people who would harm us. government. the concept that regardless of how passionately we might feel about the need for certain government intervention, we can't ever allow government to be operating completely unfettered. we have liberty in place whenever government is controlled by the people, and whenever there are certain things that are beyond the reach of the government. now, senator paul has helped identify some key areas of concern that have been implicated by the patriot act. and he has suggested that we ought to, at a minimum have, a robust debate and discussion over some amendments that might be proposed to the patriot act before we proceed. three months ago we had a discussion, we had a voargts and there were a view of us who were were a view of us who protect america. we voted against it because we love america.

because we believe and constitutionally limited government because we want totom make it better.ng tha we want tot make this somethings that can at the same time protect americans but without needlessly trembling on privacyg interest including many of those interests protected by the fourth amendment. bad things happen when we adopt a law without adequately ago whn discussing its merit. sears ago when the patriot act i was adopted there were a number of people who raise the privacy concerns, and for that and othee reasons congress made the decision we better than almost singo years ago to adopt the pri patriot act and certain provisions of it for some sun setting provisions. d the contras would periodicallyue be required to be dated and this does no good if everythinge it comes up we told you have tot vote for it or against it weebas can't really debate and discussr it.th we were told three months ago my

that in may towards the end of may and we are now here we have an opportunity to debate, discuss and consider amendments. hhat opportunity has now been wt taken away from us and with ithe the chance to address many ofo these important privacy implications many of whichpl do. implicate the fourth amendment in one way or another. senator paul refer to some of them including some of the tycuri implications of a national security letter which while not directly implicated by the provisions at issue right now inextricably intertwined withini other issues that are in frontng of us including those related tn section 215 orders including ths iving wiretaps issue that's no, th for reauthorization.reau so ior speak in support of theot idea of a robust debate and discussion especially whereass here it relates to something that is so important in theconcf american concept of limited our government. f so closely relatedou to the fouh

amendment interests. we ought t ro have robust debatr discussions and opportunity forl an amendment and i think senator paul for hisn leadership in this regard. thank you. schappell kajsenar from >> mr. president?entucky. >> senator from kentucky. >> when we look at this debate and we talk about exactly where we should go from here and why it's important, it's important to look the patriot act and say to ourselves how do we protect t our constitution if we are notsf it. ad for so many conservatives are avida. i'm one of theim. the i want to protect the second wan amendment. but i tell those who want to protect the second amendment and can't protect the second if your don't believe in the first the amendment. if you don't believe in the first amendment, you can't have that voice it will take. if you want to place limitation on groups who advocate gun adv ownership on the second amendment will limit the second amendment. you can' but likewise you cannot protect

the second amendment if you the fourth ge fourth amendment. there's no reason why we shouldc allow the government look at the gun record and to troll through all of these. la you think someone is a p terrorist common name that show person. name the place and show me allow probable cause. do we want to allow thehas government deutsch told throughd the records? the government has looked at 28 28 million electronic records. 28 million. our they are just sifting through all of our records looking for , things. i want them to catch terrorists, but i want them to use some ability to look at they constitution and use some p restraint to say this person is a terrorist or we suspect him ti be so for this reason. oerty w, need not be so frightened we give up our liberty for security. some would say over governments don't have to worry about it. wd .ou're not worried about goodvet

cevernment, you're worried aboun bad government. men were jefferson said once upon a time if all men were angels we wouldr have no concern for having t there institutional restraint.ory and but there have been times in our history and in the history of other countries where unsavory characters have won the elections. in when hitler was first elected in the 1920's and early 1930's he was elected popularly. but the thing is they were so mad and upset over world war i that they basically treated.lea they said we want a strong bu the t leader. is, give us a strong leader. but the thing is if you have er to rules that allow that leader t grab up and do things that is your danger. you're in danger is that a now, minimum now, your danger is that a great deal of a great danger to us if we allow this to go ono ifti we get a despotic governmet at some point in time. gorge not worried about good people in government, you're worried about people who might

be elected who use these powersh look what happened during certain administrations where rr people get the irs records of e. enemies. look at what is happening nowokr where the executive branch is looking at the donor's records. for those who do business withdz government. you are a contractor and do business with government want to know who you donate to.ant there are dangers to allowing wt the government to sit through your records. it doesn't mean we want to stop crime, we don't want to stop terrorism. it means we need to have the rule of law, and that we need to pay attention to the role of law. amements. we proposed several amendments.o one of the month through the judiciary committee and was deliberate on and was amended s support what we won't get a vote on it. you know, it disappoints me tha- they are afraid to debate this on t the floor and we will get o vote on amendments that were offered seriously to try to

reform the patriot act to take away some of the abuses of its. we offered three amendments to the patriot act. one was on the gun records and n thatge apparently unhinged peopy who were afraid of voting on any ghana issues, and because of that we are all going to be d denied any debate and votes and some will say you're going to te keep your colleagues here until one in the morning i think when they are here tonight at one in mayb the morning maybe they will think a little bit about whyhink they are here and why we have ny debate and why we had power to e sve the debate at any point ine time we can have a vote on the o patriot act in an hour or two hours, we could have had a vote on the patriot act yesterday that that's what the american people demand and this body demands opn that there be open and the one of our other amendments to r do with destroying records. some of these records the take

from you through the banks despite an on you or theand government study on you. they are not destroyed and i think these records should be a. some point in time for goodness sakes why are they keeping thes? records?t to b there ought to be rules on thef destruction of the records if you're not a terrorist and they aren't going to prosecute you. you should name the place andwee the person. we have one of wiretap called the john doe and they don't name the place for the person. they are not required to. s there are times it might be terrorist who say we don't want to name the person. to sa we public. we can name them to the fisa tte commission. fis i do not objecta to them being named and the name being redacted but it should bename sr presented to the judge who's making the decision, and i wante a judge to make a decision. james otis, part of ourre revolution for the 20 years leading up to the americanbout revolution was a debate aboutssw

warrants.eralle the issue what were called writs of the system there also called general warrants, they were not specific, they didn't tell you what crimes were accused of ande the soldiers came into yours house is the but lodge soldiersd and our houses and enter intotht our houses without a warrant. we pas the fourth amendment was a big deal. we passed the fourth amendmentre and was one of the primary grievances of our founding fathers. i don't think we should give upd so easily.e i don't feel we should be told d by fear and so fearful of the attack the week of our do liberties. if we do we become no different than the rest of the countries that have no liberties the liberties are what makether essentially different from othet countries. the the fact that we protect the ell, g even of those accused of a crime people say a murder wil. get a try.y' yes, they will get a trialal murderer until we convict them. we want procedural restraint an,

people say you get procedural restraints from terrorists and the very least that a judge haso to get permission before we getn records. we're the main reason is because we are not asking for ten records r or 20 records or 40 records of . people connected to terrorism. we are asking for millions of records. there are people in this room today who have had their recordo looked at. it's difficult to find outappens because what happened, and thisy is -- here's the real rub and here's how fearful they were. when the act was passed shortly after 9/11 they were so fearfuly that they said if a letter of s, demand national security letter askeerd for records you're not,e allowed to tell your attorney.r. you are gagged if you told yourt attorney they could put you in jail for five years.it i it's still a crime. punishable by five years in jaie if i have an internet service and they want my record on

somebody they don't tell me or a there's no probable cause this person might be relevant which could mean anything however can be the tangential if i don't reveal those i go to jail. re the secrecy on millions ofns ofs records trolling for millions of records is an american.odif it's unconstitutional. they modified the constitution through statutory law.- this body should be two-thirdsvg of the body voting to change the constitution and three-fourths and we did it by 50% with onehen bill. cam the bill was hot when it came cp down. there was one copy of it. no one read it.ead the we must read the bills i propose dingeat one day for every 20ea pages so we are in short of

it was hundreds of pages long and nobody read it. not one person read it. because they were not hardly printed. penci they were penciled in the margir and was passed because we werebt afraid. of our liberties.e i think it's more important than that. s doday i think it is a sad day to day d in america.thatreat const the great constitutional questions like this or greatot w constitutional questions like whether or not we can go to thee war with just the word of thense president is a great debat constitutional question are not being debated because we are so fearful of debate. i urge the senate to reconsider, i urge the senate to consider ao debating the patriot act to consider amendments and theha ob constitution think you and i yield that. the united states is at staketom and the junior senator from kentucky is complaining he's not

been able to offer amendments. they work long faith getting the agreement to consider amendments i offer a solution that is more than fear. i propose a consent agreement would have brought before the senate six amendments, more than half of which specifically wrn written by the senate from kentucky. unfortunately, in order to the political grandstanding hereject rejected that offer. the it is unfortunate because the haseriou inability to reach the agreement has serious consequences. tomor, at midnight tomorrow, the th the senator from kentucky stops standing in the way our lawour e enforcement will no longer able to use the most critical tools they need to counter terroristst and combater terrorism. these if they cannot use these tools, tools to identify and track

terrorist suspects it could have dire consequences for national security.trikes when the clock strikes midnight tomorrow we would be giving be terrorists the opportunity toen plot against the countrypl undetected. our the last several years the government has stopped dozens of would-be terrorists before theyh could strike. now the senator from kentucky io threatening to take away thehave tools when we offer stopping them. does this mean the act is perfect? of course not to a.he but today we received a letter a from james clapper of a a three-star retired general fromr the united states military, of cenetian stricter of nationalinn intelligen.ce. he knows better than any of us the effect of letting terrorists fight the tools expire. in his letter he wrote about ouf ability to conduct surveillance on the foreignhe radicals.d othr and other classified programs.ld the patriot act if we let it tim expire.

this particularly is about time to shut down electronicgrams. surveillance programs. r as hepas been widely reported in the press, we recovered thousands of documents, photos, videos and other material from osama bin laden's compound. com this material is often dozens os investigations and leads to newc terrorist suspects and terroris. activities directed towards thet united states of america.nd it continues to yield more and more information every day.refuo the senator from kentucky refuses the government will bety knable to fully pursue these ris leads. of that would increase the risk of the votel lottery terrorist the strike against the homeland and hamper the ability to deal with a tricky feat truly fatal blow to al qaeda. i repeat, director clapper, a retired three-star general asked us not to allow enrollment, interruption in the intelligencc community's ability to protect the american people. some might be asking why then,h?

why is the senator holding out?m what is keeping him from accepting the agreement to moveh forward? one that as i explained i think is more than fair to him and to the senate.uple a couple of strong democratictsd amendments and his amendments.r the reason he's fighting for an rit not amendment to protect the right o not of average citizens but of terrorists to cover up their purchases. it's all dealing with the gun heendment mr. president. t we all remember the tragic fort hood shootings list finton years ago. a radicalized american terrorist bought guns from a texas gone t story and used them to tell 13 innocent soldiers and civilians. it's hard to imagine why themage senator from kentucky would wand to hold the patriot act fort tt misguided amendment that would make america less safe. he also complains the senate hasn't had a week of debate.

the pr we would like to have debate on. this issue.have a the presiding officer would be read a lot of debate on other thingsid mr. president.hat led the presiding officer is one of the senators that lead in theake effort earlier in this session to make sure that we have more robust debate. progres we need a little progress but not enough.colaining t but the senator from kentucky complaining that we haven't had a week of debate better come up. orth something better than thatf here's why. this matter has been before the senate for one week now. i move to precede the patriot act last thursday.as o ftoday is wednesday. as of today the senate has been working towards passing this s measure for six or seven days.n there is no question that the t senators have the opportunity to ha debate the only question has been how the senators have chosen to use these last days. the bottom line is that no to matter how longge it takes to g, there we are going to have thisl vote and of the vote will win.ie

we will pass the patriot act an. do everything we can to keep thn american people safe. it's up to the senator froml kentucky whether those nationala security programs will expire before we get a chance to vote. the expiration date is extremelg important, and if he thinks that's going to be a badge of fw courage on his side to help thia mistake.his program it will set this program backt'o significantly and that's too tie bad.is in the clock is ticking and the ball is in his court. >> in response to an accusation i've been accused of wanting to allow terrorists to have weapons to attack america. a to be attacked of such a belief when i'm here to discuss and pat debate the constitutionality of the patriot act is offensive, i. find it personally insulting, and i think it demeans the bodye it demeans the senate body and

the people that we cannot have om intelligent debate over the s constitutionality of this. i am somehow to be told that because i believe a judge should sign a warrant that i'm in favor of terrorists having weapons?ult if one argues judges should sign warrants before they go into the house of an alleged murder are you in favor of a murder? can we not have a debate on aotd higher plane? debate over whether or not there should be some constitutional protections, somo constitutional procedures? fav but to come to the floor to accuse me of being in favor oftt getting weapons to terrorists? the question is can our constitution with stand, is our constitution strong enough that- we could actually captureies ate terrorism, captured terrorists and protect our liberties at thm same time, should we have some u

rules that say before they comer into your house, before they go into your banking records that a judge should be asked for permission.? judicial review. do we want a lawless land? do we want a land that is so rtt much without restraint, a government without restraint pot that at any point in time they r can come into your house? we were very worried about that. sat is why our country wasd ons founded on principles such as the fourth amendment to protecto from anve overzealous governmene but to transform an argument where good people might disagree to an accusation that i would letel terrorists have weapons na i believe we would stop terrorism but to bid in constitutional fashion where you would have a warrant issued by e judge. we don't have enough time to do at:00 that. morng, at three in the morning judges i are routinely called when acc of someone is accused of rape, wheo someone is accused of murder,

when there's an alleged crimes and how we get warrants and it'c worked for 225 years until we t decide to throw out the bec constitution. we threw up the constitution with a patriot act because in whicyh change the constitution and not by two-thirds of this body voting for it and not by three-fourths of the state buthr by a scared 51% who threw up sa. their liberties they sit make me say if i want to be safe.e i am afraid, make me say that up they gave up their liberties.hod i think it was a mistake and we hauld ve an intelligent and rational discussion over this but i don't think it furthers the debate to accuse someone whw has constitutional concern aboue the way we are t doing things to accuse them of being in favor of putting hands, weapons into the hands of terrorists i object strongly to this. the leaders said they would i compromise, one week of debate in february and open amendmentss

they would be open to amendments, even the amendments they disagree with. bil do whatever people feel isea appropriate onn this bill. ohis doesn't mean just amend t in-store not emotional or that save nothing to do with guns. on they are petrified to vote on issues of guns because they know a lot of people in america'snd w favor the second amendment and own handguns and want to protect it in the right to own handguns and have the record not siftedgt the government would eventuallye allow for direction of theuns. police towards those who own't o guns said. we don't want our records to the public. we don't want them to be sifted through by the government without judicial review. the ame they don't want to vote on thisi because they know the american q peopleue agree with us and if yu pull the question he would fight 80 to 90% of americans don'their want their banking records, be sifted through by a

government without a judge ever getting any approval of this. this is a constitutional question and i would ask the leader to stand by his agreement to an open amendment process, ak and so at this time i will askts unanimous consent that my amendment, number 363, 365 andni hour of debate on each be that followed by a rollcall vote and i ask unanimous consent this occur at this time. >> a procedural vote on extending certain expiring provisions of the patriot act is scheduled for tomorrow morning.

malae hearing none prescription drug abuse including testimony from the white house and the drug enforcement administration. in april the administration released plan to address prescription drug abuse in putting new federal requirements to educate the medical community about pain management. this is an hour-and-a-half.

>> the hearing will come to a topic that is important to the health and safety of our kids and our families and communities and that is responding to the prescription drug epidemic strategy for reducing abuse, misuse, diversion and fraud. used properly under a physician's direction, pain relievers and other prescription drugs bring much needed comfort to americans. but their abuse poses a serious growing threat to our communities and young people. in the 2,009 approximately 7 million americans reported misuse and prescription drugs. the problem is particularly acute among teenagers, prescription drugs are the second most abused category of drugs of the nation's young people and of the top ten and used substances among high

school seniors are prescription drugs. prescription drug abuse is extremely dangerous. over the last five years emergency room visits involving improper use of pharmaceuticals more than doubled. too often the consequences were deadly. according to the cdc, drug-related poisonings are now the leading cause of death due to unintentional injuries in my home state of rhode island and in 16 other states. greater even than motor vehicle accidents. diversion and abuse of drugs can also impose significant financial costs of our health care system through emergency room visits and treatment of medical complications. we take to that higher private insurance premiums and higher medicare and other public health costs. the ever-growing epidemic of prescription drug abuse demand sustained attention from law enforcement, health care professionals and converse and post-religious to those faced from other illegal drugs.

as with illegal drugs for instance, large scale, criminal networks have developed for the diversion and distribution of prescription drugs there are unique challenges and the prescription drug context. the can be readily available in our homes given ec and the direct access to approximately 70% of people aged 12 or older had used prescription pain relievers on medically in 2,009 got them from a friend or relative. furthermore education about the threat of prescription drugs is more difficult because the illegal drugs have an important medical purpose. they are prescribed by physicians and come from pharmacies. teens are too often unaware of the dangers of misuse and abuse. the special characteristics of prescription drugs demand a multi pronged strategy for reducing wrongful use. the strategy should include educating prescribe terse and

patience about responsible use of the drugs recognizing signs of abuse, providing appropriate treatment and interventions and deploying appropriate law enforcement resources. electronic information sharing systems such as prescription drug monitoring programs authorized in 43 states are promising tools for identifying health mills and doctor shoppers. i was pleased to the legislation passed last year allowing the government to perform sophisticated analysis of medicare data in order to avoid paying fraudulent claims and to give law enforcement tools for investigating criminal fraud. there are analogous ways to strengthen prescription monitoring programs so that they have more complete prescription data, use advanced analysis to identify the diversion or abuse and better allow the peacekeepers, law enforcement and others to address these problems. the prescribing can also play a valuable role, limiting diversion, fraud and medical mistakes for forgery and error.

i am pleased rhode island is a national leader in the eprescribing. we can combine the advantages of the prescribing and of prescription monitoring programs to help the physicians recognize early patterns of abuse. today's hearing seeks to advance the goals. i welcome the witness from the office of drug control policy and drug enforcement agency as well as from brandeis university and my home state of rhode island. i congratulate the obama administration on the release of the proposal for responding to americas prescription drug abuse prices. i look forward to working with the of penetration. the chairman leahy, ranking member kyl and other senators from both sides of the aisle on legislation to protect against prescription drug abuse. i saw senator carol this morning and he indicated he may not be able to attend the hearing today and his schedule has been able but tumultuous, and if he can of course, i will recognize him, but if he does not have been instructed to proceed.

i have senator sherrod brown of ohio here to kick off the hearing and senator brown has taken a keen interest in this issue and we look forward to his statement. thank you, senator brown. .. in 2000 a statistic showed that oxycodone and percocet and other prescription drugs cause more overdoses in ohio that year then heroin and cocaine combined. prescription pain medications

which is oxycontin are largely responsible for increasing overdoses and deaths and my stay. simply put pressure action drug abuse is the fastest growing, chairman said fastest growing drug problem in the nation. almost everyday in ohio there's a reported story of a child lost in prescription drug abuse or of neighborhoods harboring its illicit trade. in southeast ohio, the most rural part of the state it is particularly tragic old factory towns,. [roll call] communities have become havens for prescription drug abuse. the stories of course not limited to ohio and rhode island that across the country communities are struggling to find ways to develop strategies to reduce the diversion and abuse of prescription drugs. last year i convened the first of its kind roundtable in southern ohio with federal and local law enforcement, community activists and elected officials, drug treatment leaders and members from the medical community. they raised a concern with criminal manipulation of ohio's

medicaid program which spends upwards of $820 million in prescription medicines. most prescription pain medicines are used as prescribed as the chairman pointed out they are valuable. some criminals defraud the medicaid system and place ohioan taxpayers by requiring multiple perceptions and filling them at multiple pharmacies. a case of criminals defrauding taxpayers in the medicaid system to sell and divert prescription drugs becomes a one-two punch in the stomach to the system. that is why last month introduced the stop trafficking of pills act which was established a medicaid lock-in program for ohio and nationwide to crack down on the use of medicaid cards substate obtain and resell prescription drugs. the bill would prevent prescription drug abusers from acquiring excess prescription drugs which they may abuse or illegally resell. by barring them from visiting multiple doctors and pharmacies. nearly 20 states already have something similar to the medicaid lock-in program. south carolina's medicaid pilot program targeted high use

beneficiaries then subverted for 3% decrease in the total number of prescribed prescription pain medications. consider side of the county on the ohio river in southern ohio. and the rivertown prescription drugs cause nine of every 10 fatal drug overdoses. nearly two-thirds of these cases the individuals involved did not have prescriptions themselves come indicating of course they obtained all likelihood obtained the drugs illegally. an investigation by the gao which audited the medicaid program in the five largest states found 65,000 cases in which medicaid beneficiaries visited six or more doctors and up to 46 different pharmacies to acquire these prescriptions. this same report found approximately 800 prescription written for patients and 1200 prescriptions written by dead physicians. under the medicaid lock-in program states that if i high-risk richardson users those receiving sets of amounts of prescription drugs and those

convicted of a drug-related offense. these high-risk prescription drug users would be placed in the program and designed one assigned one physician and one pharmacy. it would mean more than -- nomar doctor shopping. to the states would identify prescription drugs dispensed under medicaid and that present a high risk of over utilization. legislation requires the government to set up a similar lock-in program for medicare or the abuse is not as high in prescription drug abuse in ohio and our nation needs to be treated like the epidemic it is. chairman whitehouse has been a leader in this issue urging the dda to implement electronic prescribing for controlled substances calling for stronger prescription drug monitoring systems. today's witnesses will describe the administration comprehensive prescription drug strategy in ways at fda can't crack can crack down on the abuse and community activist will describe the victims and families who they represent offering the stories behind the statistics and policies being discussed. for the policies and the stories it is clear prescription drug abuse knows no party lines. is clear is an issue of life or

death into many parts of our nation especially in at least in my state especially in rural areas which have experienced terrible job loss and economic hardship for hundreds of thousands of families. i will stop there. i thank the chairman for allowing this testimony. >> senator brown i appreciate very much or energy in your leadership on this issue both here and in washington and your her home state of ohio. ohioan and rhode island have a lot in common on this issue and i look forward to continuing to work with you as you go for it. i particularly appreciate his busier city are scheduled as he took the time out this morning to come to this committee in which you are not a member to make sure that your voice was heard here, and i am very grateful to you for that. i know your schedule commands you to be elsewhere so thank you or image for taking the trouble. and now, i will ask our first panel, the honorable gil

kerlikowske in the honorable michelle leonhart to come forward and let me ask you to stand. ti-hua from the testimony you are about to get there for the committee will be the truth, the whole truth and nothing but the truth? please be seated. thank you for being here. it is an impressive turnout. turnout. for those of you who did not know our witnesses, gil kerlikowske is the director of the white house office of national drug control policy. director kerlikowske served as the chief of police for seattle washington, was deputy director for the u.s. department of justice office of community oriented policing services, was police commissioner of buffalo new york and served in the st. petersburg florida police department. he has been elected twice to be president of the major cities chiefs and he has received numerous awards and recognition

for leadership, innovation and community service. he is joined by michelle leonhart who was administrator of the drug enforcement administration. confirmed in december of 2010, she had been the acting administrator since 2007 and deputy administrator since 2004. as a career dea special agent, ms. leonhart held several key positions as you move through the ranks of dea including assistant special agent in charge of the los angeles division. she's received numerous awards including the rank of distinguished executive in 2004 and a presidential rank award for meritorious service in 2005 and 2000 it is our privilege to have these two witnesses here and while they go across the table and we will start with mr. kerlikowske. please proceed with your statement. >> mr. chairman whitehouse, thank you for the opportunity to address the important issues prescription drug abuse and i'm very grateful for the

committee's attention to this topic. prescription drug abuse has been a major focus at omb pc since my confirmation and i've directed the national drug control program agencies to address this epidemic in our country. i have the responsibility to raise public awareness and coordinate federal activities and take action on drug issues that affect our nation. the efforts that we have taken are balanced and they incorporate the research and evidence-based approaches to address drug use and its consequences. prescription drug use -- abuses the fasted growing to problem in the united states. it is categorized as a public health epidemic by the centers for disease control and prevention. the number of individuals who for the first time consumed prescription drugs for a nonmedical purpose was similar to the number of first-time marijuana users. we have also seen a fourfold increase in addiction treatment at missions or individuals primarily abusing prescription painkillers from 1997 to 2007.

even more alarming is the fact that about 28,000 americans have died from unintentional drug overdoses in 2007, and prescription drugs particularly the opioid painkillers are considered major contributors to the total number of drug deaths. we believe there are two unique reasons for the growth in prescription drug abuse, the easy accessibility to the drugs and a diminished perception of risk. a comprehensive approach is required to address this epidemic. it is important to balance prevention, education and enforcement with a need for legitimate access to controlled substances. the administration has created an inclusive prescription drug abuse prevention plan that rings together federal state local and tribal groups to reduce prescription drug diversion and abuse. the plan expands upon the administration's national drug control strategy and has four major areas. the first is education,

mandatory for scriber education as well as patient and parent education. 69% of narcotic analgesics are distributed in primary care offices and emergency departments. in addition we want to make sure that patients and parents are fully aware of the dangers and the prevalence of prescription drug abuse and that they are educated about the safe use improper storage and disposal of these medications. the fda has implementing a risk evaluation and mitigation strategy plan that requires manufacturers of long will acting and extended release opioids to ensure that training is provided to prescribers. the second part of our plan includes that each state have a prescription drug monitoring program and senator brown mentioned the importance of those. i know you have another witness that we -- will be talking about those but we are strongly supportive of those and they have interoperability and that they be used by all of the

prescribers. we have also made significant investments in health information to knowledge and continue to work with hhs particularly on health information exchanges. opportunities include identifying ways to incorporate real-time pdf t. data. the third part of the plan calls for medicaid, proper medication disposal and unused medications that fit in our medicine cabinets are falling into the wrong hands. by creating a method for proper disposal of expired or unused prescription drugs we will benefit public health, public safety and the environment. in the passage of the secure and responsible drug disposal act in the 2010 was an important step forward in our efforts to make prescription drug disposal more accessible to individuals and to reduce the supply of drugs available. a drug disposal program has to be easily accessible to the public, environmentally friendly, cost effective and the cost burden should not be placed

on consumers. the last part of the plan is smart law-enforcement. you have the experts sitting to my left to talk about that but our main effort will be as they have already done with the dea comprehensive work on pill mills to address the issue of doctors who over prescribed and of course pdmp's help with doctor shopping. our office supports the high intensity drug trafficking areas and we want to make sure that local law enforcement with the cooperation of dea has the support that they need to understand these complex investigations and do a better job of wringing drug dealers to justice. in closing i want to thank all of my colleagues and the executive branch, particularly. we could not be effective in any of these areas without the support of congress. >> thank you director kerlikowske. director leonhart.

>> chairman whitehouse, senator klobuchar thank you for the opportunity to discuss the growing epidemic of prescription drug abuse and the critical role of the drug enforcement administration in the enforcement of our nation's drug laws and regulations. the diversion and abuse of pharmaceutical controlled substances is a significant and growing problem in the united states. every leading indicator shows an increase over relatively short periods of time in the use and abuse of these drugs. pain clinics have emerged as a major source of controlled substance or lawn -- non-legitimate medical purposes. dea and federal state and local law enforcement agencies have developed great working relationship sang continuously coordinate efforts to combat this emerging threat. federal administrative and criminal actions began controlled substance privileges as rare. however, such actions are warranted when a physician is issuing controlled substance

prescriptions or an illegitimate purpose and operating outside the usual course of professional practice. as administrator, it may prescription drug abuse a top irony. i am especially alarmed as another can and should bidding factor to the increase of prescription drug abuse is the availability of these drugs in the household. in many cases, prescription drugs remain in household medicine cabinets well after medication therapies have been completed. thus providing easy access to nonmedical users for abuse, accidental ingestion or illegal distribution for-profit. in the 2010 partnership attitude tracking study which we call path, noted that 51% of those surveyed believe that most teens get prescription drugs from their own families medicine cabinets. dea manages a robust regulatory program aimed at preventing and curbing diversion of of the wafer manufacturing levels to the dispensing of these

medications to patients. in working with congress dea also obtain new authority last year to regulate the disposal of unused medications by ultimate users. thereby getting unused medications out of the household's medicine cabinets in a lawful manner. dea is working diligently to promulgate disposal regulations. in the interim d.a. launched a nationwide take back initiative in september of last year and again in april of this year, resulting in the combined collection of 309 tons of unwanted or expired medications. dea will continue to hold periodic takeback events until regulations are in place. dea's obligation under the law into the public is to ensure that pharmaceutical controlled substances are prescribed and dispensed only for legitimate medical purposes in accordance with the controlled substances act. by carrying out this obligation,

dea strives to minimize the diversion of pharmaceutical controlled substances for abuse while ensuring that such medications are fully available to patients in accordance with the sound medical judgment of their doctors. in this manner, dea is committed to balancing the need for a diversion control and enforcement with the need for legitimate access to these drugs. dea closely monitors the closed system to recordkeeping requirements and mandatory reporting at all levels of the supply chain. due to enhancements to our regulatory resources, controlled substance manufacturers, distributors, importers, exporters, narcotic treatment programs are receiving more inspections and audits than ever before. a key component to our enhanced investigative resources are tactical diversion squad's. these unique groups combined the skills of special agents,

diversion investigators and task force officers. these tbs groups as we call them are dedicated solely towards investigating, disrupting and dismantling those individuals or organizations involved in diversion schemes and as of today, dea has 37 operational tbs groups. dea plans to add 27 more over the next few years. one example that the effectiveness of these tactical dispersions quads is operation pill nation, which has targeted world pain clinics in south florida since february of 2010 and culminated in a series of major takedowns this past vittori. this lead to 32 arrests including 12 doctors and fight pain clinic owners and dea also immediately suspended 63 dea registration numbers and issued orders to show cause on six

registrations which resulted in the surrender of 29 dea registration numbers. this caused a ripple effect throughout south florida. it resulted in 50 for more registration numbers being surrendered. dea recognizes that it cannot solve this problem alone and dea is working with our federal, state and local and private sector partners as a part of this administration's comprehensive approach to combating prescription drug abuse. many states also have effective prescription drug monitoring programs which are deemed to be a valuable tool in curbing diversion. the administration supports establishment of these programs in every state. pdmp cut down on prescription fraud and doctor shopping by giving physicians and pharmacists more complete information about a patient's prescription for controlled substances. in closing, prescription drug abuse is a dangerous threat and dea is determined to be a part of the solution.

with your support and that of our partners, i know we will continue to make a positive difference in the lives of millions of americans and communities across the nation. so i thank you for the opportunity to appear here today and i look forward to answering your questions. >> thank you director leonhart. chairman leahy could not be here today but he has offered a statement for the record, reflecting among other things observations we got, director kerlikowske and die with the chairman at the hearing that he held up in vermont last year with all of us together. and without objection i will add that to the record of this hearing. i have a couple of questions. i think i will probably pass on the drug disposal questions

because we are joined by senator klobuchar who is the author of the secure and responsible drug disposal at the 2010 that was mentioned in the testimony. but i do want to mention on that that i was in rhode island the other day at the narcan said they book length treatment facility and they are actually seeing effects from pharmaceuticals that are discarded down the drain out in the environment as they come through the treatment system and go out come in that case, into the river and on down to the bay. so, it is not a solution necessarily to have people dispose of those by throwing them down the drain. we really have to improve on that and i suspect she will urge you to move those regulations with some degree of dispatch.

as you know we have had a long battle over a fee e-prescribing regulations. i think that has been three years from when we have the first hearing and your predecessors at dea sat next to people from hhs and had completely different views of the world in the same administration. and i gather that has all been worked through but if you could bring me up to date on where we are under the interim final rule in terms of actual deployment and the ability to certify contractors and actually have e-prescribing take place in the field. i'm assuming that you view e-prescribing as an investigative and awareness asset in the drug diversion problem and in that frame i would like to know where we

stand. >> yes chairman, we do view it be prescribing is an important tool, a tool for law enforcement actually. we have worked very hard, especially since last march when i signed the interim rules which went into effect almost a year ago, june 1 will be a year. we have been in contact with the people that are putting together the systems. they are moving forward and we understand the first one may be ready this summer for audit, and then come on line and be available by the end of the year. we have looked at a number of the comments that came in. at the interim rule is in effect now. we believe the final rule will be ready to go early next year and there should be no reason that people should not be moving forward to implement

e-prescribing, which will help in many ways to include the diversion problem of prescription drugs as well as help with fraud and enhance health for patients. >> is there actually be prescribing of controlled pharmaceuticals under the interim final rule happening now, or are people still waiting for the contractors to be certified so that it can actually happen? it is one thing to have the rope in operation and another thing to have something actually happening in the real world and i'm not sure this is actually what the world world. can you give me the status as far as the actual flow of data across it be prescribing networks of controlled pharmaceuticals? >> it hasn't hit the real world yet, but the systems are being put in place. they first need to be audited. we understand one has announced

called doctor first. it is announced its dea compliant and is ready to move forward, and i believe it is in the auditing stages now and has identified over 150 different customers, and that will be the first one that we have heard of that will come on line probably by the end of of the your. >> i'm not going to remember the exact numbers that senator brown used, but he described individuals who had multiple prescriptions from multiple.ers and were using multiple pharmacies. that is the type of thing that the system can flag so that it doesn't happen, correct? >> that is correct. that with this restriction drug monitoring programs we will be able to identify people that are doctor shopping is you just

explain. >> i will now recognize dr. klobuchar. >> thank you. you remember that name better than i do so that is pretty good. thank you to both of our witnesses. director kerlikowske and i were together back when he was police chief and i was county attorney and then of course this winter we work together as well. you are from minnesota so you can do no harm as far as i'm concerned. i wanted to go through with senator -- as senator whitehouse mentioned we pass into law the disposal lacks something that senator korn and i authored and got it through the house and thank you for your help in doing that director kerlikowske. i wanted to find out the status of the rules acknowledged that prescription drugs are the number two-way that kids can get addicted to drugs, sitting around, the drug sitting around in their parents medicine cabinets. this allows pharmacies to take back programs more than just

police departments, clarify the details and also for long-term care facilities which it turns out where flushing a lot of these pills down the as they didn't know what they could do legally. and i know that the regulations were included as part of the plan release. this white house. can you give us an update on the drafting of the regulations and what are some of the key issues you will be looking out and what you think the timetable will be? >> senator since it is in the design of the rulemaking and the white house is not influencing the rulemaking, i would differ and asked that maybe the administrator leonhart answer that question. >> very good, thank you. >> senator want to thank you for your support. i'm not sure that bill would have passed without your fine support and the support of your colleagues. it is very important to us. i'm pleased to say that we are on track, and hope to have a final rule by the end of the

year or early next year. in the meantime, we have held their second take back just last month, which was even more successful than the first take back in september. we held a hearing open form hearing in january and had over 100 witnesses provide comments and submit comments that were looking at very closely, and the good news is we are on track to have a final rule. hopefully by the end of the year or january or february of next year. >> very good and are you working with various stakeholders on the rules and getting input? >> absolutely. the public forum has stakeholders from all entities and we have a wide range of recommendations and suggestions from them and all options are on

the table to come up with the best final rule we can get that allows for that, safe and regular disposal. >> very good because i think we know the take-back programs are great and they are becoming more and more popular but to have something that would be commonplace in pharmacies would be the best and certainly helping all of these long-term care facilities would be good as well. at a different kind of question and it is about the synthetic drugs including synthetic hallucinogens. as you know these drugs are not prescription medications but i think it is clear that the abuse of these illegal drugs and prescription drugs are closely related and i have that bill, senator grassley and schumer have one on certain types of synthetics and i have one, something that actually killed a young man in minnesota and almost killed a number of others at a party. i just wondered if you you were aware of this problem, either of

you and if we have your support in moving forward on this legislation? .. know that in minnesota as well as the other states where these synthetics have shown up. we are working with state and local law enforcement providing

technical assistance training to do whatever we can to put a stop to that. >> estimate will the process is going on, the legislative process we use the bully pulpit of the white house to be able to bring to a lot of people's attention the problems of the things such as that salt, synthetic drugs etc. so that has been helpful and alerting people of the problem. thank you. >> along the line of the tools for all of you to use, and is that the administration plan prescription drugs make reference to the role of congress and if you could touch further on the role of congress, can you talk about the potential

need for further legislation in the area of illegal prescription drugs? >> senator, we think one of the most important parts of the comprehensive prescription drug plan will be a mandatory prescribed education. what we developed president obama national drug control strategy the direction was to make sure that the voices of people across the country were heard, and we did that and included discussions are not prescription drugs and information. the actual prescription drug plan is more comprehensive, more specific and we developed it very much in the same way by listening to people all over the country particularly a number of prescribing physicians with the they were in the emergency departments or a number of other locations for instance pay management or primary care and overwhelming the information provided to me by them is additional and information and education about addiction about

the defendants, about the prescribing premeditation's was important and vitally needed to him over well lately they have told me that it should be mandatory or voluntary education is certainly something that people appreciate and i know that these are physicians who are very overworked, mandatory prescribing education is in my opinion a very important. >> thank you very much mr. chairman. >> and now we will turn to the distinguished senator from connecticut who as the attorney general in connecticut make him aware of his issues. thank you. >> senator whitehouse thank you for holding this hearing and especially for being attuned to this very, very difficult and profoundly important topic and i think you for -- thank you both for your great work on this

issue. i want to thank you also for the recommendation of the white house office of national drug control policy and its plan to combat prescription drug abuse to recommend that the secretary of veterans affairs share patient information on controlled substance prescriptions with state prescription drug monitoring programs, which i think is very important as you know the va also supports this request, and i will be introducing legislation within the coming days as a part of the comprehensive program on veterans' issues to support providing that tool in the toolbox so to speak. so i wonder if you or ms. director leonhart could

share with us and put on record your view as to why the recommendation is important. >> senator, thank you very much. i could not have a stronger partner than general shinseki in the va on this issue. i don't think there is anyone in this country that is not supportive of our active duty military and returning veterans and how they can be helped, but we also know that cells that occasion, the use of prescription drugs in the active-duty military has been well-documented, and also returning veterans is a significant problem. it's a primm problem for combat and force readiness and for local jurisdictions particularly jurisdictions where the national guard returns and there may not be as large a military base or presence. a prescription drug monitoring programs that are now in almost every state and not all of them active although we are working

to help them to become more robust, our only as effective as how they are used and if you can go into a va hospital prescription drugs and then go down the street to a private physician and the two systems do not talk to each other that's dangerous for the patient and what's the physicians in a difficult position because they don't know about what prescriptions are being offered to that patient by a different position and in a different facility. so the support of the va and the department of defense on that issue so that one system can clarify and talk to each other is good for our veterans and active duty military and it is clearly a patient safety issue and i think you for that support. >> would you have anything to add? >> i would add that it's a very serious problem. 5.3 million americans are of

using painkillers and among the 5.3 million our veterans, especially returning veterans. and the leadership of the director bringing the va to the table has been significant and i think will in the end benefits of our efforts especially those that will most affect that trend. thank you for your interest in that topic. >> it almost enables or encourages doctor shopping and abuse to have these two separate systems that are completely on linked and simply don't communicate with each other. how well are the state systems working, and do you know why the variation in the effectiveness if he would give a general assessment. >> there are a number of people that have looked at these. the cdc just released a report

although the data that the used was a bit dated. i've examined them and looked at them. there are some states particularly what is called the kasper system in kentucky which is very forward leaning in this area but there are several problems, and we address those in the prescription drug plan. one is they should be interoperable each other. during the trip to eastern kentucky and also west virginia we learned that doctors would have to access multiple systems and those in west virginia and kentucky when it came to checking on patients and making sure that they were not over prescribing for patients who were seen in fact other physicians. so the interoperable these key. the fact that it should be easy, that the information should be readily accessible and should be in as close to real time as possible are all important

efforts so this is a great first step. all the states including the state of florida passing that legislation moving forward now making them robust and you stand interoperable and all components of the prescription drug plan. >> i would add that we have seen some promising information coming from the states that actually share that information with law enforcement should show there are lower death rates in states that are sharing with law enforcement specifically of california, texas and new york, so it's a promising tool from a good to see that soon there are only two states that will be without with legislation pending not >> thank you both for your work in this area. >> just to follow a one senator blumenthal's question, have you

been alerted to any federal legislative changes to support the state initiatives in prescription drug monitoring. as i understand medicare and medicaid billing information for instance access to that for purposes of identifying prescription drug abuse and diversion is being accomplished primarily at the state level. are they running into common problems we should attend to or is the state based process is successful one in terms of something that can go forward and make progress on its own without further federal legislation. >> senator, we widely discussed the different hearings in the different business we have had around the country the issue of a national bmp. a couple things came into play. one, the experts that have developed the systems say they would be very difficult to implement because for instance just the difficulty of personal

identification when it comes to common names across an entire nation and an entire database the would be a problem. secondly, that the state's design these and operates been used themselves they could put into place the patient privacy the confidentiality guidelines that they would like and also who has access to it. there are a number of best practices and its the evaluation continues on. i'm pretty hopeful that the individual states by working together and the next witness is another subject matter expert in this can be very helpful. but right now i'm quite satisfied with what i'm seeing that the state level. >> do you agree? >> i do every. i do believe that congress could help. however, in the area of interoperable the, and of course funding is an issue for the states moving forward with visa

systems. >> thank you both very much. this has been -- >> to have any further questions, senator blumenthal? if you would like another round by just -- >> i have -- i wanted to follow-up on senator whitehouse's question about encouraging the effectiveness of the drug monitoring programs and i know that there is some reluctance to make it more national and impose the kind of national requirements. but i wonder where you see the resistance to increasing the interoperable, which i think is key as it is in so many criminal justice information programs. the failure to link the state systems is a major barrier. so i'm wondering either now or

if you want to think further about it and respond in writing or have a conversation about it i would be interested in following up on that issue. >> i know that the state of ohio and the state of kentucky signed and interoperable agreement to begin sharing information. i think that shows some fat-free to promise and i would be happy to follow-up on that question. >> thank you. >> let me thank the witnesses and reference back to a statement that director kerlikowske made about his goal as the bully pulpit as the white house of some of these issues is the role we encourage. and it might be a bit of a bully pulpit with in the white house with our friends at the office of management and budget on these relevant rule making proceeds. it has been astounding to me as a newly elected senator to see

the pace at which federal rulemaking slugs forward while the agencies themselves are not always of salt of responsibility and does seem that there is a common thread seems to bog down at the omb and if there's anything you can do to move some of these along and get the omb to expedite to the extent they can i think would be helpful to i can't tell how long it took to get through the control pharmaceutical prescribing situation in that close and. what everyone on board for the direction it should go. i don't know what you call it. but in patient i guess with the pace of federal rule making and you may be in a position to expedite and if you can, i would

urge you to do so but i think you for your dedicated effort over many years in this area and you too the attorney general blumenthal and i both know we both have people out in our streets into the streets of foreign countries everyday for resourceful and brave and take risks to protect us we have both had the pleasure and privilege of working with the agents who have been really among the finest americans who've had the chance to work with thank you for being here on their behalf >> the panel was excused and we will ticket to minute baquero the next panel assembles itself. the key for your testimony. [inaudible conversations]

[inaudible conversations] >> if the hearing room will come back to order, my first order of business is to add to the record of the proceeding a number of items, first in a letter from our colleague, senator casey and then statements from the partnership that drug free.org, from the community anti-drug coalition of america, from the american team foundation, from the american academy of pain medicine come from the international institute of pharmaceutical safety, from the federation of state medical

boards and from the american society of interventional pain. i appreciate all of their statements and they will be without objection added to the record of these proceedings. we now have our next panel. our two witnesses are first floor is manager of community prevention for the rhode island student assisted services. she also serves as the coordinator of the jamestown island prevention coalition and oversees the north kingstown rhode island drug free community grant. she previously served as project manager of the university of rhode island cancer prevention research center, worked as a student assistant counsel for in the rhode island, middle and high school and directed a group home serving individuals with mental illness and substance abuse problems. she has an undergraduate degree in education and psychology from the university of rhode island and a master's in management

from leslie university. she's joined on the panel today by john eadie of the prescription monitoring program center of excellence at brandeis university. he previously served as director of the division of public health protection and the new york state department of health from 1985 to 1995 where he directed the states pharmaceutical diversion program. including the prescription monitoring program. he was the co-founder and president of both the alliance on states with prescription monitoring programs and the national association of state controlled substances authorities. if i could ask you to stand while we have administered the oath. a dealer from the testimony you're about to give the for the committee will be the truth, the whole truth and nothing but the truth, so help you god? please be seated. and ms. hosely, welcome. thank you for coming down from rhode island. please present your statement.

>> chairman whitehouse, senator blumenthal, thank you for the opportunity to testify before you today on behalf of rhode island student assistant services and the jamestown north kingstown substance abuse coalitions. i'm pleased to provide you with our perspective on effective strategies for reducing the abuse, misuse come diversion and fraud of prescription drugs. rhode island is a small state but what we seem to show up in the top of the national statistics when it comes to substance abuse. in 2000 for the last year of the national survey on drug use and help asked about the nonmedical use of prescription drugs rhode island was tied for fifth with two other states. in 2008 when the same survey asked about the use of pain relievers, nonmedical the rhode island came in seventh. it didn't matter which of the five counties you look at the were all similar. the last rhode island survey work data showed that 11% of high school students have tried painkiller's without a doctor's

prescription. i manage a drug-free community grant in north kingstown prior to this i oversaw strategic prevention framework state incentive grants. in my 20 years of working in prevention i had never seen such well-organized efforts as with these grants. after the first three years we saw a drop in the 40 day alcohol use of 14%, and a 4% decrease in marijuana use among high school students. we focused our efforts on underage drinking. we have cooperative relationships with multiple key partners which make it relatively easy to work on media campaigns, policy changes, law enforcement efforts and more. the national prescription drug kick back program was held april 30th in conjunction with the dea in north kingstown the local police department and the state police killed five boxes. when i received the list of how many pounds of drugs are collected, i saw that the top eight communities were either

drug free communities guarantees or had the strategic prevention free bricker and are both. together the had collected over 75% of the 1,716 pounds of drugs. cities and towns that have the funding can get citizens educated and involved. they get results. i used to be a student assistance counselor, a student assistant counselors are on the front lines. unfortunately federal and state funding bill longer covers the cost to ensure minimum programs are funded especially since the safe and drug-free schools and community funding was eliminated. the rhode island student assistance program as a key element in the prevention infrastructure since the counselors are insiders. along with providing early intervention that can also assist the valuation policy and enforcement efforts in the schools last month i heard the story of a student who barged into a student assistance counselor's office acting confused and incoherent. the counselor found out that she

had taken prescription drugs that were not prescribed to hurt along with lsd and determine she was in a drug induced psychosis. the girls to gentry hospital william villans where she stayed for three weeks. she's now back in school but needs to take lithium when she's usually prescribed for people with bipolar disorder to remain stable enough to stay in school. she's still having crying about and difficulty handling stress. the boy that gave her the drugs has been released from prison and is allowed to attend school with an ankle monitored. to live is connected by drug abuse result in both having diminished chances for future success. while the violence is just beginning to address the complex issues related to prescription drug abuse among the teams of you believe one of the more effective prevention mechanisms would be the student assistance program. these highly trained counselors are on site where access for students is easy and confidential.

collectively the student assistance program working in tandem with community coalitions has been successful in reducing alcohol and tobacco. i have every reason to believe that for the drug free continuing expanding the student assistance program along with collisions to the drug free community program would help communities handle the complexity of the prescription drug abuse among the teams. i provide more comprehensive recommendations in my written statement in the interest of time and we'd like to focus on the one that is the most critical. i believe with drug use on the rise in elimination of the safe and drug-free schools and community program the federal government should focus more emphasis and funding on community and school based substance abuse prevention and intervention strategies and programs buy explicitly requiring the drug prevention and intervention programming be adequately included in the reauthorization of the elementary secondary education act and by fully funding the

drug free community program. we have the potential to reduce the abuse of prescription drugs among the use in schools and communities throughout rhode island as well as nationwide. thank you for the opportunity to testify. i would be happy to answer any questions you may have. >> thank you ms. hosely. we will take mr. eadie's segment first and then we can ask questions of the panel. but i want to thank you for high quality of the testimony for those who have not read it but are trustless and you gave a summary today that your full statement will be part of the record and will be extremely helpful. i want to also mentioned specifically with respect to the recommendation this be protected in the reauthorization of the esea. senator brown who was here has a very keen interest in all of this. this has been off the help

committee now i now want the help committees and we will be doing that bill in that committee and senator blumenthal is on that committee as well. so senators, senator klobuchar is not what you are a very good representation of that committee here i guess by fortuity so it is a good recommendation for you to make this moment. mr. eadie, please proceed. >> good morning chairman white house and senator blumenthal. thank you for the opportunity to appear before you on behalf of the center of excellence for the prescription monitoring programs at brandeis university. we thank you for the honor of testifying in on the critical matter. the center of excellence seeks to help end the prescription drug abuse epidemic without compromising pain management or the legitimate prescribing of controlled substances and a collaboration of the alliance of

states with prescription monitoring programs the senate provides academically sound and practiced relevant information evaluation and expertise to the prescription monitoring programs and of the stakeholders. it is funded by a grant from the department of justice bureau of justice assistance. the urgency of our work is based upon the knowledge that 50 people in our nation by a from unintentional overdoses and 20 times that number are admitted to hospital emergency departments for overdoses. we believe we must improve our methods for identifying and interdicting the prescription drug abuse to slowdown and reverse this epidemic ever rising toll. the rapid growth in the states with prescription monitoring programs and i'm delighted to say the number is now 48 states

five just pass legislation in the last few weeks and has been signed and we just had the district of columbia and two states left. it's a very hopeful accomplishment. the majority of the states have been authorized since 2003 where the drug monitoring program grant funding began a program administered by the department of justice bureau of justice assistance. through that program, competitive grant -- competitive grants stimulate growth and enhancement. important additional funding has been provided by them program until this new budget to the program is administered by the substance abuse and mental health administration services as a formula grant program that has been important in assisting state prescription monitoring programs by supporting their operations.

the continued operation and the enhancements called for to the drug abuse epidemic appeared to call for a continuation and expansion of both unique programs. in addition to federal funding support, we need a rapid evolution of prescription monitoring programs into a new generation of even more effective systems. a new generation whose hallmark must become productivity. the new generational to get a vintage of technological offenses and integrate them into the fabric of the operation. many characteristics of the new generation are highlighted in the white house office of national drug control policy is new prescription drug abuse prevention plan which would have discussed previously. in addition the data sharing is essential. this must be completed in order to create a national network of state prescription monitoring

programs that are interoperable through prescription drug monitoring information exchange pub nunes bja in the lions of states with prescription monitoring programs have been working to establish for six years support from the senator. the hub is operational today and several states are in the process of interconnecting. in addition, we need to work on the following issues. we must increase the productive reporting regarding to the press critters across the nation where the bmp and allies within the database and send it out when they identify potential problems and led the per scribers and for that matter pharmacists know what's going on. we also have other changes to make in the systems. you touched on some of them already. making the data more timely oklahoma is pioneering such effort to the starting in april they've got the point of sale

going into their systems. making access seamless using the electronic of record as a way of doing that, combining prescription monitoring perkins and eprescribing which we have discussed is an important element and a new element. considering with public and private third-party pay the value of mandating prez kroger's to access the data prior to issuing the first country substance prescription and periodically thereafter as a condition of payment. in addition, we need to increase the requested support in productive use of the data for pharmacy, we need to develop a verification system that the p.m. he would carry out to tie dispensing to make sure the requirements for example of this mandatory physician education to ensure that is being accomplished of the purse could pursue are not trained are not going to prescribe or if they do

report effectively. we need to also, and i cannot emphasize this enough. we need to increase and improve the access of the law enforcement for the prescription monitoring program data. both in terms of solicit reports where the request reports and in terms of unsolicited reports where they proactively identify problems and send them out. the same is true for the licensing agencies. there are other users of the pmp data you need to be involved that are not currently involved. just as an exhibit the indian health services veteran of the demonstration department of defense of care systems need to be integrated, and i know that you talked about that already. but this system has to be beyond that because it's not just the integration of the va and the department of defense, it is the access to the other prescriptions issued for the same individuals and the systems who may be going outside to get cash prescriptions which

compounds and confound us what's going on within the va system or the department of defense and they are blind to it at the moment. we need to develop an early warning system and they have the capability of doing just that. we need to develop a greater concern for the initially misidentified sycophant concerns, and we need to talk about the mandatory prez kirker education. it is from my perspective an extremely important and i recommend it highly to you. >> thank you. i appreciate it. and thank you, ms. hosely. your work in ryland must have exposed you to some pretty well-informed views about where it is youngsters in particular teenagers are getting access to these prescription drugs. and if you can comment a little bit about that and how some of

the earlier testimony about the need to improve on the regime of disposal could help this because as i understand, throwing them down the drain risks creating environmental problems, leaving them in the cabinet risks creating a use the veto that use or creating abuse and there is no clear third option but most are aware of. >> as i rode in my statement of record, students seem to know who's getting their wisdom teeth pulled and might have access to painkillers especially we hear that in schools kids have access to adderall. so it seems to be something the students may share the medication they are prescribed but also getting it from medicine cabinets from their parents and grandparents i think just the fact that these

prescriptions are over prescribed the tend to be sitting in people's homes so i think increasing awareness is huge and when we had the take that program we made sure we publicized in the papers and that we put it on the list to go home to all the parents so that they were aware that there was a way for them to get the medication to a place to properly dispose of them. i think the fact that they can't just go at any time is a little difficult. i know i missed that date and still have some prescriptions sitting at home, but i heard that next year it might be twice in the next year, at least if we had some type of mechanism in place for the disposal to increase the awareness with funding such as a drug for communities could put a multi pronged strategy on the place for whichever drugs we're focusing encore as far as prescription drugs ago it's something we need to do but i think that all the communities

need to do it and not just certain ones who are able to get additional funding. >> we have the good fortune in rhode island to have one of the largest pharmacy companies in the country headquartered, and perhaps you and i could work together once regulations are finally through the federal administrative rule making process either at the end of this year or early next year as the director leonhart suggested in the work with them on perhaps taking a leadership role in this area. so i look forward to working with you on that. mr. eadie, the states tend to manage these prescription drug monitoring programs. there has been a relatively limited federal role rather than

the grant making role. interoperable the has come up in an area where it might be suitable for the federal government to provide some support and some guidance to the state based programs. and it appears that their state base actually is an asset in terms of awareness of local conditions, comfort about privacy and security issues and things like that. without taking those elements away and making it something other than the state based program that is and has been are there other ways than that the interoperability where you think that the federal government could have a helpful role in supporting and guiding what would remain under this model in this did driven prescription drug monitoring program. i think there is a role. i think that things in mandatory

education for example if that is required the mission be a corollary that prescription monitoring programs should build into their system and a devotee to track that and make sure that the physicians are the ones that are in the dentist's for that matter are the ones who are actively prescribing. that is a simple thing. now the larger question is how to involve the federal government without disrupting the value of the state based systems and the responsiveness that you have indicated is extremely important. innovation is also important without the state run programs we wouldn't have the electronic prescription system is available to doctors today. that was an innovation that started with the state of nevada just a little over a dozen years ago. and it is now widespread across the nation. i mentioned oklahoma as an example. they're starting a point of sale, a pioneering that.

massachusetts is pioneering the health records integration and they also have electronic prescribing system testing in western massachusetts which you may or may not be aware of that was approved the waiver by the drug enforcement administration. it's funded by the administration for health research and quality. it is a small-scale project but it's demonstrated that electronic prescribing by physicians is effective and that is ongoing today. it's actually operational at the moment, and we have been a party to that in supporting that as it goes forward and i think there's a major role for the future. i think electronic press kit and should be integrated pmp. at the moment that isn't possible because it doesn't exist but it should be integrated as quickly as possible and funding support and kids for that initiative is important. in short, i think there is the broad guidelines of criteria or

of guidance is valuable. being too specific of the federal level which is a tendency to enter into the federal law or regulation specific things the states should do well at the point today it is a rapidly evolving. we cannot afford to have anything that is a rigid there could certainly be guidelines. there can certainly be statements of encouragement. there can be in effect minimal guidance such as states that are receiving federal funding for pmp should have built into them interoperable the deep with them and other states. there should be, could be as it relates to the prescribing and others things broad categories of requirements without specifics of that we can innovate and create and go forward. >> we are certainly interested in that because as you know when of the top states in the country

to go back and forth with massachusetts who claims to be number one and at the nasty enough and electronic health records that we are looking at a statutory information exchange and the data is actually flowing for something called the current care in rhode island so that it's being populated automatically into electronic health records outside of visible corporation but across entities to be as we look for to working with you on those areas and i think if we can do that and people with the front lines working with kids like ms. hosely will have an additional as a senator blumenthal said tool in their toolbox and with that, senator blundell. thank you, mr. chairman and think you both for being here for massachusetts and rhode island and thank you both for your work in this area, and i hope that folks in rhode island know how active and aggressive senator whitehouse has been with

his background in a small enforcement but also the leadership is moving to the judiciary committee to take action in this area, and i want to ask you about some of the potential actions drug companies themselves could take in the area in stopping the drug abuse apart from improving monitoring programs that exist in many states, particularly with respect to painkillers. whether there are actions that can be taken to provide for greater safeguards in these areas as you well know oxycontin has been a continuing, choxy

cone come there was an action by the department of justice and states including connecticut while i was attorney general relating to the oxycontin. the failure of the company that produces a to follow perhaps more responsible measures in the marketing and selling of the bills subject to pain release mechanisms, and i don't want to sing aloud because it would be unfair to do so any one company but i wonder if you could give your observations as folks who are dealing first hand on the ground in the trenches with this problem about actions that you see the pharmaceutical drug companies themselves potentially taking to reduce this problem. >> i'm not sure whose responsibility it would be, but perhaps if a shorter timeframe was given when those

prescriptions for prescribed so that they didn't get a 30 a prescription for having their wisdom teeth removed and maybe had three days with the option to renew i think there's just too much medication out there and i think it is way beyond what needs to be out there and that just invites the misuse and abuse of drugs. >> i would recommend a great care in the way in which funding from the manufacturers might be considered. perhaps in the provincial area substance-abuse prevention area would be helpful for having funding available. it certainly is an area where they have a need to share responsibility for what has happened with the use of their drugs. when it comes to issues closer to the regulatory activities and

things like the prescription monitoring programs, i think that one has to be very careful about considering funding that is perhaps a voluntary or so-called voluntary. i can give you the example of our own situation at the center of excellence approached by a major drug manufacturer in the first on the existence if we would be willing to do collection data and provided to them for their obligation bringing on to the market and the controlled substance product and we thought about it carefully and decided that we could not do that in good faith because number one, there would be the appearance perhaps conflict of interest on our part to do that, and second would be the potential reality of it, that is there would be no way we could look at the data without knowing somewhere in the back of our mind that how we analyze the data and the way we present it and the kind of charts we produce, the analysis we state

it all could be inadvertently influenced by our knowledge the future funding would rest on how the manufacturer would be produced. they came back with an accountable proposal that served in that capacity in the drug manufacturers, the ones working with the fda on the project and for the opioids we thought about that again. it was great value collecting the data from the states. we still want to do that. it's important to collect the data and analyze it. we know that from experience, but once again, the to caveat i mentioned a moment ago came back to our cognitive function as we thought about it very cy, and we thought about how easily it word change can be made in a

document from a word that is choice of phrase, choice of how things are presented. there would be no way that we could protect ourselves against the fought in the back of our by that next year's money would be dependent on how happy these many factors are with what we produce. and so will ultimately see freedom and said no. having said that i think that applies generally across-the-board to the prescription monitoring program activities the states are involved with. i honor what these florida state legislature has just done and passing the law that refuses to allow the prescription country program to accept funds from drug manufacturers either directly or indirectly that was a major step forward as you probably know there was a million dollars offer to them by the joint manufacture. let me give you an example. there are drug manufacturers that have been active supporting the to progress for the last decade. but if you read the material very carefully, there is no

provision within the for the kind of protective analysis of data and distribution of the data that is absolutely essential for the prescription monitoring programs to go forward particularly as it relates to law enforcement, and there is also -- there has been in recent years a number of states that have enacted law that have provided restrictions of law enforcement that extend to the requiring court orders, requiring subpoenas and a variety of what amount the door inappropriate restrictions on law enforcement access for the data and i think there is room for many factors on the other hand to contribute to a fund that might be commercially mandated by the food and drug it ministration establishes a fund that pays for its cost and which many factors are mandated to contribute to that fund and the

fund is then used to cover the cost of the fda reviewing and improving their drugs. why couldn't, why should there be a fund established by mandate of the federal congress to drug manufacturers to contribute significantly to the funds necessary to operate the prescription monitoring programs. the benefit by the extraordinarily and there is no reason why they cannot and should not contribute to the solution to the problems created. >> figure for that answer. my time is up but i look forward to working with both of you and i want to say that the maker of oxycontin by the way has taken some very responsible steps to put farmer has taken some very important leadership status and response to these problems, and one area where i was thinking more could be done is in providing warnings perhaps in

restricting the links or the amount of prescriptions that as you suggested but i look forward to working with you and again, thank you for your work in this area. >> thank you, senator blumenthal and senator brown, senator klobuchar and senator blumenthal for participating in this hearing and i guess to wrap up by saying how i think in pressed we all have been by the information we've heard about the academic nature of the prescription drug problem and the rapid rate at which is growing affecting the emergency rooms, affecting the families, affecting our schools, our communities, the areas that appear to need further attention and effort include public

awareness, and i was glad that our director of the office of national drug control policy was here to talk about his efforts in that regard. we appear to need to better coordinate our law enforcement resources of the with does appear that the prescription drug monitoring programs stand out as a growing and effective state based vehicle for addressing this problem but one that could be strengthened with further integration with electronic prescribing, integration and electronic records, some integration beginning immigration with the va, department of defense and indian affairs health systems and improve interoperability state to state. so those seem to be goals to come out of the hearing and the last is we don't seem to be in a very good place yet with respect to the disposal of unused

controlled pharmaceuticals that throwing them down the drain creates one set of problems in the cabinet another set of problems and we have not really develop a robust system for finding other ways to dispose of them and we look forward to working particularly with the pharmacy and the pharmaceutical industry to come up with solutions and it is their product that ultimately is at the heart of this problem. so, i appreciate the director for taking the time and sharing their expertise and i appreciate very much ms. hosely's testimony and her work in rhode island on the ground with the kids who are at the center of our attention today and mr. eadie for your years of service i think that you're sort of the softer or uncle or whatever you call that of the movement, and clearly it is one of the success story is

the we want to build on as we continue to move forward and address this epidemic. we will keep the record of this hearing in open for an additional seven days, an additional week if anybody wishes to add anything to the record, and other of them that, the hearing will adjourn. thank you very much for your testimony. >> [inaudible conversations] [inaudible conversations]

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[inaudible conversations] now a hearing on american children who've been of deducted and taken to other countries. the house foreign affairs subcommittee hears from parents whose children were of deducted

including david goldman whose son returned from brazil in 2009 after being of detected five years earlier. this is four hours. >> i want to thank each and every one of you for joining. to focus on the deeply troubling and growing problem of international child of deduction which occurs when one parent unlawful the moves the child from his or her country of residence often for the purpose of the other parent access to the child. it's a global human rights abuse that seriously harms children while inflicting excruciating emotional pain and suffering on left behind parents and families. international child of the auction rips children from their homes and lives taking them to a foreign land and alienated them from a left behind parent who loves them and who they have a right to know. their childhood is disrupted in limbo or sometimes in hiding as

the parent seeks to evade the law or the legal cover for their immoral actions. adopted children lose their relationship with their mom or their dad, half of their identity and half of their culture. they are at risk of serious emotional and psychological problems and may experience a society, eating problems, nightmares, mood swings, disturbances, aggressive behavior, resentment killed and fearfulness. their own personal relationships and parenting the united states ratifies the conventional the civil aspects of international child dhaka production to try to address this serious issue of. the convention creates a single framework for the quick return of children who has been of deducted and for the rights of access to both parents. under the convention courts are not supposed to open or reopen

custody determinations would rather decide the child's country of habitual residence using usually where the child is looking for a year before the abduction. absent extenuating circumstances the child is returned within six weeks to their habitual residence for the courts there to decide on the custody or to enforce any previous custody determinations. this is based on the premise that the courts where the child was living before the abduction to have access to evidence and witnesses and our appropriate place for the custody determinations to be made. however more than 80 countries have signed the convention become turned rates of american children are still devastatingly low. in 201-0978 children were adopted to the conventions and a three countries and 360 children were returned that is only 38%.

some signatory are simply not enforcing the return orders. the state department's 2010 hague convention compliance report highlights 15 countries, argentina, australia, austria, costa rica, france, germany, honduras, hungary, israel, mexico, romania, spain, switzerland and turkey for failing to enforce the return orders. many other countries, bermuda, brazil, bulgaria, honduras, mexico, the bahamas are failing to apply by the condition the the provision concerning the central authority charged with implementing the convention to the performance of the judiciary for the hague convention and the ability and willingness of law enforcement to ensure swift enforcement of orders issued under the convention. some parents will try to drag out proceedings for so long that the child reaches an age where the court will consider the

child's wishes regarding the return and david laufman and others experienced that very infamous tactic. tragically affected children are the victims of parental alienation where they fill the child's head with lions, about the left behind parent. and the child is not as an appropriate age to be heard when the child was subducted but taking a pair and should not be enabled to drag out proceedings or motivate to psychologically manipulate a child can harm a child but manipulate that child to testify that he or she does not want to return to the left behind. ..

abducted there since 1994, when the record-keeping began. japan is currently protecting the abductors of 156 american children under the age of 16. we will hear from some of their left behind parents at this hearing. japan announced this week that it is introducing legislation needed to ratify the hague convention, however i am very concerned that japan will add exceptions and reservations to its ratification that would render its dissension to the convention meaningless. and tragically and unbelievably,

japan has already indicated that its approval of the convention will be meaningless to the 156 american children already abducted to japan. the hague convention is not retroactive unless japan makes it retroactive. i and members of this committee strongly urge japan not to ignore the abducted children already within their borders. just this year, the united states lost 31 more children to japanese abductions. i can assure japan that the hundreds of left behind american parents whose children are in japan are not going away, and japan finds the hague conventioe past its reputation here in the congress and elsewhere as a safe haven for child abductors until japan returns all of that to children. these 156 american children are be reaped up one of their parents.

they cannot be ignored, nor will they be forgotten. in the last congress introduced legislation to impress upon both hague and non-hague countries alike that the united states will not tolerate child abduction or have abductors behind the hague condition. yesterday reintroduced the bill, the international protection and return act of 22011. the new bill h.r. 1940 will empower the president and the department of state with new tools and authorities to secure the return of abducted american children. under this new proposal law when a country has shown what we call a pattern of noncooperation in resolving child abduction cases, the president will be able to respond decisively with a range of actions and penalties, 18 in all. i included penalties that we included back in 2000 the trafficking protection act.

i'm the prime author that legislation. it has worked in combating human trafficking. it will work in combating international child abduction. we also included language taken right from the international freedom act enacted in 1998 which went through my committee. it was a bill that was sponsored by our good friend and colleague frank wolf. that too has promoted international freedom by having a penalty phase without which we can admonish all we want but we have to have something, carrots and sticks in order to ensure compliance. based on past experiences as i say we need to get the attention of other governments and we know that they work. also reflecting my anti-trafficking legislation, h.r. 1940 will raise the profile of international child abduction issues by appointing a new ambassador at-large at large for international child abduction's

to head a new the new office charged with helping left behind parents secure the reserve of their children and to collect detailed information and report on reports on abducted children in all countries are go this has to be taken to a much higher level and we have to put the full-court of penalties and the ambassadorial rank of this new position behind that effort. the growing incidences of international child abduction must be recognized for the serious human rights violations that it is and decisive effective action is urgently needed. our hearing this afternoon will help us all to understand better the impact the child abduction has on children, parents and entire families and provide us with the opportunity to explore the actions needed to end it. i'd like to now yield to my good friend and colleague, the ranking member of our committee, for any comments that he might have. >> thank you very much. let me begin by commending you

for calling this timely hearing. as many of us know, tomorrow is national missing children's day. and it is fitting that examine the problem of abducted, child abductions, in an international context. losing a child is a terrifying experience for any parent regardless of where they live, anywhere in the world. unfortunately, reported cases of international child abduction's are on the rise. in fact a number of cases involving a child kidnapping, kidnapped out of the united states in the countries that signed the hague convention doubled since 2006, two times more and simply five years. the troubling trend of increased international child custodyññ disputes is likely toññññ deteriorate asñ our society becomes more interconnectedñ a

mobile.ñññ these heart-wrenching casesññ warrant congressional vigilance and action. currently the hagueñ convention on the civil aspect of international child action is 85 participating countries is a principle mechanism for enforcing the return of abducted children. though in perfect the convention has successfully resolve many abduction cases and pressed signatory countries to promptly return children to their rightful residence. through the convention for example the united states government successfully returned 262 children of debt did two or wrongfully retained in the united states in 2010 along. nevertheless, as all of our witnesses will testify today key challenges remain. for example the available remedies do not apply to non-signatory countries which the parents, like eyewitness collin boll's with limited

resources and support. i thank you for being here and willing to share your distressing personal story. in providing us with insight on the hardship and difficulties of regaining children abducted to egypt, a country that chose not to participate in the hague convention. many hearing congress are concerned with your case including my friend congressman barney frank who is here in the audience and i'm sure that the chairman will invite him to com forwardñ to sit on the panel if he chooses, along with my colleague mr. smith who introduced a resolution calling on egypt to return your children

such action poses to the mental well-being of the child. the international parental child abduction deterrence act of 2009 introduced by my colleague from new jersey, representative rush holt which i cosponsored is designed to deter potential foreign national parental child abductors by increasing the potential penalties associated with such abductions. proposed penalties against the parental abductors includes freezing financial assets of foreign nationals within the united states jurisdiction, in

revoking or denying their visa eligibility to the united states. as well i look forward to your analysis of the convention and the opportunity for improvement, including u.s. legislative options. as we reflect on the risks of abducted children face internationally, i would like to further draw special attention to africa, where at times weak governments, poor legal and judicial systems and widespread poverty prevent adequate country response to child abduction. these children are especially vulnerable. globally children in conflict, post-conflict and natural disaster crises are especially at risk for child action, or its pernicious counterpart, child trafficking. in some african countries like sudan and regions in that area, such as the suhala countries in

northwest africa,, abduction antislavery remains a horrendous practice. child abductions between active factions in the sudan conflict and especially of children to the north from the south speak to the enhanced vulnerability children face during conflict. as a matter of fact many of us got involved initially in the sudan crisis even before the war really broke out because of the abduction of children, and they were being sold into slavery. in other conflicts such as those in somalia and central africa republic amongst others, children are still at risk for abduction, and forcible conscription as child soldiers. scandal such as the is the case of french aid workers attempting to remove chadian children whom they falsely claimed were often

sudanese refugees when arranging for adoption abroad or that of the americans from the southern baptist missionary who attempted to remove haitian children two weeks after the devastating earthquake also falsely claimed to be orphans remind us of the need to ensure that children are protected in poor, especially in post-conflict and post-disaster areas. mrs. elias i look forward to your testimony on the risk children face in such situations and how we can work to protect children from abduction and trafficking when they are in the most vulnerable states. so i look forward to hearing the witnesses and with that i wield the balance of my time. >> thank you very much. we have to roll calls on the floor so we will may could very brief. we are almost out of town -- time so we will vote on the second one and come right back and reconvene on the hearing so we stand on votes.

>> beginning with mr. david goldman who is the father of sean goldman born in red bank and 2000. he was abducted to brazil in 2004. mr. goldman spend five arduous years devoting enormous ounce of time and financial resources at a great number of people supporting him in the community to secure the return of his son. in december 2009, i had the extraordinary privilege of being with david when they were finally able to return to the united states. mr. goldman recently published a book about his ordeal in titled, a fathers love, one man's unrelenting battle to bring his abducted son home. mr. goldman has been a

trailblazer in opening the eyes of our country today can he endured by left behind parents and i would just say that he had the human rights abuse of child abduction. obviously we have known about it and worked on it many of us for many years but it wasn't until david goldman opened the eyes of members of congress and hopefully other policymakers around the world that they realized just how the hague convention is also aimed by countries in this case brazil, where endless appeals can be lodged by the affecting family, so-called family, the abductors, the kidnappers and to frankly that process can be carried on week after week, month after month and year after year precluding the return of the abducted son, sons or daughters were family members. he has really refocused and revitalize the human rights movement that he launched by his leadership and i want to thank

him for it. all of the other left behind parents have been tenacious and courageous in their own right but david's case, a breakthrough case, you think will help everyone else and that is i think the subcommittee sincerest hope. secondly i would like to introduce ms. sarah edwards who is the mother of a 3-year-old, abdullah. eli's other two came to turkey in march 2010 and has since refused to return him to his mother. ms. edwards lives and works in akron a higher end is seeking concrete assistance in navigating the obstacles of her fight as they left behind parent. so we have another witness who is on his way. he is not here yet but i would like to ask mr. goldman if he would receive with his testimony if he would like. >> thank you. let me take us back in time a

little bit. good afternoon members of congress. i am honored for the privilege to testify before you today. for five and half years, i walked in the shoes of the left behind parent. i lived in a world of despondency and desperation with it the searing pain throughout her entire being. everywhere i turned i saw an image of my abducted child. sleep is hard to come by and never wrestle. if i smile, i felt guilt. when i saw children, whether it was in the store, a park or on television or even on my charter boat where clients often take their families for a day on the water, it was more than painful. for the longest time it was too painful to be around my own family members. i couldn't even be around my nieces and nephews. it was too painful. hoyer was my son? where was my child? he had been abducted.

he was being held illegally. he was being psychologically, emotionally and mentally abused. i needed to help him. i needed to save him. he needed me, his father. it was our legal, our moral, our god-given right to be together as parent and child. i did everything humanly possible, leaving no stone unturned but for many years the results remained the same, sean was not home. although i remains determined and hopeful, i must admit the outlook for a permanent reunion with my abducted child often seemed bleak at best. i felt like a dead man walking. the void left me a shell of a man i once had been. there were orders in place, many orders from u.s. ports demanding the immediate return of a child. the courts and brazil acknowledged that my child had

been held in violation. u.s. and international law. however, he remained in the possession of his abductors. why were so many laws being ignored? why were the abductors and in my case, the government of brazil allowed to flagrantly violate international law with no consequences? why it was my child and over 50 other american children still in brazil, another 80 or more in mexico and thousands of other american children also held illegally in various countries in clear violation of the hague convention on the civil aspect of aspects of international child abduction. it would take four and a half years, numerous court hearings extraordinary work from my attorneys and brazil and the u.s., one of whom is here today sitting behind me, ms. patricia apy who will testify.

a tremendous amount of political pressure applied publicly and internally and house, senate and state resolutions for me to finally be able to visit my abducted son for a few short periods of time. my son had been adopted by my wife and her parents and held illegally for over four years. it wasn't until the tragic passing of his mother that my sons of action became newsworthy. is finally brought it to the attention of those who could and would actually assist me. it's a congressman smith traveling to brazil with me. it took senator lautenberg holding up a bill that would have given brazil nearly $3 billion in trade preferences for my son to come home. sean and i are extremely grateful for all the assistance we received from supporters. it looks at officials, the secretary of state and the president of the united states

of america. nevertheless, it is extremely rare for a left behind parent to be the beneficiary of this level of help. get every other parent whose american citizen child has been at ducted deserves the same help that i received. this committee must realize that if the system had been working properly, our

another year and a half after the death of my son's first abductor on christmas eve, 2009. sean and i were finally reunited and return home. it was nothing short of a miracle. after five and a half years, my

son's illegal retention and documented abuse, he is now home and he is flourishing. he will be 11 years old tomorrow, may 25 as congressman payne pointed out. my son's birthday is on international missing children's awareness day. although the remaining abductors of my son have challenged the brazilian supreme courts decision that rocked him home and continue litigation in brazil seeking my sons returned in addition to filing lawsuits in new jersey courts, he is home, he is happy, he is loved, he is allowed to be a child again and we are father and son again. one thing my father says when my son and i finally reunited and returned home, which will always resonate within me and i've that is how these parents in families live every day. my dad said, not only did i get my grandson back, i got my son

that. our family will always be so very grateful for every ounce of support from wherever it came. it is for this reason that i'm here today to do whatever i can to ensure the remaining families desperately fighting to reunite with their affected children do not fall on deaf ears as my own please did for so many years. our foundation is assisting a number of left time parents, including nine his children remained in illegally retained it in brazil. none of these children have been abducted by someone with great influence and power like those who affected my child. however the results are the same. the children remained held illegally. other than my son, we are aware of no other child returned to the u.s. by brazil under the hague convention. in fact, since sean's return, two u.s. cases in brazil

received return orders by brazilian first level federal courts which is good news. however, the rulings were appealed, the children were not returned in the lives of the left behind parents and their children hang in the balance while every day the of doctors live with impunity as these cases drag on. brazil continues to defy international law. i would like to note that ambassador jacobs recently returned from a trip to brazil where she had gone to discuss international child abduction with her senior brazilian officials. ambassador jacobs reports that the trip was a success and that the u.s. and brazil have established a working group which will meet the summer to discuss how to speed up hague applications and the adjudication of these abduction cases. hopefully real change will happen but to be clear, the only way progress can be measured is by the number of american children who are returned.

right now, there are zero, zero consequences when a nation to flagrantly violates the hague convention and refuses to return abducted children to the united states. nations including mexico, germany, brazil and japan, which finally appears ready to ratify the hague convention, discover quickly that united states is all talk and no action. these countries play endless legal and diplomatic games with left the hind parents, frustrating their hopes and breaking their hearts month after month and year after year through endless era craddock maneuverings. the method and the excuses may vary from one country to country but the results are almost always the same. children illegally abducted from the united states almost never come home. the current system is broke and.

in the letter inviting me to speak, at this hearing today, the chairman states that the purpose of this hearing is to explore ways the u.s. can help increase return rates of children abducted internationally by a parent. first of all, we can only help increase return rates if we start with a complete understanding of the full magnitude of the problem including the true number of american children who were abducted and continue to be illegally retained abroad. this is a difficult number to find and it is not presented as part of the annual hague compliance report submitted to congress by the state department. we keep hearing that the figure is around 2800 american children. however, the last three annual hague compliance reports prepared by the state department showed that the total number of abducted american children, for those three years, was 4728.

these reports also show about 1200 children were returned although we weren't able to find return data for 2010. that would account for an increase of 3528 in those three years alone and clearly there have to be literally thousands of american children illegally retained abroad whose abduction stayed that prior to the most recent three year period. how our returns categorize? how are those children returned, if they were in fact return at all? do returns also include cases which the state department has closed for various reasons? if so, what is the criteria for closure. things need to change. we need a system by which these abduction cases are registered and monitored by each parents elected member of congress. we need our elected officials to

work closely with the state department on these cases, to make sure that all resources and additional tools are at their disposal to make it clear to these countries that we want our children sent home. there is no valid reason for foreign governments to illegally and support international child abduction's. this statement, however true, defies all logic is there is never a valid reason to break the law and support kidnapping. but as they testify before you today, this is exactly what is happening in many countries that thousands of american children and their families. these countries are breaking the law with impunity. the fact is, very few left behind parents will be as fortunate as i was in having president obama, secretary of state clinton, congressman smith and senator lautenberg all make

my son sean's return a fundamental foreign-policy goal of the united states. even then, senator lautenberg had to put a hold on renewal of gsp trade privileges for more than 100 nations, including brazil, to put the final pressure on both brazil and the administration, which led to sean's return. i wish every left behind parents could have that kind of support in the future, but we all know that his view it most and probably none will ever have that kind of leverage and power backing them. what kind of leverage with these parents be able to wield without that kind of personal high-level support i was so fortunate to receive from the white house, state department, senate and house to bring their children home? not airy much and probably none at all. the hague convention had the force of law but we all know there can be no rule of law if there is no system of justice to

punish violators. today, mexico, brazil, argentina and a host of other countries faced no real consequences for refusing to adhere to the hague convention requirements that abducted children be returned to the country where they were legally domiciled within six weeks. american treasure and our armed forces have saved guarded the security of japan since 1945 yet japan pays no price for refusing to return the abducted children of those american servicemembers as well as ordinary u.s. citizens whose children have been at.debt to japan. this committee and this congress must pass legislation that arms the state department with real sanctions to exemplify the u.s. intolerance for other nations which remain flagrant violators. chairman smith has authored such

legislation. i supported and i urge all members to do so as well. similar to our anti-human trafficking laws authored by chairman smith, his bill to combat international child abduction's provides a real and credible inventory of sanctions to be used to help get her kids back. if you armor negotiators with such sanctions they will immediately be taken more seriously. if the department employs such sanctions against the worst offenders, other nations will get the message also and hopefully start to return our children. what i do know is that if all we do today is express outrage and vow to do better as committees like this in both houses of congress have done for more than 12 years, but failed to enact congressman smith legislation with real and credible factions, our kids will not the return and

we will be back before another committee next year with more left behind families, more internationally adopted children and no new mechanism for improvement. it is worth noting that this is the seventh hearing on this issue since 1998, and i respectfully ask this committee to think about something at the conclusion of this hearing. what if anything has changed in those 12 years since we acknowledge this serious -- seriousness of the problem than international child abduction and realize that the system was failing these parents that then. when you read the testimony, it is as if we are caught in a time capsule and suddenly the dates on the hearings, transcripts don't matter. all of the stories could be told today because the reasons for the failures are the same. this is as much of a bipartisan issue as there could ever be,

and i continue to plead on behalf of all the suffering families torn apart by a child abduction for our government to act now. my son, sean, and i can never get at the time we lost because of his abduction, but now that he is finally home, not a day is lost on either one of us. let us help the rest of the families and begin with providing the much-needed tools that the state department so desperately needs to apply across the board pressure that will ensure abducted american children come home. i would like to conclude with a letter from the left behind parents of 117 american children unlawfully retained in 25 countries. the letter is addressed to secretary of state clinton and was written for the purpose of

giving a voice to the thousands of parents who were not invited to speak your today. their presence is felt and many of them are here in this room today. if i may i would like to read would like to stand with me? if the rumor bicker you can ensure there would be more families. if this rumor bicker you could be assured there would be more parents and families making it even harder. dear madam secretary, we the undersigned appeal for your help has left behind parents of 117 american children who have been abducted and remain unlawfully retained in 25 countries. we also represent a number of u.s. servicemembers whose

children were abducted while serving our country overseas. some of these countries are signatories to the hague convention while others are not such as japan, where we face overwhelming trying to reunite with their children. we and our families are devastated emotionally and financially by the loss of our children and seek your assistance in ensuring that the u.s. government is exercising all lawful means necessary to return these american children to their home country and reunite them with us. the continued retention of our children violates international law, ethical norms and human decency, and put simply our children have been stolen from us. it is our legal and our moral right to be a part of their lives as are our 85 cases demonstrate. there are a growing number of countries willfully ignoring or abusing their international

obligations with regard to international parental child abduction's. each of us has had exasperating experiences seeking justice in foreign courts where cases are often treated as custody matters rather than abduction cases. oftentimes, victim parent and court systems of foreign countries when it is well-known that such action will likely result in a decision with custody of our vector children being awarded to the objecting party. collectively we have limited or no contact with our children. their children. many of whom have been turned against us as a result of parental alienation, it documented form of child abuse. our children lost half their identities when they were ripped from their homes, families and friends. like his parents, our children's grandparents, siblings, aunts and uncles and other family members have holes in their

hearts left by the abduction of their loved ones. we were encouraged by your july 2010 appointment of ambassador jacobs as special adviser to the office of children's issues. however, in working with oci, we have experienced little improvement in the quality of service provided by the department of state and almost no positive results. the current system has failed us. while her children remain unlawfully in foreign lands, the number of new child abduction cases from the u.s. continues to grow at an alarming rate. there is an urgent need for change, not only to prevent more of our nations children are being affected across the international borders, but also to effectuate the expeditious and safe return of our abductive children. international child abduction is a serious human rights violation

in desperate need of your attention. in our experience, all too often these international child abduction cases do not appear to be addressed aggressively because the state department's effort to maintain harmonious bilateral relations with other countries or to pursue other compelling goals. the state department foreign affairs manual on the issue of child abduction highlights this point by obstructing oci caseworkers to remain neutral when handling these abduction cases. this inherent conflict of interest cannot he ignored and we need to place a higher priority on the welfare of our children. we understand the necessity of maintaining strong relations with other nations, but they should not come at the expense of our children. over the years, both houses of congress have held numerous hearings on the issue of international parental child abduction, yet precious little has changed as our epson

children grow older. on tuesday, another group of parents will gather in washington d.c. for yet another hearing as we are today. it is our hope that this will be the year that congress and the administration unite to pass new laws to strengthen our nation's capacity to help the parents of children victims of international parental child abduction. we also hope that the state department under your leadership, will embrace these changes to finally end this gross injustice affecting thousands of american children. madam secretary, we applaud your past efforts and record on children's rights issues, but we are desperate and plead for your assistance. it is long past time for this great country to show leadership on the issue of international parental child abduction. we cannot grow complacent with each successful return nor can

we forget about all the other children who are being wrongfully retained abroad. we are fortunate to have strong support of groups that advocate, which advocate for victims of international parental child abduction, however we need our government's unwavering support and determination to bring our children home. madam secretary, we would welcome the opportunity to meet with you directly to discuss how progress can be made her go please help us reunite with our children. and the families and the names of the children are at the end of the letter. >> thank you. >> without objection all of the names -- [applause] mr. goldman thank you for your powerful testimony -- testimony

the deeply held views of everyone in this room and all those who couldn't be here. i would know that this is the beginning of a series of hearings. we will hear from other left behind parents in subsequent hearings and we have three panels today. because every single one of your situations needs to be aired and needs to have the full backing of our committee which they do, in order to hopefully, god willing effectuate the return of those left behind children. i would like to yield for any comments you may have to the distinguished gentlelady from your. >> thank you mr. chairman and thank you for holding this very important hearing on the issue that will benefit from more attention and more action from this congress. the testimony of the witnesses generally heartbreaking and is the mother of six, can only imagine what the pain is when a child is abducted by a former spouse and it is probably the worst nightmare a divorced parent could face. and i want to applaud the

vigilance and the persistence of the left behind parents in your pursuit to get your child back. reading through the testimony was eye-opening and especially disturbing was the non-return rate for the signatories of the hague convention. in 2010 the return rate for signatories to the hague convention was actually 7% lower than for the non-hague convention countries. last westerlund state department handle 1501 child abduction american citizens and residents. these are our children. we must do better. this congress will do better and i assure you that with our chairman here, we will do better. thank you and i yield back. >> i want to thank the distinguished member of this committee as well. would like to now recognize sarah edwards to proceed as you would like.

>> my name is sarah edwards and i'm the mother of a 3-year-old roy named abdullah eli. abdul is a curious a curious inexorable boy and gives most wonderful bear hugs but i've not held them since march 4 of 2010 and on that day more than 14 months ago at you like's father took eli to turkey for a family visit. mohammad if i met while we repose in college and we married in canton ohio in 2003. our son was born five years later while i was in graduate school at the state university. my family and parts of mohammed's family lived in northeast ohio so when eli was six, excuse me, six months old we move back there. in january of 2010, after seven years of marriage, mohamed and i separated. we drafted an informal shared parenting agreement to outline our intentions for raising her son. i believe this document was the framework for us to work together as separated parents in

raising eli. we acted under the plan was called for equal custodial time of alternating weeks with mohammad and i each visiting two days a week with the life during each other's visitation. i fully believe the hamas participation meant he was committed to sharing parenting as i was. therefore when mohammad wanted to go forward with a visit to see his family in turkey and take eli i did not object. i thought it would be good for them to have the support of his family during the separation. mohamed provided mohammed provided me with a round-trip ticket and travel itinerary and also a signed notarized statement promising to return with our son. mohammed and eli were supposed to spend two months in turkey, now 14 months later at eli is still not home. i certainly did want want to be without my son for two months. i knew i would miss him more than i would miss anything but i have always felt it important for centeno is turkey's family and have exposure to that culture. i wanted to be fair. i myself to travel to turkey

five times before mohammed affected the lives. on two of those times, eli came with me and we also stay for two months during the state -- visit. it all seemed routine. i drove them to the airport on the day the travel and i was there as they went through ticketing and security. i blew kisses and wait to eli as eli waved bye-bye for mohammad shoulders. as i hold onto that happy last look at him i now realize mohammad actively -- we decided to separate. for the first two weeks of their trip i was able to visit with the light daily, but on march 22, 2010 my nightmare began. mohammad told me he would only bring eli back to ohio if i declared myself an unfit parent and gain full custody to him. he told me you 30 gotten a divorce and there was not a thing i could do about it. so the next day, march 23, 2010 i contacted the department of

state crime center at the american embassy consulate and scores of attorneys across turkey and all over the u.s.. it is certainly now clear mohammad never intended to bring eli home. he traveled to turkey on march march 6, and on the tenth of march 4 days later he attended a divorce hearing. one day later, march 11, 2010 the domestic court of turkey granted full custody of our son to mohammed. mohammed got full custody and divorce in a domestic court in a country where he never resided. excuse me, we never resided. according to turkey/should have been physically present for the divorce hearing. not only was i not present, was never informed of the case in any way and i never had contact with the attorneys who were supposed to have represented me. i didn't even have hard evidence that case to place until mohammad filed the turkish courts ruling as evidence in our own ohio custody case.

to date, mohamed continues to ignore the county court order to return to eli to ohio. the judge signed the order adopting our shared parenting plan in june of 2010. ahamed and i are still legally married in ohio. my turkish attorneys submitted the hague addition to the turkish authority on january 24, 2011. i have learned the turkish authorities have investigated mohammad and eli's whereabouts in just this month the turkish central authority has opened the case on my behalf in turkey for the return of my son. i await updates daily. i await updates desperately. over the past 14 months mohammed has permitted me to visit with the eli by webcam sometimes on a regular basis but he also abruptly cuts off access for long periods with no warning. i scheduled my daily life around a chance to speak with my only child. in my despair a leash and laysha and turns upon mohammed swims.

my son no longer understands or speaks english and i struggled to keep up with him and turkish. but i'm so grateful to still have contact the maintainer bond. eli was only two when mohammad took him and now at age three i see him growing and changing drastic a with each visit. everyday i wonder if he thinking about me and missing his mother the same way i'm thinking about him and missing him. mohammed threatens to take eli torturing me with the reality that it could be the last time i see him. excuse me. the obstacles that face fighting the affection of christ on our great. i am essentially on my own to fight a court battle in a foreign country where do not know the language or understand the culture. i have to be continually vigilant as i learned to maneuver this nightmare of uncertainty for the company of fighting for my son. to date i still did not know

what that eli has been issued a turkish passport. knowing can get me confirmation of mohammed will be questioned if he tries to abscond from turkey while the hague cases pending. no it can give me confirmation that mohammed will be questioned if he returns to the u.s. to renew his legal resident status. these are things we can know. these are obstacles that are ahead that need to be avoided because i think we can do it. i love my son more than anything in this world and i'm ready every minute to welcome him home and i personally ask each of you now to commit to do all within your power to restore the right of her children drab relationships with both of their parents. thank you very much. [applause] >> members, thank you. thank you ms. edwards so much for sharing that with us. we now welcome carlos bermudez who is the father of --.

sage's feather dusted him to mexico in june of 2008. mr. premade as has been three years trying to bring his son to term north carolina. he continues to do so just like all of the left behind parents who are so valiantly struggle to reclaim their children. mr. bermudez. >> the amazing support mr. goldman and advocacy on behalf of all the families victimized by international child abduction is something that i respect greatly. i am sincerely grateful your efforts and honored to have the opportunity she addresses committee. my only son was born may 14, 2007. like many parents have spent the months preceding his birth rearranging my priorities towards fatherhood and awaiting his arrival. i knew being his father would be the most important role in my life. in 2008, something was amiss with my life and i was having

reservations about a romantic relationship. i tried not to read the writing that was in hindsight on the walls and hope their problems would somehow work themselves out what time or keep long enough for me to time the energy to deal with them effectively. time was however not on my side. in june of 2083 years ago my wife falsely claimed there was a family emergency in tucson arizona. the emergency involved her never before mentioned cousin, 12-year-old who had gone missing himself and his mother was scared to reveal it to the authorities for fear of being deported. despite the discomfort i did object to my wife going to -- the only alternative i saw at that time was to take time off from my job at ibm to care for her son alone while my wife went to help find her cousin. being a sole provider for family that regrettably did not seem feasible to me at that time. my wife went there along with

her son for what was supposed to be a few days. once there she turned up her cell phone cell phone and so sent so make usually nothing she was in arizona continue to work on the family emergency. i didn't know what was happening. was myself suffering or in danger? the idea my son might be in trouble force me to stop to ask the hard questions about what was really going on. as my answered insert into your group began a frantic investigation to my wife's recent activity plans and associations. i found she wasn't in arizona at all. she was in mexico. i began to see what she was doing and what her intentions were. although my wife is never endeavored to explain to me why she did this before long i would learn my wife had been having an ongoing affair with one of her friends and her social group and left to live with them and no golos mexico. after significant effort i located my son and initiated legal proceedings for his return to the hague convention. for good reason the abduction to mention is viewed as completely ineffective and mexico. i can discuss the various

problems in mexico that prevent implementation of the abduction convention there i feel they are doing so in and in this form is as a force for the trees. in my own opinion are prater should not be to address problems in mexico but we have very little control over. child abductions in mexico from the u.s. is as much of an american policy problem as it is the maximum and as much as mexico was cited for failing to take measures to curb the international -- a chill in government is like is criticized for not taking appropriate mesh is to protect american children are support american parents in their efforts to recover their internationally adopted children. the proximity is relationship between the united states in mexico makes the problem of one country the problems with oath and by extension places a responsibility of addressing the problem on both countries. this type of bilateral cooperation as part of a recognition of the fact that his neighbors both nations share the responsibility of addressing our problems. american parents rightfully complained that they are all blown it in dealing with courts and legal system. the state department as a has a virtual monopoly on information

and refuses to share information or act as an advocate for americans victimized families. there is a explicit conflict of interest between state schools of maintaining bilateral foreign relations and effective advocacy in the system on behalf of american citizens. upon being assigned a caseworker at the office of children's issues and having the first conversation with him i remember thinking to myself my god, they put the department of motor vehicles in charge of recovering my son. to my subsequent horror i had come to appreciate how accurate that initial impression was. all of my -- for practical information howard should remove claims they should not provide legal advice. when i looked back on the way the office of children's issues oriented me on how to have the abduction of my son i have very little doubt they were setting me up for the failure of the hague application for my sons returned. by not providing me with very basic and essential fact they were effectively guiding it down a path that would lead to the

mass resolution of the meetings i wouldn't have put the result in the denial of my sons repatriation. because such a result leads to the quick resolution of a diplomatic incident they consider such results a form of success in view of the american children's heritage is an acceptable level of collateral damage. is only through this is the focus and efforts on my part that he managed to avoid the role the state laid out for me. in 2009 the mexican family court rendered a decision and contradiction of virtually every piece of evidence other than my wife's unilateral testimony and claiming my wife had been a mexico since october 2007 rather than the actual date of 2008. and i had waited too long to file an application for his return. in order to further proof during my appeal in mexican courts ever requested the u.s. state department and copies of her entry and exit records to the united states.

in the conversations that ensued i escalated this issue to the abduction unit chief who claim they could not give me this information because it would violate i weiss privacy. in spite of the fact that we remained legally married and share criminally affected our child to a dangerous country, when i asked to have the records for my son for whom i and am the legal custodial parent i was told this was not the role osi i played and they are allowed to give legal advice or assistance. for the more they said information i'm looking forward be of no use to me in court because mexico and the u.s. share a border that allows for exit of persons between the two countries therefore they claim proving she has subsequently entered and exited the country would not prove the illegal abduction and retention. i couldn't help but wonder for the 1000th time they can give me legal advice why were they now giving me legal advice? so i asked oci if they had in mexican attorney for which they pledge pledged to not but why would they tell me the

information i was requesting wasn't a legal use to me in mexican courts during my pill when it was my own attorney telling me to obtain information. at aries points throughout this request the oci told me something to the effect that a decision had been made in my case sometimes adding the appeal was up to me and my attorney. the subtext of the statements was we consider your case closed. we agreed with the family court's decision and we aren't going to involve or help you and do what we view as the except the world raffle is -- resolution. no matter how long the resolution itself may be. then poured thing wasn't over a of legitimacy has been created and a potential diplomatic irritant have been eliminated. we cannot continue to offer up our debt to children and sacrifice -- pfeffer official lance at at the altar pleasant bilateral relations. the u.s. state department and by extension the rest of the u.s. government willingness to invest a small the smallest amount of political capital in protecting our children is inconsistent with their values as americans. contrary to the idea that abandoning those children helps

us achieve our other more important policy goals, our callous indifference to the plight of our affected children serves the bulk of the argument of american critics that are foreign policies dominated by the interest of american corporations rather than the fundamental respect for justice and human rights. america's leads them when they leads by example and i hope you continue to do that. thank you. [applause] >> thank you very much for your testimony. let me begin the questioning first and i will start with you and i thank you for your very blunt assessment. i have spoken now to dozens of left behind parents and one sense that i get from some and maybe from many is the fear that if they are too strong with the office of children's issues and with their own government and even with congress and senate perhaps, that there is a sense of retaliation that might come their way or a lack of

robustness in resolving their case. somehow the case would be -- out of fear of retaliation. you spared no words in expressing your profound dismay over the performance of our government and i think that has to be taken to heart in a very meaningful way. no child should be a sacrificial lamb. you talked about the aura of legitimacy. in terms of your description and frankly when it comes to human rights in my experience over the last 31 years as a member of congress who takes human rights very seriously, writes many laws on human rights and very often human rights are demoted to when it comes to pleasant state relationships, statecraft, somehow says the human