and mr. steven dudley the code director inside crane. we appreciate your time. we appreciate your dedication and i would also like to thank all of those who worked alongside my staff in making this hearing possible. drug cartels operate out of countries in the western hemisphere and they do so by using sophisticated sister vision systems that move narcotics into and across the united states. heroin supplied by these cartels has created a public health epidemic that is fueled drug violence across the country. heroin epidemic are in force in becoming part of everyday events in our society. it's our duty to find the best possible avenues and allocate resources to provide the best tools to equip those on the frontline to fight this public health crisis. we need to examine what the united states mexico and other regional partners are doing. promoting the efficacy initiatives to stop the spread of heroin and combat the drug

cartel should be one of our top priorities. here are some facts. when the primary culprits in this fight is called benson l. it's a synthetic of opium that is 25 to 40 times more potent than heroin and a baby used to treat pain associated with advanced cancer. the cdc states most cases of fence about related overdoses are associated with nonpharmaceutical fontanelle, the type used as a substitute for heroin are mixed with heroin and other drugs sometimes without the users knowledge. in 2015 the dea to national drug threat assessment summary reported that mexico and china have been cited as the primary source in the country though some are manufactured in china. these are trafficked into the united states across the southwest border or delivered to mail couriers. much of the illegally diverted

and produced arroyo seco is found found where heroin is found according to the substance abuse and mental health services administration the estimated number of individuals who use heroin was 914,000 people in 2014. in addition there are about 586,000 individuals basically to to -- .2% of the over pot placed at the heroin disorder in 2014. while there has been increasing heroin overdoses and deaths across united states the midwest and the northeast regions of the areas are particular concern. demonstrations efforts heroin related, to this day despite the demonstrations efforts heroin related overdose deaths increased by 244% between 07 in the year 2013. the u.s. has responded to such mines by launching a heroin response judge of leveraging upon the 15th i intensity drug trafficking areas across the country.

mexico aren't original partners has displayed willingness to cooperate with u.s. authorities but despite these operations international narcotics control strategy report estimates that less than 2% of cocaine comes to mexico and is seized by this country's authorities. congress has provided billions in funds to the mexican government to improve american security and the rule of law and i applaud the continued efforts of the mexican government to eradicate drug efforts and arrest drug kingpins. i think the congress king contained a working instructor ways to promote legislation addressing opiate abuse. i'm proud to be the co-sponsor the conference of addiction and recovery act of bipartisan bill with overwhelmingly passed the senate. so applaud the house tool -- working to address this issue and i hope we will soon be a lucentis legislation to the president's desk. it's my hope today's hearing was shed light on the consequences that this epidemic will have in our society and future generations if left unaddressed and not given proper attention

but i'm optimistic this hearing will service the opportunity to learn about the administration's priorities in combating the heroin epidemic in drug violence and i hope you will adjust these in your testimony as well. with that i would now turned over to ranking member senator boxer for her opening statement. >> mr. chairman thank you so much for holding this important hearing. first i would ask if i could put in the record senator cardin's opening statement. the abuse of the legal and illegal drugs in america is an absolute crisis and despite we need to act on many fronts. take the case of opioids prayed these are legal prescription drugs that are killing approximately 125 people every single day here at home. the cdc says that in 2014, 47,000 people died from opioid abuse and just imagine now. we need to do much more than we have done so far to put real

dollars behind the effort to stop this madness. then there's the issue will focus on today is illegal drugs being transported into this country. recently i visited costa rica and they learned that this peaceful country is very alarmed about drug cartels infiltrating their population. he must help them stop this real threat and i hope to ask a question about that. while we are working collaboratively with the mexican government specifically an initiative called america initiative and while we have to date seized more than 4 billion and are caught etc. licit currency let's face it, that is a drop in the bucket. we simply have to address the demand in the united states for these lethal products. i know that is not your job and i'm not going to even ask you about that but i'm making a statement as a united states senator. we have to address the demand in

the united states for these lethal products. supply and demand go hand-in-hand through the long time ago it was an economics major, like economics 101. when people demand it products we know what happened. the supply will calm and win when even more people demand a product the price will go up and it goes around in a circle. years ago too many to even mention, i don't even know where my chairman was at that time it so long ago, very long. when i first came to congress i wrote a bill called treatment on demand because what i found out mr. chairman and members is that when there's a person in america with a terrible addiction at that time it is still chew today they wake up one day and they say i've had it i needed new life.

they can get it so people say very good comeback in two weeks. this is an emergency circumstance in many ways but it's not considered that so they will will go in and maybe get a pat on the back come back in two weeks and by then ap they have even overdose. i know we are working with colombia and guatemala helping farmers develop alternatives to opioid production but again we need to be even more aggressive in our policies regarding drug production trafficking and here at home consumption. california we have for those areas that the chairman spoke about that are designated high intensity drug trafficking areas by the obama administration. i'm extremely grateful to the administration. we had that help under george bush as well. when you identify an area that means you are going to get federal dollars in federal help

because a lot of these local people are police forces and so on and really do need that help. i'm very grateful for that. we have also discovered mexico to san diego which act as conduits for thousands of pounds of cocaine and this points to the continuous challenges we face dealing with these dangerous cartels. they are really good at what they do and they intimidate everyone. that's why this fight is so critical. we need even stronger partnerships with mexico and other countries in the region. and i want to say this, alienating our latin american neighbors and their latinos here at home is the worst possible thing we can do. first of all in the human level because in my view it's prejudice and bigotry but it doesn't make sense if we are really trying to crack down on these cartels we need our friends to work with us if we

don't need to escalate some kind of ridiculous debate about walls and all the rest. i do want to thank our witnesses for being here. there is a lot of burden on you and this is very difficult. the war on drugs is not a success and i think the reason is we haven't done enough on the demand side or on any side. we need to do much better and i want to thank my chairman because i think this is really well-timed given what we have done with the opioid crisis. >> before it began with the testimony did want to recognize the senior senator who has done a lot of work on issues regarding transnational crime if you wanted to give any opening comments. with that, please join me in welcoming our first what is mr. foote. thank you for your testimony before us here today. spina chairman rubio senator

boxer senator hernandez senator gardner thank you for this opportunity to appear before you to discuss the work at the state department's borough of international affairs bureau of international narcotics and law enforcement affairs to combat the production trafficking of heroin particularly via mexican-based drug trafficking organizations that are responsible for the vast majority of heroin on american streets today. we face an epidemic of opioid abuse. domestically produced controlled prescription pain relievers or heroin which is -- other drugs such as fentanyl. drug trafficking organizations have killed tens of thousands of citizens and these organizations continue to foam at violence, instability, corruption and addiction.

this scourge is broader than just the united states and we will not solve the lumpy the overwhelming majority of the heroin and u.s. is produced or distributed by mexican drug trafficking organizations. for many years they have been trafficking not only heroin but also cocaine, methamphetamine and other drugs that enter our country. most of these drugs enter through our border with mexico. the united states and mexico developed the merida initiative in 2007 with a major focus on combating the production and trafficking of illicit drugs across their borders. today the obama administration and penatel are committed to sticky chick goals. our merida partnership which brings together investments and capabilities of both countries continues to help told mexico's capacity to fight narcotics trafficking, organized crime and violence. together we are aggressively

responded to the threat of putting the leaders of drug trafficking organizations in jail by seizing their drugs and money and by dismantling their organizations. today through merida professionalizing and building the capacity of law enforcement agencies supporting the mexican government efforts to strengthen border management security and helping advance reform across mexico's justice center. bilaterally we have agreed the target in the production and trafficking of heroin as well as fentanyl and other dangerous substances as a top ready to do that and dea's providing training to on for some officers investigators and analysts increasing mexico's ability to identify, investigate and dismantle clandestine heroin and fentanyl labs. with our interagency partners are also improving information

sharing between our governments on heroin and fentanyl working together to get their sustenance on opium poppy cultivation and heroin and fentanyl reduction in mexico and continuing to explore other avenues to enhance or bilateral cooperation and effectiveness. building strong effective mexican institutions capable of confronting organized criminal enterprises is a difficult long-term challenge. this work must be sustained for it is only through committee coordinated effort that sustainable capacity to deter the cultivation, production and trafficking of illicit drugs will be strengthened. the significant investments of both of our governments are producing results and with your continued support for successful collaboration with mexico will continue. thank you. >> thank you mr. foote. mr. kemp chester associate director for the coordination group.

please begin your testimony. spina chairman rubio ranking member boxer and members of the subcommittee thank you for inviting me here this morning to discuss the public health and public safety issues resulting from heroin use. the governor of mexico's efforts to reduce the availability of heroin in the united states and u.s.-mexico cooperation to address heroin issues in both countries. 2014 most current year for which we have data more than 47,000 americans through approximately 129 million people -- 129 people a day die of a drug overdose. 22% involve heroin. the threat posed by heroin has continued to grow dramatically for the past several years and since 2007 deaths involving heroin have risen. a 40% from 2402 and 2007210574 in 2014.

heroin use is spreading to suburban arra anything crying out among most socioeconomic classes age groups and races. mexico is currently the primary supplier of heroin to the united states with mexican drug traffickers cultivating opiate poppy producing heroin smuggling the products into the united states. poppy cultivation in mexico has increased substantially in recent years rising from 17,000 in 2014 to 280,002,015 which could yield potential production of 70 metric tons of pure heroin. the heroin crisis is being compounded by the reemergence of fentanyl. a visit fentanyl fentanyl sometimes takes a powdered heroin to increase its effects are mixed with synthetic airline. incorporated recently recently fentanyl is being pressed into

bill form and sold as counterfeit prescription opioid pills. the majority of the illicit fentanyl ... and is only produced in mexico or in china. fentanyl is extremely dangerous and deadly. in 2014 there were more than 5544 drug overdose deaths involving synthetic or conducts other than methadone a category that includes fentanyl. this number has more than doubled from two years earlier. u.s.-mexico engagement regarding heroin has been robust. in october 20150 nbc director participate in the bilateral security dialogue for the importance of increased popular eradication efforts by the government of mexico as well as drug interdiction clandestine laboratory destruction and the disruption of precursor chemical trafficking. in early march director botticelli ambassador william brown to the assistant secretary of state for international

marcotte exam law enforcement affairs and i met with the mexican attorney general gomez and she announced her role as the synchronizer of mexico's efforts to disrupt the production of heroin and illicit fentanyl. importantly we agreed then to jointly develop a focused plan to concentrate mexico's efforts against heroin. there is a need to sustain progress toward addressing the nation's heroin in a democracy is requires increased collaboration between federal agencies and with our partners working at the state local and tribal level where the crisis is felt most deeply. november 2015 the team that i'd be the national heroin coordination group was created within the office of national drug control policy to form the hub of a network of interagency partners who will leverage their home agency resources and harmonize interagency activities against the heroin and fentanyl supplied chain to the united states. the ondcp funded high-intensity

drug trafficking areas the locally-based programs the response to drug trafficking issues facing specific areas of the country has also been instrumental. in august of 2015 ondcp committed $2.5 million in hidta funds to develop a heroin response strategy. this innovation -- innovative project provides education intelligent enforcement resources to address the heroin threat through seven original states and the district of columbia. while the have laid a firm foundation to address the heroin crisis much remains to be accomplished. for example we do have gaps in our capability to detect illicit fentanyl that orders and are mexican partners could certainly do more in the areas of old pm copy or revocation in clandestine laboratory neutralization. while my remarks are focused on addressing the supply-side of the opioid crisis we must address opening a disorder to of

the bounce approach the records addiction is that public health matter producing substance abuse prevention and treatment strategies and recovery support services. in his budget present upon a proposed $1 million of new mandatory funding to expand the availability of evidence they strategy such as medication to assist treatment and extend the availability of substance abuse treatment providers. ondcp will work with our international partners federal government departments and agencies and our partners at the state local and travel levels to reduce heroin and komsomol trafficking and the profound event these dangerous drugs are having in our committees. thank you for the opportunity to testify today and i would be happy to answer any of your questions. >> thank you and i'm going to defer my questions. i will basically be here throughout the duration so i i will turn it over to the ranking member for questions. >> i just have two questions for

mr. sub i've and mr. chester. mr. foote in 2000 mexico's congress passed a series of significant reforms to its criminal procedures. to promote greater access to justice and combat organized crime. measures that would make the mexican justice system look a little bit more like our own. these reforms were intended to be implemented by 2016. where does the implementation of these additional reform stand and how has the united states assist in this process and how do you feel about whether they are really doing what they committed to do? >> thank you senator. as you know mexico committed them pass legislation to implement a new criminal justice system which is an accusatory of justice system buts like

ourselves. at this point up to 32 mexican states, 24 have implemented this with federal level crimes and i believe nine have implemented it at state level crimes. obviously this is a long-term process and some of the states in mexico will not meet next month's deadline. we remain can committed and contained to work closely with them on a number of issues things to the gracious appropriations of congress. we have dedicated approximately $250 million to these efforts between the department state and usaid, through issues such as training judges, prosecutors, courtroom personnel, law students, over 4000 have been trained to the department of justice's prosecutorial training program.

we also have a number of law schools and institutional exchange programs like the american bar association and number of universities here in the united states. we are preparing law enforcement for their new role in the accusatory of justice sector. for instance the department of justice partners have trained thousands of law enforcement and crime scene investigations provided equipment for forensics, fingerprinting and other collection so mexico can comply with international standards. >> thank you. what i'm getting from you is that there is progress being made although not everyone will meet the deadline and second optimistic report. that leads me to my final question which i alluded to in my statement. as we continue to work with the mexican government, and that's just critical.

we have to work your come to reduce the demand that we had to work across the border to reduce the supply and that is where the rubber meets the road in both of these areas. we need to work with mexico. i'm concerned about the rhetoric in the presidential campaign describing a relationship with mexico. i know it's a tough question for you. i just wanted to say what you feel in your heart because we need to know. mexican officials have said on the record that some of the proposals mentioned on the campaign trail and we know who we are talking about here candidate talking about building a wall and having mexico do it, insulting mexican-americans here at home. some of the proposals would have a cataclysmic effect on our bilateral commissions. has this divisive rhetoric affected diplomatic relations with mexico and at this point has it impacted in nine states ability to work with the mexican

government to combat drug trafficking and are you concerned that type of rhetoric could just completely and of mine what we are trying to do here? >> just for the record she is not talking about me. >> i am so not talking about you >> excellent. i will try to strike a balance between answering your question and not answering too deeply into our own domestic politics here. >> i know it's a tough one but you know what, when people talk it has real-life impact especially a presumptive nominee >> you have all seen some of the reactions from south of the border from our mexican brothers and sisters. you have seen president vicente fox's reactions. from the embassy's bilateral level we continue to work very closely together. in my personal opinion i do not

believe it has greatly affected our ability to do business together. mexico in the last several months has reiterated its commitment to continuing with the merida initiative where the populace of mexico stands and this may be another matter but we continue to be able to work closely together bilaterally. >> with the words haven't had an impact on what is going on at the very top level in your opinion on the work that you were doing at this point? >> not in their dealings with us. >> and we have to make sure those policies come into effect. thank you very much. >> thank you senator boxer. senator menendez. >> thank you mr. chairman and thank you for your service to our country. mr. foote how many agencies are involved in the eradication efforts with perspective mexico's border with us in our

efforts to stop interdiction, stop flows, how many agencies are involved? >> u.s. agencies, i hope that's what you asked. the department state coming of the department justice, dea at the eye to a certain extent the department of homeland security is heavily involved. customs border protection immigrations and customs enforcement, homeland security investigations, our military supports some of the border efforts. mexico's military and then we have some ancillary agencies based in mexico city. while their chief focus isn't the border they do peripherally work on it such as atf and u.s. marshals. >> if you had to guess how much money has been spent on interdiction and eradication

efforts in mexico since the start of the epidemic that we are experiencing? >> my understanding is 2.50 yen dollars has been appropriated of which approximately 1.5 billion has been obligated or committed to specific projects of which we still have at this point the new initiatives for about $700 million. >> are you speaking just of merida specifically? >> largely. there is money spent far beyond merida areas. >> are certainly a senator. i'm not in a position to comment on that. >> i wasn't looking to senata pro-creation that i look at all the agencies you mention your own inl at the iphone and security immigration military alcohol tobacco and firearms.

i think to myself it has to be billions collectively. and i was one of the architects of the merida initiative which i support but what .5 billion later billions between the all of our respective agencies and what we have is an opioid epidemic. so one has to as a policymaker one has his take a step back and say themselves what is not working because something is not working. if billions of dollars later what you see is a spike versus a trend in the other direction than something is not working. if i were to say to you what's not working, what do we need to change your answer would be? >> first of all senator i think we have in the past few years come to the realization that it

is a shared responsibility between the united states and trafficking countries. i am heartened -- heartened by the senate racing passing of the opioid legislation. something that is going to help us but certainly mexico's capacities are far greater than they were when we started the merida initiative in 2007. information sharing and collaboration has led our own u.s. law enforcement agencies to interdict significantly more on our southern border do to mexico's cooperation. we still do have a ways to go. i think we also need to get better here in the united states at demand production and treating the health issues of addicted people. it is a shared responsibility that is no longer just a supply-side issue. >> as i listen to your response everything that we are doing but

a more significant effort on demand reduction. it is suggesting there is anything that we are not doing. all i can look at is if you are spending billions and instead of a trend going the opposite direction it is arising, you have to raise the question what is it that we are either doing wrong or what is it that we are not doing that we need to do in order to meet the challenge? otherwise you can appropriate billions and billions but still find ourselves in a trend that is undesirable. the only thing i heard from you and your response to me was doing more in reduction what i certainly believe is true but i didn't hear anything else. you have to question whether or not the continuation of this type of expenditure in this manner is the right policy.

>> let me ask you this. you believe there is sufficient coordination, seamless coronation on our side of the border has to relate to all the h. and sees in this fight? >> senator obviously we can always get better at everything we do. the department of state works from the southern border south so i don't feel that it's our position to comment on interagency coordination north of the border. south of the border we have robust interagency coordination through embassy mexico city. weaponize get a little better there. >> your mexican partners, are they doing everything that they can in order to meet the challenge on their side? >> during the beginning of the administration there was a cause

in the plan and merida which is a mutual assessment of the security relationship particularly on their side and over the past year and a half we have seen much closer collaboration and openness and frankness in our bilateral dialogue. it is mexico doing everything that they can? they could improve. some of their efforts are not yet at the optimal level but we remain optimistic and positive that they are moving in the right direction. >> i appreciate the optimism but seeking a dose of realism into it. part of the challenge is that you have lawless states and some of the northern part of mexico where i heard u.s. citizens who have come to talk to me say that many who had businesses and

long-term relationships on the media side of the border that basically cannot operate there because the federal government's presence, i.e. the federal mexican government's presence is not there. if you have lawlessness and if you have uncontrolled states then you have the opportunity for drug traffickers to avail themselves of that. it seems to me that while i am an incredibly strong and have been for many years strong of these u.s.-mexican relationship we need to be honest in order to make sure we are making the progress and for mexico to regain its sovereignty and parts of the northern mexico presently hasn't happened. >> let me use some of my time to follow up on that. mr. foote secretary foote how would you address the assertion made by another bus involved in the incident which 43 students disappeared and mexico bound for

the u.s.? >> senator thank you for that question. given that we have not seen the results of the final investigation from mexico i am not in a great position to answer that question right now. we would be happy to answer that for the record in writing. >> okay. senator kaine. >> thank you mr. chanting to get witnesses. to get an idea of the scope of this challenge on the mexican side in terms of the black tar heroin is the poppy production for this heroin still significantly -- by the state of nayarit or is it more broadly distributed? mexico is a big country. i worry that we are not being specific enough. >> yes, senator. our latest crop estimate that

was produced about two months ago shows two major growing areas in mexico, one in the state of guerrero and another in what is called the tri-border region and the northern part of the country. those are the two major growing areas in mexico. with very very small sporadic spots in other parts of the country but they are basic to concentrate in those two areas. >> and the fentanyl is made in labs and i gather most of the fentanyl is made in china and may be transmitted through mexico were made in labs in mexico? >> that is correct. and i will tell you our understanding and our awareness of the fentanyl traffic has evolved dramatically over the last six months as we have seen the crisis rise. in order of magnitude i cannot tell you that what i can tell you is china is a significant supplier of fentanyl to united

states or his order by individuals on the internet and using parcel post or the postal service shipped directly. we also know that fentanyl is shipped into mexico. in some cases mixed with dilute things and smuggled across the southwest border. there are precursor chemicals that are shipped into mexico that can be used for the production of fentanyl. clandestine fentanyl in northern mexico. if you look at the two main ones that we see for finnish fentanyl coming to an end states or manufactured in mexico. >> i want to talk to you mr. chester by your written testimony and i'm sorry you didn't get here for your entire oral testimony. there are several factors and shooting to the heroin prices increased availability of availability performs apparent that is relatively low-priced and relatively open at

prescription drugs transitioning to heroin. i'm trying to unpack that statement and i'm wondering if your statement puts enough of a finger on the prescription of the problem? >> i have heard through michael botticelli and others that 80% of those total od'd's started their addiction to opioids by being addicted to prescription opioids and then transitioning to heroin because they could get it for a lower price. >> is at an acra statement? >> no senator and i'm glad you asked that question. of the numbers of individuals who are not medically use opioids and then transition into hair when that number is relatively small.

>> non-medically. >> outskirts of the nonmedical use of the prescription opioids like saucy cotton and the traditional got it -- oxycontin and got it from the medicine cabinet or friends and family members with her senate of those who transition to heroin use is relatively low but conversely of these individuals who are not cheap and users of heroin 80% of them actually abused a prescription opioid in the past. while there is not a direct causation between the two, the nonmedical use of opioids is a strong risk or for eventual hair in use and even the medical use of opioids can be a risk factor for eventual heroin use. >> yes sent her that's right. and opioid and enough itself and its affect on the body obviously is very addictive drug and affects the body and unique ways as an opioids. those individuals take opioids

whether they get them from a doctor or whether they get them from a friend or family member for non-meta-reasons are at risk for eventual opioid addiction is not used properly, that is correct. >> he said the testimony is the relatively low price of heroin and that's relatively low compared to past but also compared to the cost of opioid-based prescription drugs. that's correct so the street price of a-gram of heroin compared to the street price if you will of an opioid bill or an oxy bill or something of that nature, that is what we consider to be one of the kuchar putting factors. cibula bill of the end of price and the purity and all the contributing factors. >> mr. foote talked about the work. then the spot and we are trying to harmonize with a house on this comprehensive addiction recovery act. we really believe it here and it's now bipartisan we are

seeing it in all of our states that if we don't get ahold of the culture of overprescription of opioid-based prescription drugs where hollowing out the urban suburban rich and poor. this is an issue that came out of the medicine cabinet and many insisted it was someone he trusted handing them a prescription saying this is going to do you good in this not going to do you harm driven by inadequate science and driven by frankly marketing scams and that is inextricably related to this heroin issue. i think it's hard to deal with the heroin issue in the object without talking about this culture of overprescription that hopefully we are working on together to end. it's probably too early to know this but in terms of the growth of the number of hectares of poppy production in mexico do we have any evidence to suggest whether that is connected with

marijuana legalization in the united states quickly actually like this notion of the states as labs and they can experience to see what happens but i have heard it said it might don't know whether there's any evidence to back it up to legalization of marijuana in some state that is loud marijuana to be grown has taken hector's of land that were used for marijuana cultivation and there's no market for marijuana because there's competition. is there any evidence of that? >> we have actually looked closely at the crop transference to see if there's anything there and i can tell you we at this time whether it's too early or doesn't exist we can't definitively stay -- say the farmers have decided to switch from one crop to another mexico. we can't say that with any degree of authority at this point. >> but that's something you'll continue to monitor? >> is something we will watch. >> to interject on that point

it's my sense and you are both experts that very few people wake up in the morning and say i'm going to shoot heroin for the first time. there's a gateway to the heroin use. a lot of it is being driven by people who were prescribed prescription opiates. the prescription opiate is cut off and they are going through withdrawal and the only thing is access to treatment. absent that how does someone get dependent on heroin minus the scripture and drug gateway which we have already discussed? >> senator is a difficult question just because you are dealing with a number of variables at the individual level as to the reasons why people engage in the behavior that we do. heroin in general terms is kind of at the end of a trajectory of long-term drug use and the high number of heroin users are -- drug users. they are not an exclusive heroin user.

they get the drugs available to them because the high appellate appellate -- high availability of the drug that's heroin. the other thing that we have look at and we do a number of surveys to look at this but what we realize is the ages of 13 to about 18 is a very strong factor in terms of risk-taking behavior in terms of underage drinking, tobacco and marijuana things of that nature. i think both can say is we can put a finger on this or that particular reason why a person does something but we do know the availability of drugs in society obviously increases the chances that an individual who is inclined to use them is going to intercept some particular point and it's like the discussion we had about the availability of heroin. >> we understand the bill

problem that leads to that but what you are basically saying if someone especially some point earlier in their life begins to use the substance, alcohol, whatever it may be an intoxicant of some sort. it now starts at potential trend where the next thing is what is out there that's better? once you cross that barrier you unleash this cycle basically a set of dominos that leads to the heroin. >> again it's not as direct causation but it is risk-taking behavior and patterns of behavior. that's why the prevention strategies particularly through programs like the drug-free communities program that ondcp manages are incredibly important because they are locally based and they allow trusted individuals to be able to speak to people at young ages about

things just like that in their attitudes about foreign substances in the body and things of that nature. they are able to through evidence-based prevention strategies be able to talk to people at those young ages when they are vulnerable that they carry with them for the rest of their lives. >> thank you mr. chairman and thank you for this hearing. i think this is the most important hearing we are going to have on our relations with mexico and with china this year in congress and i thank you. this issue of fentanyl is to my way of thinking kind of the most important threat that we have two families in the united states at this time. i will just give you some numbers. in massachusetts in 2015, 57% of the opioid related overdose deaths in massachusetts had a

positive screen for fentanyl specifically 1319 individuals whose deaths were opioid related in 2015 for toxicology screen was available, 754 had a positive screen for fentanyl per week and talk about prescription drugs and talk about heroin but fentanyl is now the issue and we, new england is at the epicenter of it create it comes up from a sicko to lawrence massachusetts and then it goes out into new hampshire. other states but massachusetts as well. the pathway is china, into mexico and then into lawrence massachusetts in two ohio virginia into florida. when it's over half of the deaths in massachusetts, it's clearly a looming threat. it's a preview of coming

attractions to every single city and town in our country. that's why this hearing is so important because it gets to the question of what is mexico doing and with china. we will start with that prayed mr. foote what is specifically mexico and china the highest government levels doing in order to interdict this new synthetic formula that is wasting heroin with a drug 50 times more powerful than heroin, so powerful that the dea doesn't even let its dogs any longer sniff for fentanyl for fear that the dog will die with the first sniff of fentanyl. 3 grams, three equivalents of salt grams could kill a human being if they gained access to it.

what is mexico and china doing in cooperation with you to interdict that drug? >> senator first i will touch on mexico and china's bilateral relationship on this. mexico and china are meeting and discussing fentanyl regularly every year. they are both involved in multilateral side of things. just last month at the u.n. general assembly special session on drugs they were both there. china their minister of public security led the conclusion statement they were fully on board and they are a member of both countries international drug conventions. we also sponsor in the united states annual fentanyl and precursor chemical conferences with mexico and china. >> how successful is this effort so far like. >> that's a good question senator.

fentanyl is a new problem for the department of state and it's one where we are applying lessons we have learned with other substances and other crime areas over the year and at this point we are working as hard as we can to have success but i can't quantify. >> with human rights and copyright infringement, is this issue now at the highest level of negotiations with the chinese government and with the mexican government? >> it is. mr. chester went in march with our folks and spoke to a large interagency group to the -- we regularly engage with china. art diplomats are going to china next week at a very high level diplomatic engagement. we raise it regularly in a joint

liaison group. law enforcement which has a counternarcotics working group throughout the year and we have actually seen some positive signs from china. >> if you were point to convict them of doing something but would the evidence be to convict china of actually doing something to block this from coming into mexico? what would the evidence be of doing good? >> of doing good. we have seen encouraging progress. last year their ministry of public security officially controlled 160 new substances including several analogs of fentanyl and they have expressed high activity in continuing to receive information on new synthetic substances to efficiently control them. they are doing something. there is more that can be done.

>> clearly we have the evidence in 2015 and going to be worse this year. there's evidence that this is being slowed down and it's very clear sentence of five and it's going to kill ultimately tens of thousands of americans every year. every year. there is no other threat to our country that even matches that. every single year fentanyl is going to be a lot to do that. we don't stop it it dwarfs every other issue. every other issue will be a footnote compared to the magnitude of the impact on american families. mr. chester what is the level of cooperation that you are getting from the mexican government and interdicting fentanyl? we know it's "el chapo" and his gang that is responsible for the traffic that comes to lawrence massachusetts with ready much the whole country. would assure success level with

the mexican government and getting them to understand the magnitude? >> senator i personally have been down there twice and they have dealt with the mexican embassy in the united states. united states. i will tell you that they understand how seriously we take this issue in the united states. they understand that this is our top illicit drug party and they also understand it's not just heroin but it's heroin and it is spent now. a meeting in february i put fence now on the table and i won't say that it was first with them but they weren't familiar with how serious the issue was the united states. by the time we had gone down with dr. botticelli and ambassador bromfield that was part of the problems that they agree to work with us moving forward on. i will tell you that the mexicans are understanding the importance that we place on this issue.

they are very engaged on it and they're willing to conduct china planning with us on the issues not only on poppy eradication which addresses the heroin issue but also lab identification and neutralization specifically on issues of fentanyl creation or the knowing -- melting with delete and send other matter if it's transported across the border. >> so little to irving to me from your testimony that they are just hearing about fentanyl and is just getting on their radar screen and it's just a boy of 2016. given the fact that more than half of all the people who died in massachusetts related had fentanyl in their system. it's a little bit disturbing to me. i'm going to be very honest with you. i don't like it to have been introduced that level.

i would like like to further like to have hurt the person obama has raised this issue in the present of mexico that president obama has raised this issue with president xi and china just because of the incredible level of fatalities across our country. we know specifically what the source is and so do you mind if i just continue a little bit? give me some hope here. if there is an aggressive strategy in place on fentanyl and that it has been elevated to a level where there is a no-nonsense conversation going on in terms of what the expectations of our government is. ..

fifty times more powerful and has been showing up in majority of deaths. you are not sure? >> and i need to make sure that fentanyl was part of that. >> at the highest levels. we continue to raise it at the highest levels of dialogue. next week i get the secretary will be in china, and this is high on the agenda, if not top on the agenda. i cannot promise that president obama raised it with the chinese president, but certainly it has been raised with the chinese government. >> a couple of points, 1st of all, why are these communities specifically targeted, florida, for

example, central florida, how florida, how does a community wind up targeted by these criminal gangs? as opposed to some other part of the country? >> senator, there are number of variables, one of which is the existing trafficking structure in place. in some place. in some places transportation networks, in some places the traffickers from mexico have personal or business relationship with traffickers in a particular area or geographically a place lends itself to further distribution. there are many reasons why. >> the northeast is far from the us-mexico border. why didn't they stop somewhere along i-9 five and target there? existing structures? >> there is strong evidence, the existing structure that was there before. and only specifically talk about fentanyl one of the things that we have looked at as we have tracked the

fentanyl crisis is why the northeast, the eastern united states and we believe one of the strong currents -- strong contributing factors is that fentanyl is more easily mixed into the white powder heroin that it is in the black tar heroin. and that is traditionally the heroin market in the united states, and so fentanyl introduced being mixed in the powder heroin and therefore landed in the us, and increasingly we are seeing it pressed in the bill form and as counterfeit artsy or opioid, but fentanyl has found the market probably because of those two reasons. >> i spent some time in new hampshire and found myself in many small townships throughout new england that faced an overwhelming problem almost as if they

were specifically targeted perhaps because of trafficking i was new. you will not have a thousand officer department. is there evidence that some of that is in place? where they can overwhelm local law enforcement with numbers and capabilities? >> senator, i don't know whether that was -- the size of the population or law enforcement was a particular reason why, but to your point, it is a matter of deep concern that you find increasing numbers of heroin or fentanyl users in rural areas who are starting to use the product alone. and they are far from treatment and tend to be farther from 1st responders. those are all things that make this particular prices particularly pernicious is the fact that it has moved in the rural areas which is not something we have seen in previous outbreaks. >> i know what i'm asking is

more appropriate, but some of the stuff we used to hear are increasingly because supply is driving demand, and to related. one of the things i capturing a lot, specifically targeting treatment centers, especially where they knew people were getting treatment because of addiction and were waiting for them outside to tempt them to buy, specifically targeting recovering individuals for the sale of this, and this is a pernicious, disgusting industry we are dealing with here, and in that realm i wanted to ask, since the recent arrest, this is part of mexico's concerted policy to conduct high-profile arrests of drug lords. while i am positive these organizations are being capitated, have we seen any evidence that the rest of

the high-profile individual impacts the ability of these individuals and organizations to function? is it one of those things that is now functioning the way corporate entity would irrespective of who is at the top? >> my personal experience is far more robust with columbia. we have seen where the kingpin being arrested the certainly affect an organization. the question is, how big is the structure, howstructure, how organized is it? how quickly can it recover? that is a question far better posed to our drug enforcement administration guys. >> let me ask you about will be a, nota, not directly related to the opiate issue, but nonetheless cocaine. they suspended their aerial eradication program ostensibly for fear of the impact that it was going to

have on the population environmentally. there is a counterargument that has been made in which i find credibility that this is also part of the peace process, in essence the deforestation effort was an irritant in the process with other elements. as a result we see numbers were for the 1st time in a long time there has been a massive increase in the amount of cocaine production that we had not seen in a while, and the assumption is that that cocaine will get sold, go somewhere, and we should expect to see a spike ina spike in cocaine sales in the united states. do you have a view irrespective of the reason why you're doing it, aa view of what these new numbers mean for the us in the years to come? >> we are concerned about the suspension of aerial eradication. it is a sovereign decision of the colombian government.

we believe eradication and aerial eradication are not magic pills, they are valuable tools in the supply-side intervention, narcotics that has long been a big part of our strategy in columbia comeau we continue to work closely with the colombians which is peaceful and beer or in kos to have close contact to see which direction they decide to go if and when president santos gets the peace process resolved. >> and my final question for the panel command ii thank you both for being here, your testimony and your work. we now have two separate but interrelated problems. the senator just pointed out a moment ago, the production of synthetic fentanyl, the growth of opiate poppies. up my understanding is that

the amount of opiate -- poppy -based opiate grown in the western hemisphere is a small percentage of the overall production in the world. how much -- if a poppy-based a poppy -based opiate is produced or fentanyl is produced somewhere in the western hemisphere what percentage of that is destined for the united states in particular? >> senator, we believe that mexico is the primary supplier of maryland to the united states and that the united states is the primary customer for mexican heroin. that arelationship in the western hemisphere is fairly solid. we do not see any evidence or widespread evidence of southwest asian heroin, afghan heroin, burmese heroin coming to the united states, although it does believe southwest asia is

the primary supplier of heroin, so one of the things that we have discovered is a risk and that we have identified as a risk is if we are successful against the mexican drug trafficking organizations and breaking down the supply. three open up the door for others? >> it is clear that if you see a heroin overdose that heroin or phenyl -- fentanyl came from mexico or china to the mail. my question, is the opiate being grown or produced being sold anywhere else in the world or, basically assume that all of it being grown there that you can see from the camera pictures taken from all of that is headed to a city near you? >> that is the assumption we make, senator. yes, that is correct. >> i want to thank you for being here. >> thank you.

this is the top topic. it does not get bigger than this. these are the gentleman responsible. they have them here to know they are the principal people working on it, absolutely essential. so, let me ask, your title is associate director for the national heroin coordination group, do you think it is time to just change the name to the national heroin and fentanyl coordination group? just so it advertises correctly what is going on to the american people? >> senator, after the director so that thisstood up this group in order to provide a focused effort against the heroin in the sentinel problem set, what we determine is that we're going to handle heroin and fentanyl as part of the same problem set for a lot of different reasons.

what has evolved over time and ii work and planning is that we have discovered the incredible importance of fentanyl more so than what was identified six or eight or nine months ago. the emergence and visibility is driven almost entirely by the postmortem testing done on individuals, and in those areas were testing is done you begin to see more. he leads us to believe that in looking at the heroin and fentanyl problem we have a significant problem that we believe was being masked by an increased available -- increased availability and heroin.

the same problem set because it allows us to deal with the trafficking, supply chain, and affects our communities in the exact same way. >> i appreciate that. should we add fentanyl to your title in your opinion? does that make sense? given how little it turns out mexico knows when you have the conversation in february of 2016 about fentanyl? same thing is true for the chinese. >> the issue being raised to the chinese. >> am talking about about mexico. they did not know. >> by the way,way, even when isaiah 57 percent, many experts think that is an understated number because of the poor reporting that goes on in terms of the total number of deaths. so by the way, it is no secret why they do it.

at 300 percent markup. you know in terms of their ability to make money off of it as opposed to heroin or other drugs. again, from my perspective this is the issue. this dwarfs any terrorist threat. this is what is going to kill people, tens of thousands, ultimately hundreds of thousands of americans. you are the front line on this. mexico just heard about it. i am not sure the chinese understand the priority that we expect them to deal with this issue. maybe earlier today in your testimony said that there are gaps, gaps in the interdiction of sentinel -- fentanyl from mexico. could you explain in more detail what those gaps are?

>> picking primarily about gaps in our ability to be able to detect fentanyl at the borders, and what we brought up earlier is the ability of dogs being able to detect fentanyl because it is so deadly. we work very closely with cbp in terms of intelligence and policy to address those gaps, to better detect fentanyl not only of the southwest border the thanbut than our air freight locations, u.s. postal service or commercial companies. that has been an area of ongoing discussion so that we can better determine how much fentanyl -- fentanyl is getting in the country and to be able to detect it would address -- does arrive. >> we have to move to the next panel. have to preside over the floor and turn into a

pumpkin here. >> i strongly recommend that when the president meets with the presence of canada and mexico that he raises fentanyl to the highest level with them and lets them know that that is a threat to our country, and the same thing is true in any communication with the chinese government. and it has to be at the highest level. >> thank you. this is an important issue. we will now welcome our next panel. we keep the record open for a few days. if you receive any questions in writing, respond as quickly as possible. >> as they are getting seated and situated i will reintroduce the members of our 2nd panel,, the honorable teresa jacobs is the mayor of orange county florida which we hope will

be the site of the pro bowl in 2017. we are excited about it. if you are ready for your testimony, we look forward to hearing. >> thank you, chairman. thank you for calling this important hearing and allowing me to share a local perspective. the conversation has been informative. a little background on orange county, nothing you do not know, but home to the city of orlando and 12 other municipalities, a strong economy and exceptional quality of life, a population of 1.2 million people that call orlando home and 66 million people on an annual basis and

continue to shatter national records are tourism. the bad and sad news is that we like many others have seen alarming increase in the number of heroin overdoses and related deaths when. when i say heroin, i mean opioids, opiates, fentanyl come all combined. last year we lost 85 lives to heroin, 52 to fentanyl. we are testimony with the increase in deaths related to opioids and opiates of anywhere from 240 percent since 2007, and orange county a staggering 600 percent increase since 2011 alone and already this year we have had 90 reported opioid overdoses, one in ten resulting in death. as far as fighting against this current wave, it began

about five years ago. in 2010 florida was known as the pell-mell capital of the country. practitioners were prescribing oxycodone levels that exceeded all other states in our nation combined. at a state and local level we responded, yet today the battlefront is moved. today we fight heroin and fentanyl. given the dramatic rise, one can only surmise that drug cartels perceived as says a right marketplace. it is impossible to accurately assess the size of the threat in florida and across states in the nation. last year approximately 2,000 heroin users moved to york county jail alone. we know they housed 100 expectant mothers is babies

almost certainly be born tragically addicted. over 60 percent of patients are uninsured. for all four counties in the region with a combined population of two and a half million. we know our county jail has become the treatment center of last resort. i get of our citizens we are fighting back command here is how. the passage of the 2016 florida legislature. there are some universally effective approaches, but we

must recognize that we must address the demand side while we attacked the supply side. an either or policy simply won't work. we have joined forces with our k --dash 12 support system, universities, faith-based communities, medical communities to launch a social media campaign to educate the public on the risk of this highly addictive and deadly drug trying to convince citizens and one them in advance that this is something they want to avoid at all costs, and also not only treating addicts in jail but implementing a new medically assisted treatment program using the virtual which is an option for all of our addicts that are leaving jail, but we need the federal government's help to treat more addicts. addicts. as i mentioned, we are woefully short on beds and resources. on the supply side we are doing our best to arrest traffickers on the street. local efforts are simply no

match for the drug cartels and organize traffickers to me across the country's borders which is why we need your help to help stop the influx of drugs, todrugs, to end the crisis, save lives, safe communities. we each have a role to play. local governments have a crucial role to play. but efforts need to expand beyond government. we need government. we need every citizen that is a mother or father or friend of an addict, our entire communities engaged, doctors, clergy, counselors, teachers, all of them to be informed which is why i think we also need a nationwide awareness campaign. we talked briefly about kayfive. it needs to increase the high risk and low cost of fentanyl. it is less expensive for many of our addicts to get

high on opioids that it is to going to the happy meal. that is a sad state of reality that must be addressed. thank you for this opportunity, mr. chairman. thank you for you and your commitments continued service and leadership. >> and thank you for your work on this. we will talk about that. thank you forthank you for being here. we look forward to your testimony. >> thank you. as we know, us consumption of heroin has increased significantly, the us portion of the world heroin market is quite small by comparison, but outsized in terms of potential earnings. the rand corporation estimated us consumer spend as much is $27 billion on heroin each year increased from 20 billion in the year 2,000. criminal organizations have reacted to changes by producing more heroin. as

noted already in the earlier panel mexico accounts for the bulk of poppy production in the region. seizureseizure data of heroin along the southwest border also indicates mexican criminal groups are moving increasing amounts into the market. criminal organizations are the crete -- key transport is a colombian heroin and manage and purchase the heroin produced in guatemala or opium gum wholesale and process it themselves. the trend appears to be the same. >> can groups are seeking an increasing demand of the market share and distribution, displacing other wholesalers. the picture is one of an increasing lucrative vertically integrated market managing the product from the point of production to the point of sale and seeking a greater market share and sale.

the reality of the supply chain however is much more complex. it helps us to you well worn monikers been talking about organizations, the truth is they are not nearly as strong or monolithic as they once were , some names may still invoke fear and sometimes i'll call but there not organizations is much as brand names and in many cases the individual ports have as much contact with the bosses as a local coca-cola bottling plan manager might have with corporate headquarters. even this and although it cartel is more horizontally and vertically integrated. before they were arrested the floor as brothers were said to be set a lower distributors in chicago. they were, but as federal intercepts of the conversation show, the two brothers negotiated independently with each of the top two members, obtaining different prices for the product they were selling, even after a war started between the solo a

cartel and the rival group, thegroup, the floor as brothers continued to purchase drugs from portions of the organization. the case cuts it to different myths about the cartels, number one that it is a single organization and number two, that it is tightly controlled by a single leader or group leaders. as shipment gets further and further from mexico's wholesale points loyalties become more dispersed in some cases completely disappear especially true in the us market or violence is not a viable long-term option. may the distribution chain is more demographic. this is evidence in other ways as well. more heroin available the

single kilogram. a ten to 12-pound shipment. the laredo brothers recently indicted in the eastern district of pennsylvania, indicative of these trends, charged with moving a ton of heroin over six years, but 14 kilos per month. so subtle and as one put it mom and pop the mexican authorities ride and aware. this brings us to mexico, the horizontal nature of the distribution chain makes it is difficult law enforcement problem in mexico as well. as noted, the once monolithic organization are shells of what they once were in part due to infighting of the type mentioned earlier but also mexican law enforcement efforts and many pieces have formed their own criminal organizations and brand names.

the chain of production is broken and numerous pieces including small and large producers of opium poppy plants, the gum producers, processors, all sale purchasers and transporters. they may all be different organizations. the laredo brothers were purchasing gum and processing it themselves and distributing it in small quantities in the us for years without running into trouble with the large supposedly all controlling cartel. to be sure the violence is viable option in mexico, so the pendulum may swing back, but for the moment the reality is there are literally dozens of small criminal organizations involved from the point of production to the point of sale. the level of control exerted is clear but we are not

talking about one or two criminal groups but dozens of interlocking organizations whose alliances constantly shift. the supply chain appears to be a largely horizontal, diversified organization with multiple actors obedient to market forces rather than one or two single integrated distributors. the result is law enforcement efforts are largely muted. you are hindering a small part of the overall production and distribution chain. even if you didn't slow the heroin you are facing insurmountable task stopping the flow from other countries which would undoubtedly fill the void and account for the bulk of worldwide production anyway. canada gets up to 90% of its heroin from afghanistan in the united states once got all of its heroin from the asian markets.

thank you for your time and attention. >> thank you both for being here. i want to begin with a question i alluded to during testimony. it has been anecdotal, but the notion that these criminal groups are specifically targeting people recovering, in essence, basically stationing themselves outside of a rehabilitation outpatient center, even in patients under knowing that people are vulnerable and intestine in the fall back into addiction. ..

>> certainly i look to the increase in harrowing coming into our communities, the increase of fentanyl at the same time we were restricting access to prescription drugs suspecting that there is a strong correlation between those two. i do not have direct evidence of it, just seems hard to imagine that there would not be a direct relationship between them. >> thank you senator. i also do do not have direct evidence of this activity. i will say, in mexico criminal groups have targeted recovery facilities but more as recruitment centers. >> recruitment centers?

>> to build out their own criminal operations. >> you me for like dealers? not for dealers, for membership. people who would participate in the criminal organization. that has really happened especially in regards to a very famous group there. the upshot of this is to say whether or not they are targeting, their pushing drugs in certain areas i'm not sure is as relevant for the whole picture which is what the mayor alluded to was this idea that this is largely driven from people who use pharmaceutical drugs. those people you you can find all over. that accounts also for the dispersed nature of this epidemic as opposed to the 1970s where you had a very concentrated in urban areas.

now it is spread out through different parts of the united states. >> so i want to share with an anecdote, i've a a personal friend was a police officer in miami-dade county. he pulled up to a car that is on the side of the road and there is a woman in the driver see, she was lumped over and it caught his curiosity. he pulled over and knocked on the window. it was a nice car, by the way this is a person with financial means. next on the window and the person immediately pops to attention and he can see in her arm there is a needle. she was basically shooting up on the side of the road in the luxury vehicle. he not in the window, and she rolls down the window, they begin to interact. i've easily he has a decision to make us to how to treat her. ten years ago he would've arrested her and taken her in as a criminal using drugs in the street. today his perception has changed because he has had several interactions including this interaction with a person who, by the ways a member of the florida bar, is a successful,

functional attorney, whose hudson husband also has a problem. the fundamental challenge he faces as he does not want to take her to jail doesn't view her as a criminal. he. he views her as someone who has a disease and -- and her gateway into heron was a pharmaceutical painkiller for surgical or siege or six to seven years ago and she lost access to medicine and this is what happened. the concern i have is this, number one, if today you are dependent upon opiate substance, your respective of how you got there, less in the case of this person because of the use of a pharmaceutical that led to this point. there is still in a store near a stigma associated with it. you're a bad person doing a really bad thing and needs to be punished for it. second, even if that stigma were to change so we can get more people in to treatment and accepting the fact that i am physically dependent

on the substance, in many communities there is nowhere to take them. the only place you can take them potentially is to a jail where you hope there withdraws our management may not be. in essence, there is nowhere to go. many places many places don't have the capacity to meet that reality. that leads to the third problem and that is the number people who end up in a jail cell for 15 days, go through withdrawal, do not realize they have lost their tolerance even in that short period of time, and when they fall off the wagon they go back to using the level they were using before they went through withdrawal, and it kills them. because they lost their tolerance for an opiate. so given that perspective, i'm that perspective, i'm sure there are hundreds if not thousands of cases like that, what are the impediments to getting someone who faces this, but they could be them i don't think so but

they could be watching c-span, not many people watch c-span but what's out there today, what is missing for someone who needs this treatment and doesn't know what to do about it next? especially for the uninsured. they're not uninsured. they're not many options for my understanding. >> thank you mr. chairman. i think that is a key part of it addressing the demand side. part of it is educating people and helping them make the right choices to avoid overuse of prescription drug. the other part is, how how do we provide the resources to treat people that are addicted? the treatment options are very limited. for the uninsured as i pointed out, 26 beds for 2,400,000 people. our jail alone, one out of four jails in the region, we have on average 200 in the region, we have on average 200 people that we are treating for withdrawal system symptoms and offering them a treatment program when they leave. we need more treatment facilities. when he asked the question our traffickers, our dealers preying on people coming out of treatment centers, the reality reality is we don't have enough treatment centers to pray on.

>> you said in your testimony that you believe florida was specifically targeted because they knew we had the pill mill problem and what once i was cut off the folks were going to need -- >> exactly. that's what i believe i don't have have empirical evidence. what i have is the evidence of the increase in the flow of heroin and the increases in death related to herod in correlation to our cutting off the pill mills. while we were dispensing more oxycodone than the rest of the country combined out of florida, most of that was leaving our state. most of these pill mills you could drive up and you could look in the parking lot in the parking lot would be full and only small percentage of those were local license plates. so so the cartels may have missed judge the appetite, but no question they have flooded us with very cheap drugs and the number of youth that i have seen that are struggling with addiction and have turned the corner and have had the good

fortune of money to find treatment. the insured portion of that population to see that there actually is life after heroin addiction is very encouraging. what is very discouraging is that most people that are addicts have idea that there is life. most addicts have no opportunity to get to the treatment center. >> just to fill the gaps of those who may not be aware of the florida pill mill problem. we had these the facilities and you would say mina kurtz, my back hurts and by routine they would give you a package you a package of prescriptions, it wasn't just oxycontin it was other also other stuff in there. you you had have busloads of people come in sometimes. it was a huge problem. the florida legislator close that loophole, just to be fair we're not talking about ic prescription being driven by a dr. at the office, it was a specific facilities that are of this. did you want to add something on the trim a part of it? at one more question.

>> this is obviously framed as a law-enforcement debate and certainly i was asked to talk about the criminal organizations. as you pointed out, this is a public health issue. at the heart of it this is a pharmaceutically driven epidemic and it is a public health issue. that is really the difficulty in facing up to this. it is not necessarily strictly law-enforcement. were not in talking about throwing people in jails. we need to be talking about how to get them better treatment. >> my sense of the human side of it is that i do not leave anyone wakes up in the morning and says today's the day day become a heroin addict or an opiate addict. it's not something someone wants to happen. you be throwing evidence. there's no responsible way to use this. its impact on everybody is different. we know some people are more sensitive or susceptible to addiction than others. it basically restructures the brain chemistry in the way a disease does. i i look at the statistics, for example in florida, orlando has 83 heroin

deaths in 2014, other communities have large numbers, miami at 60, 60, sarasota 55, but that number pops out of you as a place that is been targeted. then he see see the rising death some spike we have seen across the country in heroin and opiate deaths where the takeoff point has been is the introduction of fentanyl. as we have seen from testimony today it is an incredibly powerful and lethal substance. in fact, for my understanding it is not prescribed outside of a hospital setting to begin with a pharmaceutical side. it is not being laced into -- and i want to go to senator keynes i wanted to leave with this thought. i read a report were someone who was a former and recovering addict was asked about this and say, when you hear that someone has died from an overdose, that

was sold by a particular dealer, it makes you want to buy from that particular dealer because you know what they are selling is the strong stuff. now maybe that was just one line, one interview but it tells you the point that we reached where it's very difficult and debilitating condition that we have to try to understand here. i think a key key is to remove the stigma associated with it. many of us would be very surprised at the number of people we interact with on a daily basis that on some level have a dependence problem. maybe not street heroin but some sorts as a result of what we have seen happen in this country. hopefully. hopefully we can make advances in pharmaceutical so we can draw the line and we will be able to treat pain effectively in this country without putting people at risk. >> thank you. and thank you to each of you. i'm sorry mr. opening testimony although i read your written testimony. i was the mayor two in richmond, it was only when i was mayor that i fully grasp the demand side of this challenge.

you can arrest the dealer and arrest the dealers, but if the demand for drugs is so potent, if it has its hooks and people so deeply the next dealer will appear tomorrow. we have a really tough problem enrichment. a lot of drug related homicides were taken place in this neighborhood near where the church i go to. the number of stories that would appear in the front page of the paper about someone from the suburbs coming into by drugs and getting shot, you think about five of the stories people would quit driving into drive by drugs there. they would keep driving into by drugs and that's evidence of how powerful addiction is. we would have this objective evidence that says this is going to be dangerous much less the drugs could be dangerous, could be shop at that need is so intensive that i'm gonna go. it sounds like you've seen that

in your community. i was a mayor 20 years ago the drugs were different, but is the same thing of this addiction per that's why the treatment issues are so important. the the other thing we used to hear anecdotally, i'm not an expert in this field, when someone is under the grip of addiction says i want treatment, that is a window that opens that if it's not there at the window can close. a month from now with the bed opens up the individual might be past the point of wanting treatment, may have od but or lapsed into other behaviors. i do appreciate what the chair was saving you are saying about the need for treatment. i'm curious curious if you could talk about, as a mayor, the way to sell some of the challenges is definitely through having partnerships, state, federal, talk about what you have done in your county on the partnership side, do you have the right stakeholders around the table, other things we can do from the federal level to ensure that we are issuing

funds and we do it in a way that requires regional cooperation or multilevel strict holder cooperation. >> red is on. red is off in orlando. i will get through this. in orlando, what we have done very effectively is a regional cooperation and i think that is crucial in tackling any issues such as this. one of of the reasons we pull together the task force would it is we brought in so many different disciplines to make sure that we could attack this problem from all angles. so i would suggest that as it so important that we have limited resources at government levels. it always seems that the demand for resources outpaces supply. it is important that programs are structured in a way that funding is put to the best use. i do think that collaborative effort is important. we have have metropolitan bureau of

investigation that pulls together, the fda, or local law enforcement, our sheriff, our state attorney's office, that has been very effective for us on the enforcement side. in terms of your comments about that window of opportunity for addicts, i cannot understand it either because i have never experienced a feeling of needing something so badly that i am willing to risk my life to have it. i do understand that is the reality. i know enough people, enough people came forward, literally walk up to me on the street, you know what is like being a local mayor. people recognize you and they come up, they pour their heart they for the heart and soul out too. it's a blessing to be at that level where you can really hear firsthand. i have seen young people that you would never in your wildest imagination thought they were

heroin addicts tell me their stories. what i also side think i mentioned before you walked in here is i also saw the other side. i i saw that they came out the other side of heroin addiction and their living full lives and getting college degrees. they're going to to be productive members of society. i think that most heroin addicts do not believe that is a possibility. if they have that moment, if it's 15 minutes, and it's two hours, two days, where they say gosh i want to kick this, reality is kick this, reality is they're not going to be waiting for two weeks. where month. they're going to be waiting a lot longer and most of our communities to get into a treatment facility unless they have a substantial amount of money. that is a huge problem. as i said in my testimony, the best option is our county jail, right now. that is a lousy option. not to say we have a bad gel, we do our best, but having a record

does not help the situation. so we really need to have options available. we need to have education, we need, we need to have hope we need to have the in tire community engage. as you pointed out is destroying more than lives, it's and destroying community. >> thank you sir. >> mr. chair, we had a chart recently recently placed before us in another hearing about ods per capita, the 50 states and it was unlike any chart i have ever seen, ever. if you look at a chart that is usually about some kind of problem or crime or social breakdown, high income states will be at one part of the states and low income will be at another part. if you looked at the top ten most effective states that included some of the poor states in the country and some of the richest states. if you looked at the bottom effective states they included some of the poorest states in the country and some of the richest. this is really unlike any similar epidemic or law-enforcement problem i've ever seen in the traditional

demographic is not a predictor. it is a rural, urban, suburban, it is all regions, i went to a drug court graduation, the founding drug court in virginia and the judge who founded it, he was a super, farsighted thinker about the need for drug courts had a child too, many years later was killed in a drug related incident. after i spoke at the graduation, one graduation, one of the probation officers who helps the court run and has done so as a spectacular advocate said this is my second drug court graduation this week and i said did you have never class and he said no i went to my son's graduation in a community two hours from here. this affects every level, that that is why we are now spending the time that we are, but we have not spent time in this committee on it and it's important that we do so. this is not, just like it doesn't have demographic

borders, this is not a problem that has national borders and we have to get a hold on some of the dimensions, mexico, china, some of the other nations that are experiencing this and build the partnerships, not even in a metropolitan region but we have to build law-enforcement internationally. thank you for your testimony. >> thank you senator. i just wanted to ask you about the transnational groups that are targeting us, i think in your testimony talks and i wanted to reiterate, again, wethers button all being produced synthetically or poppy -based opiates being grown in the western hemisphere, in particular in mexico, they're coming here. this is almost exclusive market for these trafficking networks, is that correct? >> that is correct. absolutely. there is a small market, local market that they can satisfy but it's minimal.

>> you heard the testimony before so you would think logically they are crossing the border you think the easiest, from a logistical point of view is still flood into texas, california aboard a state but what you're hearing is where the outbreaks are this is a national problem, there's no community in the nation that doesn't face it, you see these outbreaks in the northeast, new hampshire, massachusetts and central florida, so it what is your view, how is it wanting up in these pockets. what are the distinguishing characteristics. what in your view is the distinguishing characteristics that turn a community into a high propensity, high risk area? >> it is such a new phenomenon because it is so dispersed. the fact that it is so dispersed is really what leads to the

criminal organizations being so dispersed. the notion that we have one, single all-encompassing enemy is called the cartel and once we incarcerate el chapo everything will be resolved and that's not correct. just because the dispersed nature of the market in the way in which the criminal organizations will satisfy that market. it's not thing because in a way there certain elements of this epidemic that we are victims of our own success. the fact that you would create ways so that you cannot tamper with oxycontin for example. you can't snorted anymore, the way in which it's distributed, will then that makes it less available to people so then they they start to search out other things. the way in which the mexican government with the united states government has captured or killed several of the larger

leaders of the criminal organizations that has led to a fragmentation of these groups. so you have groups like you referred to earlier there's a group that was the group responsible for the massacre or supposed massacre of the 43 students that disappeared, this is a group that was an offshoot of a larger group and there are several like them. so in order to wrap your hands around this says law-enforcement issue it's incredibly difficult because the train is so horizontal than vertical. even when you take out the larger leaders what you're left with is a fragmented criminal

landscape. a landscape that doesn't necessarily come in the cocaine market they might depend on getting product from another country, in fact they do from the andes. they need to get their product from other criminal organizations. but they don't have that dependency when it comes to the poppy production which is local and the heroin production which is local. so they can produce this themselves which makes it much more difficult to wrap your hands around as well. >> to have anything further senator? i want to think about her being here and were going to the previous testimony. i hope that was insightful as you go back and continue work. thank you for coming today and be a part of this hearing as well. it's an important issue in there's been a lot of debate about what's being done domestically on this issue. am glad we touched on the. i think it has to be dealt with. there's not one law that can deal with this it has to be dealt with comprehensively whether it's on the treatment sigh, prevention side, and also by targeting these organizations who are in the business of murder. which is basically what this is, not just murdering each other for territory, but the direct murder of americans by targeting us with the distribution of

these products in our country. i want to thank all of you for being here. i also want test consent to enter a statement for the record of jack riley, the acting deputy administrator. the record for the syrian is going to remain open until the close of business on tuesday, may 230 to 31st. you may receive some questions in writing what's possible i ask you to respond so we can close the record on this. without i thank you for being here in this meeting is adjourned. [inaudible] [inaudible] [inaudible]

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