an expectation whereby opioids are the first line of defense around pain therapy. I think what we are trying to do , specifically for people with chronic pain, is that opioids are not the first line of defense to reduce pain. We have to focus on others and the evidence seems to be strong that people in chronic are not significantly better functioning on opioids. We need to be thinking about exercise and diet and cognitive therapy, not opioidbased therapy for people with chronic pain. Last question. Mr. Turner asked a critical question. I guess he was talking about treatment in prison. Is that right . What stops you from providing treatment in prison . Is that what he was asking . There is a regulation that says you cannot do that . Yes. I want to check into that and make sure i get you a complete and accurate please do. I am wondering if it is something that congress should be i do not know if that is in your control or our control. Do you know . I do not. Thank you. While i do not know if marijuana is a gateway drug to , every single kid i am dealing with who is on opioids started with marijuana. There is a perfect match, 100 . Onry kid i am dealing with opioids, when i asked them what they started with, they all say marijuana. Maybe it is susceptibility or something. It is not anecdotal. It is empirical. Thousands of kids. It certainly points in that direction. I think it deserves a cautionary note in terms of marijuana legalization. One thing i want to talk about and get your opinion we have not talked about the power of these opioids. I will give you a couple examples. A young woman in my district had an extraction. They gave her a large prescription of oxycontin. She consumed that and complained falsely of pain. Got another prescription and went in and complained. Heris yanking teeth out of head to get prescriptions. That is unbelievable. I talked to some of the docs in the boston area. The chemical change in the brain overrides oxycodone endorphin creation in the brain. It is more powerful than the endorphins the brain can produce on its own. When they come off of that, that is why they are going towards heroin. The only thing that can scratch that itch. We need to think about this. These Drug Companies are creating customers for life. Another young father in my district, shoulder pain. Same deal. Much oxycontin. Now he is buying it on the street. A good dad, good family, just totally fell into that trap. It is a huge commercial advantage for some of these companies to produce a product that creates a customer for life. We have to think about what we are doing in that regard. That is a huge commercial advantage, and i think that should have just come out and said, if you are going to prescribe this stuff, you can only get so many pills. It also talked about the drug monitoring peace we are doing along those lines. But is there anything on the mike, we can be doing to stop the number of people . Once they get in, we are having terrible, terrible problems. Recidivism, relapse. We need to spend money for rehab, but on the front end, to stop these kids from being trapped is there anything else we can do to stop that from happening . I thank you for that question because i think it is important. C just released guidelines, but they are only guidelines. I agree the vast majority of physicians and dentists are wellmeaning. Part of what massachusetts has done, there is legislation on mandatory prescriber education. But is not about bad docs, they have gotten misinformation from Drug Companies that these are not addictive medications. The middle of in an epidemic it is unreasonable to take arescriber minimal amount of education with regard to prescribing. Thereg at the overdoses, is a correlation between the amount of prescriptions we are giving out and Overdose Deaths that has been going on for 10 years. I think the metal goal community has a role to play. What about liability . What about liability for Drug Companies and the docs that push this stuff out there . I agree. There has been litigation against purdue pharmaceutical for that reason. They have a role to play in meeting the letter of the law about marketing and deterring abuse. Andeed to work with the dea others to go after outline wantonlyrs who are ignoring the law. We need drug monitoring programs so physicians can identify people who may be going from doctor to doctor. Reduce theoing to magnitude of the problem, we have to scale back on prescribing and identify people who are developing problems. Thank you. Also, i went into one of our drug programs in my community, talked to every kid i could. They are all in the treatment program. Every kid told me the same thing. Key started with marijuana and they go on to the rest of that stuff. We have a serious situation in this country. Gentleman from virginia. Thank you, mr. Chairman. , mr. Mike and i had a series of hearings on drug policy that included marijuana. It forced me to reexamine some abouti thought i knew drug policy with respect to marijuana. What is disturbing to me is, if it is a gateway drug to heroin, it is opiate Prescription Drug addiction. Far more than marijuana. That is why this hearing is so timely. It is affecting every community we represent here in this body. It is not a rural or urban phenomenon or suburban phenomena in. You, mr. Botticelli how did we get to this point . I do not want any doctor to leave a patient in pain, serious pain, you know . It is a terrible affliction. First, you do no harm. How do we draw that line between Pain Management and just avalanche ofle prescriptions that has led to an epidemic of addiction in america, with presumably the best of intentions . I agree. Ofn you look at the roots the epidemic, it is really about the overprescribing of addictive pain medication. Why . How did we get there . Doctors are not stupid people. I think that doctors were given a significant amount of misinformation from pharmaceutical companies and medical professionals that these were not addictive medications. Scant scientific evidence, there was a fullcourt press to educate physicians in saying that the medications were not very addictive. Had a nobletime, we goal we have to do a better job at pain treatment in the United States. There are a lot of people with significant pain. You have these complements of a fullcourt press to treat pain and little education on the part about howscribers addictive the substances were, how to identify people. So physicians in the United States gave very little training on appropriate pain prescribing. Veterinarians get more training in pain prescribing, and physicians get little training on Substance Abuse issues. With this mixture of factors that really drove up addiction in the United States, i think, of late, you have that compounded by heroin and fenta nyl. , what is effective treatment and the system for recognizing that, hey, someone has a problem . Ficacious treatment in trying to turn this around early before it moves onto heroin or something worse . It is often said that notcine is an art and completely a science because pain is subjective. That is why doctors need discretion about how to treat each individual patient based on their symptoms and who they are, also recognizing it is not just about medications. We have to do physical therapy, counseling, education that sometimes pain is ok. We do not have to treat everything with a pill. We agree with the increased use of pdmp, though recognizing that some are cumbersome to use. Ini am seeing 40 patients eight hours, i cannot spend an hour trying to figure out how to get into a pdmp. So what is efficacious treatment . What do you recommend . We recommend judicious use of pain medication. I get that. Were talking about treatment. What have we learned . Look, we are policymakers. We want to solve a problem. A point where we have an addictive problem and are trying to prevent that person from going onto the heroin part, what works . Recognizing that addiction is a disease. Therefore, we have to get people into Addiction Treatment, medically assisted treatment, social counseling, and wraparound services. The World Health Organization shows for one dollar invested, it saves 12 for society. Thank you very much. Thank you for the hearings. They were quite informative. Them. Got criticized for it is now 1 00. We started some three hours ago. In the United States have died from overdoses, three of them from heroin. 120re the days over, americans will die, 24 from heroin. We have heard Different Things today. Some people said we need to put more money in treatment. Treatment is essential, but treatment is at the end of the line. You heard a couple comments from the other side of the aisle that we need to act before we go home at easter and put more money into the heroin and Drug Overdose situation. This is the remarks of senator grassley on the floor. In fact, according to the office of National Drug control policy, passed inpriations act december provided more than 400 million in funding specifically to address the opioid epidemic. 100is an increase of million over the previous year. That is 25 increase, ok . None of that money, when he said that a few months ago, has been spent yet. All of that money is available today. Is that right . Most of it . Tell me. Most of that money is available today. You wouldnt think we are going out of here not providing money. 25 increase. I want this in the record. Lets put in the record of how much was asked for and how much was appropriated. How much was taken from interdiction and Law Enforcement and put in treatment . These are the facts. We do not want to deal with the facts, but we will put this in the records so you will see there is money there. And i want a report. Telling report, i am you, this week of how much money is spent. I want that in the record, ok, mr. Botticelli . I want something from you too, director of our health and Substance Abuse office. I want to see how much money is pending. Office byin my friday, close of business. I know the money is there. It has not even been distributed. We are not going to play these games. I want the facts. We need to stop this stuff at our border. Boatloading in by the across the borders. I have one question. I talked about el chapo, biggest czar, coming across the border like it was a vacation holiday. Weapons,d, speaking of which are used in most drug in orlando, we kill them at the mall, at our streets, great communities. We are killing them. Most of them are gone deaths related to drug trafficking, our debate mr. Maloney . Arent they mr. Maloney . A lot of dems are illegal weapons. El chapo, who is coming back and withinhe also had a traced to the fast and furious. Weapon traced to the passenger is. Supplied by the u. S. Government and the stroke traffic or drug trafficker crossing the border like a holiday visit. Are you aware of that . Can you confirm that for the committee . I would not be in the best position to do that. I will take it back to the department. Rep. Mica i want you to check on it and let me know. I am pleased with the people out there. I met with some of your people. The prosecutions are not what they should be. You go to singapore. They do not have a treatment program. I want to put you out of business. All the treatment programs. I want to put them out of business because our kids and adults should not have to go to treatment. But we are allowing this crap to come into the United States. It is offensive. We are killing tens of thousands, folks. And anything else, people would be outraged. Where are you . Just say no, and just say maybe. There are consequences, just say okay. It makes a difference to our young people and what is happening. Hot. An tell i get a little the italian comes out of me. I see them dying in the streets of baltimore, diane again in my community. We need to do something about it. That supply has to be cut off. Then i can put others out of business. We dont have to treat people and have the scourge on our streets. There being no further business before this committee, this hearing is adjourned. Thank you witnesses. Host cspans issue spotlight looking at Prescription Drug and heroin abuse and addiction. There is more to come. We will just take a break and hear from you what youve seen so far in the problem of description drug abuse. In particular, governments role in solving the program. We will take your phone calls in just a couple minutes on cspan. For democrats you can send us a tweet. We are cpsan. Comeost recent comments from a summit in atlanta yesterday. President obama visited there on the opioid addiction problem in the u. S. The president saying the issue is not a Law Enforcement problem, but a health problem. Heres part of what he has to say. Pres. Obama the most important thing we can do is to reduce demand for drugs. And the only way that we reduce demand is if we are providing treatment and thinking about this as a Public Health problem and not just a criminal problem. [applause] this is a shift that began very early on in my administration. Drug is a reason why my czar is somebody who came not from the kernel justice side, the criminal justice side, but the treatment side. [applause] this is something that i think we understood fairly on. I will be blunt. I hope people dont mind. I said in a speech yesterday, your last year in office, you are getting a little loose. [laughter] in West Virginia as well. I think we have to be honest about this. Part of what made it previously difficult to emphasize treatment over criminal justice has to do with the fact that the populations affected in the past were viewed as or stereotypically identified as poor minority and, as a consequence, the thinking was it is often a character flaw in those individuals that live in those communities. And its not our problem that they are being locked up. [applause] one of the things that changed in the opioid debate is that recognition that it reaches everybody. There is a real opportunity not to reduce our aggressiveness when it comes to the drug cartels trying to poison our families and kids. We have to stay on them and be just as tough. But a recognition that in the same way that we reduce Tobacco Consumption i say that as next smoker. That as an exsmoker. [applause] we greatly reduced traffic fatalities because we applied a Public Health approach. Host president obama yesterday in atlanta at the opioid abuse summit. The president not only speaking at the roundtable, but bringing money, money the executive branch can provide. In particular, 94 billion for Community Health centers. Some 270 centers to expand and Addiction Treatment programs. 11 are in dollars for states to buy the drug narcan, used in treating individuals undergoing an overdose situation. 1. 41. 4 billion million in Rural Education programs. This funding, which does not need congressional approval, could provide 124,000 additional drug patients across the u. S. We will get to your phone calls momentarily. We are asking the governments role in combating and ending opioid addiction. We are joined by a political correspondent, who covers this issue. A politico correspondent, who covers this issue. We talked about the drug czar being there. He made the case that this is an issue of overprescribing. A week ago, the cdc announced new guidelines for prescribing for doctors. Why did the cdc do that . Like you said, the cdc sees that as an epidemic in the Health Care System that often does start with doctors prescribing a patient a prescription. 15 years, since 1999, the cdc says sales of prescription opioid medications have quadrupled. Corresponding with that is a quadruple in the number of Overdose Deaths. The cdc guidelines are trying to change how doctors think about prescribing opioids, encouraging them to prescribe much shorter durations of treatment. Lower doses of the medications. And also in many cases, encouraging them to think about not starting a patient on opioid, if thats not necessary. Other kinds of perception medications, even trying modification first to deal with pain. Host executive action from the president yesterday, the cdc making initial guidelines on overprescribing. What about on capitol hill . As the senate left, they just pass the bill dealing with opioid addiction. What would that do . Sarah that bill would direct some money the federal government already appropriated. It would do two things. It would try and help support prevention programs, once thats try and prevent drug abuse and from even beginning. Also help support treatment programs throughout the country to help those suffering from drug abuse. Host seems like one of the big amendments was some 600 million by senator shaheen. That amendment was defeated. What without money have done, and why was it defeated . What would that money have done, and why was it defeated . Sarah theres not a lot of appetite in the Republican Congress to spend new money. So they basically took money that had already been given out and regarded it here. A lot of democrats were pushing for congress to give more money to fight the problem. And it does seem like in the next set of appropriation bills, assuming those go through, that a lot of republicans in congress are thinking about providing more money to address the opioid epidemic. We will see how that plays out. Also when the house considers some more legislation, whether they decide to add a money component or not. Host any word whether the house will take up that senate bill . Sarah its not clear yet that they will. The chair of the house Judiciary Committee, who would be the committee taking up this bill has expressed interest. He says he wants to look at the costs of the bill and whether its the best way to address the crisis. There is a lot of momentum. A lot of advocacy groups are pushing measures forward. The house is not quite started any work at. Host viewers can follow more on the bills and the opioid problem politico. Com. Sarah, thanks for being with us. Sarah sure, thank you very much. Host lets get to your calls and comments. What should be the governments role in combating opioid addiction and abuse . Barbara on them s line. Caller i think the advertisements from drugs and education to the public this has been proven to be true just as they banned cigarette ad. We need to ban Prescription Drug ads. When a patient season at, they are told patient sees an ad, they are told to ask their doctors. Congress gets money the same way they got money from tobacco companies. Im sure Drug Companies will suppress any bills that would suppress any of their money they are getting. From reba inear california. Hello there. Caller hi, my husband has been prescribed that. Opioids. He has been on them for quite a few years. They tried everything else. They tried stimulators, pain pump, they tried everything. With the New California law, with workers compensation, everything has to go through a board. All the pain doctors are quitting because they have to fight the review board. All of a sudden they are fast. Ng his opiates hes going through withdrawals. I think there should be some kind of law to help people on work comp that are already stuck on opioids. Host are you concerned about the new guidelines the cdc has putting out about overprescribing . Caller probably. My husband is not the kind that would overdose. He is the kind that absolutely needs them because there is nothing else. They have tried everything else. Host moreover issue spotlight program coming up on opioid addiction. The governments role in addressing the problem. Lets hear from paul in new orleans. Welcome. Caller thanks so much for cspan. Host you bet. Caller id like to point out, if the nsa can record everything will conversation and email in any form of communication for the purposes of terrorism, which is quite awful, but is not killing that many people as compared to all the other forms of International Criminal activity that kill us. Why dont they turned those resources and tell us who is bringing in all this dope . They are certainly using faxes, emails, every other form of communication. You can tell me who is killing us with terrorism, but you can tell me who is bringing in the dope . Host what do you do about the legal the legal prescriptions . What about that part of the problem . That is a corporate problem. You have corporations controlling the government to be allowed to use us as guinea pigs and consumers, not citizens. We are just here to eat and consume and chew up resources. In return for whatever little value we can give in return. Host lets hear from saginaw, michigan. Johnny on the democrats line. Caller good evening. Host go ahead. Comment when , i am astening to this patient. Ive noticed a lot of times, they tried to push pain pills and other drugs for new doctors coming in. , they have to overprescribing have ay they cant controlled substance without regular medication. A lot of times i get more medication than a i need instead of a one time payment occasion that i need once a month. Medicationsof the than i really need to get this other medication. Ust d want to share with what kind of medication you take . Taking vicodin, what they call hydrocortisone. And there. It here it, they wered giving me too much of it to cover the one medication that i needed periodically. Host the question this evening, is the governments role in combating opioid abuse . Part of the effort has been the senate bill. Just to recap the Senate Passed, this bill before the went on break. Grant additional money to education and treatment programs. It would expand the ability of naloxone, or narcan, the one they use in overdose situations. And it would strengthen Prescription Drug monitoring, which seems to be the focus of the senators for the centers for Disease Control. Checking a couple of tweaks, we are at cspan. The federal government should stay out. States should legalize and tax cannabis, use the rest of the money for treatment. I wonder what types of incentives are given to doctors to prescribe drugs. cspan is how you send us a tweet. Mike from pennsylvania on the others line. Caller hi, i want to comment how these people are saying marijuana is a gateway drug to heroin. I did not start with marijuana, i started with cigarettes and high school. Because i Smoke Cigarettes i fell into a particular clique. In that, there were those that had various types of drugs. I started with pcp and angel dust. I have been smoking marijuana for 40 years. Ive held good jobs , i run companies, raised a family. No problem with the marijuana. Once i started buying the marijuana and going to these places where people sold it, i came across the other drugs. If marijuana was legal, i would never have been exposed to all of these other drugs that these drug dealers had to deal the marijuana. So i wanted to get the point across. Everybody does not start with marijuana. Legal and i could go to a store and buy it, i would not have access to all those other drugs throughout the years. Host hey mike, had you keep that from being a gateway drug . You said you have been using it for 40 years. Are there times where you are tempted to use something stronger . Caller in all the years i have done all kinds of things. But it wasnt because i was smoking marijuana. I had five years in addition to methamphetamine, five years to crack cocaine. I was able to be all that. And i am still smoking marijuana and is not trading problems in my life. Creating problems in my life. If i did not have to go to these drug houses to buy marijuana, i would not have been subjected to the crack cocaine, heroin, the meth, etc. Host mike, thanks so much. We will hear from fred in michigan, democrats line. Governmentt is the going to do to save those that are crippled and in need of opiates . Twice have been told that i was going to die. Once from a car wreck, once from people breaking into my house for drugs. My exgirlfriend told them that andd 20 pounds of pot 20,000 and the next thing i know, im nearly beaten to death with a hammer and a bat. Host so you were prescribed some sort of opiate . On norco and oxycontin. They walked away with hundred 78 and about 15 pills. And 8th of pot. And they put it in the paper as a drug case. All these doctors are running out of this area. Poor people dont have the ability to make it to a doctor. Host weve got about 10 more minutes. I did want to show you a pretty graphic look at how the problem has expanded. This is a graphic done online at bytimes. Com. At nytimes. Com. How the epidemic of Drug Overdoses deaths ripples across america. This is a map, the red and orange part is the expansion of Overdose Deaths per 100,000 s ince 2003. You focus in 2014, and that map has gotten pretty broad across the u. S. Just a couple of stats from that. They say the depths from overdoses the deaths from overdoses are reaching similar to the hiv epidemic at its peak. Times, from the new york statistics from the cdc. There is the map currently, Overdose Deaths from 2014, in the neighborhood of 28,000. Lets get back to your calls. Here is mary in greensburg on the republican line. Caller hi there. Im a 75yearold person with all kinds of ailments. Ive been on a patch for at least 12 years. And now they are trying to take this away from me. On not selling it. Im not giving it to anyone. I change it every three days. Thats not the only problem i have. I just dont understand, if teenagers know where to go buy this stuff, why dont the cops and undercover people know . Host mary, how are they trying to take this . Are they offering you another painkiller, or are they raising the price . Caller no, let me explain. They want me to go to a pain clinic. Because i cannot take anything with aspirin, my doctor said i would lead to death. I would bleed to death. I cant take anything, if i have been exposed to tuberculosis, so many of these means your immune system is way down and youll get an infection. I mean, i just dont understand it. If you want the call me a drug addict, thats fine, and i need this patch. But summary is going to sign my death certificate, because if i dont get it, i dont know what im going to do. Host thank you for the call. We go to lee, in medicine, alabama. Lee in madison, alabama. The governments role in combating opioid abuse. Caller im coming from this from two sides. My dad takes a lot of opioids, mainly hydrocoding. He recently switched to a different drug. And he needs it for back pain. But for me, i started opioids due to a car wreck and became highly addicted to the point where i was buying it off the black market. I almost overdosed. I went to the hospital. Luckily i was put through a program and am greatly recovering. I help as many of my friends as i can. In the past four years, ive seen four of my very good friends o. D. Im 30. Benow there needs to stricter ways of dealing with this. That takingknow away from people with chronic pain is the way. I think that the police need a better way of finding the people that are selling. If im 30 and i can find it on the back streets, im sure that with a little bit of effort, the police could find those that are selling. Host i appreciate your input. Lets hear from new york on the republican line. My producer tells me you are a doctor . Caller yes, correct. Host welcome, go ahead with your comments. Caller yeah, im a physician who treats addictions and addictive disorders in my community. I have the opinion that this is completely and absolutely required of the government to intervene and manage this epidemic. All the colors the callers are indicating they almost have a deterioration and disruption in their life due to the drugs, every single one. Cannotle, they all control it. They have also witnessed those that have overdosed and died. Without government intervention, this is only going to grow. Intervention, this is only going to grow. Only hasbeing passed to do with expanding the prescription monitoring program, extending the view of capturing the people who are taking it the wrong way. The people who are taking the medication will be prescribed, and there is nothing against those people. The people who are using it to sell and using it themselves and doctors are the ones that need to be stopped. The medical