to handle the chaos going on. we want to present the next president a stable set of partners. as we address those we would like a political process that all parties in syria have engaged in. i think we have made progress on that. not withstanding today's news. and we will see an isil on a pathway to ultimate destruction. >> when do you project that will start and the policy will ba bare -- bear fruit? >> i would say we have seen progress over the last several months. it is not sufficient and we will continue to press that aggressively with partners in the region, state actors, and forces on the ground who have to take the fight to isil, and then

of our own accord using the kinetics we have seen. we have seen good progress but it is insufficient and we will continue to lean on that. as it relates to the political process, we have through secretary kerry's efforts in the geneva process a pathway forward for the parties to work. and the biggest and most immediate challenge, i think particularly as it relates to the spillover is had refuge challenge and we will continue to work that. >> continue to work that including perhaps opening our doors to more refuges? >> not opening our doors but rather continuing decades long and generations long tradition of maintaining the doors open in this country as a source of refuge to to the world's most vulnerable. that has been the case, i think

admirably since our earliest days. >> in the first term an official told me once of the conversation with the president in which the president was asked how do you wish to be remembered context was foreign policy and the president answered he wanted to be remembered as the president who began a repair moment between the muslim world and the west. that hasn't happened. is that a disappointment? how does he think about the fact that he came into the office perhaps, uniquely suited, because of his father's heritage, because of who he was and where he came from. perhaps uniquely suited to be a bridge figure between the two

civilizations and it hasn't happened. sdwl >> yes, it doesn't sound familiar to me. i think when i hear the president talk about foreign policy i think he talks first and foremost about maintaining the strong national defense and protecting this country, expanding our influence overseas in the most general sense, and i think in both of those there is no question he succeeded in that. i think as it relates to the broader question of the relation between this broadly defined muslim world and the west -- i think the president has set out a series of challenges to our friends in the muslim world because i think, first of all,

to suggest there is one muslim world is a mistake. i think the saudi arabians and iranians for example have deep division between the sunni and the shitte. but what we are seeing play out among the sunni to include actors like isil there are deep divisions within sunni islam. those divisions won't be resolved by the united states. they have been to resolved by those countgies religious leaders. what we'll do in that context is partner with those friends who want to partner with us and we will aggressively, very aggressively defend our interest and that includes against this

perversian of islamic groups namely isis. >> we are involved in aggressive action against isis in iraq and syria and elsewhere as well. recently there has been a lot of talk about perhaps a more dramatic esculation of what we are doing in libia. >> i think the reporting included by not only people who work in this building but people in the audience and among the press generally on isil and on the expansion of its kind of brand is really remarkable. it rivals and it is as good as

anything that we have access to. so i think people we owe a debt of gratitude for thprofession. i think what the reporting tells us is isil is for a variety of reasons to include the pressure they are under in syria and because of the chaos in a place like libia is looking to expand. we are eyes wide open. -- libya. -- what the president said is we will exercise all of the elements of our power to protect our interest where we need to do include the use of force and you saw that last november in libya that led to the demise of the leading of isil at the time. i am not saying we are at at

point of dramatic esculating, but we need to be open about where they are trying to grow as they were under pressure in that strip of land along the afghanistan and pakistan border. they sought to move out and i have every believe that isil will do the same. we will not let up as they do that. >> since we are in a roomfull of journalist, that brings me to my next question and that is relati relations among the obama administration and media have been scratchy at times. >> really? >> i don't know if you notice.

>> we have heard people say this is a closed administration. >> yes. over zelious and is locked down and doesn't tell us what we need to know. how do you respond? >> i think we had a nice conversation on this. this is something we thought about. i think if there is not a degree of friction between any white house and any press core then someone is not doing their aub job, us or the press, then friction is a very influential guy. without the music there is no democracy. and i think that friction is something we need. that is the most important

point. you know, in terms of access to the president and policymakers i think this is something that we -- as any administration struggled with. i think there are things about our record i am very proud of in terms of access to the president. i think there is certain things as the media environment changes and our obligation is to make sure the american people has complete understanding of the president's policies as possible. we have to use every channel we can to get that thought out. on my run today, i was struck that there are families in iowa who are convinced that the president wants to take their guns. >> yeah. >> we have no policy proposal and we have never indicated any interest in a policy proposal to take guns from law-abiding

citizens. nevertheless, that is an understanding. so the question is when that understanding develops, either because of misinformation or otherwise, it is incumbent on us that people don't have a misrepresentation. some of the friction between us and the white house core stems from our effort to use all sorts of new media channels to get a more complete picture of our policies out there. but i think that in the main we have lived up to our commitment to the american people to be a transparent administration, to be an open administration. and in as much as you all will

n n not grant that fact i think it is evidence of the needed friction we will continue to operate under and i have ever expectation we will continue to operate under. >> this is good. >> especially characters who have been generating some of that friction. >> well i promise to be respectful of dennis in the sense we have time for a couple questio questions. anybody? just yell. [inaudible question] >> it is my perception that under the obama administration americans have become more afraid. what can obama do to relieve the fears and actually put terrorism in per spebtiv fb sive?

-- perspective? >> i think the principle challenge we have is to be successful against an enemy that either a; because they are successful of you even when they are not have very low barrier to entry, a very low barrier to success. ...

really colors that effort which i think is a shame. at some point we will get back to the watershed mentality convert -- colored foreign-policy. we have to be better at getting outing in testing these ideas. i think that the ability of some of the most heinous actors on the face of the earth to get some

unbelievably hateful propaganda is a huge challenge it makes what is in some ways a distant threat very personal and close. and until we are as effective in that space as we can be, and the leaders in that technological menu then we will continue to confront greater unease among the american people. so this is the area where, in my view, i feel the pres. most dramatically since ii have gotten into these jobs over the course of the last several years. we are bound and determined to leave the ex-president much more effective infrastructure to allow us

to confront the stuff. >> all of the president share his feelings. i think that there is -- part of my answer will reflect back to the last part of my last answer, which is asked -- and i think the president's speech addressed some of this, we are at this moment where ironically super dynamic global economy and a dynamic economy, the benefit the

most. so the strength of us in this economy is a threat to us in this economy, like the threats and national security, not a weakness economically or otherwise but the weakness of other states of players nectars. so notwithstanding those trends or maybe perhaps because of those trends people feel on the outside. the institutions are not keeping pace with the change , whether they are congress, the administration , or colleges which are getting more and more expensive even as they get more -- get to be more

and more baseline requirements. people are feeling caught out of the dream in a waya way that they have in a long time. and i think the challenge for us is governors in this effort, as people running the government is to figure out how to make the government responsive to people's concerns again, answering questions people are asking and at the moment i think in the political debate you have a lot of emotion and energy around the questions. i wish there were similar amounts of energy and emotion around the answers. which are quite limited.

>> now our publisher will say a few words. >> thank you everyone who is part of that discussion that got us started. i just want to say we were thrilled. in almost any endeavor is a recognition for excellence.

many platforms a seek to entertain we rise for the standards of quality in our profession and the standards set by the pulitzer prize. and we started when those not just -- just for bragging rights,rights, although those are nice. they have contributed something meaningful. the humility and honor to have those words but ii want to set those aside for another occasion. but it was a much bigger day for jason and his family and all of us because he is a free man now.

[applause] and i think it is really a bigger day than that and jason would agree, victory for everyone who has chosen the brave course of journalism knowing that it comes with risk that sometimes includes imprisonment and losing one's life. we all of the terrifying stories of journalists around the world being imprisoned simply for doing their job. others lose there lives in war zones as collateral damage and sometimes direct targets and had a great dinner tonight's ago, jason, his wife, and marty in bob woodward and couple others and jason share this remarkable story. they had the port of entry.

phone, documents, everything and there were not sure what would happen. jason was telling us this big burly guy walks up to them and says they need to no that when they mess with one of us the mess with all of us. and that was aa powerful statement about how we stick together with americans. but i want to use my moments to say thank you to you for standing together as fellow journalists and members of the creative community conditions cause. thank you for locking arms and uniting find a global effort. from the great work the national press club did, the terrific editorial pieces in the new york times and other publications at a terrific coverage.

i think that played an enormous part and can contributing to the efforts to secure justice freedom. i can tell you at the "washington post" we know there are more jason's out there who sit in prison is now and there are sadly future jason's doing our jobs today and maybe in prison tomorrow. for everyone on the "washington post", thank you for your role and please know we will send together with you and your colleagues who take these risks to perform the essential role of media and society. though we hope it never happens we will be there with you. i want to take a moment to personally thank someone who

played an important role. yesterday we were able to take secretary kerry for serving as a.man in the negotiations are gratitude goes to someone else who played a very important role [applause] for my own perspective dennis made this a personal mission. engaged, proactive, willing to spend long days and nights to explore any and all options. he kept confidential information.

accessible by phone, email, multiple times face-to-face to your views and think creatively about how we might get jason back. and you have to have the ability to drink out of multiple firehouses at once. dennis found time to make this a priority. the work reflects an excellent profession that is temporary right now thank

you for coming and we look forward to hosting you again soon. [inaudible conversations].

>> the director of the national institute on drug abuse says the overprescribing of painkillers must be addressed if the nation is to address the heroin addiction epidemic. also on c-span2 9 news".

>> america is experiencing an historic epidemic of drug overdose. also on c-span2 9 news". 47,000 died from overdoses and 2014. to put this in perspective, more deaths resulted from either car crashes or gun violence. addiction to opioids primarily prescription painkillers and heroin is driving this epidemic, destroying lives, families, and the fabric of entire communities. it is something i am hearing about in iowa and other parts of the country that have been hit harder. at today's hearing the

committee will learn more about this terrible epidemic , what is being done to address it and how congress can help. the result of the leadership some senators white house, portman, clover char, a yacht on this important issue. over the last 20 years or so doctors have increasingly prescribed opioids to help patients manage pain.

treatment admissions link to them more than quadrupled between 2002, ten years later, 2012. the use of heroin has also spiked sharply. the national survey on drug use and health reports over 900,000 americans who used heroin in 2014 and the previous year. this year or last year that

number rose to 38 percent more than any other drug. according to numerous studies prescription opioids and addiction mexican cartels are expanding into new territory because the administration has not secure the border. indeed, heroin seizures have more than doubled since 2010.

this is a complex crisis requiring a multifaceted solution. the most important part must be prevention to head off addiction before it can begin. the dangers of the substances including the important work of anti-drug coalitions andanti- drug coalitions and educating doctors, taking a hard look at perverse incentives that may lead to overprescribing. exploring whether patient satisfaction surveys linked to higher medicare payments

friends or relatives. i was pleased when da at the same time it is concerning the department of justice

continues to the client forcing our federal drug laws in this area. according the cdc report a person who is addicted to marijuana better treatment options for those who become addicted. so along that line overdose deaths may be reduced by the more widespread use of melodic son we can continue

to crackdown on unlawful prescribing practices, enforce our border with mexico and target the violent cartels trafficking heroin in this country. so i get back to something else, member of this committee and i have been involved in. senator feinstein and i introduced the transnational drug trafficking act of 2015 making it easier for the department of justice to prosecute cartels it harm our communities from abroad in october our bill passed the senate for the sort -- the 3rd straight congress but has not found success in the house. it is critical that the

representatives finally pass this legislation which will help protect our communities from transnational drug trafficking threats. so i welcome our guests and i will introduce them and turn to senator leahy. >> you look around this committee. we know that there are communities whether urban or local no matter what their size grappling with the tragic effects of the epidemic of heroin and prescription opioid abuse. we have all seen the statistics. i will tell you one thing about the dramatic rise in overdose deaths, particularly among young people.

trying to find the treatment for loved one hooked on pain killers. left behind. victims field by addiction. law enforcement community officials overwhelmed by the floater opioids and cheap heroin. the stories we have heard from families and parents had a couple.

got a question of whether there is no epidemic but what we do about it. it does like many other states have not been immune to discourage. but what we normally do is rally together to tackle the problem head-on through community-based and comprehensive strategies. it makes me proud. we heard testimony during a series of field hearings that convened, and in one city they went to the mayor, strong republican and said do we want to talk about this? and we had to keep changing the venue we heard from all

of them. and all of my conversations with vermonters from law enforcement down through one thing is clear, we cannot arrest or jail our way out of the problem. we lost the war on drugs because we rely primarily on unnecessarily harsh sentencing laws. we cannot repeat the mistakes of the past. we also must work on the demand. if we have demand in this country it will come from

somewhere else. it will come here we have got to stop the demand. we have to identify and support the prevention or treatment recovery programs and cannot pay lip service to the communities. advocated for new federal grant programs for heroin opioid abuse. going after drug traffickers 65 percent increase in the number again treatment for addiction. but on any given day there are hundreds more to find themselves on waiting lists.

additional public health outreach and treatment. proudly cosponsor the comprehensive addiction recovery act. we can talk about it, have bills and resolutions the spend the money. this is a great danger and we can spend money on it governor, you have been a national local leader on the issue and a lot of people want to pretend we don't have the problem. the governor gave a state of the state address in the past.

did not say everything was going great. he talked about this problem. that was the whole issue. it's about time someone speaks up. so i thank you for convening this hearing. provide the resources and support necessary, but we must act. we will not rest our way out of it. everyone knows out of -- everyone knows that. they will come from another. we have got to attack and work and do all of the comprehensive programs, the faith community, educators, law enforcement, medical facilities to stop the demand.

we will always have the problem. >> continue your introduction. >> thank you. >> go ahead. >> obviously when your introducing colleagues like i am you know what awful lot about them. >> can't do that. >> i can say all of them are extremely dedicated to fighting the opioid epidemic sweeping the communities and i'm grateful that they are all interested in this and i think from an initial discussions with members of the colleague we feel both from a cost standpoint that we might be able to move ahead. at least i hope that is the outcome.

our 1st witness is senator ayotte new hampshire, co-author and original cosponsor of the bill, s 524 comprehensive addiction recovery act, former prosecutor and attorney general comeau one of the leading voices in congress seeking solutions to opioid epidemic. our 2nd witness, senator shaheen also cosponsored and highly effective leader. new hampshire is fortunate enough to have two senators working across the aisle. next line the robert portman from ohio co-author and lead republican sponsor of terror working tirelessly in bringing awareness to the epidemic throughout the state including the drug

free community act and also 20 years ago came to my state to help me with a nonprofit organization that i started in my state as well. our relationship goes back a long, long time. now it is your opportunity on the government. >> served as governor of vermont since 2010, small business owners, public servant, father of two, two wonderful young women, committed entrepreneur, longtime codirector along with his brother the 81st

governor of vermont.

and having served as the attorney general of our state i can assure you i've never seen anything like this in terms of the epidemic were facing. the timing of this hearing cannot be more important. the homeland security committee and heard from people in new hampshire but also heard from director botticelli of the office of national drug policy has been a strong partner with new hampshire.

fond coalitions across the country and now working with some of his close shower and white house i was proud in september of 2014 to introduce the comprehensive addiction recovery act. i want to thank the members of the committee for sponsoring the act, ranking member, senator hatch, blumenthal's and donnelly for the work we have done on legislation. today you will here from the police chief of our largest city manchester, new hampshire who will talk about the epidemic facing our state, how we can address it together, both law enforcement working with those in prevention,

treatment, recovery command i have the privilege of doing a ride along and evolve with the manchester fire department. i was there an hour and a half and we went to to heroin doses within an hour and a half. this is sitting every family in some way new hampshire. i watched the 1st responders bring people back to life. but for them being there they would have died. and it just struck me how devastating it is because one of the cases i wenti went to there was a baby in a crib in the corner. we think about this. it is not the impact of the struggling with addiction but the impact on all of our quality of lives in the future for our children. in new hampshire in 2014 we had 320 drug overdose deaths a 60 percent increase from

the year before. this year chief medical examiner tells us 385, 148 of those deaths are attributed to a devastating drug called sentinel which the dea tells us is 50 times more powerful than heroin which is an issue i believe needs to be addressed by the committee as well. solving this crisis requires a holistic approach, and the comprehensive addiction and recovery act that so many members command i appreciate the leadership on the committee, it's critical. we brought together over 120 stakeholder groups around the country but this legislation together. those on the front lines in every aspect command has the endorsement of the national district attorneys general, the major county sheriff's association, the community

and i drugi drug coalition of america and the national association of attorney general. my attorney general from new hampshire has endorsed it, theit, the iowa attorney general has endorsed it, the vermont attorney general and many others have said please pass this legislation. it focuses on a holistic approach, expanding opioid abuse and prevention and education efforts. identify and treat incarcerated individuals so that we can and the revolving door we see, expand drug take back effortstakeback efforts to promote the safe disposal of unused on more prescriptions , strengthen prescription monitoring drug programs and launch

prescription opioid and heroin treatment intervention program. we can administer narcan in our 1st responders are doing an amazing job, but if we do not get the support and treatment for those struggling with addiction and deal with underlying issues we will not solve this problem. as the chairman -- and you will hear from chief willard today -- we cannot arrest our way out of the problem. this is not just about statistics. it is about real people dying, real people like courtney griffin, 20 years old, such a promising life before her. realreal people like the grandmother told me as she waited on me in the store, i lost my granddaughter. we can make a difference in the senate and in this committee the passing the comprehensive addiction recovery act, by working together to not only support our 1st responders but to make sure we are focusing on prevention, those who are struggling with addiction,

that we get them support for treatment and recovery and most of all that we can turn this around because i have also heard the redeeming story, people like eric stoppard addicted to heroin and now has established treatment facilities and new hampshire and is turning this around, but we need to act immediately. this is a crisis. i am glad you're holding the hearing. i think all of my colleagues and this committee for its leadership and look forward to working with you. thank you. >> thank you. >> thank you, chairman, ranking member, members of the committee for giving me the opportunity to testify this morning. i am a cosponsor of the comprehensive addiction and recovery act and appreciate the leadership of my colleague. working on that legislation.

i am actually here to testify not on that bill but onto bills that i have introduced, that is a mouthful, but what the bill would do is allocate 600 million in emergency funding to address this national crisis. the 2nd bill is the combat heroin epidemic and backlog act which would authorize a grant program to reduce the chronic backlog of heroin and fentanyl cases at state police crime lab's and you and senator leahy in my colleague talked eloquently about the statistics that affect this epidemic. epidemic. the fact is, i believe that we have is a pandemic affecting young and old, urban and rural, rich and poor, white and minorities and is burning to every state in the country, including alaska and hawaii.

in new hampshire we are losing more than a person the day and we just had a study come out on mortality rates in this country that show that mortality rates among middle-aged white americans are actually increasing for the 1st time in decades rather than decreasing which was attributed primarily to the rising substance abuse disorders. so as the sen. said, those statistics do not adequately describe the devastation to families who lost loved ones and do are stillyou are still struggling with trying to get loved ones and the treatment. but despite the statistics public health and law enforcement agencies at all levels lack the resources,

and effective response. nearly nine out of ten people who needed drug treatment we need to mobilize a national response specifically providing an additional 200 million under the edward burrell memorial assistance grant fund for state and local efforts and less you think 600 million is too much $5.4 billion in emergency funding to compat the ebola outbreak last one

person to ebola congress passed 2 billion. we need more resources and you will here the challenges they are having. i also want to touch briefly on the combat heroin epidemic and backlog act designed to help drug labs across the country, crime labs across the country as they analyze drugs. this is modeled on what we did in 2,005 to combat methamphetamine and what we are seeing across the country is that state police forensic laboratories have accumulated backlogs of heroin and fentanyl cases because they do not have the resources to do the testing.

the state forensic lab received 750 testing requests each month but can only process 450, and the growing backlogs result from an increase in heroin cases and a dramatic surge in fenton on cases, and to give you some idea and new hampshire in 2013 we had 193 overdose deaths, 18 of which were fenton not related. in 2014 we had 100 25326 overdose deaths, 145 or fentanyl related and in 2015 we had 385 deaths from overdoses, 253 were fenton all related. we have to act with a sense of urgency because delays and processing drug samples have disrupted every stage of the policing and judicial processes.

no longer able to identify combination and designer drugs by site, undercover law enforcement are forced to way to verify samples before continuing investigations and prosecutors and judges are less likely to offer plea deals with the lab confirmation of the drug's authenticity. put simply, thesesimply, these backlogs are keeping us from putting dangerous criminals and drug traffickers back in jail and getting them off the streets. i believe it is something that we can overcome. thank you very much. >> thank you for having the

hearing and letting us come before you. it does so in a comprehensive way. we have been working on this for a few years now. i was encouraged by your comments earlier and by the ranking member's comments

about this issue in a comprehensive way and the importance of moving this legislation forward and i thank you for that. it is the appropriate federal response. i also want to thank those from every area of prevention through recovery who have worked over the past years in putting this together and participated in the forms we have had with a have come in and given input. and no matter where i go i here the same story, from mothers,, from mothers, fathers, sisters, brothers, friends, heartbreaking stories how addiction is running lives. tearing apart families, devastating communities. this epidemic is striking close to home. and you are hearing that as you go home. last year 2,482 ohioans died from a drug overdose. this should demonstrate how difficult it is to break through this addiction, the

bonds of addiction that are so strong. i was in the hospital last week looking at the amazing care that they are giving to addicted babies. had a chance to talk to some others that is how strong is bonds of addictions are. thousands more are surviving overdoses but are still struggling to hold the job, take care of families. addiction costs the country's $700 billion every year more crimes, cost of incarceration, policing, a lot of money. y'all talked about that this morning.

this hearing will be effective in helping bring awareness to the severity of the problem but it is just as important we talk about the reasons for hope, there are alternatives, ways to address this, make progress in combating this epidemic and lives can be slaved. i have been at this now we need to do more not just on the prevention and education but dealing with recovery. i have seen amazing people who actually work, visited with men and women who struggle with addiction and have been fortunate enough to get to know a lot of ohioans have channeled grief

in the something constructive. help others break the stigma of addiction. you will hear from one of those women his morning. i 1st met last fall, came here for the rally on the mall against addiction and she told her story to me, one that breaks your heart. her daughter was 21 years old when she died of a heroin overdose. she did not fit the stereotype of someone who was a heroin addict, excelling in school, a lot of friends, selected for homecoming prom, building a life for herself coming days to be married in the 20th birthday celebration of

friends of hers is about to try this. when she added in the grips of addiction. as you will hear later she did what any mom would do helping her daughter trying to get into treatment. went to rehab, gained a. teefive gained a period of sobriety but then addiction to go. she overdosed and died. again, taken that tragedy and used it in a constructive way to help others. she now has 40 chapters around ohio in the country and it is in the hopes that other guys will not follow that similar dangerous path. i commend her. there are so many others who have done the same thing. last week i visited marion and met bethany the struggle

with heroin addiction, as, as a teenager, promising athlete, going to college, had a scholarship, but got sidetracked through addiction, and expecting mom and used and says that tearfully now, arrested. law enforcement tried to deal with her issue by not putting her in jail but finding alternatives. she finally figured out that she had to beat her opiate addiction because of her kids.kids. and she did it. detox was hard, recovery harder. she went on to graduate from the treatment where to provide resources for mothers facing substance abuse and for five years of being sober she now leads that as a coordinator to help other month in recovery.

to my colleagues this morning that story tells us why there is hope in the face of addiction. you have seen it in your states. we have seen it around the country. people, listening and learning from these families is what helped us form every step of the way. from prevention efforts to law-enforcement strategies to addressing overdoses and expanding evidence -based treatment this legislation is comprehensive, will help entities command we need them all, not just one. i am committed to passing this bill in getting its signed and the law. so the nine members of this committee who cosponsored legislation, thank those who are willing to work on

getting misreported out onto the floor for a vote. it is an investment. an investment at a time when communities are desperate. it is a small investment for the future. we will know success by empty jail cells, the number of people who never have to struggle with addiction in the 1st place. the message is simple. there's something we can do. you are not alone. we are with you. there is hope, and that can be furthered by this committee leading the way. thank you. >> thank you. >> governor. >> go ahead.

>> inviting me down. glad to have my us attorney here with me. i would say, when governors give the state of the state it is kind of a big deal and we spend a lot of time on it and layout proposals that make a difference. i made the mistake of doing that. acknowledging two of my favorite people on this earth. they get the longest biggest standing ovation of the speech and they get the biggest ovation. i will not make that mistake

again. i was going to share with you many of the stories that you just heard from your extraordinary colleagues, so i won't. vermont has the same heartbreaking stories. but i dedicated my address to the subject it was a lonely place to be. there was a long debate about whether they havehad that big a problem and should the governor be spending this much time. it gives me hope to hear from your colleagues as well as to see the committee focusing intently on the challenge that we are all facing together. i came into this knowing very little about addiction that i was listening and

started asking how we get into this mess and what we do to get out of it. when i started talking i learned we were doing almost everything wrong, almost everything wrong. first, criminal justice was designed to maximize addicts going to prison and not treatment. plain and simple. i learned that the most likely chance you have to move someone from the nile -- in denial of this addiction is extraordinary. but the most likely chance you will get to get an opiate addicts to agree that they have a problem to go to treatment is that moment when the blue lights are flashing, hank server on, and they have bottomed out. ..

father and.

>> we are moving on to treatment, recovery, not that there are not failures another they do not have setbacks but it actually moves them into recovery. it has reduced our incarceration population dramatically. from $50 million in the last year's not locking folks up but putting them into a treatment program. it is working as well as one might hope. second, we have expanded treatment like mad. even with tough budget times we have made tough choices but we are building out our treatment centers as fast as we can. that too is having a huge affect. our problem is, as we remove the stigma, as you're helping to do in this hearing today, we have more folks who are willing to come forward and say i have the disease, i need help.

as we build up the treatment centers and i know new hampshire is fine in the same challenge we are literally fighting longer waiting lines because there's more demand. we have to keep building out treatment centers. we need help help in building out those treatment centers. third, the rescue kids that your calyx mentioned about the narcan is absolute critical. we are the first state to get it into police hands and law-enforcement at every level, together they have the firefighters, we have saved hundreds of lives. this is expensive. this is expensive stuff. we need help saving lives. prescription drug monitoring program that senator has mentioned to build upon it is critical. we have governors over new england working together to improve the data were people are shopping for prescription drugs across state lines. so without telling you more about what i think we're doing right and what is giving me

hope, i want to mention a little about about what is not given me so much hope. listen, we need financial help. the states cannot do this alone. as an example, when senator leahy help give us for 3,000,000 dollars, it seems like a small amount of money in washington but it was huge for remount allowing us to get it to the howard center, the resource center, to actually help us build out the treatment centers. we are scraping together pennies to try to make our treatment centers stand on their own. so financial help from washington is critical area dynamic urged by the bipartisan support in the senate to help us get the financial resources that every state needs to fight this battle and to win it. money is huge, second, we have to look at what is holding us back a treatment. one of the things i have things i have to tell you that i found in vermont

is as we build out treatment centers, particularly true of small rural states where we are having challenges getting enough primary care doctors in the medical field to deal with illnesses that we are all facing with the medicaid underpayment to them and so forth. we do not have an extra physician force to deal with the magnitude of treatment that is necessary to successfully when this crisis. to get treatment to people that needed. you have to ask this question in this is a federal change that i beg you to make. why is. why is it that physician assistants and nurse practitioners can prescribe oxycontin and other drugs that lead to heroin addiction that they cannot prescribe the treatment drugs that would allow someone to get off the stuff .. to normal life? why is that? i ask you to help us in expanding the force on the ground that will help us be able

to treat folks by making it immediately possible for physician assistants and nurse practitioners, under the direction of a physician to be able to prescribe the maintenance drugs that allow us to move from addiction. i just want to close by saying this. we do need to ask this question, why are we in this mess? what led us into this mess? why are all 50s the untrained states on a bipartisan basis saying we need help? this is everybody having this problem. this disease knows no racial boundaries, no income boundaries, no partisan boundaries. everybody is in. i think we have to have a more honest discussion about what led us into this mess. listen, i know our instinct is to say wow, those folks in south america and other places are sending us lots of heroin and it is a huge problem. well of course it is.

but i ask you is that a new problem? has something something changed dramatically in the last decade or so that has brought this heroine to america? i would say no. we have always had this problem of drug dealers trying to get support their countries and their wars and everything else by sending illegal drugs to america. so then what did change? i think an important a to have an honest conversation about this. what change was we changed our attitudes in america and our practices in america in the late 1990s about how we deal with pain. why are we talking about that? this i can tell you. i have a lot of hope for where we are headed, i am incredibly discouraged that we still have more people signing up for opiate addiction in vermont then we had when we launch this battle two years ago.

why? the facts matter. when the fda approved oxycontin, purdue, several years later the manufacture of that drug pleaded guilty to two for telling physicians and dock that this painkiller was not addictive. he paid a fine in the same year that 11,000,000,000 dollars worth of oxycontin of the painkillers were sold in america. these facts matter. in 2010, we prescribed enough oxycontin in this country to keep every adult in america high for one month. we did. those are just facts. in 2012, we prescribed 250 million prescriptions of oxycontin. now there is only, bless him i checked 250 milli-people in our country, so that our country, so that is a prescription for every living american. just a few years ago the fda

approves the soul hydro. i call it oxycontin on steroids. we are about to do this all over again team and guess what? when they approve that they did not make it tamper-resistant so you can snort it, you can shoot it. that is what led us into this mess. just this year they approved oxycontin for kids. you can not make this stuff up. so i ask us, to pause, to take a deep breath and to ask this question, are, are we willing to have an honest conversation about the way we are dealing with pain medication and america? i can tell you that until we do, all of the good work they were trying to do together will lead to more tragedy, more loss loss of life, more of our sons and daughters dine of opiate addiction because that is what has changed. what has changed is that we

simply pass out painkillers like candy in america and we are unwilling to have that conversation. thank you. >> mr. chairman i assume arsenic colleagues probably have to leave, i have seen the senate schedule, it's not the house schedule but the house schedule is pretty busy. -- left i asked that those senators to be excuse, but i do have a question. >> i don't have questions for you we can talk any time and i look forward to continue conversation on this legislation with my colleagues. so you can stay if you want to, go ahead asked the governor your question. >> thank you, governor you and i have talked about this a lot. i appreciate your passion, evan over everybody here this is not

just something that governor says publicly, he has talked about it a lot privately. i think it is fair to say that you feel the same way i have heard from police officer all over the state of vermont, it is not just the law-enforcement problem. i think a lot of them certainly tell me that both the federal level please, the state police, local police, county, and they tell me if they could get people into treatment they would much prefer doing that. is that the same thing you're hearing? >> absolutely. i have to to say law-enforcement has been an extra in her i'll lie in this battle. that's true across the country. i was i was recently on a panel with the police chief in massachusetts who literally

said, here is my policy, and now hams sure new hampshire sure and vermont are doing the same thing. if you are addicted to opiates, come to my station, we will not arrest you, will get you into treatment. we are not arresting any more folks were addicted to this disease and are nonviolent. i sometimes think we do not give law-enforcement enough credit for being on the frontlines of this. for years we said to law-enforcement this is your problem, go problem, go settle it. if i was law-enforcement i would be a little raw about that. instead, they have said we want to partner with the medical community and treatment folks, with families to try and solve this problem as a disease not a crime. without them we would not be where we are. >> but we also have to have a place where they can bring them who have a diversion program. i think would all agree you have to then have the people there.

>> absolutely. we are literally scraping together the resources to try to pull this off. i cannot tell you that vermont, i bet the senator from new hampshire and i will would say the same thing, we are not there yet but we are doing the best we can with the resources we have. >> senator grassley mentioned to me nurse practitioners, i think we ought to follow up. >> we the attitude towards nurses in america you can have a nurse unless you have a dr. looking over you, we have to change that. i think your suggestion. i think. i think in rural america we are going to have to make greater use of nurse practitioners. >> i am somewhat partial to nurses as you know, i have a daughter-in-law who is an active nurse practitioner. >> i want to thank my colleagues were coming. i have done roundtables around illinois, there is there's no town too small, no suburb to wealthy not to have heroin overdose deaths in the state of illinois. i want to especially thank the

governor because i think you pointed to something that we need to point to. we can all indoors the legislation that has been described, every single piece of it nice thought i am for that. you go to the heart of our responsibility. the fda, the farm industry, the dirty docks. we don't have to go to the border here to see the source of opiates. you go to the pain clinic in the mall, you go to the dr. just around the corner. you go to the pharmacist to look the other way. clearly i think we have responsibility here. farm is making a fortune off of this. i will concede the fact that over the last ten years we have decided to tackle pain directly and i'm glad. for a lot of people it is the difference of quality of life and we have to readily acknowledge. with it has come a dramatic

abuse to think that the prescriptions, legally written prescriptions in this country, result in a bottle of pills for every single adult american. as you said, to treatment with this drug for at least one month tells me it is out of control. congress, what are you doing about this? senate, what are you doing about this? the fda is? the fda is dreaming up new application for children and first super opiates? where in the heck is the congress in terms of our responsibility when it comes to this? the second point i would like to make is, the police chief and closser ought to be here today, because dixon, illinois population 20,000 went to visit with him and decided after four heroin overdose deaths in one weekend they were going to buy into his program. twenty-five kids, young people came forward. they went into treatment.

you know what happened to the jail? it was empty. the petty crimes, burglaries, thefts started disappearing. but there is a creep key element here. how do they get into treatment? if they are lucky enough, if they're lucky enough to have health insurance and their families have access, if they're lucky enough to the affordable care act to have access to medicaid the may get into treatment. we all know that we do not have enough resources to treat these people. we absolutely positively have to do it. i want to commend two, we have senators from minnesota here, in a bipartisan effort they demanded and family after you're succeeded in bringing reform to health insurance so it now covers mental health counseling. and now covers addiction services. those who those who want to repeal the affordable care act, if but your hand up if

you want to repeal that part of it. it would be disastrous across america when you consider this drug overdose and other things. thank you thank you for turning the spotlight back on us. it is not just all of the things we have her, we have to look at fda, pharma, pharma, we have to look at what is going on with illicit prescription and filling out prescriptions across america. that is is our responsibility. thank you. >> will go back and forth. >> i just wanted take a second to think our colleagues for your powerful presentation here today. i think what we are seeing in america is that we are reconsidering a lot of our criminal justice policies. this committee is under the leadership of chairman grassley has passed out criminal justice reform bill, i know other senators have worked on it a lot. i hope that as we look at this terrible pandemic that we look at this comprehensively.

i do not know if you can draw any artificial lines between dealing with mental health issues in the criminal justice system and drug addiction issues because we know talking to her sheriffs that many of our jails are populated by people with mental health issues for which they self medicate. if they're unable to find other places where they can get some help. i'd also like to make a plea of my colleagues on behalf of someone who represents a state with 1200 miles of common border with mexico. demand is a big problem. governor, thank you very powerful testimony. we also need we also need to deal with the supply issue as well. i know it is tough, our friends in mexico say what we would not have all of the drug cartel activity and all of the transportation of drugs into the united states if there was not such a demand in the united states.

so we do have to deal with both of these. i hope as we look at these will not draw any artificial lines or create stovepipes and we will try to find a way to deal with this in a broader, more liberal sort of way. >> mr. chairman, i will put my segment of the record so we do not go on to great length. we have two panels ahead of us still. while the senators are here i wanted to thank them for their terrific work they did as original co-authors of the bill, we are very grateful and they were joined by others very early on in the proceeding. i thank them but i also want to particularly thank senator hatch and senator graham who were the first to committee sponsor of a committee site for this bill. they helped make sure that we had this hearing today. i just want to make a record of how important they have been in getting us to this point. thank you very much and the rest

i went to the record. >> thank you mr. chair. thank you for being here and thank you for your work on this, i have already expressed thanks to you who wear panthers black and blue after your patriots got illuminated. [laughter] governor,. [inaudible] [laughter] i think it's a great -- i look forward to seeing them move through the process. governor governor i had a question for you. i'm a personal friend of your speaker, i have known him for about five years, to the point that senators making, and i do agree to a large extent to what senator durbin said but if we focus on, for example the prescribed painkiller problem that i think we're going to see

an increase in uptick in heroin abuse. this happened in north carolina, we've done a number thinks a crackdown on drug shopping and the things that we have seen and there is a direct correlation between a reduction in those prescribed opiates and an increase in heroin abuse. so as a matter of state policy, what are you looking at? almost the very struck by the fact that some states there's great disparities between overdoses and deaths. i was shocked to know that ours had gone up 40 480%. what are we doing to address the specific issues and what risk do we run a federal policy potentially hampering what you think in your speaker when your

senate leader need to do to address the things that are unique to some of the state seem to have disproportionate problems. >> that's a great question. i can't tell you why some states are being hit harder than others. this i am convinced out. i i do not think that we would have the heroine problem in america if we were not starting folks out on opiates that are sold over the drug counter source. it is not coincidence that our exuberance around painkiller is matched by the rising heroine crisis. so i'm convinced that if we went back to the old policy on pain medicine which is, when someone has chronic pain treated and treated hard. but do not pass the stuff out as if it is not a problem, which is what we're doing pretty i will give you an

example and i know we can tell this story's. i i had reporter come into my office and she just had surgery for carpal tunnel and i said how many did you get? is that what you mean? and i said how many axes did you get and she said 80. i said how many did you take? she said half of one. so there 79 and have left behind. three weeks later my head of healthcare daughter later my head of healthcare daughter comes by she's a sophomore college. she had four molars pulled out. i said did they give you any pain killers? she said yeah. i so what did they give you? and she said oxycontin and how many did you get? she supported. said 40. how many did you take? she said none. so there is 40 more. my point is, there is no question that when we made a tamper-resistant folks went to the heroine because it is cheaper and it is easy to get. but, we cannot lose sight of the fact that we are not having this

problem prior to the invention of oxycontin, we just were not. we have got to go back to the source. i think the senator from illinois said, just remember so hydro, when the if da approves so hydro, its own advisory panel voted 11 - two, do not approve this drug. they did. my point is, there is a correlation if you talk to folks are at it. many times, 89% of the folks say i had a car accident, had surgery, this happened to me, whatever it was that led me into this mess. >> the senator want to test some. >> i think we have talked about the fda, everybody here has talked about pharma and the role of prescription drugs. what we have not really talked about his medical schools and doctors. it

is my understanding that most medical schools do not have any courses on prescribing medication, on recognizing drug abuse and it seems to me that we also have to get some attention from medical schools who are turning out doctors who are prescribing practices without the history of what has been race at the hearing. >> amen. >> i certainly fully agree with you on this. we have to engage the medical community on this. also for example in new hampshire, back when i was attorney general i was fighting for prescription monitoring then and our state was late to the game on it. when we look at this data and giving positions the information that they can have and that is one of the pieces of this bill is to support the prescription monitoring program, physicians that want to do the right thing it gives them the data to understand if someone is dr. shopping. it also gives us to know about particular doctors actually exceeding his or her bounds

because it's all focusing on them. so that allows us to address that. we have to engage the medical community. i. i think sampson who you will hear from will tell you that four out of five people started with overusing or misusing prescription drugs. your point chairman that you raised in your opening, we also right now with the patient survey are encouraging reimbursement based on how satisfied people are with pain. that has to be addressed as well. i know that cms is working on this but it has to be a priority because we do not -- and this is brought to our attention to doctors who are concerned that if they are worried about an addiction issue they are being judged on a survey that is a, how's your pain satisfaction? that needs to be addressed as well. >> just quickly mr. chairman, i don't don't disagree with the, made here.

as a result, and this legislation we not only have a drug monitoring programs which are incentivized and two senators question about how the states will respond to this legislation, does not mandate the states to do this. i think it's very important to that point that every state is going to be different. some states have done cutting edge which work. think about it, interstates we may have a great program in my state of ohio, west virginia and kentucky have different programs. you. you don't know someone has a prescription pill in ohio that something the government can exclusively do. we have legislation on that. second, this drug take back program is incentivized to this legislation. we focus on getting the drugs off the shelves which you're absolutely right. the final thing i'll say is that having talked to hundreds of people who are recovering, who have been at x because of prescription drugs, i understand that issue very well including

the athlete i talked about early. i will also also tell you that there are people i talk to who jump that step. they went straight to heroine. holly is an example of that who we will hear from her mom later. i think now because heroine is so plentiful, is just with the fbi in ohio yesterday talking about this, the drug cartels from mexico are in ohio, illinois, interstates, because it interstates, because it is so plentiful and cheap, it's not just about prescription drugs anymore. it has been a a gateway for a lot of people. now there is a problem directly with heroine, even first use. back in the days where we worked on this issue of cocaine and marijuana, heroin was not first used drug. it was a drug you use after other gateway drugs. with young people as he has 13, 14, 1513, 14, 15 years old, they are using heroin today. this legislation is comprehensive it deals with a prescription side but it deals with the heroine issue which that we need to confront perhaps

because of this onslaught that came from the overuse of pain medication but now the heroine is upon us. >> thank you very much mr. chairman. i want to get to this point about what we should really be looking at here and what we have some control over and the congress. i'm a a former prosecutor, i know these drugs have been coming in as you stated, but i think the number one thing that we can do right now in addition to funding are law-enforcement, making sure we have efforts with dea fund a, is really go after what is been happening with prescription drugs. while it. while it is true that there are people who are originally hooked on heroin, the fact is a fact, four out of five, 80% of these heroin users started with

prescription drug. what the governor has been telling us somewhat senator has been telling us is that this is different than it was even when i started as a prosecutor in 1998. this is a different situation. we have these prescription drugs, but everyone in this room you have some in their cabinet or has some or know someone in their family, where he just took one or two as the governor pointed out and there's 20 left or there's 30 left. they're sitting in there. we passed the prescription drug takeback law years ago and we finally got the rules of the dea to get that moving. that's not going to solve it if it is just keep happening over and over again. in this bill are the works that the senator and i did on the prescription drug monitoring. just having, come from a state where we are not just the state of 10,000 lakes but of 10,000 treatment centers. i know from talking to those the doctors and

experts that we are not really going to change this until we change the way these painkillers are given out. that is. that is why the dr. monitoring, the have a more limited dispatch in of these kinds of drugs is going to make the biggest difference here. i am all in all trying to do everything we can to give these dangerous drugs out of our time. the change here and what what we have more control over is how we give these people hooked on drugs in the first place. sometimes they are such innocence, they just have a bad back. no one warns them that even their particular makeup if they take these drugs for four days instead of maybe just one day or just want, they are going to get hooked. we are doing this in our country. our policy, not a drug dealer on the corner. that is what we need to focus on. that's why i'm pleased with this bill. >> i think senator is correct. and a point to the report on the new york times that is written an online book that says these pills delay healing. the paint peels, the where you take the longer you have these problems. a lot of points that

we really need to reduce the amount of prescription drug. as a former prosecutor myself, we targeted prescription drugs in mobile, alabama that most -- it can be the most successful reduction of drugs there is because they're not many sources. only a certain doctors are of the list, we found really the legality was coming from drugstores, to drugstores. when you eliminate that you do not plea bargain with people until they tell you where they got their pills. you can quickly go back to the sources that are out there. this is a minimal thing thing and it does lead to additional drug use. thank you. >> think it's chairman grassley. i just hope the american people notice the striking

bipartisanship of this panel has shown. senators and governor the questions, the, so we have heard from members of the judiciary committee, the input we have heard from senators i've worked so hard on this issue for a long time. my home state of delaware, like your status also struggling with an opiate addiction challenge that has penetrated every level of society and background. i have stories that we can share about our local law-enforcement, paramedic and first responder committee. i'm just. i'm just thrilled to support up bipartisan bill that lays out the authorizing background for expanding prevention and supporting recovering an emergency supplemental to make sure we have the legal framework in the financial resources. this is a genuine genuine problem in all of our states. it is my hope that people watching will recognize that you have republicans and democrats working together to craft a thoughtful, broad strategy, it is my hope that will get these bills moved. thank you mr. chairman. >> we have had a forceful discussion, very seldom to our colleagues get involved with questions from their colleagues. thank you all for your patience.

i'm going to move on to the second panel now and i know that i don't have to tell you that will be talking about this in the future because you are going to make sure we do. okay, well we we have commotion i'm going to call the second panel. our first witness is michael botticelli, director of the national drug control policy at the white house. as director he has the obama administration drug policy efforts and is responsible for creating the annual national drug control strategy. previously he served a director of substance abuse services in massachusetts, he has an undergraduate degree from siena college and a masters of education, education, st. lawrence university. second witness, doctor nora director of the national institute of drug abuse which supports most of the world's

research on health aspects of drug abuse addiction. previously she worked at the department of energy's brookhaven national laboratory where she held several leadership positions, she earned her medical degree at the national university of mexico. our third witness, cana, she serves as the acting administrator of substance abuse, mental health services administration. that agency leads public health efforts to advance the behavioral health in our country. she has worked at -- since 1998, heard a bachelor's a bachelor's degree at a masters degree in psychology from ucla and is also a graduate of harvard kennedy school of government. our final witness is louis,

deputy assistant administrator office of the division of control within the drug enforcement administration. in that that position he was responsible for overseeing and coordinated major pharmaceutical and chemical division investigation drafting and promulgating regulations. he he has been with the dea and multiple capacities since 1997 and holds a ba from villanova university. we will go the way that we energy. >> thank you for the opportunity to be here today. as you know it is an important issue for president obama.

during his state of the union address early this month the president specifically mentioned addressing prescription drug use and heroin as a priority. an opportunity to work with congress on an issue that transcends party, income level, gender, and race. i also want to think many of the members that are here today for their ongoing leadership and support of the work of our office on this most pressing public health and public safety issue. the national drug control policy produces the national drug control strategy which is our blueprint for drug policy. using our role as courtney deferred drug control agencies in 2011, the 11, the ministration released a plan to address the rise in prescription opiate drug use. this plan categorized in four areas, many already discussed today. educational prescribers and patients. increase and use of prescription drug monitoring programs. proper medication disposal. an law-enforcement effort. since this plan law-enforcement effort. since this plan was released, this crisis has clearly evolve. with an increase in heroin use

and frontal use in overdose death. the administration is but for new initiatives to help deal with emerging issues. as you know we need to a comprehensive approach in response. opiates are taking a horrific toll across the united states. we talked about the number so i will not repeat them. these numbers are harrowing but we are making some progress. this past month nonmedical use of opiates by americans 12 and older was lower in 2014 from its peak in 2009. the number of people initiating nonprescription use also decreased significantly. this progress has been counteracted by an increase in the availability and use of heroin. although nonmedical prescription opiate use continues to suppress her when use. heroin. he has been rising while prices

remain low. the harrowing crisis has been compounded by the reemergence of illicit fentanyl, a synthetic opiate that is added to heroin to increase its potency or used on its own. since fentanyl is is more potent, it has increased risk and overdose death in the united states. although the transition from obedience to heroine occurs at a low right, recent article concluded that this transition appears to be part of the progression of the disorder among those with frequent, nonmedical prescription user dependence. we have talked about the need for enhanced prescriber education because they do not provide a company has a identification and treatment of opiate use for safe and affected opiate prescribing. what are the most jarring studies i have seen in my ten years of doing this work, recent evaluation of healthcare claims

data from that the majority of nonfatal opiate overdose victims were receiving an opiate prescribed at the time of their overdose the most alarming, 91% of them received an opiate prescription again from a prescriber. 70% from their own prescriber before they overdose. response president obama released a presidential memorandum requiring training on the appropriate prescription. the ministration continues to press and will continue to work with congress to pass mandatory prescriber education tied to controlled substance licensor. the ministration is focused on several areas to reduce opiate overdoses including average kid

in the public on overdose risks and intervention, increasing third-party and first responder access to the opiate reversal medication, working with states to promote good samaritan laws, and connecting connecting overdose victims and persons with opiate disorder treatment. we appreciate that congress provided more than $400 million in funding in the fy 16 appropriation act to address the opiate epidemic an increase of more than 100 million from 2015. to address emerging rise in heroin fentanyl use, the 2015 strategy focuses on identifying and disrupting criminal organizations. working with the international community to reduce poppy, and we have also been enhancing our efforts along the nation's borders and have been actively engaged in government of mexico on supply reduction issues to decrease the flow of these drugs

in our country. finally this past summer, we committed 2,500,000 to our high intensity drug trafficking area program to develop a strategy to respond to the heroin epidemic providing resources and addressing heroin threats across 15 states and the district of columbia. the sum ministration continues to work with our federal, state, local and tribal partners. to reduce the public health burden consequences of prescription, opiate, and fentanyl. i want thank you for your ongoing commitment to address this public health, public this public health, public safety concern. thank you. >> thank you. >> good morning everyone. i want to thank you all for giving me the opportunity to participate in this hearing.

what is the nature of the problem? chronic pain is the monk the most prevalent and debilitating medical conditions with over 30%% of americans suffering from some form of chronic pain. the effectiveness of opiate for severe acute pain and the alternative for chronic pain have combined to produce an over reliance on opiate pain medications even when the benefit for chronic pain are questionable. what is no longer questionable is that opiate medications are being widely diverted and have produced an epidemic of opiate overdose deaths and addictions including those from heroine. opiate medications such as oxycontin and hydrocodone have been abused because just like harold, they bind to opiate receptors. upbeat receptors are located in regions of the brain that regulate pain which is why they're such potent, but their concentrated also in regions

which is widely produced addiction. opiate receptors are also located in brain regions that controlled breathing which is also why they can produce overdose and death. so how can we help with the issue. they supported the development of the three medications that are currently approved for the treatment of opiate addiction. their strong evidence for the effectiveness of these medications in the treatment of opiate use disorders in the prevention of overdoses, and the the prevention of infection such as hiv, and an improving the outcomes of opiate addicted pregnant women. despite the strong evidence, less than 40% of those being treated for opiate addiction receive these medications. expanding medication is a

critical part for the hhs strategy. the research to develop implementation strategies for the use of medication and substance abuse treatment programs, and the healthcare system, and in criminal justice settings. examples include administering the drug an emergency room or integrating the management of medication with an infection disease clinic. in criminal justice setting it includes administering the drug the month prior to release -- thus interfering with lots then overdose. we also fund research on develop treatments that will improve compliance such as things that require dosing every six month.

where new transformative solution such as the development of a heroine vaccine. oxycontin component of the strategy against this prescription epidemic is expanding by -- a medication that can reverse an opiate overdose. to this this end we have funded the development of drugs that are now requiring injections making them much easier to use for those that have no medical training. one of these products was just approved by the fda last year. finally, the limited treatment alternatives for the management of severe chronic pain has led to the over reliance on opiate medication, we also fund development of better and safer treatment for chronic pain, including drugs that are less addictive, pain medications that are not relying on the opiate

stem and not medication interventions. yet the opiate prescription abuse and the rising heroine of use result both from the lack of knowledge of healthcare providers on the management of pain including appropriate use of opiate medication, as well as the lack of knowledge around identification and management of addiction. thus a fundamental component to reverse this epidemic required the education of healthcare providers both in management of pain and in disorders. to help address this in partnership with other nih institutes have created centers of excellence for the development of education curriculum for pain. the urgency to address this epidemic is highlighted by the

nearly 30,000 debts for opiate overdose that are occurred in 2014, the highest ever recorded. solutions highest ever recorded. solutions are already available. the challenge is implementation. we will continue to work closely with other federal agencies, community organizations and private industries. >> thank you. >> chairman and members of the committee thank you for inviting me to represent today. it's a great honor to talk with you against the role we play an offense in the behavioral health and what we are doing to address the opiate crisis. i want to thank the first panel for providing great leadership to wendy's awareness and catalyze action. i know this creates has devastating consequences in all of your states. i agree agree with you, this is a winnable battle. you have already heard that we're facing t t