agrapher craig shirley, professr talks about her book, opting out of congress and we close with former u.s. trade negotiator, ira shapiro and his book, broken. book tv at 8:00 p.m. eastern here on newschannel5.

up next, we'll very you a portion of event c-span that covered in 2018, featuring state governors, white house officials, health experts and president trump. we begin with a senate health and education committee hearing and remarks by author sam quiñones. >> i'm pliesed to welcome sam quiñones and his family today. he was 30 years of experience as a journalist and author and has written extensively on the opioid crisis and drug trafficking. he won the national book critics circle award. earlier in his career mr. quiñones was the recipient of the maria moores cabinet prize. the older international married journalism for work covering

latin america and the recipient of a fellowship awarded to outstanding print journalists who pursue stories in the public interest. welcome. you'll have ten minutes to give your testimony and then senators are looking forward to having a conversation with you. >> thank you very much. clearly i'm a rookie here. chairman alexander, senator murray and honorable members of the committee, i'd like to thank you for these hearings on our national epidemic of opioid addiction and for allowing me the honor of addressing you. i'm very happy to be here with my wife and daughter, who are part of producing dreamland and without whom the book could never have been finished. this is a deadliest drug scourge we have known in this country, hitting years of the country

that have never seen this kind of drug problem. it is the first in modern america to be spread not by mafia, not by street dealers but by doctors, overprescribing pain pill, convinced they were doing right by their patients. urged on by the pharmaceutical industry, by the medical establishment and urged on by us, by american health consumers who too often want ad a quick and easy end to pain. isis could not have dreamed of caused the kind of torment and death we have put on yourselves through the overuse of opiates. these drugs are a symbol for our era, for almost four decades, we have exalted the private sector, the individual, while we ridiculed got of government as inefficient, incompetent and waste. we admired wealthy business people, regardless of whether the way they made their money produced anything of value for

our country and our communities. we wrought a second gilded age. this epidemic of addiction to a class of drugs that thrives on isolation, re-forgets all that. this epidemic's costs have been borne by the public sector, profits are private. i believe the scourge is about issues far deeper than drug addiction. it's about the effects of this very cultural shift. it's also about isolation in areas rich and poor. about the hollowing out of small town america and the middle class. of the siloization of our society and a culture that amounts as if buying stuff this pact to -- path to happiness. we believed problem quds be attacked with one magical silver bullet, pill for all our pain, a

jail cell for i every addict. exalted the public and mocked the public and communal and rid ourselves of things so essential to us they have no price. we have been invaded by cheap junk as a result. we dug up dreamland pool and replaced it with a strip mall across america for years now. heroin is what you get when you destroy dreamland. i believe isolation is heroin's national habitat and the epidemic is calling on us to coming to as americans. i believe more strongly than ever that the antidote to heroin is not naloxone. it is community. people coming together and working in small and local pays towards solutions. no one saving the world alone.

the good news in fact in all of this is that there is no solution. there are many solutions. each small, each must be tinkered with, improved, some maybe discard, each must be funded fully and for a long time. but none of them is sexy. none will do the dribbing alone. believe that across america today communities are finding solutions. the more they band together, the more they leverage all that talent and energy, bringing ptas, pastors, artists and athletes, recovering addicts and primary care docs, librarians and chamber of commerce. the more cops and public health nurses go out for a beer, bridge that cultural chasm and this is happening in counties across america. it's my opinion, the evidence

shows that supply has ignite all this. we did not have this demand, this widespread addiction, until we unleashed a large supply of powerful, legal narcotics on the public for the last two decades. thus i believe it essential that doctors reassess how and to whom and in what quantity they prescribe these drugs. that does not mean just cutting people off who are on high doses of these drugs and leaving them to fend for themselves. it does mean lobbying insurance companies to reimburse for pain strategies that do not involve narcotics. allowing doctors a wider array of pain strategies than simply pain pills. young docs need more education in med school in pain management and addiction treatment. i have to say that it think it's delusional to spend time and money on yet another wall along the u.s. mexico border, hoping that this will somehow staunch

the supply of heroin and fentanyl. they're coming in throughaires walls already immigrant believe a wall will corrode the only thing that will truly help stop these drugs from flowing into our country. that is a deep respectful but also forthright, blunt, on relationship with mexico to it finally becoming the kind of neighbor and partner we can work with effectively and become the tuned of neighbor that country needs of us. another wall, however, seems to me is just like heroin. it feels good for the moment but it will leave us worse -- in a worse place in the long run. another silver bullet for a complicated, adult problem. sometimes the solutions are about the mundane mechanics of governing. we should find, for example, new waves funding coroners offices around the country, and

expanding our national forests of forensic pathologists which i dangerously dwindling. this epidemic spread because so many of the offices are so poorly funded. i believe we must expand treatment options in this country. one place to do this, ironically, crucially, is jail. consider how the country will be helped by transforming jail into a place of nurturing, recovery instead of a place of predation and tedium, becomes then an asset instead of a liability and this is happening, particularly, i would note, in the state of kentucky. i'd like to add that cross america are families suffer do to the addiction of a loved one or the loss of the loved one. believe they are a raw material to be marshalled, hard nashed in the fight. man now want to be involved, need to be involved. to help solve the lacerating wounds that will last a

lifetime. i believe you as senators can help this by recruiting them, recognizing them, giving them platforms from which to tell their story. maybe it's because i'm a reporter but i believe through their stories the awful stigma of addiction will be reduced. i'm happy to elaborate on this. urge you to view this as an opportunity to revive those regions hammered by globalization and free trade. the roots of our national epidemic of narcotic addition lie there, while the epidemic nit turn stands in the way of their revival. many of these regions cannot revive until enough of their people can pass a drug test to fill new jobs, and indeed this is not only a story of a drug addiction, it is a story of economic affliction. as politicians, i suspect your natural response to a crisis

like this is to look about for things you can do quickly, to show constituents your taking action and that is entirely understandable. i would caution, however, against believing in short-term responses. the cures act is a great start and i thank you for them but they're only a start. everything i've learned but this issue has taught me the importance of long-term community responses and commitments. i believe american history offers us two templates for action from which you might take guidance and inspiration. first is the marshall plan to rebuild europe after world war ii. the second is our space program. each involved government and the private sector acting in concert over many years, bringing money, brains, energy, and of course, long-term focus to bear. each achieved an unalloyed good

for our country. though they were about doing things that seemed on first blush far beyond our own short-term self-interest. the marshall plan was but building up ravaged regions to allow them to function independently while containing communism. allowed reborn countries to prosper and contribute to the world again. a marshall plan for american recovery might focus on rebuilding regions caught in dependent on dope and ravaged by economic devastation to contain the viral spread of addiction. through our space program, we were inspired as a people to spend years and dollars, all to achieve something no previous generation ever thought possible. we ended up far beyond the moon. the spillover in economic benefits, increase of knowledge, and in simple human inspiration, is beyond calculation.

seems to me that we might profitably apply these examples, the marshall plan, and the space program, to regions of forgotten americans where this problem began. let's do it not because it is easy but because it is hard. because that is what americans do. and have always done. at their greatest. we must focus on community destruction and the hallowing out of stretches of the country. thus i'm here today to urge you to see this not only as the catastrophe that it is, but also as the gift that is can be. it offers an opportunity to reinvest in areas that need it most. a chance to inspire us as americans again to do something great. it's an opportunity to bridge

that political porlarization that so gnaws at our country. one of the few issues today that can do that. do not miss this opportunity. it does not come around often. this calling, i suspect, is very reason many of you got into public service in the first place, and you are lucky, i think to be here when it has, again. you will be remembered for acting when acting was not easy to do. if you do, i believe your home towns will thank you. your counties will thank you. and we, your countrymen and women, willing thank you long after you're gone. >> up next, a portion of the annual conservative political action conference in washington. this panel includes former vermont governor, who first called attention to the opioid epidemic during this 2014 state

of the state address. the panel is moderated by common indicate you're great to van susteren. >> good afternoon. very happy to be here today moderate this fabulous panel but a very distressing issue, an issue that is bipartisan, affects republicans, democrats, independents, libertarians, affects everybody, and my panel is bipartisan as well and i want to start right away. this is a problem what the all need to sort of think but in talk about. talkative you lieutenant governor of ohio. why is this topic important to you? there are lot -- you could be talking about jobs in ohio and. why do you want to talk but this one? >> this an issue that impacts every family and has impacted my family but i've also seen it in the state of ohio. i've talked to parents who have

lost loved ones. i've talk to people who are suffering in the crisis that is the addiction issue, and it is touched every single person i've come across, and we need good leaders who will stand up and provide real solutions to give hope and help and heal to so many individuals today that are suffering. >> andrew, government can't solve every problem. government can help solve problems. government can lead. what do you see as the role of government in this crisis, this epidemic, which is nationwide and a health epidemic? >> thank you, greta. i'm thankful to be back at cpac. i hoover coming every year so thank you. this is a critical issue. you opened up saying that it's not a conservative issue or liberal issue. at a conservative issuing this is a really important issue and working for president trump who cam attended vigorousry during the campaign on this issue in

states that's have been devastated by this epidemic, helps us understand why it is anish you're right, government as a legitimate role to play in tackling certain issues. we love living in a free society where government doesn't everything but the are areas where the got has to do something and this is an area that the government failed and this is something president trump has talk about as a candidate and has led over and over again, talking about the need for states and localities, from the medical professionals and law enforcement to come together to help address this crisis in our community. >> if it were easy would have been solved a long time ago. if north korea were easy it would have been sold. 216, 64,000 people did from this. and to give you a point of reference, car steps took the lives 40,000 people. -- car accidents took the lives 40,000 people. this is a challenge. governor, what strategy or what

new ideas or what else can be done? everyone is at wit's end. >> thank you for having me because this is a bipartisan issue, and as a governor, we're all dealing with it. doesn't matter what you state or politics are. i think the question is, to answer your question, what are you doing? what's the solution? i think this is an easy one to solve. most people don't say this. this is easy to solve if we have the courage. why are we in this mess, on a stage where you just heard but his son, the lieutenant governor is dealing with the challenge with her sons. why are we all in this mess? why have wiles more folk opiate addition since 2000 than we lost in world war 2 and vietnam combined. in 1990 we approved the -- the oxycon -- oxycontin. we were told we have the first nonaddictive pain killer and we

were all rejoiceful. they were wrong and not only were they wrong but they plead guilty to lying fda -- the best kept secret in america -- paid a fine of roughly 700 million, four lying to the fda, 85% of the folks addicted to heroin start with fda approved pills from the drug store. the question is, what is the solution? my view is, if governors like me, we do criminal justice reform. we build out treatment. we get rescue kits that will take them. we all do the same things but it's after folks have become addicted. this is the worst disease to have that one can contract in terms of the fight, the struggle, what it does to your family members and what it does your lives. so, my answer is a simple one. listen, there's two things to do and this isn't hard. number one, the fda should revisit the decision they made but passing out pain killers like candy, now that we have

admitted that they got lied to in the first place. second -- [applause] -- second, just like what happened with tobacco, we have governors like me, we have attorney generals, i lieutenant governors, all over the country, mayors, municipalities, all suing the folks that put us in this mess to try to get money for treatment and change the behavior. why don't we do what we did with tobacco, get them all in a room, the president of the united states, president trump, has the ability to be the winner on this, and i can tell you, president obama messed this one up when he reduced the burden of proof for the pill mill folks that were having these trucks, truck this stuff to the pain -- pill mills. that's where folks get a lot of these pills. the obama administration literally reduced the burden of -- raised the burden of proof so the enforcers have to get these folks to plead guilty

before they can stop the trucks moving to the pill mills. here's my point. there's no one in any view who knows more but this kind of issue than john cole, who is here today. i want folks to know who you are. got tobacco in a room, back years ago, and got them -- >> handsome, too, i might add. my husband. >> my point is, president trump has the ability to be a hero here. he can put them in a room, say don't come out until you settle this. time nor taxpayers to stop paying for treatment you guys have to pay. you guys have to pay and change your behavior and you're not coming out of the room until you. do that's the opportunity of the president of the united states. >> governor, i have two questions. one is if the great thing about this, to what extent do you agree with or disagree with governor, we're trying to come up with some sort of ideas or

solutions. but wet get to that -- before we get to that, people say we're in real pain but say don't take away my pain pills and we need to keep people out of pain. there's another element of this. some people genuinely have pain -- they need help. >> so i'll start with first of all, there is a conservative solution to this, and i believe that the government has a role to play but government is not the solution. we do need comprehensive care and need to make it available to citizens living in addiction today. it is a long road, as you said, governor, to health and recovery, and there is a role for government to play. it's to incentivize the private sector to build out the type of care that is necessary to restore lives, but we also have to foster and encourage looking for alternative ways to treat pain and is a patients, we shouldn't accept that disease addictive pain pills is the best

we can do. individuals living in pain today i would recommend, we need to be -- open up the opportunity for these alternative ways to treat pain and not just accept the best i can do is a pain pill. >> before these opioids came on the escape, lloyd to might 90,people had pain, right? was it -- was there inadequate pain management or did we have something that would -- that helped and wasn't quite as addictive? >> my understanding, based on what i have read -- >> and feel free to jump in when they started treating pain as a vital sign, in my opinion, it all shifted to our medical community now being judged and being rated based on how well they were treating, yet pain is subjective. i'm not a medical professional but pain is subjective and if i said, how is your pain? >> 10. >> right. i have to treat you because you're going evaluate me. >> i'm afraid if i don't say ten

you'll give me two and i'll be in pain. >> right. >> but started in my opinion when i look back at the history, it all seemed to start to shift at that point and that's -- government had a role to play there they're the ones that said, we're going to treat pain like a vital sign. it became the fifth vital sign and not measurable. and we created this crisis. >> let me give you another statistic which i find stunning. in the -- between 2006 and 2016, out of state drug companies shipped almost 21 million opioid pills to two pharmacies in williamson, west virginia, who had a population of 2,900. and andrew, i'm not a doctor either but that doesn't seem right either to me. >> that is right. and i want to follow up on a point the governor made about law enforcement. we saw in the last administration, president and attorney general who i don't believe respected the rule of

law, respect due process right order vigorously enforced the law. we have a president and an attorney general who are vigorously enforcing the law and that starts with enforcing the law against companies who have broken the law, including criminal investigations and civil investigations and then also going after people on the streets who are pushing drug into our communities. the last administration said, it was okay to do drugs, downplayed this as an issue. we need to do a better job teaching our young people, don't go down the path of addiction. we need to provide treatment. and treatment is a hard road. myself, most of the people in this room have had family members who struggled with addiction and needed treatment. the president spoke passionately about this last year, that his own family, where he saw the life of his older brother, dealing with alcoholism and what that did. the most important message we need is ensure that people do not start down the road of doing

drugs, and leading down this path towards addiction. that is so hard to come back from. the best thing from a treatment standpoint is prevention action that prevents people from starting to use drugs. >> that is one of the biggest problems. if you're at the point where you need treatment and some people need treatment, you have lost your job, lost your family, you have completely -- it's been terrible pain to your friends -- everybody. it's really -- so, governor, how do we start at the beginning, realize we have to deal with to who addicted and pain pills for those -- how do we start at the beginning so we don't have this whole universe of people? >> so, let's just back up a second because everything that is being said here is true except that we are hesitant to point out that in most issues that i see as a governor -- i'm sure all governors face this -- when you get into the details of

policy, it gets a little more gray. it's not quite as clear, not quite as black and white. this one is black and white. america did not have someone dying every 15 minutes from opiate addiction before we approved oxycontin. these are the facts. we passes out like can devil these the facts. we now have thousands and thousands of good people dying every year from this disease. so why wouldn't we, if the fda admitted -- had the folks who lied to them come up and say, sorry, we didn't tell you'll the truth, why wouldn't we simply good, hey, wait a minute. we got bad information. as lieutenant governor pointed out, we reconfigured the way we judge our healthcare system based upon oxycontin so now the fifth criteria to judge by. let's undo that, back it up, and have the folks who lied and created this disease, pay for

the treatment and the prevention should be in my view, stop passing it out like candy. revisit the fda decision, let's start with we began with a more sane policy on pain drugs in america. >> i always think that the power of the government or the white house -- we all know is incredibly potent in terms of helping solve things but is going on dent on the political parties working together and this is a unanimous partisan issue. could you two work together despite differences -- you have the conduit to the president of the united states. do you have new ideas you could get -- you could ask him for help on? >> absolutely killing our kid is a bipartisan problem. no one says, this is a good idea. let's get as many folks as we can addict toes this stuff. >> the problem is if just the lieutenant governor goes to the

white house and ask no help, it's a republican asking. i you go it's a dem contract. glory a -- unique situation you come from a state where this is a scourge -- every state -- >> i would say, governor, i am a republican, i'm a conservative, and one of the challenges we face in this country is we nowhere it's coming from. it's coming from mexico. it's coming from china. when you start talking about fentanyl. now i would say build the wall because i'm a conservative republican. you may not. you may not agree with that but i bet we could get on the same page of, how do we help reinforce law enforcement to keep the drugs out of our country. >> to that point i want to say an important part, we have seen this skyrocketing of overdose deaths, just in the last few years. our country has been suffering from the scourge of drug use for a decade but the reason this is

a potent point in communes and families the number of overdose deaths just in the last few years has gone up dramatically and that is largely due to fentanyl. and the import addition by drug cartels and other criminals bringing fentanyl in from china or mexico, into our country, has get to stop. the last administration failed to protect americans from fentanyl. the trump administration is working day and night to keep these harmful drugs out and that's why we have to build the wall, i increase our border security, provide homeland security, the technical resources to screen this stuff from china and it's go to stop. >> could i make quick point. my point is this. we have always had drug problems in america and we all have different views on how to solve it or maybe we have the same views. here's what changed on this one. most -- 85% of folks who go to the heroin that has the fentanyl in it, start with fda approved

pills. they're getting those from the corner drug store. >> can we do both? >> we can do both. >> we are -- >> we must do both. >> -- stop the importation. >> president trump has the unique able and your job at the white house to be the president who solves this problem because it's bipartisan consensus. we want to stand the dying and tragedy, and i always say the biggest victims of the disease are the kids of the addicts. >> absolutely. >> as a governor that is most heart-ripping there to experience, the children left behind. >> what's your biggest challenge or impediment. >> it's a supply and demand issue. >> does the white house help you with that or not. >> both. >> host: federal government.

>> the federal and the state problem. we need to keep the drugs off the streets. we need to hold drug dealers accountable, law enforcement needs additional resources to get these guys and -- these guys killing our kids and throw them in jail. >> what about the pharmaceutical industry, those that are producing this, and the companion problem there's an awful lot of money in this town that geoff to transome on capitol hill, both sides of the aisle. how do you fight that issue? >> what we have done in ohio is we have issued -- i'm not all for regulation, not a government regulation person but this is a public safety issue. we have issued regulations where you can only prescribe a pain pill for acute pain for seven days if you're an adult and five day is you're a child. you have to -- >> federal -- >> that's state. we did it in he state of ohio. >> why don't we have that federally? >> as conservatives we recognize that state government needs to

make most policies in this country. every problem. every problem is not a federal problem. >> that's right. >> every problem is not a federal problem. every problem the federal government neats to have some response to make sure we chauffeured leadership. so states right now are being smart and innovative and passing new good legislation that bans prescriptions or limits prescriptions in certain amounts and that's great. the worst thing we could have happen is for the federal government to intervene and pass laws that were uniform across the country that try to solve the problem because we have seen this happen in heck neck and -- in health care and good intention the federal government passes the law. the unintended consequences trickle down and governors and state legislatures -- >> why not bull the -- >> limited governor conservative we should encourage our state leaders to pass these laws to take these issues on.

>> tracing back to is that the power of the white house, the power of the oval office is to get everybody into one room, basically lock them in the room until they do this. every state. governor? you have the last word. you're the minority. >> let's for a minute put our hearts aside and just use our math heads on this one. it costs me $25,000 to treat someone after they've become addicted. so it costs you $25,000 as a taxpayer every time someone gets addicted to these substances. a huge cost to taxpayers. i we have an industry, which we do purdue and others,s not just the performers and distributors, -- they're all in this. i will have them making billions of dollars off this disease that's killing people, i think the white house has a unique opportunity to replay the

tobacco tape, get the folks in a room, close the door, because these lawyers wilt run this thing like asbestos forever. this about taxpayers getting paid for the bill they're paying now for a disease that was created by lies to the fda. let's make that happen, and i think president trump would be a hero to america if he facilitated that protest. >> panel, thank you very much. and once again this is a problem that fakes all of us and -- affects all of us and to the extent we're talking about it and trying to do something you do a huge service to the country. thank you. >> thank you, greta. >> earlier this year, massachusetts governor charlie baker led a discussion on the opioid crisis at the winter meeting of the national governors association. we'll show you his remarks followed by health and human services secretary, alex --

>> i'm governor of the commonwealth of massachusetts and the chair of the nga health and human services committee welcome to welcome you to this conversation but an issue that the nga has been engaged in in a big way forks the past several years, and i think it's fair to say that every governor of every state has made dealing with this particular issue a significant and important priority in their work and that's certainly been true in the commonwealth of massachusetts. i didn't run for governor to work on this issue but it found me because wherever i campaigned i ran into people who talked to he me about it, and their stories frankly breck my heart. and over the course of the past several years, working on a bipartisan basis with our legislature others, we have made some progress in dealing with

this terrible epidemic inch massachusetts, after years and years and years of double-digit increases in opioid prescriptions, overdoses and deaths, literally for the first time in a very long time in two 2017, we had 30% reduction in overdoses and deaths. the way that was referred to by most people was positive but muted and the reason its muted is because we have so far to go and so much nor do. but after bad news every year, year after year, people did take some comfort in the fact that a trend that had gone like force for a long time, started to go like that. there's a lot of that went into that, and today's conversation is to talk about what is working and where i should we go next. some thing is believe have worked, which i'll speak to and others will add to that -- would

be the following. in massachusetts, we now require everybody who graduates from medical school, dental school, nursing school, pharmacy school, and social work school, to take and pass as part of their core curriculum a class in opioid therapy and pain management. if you're a prescriber, as part of your continuing education for growth your license renewed, you have to take and pass a course in opioid therapy and pain management. we're also one of the first states to put a limit in on first prescriptions. ours was seven days. several other states followed since then. we dramatically upgraded and simplified our prescription monitoring program. as a result of that, we finally got to the point where the vast majority of prescribers were working on that system and using it as a search engine every time

they wrote prescriptions and it finally good tot the point where it could give them decent information on their own prescribing patterns relative to their peerses. we created program to do says. work in middle schools and high schools for students through our health departments and also created as part of our sort of annual program for all athletes and their parents and coaches, an inclusion of a discussion about opioid, the positive and negative, along with discussions about hydration and health and concussions and the rest. that's kind of the prevention and education side. on the treatment and recovery side we added 1100 treatment beds, increased state spending by 60%, and a variety of addict based programs and made medication part of our rep -- pepper 2004 -- -- one other

element is wehead imped bedded recovery coaches, some of our hospital ers around the commonwealth to engage in discussions with people who overdosed and to see if they couldn't talk them into moving into treatment. most of the folks in -- who play that recovery coach role, are people in recovery themselves. it turned out that their ability to reach out and speak to people who had just overdosed and were in the throes of this addiction, this pretty powerful one. some cases we saw as much as 80% of those who were contacted and touched by this program, find their way into treatment. now, that doesn't mean 80% get out of treatment but the bottom line is for the first time we found a mechanism that really seemed to help nudge people, many for the first time, into pursuing treatment as a possible

option for them. with respoke -- respect to what is next we filed legislation that is before the legislateyear that is called the care character has number of elements that build on some of the things we have done previously. one of which is to take the whole notion of recovery coaches and turn it into a bona fide clinical program. to create a credentialing process for it and to make it as sort of fundamental part of the way we deal with addiction, especially opioid addiction, where a recovery coach can be a big part of what helps somebody, whether they're an head okayed assisted treatment or some other form of treatment, stay on, the positive side of their treatment program, as they battle their way out of this terrible addiction. the legislation also includes elements that would expand our school-based assessment and service programming, and also

for the first time, will have is engage with the folks in the pharma community to see if we can create something that looks like a blister pack, which we have in many other parts of health care, to provide the very small number of oopioids that you might want to make available to one who have wisdom taken out or minor gum surgery or sprained their ankle. the conversations with prescribers we write 30 days. let's the lowest thing we do. 30 days. 30 days for the stuff associate if with what we have been wright the prescriptions for make no sense at all. if we can create a delivery model that actually makes it possible to give somebody the or two three pills they might need, to deal with whatever the particular acute pain is coming out a minor procedure, we might be able to take a lot of this stuff off the streets to begin with. there, the final thing i'll

speck to -- speak is to fentanyl. in 2014 it was present in 30% of the overcoast deaths in massachusetts. in 2017 it was present in over 80% of the deaths in massachusetts if it wasn't for fentanyl, the success we have had in reducing overdose deaths would have dropped dramatically more. but the simple cute is, we can do a lot of things in prevention and education and i believe we are, we can do a lot of things on treatment and recovery, and i believe we are. but we have get to come together, state, local, federal, and chase this fentanyl issue harder than we are chasing it now if we want to protect the tub for treatment to be successful for anymore our states. i'm grateful to be here today to share how we see our role in complimenting and empowering the great work that you have already

been doing. as many as you know, president trump has made the opioid crisis a top priority. hhs has declared historic nationwide public halve emergency, brunning a new level of emergency to the response from the federal got but president trump and this administration recognized it's not the federal government that is on the front line of this battle. it's all of you. and your law enforcement officers, teachers, your school counselors, your community leaders, your doors, emts and nurses and your faith-based partner. we're dep candidate totem powering you and your allies in this fight. that ungirds the strategy for fighting the opioid crisis. >> it brings the unique powers and resources of the federal government bear in empowering those on the friend lines. many of you may already be familiar with the strategy but the five points but as briefly

as possible are data, research, pain, overdose reversers and access. after running through the tragedy i want to highlight a couple of pieces of news from the fda. the first point is better dat on the epidemic. we have to understand this crisis in order to stop it, which is why hhs is working with states and other stakeholders to support more timely specific public health dat and reporting. the centers for disease control and prevention, for instance, works with your state health offices and local coroners in monitoring overdose data. we need nor tools to help us win the fight which is why we support cutting edge research on pain and addiction in part through the national institutes of health.

the potential advances we're seeing at nih and the private sector, like nonaddictive pain killers and newing e methods of addiction treatment, are incredible. as they get closer to reality, we look forward to partnering with states and private partners to understand how these can best be put into practice. the third is pain management. we need to do a better job of addressing the real problem with pain in america, which is why hhs wants to ensure everything we do, payments, prescribing guidelines, best practices, and more, promotes healthy evidence-based method of pain management. we look forward to continuing to work with you on disseminating best approximates, including through the work of the federal interagency pain management task force we're standing up. fourth is better targeted over overdose reversing drugs. people in communities all across america in our own cities and towns, are alive today because of she progress that has been made in making drugs naloxone

available when they're needed. so wore,ing with cow to make sure communicates have access to these life saving drugs through hhs grants, research and technical assistance. the fifth opinion is better prevention, treatment and recovery services. we know directly providing these services often fools on state -- falls on state and local governments and community groups. we can issue grants to support access, expanding coverage through hhs programs, and providing guidance and technical assistance. as many of you know the president's budget proposes $10 billion in funding to address the opioid epidemic and serious mental illness. that comes on top of $3 billion in planned opioids funding for fiscal here 2018 we hope will be in the animal bus appropriations in march. the bug includes a range of different investments. $74 million to improve targeted

distribution of naloxone, and $150 million for rural substance abuse treatment. it also takes the state targeted response grants to $1 billion a year, twice what we have under 201st century cures. we look forward to building a base of experience from the grantses, hearing from you but how you have used this money. wasn't particular point that we want to emphasize for the 2018 grants is that states have a wide range of options for using them. this includes treatment vouchers which allow for the use of funds for evidence based services from faith faith based providers. americans of faith have taken a leading role in the compassionate approach. we have released guylines to accelerate approval of substance use disorder waiverrers in the

medicaid practice three of which we grant for indiana, kentucky, and louisiana and i would just want to note for our governors that if you have waiver requests with us and you have a particular fud waivers of this kind we can streamline pulling those out and work directly with cms for more expedite it approval around this con creed waivers so doesn't have to be caught up in broader waiver discussions we have to have. so what works? medication assisted treatment. one particular piece of our work on treatment is supporting access to medication assisted treatment. part of the tile of today's session is the, what is working? and as i said, hhs is always dedicated to advancing our understanding of what does work when it comes to public health challenges like opioidses. but we already know some important facts. one of them is this. medication assisted treatment

works. the evidence on this is voluminous and evergrowing. one study from governor baker's state, massachusetts, found that putting survivors of overdoses on medication assisted treatment, along with the appropriate therapy and social supports, reduced further -- future chance over death by more than 50%. that is a remarkable number of lives saved. and speaks to the number of lives we could be saving by expanding access to treatments that work. hhs has long been dedicated to promoting access to and awareness of medication assisted treatment, 0mat but we have long way to good. according to data just a third of specialty substance bruise treatment programs in the country offer assisted treatment. for many people struggling with addiction, fail for aller mat is like trying treat an infection without antibioticses.

having gist a third of treatment programs offer the most effective intervention for opioid addiction is simply unacceptable. under this administration we wanted to raise the one-third number. in fact it will be nigh impossible public to turn the tide. there is signatoried with mat, especially long-term therapy. but some one on-month-oldly assisted therapy -- medically assisted therapy, even one who requires long-term treatment, is not an addict. they need medicine to return to work. reengage with families, and regain the dignity that comes with being in control of their lives. these outcomes are literally the opposite of how we define addiction. our fellow citizens who commit to treatment, should not be treated as pariahs. they are role models. >> c-span's program on the

opioid epidemic continue with maryland governor larry hogan and oregon governor kate brown testifieding before the health and education committee and describe the impact on their states and answer questions on the spread of fentanyl. the role of the federal government and lawsuits against pharmaceutical companies. >> hey we have been sounding the alarm and shining a spotlight on the issue for fours year now. in my campaign for government in 2014 in the state of maryland, we're meet with local officials and community leaders and i'd ask them, what was the number one problem facing their community? and everywhere i went, whether it was in the wealthy suburbs of washington, or the inner city of baltimore or we were in small towns and rural communities, the answer was always the same, and it kind of took me by surprise but we learned about the

magnitude of this problem. one of hi first actions as governor, we established an emergency opioid and heroin task force, which as the chairman said came up with 33 recommendations; we focuses on a four pronged approach of education, prevention, treatment, and enforcement. i was the first governor in america to declare a real state of emergency on this issue, because we decided we needed to treat crisis just like we would treat nye natural or man-made disaster. we have already committed in our small state more than a half a billion dollars towards fighting the heroin, opioid and substance abuse epidemic from all directions, yet we still had nearly 2,000 people die last year. that's far more than those killed by firearms and motor

vehicle accidents together. with our efforts we have been able to bend the curve down on prescription opioidses and on heroin because new and even more deadly drug is now growing out of control across america and are that's fentanyl. overdose deaths from fentanyl were up 77%. the majority of the fentanyl is being ships from china or is a acrossing the border, smuggle in from mexico. and we simply can't stop it without the federal government stepping up. this crisis is going to take an all hands on deck approach from the federal, state and local governments. along with community organizations and faith-based organizations and others in the communities we all need no work together on this issue. i urge you your colleagues to make increased funding for the

opioid crisis a top priority, maryland and many other states are working to provide naloxone to local jurisdictions but greater federal support would help make this life-saving mid indication available to even more of our first responders, our police officers and emergency room personnel. i'd like to recommend that the federal government encourage advertising, public service campaigns, to educate the public about hoe lethal fentanyl and these other drugs are, and we also need more targeted and aggressive federal enforce; interdiction efforts, when it comes to fentanyl and these other opioids through initiatives like the synthetic tracking and overdose prevention, or stop act that's crisis evolves, so must our response. agree with senator murray, this is not just a health crisis, this is tear apart families and

communities from one end of the country to the other, from maryland to oregon and everyplace in between and this is about saving lives and will take a collaborative, holistic and bipartisan approach to accomplish that. so, again thank you, for heying us. we look forward to dialogue and answers your questions. >> thank you for heying me here today i'm honored to share the dyas with hi colleague, for hearing hogan. i hope we can underscore he urgency of tackling the opioids crisis that has touched every single corner of every state? our entire nation. what makes opioid so dangerous is the fact there is so much of it it and is isn't hard to get. abuse can begin as easily as

reaching into the average family medicine cabinet. that is what happened to max of southern oregon. he was a poet, and a chef. when he was 17 years old, he got into a car accident and was prescribed opioid pain killers. what started as therapy became self-medication, and spiraled into abuse. from prescription pills he moved on to heroin. his mother, julia, was devastated, as she watched the grip of opioids consume his life. he died of an overdose at age 25. it's hard to look back on max's story and wonder what could have been. what if we lived in a society where he wasn't shamed for having a problem or for reaching out for help. what if he had had access to better treatment? what if the first responders had had life-saving overdose drugs? addiction is blind to circumstance. but the high cost of addiction are borne by our children, whose

parents are unable to care for them while struggling with substance abuse. right now the federal government recognizes the problem, but is focused on punishment. that leaves us, the states, to right the wrongs of a war on drugs that has done nothing to address the issues that drive this public health crisis while our prisons and our foster care systems are filled to capacity with its victims. i i've seen its first hand. prior to becoming governor i was a lawyer representing parents and children in the foster care system. i watched children come in and out of foster care as their parents struggled with substance abuse disorders. as children struggled with the foster family they barely knew, their parents struggled with addictions that overwhelmed our treatment systemses. in oregon, 60% of foster children have at least one parent with a substance abuse

issue, including opioids. if we can make meaningful change in prevention treatment and recovery from beans substance abuse, we can create better lives for families and see more success for students in schools. we would lift a burden off our hospitals and law enforcement and our prisons. in my phone family, access to comprehendtive behavioral health treatments changed the trajectory of addiction. my stepchild started abusing drugs in high school. my husband and i watched him change and tent powerless. eventually teacher caught him using at school, and instead of kicking him out, she called us. we knew that just trying to stop using wouldn't work himself daily routine had become centered around getting high, he needed an immersive treatment program but our insurance

policies stood in the way. he had to go through two separate outpatient and inpatient treatments, and relapses, before our insurance could cover the residential program he desperately needed. fortunately for us, our family's story turned out very differently than the pinskis but it taught me how different recovery can look for every individual. we need to think but it as a process that needs to be tailored to a person's unique circumstances and environment, turning away from a failed first model, that is something we're work on in oregon. we're also getting more life saving overdose drugs into the hands of first responders, and implementing creative programs to provide a warm hand off from emergency room treatment and recovery. we need to make sure that we're focusing on decreasing stigmas

well. we must break through the barriers of shame to provide the best treatment possible first, and the most effective assistance now. we need to let people know that it's okay to come out of the shadows, it's okay to ask for help, and that there is a help that is available for them. at the federal level, there's so much that can and must be done in proving data sharing from the federal to state level, making affordable jenny, overdose drugs more available, rejecting a punitive approach to addiction. who knows, maybe this could have saved max pinski's life. we know it can save millions of others. thank you. >> i know you and i share -- i know your story with your back surgery and i'm sure they prescribed opioids to. you went through 18 months of battling cancer as governor and i had four or five surgeries and i know at one time three

different doctors within a matter of weeks prescribed me 30 day supplies of three different opioidses. that can't happen anymore in our state. but the fentanyl, we are really trying to crack down but it's coming through the u.s. postal service. seems like nobody use the postal service anymore but the drug dealers from china are because they aren't checking the packages the way the other delivery services are. we have to put some federal fending in that and it's now being manufactured or transported some smuggled across the border in mexico. this is fullly -- we have to do what we can on the local level interdiction but the federal got has to step up. >> would you agree with me it's also not totally an addiction problem, it's a one-time problem, too because fentanyl is so powerful, that the person can get one pill and now addicted,

never wore one but one pill could kill them alone. >> there's in question. people that are takes and have fentanyl once are killing themselves and people that don't even know are doing it once and killing themselves. it is a deadly, deadly thing, and it's 50 to 100 times worse than heroin. >> governor hogan, i want to start with you. this month, as we have talling up the numbers from 201 we have been hit with a series of heartbreaking statistics. just a few weeks ago we learned that last year drug overdoses killed a record 418 people in the state of maine. that is an 11% increase. so we're going in the wrong direction. then this week the cdc announced that in maine, emergency visits were opioid overdoses jumped by 34%. last year. in the past three years, the

number of people in maine who died didrug overdoses has doubled. at the same time, we at the federal level have increased funding and federal efforts year after year to combat this crisis so my question to you is what are we not doing right? you talk about the multipronged approach i totally agree with, education prevention, treatment, and enforcement. we due to the leadership of this committee have poured a lot of money into all four of those categorieses. so, what is it that we're not doing right? >> senator collins, thank you. we ask yourselves that same question nearly day. i mentioned in my testimony at the beginning that we were sort of ahead of the curve on

focusing on this issue, going back to 2014 and took every action anyone can think of and microsoft billion dollar into it in our little state, in state money. then we created the first state of emergency where we stood up our emergency operation snore coordinate every single state and federal and local agency to provide real-time assistance on all these different directions. and as i said we made slight improvements, and prescription opioids and in heroin because of the new synthetics we had more people die. and we had nearly 2,000 people die in our state, 70% spike in this new drug that no one knew anything about. and i mentioned a few things but i think more coordination and more cooperation from the federal government with the state and local so we all are

knowing what can we each do to collectively make this happen, and i think we do need more federal funding with some flexibility for each state, how they can utilize these funds, depending on how the issue is shifting and where they are at that point in talking with governor brown, fentanyl is not yet a big issue in oregon but i believe it will be. other things are starting on the west coast and coming to us. talked to other governors. we have all the nation's governors together last week and people were talking about crystal meth is now reviving in their states and they're lacing that with fentanyl. don't have opioids and heroin. so, i think it's going to take all of us working together. the federal government and your committee has been on of top of this issue and it's been a focus and i i know there was a task force put together with smart people and it's going to need federal funding. the stop act in fentanyl to

interdict is important the opioid response enhancement act, comprehensive addiction and recovery act, the cara, the signature athletic overdose prevention act, many good pieces of legislation in the house and senate that should be passed and they're coming from both sides of the aisle and both houses and all tooth tooth be considered. >> far too many families in massachusetts and across the country have had to bury someone they love because of this opioid crisis. more deaths, more funerals. but this crisis didn't happen overnight and didn't happen on its own, and a big reason it happened is because the biggest drug companies in the country pushed powerful bills and lied how arick if the at the pills where are and made billions of dollars doing it. it's time to start talk about hold these companies accountable, and holding their

executives accountable for the crisis they helped create in massachusetts, attorney general healy is helping lead a bipartisan coalition of 41 states investigating drug manufacturers and distributors for their role in the opioid endim more. 30 sis and towns in massachusetts have filed lawsuits and a number of native tribes, including the cherokee nation, have sued in both tribal and federal court. so let me ask this, governor hogan, maryland is part of that's investigation. baltimore and several county governments in maryland have filed lawsuits against manufacturers and distributors. do you agree that part of tackling this crisis is holding these companies accountable? >> there's no question about that and we have directed our attorney general, brian frost to also take action and to sue some of these pharmaceutical

manufacturing companies. there is liability. some of them knowingly pushed the sale of some of these drugs, knowing that they had these addictive capables and did not disclose it you can't paint all of the people trying to help people with pain with a broadbrush but the ones doing these things should be held accountable. i agree with you. unfortunately we can take the actions and we should but it's not go going to stop the people doing on the street. >> i understand. i understand. the investigation is ongoing and we should let the attorneys general do their work on this but if its turns out the drug companies broke the law, lied about it and people in order to rake in profits won't be the first time on this am few years ago a corporation made a spray out of fentanyl of powerful

opioid. the fda told the company that its spray was approved only for use in cancer patients who were in such pain that other drugs like morphine, just weren't enough to control that pain. but it turns out there just one enough office these cancer patients for the company to make buckets of money and so it started illegally marketing the drug to people with milder forms of pain, and bribing doctors to overprescribe it. a lot of states sued the company, including massachusetts, oregon was the first state in the country to reach a settlement it forced the company to pay up. so, governor brown, that settlement occurred a few months after you took office in 2015. has the money that oregon recovered from the company helped the state fight the opioid epidemic? >> absolutely. thank you for the question, senator warren. we received a little over a million dollars over half of it

went directly to opioid substance abuse treatment and recovery. a portion of it went to oregon health sciences university. they're well renown research medical university and they're doing incredible work, and i was very pleased with how the dollars were targeted. >> good. i'm glad to hear. i here's the thing. when a company breaks the law it's because people running the company broke the law, and a few months ago the department of justice announced the founder and owner of the company, along with six top executives, had been indict for fraud and racketeers because of their actions. let me ask you this, governor brown. do you agree that ceos deserve to be held personally accountable when the companies they run break the law and hurt people? >> senator warren, an an aegregious case, obviously.

this was particularly egregious case and people should be held personally accountable. >> i agree on this one. this crisis is not a democratic or republican issue, and neither is holding drug companies accountable. the department of justice announced last week they're forming a task force to target opioid manufacturers and distributors that have contributed to the epidemic and i'm very glad to see it. i think it's important. families and communities have already paid an enormous price for this crisis, and it is time to start holding companies and their ceos accountable. thank you both. >> we're joined by -- of kaiser heart news. what i is congress doing now in response to the opioid epidemic. >> congress is really interested in this. they passed the omnibus 4 billion toward general different kinds of treatment, prevention, law enforcement, and that is sort of the tip of the

iceberg right now. we have a bunch of hearings happening in the energy and commerce committee in the house. they're looking at the law enforcement side, the prevention and treatment side, trying to come up with a bunch of different bills and the chairman there says he is hoping for package on the floor by memorial day inch the senate you have this bipartisan group of senators hoping to put maybe a bill dollars towards -- through this other bill they called cara2 pot, the seek kell to something -- sequel to something under obama and hat some traction but everyone is less sure where it might go in hoe because us a it's lot of money. >> initial funding their the omnibus and some hearings moving forward on different legislation. let's look at the white house. they back in october declared an opioid epidemic. where has the administration's emphasis been? law enforcement measures? or emphasizing better prevention and treatment? >> sure. the white house called this a public health emergency in rocked and renewed that

recently. and it's kind of an odd mix. rhetorically there's lot of interest in this law enforcement, law and order, all these headlines but thank you death penalty and that was a big focus on the president's speak in new hampshire and the department of justice has been directing the u.s. attorneys in certain cases seek the death penalty for high level drugs traffickers but there is some talk of expanding access to treatment and making sure that first responders have naloxone, an antioverdose drug. that's interesting and has been talk about by a lot of public health officials, but the emphasis on law enforcement and on law and order is different from what we have seen before and has given them some pause. >> what have we seen before with the obama administration, for example? >> sure. the obama administration was certainly interested in this public health response if you will. a lot of talk about naloxone and

making sure people had access to medication that help wean them off of opioid. that is a shift how we look at addiction in this country's history and it's an interesting thing to watch and see if that will continue moving forward. >> we'll be showing comments from a number of state governors, charlie baker from massachusetts, larry hogan from maryland testifying. what are states doing and response to opioid epidemic and what do they indiana from the federal government. >> the being this -- big thing is now. they need money to give supplies to first responders who get this naloxone, to get out the medication and get folks into treatment. all these other systems have the been burdened as well. last summer i wrote but the foster care system has seen huge influxes in kids going through

because their parents can't take care of the anymore. they're looking for all theroo resources to address this issue from every angle possible. >> back to congress. new study little from the national manufacturers alliance and from the american action forum sew that the harmful impact of opioid abuse on manufacturing and the broader employment sector in the u.s., you talk about a member of congressional hearings on different laws. are employers and industry leaders pressing members of congress to do more on the opioid issue that you know of? >> there's certainly a lot of concern bet the impact on the economy and productivity and research has bun done where they show that people are less productive because they're sort of grappling with addiction, unable to work. going through other sorts of systems that leave them unable to be as productive. >> well, aside from the terrible increase in the death numbers, how that is the nature of this

epidemic changees over time, especially recent years. >> a really interesting store. this comes from we think of pain kill he, vicodin, and the percocet things enemy90s doctors were taught to treat pain aggressively and they prescribed them, and the story you hear often was the girl who skate wering, gets in an accident and brakes her arm and prescribed percocet. she goss through her per description, and doesn't realize she is is addicted until she goes into withdrawal and it's pain and she switches to heroin and it's cheaper and more point tent. and i have heard that often in the field. then you get to where we are now, there's been this crackdown on opioid prescribing so fewer pain killers out there but pill steam are withdrawing and craving this drug. so they witch to heroin which is

much more common and switch to fentanyl which is deadly and coming more from experts say china and mexico, and can kill you much more easily and produced a great are high. >> one more thing. in your piece you lead by writing the nation's opioid epidemic has become called today's version of the 1980s aids crisis. solve that took years. how long will it take to get control of the opioid epidemic in the u.s. >> i don't think they have an end date. this has to been an ongoing commitment and needs to be a promise from congress to give tens of billions every year, and there's one -- the public health commissioner from baltimore has talk about the importance of creating almost a ryan white, which is the hiv aids sprayed funding for treatment spent we knee one for opioid. >> thank you for joining us.

>> thank you. >> our program on come badding the opioid epidemic continues with walk biz senior trump administration officials. kemp chester is in the office nor national drug cowl patrol si and spoke in march at an event on opioid trafficking host inside helsinki commission. >> as you in the office of national drug control policy crafts the president's drug control strategy and over joes all federal government counter-drug related activities and related funding. i i'm the associate director in charge of the national heroin coordination group, an organization responsible for guiding and synchronizing first government activities related to elicit opioid problem sit. allow know take a couple of minutes to address the mag any dispute complicity of the crisis and then mention the things the federal government has been doing address it. according to the centers of

disease controlling and prevention in 2016, the year for which we have the most recent dat available, 63,632 americans died due to a drug overdose. a 21% increase from 2015, amounting to 174 americans every single day. opioids make up the largest category of drugs contributing to overdose deaths in america with 15,472 overdose fatalities involvings herrers and 19,431 involving sin the sick opioidses other than methadone, a category dominated by fentanyl and analogs them opioid crisis is a complex national security, law enforcement, and public health crisis, and is the nation's number one drug priority. i should mention that while fentanyl has been at the primary driver of the horrific number of deaths we have been seeing, we still have an enormous problem with heroin.

too abundant in the market and too available in our communities. along with hour heroin crisis we're currently facing the additional and related problem of elicit fentanyl and fentanyl analogs. the analogs are extremely potent and deadly, being anywhere from 50 to 20,000 times more potent than moore find and fentanyl comes in many forms. we have soon the cries evolve over the last two years. from fentanyl powder, mixed into heroin, often without the user's knowledge, to fentanyl in pill form and set al curacao photo medications, being bought and sold over the internet. through the proliferation of fentanyl analogses for sale. we have among us a family of drugs extremely addictive and deadly, sometimes ordered of the internet and purchased using crypto currencies, coming into

the country ha at a high vallejo through the mail system or commercial carriers or sometimes smuggled in, with a lowing and i a variety of forms incredibly hard to detect. this should tell us a great deal. more than anything we must accept that fentanyl, while a cries in its own right, is also very like lay window into the future of the drug problem in america. we must reduce the size of the user population and reduce the available of these drugs. as two complimentary efforts to reduce the market forces pulling these drugs across our border. we could very well be seeing a move away from the plant-based drugs towards synthetic drugs with lower overhead on flow front expend lower risk and greater profits to traffickers on the back end. we have to accept a more expanded image of the using population. the prototypical experience

intravenous drug year ising being joined by those who think they're buying offmarket prescription opioids pain relievers but in fact are buying and too often dying from fentanyl in fill form and there should be no doubt that the 'erred mace purchasing drug -- the internet has made pushing drills easier, they have empowered a democratization of the drug trade. the hierarchical drug tracking organizations we have traditionally seen and are well-postured to address may no longer have a monopoly or supplying drugs to the u.s. market. rather, individuals can simply go online, to one of the many internet drug marketplaces and purchase drugs like fentanyl for their personal use or further sale, creating a constellation of micronetworks in the country. what we do now is not only important to get ahead of the deadly fentanyl crisis in front of us and also establishes the

framework of relationships and laws and regulations and tech -- technologyies. i can tell you that we know more now about where fentanyl and its analogs are being manufactured and how they're getting into the country than ever before. thanks to the intelligence community, the federal law enforcement community, and our partners at the state level and below. greater test ago seizures and betters post motor tell -- mortem reports. our international matters, mexico, canada, and china, have internalized this problem and are taking active measures to help us address it. right here at home, targeting efforts of law enforcement professionals help us narrow the universe of all inbound items to those more likely to contain fentanyl. as this crisis has taken hold here in america, we have been

building and sustaining the architecture with the entire federal government is applying its time and temperature energy, focus on this complex problem and partners take their share of the task and achieverring complimentary effects. what you have seen from the role that congress has played in keeping this issue at the forefront of our national consciousness, from the president signing the interdict act recently to the recent announcement of the opioid initiative. tangible efforts from every agency in the federal comfort to the enormousment at the state level and communes which speaks to the seriousness of this issue and our command commit tom addressing it in a meaningful and sustainable way. the drug market is vast, dynamic, and adabtive. but it is not without its own vulnerabilities. i will tell you that it is no match for our own intelligence

and determination and the very best talent we of bring together against it. >> maybe kemp this right person for the question. we have had a great discussion and thank you for your statements. one i'm surprised that didn't couple up is the postal service. i saw it as a humongous he's of how to the drugs enter the country. are you the right person to speak to that? >> the postal servicing doing a tremendous job. ... into the united states. we begin, we begin working with him very closely and were

crossed the interagency with other federal law enforcement but to do a couple of things. the first thing is to get advanced electronic data from the shipping company or from the originating country so that they know the ship and set to come into the united states before they get here. that usually about 72 hours out and that for track and untracked packages. the volumes we're talking about our enormous, up to 144,000 packages every single day into one international service center. when you get advanced electronic data they can share that with customs and border protection so that they can pull a site can give separate attention to those companies that are most related to the illicit shipment of goods. that's the first thing. the second thing is the nonintrusive detection capability that is there at the international shipping center, for them to be able to detect

illicit substances that are in there. and the third thing is to be able to work with other law enforcement partners whether it's some dhs or from the department of justice in order to get a prosecutorial outcome for the things they intercept. i'll tell you the postal inspection service and the postal service writ large is that it meant his job in helping us to better understand this vector for these drugs getting into the united states and do intangible things against it and really over the last year and half or two years. >> ibis. a follow-up. when these drugs are ordered of dark web marketplaces, are they ship exclusively by the postal service, or a private delivery service is used like fedex, et cetera, et cetera? >> private delivery services are used as well. that's all of your major kind of express consignment carriers, all who have done a tremendous job working with federal law enforcement to share information and allow federal law enforcement to be able to assist

in intercepting these packages before they can be delivered to the end-user. when we say the postal service, that kind of one element of it by the express consignment, fedex, dhs, ups, those others all provide a means for the drugs to get into the country but those companies are working hard with the federal government to interdict those shipments. >> on march 1 the white house hosted a some of the opioid epidemic. this portion of the event features remarks by attorney general jeff sessions, homeland security secretary kirstjen nielsen and deputy secretary of state john sullivan. a reminder, you can watch visited in its entirety at our website c-span.org. >> thank you all pick it so good to be with you and we're at the point where we are going to make some progress in america. i am convinced. we know that prices for illegal drugs are down. the availability is up, and

security is up, and the diction is up and the death is up and the danger of the drugs, particularly the fentanyl and heroin combinations we are seeing are just extraordinary. i was involved in the early '80s as a united states attorney working on these issues, and we never saw anything like the deaths we are seeing today. this is totally unprecedented in the history of this country. it cannot continue. it will not continue. the president has made clear we're going to be resolute the entire administration is going to respond to his declaration of an emergency. we are going to make a difference. i believe it. i can sense it already in some of the policies that are ongoing out there. we announced in july the largest medical takedown in the history of our country. we had over 120 professionals, nurses and doctors, who had been

come out of 400 i believe, arrestees, that were involved in illegal prescription drugs. and we know that as much as 80% of addictions today start with prescription drugs. that's an extraordinary number. we will continue to research it without the numbers that we have, and i've no doubt it's an extraordinary high amount starts as prescription drugs. we also had the shutdown of alphabay. this is important. it's a dark web site in which had 220,000 sites where people could order directly through the mail illegal drugs. fit note, for example, so small and so compact and such a little bit is so powerful that it's easy to ship these kind of drugs through the mail.

the fbi has doubled its resources to identify earlier. we are not going to let those sites that big again in the future. that is certainly a goal and we will continue to work on that. we have 3000 defendants for distributing drugs in 2017 and we created the opioid fraud abuse and detection network which is a data analytics system that's well within the existing computer systems of the drug enforcement administration so we can easily determine what physicians, pharmacies and other distributors are moving prescription drugs. some of them are extraordinary outliers. they give us indications where fraud and abuse is occurring, and we can move quickly on that. that's not been really done before. target packages are being sent out right now to investigators

and cases are being made. one assistant united states attorney said i didn't think too much about it, but when i looked at what happened we knew there were six professionals, mostly physicians in pittsburgh, and every one of those were on this list. it made me a believer and a lot more were on the list that he didn't know about. we sent out 12 special experienced assistant united states attorneys to hotspots around the country to focus on that. we have indicted two chinese nationals for the first time on that no charges. most of that is coming from china, as you know, often to mexico, sometimes directly through the mail. through our communities that we establish a new program called j-code. that is the fbi's program with dea to identify through the darkness and actually purchased

undercover drugs in that way and to target those groups. we announced the prescription intervention and litigation task force that would utilize our civil department to file civil lawsuits. we believe we can get an injunction to stop a physician or a pharmacy immediately from prescribing drugs because they have to comply with the law and we can get a civil injunction and then continue if need be a criminal investigation. i'm excited about that, and was also filed litigation in support of, i believe it will be filed today, we've announced our intention to file a statement of interest with the multidistrict litigation effort by a lot of the attorneys general around the country on that. thank you. [laughing] i think -- okay, good. i'll just in there to say, this

is what we're doing in our department. you see it from the people you saw earlier on the first panel. i believe if we do these things effectively we can reduce the amount of deaths, addiction and destruction that these drugs are causing today. it's just unacceptable in this great country. we will do our part and kellyanne i know, i have to say, kelly ann's leadership is going to be so important in this because we do want prevention. we do need to educate people. the present use the phrase just don't start. if you don't start like he never started, and you don't get addicted. so we need to be cautious about come encourage people not to do that. kellyanne knows how to communicate well and will be a great asset to us. so kellyanne, thank you. >> thank you very much mr. attorney general. thank you. [applause]

>> i was there on tuesday when you have the press conference with the states attorney general and the acting director of the dea and others, and was really struck by the bipartisan approach that the attorneys general had towards your prescription, intervention integration announcement. going on to secretary kirstjen nielsen at the department of homeland security. so many aspects of the interdiction law enforcement front in waging this battle against this crisis, sector nielsen, falls under dhs so we most juries to hear the progress report and also the vision for the future. thank you. >> i did it. good afternoon, everyone. i really appreciate the opportunity to join you today. this truly is a shared fight. i'm sure you've heard before and will continue to hear from the rest of today how we must do this in partnership. i'm particularly honor to be joint i leadership from the

department of homeland security. we've got iced ncb. , kevin and tom. they do this work everyday that in and day out to protect our borders from all threats and injured from all threats but that increasingly a fortune includes opioids. so the the president when he declared an opioid crisis as a public health emergency, he really sent a very strong statement. a statement to us in america is fighting back. we will continue to do that with all the tools we have at our disposal at the department of security in conjunction with our partners the department of justice and the department of state of monks many others. since we at dhs have very he proactively assess the current threat, determine what might have gaps and what else we can throw at it, if you will. this has allowed us to leverage our investigative intelligence efforts. you may or may not, you may or may not know, dhs is law enforcement agency. we have 60,000 in cbp alone but

with multiple agents throughout the department that play a role in this. leveraging the investigative and intelligence efforts. we also do interdiction operations with our international partners and with that a great success on that front, particularly with our friends and close partners in mexico. we continue to look for new partners because as you know this dreaded drug, fentanyl, continues as the attorney general mention, to come in packages of all sorts and sizes and didn't get in the hands of people who otherwise use in the drug flow. we look at this two ways, within our borders and then we look at stopping across our borders. to prevent entry we do work with doj in state state and our law enforcement counterparts in mexico, south and central america and china as well to prevent the flow. but also most importantly to share the information. the sharing of information has

two main purposes. what is to hopefully stop the drugs before they come into our country but the other is to help us as partners dismantle the tco skin cells that are the force behind epidemics. this information sharing helps us stop the flow, facilitate the dismantlement and it also provides clear roles and responsibilities amongst all partners to bring all that we have to bear. just want to use one example. we have border enforcement security task forces which likely never as one of those good acronyms, best to . some of her acronyms at dhs are not so well done. and these are cbp and i.c.e. primary to investigate opioid smuggling domestically. i have bested ticket locations that the united states leverages more than 1000 federal, state and local law enforcement officials and represent over 100 law enforcement agencies.

cbp has offices in hundreds of ports of entry. as you know of another would check billions of dollars of cargo each day, millions of passengers a day, but they are particularly focus recently on fentanyl. cbp seizures a fentanyl has significantly increased over the last three years. we had only been two pounds in 2013. we had 1485 pounds in 2017. remember, this drug in extraordinarily small quantities is lethal. 1485 pounds is substantial. that is an epidemic. so to confront this explosion that expanded the use of k-9s and were happy to report that all cbp k-9s working in the international mail and express consignment environment now have the ability to detect drugs and fentanyl in particular. while we don't see yet a significant amount of the opioids being traffic i seek him his coast guard maritime interdictions and other narcotics are increasing and, of

course, that deprives the funds from the tcos or otherwise to the wise use of funds who traffic in the opioids a fentanyl. to prevent the sale of, talk about the permanent we are also committed to not only presenting them at their source but then of course pretending they're moving into an sale within a country. the attorney general mention the dark web. we support his efforts. our united states secret service has cyber to build an investigation side and also contribute to this fight. and so does i.c.e. come homeland security investigations again dhs has a broad mission set but we do in all times worked to bring everything we have to bear. the darknet i i would just add one, to what the attorney general said, it's anonymous. it makes it that much more difficult to track it was doing what on the darknet in terms of wine in selling. but with our partners at justice and fbi and within dhs we are

doing just that. the job doesn't end there. we also work to support the apprehension of prosecutions. again we were close with our law enforcement brethren. what i would say in closing is the sheer magnitude of this means that we have to partner. as i said many times today, actually and other fora, there's not one entity that has all of the authorities, capabilities and capacities to fight this alone so we greatly appreciate everyone in this room, your interest, your support come your partnership. we can't do it without you. he thanked the president and the vice president for the continued leadership and certainly kellyanne for all the human work you been doing to bring us all together. >> thank you very much, secretary tillerson. thank you. [applause] -- secretary nielsen. >> really terrific to have state department involved in this effort is open today i'm very happy to present to you for his remarks the deputy secretary of

state mr. sullivan. >> thank you, kellyanne. it's an honor to be here. delighted to see of you in here. thank you for your leadership, and to general sessions and secretary nielsen. you might wonder why the state department is here. this is this is a whole of govet effort. the president has made this a top priority for his administration. the state department is involved because the problem we confront is not merely a domestic problem. the opioids that killing american citizens today are produced overseas. traffic by criminals and criminal organizations that operate transnational. the state departments role is to stop transnational criminal organizations, so-called tcos, at the networks criminal activity they perpetuate in trafficking drugs and destroying the lives of our loved ones. addressing the opioid crisis as i say is a whole of government effort and the state department's role is to apply

its resources abroad with our partners, allies and others to support all the work of the department justice, department when security and the other cabinet departments to address this problem and this enormous scourge we have an to enlist the support of our allies and partners and neighbors in mexico in particular. it's our highest of the statement park encompasses a highest drug control priority. policy. the bulk of the state department counter-narcotics work is focused on countries were opioids originate. opium harvested in mexico is the root of over 90% of the u.s. supply of heroin. the tcos that smuggle it across our border to be sold by dealers throughout the country are the targets that dhs and the department of justice are working to stop. we are strengthening cooperation

with mexico through the merida initiative to interdict illegal transport, find and punish criminals involved in these organizations and cut off their sources of funding. in december of last year secretary tillerson's and i along general sessions and secretary nielsen continued the strategic dialogue we have with mexico on disrupting transnational criminal organizations. we're working with their mexican counterparts to find new ways to disrupt the revenue streams of tcos that are responsible for trafficking heroin and other illicit drugs into the united states. we are also working with mexico to more aggressively eradicate poppy crops, trained law enforcement, enhance or security and bring drug traffickers to justice. over 100 of mexico's most wanted high-value targets like chopper guzman come have been arrested, deal or extra dated -- extradited. we support their efforts to find

investigative destroy clandestine drug. the department of state has funded dea training of over three had a mexican counterparts and special tactics to go after those labs. since 2008 the united states has donated and supported training of more than 500 k-9s foresighted mexican federal and state law enforcement agencies. responder training for k-9s and handling teams to detect weapons, cash and trucks. this includes for the very first time fentanyl specific detection training through cooperation with our neighbor to the north, canada. last fall the u.n. commission of narcotic drugs put new international controls in the two primary ingredients that are used to produce fentanyl. this actually is taken at the request of the united states in such measures are already producing results. due to this change in other

efforts dea has seen a decline in the presence of these chemicals in the illicit drug market. in two weeks again at our request the commission will address controls on five other synthetic opioids, including the daily opioid carfentanil. the state department has also building partnerships to more effectively stop the traffic of synthetic drugs since two international mail and courier systems which are general sessions mention. these efforts allow for law enforcement to easily interdict any packages that may contain illicit fentanyl. china is a growing area of focus on the fight against opioids. energized i president trump's visit to china last november, the united states and china have forged a productive counter-narcotics relationship. as a result of our cooperation china has established domestic restrictions on the production and sale of 143 substances, including a number of the more

related compounds. china's tightening of regulations has significantly contributed to the reduction of these substances on the streets of the united states. unfortunately, we are seeing, we are beginning see a new trend of rogue chinese chemists who are manufacturing illicit opioids, selling them online to drug traffickers and users, and shipping them in small quantities through the mail. as secretary nielsen mentioned, the amount of fentanyl that is necessary to convey a lethal dose is extremely small so we talking about small quantities of these illicit substances. in response we're working closely with the chance to prove coronation at screening of package between the countries. we are on a aggressive timetable to get all packages coming from china tag with advanced electronic data and we will continue that close cooperation with china and other countries that are sources of these chemicals and illicit opioids.

collaboration is the only way we can tackle a problem that has no regard for international borders. the state department will continue to aggressively pursue this fight against opioids in partnerships with all other nations. 90. >> the house energy and commerce committee is considering a number of bills addressing the opioid epidemic. and it held a a series of hears on the issue in march. we will show you portions of those hearings including testimony by dea acting administrator robert paterson, fda commissioner scott gottlieb, doctor and sugar of the cdc and doctor christopher jones, director of the national mental health substance use policy laboratory. >> over the past 15 15 years or nation has been increasingly devastated opioid abuse. an epidemic fueled for significant. of time by the overprescribing of potent prescription opioids for acute and chronic pain.

this indiscriminate practice created a generation of opioid abusers. presently estimate of more than 3 million americans. over the past few years we have begun to see a dramatic and disturbing shift. as a result of the increase awareness of the opioid epidemic, prescription opioids have started to decline, obviously somewhat a success. but organizations in particular the well-positioned come in particular position basic and drug cartels have built filleds point by producing and distributing cheap powdered heroin often mixed with illicit fentanyl and of the fentanyl related substances. and selling it to the users in both traditional powdered form and in some cases pressed into counterfeit bills made to resemble illicit pharmaceuticals. there are two central element dea is addressing as part of this administrations collective efforts to turn this type. with a third piece that must also be addressed. first and foremost its enforcement. based on our investigations,

actions undertaken every day using our criminal, civil or administrative tools to attack the traffic in illicit drugs and the diversion of illicit supply pick second is education. i strongly there's about it and natural fit for the dea in this space. and look whenever possible to partner with leaders in prevention and education. the third element is treatment for the dea is committed to doing what we can to improve access to drug treatment and recovery services working alongside our partners at the department of health and human services, the utilized evidence-based strategies that minimize the risk of diversion during this public health emergency. ultimately the only way to fundamental change this epidemic is to decrease demand for the substances and address the global licit and illicit supplies -- licit supplies concerns efforts of dea and all of its partners. the action of dea's diversion control division are critical with specter addressing illicit

supply your diversion of prescription opioids by a few has a disproportionate impact on the availability of prescription opioids. the fact remains a majority of new heroin users stated that they started their cycle of addiction on prescription opioids. as a result we're constantly evaluating ways to improve our effectiveness to ensure that are more than 1.7 1.7 million registrants comply with the law. our use of administered tools and legislations have change our authorities has been the subject of numerous media reports. let me address that issue up front. dea has continued to revoke approximately 1000 registrations each year through administrative tools such as order to show cause, immediate suspension orders, and surrenders for cause. we have and will continue to use all of these tools to protect the public from a very small percentage of registrants who exploit human frailty for profit. where an license revocation is not necessary with aggressively pursued civil actions and

m.o.u.s designed to ensure compliance. over the last decade d aasa levied fines totaling nearly $390 million against oprah distributors nationwide and entered into m.o.u.s with each. dea has also reprioritize a portion of his criminal investigators and abetted them in with diversion investigators and enforcement groups referred to as tactical diversion squats. currently with 77 of these groups nationwide and are solely dedicated to investigating and disrupting and dismantling individuals and organizations involved in diversion schemes. dea's diversion control division assigned to as a work to improve communication and cooperation with the registrar community. as an example of this outreach dea offers year-round training for your charge to pharmacist, distribute and manufacture spirit we just completed training more than 13,000 pharmacists and pharmacy technicians on the important role they play in ensuring that only fill valid prescriptions.

inmate dea was initially, initiate certain nationwide effort to provide training on the vital role that prescribers plate in carving this epidemic. this will start with specific focus on state what we've seen little decrease or in some instances an increase in opioid prescribing rates. administrative actions civil fines and criminal cases are all important steps. where we've fallen short in the past it is by not proactively leveraging the data that has been available to us. while i'm happy to discuss what happened in the past i focus my time on moving or agency forward and appreciate the opportunity to update you on what we are today and when we intend to go. for example, in january we utilized arcos data overlaid with data from hhs and when available state pmp programs. the result was approximately 400 targeted leads that dea was able to send to its 22 field divisions nationwide for further investigation. while working with all the

federal agencies in the space, i'm sorry, we are awake with all federal agencies into space. while we continue to work well with our colleagues at omb dcp, ccb, niaid, the mutual issues that we face today have crystal and critical partnership with fda and hhs. i will finish up by saying i like to recognize health subcommittees efforts to hold a legislative hearing started tomorrow on more than 25 pieces of legislation. that effort that only underscores the and president they took place of feel-good crisis would also demonstrates we must all take action to address this threat together. >> good morning. thank you for the opportunity to discuss fda's role in combating the ongoing crisis of opioid addiction. confronted this epidemic remains one of my highest priorities. i'm committed to re-examining all of our authorities and for the steps fda can take and ungrateful for this committees commitment for the fda has in combating the epidemic. he enters an additional tools that could enhance our ability

to respond such as those would support our work and interdiction of illegal drugs including narcotics inside international mail facilities. to address this crisis fda is working across three broad domains. first were taking steps to improve our medical technology. this means better drugs to treat addiction through medication-assisted treatment and new pain remedies that are resistant to manipulation, misuse or are not as effective as traditional opioids. .. step to require sponsors to ensure subscribers but

provide specific documentation by a specified amount. such a framework would be based on evidence-based guidelines and treatment for a given indication. third, we are ramping up our efforts in the interdiction of illegal drugs including narcotics including new authorities and resources and networking and international mail facilities. there is a virtual flood of dangerous products entering the us through mail products that expose americans to dangerous pills. we are dealing with sophisticated bad actors that are aware of the gaps and try to exploit them. primary responsibility for importing narcotics falls to border protection. anything believed to contain controlled substances goes to cbp before packages are sent to us at the fda. we are seeing more controlled substances heading our investigators. and what one six-month period we expected 600,000 packages, including opioids.

i'm increasingly worried that those seeking opioids through the mail will disguise them as ordinary drugs to avoid detection. it's estimated that less than 1/10 of one percent of the packages that contain drugs actuallyundergo the physical inspection. the risk is that many illicit drugs are slipping for our grasp . as you know we prioritized our work in the ims and invested in our capabilities there but there is more that we must do. we've increased our staffing and are seeking support to grow our interdiction work further. additional staffing is critical but to maximize what we can do i want to focus on additional authorities we've discussed with congress. these include detention and destruction authorities. our operations with the imf is receiving details for the facilities, some in boxes but

many simply in thousands of loose pills and huge boxes. we're required to open every package to document the contents and find supporting evidence of the use of the drug in order to detain and destroy that article but the evidence is insufficient under our existing standards for destruction, we refuse entry and send the package back to its source. it's not uncommon for our investigators to see the same package again and again as they sandbox the second or third time. this process is not a deterrent. the fda has the authority to destroy unlabeled products found as being active ingredients or analogs to fda drugs but can remove more dangerous products from the supply chain. second, this is also a numbers game. the bad actors are spending hundreds of thousands and parcels through the individual mail to individual recipients. these shipments are intended

for further domestic distribution. each package may violate fda law but they know that fda can't examine or stop them all because law requires us to pursue legal proceedings against each package separately. they simply overwhelm our system with volume. improving so we can refuse both shipments of individual packets from an simple source would create a big difference and protect americans from dangerous imported substances. while substances already scheduled are referred at the border, fda regulated articles contain substances that haven't been scheduled, fda is responsible for that product. this is an issue with the high volume of narcotics coming from china. right now we can refuse to destroy these unlabeled products without junk drug claims such as fentanyl analogs just because they are articles that concern the epa. refusing to chain or destroy products before the a scheduling takes place, to get dangerous articles that are not obtained off the street. these are some of the tools that could enhance our mission and i appreciate your support and interest and i look forward to working closely with you to help save lives. >> thanks gentlemen, five

minutes for an opening statement's good morning chairman burgess, ranking member agreement and members of the committee. the cdc has vast experience tackling epidemics and i appreciate the chance to talk about ourwork fighting the nation's opioid crisis. at cdc we are focused on using data for actions to inform strategies to prevent opioid misuse, abuse and overdose , to prevent health related consequences of opioid abuse including the spread of infectious diseases like hiv and hepatitis and the impact of opioids on mothers and babies. cdc leaves prevention efforts by promoting responsible opioid prescribing, driving community-based prevention activity . reduce opioid overdose deaths and related harm. america's opioid overdose epidemic affects people from every community. the problem is getting worse. in 2016 more than 53,000 people died of drug overdose

and preliminary data indicates a trend in 2017 is increases in babies born withdrawing from narcotics, that 80 suggests one baby is born with signs of neonatal abstinence syndrome every five minutes, about 100 babies a day. we're also seeing a drop in life expectancy for the first time since 1993. for every one person who dies of opioid overdose, the more are already addicted to prescription opioids and almost 400 misuse them. cdc supports state health department providing resources and guidance to implement evidence-based prevention intervention, so states can rapidly adjust as we learn more about what works best in this very fast-moving epidemic. both federal and state response. cdc funds 45 states in washington dc through prevention including my

improving prescription drug monitoring programs, improving prescribing practices, gathering timely, high quality data and evaluating policy. we hope to expand thisfunding the 50 states . states are making progress working toward more comprehensive and effective monitoring through their pe these . it's essential to improve ethical decision-making and use data as a public health balance tool. with cdc funds many are increasing the use private providers and pharmacists, enhancing the timeliness of reporting, integrating with electronic health records. for example in north carolina, integrated presiding data from the emp within the workflow of existing health information systems across the state . improvements like that show how we can make vital data actionable goal of saving lives. also leading improvements to the public health data needed to understand and respond to crisis.

we improve the timeliness of reporting, updating preliminary data on overdose deaths on our website every month . through our funding to states we are renting our efforts to get timely data from emergency medical services, medical examiners and corridors. we are tracking non-fatal overdoses and is currently reported on the 30 percent increase across the country. we also recently released data using pathological and death scene evidence from unfunded states , allowing for a more robust estimate of opioid guests. ãdown to fentanyl which is involved in half of the opioid overdose deaths. cdc continues to educate providers in the public on opioid use for the implementation of our guidelines for prescribing opioids for chronic pain and our awareness communication campaign. you're making the guideline more accessible for

admissions through interactive screening and immobile ass, campaign focusing on risks of prescription opioids. features real-life accounts of individuals living in recovery and those who lost someone to this terrible problem and in addition to our partnership with the state, cdc believes this epidemic requires a collaboration across every effort. we've been working with law enforcement the dea to determine risk factors for illicit opioid overdose, targeting implementation plans community specific prevention strategies. we draw on across our agency to address the manufacture of the crisis. the comprehensive public health approach is playing a key part in addressing the epidemic. we didn't get intothis epidemic overnight , we're not going to get out ofit overnight . we need intensify efforts to reverse the epidemic. >> doctor helton, you are recognized for five minutes. >> thank you, chairman

burgess, members of the committee, thank you for the opportunity to discuss the opioid crisis in the federal government response and in the start of this ministration, presidential has made addressing the opioidepidemic priority and we share the president can bring an end to the crisis . communities across the nation have been impacted by prescription and illicit opioid abuse addiction and overdose and the emergence of illicit fentanyl and other synthetic opioids only fuel the crisis in recent years. at the department's lead agency for the natural health, we've been at the forefront of the response to the opioid crisis. under the hs ob strategy our work focuses on advancing prevention treatment and recovery services overdose prevention funding to build state and local capacity, providing education, training and assistance in data collection, analysis to track emerging trends, identify what the integration of evidence into practice. today i want to focus on several recent actions we have taken to enhance our

response to the crisis. in the area of funding, we've attributed $485 million for territories under our state targeted response to the crisis in may 2013. this funding supports state efforts to reduce overdose deaths provided complement of recovery services. in november 2017, announced it was accepting applications for $1 million in supplemental grants to expand and enhance those efforts in the state hardest hit. on monday of this week, since all boarded supplemental branch to new hampshire and west virginia. so also they provide clinical funding for treatment and recovery services for specific high-risk and vulnerable populations, to those involved in the criminal justice systems and postpartum women. the instructor for over 20 team, we awarded $20 million for new state grants authorized enable

outpatient-based care for pregnant and postpartum women in nearly $50 million over five years in new grants to support residential treatment services to pregnant and postpartum women. we've been a leader in efforts to reduce deaths by increasing access to naloxone. samsung awarded funding to grantees in 22 states from programs authorized by carrot to provide resources first responders and treatment providers who work directly with populations high risk for overdose. developing a well-trained workforce and facilitating the intervention systems are key goals of their education and evers. in january, samsung awarded $20 million, we awarded $20 million to create the fdr technical assistance program. this program is providing direct assistance to states and local jurisdictions to support the implementation of evidence-based practices that are tailored to the states

context and last month, samhsa released medications for opioid abuse disorders which include information about all the fda approved medications for the treatment of opioid use disorder. in addition, samhsa's providers clinical support system for treatment which provides national training and mentoring to support clinicians interested in providing addiction care has also revised waiver training to includeinformation on all fda approved medications . given the importance of providing collections and patience with information about opioid addiction, last month samhsa released guidance for treating pregnant and parenting women with opioid abuse disorder in their infants. this guidance provides information on a range of real-world scenarios faced by healthcare providers. in january 2018, samhsa issued a final role

pertaining to records commonly referred to as part two. as required in 21st century, samhsa held a public meeting in january to obtain feedback on part two. the vast majority of those who spoke at the meeting expressed their support for further aligning and acknowledged that congressional action would be needed to achieve many of their goals. in the area of data analysis and evaluation, samhsa is standing at these policy laboratory created under the 21st-century cures.the lab was supporting innovation, evaluating promising approaches and facilitating the adoption of prioritizing efforts on opioids. the president's fiscal year 19 budget includes $15 million to reestablish the drug abuse or the network, national public health surveillance system that will improve monitoring of substance abuse including opioid misuse. samhsa is committed to combating the prices and look forward to working with congress. thank you for inviting me to testify and i look forward to yourquestions .

>> the final portion of our program features president from manchester community college in new hampshire. he traveled to the state on march 19 to announce a plan aimed at addressing the epidemic for accommodation of law enforcement and health measures. >> this portion of his remarks is about five minutes. >> i especially want to acknowledge all the families with us today who have endured terrible addictions because of the opioid crisis. and especially those who have lost precious love ones. i've been saying this for a long time, and it all started right here. i see what you're going through. about as bad as there is anywhere in the country. and i said i'd be back, and we are pouring a lot of money and a lot of talent into this horrible problem. and we pledged to honor the memory of those you lost with

action and determination and resolve, we will get. >> will not rest until the end. and i will tell you, this scourge of drug addiction in america will stop. >> it will stop. >>. [applause] >> every day, 116 americans die from an opioid -related overdose. in new hampshire, the overdose really, death threats, can you believe this? death threat is double the national average. but difficulties like people wouldn't believe. the feeding this epidemic will require commitment from every state, local and federal agents. failure is not an option. addiction is not our future. we will liberate our country from this crisis. never been like this . hundreds of years, never been

like this area and we will raise a drug-free generation of american children. last october we declare the opioid crisis a public health emergency. it should have been done long time before. it says that we've worked with congress to ensure at least billion additional dollars going through right now for new funding, 2018. and 2019 to combat the opioid crisis and we will be spending the most money ever on the opioid crisis. [applause] >> on our most recent national prescription drug take back day, all across the country. more than 900,000 pounds of unused or expired prescription drugs. more than the weight of three

bowling 757s. >> our custom and border protection and these people, the job they do is incredible. the these really 1500 pounds of fentanyl last year, nearly 3 times the amount seized in any 16. and i told china, don't send it. and i told mexico, don't send it. [applause] don't send it. in 2017, i saw arrested criminal aliens with 76,000 charges. and convictions, for dangerous drug crimes. last year, the department of justice prosecuted more than 3000 defendants, all of the traffic and related crimes, 3000 cases including a pharmacist, a physician's assistant and an opioid trafficker, each chart with

committing serious drug crimes in new hampshire. whether you are a dealer or doctor or trafficker or a manufacturer, if you break the law and illegal pedal these deadly poisons, we'll find you, we will arrest you and hold you accountable. [applause] thank you. here in new hampshire i applaud all the drug enforcement agents and law enforcement officers who recently coordinated. operation granite heal, an 18 hour enforcement action targeting drug traffickers that resulted in the arrest of 151 people, these are terrible people and we have to get off on those people. because we can have all the blue ribbon committee's we want but if we don't get tough on the drug dealers, we

are wasting our time. just remember that, we are wasting our time. and this includes the death penalty. [applause] you know, it's an amazing thing. some of these dealers will kill thousands of people during their lifetime. thousands of people. and destroy many more lives. but they will kill thousands of people during their lifetime. and they will get caught and they will get 30 days in jail or they will go away for a year or they will be fined and yet if you kill one person, you get the death penaltyor you go to jail for life . we're not going to get tough, on the drug dealers who killed thousands of people

and destroyed so many people's lives, we are just doing the wrong thing. we've got to get back. this is not nice anymore, this isn't about committees. this isn't about letting everybody and having dinner and let's have everybody go to a blue ribbon committee and everybody get a medal. frankly, talking and doing nothing. >> this is aboutwinning . a very, very tough problem. >> if we don't get very tough, with these dealers. it's not going to happen for us. >> is not going to happen and i want to win this battle. i don't want to leave at the end of seven years and have this problem. i don't want to. right? >> thank you. >> not going to happen. thank you all. >> tonight on c-span2, but

stevie in prime time focusing on politics. we start with joseph alfano, anaide to president lyndon johnson and secretary of health, education and welfare under president carter . his book, our damage democracy. committee spokeswoman kaylee mcinerney on grassroots populism in theus . her book is the newamerican revolution . also tonight i discussed the republican party for the 10th annual tucson festival of books with conservative author and biographer craig shirley and syracuse university professor daniel thompson discusses her book opting out of congress. and we close tv in prime time with former us trade negotiator ira shapiro and his book broken. >> book tv in prime time, starting today at 8 pm eastern here on c-span2. >>. >> next week, facebook ceo mark zuckerberg will testify more before a senate and house committee on user

information and data privacy. today 2:15 p.m. eastern on c-span3 in a joint hearing before the senate judiciary thomas committee and on wednesday at 10 am eastern on the season pantry before the house energy and commerce committee. watch live coverage on c-span3 and c-span.org and listen live. >> former hawaii senator daniel acosta died early this morning at the age of 93 . he served in the senate from 1990 until his retirement in 2012. he made a farewell speech in december of that year. >> mom president, i rise to give my remarks and myeloma to the united states senate.