think as much as almost a dollar. this is prime property area. you are seeing investors who want a review of their investments. we have a lot of what we call a accidental landlords, people who wanted to sell their homes and could not sell them. they ended up having to rent out the property in order to keep paying their mortgages. that have madecom these conversions from being an owner occupied to tenant occupied, it is hard to -- anecdotally, there is a shift. again, this is what happens when

you change the competition of owners verses renters. another issue is the american dream shifted to this idea that you do not need to own your home in order to have a piece of that dream. is there a population that links employment with mobility and actually says, i will be able to get up and go because the job market is unstable and i will be able to rent for the next two years or rent indefinitely. that brings up the question of becoming a nation of renters. host: thanks for joining us this morning. guest: thanks for having me. host: that is all for "washington journal" this morning.

thanks for joining us. we will see you tomorrow at 7:00 a.m. eastern time. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2011] >> next, a look at president obama's arrival at buckingham palace and his speech to parliament. and then the first -- the french

president on the g-8 summit meeting. as part of his week-long visit to europe, president obama a riot at buckingham palace on tuesday. there was a formal welcome ceremony hosted by queen elizabeth. here is a look. ["star bangled banner" playing]

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wednesday. he delivered a visit -- delivered a speech to parliament. he talked about the need for building a new economic partnership investing in science and innovation. this is just over one hour.

>> mr. president, ladies and gentlemen. history is more than the path left by the past print it influences the present and can shape the future. we meet today in westminster hall, a building began 900 years ago when the vikings were visiting the shores of what would become the united states. even if it was columbus who would subsequently demonstrate art of writing's late but claiming all the credit. this hall has witnessed

coronation banquet, ceremonial addresses and the corpses of those receiving the last respects of our people. few places reach so far into the heart of our nation. until today, no american president has stood on the steps to address our country's parliament. it is my honor, mr. president, to welcome you as our friend and as a statesman. statesmanship is the cement which seals our shared idealism as nations. it makes real our passion for freedom and abhorrence for injustice that is the call of our allies.

it is up to you to tackle economic turbulence at home, to protect the health of those without wealth, and to seek that precious balance between security, which is to ban often threatened, and human-rights, which are too bad often denied. history is not the burden of any one man or woman alone, but some are called to meet a special share of its challenges. it is a two that you discharge with a dignity, determination, and distinction that is widely admired. abraham lincoln once observed that nearly all men can stand adversity. but if you want to test a man's

character, give him power. ladies and gentlemen, the president of the united states of america, barack obama. [applause] >> thank you. [applause] thank you very much. thank you. thank you so much. my lord chancellor, mr. speaker,

mr. prime minister, my lords, and members of the house of commons. i have known few greater honors than the opportunity to address the mother of parliaments at westminster hall. i am told that the last three speakers here have been the pope, her majesty the queen, and nelson mandela -- which is either a very high bar or the beginning of a very funny joke. [laughter] i come here today to reaffirm one of the oldest, one of the strongest alliances the world has ever known. it's long been said that the united states and the united kingdom share a special relationship. and since we also share an especially active press corps,

that relationship is often analyzed and overanalyzed for the slightest hint of stress or strain. of course, all relationships have their ups and downs. admittedly, ours got off on the wrong foot with a small scrape about tea and taxes. [laughter] there may also have been some hurt feelings when the white house was set on fire during the war of 1812. but fortunately, it's been smooth sailing ever since. the reason for this close friendship doesn't just have to do with our shared history, our shared heritage, our ties of language and culture, or even the strong partnership between our governments. our relationship is special because of the values and beliefs that have united our people through the ages.

centuries ago, when kings, emperors, and warlords reigned over much of the world, it was the english who first spelled out the rights and liberties of man in the magna carta. it was here, in this very hall, where the rule of law first developed, courts were established, disputes were settled, and citizens came to petition their leaders. over time, the people of this nation waged a long and sometimes bloody struggle to expand and secure their freedom from the crown. propelled by the ideals of the enlightenment, they would ultimately forge an english bill of rights, and invest the power to govern in an elected parliament that's gathered here today.

what began on this island would inspire millions throughout the continent of europe and across the world. but perhaps no one drew greater inspiration from these notions of freedom than your rabble- rousing colonists on the other side of the atlantic. as winston churchill said, the "magna carta, the bill of rights, habeas corpus, trial by jury, and english common law find their most famous expression in the american declaration of independence." for both of our nations, living up to the ideals enshrined in these founding documents has sometimes been difficult, has always been a work in progress. the path has never been perfect. but through the struggles of slaves and immigrants, women and ethnic minorities, former colonies and

persecuted religions, we have learned better than most that the longing for freedom and human dignity is not english or american or western - it is universal, and it beats in every heart. perhaps that's why there are few nations that stand firmer, speak louder, and fight harder to defend democratic values around the world than the united states and the united kingdom. we are the allies who landed at omaha and gold, who sacrificed side by side to free a continent from the march of tyranny, and help prosperity flourish from the ruins of war. and with the founding of nato - a british idea - we joined a transatlantic alliance that has

ensured our security for over half a century. together with our allies, we forged a lasting peace from a cold war. when the iron curtain lifted, we expanded our alliance to include the nations of central and eastern europe, and built new bridges to russia and the former states of the soviet union. and when there was strife in the balkans, we worked together to keep the peace. today, after a difficult decade that began with war and ended in recession, our nations have arrived at a pivotal moment once more. a global economy that once stood on the brink of depression is now stable and recovering. after years of conflict, the united states has removed 100,000 troops from iraq, the

united kingdom has removed its forces, and our combat mission there has ended. in afghanistan, we've broken the taliban's momentum and will soon begin a transition to afghan lead. and nearly 10 years after 9/11, we have disrupted terrorist networks and dealt al qaeda a huge blow by killing its leader - osama bin laden. together, we have met great challenges. but as we enter this new chapter in our shared history, profound challenges stretch before us. in a world where the prosperity of all nations is now inextricably linked, a new era of cooperation is required to ensure the growth and stability of the global economy. as new threats spread across

borders and oceans, we must dismantle terrorist networks and stop the spread of nuclear weapons, confront climate change and combat famine and disease. and as a revolution races through the streets of the middle east and north africa, the entire world has a stake in the aspirations of a generation that longs to determine its own destiny. these challenges come at a time when the international order has already been reshaped for a new century. countries like china, india, and brazil are growing by leaps and bounds. we should welcome this development, for it has lifted hundreds of millions from poverty around the globe, and created new markets and opportunities for our own nations. and yet, as this rapid change has taken place, it's become

fashionable in some quarters to question whether the rise of these nations will accompany the decline of american and european influence around the world. perhaps, the argument goes, these nations represent the future, and the time for our leadership has passed. that argument is wrong. the time for our leadership is now. it was the united states and the united kingdom and our democratic allies that shaped a world in which new nations could emerge and individuals could thrive. and even as more nations take on the responsibilities of global leadership, our alliance will remain indispensable to the goal of a century that is more peaceful, more prosperous and more just.

at a time when threats and challenges require nations to work in concert with one another, we remain the greatest catalysts for global action. in an era defined by the rapid flow of commerce and information, it is our free market tradition, our openness, fortified by our commitment to basic security for our citizens, that offers the best chance of prosperity that is both strong and shared. as millions are still denied their basic human rights because of who they are, or what they believe, or the kind of government that they live under, we are the nations most willing to stand up for the values of tolerance and self- determination that lead to peace and dignity. now, this doesn't mean we can afford to stand still. the nature of our leadership will need to change with the times. as i said the first time i came to london as president, for the g20 summit, the days are gone when roosevelt and churchill could sit in a room and solve

the world's problems over a glass of brandy - although i'm sure that prime minister cameron would agree that some days we could both use a stiff drink. [laughter] in this century, our joint leadership will require building new partnerships, adapting to new circumstances, and remaking ourselves to meet the demands of a new era. that begins with our economic leadership. adam smith's central insight remains true today. there is no greater generator of wealth and innovation than a system of free enterprise that unleashes the full potential of individual men and women. that's what led to the industrial revolution that began in the factories of manchester. that is what led to the dawn of the information age that arose from the office parks of silicon valley.

that's why countries like china, india and brazil are growing so rapidly -- because in fits and starts, they are moving toward market-based principles that the united states and the united kingdom have always embraced. in other words, we live in a global economy that is largely of our own making. and today, the competition for the best jobs and industries favors countries that are free- thinking and forward-looking, countries with the most creative and innovative and entrepreneurial citizens. that gives nations like the united states and the united kingdom an inherent advantage. for from newton and darwin to edison and einstein, from alan turing to steve jobs, we have led the world in our commitment to science and cutting-edge

research, the discovery of new medicines and technologies. we educate our citizens and train our workers in the best colleges and universities on earth. but to maintain this advantage in a world that's more competitive than ever, we will have to redouble our investments in science and engineering, and renew our national commitments to educating our workforces. we've also been reminded in the last few years that markets can sometimes fail. in the last century, both our nations put in place regulatory frameworks to deal with such market failures -- safeguards to protect the banking system after the great depression, for example, regulations that were established to prevent the pollution of our air and water during the 1970s. but in today's economy, such

threats of market failure can no longer be contained within the borders of any one country. market failures can go global, and go viral, and demand international responses. a financial crisis that began on wall street infected nearly every continent, which is why we must keep working through forums like the g20 to put in place global rules of the road to prevent future excesses and abuse. no country can hide from the dangers of carbon pollution, which is why we must build on what was achieved at copenhagen and cancun to leave our children a planet that is safer and cleaner. moreover, even when the free market works as it should, both our countries recognize that no matter how responsibly we live in our lives, hard times or bad luck, a crippling illness or a

layoff may strike any one of us. and so part of our common tradition has expressed itself in a conviction that every citizen deserves a basic measure of security - health care if you get sick, unemployment insurance if you lose your job, a dignified retirement after a lifetime of hard work. that commitment to our citizens has also been the reason for our leadership in the world. and now, having come through a terrible recession, our challenge is to meet these obligations while ensuring that we're not consuming -- and hence consumed with -- a level of debt that could sap the strength and vitality of our economies. and that will require difficult choices and it will require different paths for both of our countries. but we have faced such

challenges before, and have always been able to balance the need for fiscal responsibility with the responsibilities we have to one another. and i believe we can do this again. as we do, the successes and failures of our own past can serve as an example for emerging economies - that it's possible to grow without polluting, that lasting prosperity comes not from what a nation consumes, but from what it produces, and from the investments it makes in its people and its infrastructure. and just as we must lead on behalf of the prosperity of our citizens, so we must safeguard their security. our two nations know what it is to confront evil in the world. hitler's armies would not have stopped their killing had we not fought them on the beaches and on the landing grounds, in

the fields and on the streets. we must never forget that there was nothing inevitable about our victory in that terrible war. it was won through the courage and character of our people. precisely because we are willing to bear its burden, we know well the cost of war. and that is why we built an alliance that was strong enough to defend this continent while deterring our enemies. at its core, nato is rooted in the simple concept of article five. that no nato nation will have to fend on its own, that allies will stand by one another, always. and for six decades, nato has been the most successful alliance in human history. today, we confront a different enemy. terrorists have taken the lives of our citizens in new york and in london. and while al qaeda seeks a religious war with the west, we must remember that they have

killed thousands of muslims - men, women and children - around the globe. our nations are not and will never be at war with islam. our fight is focused on defeating al qaeda and its extremist allies. in that effort, we will not relent, as osama bin laden and his followers have learned. and as we fight an enemy that respects no law of war, we will continue to hold ourselves to a higher standard - by living up to the values, the rule of law and due process that we so ardently defend. for almost a decade, afghanistan has been a central front of these efforts. throughout those years, you, the british people, have been a stalwart ally, along with so many others who fight by our

side. together, let us pay tribute to all of our men and women who have served and sacrificed over the last several years - for they are part of an unbroken line of heroes who have borne the heaviest burden for the freedoms that we enjoy. because of them, we have broken the taliban's momentum. because of them, we have built the capacity of afghan security forces. and because of them, we are now preparing to turn a corner in afghanistan by transitioning to afghan lead. and during this transition, we will pursue a lasting peace with those who break free of al qaeda and respect the afghan constitution and lay down arms. and we will ensure that afghanistan is never a safe haven for terror, but is instead a country that is strong, sovereign, and able to stand on its own two feet. indeed, our efforts in this young century have led us to a

new concept for nato that will give us the capabilities needed to meet new threats -- threats like terrorism and piracy, cyber attacks and ballistic missiles. but a revitalized nato will continue to hew to that original vision of its founders, allowing us to rally collective action for the defense of our people, while building upon the broader belief of roosevelt and churchill that all nations have both rights and responsibilities, and all nations share a common interest in an international architecture that maintains the peace. we also share a common interest in stopping the spread of nuclear weapons. across the globe, nations are locking down nuclear materials so they never fall into the wrong hands -- because of our leadership. from north korea to iran, we've sent a message that those who flaunt their obligations will

face consequences - which is why america and the european union just recently strengthened our sanctions on iran, in large part because of the leadership of the united kingdom and the united states. and while we hold others to account, we will meet our own obligations under the non- proliferation treaty, and strive for a world without nuclear weapons. we share a common interest in resolving conflicts that prolong human suffering and threaten to tear whole regions asunder. in sudan, after years of war and thousands of deaths, we call on both north and south to pull

back from the brink of violence and choose the path of peace. and in the middle east, we stand united in our support for a secure israel and a sovereign palestine. and we share a common interest in development that advances dignity and security. to succeed, we must cast aside the impulse to look at impoverished parts of the globe as a place for charity. instead, we should empower the same forces that have allowed our own people to thrive. we should help the hungry to feed themselves, the doctors who care for the sick. we should support countries that confront corruption, and allow their people to innovate. and we should advance the truth that nations prosper when they allow women and girls to reach their full potential. we do these things because we believe not simply in the rights of nations. we believe in the rights of citizens. that is the beacon that guided us through our fight against

fascism and our twilight struggle against communism. and today, that idea is being put to the test in the middle east and north africa. in country after country, people are mobilizing to free themselves from the grip of an iron fist. and while these movements for change are just six months old, we have seen them play out before - from eastern europe to the americas, from south africa to southeast asia. history tells us that democracy is not easy. it will be years before these revolutions reach their conclusion, and there will be difficult days along the way. power rarely gives up without a fight - particularly in places where there are divisions of tribe and divisions of sect. we also know that populism can take dangerous turns - from the extremism of those who would use democracy to deny minority

rights, to the nationalism that left so many scars on this continent in the 20th century. but make no mistake. what we saw, what we are seeing in tehran, in tunis, in tahrir square, is a longing for the same freedoms that we take for granted here at home. it was a rejection of the notion that people in certain parts of the world don't want to be free, or need to have democracy imposed upon them. it was a rebuke to the worldview of al qaeda, which smothers the rights of individuals, and would thereby subject them to perpetual poverty and violence. let there be no doubt. the united states and united kingdom stand squarely on the side of those who long to be free. and now, we must show that we will back up those words with

deeds. that means investing in the future of those nations that transition to democracy, starting with tunisia and egypt - by deepening ties of trade and commerce, by helping them demonstrate that freedom brings prosperity. and that means standing up for universal rights - by sanctioning those who pursue repression, strengthening civil society, supporting the rights of minorities. we do this knowing that the west must overcome suspicion and mistrust among many in the middle east and north africa - a mistrust that is rooted in a difficult past. for years, we've faced charges of hypocrisy from those who do not enjoy the freedoms that they hear us espouse. and so to them, we must squarely acknowledge that, yes, we have enduring interests in the region - to fight terror,

sometimes with partners who may not be perfect, to protect against disruptions of the world's energy supply. but we must also insist that we reject as false the choice between our interests and our ideals, between stability and democracy. for our idealism is rooted in the realities of history - that repression offers only the false promise of stability, that societies are more successful when their citizens are free, and that democracies are the closest allies we have. it is that truth that guides our action in libya. it would have been easy at the

outset of the crackdown in libya to say that none of this was our business - that a nation's sovereignty is more important than the slaughter of civilians within its borders. that argument carries weight with some. but we are different. we embrace a broader responsibility. and while we cannot stop every injustice, there are circumstances that cut through our caution - when a leader is threatening to massacre his people, and the international community is calling for action. that's why we stopped a massacre in libya. and we will not relent until the people of libya are protected and the shadow of tyranny is lifted.

we will proceed with humility, and the knowledge that we cannot dictate every outcome abroad. ultimately, freedom must be won by the people themselves, not imposed from without. but we can and must stand with those who so struggle. because we have always believed that the future of our children and grandchildren will be better if other people's children and grandchildren are more prosperous and more free - from the beaches of normandy to the balkans to benghazi. that is our interests and our ideals. and if we fail to meet that responsibility, who would take our place, and what kind of world would we pass on?

our action - our leadership - is essential to the cause of human dignity. and so we must act - and lead - with confidence in our ideals, and an abiding faith in the character of our people, who sent us all here today. for there is one final quality that i believe makes the united states and the united kingdom indispensable to this moment in history. and that is how we define ourselves as nations. unlike most countries in the world, we do not define citizenship based on race or ethnicity. being american or british is not about belonging to a certain group. it's about believing in a certain set of ideals -- the rights of individuals, the rule of law.

that is why we hold incredible diversity within our borders. that's why there are people around the world right now who believe that if they come to america, if they come to new york, if they come to london, if they work hard, they can pledge allegiance to our flag and call themselves americans. if they come to england, they can make a new life for themselves and can sing god save the queen just like any other citizen. yes, our diversity can lead to tension. and throughout our history there have been heated debates about immigration and assimilation in both of our countries. but even as these debates can be difficult, we fundamentally recognize that our patchwork heritage is an enormous strength -- that in a world

which will only grow smaller and more interconnected, the example of our two nations says it is possible for people to be united by their ideals, instead of divided by their differences, that it's possible for hearts to change and old hatreds to pass, that it's possible for the sons and daughters of former colonies to sit here as members of this great parliament, and for the grandson of a kenyan who served as a cook in the british army to stand before you as president of the united states. [applause] that is what defines us. that is why the young men and

women in the streets of damascus and cairo still reach for the rights our citizens enjoy, even if they sometimes differ with our policies. as two of the most powerful nations in the history of the world, we must always remember that the true source of our influence hasn't just been the size of our economies, or the reach of our militaries, or the land that we've claimed. it has been the values that we must never waver in defending around the world -- the idea that all beings are endowed by our creator with certain rights that cannot be denied. that is what forged our bond in the fire of war -- a bond made manifest by the friendship between two of our greatest leaders. churchill and roosevelt had their differences.

they were keen observers of each other's blind spots and shortcomings, if not always their own, and they were hard- headed about their ability to remake the world. but what joined the fates of these two men at that particular moment in history was not simply a shared interest in victory on the battlefield. it was a shared belief in the ultimate triumph of human freedom and human dignity - a conviction that we have a say in how this story ends. this conviction lives on in their people today. the challenges we face are great. the work before us is hard. but we have come through a difficult decade, and whenever the tests and trials ahead may

seem too big or too many, let us turn to their example, and the words that churchill spoke on the day that europe was freed. notthe long years to come, only will the people of this island but the world, wherever the bird of freedom chirps in [the] human heart, look back to what we've done, and they will say 'do not despair, do not yieldmarch straightforward'." with courage and purpose, with humility and with hope, with faith in the promise of tomorrow, let us march straightforward together, enduring allies in the cause of a world that is more peaceful, more prosperous, and more just. thank you very much. [applause]

>> mr. president, i think that response describes are more eloquently the many -- in the words of mine could do, how much that very memorable and inspiring address was appreciated by everybody who heard it here today. [applause] you spoke with great warmth and great generosity about the british parliament and the british people, and about the links that bind us, the values and traditions that we share,

the history we have experienced together. but more than that, you spoke not just of the relationship of the past, but the relationship of the future. and i think that was what made what you said so inspirational. it was a distinguished american governor of new york who remarked on the propensity of politicians to campaign in poetry, but to govern in prose. the world you described to us today was not just one that is prosaic. it is one where the challenges are difficult and sometimes dangerous, one that offers at

least as many threats as there are opportunities. in the of the quince of your address, you remind us of the importance of maintaining the poetry in government. because to lead, that poetry is necessary, necessary not only to articulate the challenges, as you did so masterfully, but also to bring others together to face those challenges with common principles and with shared purpose. mr. president, it has been a privilege or all of us to hear you speak today.

it is a privilege for me to have the responsibility of banking you on behalf of both houses of parliament, for coming to westminster hall, and to wish you and mrs. obama a very happy and pleasant rest of your stay in the united kingdom. thank you so much. [applause] ♪

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>> president obama gave a speech today in warsaw poland after meeting with the polish president and prime minister. he called: a model of democracy for the world. he is robbing a bit week-long visit to the geert -- to europe. tomorrow he will fly to joplin, missouri to see the damage caused by the tornado that struck their earlier this week. the president also attended the g-8 summit in france. at the end of those meetings, french president and host said g-8 members are committed to providing aid to the new democracies in the arab world. during the 40-minute closing news conference on friday, the french president also answered questions about the libya in my -- in the migration in libya and

the investigations into dominique strauss-kahn. this is 45 minutes. cut in the communique you say gaddafi on -- >> in the communique you say gaddafi must leave, but he refuses to leave. so what? >> we must step up militarily. we have to work on a wide ranging objective.

the specifics with mr gaddafi have been very clear and very tough and have been endorsed by all of the g-8, including russia. furthermore, all african partners have shown tremendous solidarity. if he leaves, he will avoid much suffering for the libyan people. if he stays, he'll have to pay the consequences himself personally.

>> [unintelligible] and yet the u.s. had 40 billion. >> yes, i can give you the actual figure, 20 billion. we thought it better not to involve the imf in this figure. because the imf makes loans, or is prepared to make loans to egypt and tunisia. in the bilateral communique, speaking for france, there will be 1 billion, and lastly, $10

billion -- $10 billion that we will put into a trust fund specifically dedicated to these to get -- the two countries. " if you add all that up, including multilateral banks, bilateral commitment, and gulf states, that is a good commitment. >> after your talks with president medvedev and president obama, with respect to the security council position on syria, d using this resolution will be passed? -- do you think this resolution

will be passed back more have been killed. -- will be passed? more have been killed. more have accepted a conference in israel and palestine where peace can be launched as well. >> the terms of the language that we have used in the g-8 communique is unambiguous and condemns totally the actions taken against peaceful demonstrators. our russian friends have validated that and endorsed

that. who could have imagined that what we write in the g-8 might lead to a different position within the united nations? of course not. to the peace process, this morning, we spent a long time discussing that with president obama in the presence of the foreign secretary. we believe that palestinian reconciliation is good news. we believe that there is an opportunity to unlock the situation. above all, there is a center of -- a sense of urgency because the democracy in arab states have given peace and opportunity because of a very characteristic -- a very

characteristic of democracy is that they do not have to go to war with one another. this recent development will enable-energy -- will enable negative energy that was being used by decatur's to mobilize in dupont -- by dictators to mobilize into positive growth. urgency arises from the fact that when talking today, we have the u.n. general assembly coming up in september. we could have difference up -- and differences of opinion as to june or july. we will be in a position to take stock after my foreign secretary

goes there by at least next thursday. we will be working very closely. we cannot agree to this conflict continuing endlessly. and we know perfectly well what the parameters of peace are. and they were called very lucidly and boldly and courageously by president obama in a recent speech. there has to be good will on the part of all parties to get this process of rolling again. there are suggestions that we put on the table and you will find them in the g-8 communique.

>> sub-saharan africa is represented frequently, but is its voice really clear? >> i will say that this is the first time i believe there is a common declaration on the part of the g-8 and africa on such considerably important issues. there is so much at stake. france clearly wants to prepare for the next era. this should not lead to a drawdown, but that we commit to reducing greenhouse gases, that we uphold protections with respect to our planet. that will be the topic of the

doha round, a trade aspects. whatever the prospects for the doha around, we do not want the poor countries -- the poorer countries to be caught between a rock and a hard place. then there's the old issue of how we build the infrastructure, which will be a very specific and important chapter of the g- 20. i was delighted to hear baradu de say that he was interested in these mechanisms.

it was moving to your three african states to have recent democratic elections -- to hear three african states who had recent democratic elections come to this meeting. that is the new basis of our cooperation with africa, up from the north to the south. >> the restructuring of the greek debt, must be avoided at all costs? is this something you would discuss with angela merkel?

>> know, this is not something that we discussed within the g- 8. -- no, this is not something that we discussed within the g- 8. the point we made was europe is a stable zone where growth has actually picked up quite rapidly. but the first of the year, average deficits were lower [unintelligible] we must be at about 4.5% of average deficit. the problem with the bureau is strong.nprecedented lely the euro versus the dollar

ranges 140 to 150. weak currency is the currency that is trading at those sorts of rates. this is almost a source of the problem these of the exports. hot -- by way of exports. of course, we did discuss it. what did we say? it is credibility and it is stability. the french, the germans have long been saying that the hero is a non-negotiable issue because it represents europe. it is europe and anything that might jeopardize the future of

the euro would jeopardize the future of europe and therefore jeopardized the future of france and germany. and at that point, i will of course, to explain whatever decisions we need to take. >> on syria, would you be prepared to send president bashar al-assad, the same message by president obama just send him, i support democracy where you step down -- or you step down? >> could i have said that, yes. but president obama said it.

but if you want to make me say that we follow him, in the excellent footsteps of president obama, i have no problem saying that. we have done everything we could to bring syria back into the fold of the international community. everything. we talked with them. we discussed with them. we tried to help them. we tried to understand them. thanks to this new relationship we were able to make progress in lebanon. and unfortunately, it saddens me to say that the syrian leadership seems to be backing down and backing off and france is criticizing what needs to be criticized, and withdraws its trust. assad knew

very well this would be france's position once he started backing away from democracy. -- it would appear that russia appeared to limit -- to mediate over libya. what are your views on this subject? and also, i know you do not like to talk about your private life, but first of all, congratulations. do you know if it is a boy or a girl? >> you say you do not want to talk about my private life, but what would it have been if you had? i assume you would have talked battalion. -- italian.

what does mediation mean? there can be no mediation with gaddafi. gaddafi has to leave. we can discuss the way and means in which he leaves, where he goes, which country he goes to, which part of libya he might go to. that can be discussed. why not use his persuasive powers on behalf of russia? yes, we need pres. medvedev. at the security council he was the one who made it possible for us to adopt a resolution 1793. any help he can give us on this matter and any other is welcome,

just as he has been extremely useful in all of the issues dealing with iran. russia is a great partner. >> i am not going to talk to you about your wife, sir, but greece. it is fascinating. things seem to be getting worse. the imf has said it might not be willing to go ahead with a second tranche of loan relief. it would appear that this new downgrading is the result of the german position and germany is firmly against the restructuring of agreed debt -- the greek debt.

half president obama does not talk about his concerns -- >> president obama does not talk about his concerns because he is the president of the united states. how can he be worried of an average of the of 4.5%. how can that make sense? second, germany is a major player and a strategic partner for france. the relationship between germany and france is one of trust and it is indefensible.

i think this word restructure is not used in its proper function. if a restructuring means for a country to repay its debt, then this is a word that france will not use. if the question is can we think about it way in which private partners might take part of the burden, there are other words. there are other forms of words. what matters is that we will defend and endorse the hero and the solidarity of the european union. -- endorsed the euro and the

solidarity of the european union. there are many ways of going about it without in any way undermining credibility. i think restructuring is not a word that we should use and it is not a factor that we should contemplate. >> it was said that up to 28,000 to me since arriving in europe is not considered to be -- tunisians are arriving in europe

is not considered to be an imbalance, if you have -- considered to be an imbalance. >> i would not have used those words. but you did. you are entitled to do so. i have never claimed that we should have zero immigration and i will not start now. i think that we can handle together migratory flows and immigration helps to be thought through by people who have a sense of responsibility and.

we will continue maintaining france as well as tunisia, but you need years to train people. i think you'll find we are striking the right balance. there is no tension. furthermore, it seems to me that tunisia was quite sensitive to the fact that the g-8 of french presidency invited to tunisia.ah -- teres

>> produce a few words about [unintelligible] >> by and large, the partnership between france and russia and russia and europe is going to continue to get closer and closer. it wants to russia takes on -- once russia takes on the responsibilities that it is doing, there is no reason --

>> can you tell us what came out of your discussion with president obama about the imf and the candidacy of kristie in the guard? >> of course, we discussed it, but i cannot speak for president obama. he is waiting for the right opportunity and moment to make an announcement. a big we would be very ill- advised to give an impression of

what the countries have to say on the subject. meanwhile, i have read on the subject and i cannot imagine where president obama and i are not in agreement. >> do you believe it is useful to talk about the 67 lines and borders -- the 1967 lines and borders? do you believe that all of the measures that have been taken have not swept the iranian issue under the carpet? >> you cannot talk about borders and lines without specifying

which borders and lines. because it is just hot air. i think what makes president obama's speech courageous is that he refers to the 1967 lines. on iran, likewise, i'm very clear. iran is evidently trying to reap the benefits of the solicitous of sense in other arab countries in order to turn a blind eye to its own children moved toward acquiring nuclear weapons. we will take the necessary steps in that direction.

something else that is fragile in this world are young people. how you see -- i wonder how you see countries such as the arab states on the international scene. >> frankly, you cannot compare the use of tunisia -- youth of tunisia and egypt with those in spain. you can only compare like and like. you can only inspire.

as to the ig-8, it is the use of themselves that out to do this -- of how to discover. they will meet every year. we can get a ball rolling, but it is not up to us to keep it alive. otherwise, it will just be artificial. because there would be and ig-8 of others. it takes two to tango. summit that was a success, it would be because the players endorse it.

it was the french president who put the idea on the table. and that is the way it should be, and there will be such a meeting in the future. i do not want to be constantly pumping air into the chamber of this particular tyre. -- this particular tire. it is up to the users to keep this one going. >> in regard to what you said to as

to dominique strauss-kahn, do not think the arrest and the patika house he is saying [unintelligible] whenever i have said on the subject or stay on the subject, i will be criticized. i am not criticizing you for putting the question to me, but i believe that all of this is sufficiently miserable, sad. for the whole political world to remain dignified in what they say. i have mixed feelings, quite contradictory.

as head of state i should adopt -- i should adopt a position. basically, what you are saying is that this has harmed the image of the director of imf. i will stick to the position hamas where i stand -- the position where i stand back as an observer and wait for things to panel.

even when i have tried to keep my distance, some of things we have heard we would rather not have heard and some things we have seen we would rather not have seen. and it is not a political issue. honestly, some words that have been uttered have been deeply, deeply shocking. >> the technology transfer has led to some concern in nick -- in russia oppose the neighboring states.

is this a sort of quid pro quo? >> there is no quid pro quo in russia. russia is 46 times the size of france, twice the size of the united states. it has 400 million inhabitants and it is diminishing each year. it is not growing. it is doing exactly the reverse. as the population dwindles, it is more than unlikely that it would have any desire to invade its neighbors.

i would say the situation is very stable. russia is a great country with a lot of raw materials. europe has a lot of technology. we can do it together. when we saw the president of the red states and the president of russia together at the nato summit we thought, oh, at long last. the cold war is over for once and for all. if russia is, indeed, our ally, why should we not sell ships to russia? who are they going to invade? who would you might think they are going to invade? as for my friends in georgia come on -- in georgia, i have

been invited to georgia and i think they have moved on from their 2008 agreement. georgia is a free country. we stopped the tanks 40 kilometers away from the e tbilisi. when you sell something to them, they ask for a technology transfer. i take full responsibility for those decisions that have been

made, but i have never said anything else but in agreement. in fact, when we clinched the deal we were no way engaged in libya. there's no reason you should put the two together. we have not actually completed a negotiation on these contracts. when mr. medvedev abstained on resolution 1793 we had not actually completed negotiations on these contracts. >> [unintelligible]

>> i discussed it with the head of the transition council. what we want is when the time is right we should go there to have a meeting and need all those who wish to build a democratic libya tomorrow. and we should do this hand in glove with the members of the transition council. we discussed this with david kampen -- david cameron. i think it would be ill- conceived to do other things. it is still very much on the table. we have not set a date as of yet. so perhaps, a couple of questions you wish to ask?

>> is osama bin laden -- why has the g-8 not cancelled to andtunisian debt? and would you consider the g- nine, a new format? in terms -- >> in terms of the debt, we are not able to do that from here. maybe it is a little heavy for our friends in tunisia. if we decide unilaterally for one country to cancel the debt,

that all of the of the country's will see that as a signal. we will discuss this with the foreign minister of the g-8 and the foreign minister of tunisia as well as the finance minister of the economy. we have made a commitment, but we have to implement it. that is technical. perhaps a last question? >> the question on libya again, today, the frozen assets and cash bar real-world -- around the world that belong to the libyan leadership, have you with

the g-8 talked about freezing these funds to help the tmc with its work to free those funds of with the transition government? and is it your personal view on this question -- i think it should go quicker -- and is it your personal view on this question? >> i think it's to go quicker. -- it should go quicker. there are certain funds, but there are legal issues here. and we are states that have will of law. justfore, the genends do not justify the means. we are going to look at that issue very soon.

before i thank you for covering this g-8, i want to thank our friends of the region. i'm sure it has always been easy for the city to manage it. but the region has been put in the forefront, in the spotlight of the world are on the world and i think normandy has given us some beautiful moments. with a weather that was the enormity weather, a perfect normandy weather. there were some wonderful moments and a beautiful breeze. i know the farmers around here would like to see more of rain, but there is great dynamism in this region.

every moment spent here in normandy is special and wonderful. and for all of those who love normandy like all of us, we were dining with the president quite late. we were on the beach and there was an incredible sky. during dinner we remarked how we change colors and change moods. angela merkel particularly noticed how beautiful it was. and if she is happy and touched by the environment of the g-8, then it is a successful g-8 for me. i can tell you that much. thank you. [applause] [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2011]

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comments. start your twitter account today cspanwj.er.co/w >> how much time to spend riding and how much on research? that is a great question. no one ever says, how much of your time you spend thinking? and that is probably the most important part of it. >> david mccullough, his writing process and "the greater journey, americans in paris." next, as senate judiciary senate committee hearings on prescription drug abuse. that will be discussing some -- proposed solutions to the problems.

this is about one hour and 30 minutes. >> this is incredibly important to our families, and that is dealing with the prescription drug epidemic. used properly, pain relievers and other drugs bring much needed comfort to americans. but there abuse poses a serious and growing threat to our communities and young people. in 2009, approximately 7 million americans reported misuse of prescription drugs. the problem is particularly acute among teenagers. prescription drugs are in the in

second most used -- second most of us category -- most of used categories of property -- of drugs. prescription drug abuse is extremely dangerous. over the last five years, emergency room visits involving improper use of pharmaceuticals more than double. too often, the consequences were deadly. according to the cdc, drug- related poisonings are now the leading cause of death due to unintentional injuries in my home state of rhode island and 16 other states, greater even than motor vehicle accidents. it can also impose significant financial costs on our system because of emergency room treatments for complications. we pay for that through higher insurance premiums and medicare and other public health costs. the growing epidemic of prescription drug abuse demands sustained attention,

enforcement, health care professionals, and congress. it poses challenges similar to those faced from other illegal drugs. as with illegal drugs, large- scale criminal networks have developed for the diversion and distribution of prescription drugs. however, there are unique challenges in the prescription drug context. the drugs can be readily available in our homes, giving teens easy and direct access. approximately 70% of people 12 or older who used prescription pain relievers non-medically in 2009 got them from a friend or relative. education can be difficult because they are used for medical purposes. the special characteristics of prescription drugs demand and multi-pronged strategy for

reducing use. it should include educating prescribes and patients about responsible uses of the drugs, recognizing signs of abuse, providing appropriate treatments, and interventions, and deploying the appropriate law enforcement resources. electronic information sharing systems such as the prescription drug market in programs authorized in 43 states are promising tools for identifying pill mills and doctorate shoppers. i was pleased to get bipartisan legislation passed last year allowing the government to perform sophisticated analyses of medicaid data to avoid paying fraudulent claims and give law- enforcement tools for investigating criminal fraud. there are analogies ways to strengthen prescription monitoring programs so that they have more complete data, use advanced analysis to identify abuse, and better allow law enforcement and others to address the problems. e-prescribing can also play a

valuable role by reducing opportunities for forgery and error. i am pleased that rhode island is a national leader in e- prescribing. this can help doctors recognized early patterns of abuse. today's hearing seeks to address these goals. a welcome our guests. i congratulate the administration on the release of the proposal for responding to america's prescription drug abuse crisis. i look for wood to working with the administration. chairman leahy, ranking member kyl, and others on this legislation. senator kyl said he may not be able to attend. his schedule has been tumultuous.

if he can, i will recognize him. if he does not, i have been instructed to proceed. we have senator brown from ohio. to kick off the hearing. he has taken a keen interest in the issue. we look forward to a statement. senator gramm? >> thank you for allowing me to testify and for your leadership on this important subcommittee on crime and terrorism. we served together in the labor and pension committee where we worked together on the patient protection/affordable care act. 3 our time and send, i value his expertise and the connections between health care and the legal system. today's hearing is an example of that connection, how the rampant abuse and trafficking of drugs pose a public health threat and law enforcement trip. increasing years, more ohioans have died from prescription drug overdoses and car accidents. prescription drugs cause more overdoses in ohio that year than

heroin and cocaine combined. prescription pain medication is largely a response will for increasing overdresses and deaths in my state and across the country. is the fastest-growing drug problem in the nation. almost every day in ohio, there is a story about a child lost to prescription drug abuse or neighborhoods harboring the illicit trade. in southeast ohio, the most rural part of the state, is particularly traffic. old factory towns and rural communities have become havens for prescription drug abuse. the stores are not limited to these states. across the country, states are struggling to reduce the diversion and abuse of prescription drugs. last year, a convened a round table in southern ohio with federal and local law enforcement, community activists, elected officials, drug treatment leaders, and members of the medical

committee. they ranked the concern with criminal manipulation of the medicaid program. zeropends more than $820 million on prescription drug medicines. most are used as prescribed and are valuable. some criminals defraud the medicaid system and fleece taxpayers by acquiring multiple prescriptions and filling the multiple pharmacies. the case of criminals defrauding taxpayers in the medicaid system to sell and avert prescription drugs becomes a punch in the stomach to the system. last month, i introduced the "stop trafficking of pills" act that would establish a medicaid block in program for ohio and nationwide to crack down on this. the bill will prevent prescription drug abusers from requiring access prescription drugs that they may abuse or illegally resolell. bars them from visiting multiple doctors and pharmacies.

other states have something similar. the south carolina public park. -- project spurred a 40% decrease in the number of prescribed pain medications. consider scioto county in southern ohio, prescription drugs caused nine out of every 10 fatal drug of roses. nearly 2/3 of the cases had individuals that do not have prescriptions themselves. in all likelihood, they obtained the drugs illegally. the gao investigation in five states found 65,000 cases in which medicaid beneficiaries visited six or more doctors and up to 46 different pharmacies to acquire prescriptions. the same report found 800 prescriptions written for dead patients and 12 under prescriptions written by dead physicians. under medicaid programs, states

would identify high-risk prescription users, those receiving an excessive amount of prescription drugs or those convicted of drug-related offense. these users would be placed in the program and assigned one physician and one pharmacy. it would mean no more doctor shopping and no more pharmacy hopping. states would identify drugs dispensed under that possess a high risk of over-utilization. prescription drug abuse in ohio and our nation needs to be treated like the epidemic is. the chairman has been a leader on this issue and calling for stronger monitoring systems. today's witnesses will describe the comprehensive prescription drug strategy and waste the fda can crack down on abuse. community activists will describe the victims and families represent, offering stories behind the statistics and policies being discussed.

it is clear prescription drug abuse knows no party lines. it is clearly an issue of life or death. in my state, especially in the rural issues, people have expressed -- experienced job loss and economic hardship. i will stop there. thank you for allowing me to testify. >> i appreciate your energy and leadership on this issue in washington and in your home state of ohio. our states have a lot in common on this issue. i look forward to working with you. i appreciate you took time out this morning to come to this committee, of which you are not a member, to make sure your voice was heard here. i am very grateful to you for that. i know your schedule commands to be elsewhere. thank you for taking the trouble. now, i will ask our first panel,

the honorable gil kerlikowske and the honorable michellmichele leonhart to come forward. let me ask you to stand and be sworn. do you affirm the testimony before the committee will be the truth? thank you. please be seated. thank you both for being here. out. an impressive turned ou kerlikowske is the director of the white house office of national drug control policy. he served as the chief of police for seattle, washington. he was deputy director for the u.s. department of justice office of community oriented policing services. he was the police commissioner of buffalo, new york. he served in the st. petersburg,

fla., police department. he has been elected twice to be president of the major cities chiefs. he has received numerous awards and recognition for leadership, innovation, and community service. he is joined by michele leonhart, administrator of the drug enforcement administration. she was confirmed in december 2010. she has been the acting administrator since 2007 and deputy administrator since 2004. as a career the a special agent, she has held several key positions as she moved through the ranks of dea, including special agent in charge of the l.a. division. she has received numerous awards including the presidential rank award for meritorious service in 2005 and 2000. it is our privilege to have these witnesses. let's start with mr. kerlikowske. please proceed with your statements. >> and thank you for the

opportunity to address the important issue of prescription drug abuse. i am grateful for the committee's attention to the topic. prescription drug abuse has been a major focus since my confirmation. i directed the national drug control program agencies to address the epidemic. i have a responsibility to raise public awareness, coordinate federal activities, and take action on drug issues that affect our nation. the efforts we've taken our balance. they incorporate new research and evidence-based approaches. prescription drug use -- abuse is the fastest growing drug problem in the united states. it is categorized as a public health epidemic by the centers for disease control and prevention. the number of individuals who for the first time consumed prescription drugs for a non- medical purpose was similar to the number of first-time marijuana users. we have also seen before-fold

increase in addiction emissions -- admissions for those abusing prescription pain medication. even more alarming is the fact that 20,000 americans have died from unintentional drug overdoses in 2007. prescription drugs are considered major contributors to the total number of drug tests -- deaths. we believe there are two reasons come easy accessibility and diminished perception of risks. a comprehensive approach is required. it is important to balance education and enforcement with the need for legitimate access to controlled substances. the administration has created a comprehensive plan that brings together federal, state, local, and tribal groups to reduce prescription drug diversion and abuse. the plan expands upon the

administration's national drug control strategy. it has four major areas. the first is education, mandatory prison. education as well as. and patient education. of narcotics are distributed in emergency care departments. we want to make sure that patients and parents are fully aware of the dangers and prevalence of prescription drug abuse and that they are educated in the safe use and proper storage and disposal of the medications. the fda is implementing a risk evaluation and mitigation strategy plan that requires manufacturers of long-acting and extended release of the lloyd's to ensure training is provided to. progress. the second part of the plan includes that each state having prescription drug monitoring program. senator brown mentioned the importance of those. i know you have another witness that will be talking about those.

we're strongly supportive of those. they have interoperability and should be used by all of the. scrubbers. we have made significant --. scribers. we've made significant advancements in technology. we continue to work with the health information exchanges. opportunities include identifying ways to incorporate real time data at the point of care and dispensing. the third part of the plan calls for proper medication disposal. unused medications that sit in our medicine cabinets are falling into the wrong hands. by creating a method for proper disposal of expired or unused drugs, we will benefit public health, safety, and the environment. passage of the secure and responsible drug disposal act in 2010 was an important step forward in our effort to make disposal more accessible to individuals and reduce the supply of drugs available.

the program has to be easily accessible to the public, and from a friendly, cost-effective, and the cost burden should not be placed on consumers. the last part of the plan is smart law enforcement. you have the experts sitting to my left to talk about that. our main effort will be, as they have already done with the dea to address the issue of doctors who over prescribed. our office supports the high- intensity drug-trafficking areas. we want to make sure that local law enforcement has the support they need to understand the complex investigations and do a better job of bringing drug dealers to justice. i want to thank all of my colleagues in the executive branch. we cannot be effective in any of these areas without the support of congress.

>> thank you, director kerlikowske. director leonhart? >> thank you for the opportunity to discuss the growing epidemic of prescription drug abuse and the critical role of the drug enforcement administration in the enforcement of our laws and regulations. diversion and abuse of pharmaceutical substances is a significant and growing problem. every leading indicator shows increases over relatively short amounts of time in use and abuse of these drugs. pain clinics have emerged as a major source of controlled substances for non-legitimate medical purposes. dea and other law-enforcement agencies have developed a great working relationships and continuously coordinate efforts to combat emerging threat. federal administrative and criminal actions against a physician with a controlled substance privileges is rare.

however, such actions are warranted when a physician is issuing a controlled substance prescriptions for an illegitimate purpose and operating outside the usual course of professional practice. as a minister, i have made prescription drug abuse and a top priority. -- as administrator, i have made it a top priority. one intriguing factor is the availability of drugs and household. -- contributing factor is the availability of drugs in households. they remain in drug cabman's well after therapy has been completed. that provides easy access to non-medical users for abuse, accidental ingestion, or illegal distribution. in the 2010 study, it was noted that 51% of those surveyed believe most teens get prescription drugs from their own family medicine cabinets. dea manages a robust regulatory

program aimed at curbing diversion from manufacturing to dispensing. working with congress, dea obtained new authority last year to regulate the disposal of unused medications, thereby getting unused medications out of the households in a lawful manner. dea is working diligently to promulgate disposal regulations. in the interim, we launched a nationwide take back initiative in september of last year and again in april of this year resulting in a combined collection of 309 tons of unwanted or expired medications. dea will continue to hold periodic events until regulations are in place. our obligation under the law and to the public is to ensure that controlled substances are prescribed and dispensed only

for legitimate medical purposes in accordance with the controlled substances act. by carrying out this obligation, dea strives to minimize the diversion of pharmaceutical substances for abuse while ensuring that such medications are fully available to patients in accordance with the sound medications -- judgment of their doctors. we're committed to balancing the need for the version control and enforcement with the need for a legitimate access to these drugs. dea closely monitors the closed system to record keeping requirements and mandatory reporting at all levels of the supply chain. because of enhancements to our regulatory resources, a controlled substance manufacturers, distributors and importers, exporters, treatment programs are receiving more inspections than ever before. the key component are the

tactical diversions' course. these unique groups combine the skills of agents and and officers. these agents are dedicated solely toward investigating, disrupting, and dismantling the individuals and organizations involved in diversion schemes. as of today, dea has 37 operational groups. dea plans to add 27 more over the next few years. one example of the effectiveness of these tactical diversion squads is operation -- the operation that has targeted roque clinics in florida and culminated in a number of take downs in february. this led to 32 arrests, including 12 doctors and five pain clinic owners. dea also immediately suspended

63 registration numbers and issued orders to show cause on six registrations the resulted in the surrender of 29 registration numbers. this caused a ripple effect around south florida. it resulted in 54 more registration numbers being surrounded -- surrendered. dea recognizes it cannot solve the problem alone. it is working with state, local, and private sector partners as part of the comprehensive approach to combating prescription drug abuse. many states also have adopted prescription drug monitoring programs deemed to be a valuable tool in curbing diversion. the administration supports the establishment of these programs in every state it is helped cut down on fraud and doctor shopping by giving physicians and pharmacists more complete information about a patient's prescription for controlled substances.

in closing, prescription drug abuse is a dangerous threat. dea is determined to be part of the solution. with your support and out of our partners, i know we will continue to make a positive difference in the lives of millions of americans and communities across the nation. thank you for the opportunity to appear here today. i look forward to answering questions. >> thank you, director leonhart. chairman lee he could not be here today. he has offered a statement for the record reflect ing observations we got at the hearing he held up in vermont last year with all of us together. without objection, i will add that to the record of this hearing. i have a couple of questions.

i think will pass on the drug disposal questions because we're joined by senator clobuchar, the author of the act of 2010 mentioned in testimony. i was in rhode island the other day at the treatment facility. they are seeing effects from pharmaceuticals that are discarded down the drain out in the environment, as they come through the treatment system and go into the river and on down to the bay. it is not a solution to have people dispose of this by having them throw down the drain. we really have to improve on that.

i suspect she will urge you to move those regulations with some degree of dispatch. we have had a long battle over prescribing regulations. it has been three years since we had the first hearing. your predecessors sat next to people from hhs and had completely different views of the world in the same ministration. i gather that has been worked through. if you could bring me up to date on where we are under the interim final rule in turn sets of actual deployment and the ability to survive contractors and have e-prescribing take place in the field. i am assuming you view that as an investigative and awareness outset in the drug diversion program.

-- problem. in that frame, i would like to let me know where we stand. >> we do view e-prescribing as an important tool for law enforcement. we have worked hard, especially since last march when i signed the interim rule the win into effect almost a year ago. june 1 will be a year. we have been in contact with the people putting together a the systems. they are moving forward. will understand the first ones may be ready this summer -- we understand the first ones may be ready this summer for audit and be available by the end of the year. we looked at a number of the comments that came in. the interim rule is in effect now. we believe the final rule will be ready to go early next year.

there should be no reason people should not be moving forward to implement e-prescribing. that will help to improve the diversion problem of prescription drugs as well as help with fraud. it will enhance health for patients. >> is there actually e- prescribing of full pharmaceuticals under the interim rule happening now? are people still waiting for contractors to be certified so they can actually happen? it is one thing to have the rule in operation and another to have something happening in the real world. i am not sure this has hit the real world yet. can you let me know the status in terms of actual flow of data across e-prescribing networks? >> it has not had the real world yet, but the systems are being

put in place. they first need to be audited. we to understand one has announced that it is dea compliant and ready to move forward. i believe it is in the auditing stages now. it has identified over 150 different customers. that will be the first one we have heard of that will be coming on line probably by the end of the year. >> i am not going to remember the exact numbers the senator brown used. but he described individuals who had multiple prescriptions from multiple doctors and were using multiple pharmacies. that is the type of thing that this sort of system can flag so it does not happen. >> correct. that with the prescription drug

monitor programs, we will be able to identify people doctor shopping. >> with that, and will recognize senator clobuchar. >> thank you to both of our witnesses. director kerlikowske and i worked together back when he was police chief. i was a county attorney. this winter, we worked together as well. you are from minnesota. you can do no harm, as far as i am concerned. i want to go through that we passed the secure prescription drug disposal of. we got it through the house. thank you for your help in doing that. i wanted to find out the status of the rules. this bill acknowledges. the prescription drugs are the number two way that kids can get

addicted to drugs. this allows pharmacies to do take back programs more than just police departments. it turns out long-term care facilities were flushing a lot of these drugs down the toilet because they did not know what they could do legally. i know the regulations were included as part of the plan released by the white house. can you give us an update on the drafting of the regulations and some of the key issues you will be looking ouat? what do you think the timetable will be? >> the white house is not influencing rulemaking. i would defer and ask that may be administrator lynn hart answered that question. -- may be an administrator answer that question. >> it is very important to us

and i am >> i am on track and i hope to have a final rule by the end of the year or early next year. the second day back earlier this month was even more successful than the first take back in september. we held a hearing in january and had over 100 witnesses provide comments and submit comments that we are looking at very close lee -- very closely, and the good news is that we are on track to have a final rule holly by january or february of next year. >> very good. are you working with stakeholders on getting input? >> absolutely, a public forum has stakeholders from all entities, and we have a wide

range of recommendations and suggestions from them. all options are on the table to come up with the best final rolrule we can come up with that allows for state and regular disposal. >> very good. the tape back programs are becoming more and more popular, but to have something that would be commonplace in farming -- and pharmacies would be best, and of course, long term facilities as well. i have a different kind of question and it is about the use of synthetic drugs, including synthetic hallucinogens. these drugs are not prescription medications, but i think it is clear that the abuse of these illegal drugs and prescription drugs are closely related. i have a bill on certain types of the end -- synthetics. it is based on tee, that almost

killed a young man in minnesota and several others at a party. i was wondering if you were aware of this problem, either of you, and if we have your support in moving forward on this legislation. >> we are absolutely aware of the synthetics, and especially of the young man that lost his life. weather is synthetic cannabis or a synthetic stimulant or a hallucinogen, young people are attracted to that. it concerns us. we support any legislation, any tools that congress can put forward that will help us combat that. and i know that in minnesota as

well as the other states where these synthetics have shown up, we are working with state and local law enforcement with providing technical assistance training to do whatever we can to put a stop to that. >> senator, wallaby legislative -- while the legislative process is going on, we have used the bully pulpit of the white house to bring to the attention of a lot of people the problem with things such as basalts, synthetics, etc. >> i think that the more we can listen to these, that helps to make them illegal. i think no one anticipated these drugs a decade ago. my last question is along the lines of a tool for you to use. on administration's plan

prescription drugs makes reference to the role of congress. if you can touch further on the role of congress. can you talk further about the potential need for legislation in the area of prescription drugs? >> senator, we think one of the most important part of the comprehensive prescription drug plan will be a mandatory for schriber education -- mandatory prescriber education. we made sure that people's voices were heard. the actual prescription drug plan is more comprehensive and more specific and we develop it by listening to people all or the country, particularly a number of prescribing physicians, whether in emergency departments or in a number of other locations, for instance, pain management or primary care.

the overwhelming information provided to me by them was that additional information and education about addiction, dependents, about prescribing pain medications was important and vitally needed. overwhelmingly, they told me that it should be mandatory, although voluntary education is something that people appreciate. and i know that these are physicians who are very overworked. mandatory prescriber education in my opinion is very important. >> thank you. >> and now, we will turn to the distinguished senator from connecticut, whose many years of exemplary service as attorney general in connecticut -- make him important to this hearing. >> thank you. thank you for being attuned to this very difficult and profoundly important topic. thank you both for your great

work on this issue. i want to thank you both for the recommendation of the white house office and drug abuse policy and to recommend that the veterans affairs secretary share information on controlled substance prescriptions with drug monitoring programs, which i think is very important. as you know, the d.a. also support this request. i will be introducing legislation within the coming days as part of a comprehensive program on veterans. it will support providing that tool in the toolbox, so to speak.

i wonder if you, director len hart, could share with us and put on the record your views as to why this recommendation is important. >> senator, thank you very much. i could not have a strong report are then general shinseki and the v.a. on this issue. i do not think there is anyone in this country that is not supportive of our active duty military and are returning veterans and how they can be helped, but we also know that sells medication, the use of prescription drugs in the active military has been well- documented, and also in returning veterans. it is a significant problem. it is a problem in combat readiness, a problem for local jurisdictions, particularly where there are national guard returns and there may not be as large a military base or presence.

prescription drug monitoring programs are now in almost every state and we are working to help them become more robust. they are only as effective as how they are used. if you can go into a v.a. hospital and obtain prescription drugs and go down the street to a private physician and the two systems do not talk to each other, that is dangerous for the patient. it puts the positions in a difficult -- the physicians in a difficult position because they do not know what is being offered to the patient by a different physician at a different facility. the support of the v.a. and the support of the department of defense on that issue is about one system can clarify and talk to each other is good for our veterans and are active duty military, and it is clearly a patient safety issue. i thank you for that support. >> would you have anything to add?

>> i would add that it is a very serious problem. the 5.3 million americans are using painkillers. among those our veterans, especially returning veterans. bringing the v.a. to the table has been a significant under the leadership of the director. it will benefit all of our efforts, especially those that will most affect veterans. thank you for your interest in that topic. >> it almost enables or encourages doctor shopping and abuse to have these two separate systems that are completely not linked. and they simply cannot communicate with each other. -- do not communicate with each other. i realize this is an open-ended question, but how well or the state systems -- how well are the state system is working, and

you know the degree of effectiveness there? >> there are a number of people that have looked at these. the cdc just released a report, although the data that they used was a bit dated. i have examined them and looked at them. there are some states, particularly what is called a casper system in kentucky, which is very forward leaning in this area. but there are several problems and we have addressed those in the prescription drug plan. one is, they should be interoperable and talk to each other. during our four-day trip to eastern kentucky, and also west virginia, we learned that doctors would have to access multiple systems, those in ohio, those in west virginia, those in kentucky when it came to checking on patients and making sure that they were not over prescribing for patients who ing other physicians. interoperability is key. the information should be readily accessible and should be

as close to real time as possible. those are all important efforts. this is something that all the states, including the state of florida passing that legislation, moving forward and making them more robust and making them interoperable -- those are of key components of the prescription drug plan. >> i would add that we have seen some promising information coming from the states that actually share that information with the law enforcement. for instance, recent studies show there were lower death rates in states that were sharing with law enforcement, specifically california, texas, and new york. it is a promising tool. it is good to see that as soon there will only be two states that will be without pdmp's or without legislation pending.

>> thank you both for your great work in this area. >> just to follow up on senator bluhm and paul's question, have you been alerted to -- blumenthal's question, have you been alerted to any changes in the prescription drug monitoring systems? i understand medicaid and medicare billing, for instance, the version is being accomplished primarily at the -- diversion is being accomplished primarily at the state level. do you think the state process is a successful one in terms of something that can go forward and be successful on its own? >> senator, we have widely discussed at the differ hearings -- different hearings the issue of the national pdmp. a couple of things -- one, the

experts there run the system said it would be very difficult to implement because, for instance, does the difficulty of personal identification when it comes to, names across an entire nation and an entire database. that would be a problem. second, that the state's design these and operate these themselves and they can put into place the patient privacy, the confidentiality guidelines that they would like, and also, who has access to it. i think there are a number of best practices. and as the evaluation continues on, i am hopeful that the individual states are working together. and of course, your next witness is certainly another subject matter expert and will be very helpful. right now, i am pretty satisfied with what i'm seeing at the state level. >> do you agree? >> i do agree. i agree that congress could help. however, in the area of

interoperability, and of course, funding is an issue for the states moving forward with these systems. >> thank you both very much. do you have any further questions senator blumenthal? are we ready for the next panel? if you would like another round -- >> i wanted to follow-up on senator whitehouse pose a question about the drug might trim programs. i know there is some reluctance to make it more national and impose national requirements. but i wonder where you see the resistance to increasing the interoperability, which i think is really key, as it is in so

many criminal-justice information programs. the state system is a barrier. would you like to think further about it and respond in writing or have a conversation about it? i would be interested in following up on that issue. >> i would note that the state of ohio and the state of kentucky have signed an interoperable agreement to begin sharing information. i think that shows some promise and i would be happy to follow up to that question. >> a great. thank you. >> let me thank the witnesses. let me reference back to a statement that the director made about his role as the bully pulpit at the white house on some of these issues, which is a role that we obviously encourage, but i would hope that you would also be a bit of a bully pulpit -- political but -- bully pulpit within the white

house as these office of budget and will makings proceed. it has been astounding as a newly elected senator to see the pace at which the federal moves. it does seem that there is a common thread that things do bogged down at omb. if there's anything that you can do to move things along and get things expedited to the extent that they can, i think that would be helpful. i cannot tell you how long it took to get through the control pharmaceutical e-prescribing situation, and that was in. pretty much everyone on board as to the direction it should go. i do not know what you call it,

but impatient i guess, with federal rulemaking. you may be in a position to expedite, and if you can, i would urge you to do so. and i thank you for your many years of dedicated service in this area, both of you. we have people out in our streets and in the streets of foreign countries every day who are resourceful and brave and take extraordinary risks to protect us. we have had the pleasure and privilege of working with the dea agents and they are among the most fun americans i have ever had the chance to work with. thank you for being here on their behalf. the panel is excused. it will take a two-minute break while the next panel assembles itself.

[captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2011] >> all right, if the hearing will come back to order. my first order of business is to add to the record in this

proceeding and number of items -- a number of items. first on the record, senator casey. and then statements from a partnership at drugfree.org, from the anti-drug coalition of america, the american payne foundation, the american academy of pain medicine, the international institute a pharmaceutical safety, from the state medical boards, and from the american society of interventional paying positions. i appreciate all your statements and it will be added to the record of these proceedings without objection. we have for our next panel, our two witnesses. first, laura hosely serves as rogan and student assistance

services and oversees the north kingstown rhode island drug free communities grant. she worked as a student assistance counsellor and directed a group home.

he was co-founder and president of the alliance state's prescription mantra in programs and the national association of state controlled substances authorities. if i could ask you to stand while we administer the oath -- >> do you affirm that the test when you are about to give before the committee will be the truth, the whole truth, and nothing but the truth so help you god? please be seated. please, present your statement. >> chairman whitehouse, senator blumenthal, thank you for the opportunity to testify before you today. i am pleased to provide you with our perspective on effective strategies for reducing the abuse, misuse, diversion and fraud of prescription drugs. rhode island is a small state, but we seem to show up in the top of the national statistics

when it comes to substance abuse. in 2004, the national survey on drug use and help as about the use of nonprescription drugs. ryland was tied in first. in 2008, when asked about the use of pain medicines non medically, road island was in the top five. 11% of high-school students have tried painkillers' without a doctor's prescription. i manage a drug-free communities grant in north kingstown. prior to this i oversaw the state incentives grants. in my 20 years, i have never seen such a well-organized effort as with these grants. after the first three years, we cite drop in alcohol use by 14% and a 14% increase in marijuana use by high school students.

we have focused our efforts on underage drinking. we have cooperative relationships with multiple key partners that make it relatively easy to work on media campaigns, policy changes, law enforcement efforts and more. the national prescription drug take that program was held on april 30 in conjunction with the dea. the local police and state police killed five boxes. i saw that the top -- collected five boxes. i saw that the top committees were part of the grant. they had collected 75% of the 1,500 pounds of drugs. i used to be a student assistance counselor. student assistance counselors are on the front lines. unfortunately, federal and state funding no longer covers the cost to ensure that minimum

programs are funded, especially since the safe and drug-free schools communities were eliminated. the counselors are insiders. along with providing early intervention, they can also assist with evaluation, policy, and enforcement efforts with the schools. last month and i heard the story of a student who barged into a student assistance counselor's office acting confused and incoherent. the counselor found out that she had taken prescription drugs that were not prescribe to her along with lsd, and determined that she was in a drug induced psychosis. the girl was taken to the hospital by ambulance where she stayed for three weeks. she is now back in school, but need to take lithium, which is usually described -- prescribed for people with bipolar disorder, to remain stable enough to stay in school. she is still having bouts of crying and having difficulty

with stress. the boy you gave her the drug is allowed to stay in school with an ankle monitor. two lives with diminished chances for future success. walworth island is just beginning to address the complex issues -- while rhode island is just beginning to address the complex issues, i think an effective mechanism will be the student assistance program. these counsellors are on site and can act easily and confidentially. they're working in tandem with community coalitions and have been successful in reducing the use and abuse of alcohol and tobacco. i have every reason to believe that through the drug-free -- that continuing and expanding the student assistance program along with the coalition for the drug-free communities program will help handle the prescription drug abuse among teens. i have been providing more comprehensive recommendations in

a written statement, but on the interest of time i want to focus on the one that is most critical periods with drug use on the rise and with the elimination of the programs in schools, the federal government should focus more emphasis and funding on community-based substance abuse prevention programs by explicitly requiring the drug prevention and intervention programming be adequately included in the reauthorization of the elementary and secondary education act, and by fully funding the drug-free communities program. we have the potential to reduce the use of prescription drugs among those in rural thailand as well as nationwide. i -- in rhode island as well as nationwide. >> thank you. we will take your statement first and then ask questions.

you gave a summary today, but your full statement will be part of the record. i also wanted to mention with respect to the recommendation that this be protected in the reauthorization of the esca, senator brown who has a very keen interest in all of this, i guess he is located off of the health committee now. i am not on the health committee. -- i am now on the health committee. and senator blumenthal as well. you are a very good representation of that committee -- you have a very good representation of that committee today. i guess, by fortuity.

>> thank you for the opportunity to testify on this critical matter. we seek to not compromise pain management in regard to controlled substances. the center provides academically sound and practiced to relevant information, evaluation, and expertise to the prescription maturing programs and other stakeholders. the senate is funded by a grant -- the senator -- the center is funded by grants. our work is based upon the knowledge that every day, 50 people in our country die from

overdoses. daly, 20 times that number are admitted to hospital emergency departments for opioid overseas. we believe we must improve our methods for identifying and interdicting prescription drug abuse to slow down and reversed the rising toll. the rapid growth in states with monitoring programs -- i am delighted to see the number is now 48 states. five have just passed legislation in the past few weeks. it has been signed. it is a very hopeful accomplishment. the majority of these states have been authorized since 2003 when the drug monitoring program grant funding began. it was a program administered by the department of justice.

through that program, competitive grants have stimulated growth and enhancement among pmp's. additional funding has been provided until the new budget. the program as a minister by the substance abuse and mental health services administration is a formula grant program that has been important in assisting state monitoring programs by supporting operations. the continued operation and the significant enhancements called for to address the epidemic appeared to call for a continuation and expansion of both in the programs. we need a rapid evolution of prescription monitoring programs into a new generation of even more effective systems. a new generation whose hallmark must become productivity --

productivity. it will take advantage of the dances and integrate them into operation. many characteristics of the new generation are highlighted in the white house's new prescription drug abuse prevention plan, which you have discussed previously. data sharing is essential. this must be completed to create a national network of state prescription monitoring programs better interoperable -- that are interoperable through the exchange that bja and the states have been working to establish for six years with support from our center. the how is operational today. several states are in the process of interconnecting. -- the hub is operational today.

we need to work on the following issues. we must increase the correct reporting where pmp's and into the data and send it out when they and by potential problems to let pharmacists know what is going on. we have other changes to make the system. you touched on some already. making a more timely. oklahoma is pioneering effort today. starting in april, they have point-of-sale data going into their systems. making access seamless using electronic health records is a way of doing that. combining monitoring programs and e-prescribing is an important element. with public and private third- , monitoring as a condition of payment.

in addition, we need to increase the request of reports and productive use of the data for pharmacies. we need to also develop a verification system that pmp's would carry out to tie to dispensing. if there is mandatory physician education, the prescription monitoring program should ensure that is being accomplished. subscribers --. scribers not trained will not prescribe or will report effectively. we also need to increase and improve the access law enforcement agencies have to data. that is in terms of solicitude reports and in terms of unsolicited reports where the mpm's identified problems and send them out. the same is true for licensing

agencies. there are other users of the data that need to be involved. the indian health services veterans administration's, and department of defense health systems need to be integrated. i know you have talked about that already. the system has to be beyond that. it is not just the integration of the day -- va in department of defense. it is for the same individuals in the systems may be going outside to get cash paid prescriptions that compound and, found what is going on within the va and a partner defense. we need to develop an early warning system. pmp's have the capability of doing that. we need to develop greater concern for youth. we've identified significant concerns there. we need to talk about mandatory for scriber education. it is extremely important. and recommend it highly to you.

-- i recommend it highly to you. >> thank you both. your work in rhode island must have exposed you to some pretty well informed views about where youngsters and teenagers are getting access to the prescription drugs. comment a little bit about that and how some of the earlier testimony about the need to improve on the regime of disposal could help this. throwing them down the drain risks creating environmental problems. leaving them in the cabinet risks creating abuse or encouraging abuse. there is no clear third option the most ryland -- rhode island

ers are aware of. >> students seem to know who is getting their wisdom teeth pulled and who might have access to painkillers especially. we hear in school kids have access to adderol. it seems to be something where students may share the prescriptions they are prescribed and also getting it from the medicine cabinets of parents and grandparents. the fact that these are over- prescribed, they do tend to be sitting in people's homes. increasing awareness is huge. when we had the take back program, we made sure we publicized in the papers and put it on the list serves to go home to parents so they were aware there was a way for them to properly dispose of them. the fact that they cannot just go at any time is a little difficult. i know i missed the date and

still have some prescriptions sitting at home. i heard that next year, it might be twice in the next year. at least if we have some mechanism in place for the disposal, that would help. we need to increase the awareness. with funding, we can put a multi-pronged strategy in place for whichever drug we're focusing on. i do not think we have done that yet as far as prescription drugs. it is something we need to do. all the communities need to do it and not just certain ones who are able to get additional funding. >> we have the good fortune in rhode island to have one of the largest pharmacy companies in the country headquartered there, cvw. -- cvs. perhaps we could work with them

once they are through the federal rulemaking process as the dea director suggested. i look : to working with you on that. -- i look forward to working with you on that. mr. eadie, states tend to manage these monitoring programs. there has been a relatively limited federal role other than the grant making. interoperability as, as an area where it might be suitable for the federal government to provide some support and guidance to these state-based programs. it appears the state-base is an asset in terms of awareness of local conditions, comfort about privacy and security issues and

things like that. without taking those elements of way and making this something other than the state-based program than it has been, are other thanr ways are the interoperability where they can have a helpful role in the guiding what will remain a stake driven monitoring program? >> i think there is a ruole. if mandatory education is required, it should be a corollary that prescription monitoring programs should build into the system and ability to track that and make sure that the trade facilities -- physicians and dentists are actually prescribing. that is a simple thing. the larger question is how to

involve the federal government without disrupting the value of the state-based systems. the responsiveness you indicated is extremely important. innovation is also important. without state run programs, would not have the electronic systems available today. that started with nevada about 12 years ago. is now widespread across the nation. i mentioned oklahoma as an example. they're starting the point of sale effort. massachusetts is pioneering health records integration. they also have an electronic prescribing system testing in western massachusetts. it was approved by a waiver of the drug enforcement mr. zhu. it is funded by the institute for health research and quality. it has demonstrated that electronic prescribing by physicians can be operational and is effective. that is ongoing today.

it is operational at the moment. we have been supporting the. i think there is a major role in the future for that. i think electronic prescribing should be integrated with pmp's. it should be integrated as quickly as possible. federal funding support indicates support for the initiative and is important. broad guidelines of criteria or guidance is a valuable. being too specific and the federal level -- at the federal level the specific things shapes should do well ossify the systems when the technology is rapidly evolving. we cannot afford to have anything --. there can certainly be guidelines and statements of

encouragement. states that receive federal funding should have built-in interoperability with other states. there could be the same thing as it relates to the electronic prescribing. broad categories of requirements without specifics so that we can innovate and go forward. >> we're certainly interested in not in rhode island. we're one of the top e- prescribing states in the country. we go back and forth with massachusetts on that. we are advanced enough in electronic health records that we're looking at the statutory health information exchange. as we speak, the data is flowing through current care. it is being populated automatically into health records outside of a single corporation. it is across entities. we look forward to working with you on those ideas. i think if we can do that,

people at the front lines fo working with kids will have an additional tool in their toolbox. senator blumenthal? >> thank you both for being here from massachusetts and rhode island. thank you both for your work in the area. i hope the folks in ryeland know how active and aggressive senator whitehouse has been with his background in law enforcement and his leadership in moving the judiciary committee to take action in this area. all i want to ask you about some of the potential options that drug companies could take in the area of discouraging or stopping drug abuse, apart from improving

the monitoring programs that exist in many states. that is particularly with respect to painkillers. whether there are actions that can be taken to provide for greater secrets -- safeguards in these areas. oxycontin, oxycodone are ongoing problems. there was a case when i was attorney general relating to it and the failure of the company that produces it to follow a more responsible measures in marketing and selling the polils

for pain relief. i wonder if you could give us to a cultivations, as folks dealing first hand on the ground with the problem, about actions the drug companies can take to reduce the problem. >> i am not sure whose responsibility it would be. perhaps if a shorter timeframe was given when the prescription is were prescribed so they did not get a 30-the prescription for having their wisdom teeth removed and maybe had a three- day with the option to renew, there is just too much medication out there. i think it is way beyond what needs to be out there. that just invites the abuse of the trucks. -- that just invites the views

of the drugs. >> i would recommend great care in which funding from the manufacturers might be considered. in the provincial area, it would be helpful to have funding available. it is an area where they have a need to share responsibility for what has happened with the use of their drugs. when it comes to issues closer to regulatory activity and things like the prescription monitoring programs, i think one has to be very careful about considering funding that is perhaps voluntary i can give you an example. we were approached by a major drug manufacturer in our first month of existence and asked if we would be willing to provide data to them for their obligations as it related to a new product they were bringing

on to market. we thought about it carefully. we decided we could not do it in good faith. there would be the appearance perhaps of a conflict of interest on our part to do that. secondly, there would be the potential reality of it. there would be no way we could look at the day without knowing somewhere in the back of our mind that how we analyzed the data, the way we presented it, the analysis we stated all could be inadvertently influenced by our knowledge that future funding would rest on how happy the manufacturer would speak with the reports that we produced. when we said no and say to them, they came back with a counterproposal -- thanked them, they came back with a counterproposal.

we thought about it again. there was great value in collecting data from the states. we still want to do it. it is very important to collect and analyze it. we know that from experience. the two caveat and mentioned a moment ago came back to our cognitive functions as we thought about it very carefully. we thought about how easily a word change can be made in the document, the choice of phrase and how things would be presented, they're ripping away could protect ourselves against the thought in the back of our minds the next -- there was no way we could protect ourselves against the thought about reminds that the next year's funding may be affected. i think this would apply across the board to any of the monitoring activities with the states.

i honor with the florida state legislature has done in passing a small that refuses to allow their prescription monitoring program to accept funds from drug manufacturers directly or indirectly. that was a major step forward. there was $1 million offered to them by a drug manufacturer. let me give you examples. we know there are manufacturers that have been very active in supporting monitoring programs for the last decade. if you read the materials carefully, there is no provision for the kind of protective the proactive analysis and distribution of data that is essential for the monitoring programs to go forward, particularly as it relates to law enforcement. there has been in recent years a number of states that have enacted laws that have provided restrictions on law enforcement that extend to requiring court

orders, subpoenas, a variety of what amount to an appropriate restrictionsn w eorme ce t t da. i think there is room for manufacturers to contribute to refund that might be congressionally mandated like the food and drug administration establishes a fund that pays for its cost. manufacturers are mandated to contribute to the fund. the fund is then used to cover the cost of the fda in reviewing and approving their drugs. why could there not be an equivalent fund established by mandate for drug manufacturers to contribute significantly to the funds necessary to operate these monitoring programs? they benefit by it extraordinarily. there is no reason why they should not contribute to the solution to the problems created

by their drugs. >> thank you for the answer. my time is up. color: to working with both of you -- i look forward to working with both of you. the maker of oxycontin has taken responsible steps. others to take a leadership steps in response to the problems. one area where i was thinking more to be done was in providing warnings perhaps investing the link or amount of prescriptions, as you have suggested. i look forward to working with you. thank you, mr. chairman, for your work in this area. >> let me thank my colleague, senator brown, senator klobuchar, and senator limassol for participating in the hearing. -- senator blumenthal corporate is abating in the hearing. let me wrap up by saying how

impressed we have been by the information we have heard about the epidemic nature of the prescription drug problem and the rapid rate at which it is growing and affecting our emergency rooms, families, schools, communities. the areas that appear to need further attention and effort include public awareness. i was glad the director, mr. bill kerlikowske -- gil kerlikowske, was here to talk about that. we need to coordinate resources. it does appear the prescription drug motrin programs stand out as a growing and effective state-based vehicle for addressing the problem.

it is one that could be strengthened with further integration with electronic. carving -- with electronic prescribing and health records, the v.a., department of defense, and indian affairs, and improved a. in -- and improved interoperability was states. that seems to have come out of the hearing. we do not seem to be a good place yet with respect to the disposal of unused controlled pharmaceuticals. throwing them down the during creates one set of problems. leaving the cabinet creates another set of problems. we've not developed a robust system for disposing of them. we look forward to working with the pharmaceutical industry to come up with solutions. it is their product that is alternately at the heart of the problem.

-- ultimately at the heart of the problem. i appreciate you taking the time to share their expertise this morning. i appreciate very much miss hosley's work on the ground in ryeland with the kids at the center of our attention today. mr. eadie, for your many years of service. i think you are sort of the father of the pdmp movement. it is clearly a success story we want to build on as we continue to move forward and address the epidemic. we will keep the record of the hearing open for an additional seven days, a week, if anyone wishes to add anything to the record. other than that, the hearing will adjourn. thank you very much for your testimony. [captions copyright national cable satellite corp. 2011] [captioning performed by national captioning institute]

>> good job. >> and the same to you. very important work.

what's the republican senator and a cola. was a member of the gang of six.

he left the group on may 17. senator coburn talks about the debt situation, the gang of six. >> now available, the c-span congressional directory, a complete guide to the first session of the 112th congress. inside, new and returning house and senate members with contact information, including twitter addresses, information on the white house, supreme court, and governors. order online at c-span.org/shop >> next, a discussion on the unrest in the middle east. hanan ashrawi is a member of the executive committee of the palestinian liberation organization. she spoke at the carnegie endowment for international peace in washington, d.c. this is about 90 minutes.

>> welcome to another event on the arab spring. it is my pleasure to welcome dr. hanan ashrawi. she is not known to the rest of the world, but she is someone i can claim as a close friend. -- she is known to the rest of the world and someone i can claim as a friend. she needs no and introduction. she is the founder of the palestinian group for the promotion of dialogue and democracy. she is an elected member of the palestinian legislative council, the executive authority, the plo executive authority. she is more things than i can

start to count. one particular thing i particularly like about hanan is that she was always interested not just in peace but also in democracy, reform, institution- building. she is someone who has devoted her life towards these noble goals. it is a particular pleasure of mine to introduce hanan. will talk to us about the arab spring. then we can all engaged in conversation about this and other issues i am sure you are concerned with. hanan, welcome to carnegie. [applause]

x up of the context was palestine in the context of the arab spring. you are not going to avoid palestine. it is certainly a pleasure to be here with you and with marwan. if you have not read his book by now, those of you who have not should read it. you would have been prepared for the arab spring. they moderated the political agenda on peace but did not adopt reform on human rights and democracy. it seems to me that book certainly forecast what is going on with the arab world. it would have been a very good introduction for what is happening. those of you who have not woread

his national reform plan on i thought it could be the basis for national reform plans all over the world. we would like to incorporated into our national reform plan in palestine. you are a pioneer. you have a sense of foresight that should have been listened to very carefully. i think you for being a person with such astute in sight and foresight. those of you have read the u.n. human development report should not have been surprised by the young generation feeling disenfranchised, excluded, oppressed by the freedom deficit

and other deficits. we knew that those would -- that there would be serious upheaval with those demographics. unfortunately, most people were taken by surprise even though certain currents were beneath the serve in the -- beneath the service -- service and things were bring. again, people were surprised. we're used to talking about the arab world as polarized and the systems polarized in the sense that you have a national regime that is often seen as corrupt, autocratic, dictatorial, and so on. the only alternative was political islam. the people that get caught in the middle are the democratic

forces. this is certainly true. we had hoped in palestine we would avoid this. ultimately, it reflected on palestine. we can talk about that later. others were losing credibility and standing. they were seen by their own people as being despotic, autocratic, and repressive. another aspect that has been ignored is that they were helpless with the israeli injustice. they seemed to be incapable of standing up two arab causes in seen as doing the bidding for other external causes. many were seen as using the security excuse, that we have an external enemy to evade

democracy and human rights and accountability. the thought we musthother was exist with the current system. all of these contributed to the rift in palestine. the era of competition and polarization in palestine, particularly in the 1990's after the rise of hamas. the rift was used and abused for self-interest by different countries. we know that each country has different conditions.

there is a great deal of diversity in the arab world. a major feature is that we're in the midst of a time of flux, a change, a transition period that means by definition is that the specifics of the outcome are not certain. what is certain is that we're seeing a change, a definite break with the past and in many countries, of breaking through of the barrier of fear. that is important for the arab peoplee. . many people see this as a cry for dignity, empowerment, sharing in the resources of wealth, participating in democracy. but still, a great deal of arab

dignity, national arab dignity, has been affected in the face of the continuing indignity of the occupation. palestine has never been absent. emotive.ns vocal and the motiv many say the regime exploded palestine. others have a more visceral relationship to palestine, much more than people saw. we had several meetings with groups from jordan, lebanon, egypt, and other places. it was amazing how the young were really committed to the cause of palestine.

this is something that people like netanyahu and israel tried to ignore and say that the arab spring has nothing to do with palestine. the fate of the arab world has had a lot to do. the fate of palestine has had a lot to do with the things brewing in the middle east. the air spring will reflect on palestine. the emerging representative government will respond. that is internally and on the national level, the same principles apply to all. that bodes well for energizing

future. the engagement in the palestinian question and rectifying the previous perceived ordeal. that means they are standing of to their situation. this awakening resonated with in palestine and among the palestinian people as a whole. in many ways, it was seen as reminiscent of the first intifada were use of solidarity -- where you saw solidarity, a sense of respect, dignity, standing up. men and women were standing at the sink heavily armed israeli soldiers. this is a kind of invigorating energy that palestinians went through in the late 1980's and early 1990's. they saw the arabs bring us something reminiscent of that kind of movement.

residents -- it resonated with the youth in palestine and palestinian public opinion. all of the means of communication, networking, have come tomation be used not just by the arab youth but by palestine. have always relied on the international world because we are subject to control. the side effects have been expensive. the arab spring provided motivation and a common means of mobilization and the sharing of information. the identification of solidarity triggered further action. palestine is unique because

we're still under occupation. going tok when we're rise. we ask against whom and what. the movement in palestine is very active. the movement for change is still very active. other societies have been critical of palestine. people were looking for the right objectives, the right slogan at this time. some focus on the need to end the division. this became a slogan and rallying cry. this was a means of ending the occupation. under occupation, you have the internal domestic needs of putting one house in order and emphasizing reform. you also have the need to stand up to the occupation and get rid

of the occupation. the risks and efficient were one way in which the palestinians were weekend and could not face the occupation the way they should have. among the first visible effects or results of the arab perform is the reconciliation and unity within palestine. previously, the arab world cocontributed to the rift. now it is contrary to the healing of the rift. because of the pressure of public opinion and the youth, and because of the energized role of egypt, and because of the syrian crisis and what that is doing to hamas. there is a recognition that neither agenda really delivered,

neither of hamas with armed resistance nor the agenda of total commitment to negotiations. there was disaffection with both. the arab spring also enhanced the non-pilot process of resistance. -- non-violent process of resistance. this gave people hope that this would produce results where other things would not. the most visible outcome is the example of the may 15 marches and commemoration, not just within palestine but without palestine, as a result again of the communication and mobilization. proved there is an

additional aspect, a popular unity of the palestinian people, even in exile. the one aspect is that people always look at the palestinians after occupation, in the west bank, gaza, jerusalem, and so on. may 15 mobilized everybody, even the palestinians within israel. there was a sense of cohesion among palestinians that anywhere we are, we can present the same message. this is something new. it is part of the arab spring, regardless of the fact that some people try to exploit it. i think this is important. i think you will see a growing movement there. another outcome of the weakening was the redefinition of arab nationalism. hours to explorer

it completely. this is a new bottom up, grass- roots movement on the basis of shared values and aspirations. it is probably global in nature. it is also claimed in the arab world as part of their own people's rights. that is particularly true in discussing democracy, determination, accountability, and transparency, and so on. these were scenes as the means of reactivating the arab world and resolving longstanding grievances, problems within the arab system. this was seen to be more effective globally than the tired cliche s of traditional

slogans of the elite and the regime's. now there is a sense of a very active redefinition of arab nationalism. it is closely connected to the sense of arab identity and dignity. we're not part of the 19th century. we're catching up to the 21st century. another redefinition is that of leadership and the source of legitimacy and credibility. quite often,. bridges and leaders use -- quite often, the leaders use external forces as the source of their power and legitimacy. they do that rather than use their own constituency and responding to the needs and rights of their own people.

this is shifting. leadership and credibility do not come as a result of control or monopoly over the sources of power, be they will, natural resources, or control over information and media, all the traditional sources of power. there are new sources of power now available and accessible to the system. positions are inherited. -- positions are no longer in heretic within the society. the membership in the ruling party, egypt and tunisia demonstrated membership in the ruling party that is corrupt and controlling is a liability in the long run. this is what happened.

in palestine, it is going to be a more complex situation. it is no longer being part of the national struggle or membership in any faction or how many times you have been to jail, or the usual sort of nationalistic credentials. there are new elements based on the new definition of being a meritocracy, access to information, mobilization, as well as national commitment and being part of the struggle. this meant that the new leadership does not have the access of the old leadership to the streets, to the grass-roots .ovements

they have not been engaging in actual organization on the ground or in party politics. that has become a major weakness. they have three year medical know-how and ideas -- they have the theoretical know-how and ideas but they do not have the experience of organization, building parties and movements, and so on that you need to participate in elections and so on. you need that too. about a leadership that can really take over. -- union that we do you need that for a leadership to really take over. the lack of total preparedness is going to mean a time of transition. we know this transition is moving ahead in favor of the new

definition of leadership we talked about. also, there is a new coordination and identification with civil society whose role and influence is growing throughout the arab world because it was the most oppressed in many ways. now it can be part of shaping the agenda. palestine has been exposed to the failure of the two agenda s as we saw with the armed resistance in gaza and the changes in the political agenda of hamas and the ineffectiveness of only negotiations as a means of solutions. tremendous pressure was exercised on the leadership in acceptto carry out or excep

things that totally undermined them in eyes of their own people. there is a new agenda and empowerment and popular resistance. there's also the need for innovative politics linking to the energized arab world and in gauging the international community -- being engaged in the international community as an equal. we do have to have an agenda that works. you have to have a political vision of where you are going. this is important if the new leadership wants to succeed. there is an agenda in palestine committed to going to the u.n., for example. it is not an end in itself. it is a means. it is a way of validation and trying to achieve recognition of

your borders, your capital, and get access to international organizations that would hold israel accountable. our agenda it should involve nation-building and good governance. the arab spring shows the limitations of the role of the non-arab players. in many cases, it was exaggerated and needs further study. we believe we can influence non- arab states as well as receiving influence. and occupation cannot be really democratic. this is something we knew all along. they were caught entirely off guard and were trying to resist change. remember when people were

calling for regime change and getting rid of mubarak, it was netanyahu saying to keep him and protect him. how democratic are you if you are asking the u.s. to intervene in a domestic, democratic, a popular movement in egypt? the whole approach of israel is only what is good for israel and how can it subjugate the countries around and leadership to maintain the status quo. that is an impossible task. the status quo is certainly not sustainable. he cannot be maintained at all. even in syria, there were voices saying we have a common border with syria. everybody was telling them do not say that because you will condemn the regime.

rather than understanding why they are being isolated or why the occupation is legitimizing israeli policies, they started explain the arab movement is trying to isolate israel. this is misguided. instead of trying to understand the violence and brutality, there were instruments israel could use even obama said they were leaving themselves exposed to an international opinion that is watching and following what happens. netanyahu presented himself and his policies as being very regressive, out of step with the times, trying to hold on to obsolete forms of power and control, trying to maintain a system of domination that has no

place in the contemporary realities of the arab world. we can talk about his washington performance later if you wish. he certainly missed an opportunity to catch up and engage by presenting a bold vision, a plan rather than this sense of being overbearing and so on and trying to cloud the issues. his agenda was in contradiction with everything being imagined now in the region. he has all sorts of pre- conditions. all of the arabs have to become

extreme right-wing zionist but acknowledging the jewish state. when we ask for includes a democracy, we're being asked to deny our history and past and the rights of palestinians. except thet exclu exclusivity of israel. he has a precondition that will not be accepted. presented it as security for israel agenda. security is the defining principle. he wanted to maintain a military presence in the jordan valley and control over the borders and crossing points, early warning stations, a demilitarized palestinian state, and unilaterally decided on the outcome of the shape of peace and negotiations by saying no to

the refugees' right of return, note to jerusalem, and deciding single-handedly that they're going to annex all of the settlements. by condemning israel and palestinian unity, he says all they have to do is keep security. the west and is not represent all palestinians. -- the west bank does not represent all palestinians. now that you are you 19, you are having a palestinian equivalent of al qaeda as he called in. -- now that you are united, you are having a palestinian equivalent of al qaeda as he called it. this is a flimsy excuse for avoiding engagement. you do not ask every single party to accept a state or adopt a political platform for the country like israel wants.

we have a formula for our reunification. it puts together a government that is an address for providing services to the palestinian people, building institutions, and so on. it is going to be made up of independents and not card- carrying members of any party. the plo remains a political address for negotiations. the political program has not changed at all. for anybody who knows anything about the situation, you would know this is just a very flimsy pretext. it is an excuse that is baseless. it is a non-argument. i do not see why it was presented were believed -- or believed