loxin." are in a change of state in the country. >> dr. hart, can you tell us about yourself? >> im here because i came last year to chicago ideas, and i love chicago. hello, chicago. [applause] that is light i am really here -- why i am really here. i'm also here because i got partlyted in heroin because i really like opiates, myself, personally. research, and am also

really concerned about major distractions at the political level, particularly as it relates to drug. i have seen how drug use is used as a political football in order to distract us from what the real issues are. heroinhe situation with in the same way. i think we have to be careful in the country and that, when we talk about heroin being an epidemic, and then we start to look at heroin use, compared to other drugs, it pales in comparison to cocaine, marijuana. then, when we start talking about heroin o overdose deaths, 70% occur in combination sedative.er sid i start to see all of this

misinformation that distracts us from really dealing with what the real issues are. i get concerned, so i want to have my voice in that discussion. that is why i am here. >> great. chief, i read the you started your initiative with a post on facebook. how us a little bit about you are here and how this got started for you. >> it was started out of a community forum in gloucester, where we decided we needed to do more about the epidemic that affects so many communities. the police could definitely be doing more. my officers came to me and said, we are arresting the same people over and over again. they are back on the street, they are hurting themselves, hurting others. we decide to take a very provocative step, refusing to arrest any addict that walked into our police station.

up. has apparently blown [applause] is whatthe bottom line was the responsibility for gloucester has become the responsibility for half the region, and maybe larger. bring a new voice, a powerful voice, saying we are not going to do this anymore. it is a public health crisis, not a public safety crisis. >> a lot to unpack here. there are basically, by my count, five people appear who all think the previous approaches have not worked. how come we are still where we are? made the argument that things are starting to change. are they? i will start with you, governor. let's keep this free-flowing.

feel free to jump in. >> can you tell us where we are first? i will putt you> -- this back to you. you said we are playing political football. in some of the numbers i put out there, you were saying the context -- you talked about the epidemic. when you look at something who have usedke heroin in the last month -- that is like an indication of recent heroin users. when you look at that number, there are about 30 300,000 users in the last month. that number is down from 2006. but, if you look at the last year, who has used the drug in the last year? that number is up. it all depends on what your indicators are. we have to be careful.

when i say, where we are, i ain't concerned that we tend to think about heroin use -- we tend to go to the frame of the heroin addict. the vast majority of people who use heroin are not addicts. obviously, with the chief is doing is creative, innovative, and i think a great approach. the thing we have to be careful about is just remember, there are people who do not need treatment, they need education about what the real dangers are. shot at youre a question. i think what we have to remember is we are not talking about heroin, we're talking about opiates and painkillers. in my state of vermont, which standards ofe best life in the country -- better than chicago?

>> better than chicago. i'm not getting votes here. [laughter] oxycontin,a approved and we started handing it out, think about this -- in 2010, we prescribed enough oxycontin in america to keep every single american adult high for one month. that is what we did. the companies who sell it got $100 million that year. two weeks ago, fda approved oxycontin for kids. one year and a half ago, they cottond what is aussie -- oxycontin on steroids. this is not a huge puzzle. we started passing out oxycontin, we created an opiate

problem in america that is now transforming into heroin addiction because it is cheaper, stronger, and easier to get. we should not be having a lot of debate about what the problem is, the problem is we have way too many people addicted to opiates. if we do not quickly have a conversation about how we treat pain, we will not only have many more people dying, many more destroyed,ves being but we will continue to lose the of our qualityc of life. > the average user is not an

addict, and not necessarily a user, right? >> i think there is a tension that we think may be different -- that is the moral panic associated with drug scares. we know there will be another drug that will come along that the same kind of concern among people. going to change. what is changing is the way we are treating people with opiate use disorders. p seeingaming of people with addiction as people who need help and care, to me, influences the entire drug discussion. we can debate whether or not it , about themic

household data, but obviously, it is clear that there is an increase in deaths, and what i see is the way we are coming at it is fundamentally different than the way we were coming at it, what the chief is doing, what states are doing, is different than what it was 15 years ago. hugely different, more effective. >> so, i just met you. [laughter] ainth s good. >> i love you. everything will percent -- every single person -- is addiction a disease?

>> of course. why is that everything will person addicted to heroin getting treatment now? >> that does not have to do with the number. >> irresponsible, and not correct. everything oh percent who presents to law enforcement and the government is addicted without choice and deserves treatment. you staying that -- >> i did not say that. please, do not misconstrue my words. what i said is the vast majority of people who use heroin are not addicts. not the vast majority who present to you, but the majority. >> i think it is irresponsible. >> it is reality. the facts are facts.

>> it is difficult to untangle this because there is something called selection bias. the people presenting themselves in our communities are addicted to heroin. that does not mean that every person using heroin or opiates is addicted. that is important. >> what are we talking about by addiction? >> what i am talking about is what we talk about in medicine. there are a set of criteria by which we go by and we determined people are addicts. it is clear that people can become addicted to heroin and prescription opiates because they do. the point here is when we have these extreme terms, labeling

things, who uses these like the vast majority who use opiates do so safely, and according to their prescriptions. everyone who is using these things are addicts, what we do is run the risk of restricting, or eliminating, this important tool in medicine. >> let me rest likely disagree -- respectfully disagree with your statement. as governor, i have constituent after constituent who comes to me and says, i went in for this and had , and handed oxycontin, and that is what leads me to addiction. that is the reality of what we deal with. we can talk about the nuances

fear the question for this panel is, what the heck are we going to do about it? >> first of all, we have to define the issues. >> for me, the issue is i have too many vermonters dying, ripping off their family, fighting the most difficult, awful disease i have ever learned about, which is opiate addiction because they are addicted. that is my problem. >> if we are saying they are dying, we have to find out why they are dying. 75% of them are dying because they are using heroin with other things, you have to educate them to not use that combination. >> we are talking about several different issues at once. there is an issue of people which, the use, anecdotally, at least, seems to

be connected. we're talking about criminal justice issues, people committing auxiliary crime use drugs.y want to we are talking about the drug market created because of neighborhoods and seat out, or whatever. we're talking about all of these different things at once, and also the political response to these things, which right now, is heightened because, i would argue, the visible signs of heroin abuse, mainly overdoses, have moved into areas that have not traditionally seen them. >> can i say one thing?

is mydy asked me, daughter uses this drug, is she automatically an addict? no, that is not accurate. we need to be having honest conversations. drugs are not magical. causes us to this become addicted. thatis probably underlying substance use disorder is some co-occurringding -- disorder, that someone is self-medicating for. that is important for us to a knowledge. we do not want to give the wrong message so that a kid goes and uses heroin, and says, i did not

get addicted. the idea of being real about what we are saying to kids and to the public about the effects of substances needs to be grounded in science. >> one of the reasons i think we are here is because if not the rise of overdoses, the coverage e of overdoses. maybe we can agree on that, and if not, i'm still the moderator for five more minutes. have are other places that tried different approaches. i will throw out portugal where basically drugs have been decriminalized. if someone is essentially cut with different circumstances, including heroin, they are steered towards treatment. correct me if that is not right. > what they do in portugal is

you get assessed to see if you need treatment, but the vast majority do not need treatment. they may get a fine, or they may get a warning, but the vast majority do not need treatment. the same is true in the czech republic. for our discussion, since we are talking about heroin, we should .hink about the swiss i spent the last three months studying heroin in heroin clinics, where they actually gave heroin to people in the clinics. they go to work, take care of their families. >> this is something that happened in this country. >> of course, they are in treatment. >> just to clarify --

>> i don't know why i am here if there's not an addiction problem. there is a vast majority of people addicted to this drug, and a vast majority of people addicted to pharmaceuticals. is ank to underplay that very, very dangerous path to take. just because no one has presented to a police department iho is not addicted -- understand what you are saying, but i have never met any ancillary people who say, my kid is on heroin, but not addicted. i think the clarify message here is whether you are right, whether someone else's right, there are people -- there are vast numbers of people who are treatmentg

for addiction. that has to change for the vast number of reasons that we are here. >> i want to go to the chiefs point. i can tell you what we are doing in for a month. power to portugal, switzerland, wherever, but we are in chicago. i think we have to ask ourselves, what will we do in the united states of america. in vermont, we were doing everything wrong. everything. we say to folks who need treatment, go to jail. we say to folks who need treatment, you are in a different class of people than everyone else who is sick. the criminal justice system, with all the good intentions, and all the hard work, the chief

has come to the right conclusion, and more folks sure. we are saying to them, this is your problem -- get the numbers on this. spent 1135 dollars per week putting people in prison. it costs me $120 per week to put treatment a great problem. there is a huge denial factor. with opiate addiction, put that denial on steroids. i would found that we would make the arrest, all research suggests that is the best

possibility for treatment. months forke 4-5 them to get to the court system, and by the time they got to a judge, they were already using again. what did we do in vermont? we had people come in and say, this is someone suffering from a disease. they should get back in the workforce, and back into productive lives. treatmentut our centers because we were telling people to wait in line, and we as a it from being treated criminal prosecution, to be treated as the disease it is. we are out of time, but what you are talking about is, in some ways, moving towards the treatment model.

>> there is not enough time to deal with some of the statements that have been made. this is a fraud, this conversation. >> you are wrong. >> we will take some questions. >> i'm sorry this is a fraud. i did not fly 1000 miles to come down here, and have the person sitting next to me say the people coming to my station, asking for help, is a fraud. >> do not point your finger at me. >> gentleman, we are going to have some questions from the audience. we all have different views of this, from different positions, different angles. please, be respectful. say, you are so disrespectful to those of us here.

>> ok. >> we want to hear from all of gets a little it passion to appear -- i think that is a good thing -- actually, i think this is a great discussion. >> good afternoon, almost evening, my question is, dr. carl hart, what else would you like to tell us? >> thank you. number one, no one is saying not addiction is serious problem. the point i was making is that people who use struts are not addicts. if you treat everyone in these extreme anecdotal cases, you are going to go down the wrong path, and miss an opportunity to actually help people. ,f we are worried about deaths for example, tainted heroin, if

we are worried about tainted heroin, why don't police forces publish what heroin is tainted for local communities to know. heroin itself is not as dangerous -- this does not mean people should go out and use heroin -- it is not as dangerous and not as likely to cause an overdose, particularly in people using heroin for a while. usedrry about heroin being in combination with other sedatives. that is the message we should be getting out. >> a quick response? >> first of all, i would like to apologize. opinion,has earned his for anyone listening. it is no disrespect for you, dr. hart. the reason we do not publish what we think is bad is because

we do not think there is any good heroin. that is our feeling in policing, not publishing what is a particularly bad batch. >> my name is kim. , from myon is perspective, is heroin addictive -- i don't know much about it. everything i have read about or viewed seems like you cannot really use it recreationally. if you use it once or twice, it is like that slippery slope. >> yes, you can use it recreationally>, and this is not an endorsement to use it recreationally. >> it seems like the repercussions of it our way

severe, andore people's lives seem to spiral out of control. andnce you have a habit psychological dependence, if you don't have access to opiates or heroin, you're going to be sick. that is the point at which you are dependent. you might not even have substance use disorder addictive behavior if you end it there. i will tell you, from my andrience, that is strong, it happens quickly. that is obviously different for every person. have i known people who have recreationally used heroin? i have known people. i have no more people who did not get addicted in the circle of people that i knew, then the people who did get addicted.

that is not to say that we do with the wayoblem, we have been approaching the spirit that is where i think we can probably agree that the way we are trying to approach this in a different way is a much better way to deal with it. >> can i quickly take a shot? opioids are highly addictive drugs. if you start to take oxycontin on a continual basis, you will be addicted. in any kindheroin of continual way, you will be addictive. i'm surprised that people are suggesting this is not a terrible, terrible disease to

get, and the way to avoid it is to not take it in the first place. there is a line of thinking that if you put out the word that every time you are to get heroin, you will be addicted, that is misinformation, and makes the situation worse because some people think everything they have heard is wrong, and that can draw people deeper into use and abuse. >> and that there is no withdrawal syndrome, it only happens to other people. that way.seductive for the people who are going to develop substance use disorders, there is a honeymoon period. they do not see this coming, it happens, and when you dig deeper, it is not just the use

of drugs. why are they using the drugs in the first place. not taking are potent painkiller if you are not in pain. you could be doing it recreationally, but you're not doing it every day unless you are dealing with some pain. i think when you do that a lot, thatave to recognize that is indicative of another issue. i just want us to not think of asoin as magic, or opiates magic. it is about the underlying conditions in which the person is living, it is there an environment -- their environment . andou prescribed oxycontin are working, but then you get laid off the next day, that use,

which may have been prescribed, might give you a different feeling. it might make you feel less about your job. you might take more. it is not just about the jugs, but about the environment, the individual, and all of these different things. >> we all agree on that, i think. i'm a physician, a researcher, i have to get in like a surgeon, and go to the heart of this. whether or not we're talking addiction, casual use, the amount that our profession has done is a factor. doctors, andm of we were told to treat pain. could talk about the pain -- it is so may factors that to tease them

out right now, we could not do that. clearly, when i look at 80 people in my city, i am not going to sit on the head of a pin, and wonder whether or not that person was an addict. it is a moment in history when there is a disruption. hart, would you give as an anecdote to what is going on in these communities? thank you. >> that is a question to me. right on. >> [indiscernible] what they are trying to do is change the paradigm of how we wake up every morning. >> thank you.

you asked what i would do. issue, the at this people that are most likely to be addicted to heroin are white men, to lee young white men in their 20's, unemployed, uninsured. poor white men are the primary people we are concerned about. the issues that you raised. i think about making sure they have something to do, activities. they are not the most likely people to die of heroin. the most likely people to die are people that are 45-50 years old. they are that keep who are taking also other medications. that would require another solution. that is all i am trying to do, tell people to look specifically

at what group we are talking about, instead of lumping this whole thing into one problem. [indiscernible] what is it you would put in everyone's mind, whether you are the least sergeant, or the government? let's get creative. >> can i answer that one? we are trying get in vermont. our most successful example is happening in rutland, vermont. everyone came together, and said, we have to deal with this. we later the put everyone on one floor. everyone is there. community workers. we monitored with the police and literally went

into the houses, not on doors, and said, what is going on with your life? how can we preempt the disaster before it ends up in death? effectivee most thing, as far as prevention. what do we do to cut this off in the first place? we talkes me that as about the things we are trying to do, the crises we are facing, and everybody from hillary , we still jeb bush refuse, as a nation, to talk about what you brought up in the first place which is the way we deal with pain and pain medication has changed drastically since the approval of oxycontin. we will be having this conversation for years and years, and losing more lives.

>> i'm michelle. conversation. the thank you, dr. hart, for your point of view. pose a question to everybody. my stance is that all drug .hould the legalized i think people should be able to use them recreationally. >> i think drug should be decriminalized. i think we need to implement something like a portugal model. i cannot think of any country in the world that has legalized all drugs. i'm a pragmatic person in that sense. i like to see what a model looks like before i understand how that could be implemented. i do think there is a lot that can be done on the public health

front. i do not see what that could look like. i don't see how the regulation or education -- what does that mean. when people say, let's legalize all drugs. what does that mean? can i buy it in a 7-eleven, can vs, what does that mean? i will just say, that is a really complicated question. you need to operationalize what legalization means. i am a governor, not a federal guide, i deal with the tools i have. in effect, that is what we are doing by saying, it is a disease, we will treat it as a disease. in vermont, if you are busted for heroin, or opiate addiction, or other drugs, and you are not deemed to be a threat to the community, only to yourself,

which is true with most addicts, you will never see a judge, never see a criminal record, or in criminal process when you join up and deal with the .isease that, in effect, is what we are doing, saying, listen, the past has not worked, we have to figure out how to shut off the supply, but meanwhile, we will treat this as the disease that it is, no different from kidney disease, heart disease. ,> in terms of operationalizing this is not that complicated. we put people on the moon. we say operationalize, when you think about regulating marijuana, or regulating drugs, you can regulate it in the same way we regulate things like alcohol. that is not the complicated.

in terms of the governor's response, treating this like a disease, that is great, particularly for people who have the problem of drug addiction. that is absolutely great. then, you still have these people who are not addicted, and are using these drugs recreationally. what do you do about those people? they are adults. do adults have the right to use psychoactive substances to alter thatelves in the same way some of you all will go tonight, particularly after this conversation and have alcohol? do adults have the right to go and alter themselves with an opiate? with cocaine? >> from a law-enforcement standpoint, you will get a law enforcement answer. i think you will like it, actually. [laughter]

marijuana will be legal, whether not, andt or law-enforcement. someone asked me, what will you do when marijuana is legalized? on my go smoke a fatty front porch. we have to make it so people who cannot make choices for themselves, under 21, can be regulated. we have to make it so that someone does not get in a car, and drive. we have to make it so that someone does not go to the workplace, and affect someone adversely. alcohol and tobacco were invented today, with all the destruction they have caused over the last 100 years, the billions and billions and aliens upon billions -- billions upon , they would be legal before they hit the market.

>> thank you. i am the moderator. i will say one quick thing. i write about politics. i do not think this is simple at all. marijuana is clearly going the way of legalization around the country. here in illinois -- illinois is screwed up in so many ways -- you cannot even get a medical marijuana program off the ground. there is a lot of money involved. i definitely think we should and politicalls debates, at the highest level, about what to do about all drugs, including alcohol, tobacco, which are legalize drugs now. anyway, i'm reading from the script now. thank you for taking part in the conversation today on the heroin epidemic. make sure to check out the ideas week, and tell us what you thought of today's event. i'm sure you had no opinions whatsoever, just like the

panelists. [laughter] "ideas" to fill out a survey. thanks for being here. thank you to the panelists. [applause] >> john hinckley was the person reagan. president lin president reagan was not wearing a bulletproof vest, it was a short trip. >> sunday on "q&a," the author , "assassinations, threats, and the american presidency." been 16 president to have faced assassination nonets, though directly eyeball to eyeball. i also covered three

presidential candidates. i talked about huey long, who was assassinated. i talk about robert kennedy, who was assassinated. and, george wallace, who was shot and paralyzed for life in 1972. i cover candidates, as well as presidents. it is a long list. >> sunday night on c-span's "q&a." >> all persons having business before the audible supreme court of the united states are admonished to draw near and give their attention. >> coming up on c-span's, "my cases." landmark >> she grabbed it out of his hand to look at it, and a scuffle started, and she put this piece of paper into her

bosom. and, very readily, the police officer put his hand into her bosom, and removed the paper. her while, handcuffed the police officers started to search. >> in 1957, the cleveland police went to the home, where they bomber, andbe a demanded entry. she refused entry without a worry. rant.r she was arrested and sentenced years for contraband. she sued, and her case reached the supreme court. versus explore mapp

ohio, and how this and other supreme court cases impacted policing practices. for background on each case what you watch, or do your copy of the "landmark cases" companion book. it is available for $8.95 at c-span.org. >> coke industry -- koch industries spokesman, steve lombardo, recently discussed the koch brothers. andcs included think tanks politics supported by the koch brothers. this is 45 minutes.

>> good morning. on behalf of faculty, staff, and students, i would like to welcome you and thank you for joining us this morning. the institute's mission is to educate, engage, and empower students of all ages to actively civic democracy. this morning speaker, stephen ve lombardo, is an alumni of say anselm college. lombarorning, mr. the beyond thedo political spin here go following his speech, we will have a brief question and answer

period. please wait for the microphone to reach you before beginning your question. ladies and gentlemen, please welcome steve lombardo. [applause] lombardo: thank you. i always appreciate those comments. it is a pleasure to be here with everyone. i understand that donald trump will be here tomorrow. similarbe, may be a sized audience. in the spirit of mr. trump, i will estimate this crowd of 5000 people. everyone ok with that? [laughter] i think, maybe 30 years ago, or so, then i walked across the stage on this campus, and accepted a diploma, much to my professors and my parents dismay . it was a special place.

it is great to be back. it's incredible to see what has gone on here, frankly, the size and scope. the facilities are amazing. it is really terrific to be back. i graduated with a degree in political science. the lessons i learned from that, thefrom the experience from professors. i learned the integrity that they instilled with people like myelf has stayed with me entire career. it has been a few years since i have been back, but the amazing and the on campus, as ever.re as vibrant i have won a number of hats in my life and career. i am currently, as mentioned, serve as communications and marketing officer for coke industries. our principal shareholders are charles and david koch.

don't lie, that name either makes you shutter or smile based on your political perspective. what i want to do today is talk about the company i work for, the people i work for, and what they stand for, what we do, and have a discussion about that. i look forward to that discussion. based on what you have read on tv, you have come in with a perception, a preconceived notion. perhaps what you have heard over the years may or may not be accurate. what i hope to do is fill in the information got for you might have, and talk a little bit about what we do. to kick things off, let me ask you a question. if i ask you, do you want to live in a country that maximizes these and stability, and

citizens, i'm pretty sure your answer would be yes. if i asked you if you believe in integrity, respect, responsibility, and tolerance, and they are important qualities to have, both as a person and a nation, i'm pretty sure your answer will be yes. if i asked you what is the best way to promote and preserve these qualities, my guess is the answers would start to vary. that is because there are remarkably different and competing views on how to achieve those goals. that is what i want to talk to you a bit about this morning. for example, one vision is a vision that believes in life, liberty, and the pursuit of happiness. with minimal interference from government. another vision leaves most decision-making, within reasonable limits, to the individual. a much different vision believes

that governments must actively intervene. it is a vision of the police government usuallyand the .ndividual 200 years ago, thomas jefferson predicted which of these two visions would have the upper hand. he said, "the natural progress of these things is for it is sad to say that prediction has very much come true. does that sound extreme are extremely inaccurate to you? consider a few fact about our nation. first, occupational licensing requirements which make obtaining certain jobs enormously burdens and especially for low income and .inority jobseekers in several states in fact, hair braiding, license requires more