Skip to main content

tv   Key Capitol Hill Hearings  CSPAN  March 23, 2016 4:00am-6:01am EDT

4:00 am
misinformation from drug companies that these are not addictive medications. think quite honestly in the middle of an epidemic it is unreasonable to ask a prescriber to take a minimal amount of education. if you look at the overdoses that we have seen, there is a direct correlation between the amount of prescriptions that we are giving out and overdose death did it has been going on for 10 years. i think the metal community has a role to play. >> what about liability? drug companies and the docs who push this out there. people are getting addicted like that. >> i agree. they have a role to play, not only in terms of making sure they are reading the letter of the law in terms of marketing. we do need to work with the da and others to go after outline
4:01 am
prescribers who are wantonly ignoring the law. you're right. we need the scrapper education. good discussion junk monitoring programs. physicians can identify people who are going from doctor to doctor. to your point, if we are going to reduce the magnitude of the problem, we've got to scale back on the prescribing. identify people who are starting to develop problems. -- >> every kid told me the same thing, he started with marijuana could then they go on to the rest of it -- marijuana. then they go on to the rest of it. we have a serious problem in this country. mr. wahlberg's next. gentle and from michigan. -- gentleman from michigan.
4:02 am
>> inc. you mr. chairman. -- thank you mr. chairman. i apologize for being out. rosie the riveter showed up. it does affect all of us. my district in southeast and the south central michigan has tremendous challenges. i appreciate efforts all of you have shown toward this issue. mr. milione, how long has the dea and aware of the increased prevalence of that null laced drugs. how are you responding specifically? >> we have been aware of fennel going back several years. we have seen it fled the country. what we are doing? we do basically what we're doing with all criminal investigations. criminal trafficking organizations. capture and convict them. we are try to educate our state
4:03 am
and locals of other risk associated with fentanyl. it is a multipronged approach. -- multipronged approach. the users are being exposed when it is combined with heroin or put into a replica of an opioid pill. >> are those especial enforcement challenges that you have? or are there others? >> there is a whole panoply of challenges. it poses a risk to law enforcement brother and sisters -- brothers and sisters who encounter fentanyl. it can be inhaled with tragic consequent is. it is a major problem for us. for users and for the country. >> what has the da learned about the source of fentanyl when it appears in heroin? >> to primary sources. the majority coming up from mexico with precursors an actual
4:04 am
fentanyl shipped from china into mexico and then it crosses the southwest border, particularly up in the northeast. the readily from china. -- then directly from china. >> it is my understanding that mix go has been a primary source. been a mexico has primary source. is that true? how have you worked to decrease this trafficking? any additional efforts that you can talk about? >> we have a great relationship. it is not our largest office in the -- in mexico. we have a great relationship with our counterparts. the cartel is probably the most powerful cartel down there good it is a trim it -- it has a command is this to be ship cartel. they are flooding the country with heroin but they are also flooding it with fentanyl. we are going to continue an
4:05 am
aggressive reproach -- aggressive approach on the law-enforcement side. efforts is the u.s. engaging in to work with governments where heroin is produced to cut off the supply? involve, this identifying labs in countries like mexico which may be trafficking bonanza of heroin and fentanyl in the united states. what are the biggest barriers? ,> as we look at this issue having an aggressive approach that reduces just that reduces simple -- that reduces supply. i was just in mexico meeting with the attorney general calling for enhanced action, but deeply as it relates to heroin, looking at enhanced eradication efforts. looking at how we go after labs.
4:06 am
how we continue to support mutual collaboration on going after the organizations that deal with it. we have been working with the reducing andng at going after those organizations that are trafficking heroin and fentanyl domestically. it is important for us to have this holistic approach and to focus on a robust law enforcement response to reduce the availability of heroin and fentanyl. we have to look at how we work with our customs and border protection. to decrease detection -- to increase detection of heroin and fentanyl and we have to look at our international work with produces these precursor chemicals desk precursor chemicals. we were pleased that china moved schedule over 130 substances, .ncluding one of the precursors it is important for us to work
4:07 am
with our international partners, --ifully china, mexico particularly china, mexico. >> the gentleman from pennsylvania. >> thank you actor chair -- thank you acting chair. thank you to all the witnesses. i have listened to all of your testimony. it is well taken. i come from pennsylvania. pennsylvania, hospitalizations for overdoses due to pain medication increased 225% from 2000 to 2014. drug overdose deaths in pennsylvania increased by 12.9% between 2013 and 2014. increaseto a 6.5% nationally in the same time. -- time period. it is a huge problem in pennsylvania. mr. botticelli you mentioned
4:08 am
attending a town hall. . did a townhall in my region sadly we get between 30 and 40 desk typically we get 3040 people out. at this one we had over one at people come out. nobody was smiling. every family is touched by this crisis, by this epidemic. the question is what can be done to combat it? there is a company, evoke of pharmaceuticals that is using nanotechnology and is following the fda technology to use the most effective dose for chronic pain and it is an afghan american owned company that is growing -- and african american company that is going by the month. a logical solution to our opioid epidemic. i also believe there are legislative solutions to help
4:09 am
adjust the issues. 953, the conference of addiction and recovery act. how this was introduced in the house i be representative of wisconsin. in the senate, the same bill was introduced by senator whitehouse of rhode island. that bill passed the senate. in the house, i am a cosponsor of 953. it is a bill that would adjust edge -- existing authorizations to provide incentives to help of care providers, law enforcement officials, state and local governments expand drug treatment prevention and recovery efforts. through funding toward those efforts. i wish to urge republican leadership to move hr 953 through the house floor for a vote. it is a concrete step we can
4:10 am
take in the right direction. lynch talkedmr. about new england. the new england area has been referred to as "the cradle of the heroin epidemic." i see you nodding your head mr. milione. you are aware that. >> yes or. >> -- yes sir. >> 63 point 4% of new england law-enforcement agencies reported heroin as their greatest drug threat. just last week, governor charlie barker making massachusetts the first state to pass a statewide cap on first time opioid restrictions. my question is with the rising numbers of opioid gifts, what steps has the dea taken to collaborate with the state and local law enforcement agencies
4:11 am
to reduce opioid overdoses and deaths? >> copies meant thank you. -- congressman, thank you. we've got a great relationship with the u.s. attorney's office. they are brought together all of the different elements working with the community to identify with the hotspots are. also do the enforcement on the groups that are trafficking in those substances. >> dr. botticelli, how is the federal government working to encourage innovative ideas by the state to combat the opioid epidemic? >> i think there are a number of ways that we are doing that. looking at funding opportunities to provide states with the opportunities to create innovative strategies. one of the things that our office does is look at how do we promote some of the innovative things that are happening at the state levels. whether that is law enforcement that are working to get people into treatment, or things like
4:12 am
the 21st -- the 20 47 triage programs. 24/seven triage programs. secretary tennyson in pennsylvania has been mistreated some strong leadership in terms of the work that is happening here. i talked with the secretary just about every day in terms of looking at what more the federal government can do. the largest auction that we have is making sure the locals could the resources they need to continue to develop and show leadership on this issue. >> amen to that. i yield back mr. chair. recognize georgia. >> thank you, the cdc in georgia has reported that georgia alone has seen a 10% increase in overdose deaths. i'm sure you have seen that in the last couple of years. to me, this is alarming just by the fact that high school students are using painkillers
4:13 am
at alarming rates which makes them 40 times more vulnerable to use heroin. the dea said that heroin is available in larger quantities. that it is used by a large number of people and it is causing an increasing number of overdose deaths. is that correct? >> i want to focus on where the stuff is coming from. mr. milione, let me start with you. from your testimony, regarding the dea's new strategy which you referred to, it sounds to me like the dea is going to focus less on the mexico-based organizations that are trafficking heroin and focus more on the street gangs that are distributing heroin, is that correct?
4:14 am
>> it is not. it is more nuanced. we are never going to go away from our core mission. the 360 focuses on the link point that bridges the violent distribution that are affecting the communities and also the cartels that are flooding the country. it is actually not one of the other. it is a conference of approach. >> is there a greater emphasis on the dish to be since i do things? >> i would not say a greater emphasis. it is a shift of focus so that we can do everything we can to get the violent disturbance in sales under control. ours it fair to say that interdiction efforts with the cartels have failed? or at least not been as successful as we have hoped? >> i would not characterize it as a failure did interdiction is one part -- failure. interdiction is one part of it. we are focused on going after the individuals were selling the powder and pushing it. the money, those of the things
4:15 am
we're focused on. interdiction is one part of that. >> it sounds to me you were saying the emphasis is going to be on the description set of things. say that the focus is going to just be on the decision. >> i did not just say -- i shake my head with all of this because we have been at this war on drugs forever. it is getting worse. we're not making any headway. you mention and while ago that we have a great relationship --h the mexican government you mentioned a while ago that we have a great relationship with the mexican government. the reality is heroin is coming across the border more now than it ever had. what good is a greatly ship if we are not addressing the problem. at this point, this thing is getting worse and worse. we are throwing more money to it all the time.
4:16 am
frankly it doesn't appear to me as though anything is happening that would problem go to the point of what you said a while ago that we are addressing this aggressively. >> congressman, as someone who served for 20 years and have seen the sacrifices that the brave men and women do every day , we are doing every thing we can to deal with a very difficult and complicated problem. we are working to reduce demand, but we have to go after the organizations that are flooding our country. the war on drugs is not necessarily a phrase we would use. we do criminal investigations into highly dangerous and sophisticate cartels operating >> i take my hat off to the ages out in the field. -- the agents out in the field. but for us to come in here and i quite we are painting a picture that we are -- >> i have to disagree.
4:17 am
>> you can does recall you want, that the problem is it is getting worse. >> there are parts of it that are getting worse. thatnot painting a picture is inaccurate when i say that we are aggressively going at it. we're doing every thing we can. >> how many criminals have been arrested under dea's rolling thunder graham? -- thunder program? >> i can i give you a number. >> you do not know any number of arrests? >> i left to get back to you. -- i will have to get back to you. california,al of mr. d selling you a. you are recognized. >> we appreciate the panel. about us have stories constituents who have been affected by this and the
4:18 am
frustration that some of my colleagues and our inabilities to deal with the drug problem the matter what we try. i would like to ask a couple of questions on the opiate side. me constituent who came to and made me aware of her personal situation where her son was going to school at the university of arizona and drove to los angeles with some other students to go to a doctor in overdosed. and then the doctor was recently convicted of multiple convictions in los angeles. another constituent th went up to a baskin-robbins and one of his two kids was killed right in front of them when a woman who had been abusing opiates and drinking came across. all of us have the stories. one of things we are able to do a california was update our prescription monitoring system. my question is around electronic health records where i would talk to doctors and say about --
4:19 am
electronic health records are right around the corner. we worked with the attorney .eneral in california that process is in effect now. we're waiting to see how effective that is. mr. botticelli, maybe you could tell us just one of the freshening things is when you have this patchwork of different states on different things, it seems to me to be fairly efficient for the government to provide the info structure for nationwide electronic monitoring systems so that the department of justice in all 50 states would have red flags so they would see if a doctor is abusing his or her privileges. or if a client is doctor shopping. >> perception drug monitoring programs have been a part of our main emphasis. to your point, we're seeing at your medicine amount of success. -- we had so many
4:20 am
states that as a many existing programs. what we are try to focus on next is interstate data sharing. so that states can talk to each with and interoperability electronic health records. that is the next phase. we want to be responsive in terms of the burden of workload and look at how do we get tammy information to them by supporting that yak -- did timely information to them by supporting that. talking to the national governors association in terms of what states can do. one of the more effective tools that we have seen it we also need physicians to use them. part of this isi think we are past mentor- education but like massachusetts just did, taking the prescription junk monitoring
4:21 am
program -- perception drug monitoring program. so they are only as good as when people use them. >> maybe you could talk to this. in northern california, we have a lot of kaiser clients. there is a financial aspect to this. for them, if they were able to use electronic records for the cost and efficient use, but also to protect doctors from being overly prescribed. how far away are we from having a strong electronic monitoring system that can do both? >> we are seeing in some states rate progress. in 2000 talk, we had the opportunity to issue -- the and operability with the hr and the interstate and operability.
4:22 am
during the. of the grant, with that six out of the nine states that were able to achieve the -- we had two more states that are online with our mo use so they should be up to start exchanging information there is a. out -- very soon. ondcp weith cdc and were able to get eight out of nine states to achieve that level of and operability. -- of an operability. >> we use over 80% of the opiates how much of this is a criminal aspect of it? >> i was a very little good i think this is just very little. i think this is been a concerted effort by the pharmaceutical company to look at falsely promoting medications. in 2013, we prescribed a number of discussion medications to is why the-- that
4:23 am
cdc guidelines become so important at looking at not looking at therapy as a first-line defense for chronic pain. for some people who need them, starting with the lowest dosage and the smallest possible amount. i do believe we have made progress in many areas and i don't believe we have made enough progress in incrementing safe opioid prescribing behavior. >> thank you. let me recognize mr. carter from george are. let's think you for being here. i have been in and out. i apologize. myself withsociate all of the comments that have been made about marijuana being a gateway drug and leading to drug abuse. i could not fill more at me about that just feel more adamantly about that. -- feel more adamantly about that. i am the only pharmacist in
4:24 am
congress. i have more than 35 years of experience. i am very blessed that have never taken any drugs. never had that you diane human and i have weaknesses -- never had that. i am human and i have weaknesses. this is very uncomfortable. i would tell you that a little in -- almost a year ago tampa, a judge ruled against the actions of the da and you rated the compounding pharmacy. you destroy the medication and shoved that the pharmacy without any real cause. this is westchase pharmacy in florida p are you familiar? >> i am not here to >> you need to be. this is not a shining example that you want to point toward good this is an example with one of your supervisors inducted a raid desk conducted a raid -- conducted a raid. had not read the da test the dea
4:25 am
handbook. handbook. seized hundreds of thousands of dollars in medicine. all because the dea misinterpreted and failed to follow their own walls. it this own laws here is foster's -- their own laws. this is preposterous. i support the dea. we've got bad pharmacies. we've got bad pharmacist and doctors. dr. wen, there are bad doctors. you cannot paint with a broad brush. is totallyf action of acceptable. especially when you have someone come to your pharmacy bearing guns, that is unacceptable. i hope you look at that. it is westchase pharmacy.
4:26 am
i hope you'll research that. i want to ask you, dr. wen, we have talked about opioids being drug forhe entry-level pain control. one of the is the fdasee here medicines off the market. much i imagine how dispensed in my career. when they took it off, what did he do? and lead people into opioids. it was the only choice -- it lead people into opioids. it was the only choice. the practicing pharmacists, i can tell you, you try to get a patient to take something that is available without a
4:27 am
prescription, you are not going to be up to convince them that it is going to work. that is just the way it is. it is not right. i will try as hard as i can and i cannot convince them. -- don't the oxygen give me the white one. the pink one, that is the only one that works. one of the problems i think is -- i know that it has its problems. i am not trying to question that. what i am try to point out is we need more entry-level drugs, something in between opioids and ibuprofen and acetaminophen. those would be better. the cdc guidelines that have come out for prescribing guidelines for doctors, i think that is very helpful. it needs to be enforced more. it needs to have some sort of teeth in it. i'm running out of time because of want to get to so my things. another problem is mail-order pharmacies sitting these gigantic -- sending these
4:28 am
gigantic containers of opioids to the doorsteps of people, -- who them for them knows what is good to happen to them? you get a 90 day supply. they bring into this drug stores all the time giant containers of opioids. that needs to be suppressed. the dea needs to do something about that. that is ridiculous and something we need to address. the last thing i want to talk about is 21st century cures. 21sta big proponent of century cures. it is some of the best legislation with past its i have been in congress. that locked in provision is very dangerous. you have a relationship between pharmacies and patience. into it, it is going to be difficult. you need pharmacists to participate in this and help us
4:29 am
to curb this problem. i have seen it ruin families, lives, careers. it is worse than can be imagined at this point it mr. chama, i know i have gone over. i apologize -- mr. chairman, i know i have gone over. i apologize. >> thank you mr. chairman. , mr. mike and i have had a series of hearings in the previous congress on u.s. drug policy. that included marijuana. it forced me to re-examine some things i thought i knew or believed. with respect to marijuana. me is ifisturbing to there is a gateway drug to heroin, it is opium production drugs.
4:30 am
far more than marijuana. that is why this hearing is so timely. it is affecting every community we represent. it is not a rural phenomena or an urban phenomena. or suburban phenomena. let me ask you, mr. botticelli, how did we get to this point. i don't want any doctor to leave a patient in pain. serious pain is a it terrible affliction. first, you do no harm. but how do we draw the line between pain management and an
4:31 am
unbelievable avalanche of prescriptions for opioids which is now led to an epidemic of addiction in america. with presumably the best of intentions originally. >> i agree. at the significant drivers, there are other things going on. it is about overprescribing addict of medications. >> why? how did we get there? . there's are not stupid people. botticelli: doctors were given information that these were not to addictive medications. that is what started this. aspite evidence, there was thatto educate physicians these medications were not very addictive. time, we had a noble
4:32 am
goal that we had to do a better job at the treatment in the united states. a lot of people have significant pain and needed. there has to be a full-court press to treat pain. the government even talked about it as a vital sign. the prescribers on how addictive they were, how to identify people -- so, physicians in the united states get very little training on appropriate prescribing. i think there was a study that showed veterinarians get more training on pain prescribing and physicians get little to no training. there was a whole set of factors that drove addiction and over does in the united states. by we have that compounded carol when vulnerability. wen, one is effective
4:33 am
treatment. i mean, what is the system for recognizing someone has a problem? efficacious treatment in trying to turn this around her early before it moves onto to hair one or something worse? dr. wen: medicine is an art and not completely a science, because even something like pain is subjective. what is pain to you is not the same to someone else. treats must know how to each individual patient based on their symptoms into they are. it is not just about medication. therapy,eed difficult , education,therapy we do not have to treat everything with a pill. pdmave to recognize some pes are cumbersome to use.
4:34 am
40 patients in several hours, i cannot spend an hour trying to figure out how to get p.o every patients pdm we recommend the judicious use of pain medication. >> i am not talking about that. we have a problem. what is efficacious? we are policymakers. we want to solve the problem. we get that part. if we have gotten to the point that we have an addictive problem and we are trying to get that person to not go on to the hair when part, what is your experience of well works? addiction is ak disease and we have to get people into treatment. andhosocial treatment services. we know the world health organization shows that for
4:35 am
every one dollar invested in treatment it saves $12 for society. >> thank you very much. and thank you for the hearing she went on. they were quite informative, probably the only ones in congress and we got criticized, but we went to government operations and he was my ranking member years ago. think you very much. gentleman from wisconsin, mr. grossman. >> i would be remiss if i did not mention in atlanta we are having the national prescription drug abuse and hair when summit with a representative from kentucky who has been a champion and is a cochair of that. opportunity to learn more about prescription drug abuse. i encourage everyone to attend. i thank the gentleman for yielding. >> anytime.
4:36 am
now i have a question. one of the things that bothers me is the legal prescription of opiates. i had to minor things in my life. both times medical professionals were willing to give out opiates. like a month worth of opiates for something that had no business under any circumstances for prescribing opiates and they would not have done so five years ago. what can we do to stop in these basically things? medicalt to impairs the professionals. one of the things is to say we are not going to reimburse for medicaid. we're not going to reimburse for medicare. reimburse ifng to it is anything else the federal government is kicking in war , noe sort of problems matter how much pain you claim you have.
4:37 am
evene could perhaps say for cms, we are just not going to reimburse across the board. if we ever do, it is for like three days, none of this month stuff. is that something that could be done? i don't think we should give the medical profession a lot of room here because they have shown in the past the abuse it. >> you are right. i think there are opportunities to work not only with cms but private as well. actually, cms sent out a letter to state medicaid directors to look at putting in place thecribing protocols around . i also think we really need to continue to focus on mandatory prescriber education. i am not a big fan of government mandates, but again, we really need to educate the medical profession about say and affect
4:38 am
of opioid prescription. all you need is a little common sense. if we have that many people in field lacking common sense, we have a problem. >> i think it is a matter of the medical profession very well-meaning but given misinformation on the lack of addict the properties of these drugs and it was a full-court press to more appropriately treat pain with the prescribing community the gets little to no training on prescribing medication. know this is all screwed up, i cannot believe the medical profession needs training. but ok, you say they need training. now on the penalty thing, mr. malone, i got here late and did not hear your name. it seems to me that the penalties for people who sell hair when is not as high as it should be.
4:39 am
or they are not going to prison for as long as they should. a lot of this is local stuff. it is not a federal issue. that i sit we at do arrest be the federal government arrests people who possess hair when, at least enough that you could assume they are dealing in that joint. that andest people for if we do, what is the recommended sentence? >> congressman, the da and the are nottask force, we at all focused on user possession. i am saying if you get somebody with enough air when you know it is not for -- heroine where you know it is not for personal consumption, what do you do? >> i cannot say.
4:40 am
ultimately a judge decides based on the guidance he gets. that is the clearest answer i can give you. i know it is muddy, but it is the world we live in. >> i will give you one more question. what do they do in other countries? country and ier asked about the drug problem and they told me the creeps -- the shock in the was a eyes. what did they do in other countries? what kind of penalties do they hand out? >> interesting. i returned from a u.n. group of my colleagues from around the world looking at the global approach to drug policy. i think there is an emergency consensus that we need to focus
4:41 am
on and an enhanced response. while there is a response for toor traffickers, we need look at alternatives to incarceration. i i don't mean to cut you off am well past my time i would ,ike you to answer my question ok? i know there are a lot of people out there who like this public health response, ok? i am under the impression we put reason,n prison for a ok? other countries have very large penalties and much less of an opiate problem. can you tell me what their penalties are? >> they probably have much less of a problem because they don't have as much access. it is not a question of penalties. >> you were wrong. just tell me what they are. these are countries that are fairly advanced and they have pretty dramatic penalties.
4:42 am
do you know what the penalties are at southeast asia? >> i do not. it i can tell you southeast asia considers labor camps part of their treatment regiment. so i would not equate drug policy around there as it relates to their drug problem. they alsoapore, execute them. california, you are recognize. >> it let me begin by saying the current terror when and opiate heroin and opiate epidemic has different punishments. one of the reasons is the crack epidemic mostly affected poor
4:43 am
people of color. at the base of the opiate different. much 90% of the people that tried hair a win for the past decade heroinite -- that tried for the last decade are white. sayse an article that less families would like four -- forr -- heroin. i believe we must address these issues among the white middle class. and across the country socioeconomic or race status.
4:44 am
we take care of this for unique communities. workhave been doing this for the better part of my life into i am glad that in this country we are only at a point acknowledged the disproportionate affect on people of color and poor folks on this issue. hugeglad we now have a political movement. sure thee have to make policy and programs we are implementing our targeted at those who have the most pressing needs and when we talk about criminal justice reform, we are talking about it for everybody regardless of color as it relates to this. response to this epidemic needs to be a human response for everybody and not just for the 90% of white people affect did by this issue.
4:45 am
i am glad we have learned a lot over the past 40 years in response to drug policies for this. i am glad we are acknowledging this is a disease and we cannot make jails and prisons de facto treatment centers. i feel tremendous responsibility to make sure we use this moment in time where there is broad acknowledgment that this is a disease and we cannot incarcerate and that we implement policies for everybody. >> thank you. enter for theo record this new york times article that white emily's seek a gentler war on -- that white families seek aentler war on heroin. >> have you read that article a myth that will not die?
4:46 am
it says scientist to have abandoned the idea that marijuana causes people to use other drugs. in 1999, looking at the dangers of medical marijuana, the academy of sciences wrote, there is no conclusive evidence that marijuana is a causative or correlate of effect for heroin use. is also a correlation with our call use. marijuana is not the most common, it is rarely the first gateway to illicit drug use. the article went on to say, why might there be a correlation. one reason, people are interested in altering consciousness and want to try to do that. if you are a true music fan, you won't just look at one band.
4:47 am
that does not mean it's a gateway to the grateful dead. people who like music probably like many different songs and groups. is there not a sign that marijuana is not a causal link to drug use? >> i think the evidence is pretty use that early use of alcohol, tobacco, and marijuana, often used together significantly increases the probability that person will develop a larger -- more addiction later on in life. the music analogy is in accurate because early substance use affects brain development. not just affects music. for he disposes people for more significant vulnerabilities later in life. >> thank you. my time is up, i will send you
4:48 am
the article. i would like to enter into the articlehe time magazine that says marijuana is a gateway drug. >> the gentlelady from new mexico. >> thank you, mr. chairman. i have no doubt we will continue and localities and cities and states will continue to debate about gateway drugs. i have participated in many of those discussions about alcohol which is the foundation in terms of creating an environment where you point yourself more at risk, particularly in adolescence. i come from a state that has some of the highest abuse and overdose rates in the country. botticelli, i appreciate your raising the issue in your testimony and talking about it. direct andvery specific correlation between the number of prescriptions that have gone up and the number of prescription drug issues which
4:49 am
we are trying to deal with today. while i would hope that congress undertakes an effort in combating the opioid problem that we will get drug issues in general and policies in general, we certainly continue to debate and work on criminal justice reform so we are focusing on prevention and effective treatment which is really the way to get out of this. i appreciate the panel and member questions. i am in a state that just passed legislation that would make a certain drug available far more than just the medical providers. we want first responders and first responders was debated to family members and close proximity so we can present overdose death. the state has a republican house it wasocrats senate and
4:50 am
great to have bipartisan response. let's not minimize everything else. potentially, a question and wen canrector or dr. answer. problem and itex does not mean we should walk away with it. i could debate with you about how it can be a benefit and limit access. one of the realities about that theribing is sellers and manufacturers have now itch a great job and is cheap so insurance companies are more than happy to make sure it is there. back toou cannot get your physician, if you are in the hospital or emergency room and you waited 27 hours to be to make sureed whatever prescription they give you will tide you over. patientsrences, these have other family members that than have the access to the excess medication. ofm struck i the number
4:51 am
large pharmacies that are thinking about making sure they and opportunities to get rid of the drugs safely to get them out of the hands of kids, grandkids. that is clearly part of the epidemic year. complexities, i really want to talk about the toavioral health issued there really is not mental health parity. to my state, i should admit you it is partially the fault of this administration. there is zero treatment available. heroin the highest overdoses, the highest one and 500 will die of a heroin overdose. it is huge. decades old. this is not new. what are we doing to create
4:52 am
dualy, recognizing that diagnosis and self-medication is part of this larger problem? and then i amt sure other folks on the panel can do that. i think there are a number of things from a policy perspective. one is the affordable care act. one of the dramatic things white to out of 10 people -- >> i am going to caution you. the affordable care -- care act says it is why they're are able to cancel 100%. make no mistake, you should know that about new mexico. >> i will say that part of the reason people are not able to access care as they do not have affordable coverage. we know that data. the affordable care act says that to mental health and substance benefits have to be
4:53 am
part of any marketplace plan. that is huge because there has always been a lack of coverage. the second thing it does is to say to insurance companies, you cannot discriminate in the provision. >> how are we enforcing that? accessll tell you that delay is a giant issue in my state. we recognize and then policy. making sure it is occurring. medicaid is largely a managed care environment. the reality is, the insurance companies are not making it available and if so then you do not have access in spite of coverage. quitegree and i hear that often in my travels around the country. the government could do much more work in enforcing parity. providers play a key role in making sure complaints get to state insurance commissioners.
4:54 am
we all have a role to play and terms of enforcing parity and making sure we are about to enforce medicaid -- medicare and when it comes to health mental health care. >> thank you very much. >> thank you. the gentleman from south carolina. >> thank you. agent milione he, i want to talk to about drug court. would you agree that there are some who traffic in narcotics who themselves are not users? a: i would agree. >> so drug court is not going to be much help for us or them because they are not addicts and they do not use. those who are using drugs. i think you would also agree with me that old so use drugs
4:55 am
commit robbery and burglaries and domestic violence and a host of crimes we would consider to have an element of violence. >> certainly. dealers whou have do not use and you have drug addicts who are not engaged in title 21 crimes. >> correct. >> all right. >> and there are different models for drug court. some are divergent where you diverge out of the criminal justice system altogether. some, you plead guilty and your sentence is drug court. we had a different set the time in south carolina and heading defense attorneys to plead their clients to drug court even though in the eyes of everyone it was better for their client who happened to be an addict. it is tougher than probation. so the attorneys had no interest in that.
4:56 am
so how do we devise a plan where you get drug court even if your criminal defense attorney does not want you to have it? ask congressman, i do not know if i'm the right person to answer that because it is the federal level. that would be more the state and local level with task forces. i am not in the best position to answer. before we go to mr. botticelli, i want to ask you something that might be in your wheel house and that would be divergent. do you have a background in diversion, agent milione? milione: a yes. bf ae standard used to drug was prescribed outside a medical practice, they could be prosecuted themselves. agent milione he: that is correct. >> it seems to me in the number of cases the dea was pursuing
4:57 am
lowered. is that an illusion? milione a: i need to know if you are talking about criminal cases. i am not aware of such cases. i am not aware if you're talking about criminal, i am not aware criminal a dip in any numbers as far as prosecution. >> would you check that for me? >> i would be happy to. who were you speaking to? rep. gowdy: i have been gone since 2010. it seemed after that it was shipped over to pharmaceutical companies. you, there has not been a shift. we have aggressively gone after.
4:58 am
small number of dea registrant's. but i will look into it and get back to you. gowdy: i know it is hard to prosecute doctors, but when they do an examination and are just running a hill mill, prison -- a , prison might be the best place for those doctors. >> what kind of a court system would you say would not have defense attorneys who would advise their client to go to probation instead of drug court? are you familiar with that? >> actually, there has been huge support across the board as a relates to our drug court. bags i am sure it is if it is a divergent court. >> i am sure it is. i am not talking about diversion where you have no record and
4:59 am
don't face any consequence. i am talking about you plead guilty and your punishment is of probation, sit with provision being much easier than drug court. >> there are many drug courts that operate under that model so it is interesting. it has wide support a month many folks in the criminal justice world. so if there are particular folks you would like us to work with in terms of doing more education around drug courts and the various models, we work very closely with the national court of drug professionals. >> i am time, could i ask one more question? let's assume that you plead the guilty to robbery and your sentence is drug court. how many lapses do you think are appropriate before the actual sentence imposed is carried out? >> i would have to go back and look at the guidelines. i assume that gets interpreted differently by different judges.
5:00 am
>> i was asking you. do not know if there is specific guidance. >> i am talking about best practices. the first offense. the first relapse does not make sense. begin a senset either. >> i would have to look at the nationalization should of drug or. it does put out practice guidance. >> would you do that for me? >> absolutely. to your point, i think there is an acknowledgment that many people is drug treatment disorders do relapse and i think we need a good response. people need to be held accountable for their actions. so there is a balance between recognizing relapse and holding people accountable. >> itinerary what i will do, in honor of you, i will acknowledge there are relapses and in nextal honor of me, the time you have a chance to talk to criminal defense attorneys you tell them it is overall and their clients best interest to get off drugs, not onto
5:01 am
probation which is easier to navigate then drug court. >> happy to do that. >> thank you. >> to conclude, we will do a quick round of summary questions. mr. cummings. wen, one of: dr. the things that is so disturbing to me is there are certain areas in baltimore where people are getting methadone treatment and when you see the number of lives have been destroyed, and we see masses of them. carolina, weth gowdy, tote you, mr. come with me to baltimore.
5:02 am
when you see the masses of not -- it ise painfully painful, i tell you. i agree there are those who are selling drugs who are not using. i agree with you that there are folks who are committing a lot of crime. matter of fact, probably most of the crime in baltimore is related some way or another, but there are also a group of people who are truly addicted. they are dying at 78 a day. that is majors stuff. so i would invite you. it likewhen you see that, a gentleman came with me to baltimore and saw what we are talking about. i think there are a lot of
5:03 am
different remedies to address these things. not wantinginitely to be soft on people who are going around and selling death. the same time, we have a lot of people who are truly a dip it. so, the chairman from south carolina made some good points. huge or the line to say, ok, i have got these addicts. some of them are committing crimes. what do you think of the methadone treatment. a lot people question whether you are just keeping people continuing to be addicted to a substance. >> thank you very much, congressman cummings. knowirst issue is that we
5:04 am
and baltimore that to there are 20,000 people who use hair when and many more addicted to other drugs and most of the drug arrests, there are 73,000 arrests every year. sellingrity for only drugs to feed their own habit. what they need is not incarceration, it is drug treatment. providewhat we have to and if they are incarcerated, they have to get treatment in jail. >> one thing people don't know about heroin is you can the addict to two heroin for 30 or 40 years. am i right question mark and still function. am i right? dr. wen: yes. high's some people in very walks of life. all walks of life will stop to your point about treatment, i am a doctor and scientist and i have to use the evidence. showse danish -- evidence treatment including methadone
5:05 am
and nora for nene are the standard of care when it comes to a b or a debt addiction. we also agree we have to have increased treatment, which can be given in an office setting. some of that reduces the stigma. i want to thank you for your leadership and baltimore city and we hope there will be greater funding to rescue our areas of greatest need. we are the ones who are innovating and we are the one who need the most resources rather then having the peanut butter spread evenly across all areas. gettingdea that we were --rocks and four $120 and for $420 then they increased it.
5:06 am
attorneytates and our general has been working to get that cost down. have you seen any movement in that area? mr. dr. wen: we have not. we have not in baltimore city. generous had a contribution from a pharmaceutical agency that we cannot rely forever on the generosity of pharmaceutical companies. we have to have a generic medication on the world health organization lists so we can save everybody's life. >> i want to thank all of you for being here today. we have a lot to do. it is a serious problem. we are going to have to hit it from a lot of angles. i,rs ago, the chairman and he was chairman and ranking member of a committee called the drug subcommittee. lot of work and we are
5:07 am
going to have to do a lot more. i think all of you. >> i will give you two quick questions. driving is a drunk big problem in our society. when we arrest somebody for drunk driving, some are alcoholics and have an addiction and some are just curious, social pressure, whatever. to people innown my life of used heroin. both thought they were not addicted. the peopleise, of arrested for heroin addiction or whatever, what percentage are addicts and what percentage are feel-good or whatever. what percentage need treatment and what percentage is like the person who gets a drunk driving because they were irresponsible? can you give me your guests. >> i will take a stab at it.
5:08 am
i would assume the rates of non-addictive heroin are incredibly low. each one just give me a percentage. what percentage of people who are arrested for addiction are toe the two people i talk who did not crave it, did not need it, one was doing it for social reasons the other was depressed. has percentage are using it my buddy was using it and it was cool. totally backwards. i would say 5% of people using marijuana have no addiction -- i mean heroin. >> 5%. next gentleman. able to give you a percentage. that is not how we encounter people. not at the dea.
5:09 am
i cannot give you a percentage. give you is data from our survey which surveys on how many people of used tear when in the last month, year, and how many have a disorder. i would imagine you would i'm parallel realities. we do not do screening. we do not have time to do diagnostic screenings on everyone arrested for possession. so we do not have the data available. >> do have an opinion? >> no, but i am happy to give you the data we do have. anyhis anyone else have idea on percentage just using an percentage addicted? >> in baltimore, the best over 90%, will be individuals who have an addiction. and itcomes from opium is one of the most addictive substances in the world.
5:10 am
can tell you that out of the 2000 people come through our jail that have been addiction and acknowledge it, the reality is they are eligible because they know they are going to go through withdrawals. i think your is some information we could obtain from some databases dealing with people that have been prescribed opioids and how many have become a addicted. >> one more question. maybe the two people i've met who have actually used heroin and got caught, when they said they were not craving ethanol, maybe they were an aberration. next question. i break my arm, just a simple break, do you think under any circumstances, and having that they never prescribed in 15 years ago, what percentage of time do you think a doctor should prescribe opiates for a broken arm? broken arm is extremely painful and if somebody had come
5:11 am
with aemergency room broken arm, i would give them, even iv medication for opioids. this is a reasonable use. are totallyou irresponsible. does anyone else think for a broken arm you should prescribed opiates? >> for how long? what percent you think if you have a broken arm you should prescribe opiates for a week? >> i can tell you with the cdc recommends. that is a decision that needs to be made between patient and her. or should be a conversation. the guidelines say the lowest possible dose and the shortest possible duration. >> would you give a prescription for at least a week if you are a doctor? politicians are not known for giving straight answers, but go ahead. atbody else have a stab this? is it responsible to give a
5:12 am
prescription for opiates for at least a week if i break my arm? i am ai am not a doctor, mother of four children. one of my children has had multiple broken bones and sports. another had a meniscus tear and tears.a.c.l. each time they have been given opioids, each time for about one week. in all cases they were warned and i was warned about what to look for in case of addiction. in every case, they were not on opioids for more than 48 hours. we took them off in 48 hours. i can tell you a severe as those injuries were, we weaned him off. i had a severely broken bone in both of my arms, i was off and killers in three days and never on opioids. anything more than that really needs to be carefully look at. >> are you a health
5:13 am
professional? >> no. i am a mother of four kids. i could be a mental health professional by the time i raised four children. >> good. we got one common sense answer and it was not from a health professional. thank you. >> thank you. i want to thank all of our panelists and i want to thank my friend from maryland for his gracious invitation which i will take him up on. see what is to go happening in baltimore. i suspect, mr. chairman, it is or largern a large scale of what was happening in my own hometown when i started a drug court. in addition to that drug court we started a drug court for expectant mothers who are using drugs in the course of their pregnancy. i do believe that getting them off drugs is in the nightly preferable to keeping them out
5:14 am
of jail in nonviolent cases. i would also say this to my friend from maryland, there is no joy like going to a graduation ceremony for those who have concluded drug court successfully. -- i have hadted people who i prosecuted stop me in the grocery store to show me their certificate. of that were prouder then anything you or i could have accomplished in the course of our careers. when we open up drug courts, maryland is right. half of the crime we saw for 16 years, drugs and alcohol were at the root of that. there was one addict in particular, mr. chairman, who took a hammer to the older couple that lived next to him
5:15 am
and beat them. in bed, sleep, in the middle of the night. he broken to rob them anti-beat them with a hammer to the point they were unrecognizable as humans. that was the pathologist's description, not mine. then he raped the female victim host boredom. he was an addict. we are going to have to hold onto those prisons in addition to the drug court. i would be happy to go to maryland with my friend and i to savevite him people's lives. i just hope they get off before they do acts of violence against the innocent public, because the addicts sometimes leave a wake of violence and mayhem in the wake of their addiction. i yield back.
5:16 am
>> i want to thank you. to go to south carolina. i would be happy too. one thing, mr. chairman. i agree with you. we have very effective drug courts in maryland. and, i know what you are talking one of my first cases was a death: he tastes. hisung man hammered grandmother to death and he was on drugs. i get to it. i get it. here oferent categories both, i swear, i just wish we could catch them early like you said. these substances are bad. bad. the thing is trying to figure out a balance.
5:17 am
when you figure out the balance, you still find people falling through the >>. cracks.gh the a final thing. we started this three hours ago. 15 people have dried -- died from drug overdoses. three of them from heroin. over, one day is hundred 20 americans will die, 24 of them from heroin. we have heard many things touted here today. some of them have said we just need to put more money in to treat it. treat and is essential but treatment is at the end of the line. and, you heard a couple comments from the other side of the aisle today that we need to act before we go home at easter and put
5:18 am
more money into the heroin and drug overdose situation. the remarks of senator grassley on the floor. in fact, according to the office olicy,ional drug control the appropriations act passed in december provided more than $400 million in lending specifically to address the opioid epidemic. of $100in increase million over the previous year. that is 25% increase. ok? none of that money, when he said that just a few months ago, has been spent yet. all of that money is available today, is that right push mark or most of it? tell me! most of that money is available today and you would think we were going out of here not
5:19 am
providing money. increase. i want this in the record, and lotus put it in the record, too, how much was asked for and how much was appropriated. how much was taken from interdiction and lot enforcement and put into treatment. ok? this is just the facts. we don't want to deal with the facts but we are going to put this in the records of you can see. there is money there. and, i want a report! i want a report, i am telling you, this week, of how much money is spent. and i want that in the record. ok mr. botticelli? and i want something from you, too, mr. direct her of our substance and health abuse office. i want to see how much money is pending and i went to see how much it is by friday. ok? as i know the money is there. it has not even been distributed.
5:20 am
we are not going to play these games, i want the back. stop -- westop the need to stop this stuff at our border. i just challenged our mirror. it is coming in by the boatload across the borders. i have one question, too, i talked about el chapo. the drugs coming across the border like it was a vacation holiday. told, speaking of weapons used in most drug offenses, this is murders. in baltimore, they are killing people. are killingthey them. we kill them in the mall. we kill them on our streets, in our great communities. in our work communities. most of them are gunned it down and it is related to drug trafficking. ok, mr. maloney? and a lot of those are illegal
5:21 am
weapons. this morning, el chapo, who was coming back and forth, one of the weapons he had was traced to the fast and the furious. a weapon supplied by the united states government. the principal drug trafficker trafficking across the border like a holiday visit, he had one of the past and furious. are you aware of that? >> i am aware from the press report. >> can you confirm that for the committee? >> i would not be in the best position to do that. >> i want you to check on it for me and let me know, ok? i am very pleased i the people out there, but i've met with some of your people on the prosecutions are not what they should be. you know, you go to singapore and they do not have a treatment program. i want to put you out of this news, dr. wen. all the treatment programs.
5:22 am
i want to put them out of business because our kids and our adult should not have to go to treatment. but we are allowing this to come into the united states. it is offensive. we are killing tens of thousands. bething else, people would outrage. wherare you? just say no and it just say may be? there are consequences. just saying that ok'd a difference to our young people. you can tell that i am getting a little hot. the italian comes out of me. that i have seen them dying on the streets in baltimore and dying in my community and we need to do something about it. the supply needs to be cut off. then i can put dr. wen and others out of business. we will not have to treat people, we will not have the scourge on our streets. this hearing is adjourned.
5:23 am
thank you, witnesses. [gavel] [indiscernible conversation] [indiscernible conversation]
5:24 am
[indiscernible conversation] announcer: february, president obama announced his plan to close the guantanamo bay detention center in cuba. today, officials testified before the house worn affairs committee. 9:30heir testimony live at a.m. eastern time on c-span2. presidentialic
5:25 am
candidate bernie sanders speaks to supporters at a campaign rally in san diego, california. held at the san diego convention center where mr. sanders announced there were 9000 people in the room and more waiting in an overflow area. introducedders was by actress rosario dawson. this is about one hour. [cheers and applause] rosario dawson: wow. [applause] been herewson: i have to this convention center many, many, many times. i have seen a lot of people before, but never like this. [cheers and applause] rosario dawson.
5:26 am
i see all of you. and, i am so grateful that you are here. mediaunately, the mass said, do not even bother. [booing] dawson: i am really glad that you showed them what is up. we have to keep doing that. at stake. lot i have been doing voter registration for 11 years and i can tell you the one question i am master over and over again is, where are the young people? right? right here. where is diversity? right here. where are people coming together under one umbrella with one vision that we can all dream and believe in? right here.
5:27 am
that this election is -- i -- i am on a loss of words because this election being critical is too small to talk about it. this is like kerry belafonte said that about the soul of our country. the soul of our policies and vision. we do not need incremental change, we need bold leadership and that is what bernie sanders brings to the conversation. we do not need somebody who is ready to hit that shiny red button when they get into office and create more wars, more inhumanity, more tension, more fear. [applause] rosario dawson: understand how significant this is. you are here because you are talking to each other. not because you are being
5:28 am
encouraged by the dnc. not because you are being encouraged by the media. but because you are talking to each other. so, understand what that means. allernie does not take this the way, if we do not help him, if we do not make sure he takes this all the way, net neutrality will be pushed back. a senator said, the reason superdelegates exist is to specifically push back against a grassroots organizing. so, we need you now more the in ever. we need you to spread the message and talk about our future. rightuth has been on the side of history on every issue. applause] rosario dawson: they talked about those
5:29 am
hippy college kids when they were protesting against vietnam. martin luther king, junior, who bernie sanders walk with -- [cheers and applause] rosaria dos and -- rosaria he put it right when he said high school students were not afraid to do anything. they did not talk about it when there was no one the bailout. they did not talk about how remarkable and beautiful it was when millions of people marched for these before the iraq war. millions of people marched across cultures, across boundaries, burning is not the only one who walked against the iraq war. we were. it is time we make them listen. i'm not going to vote against
5:30 am
the patriot act once. i'm going to vote against the patriot act twice. thank you, bernie sanders: fwoirn. -- thank you bernie sanders. we need someone who has bold leadership who understands with climate change, with health care, with education, with our future at stake that we need bold leadership from someone we can trust. someone who has stood up for justice his entire life. they have not listened to him, but we are. and we need to keep spreading that message, because people are voting against themselves. they are hurting themselves and their future. and we need to help them. we need to help them and each other, because this is about us. not me. it's not one person. it's not just a party. it's not the g.o.p. versus the
5:31 am
d.n.c. this is about the 99% that is too big to fail against the 1%. so when i hear someone ask me, well, well, well, if it comes down to it, will you vote for the other candidate if it's trump? i say if you want to beat trump, vote bernie. we are playing chicken here. and we can't pull back. they are going to have to turn. that candidate is the ralph nader not bernie sanders. as an independent he is doing a service to the democratic party right now. the democratic party -- we haven't left them. they have left us. this is an opportunity to turn the tide and change history. do we really want someone who
5:32 am
condones mass incarcerations? who thinks that the death penalty is ok. who hesitates on environmental injustices and issues? who thinks that regime change is an idea for foreign policy? no. what we need is bold leadership from a great leader. time has come. truly this is a future to believe in. it is not a dream. it is a vision and it is worth going for with all of our minds. this is for our future, for my children, your children, our great grandchildren and beyond to know that when this happens and the future that comes and they say you know when immigration reform and education and health care, when we were at war around the world and things were happening, what did you do? you can say i voted for the
5:33 am
person who turned the tide. so make sure that you're not just liking this on facebook but that you are bringing 10 people, each of you, i really mean it across the states and talk to them and say this is what is at stake and make sure this is reflected here amongst ourselves. something that has pushed through and something that we get to see in the history books. because history is -- by the winners. and we must win. thank you. [applause] crowd chanting "bernie"] >> i would introduce him but i think you are already. please welcome to the stage
5:34 am
enator bernie sanders. [cheers and applause] crowd chanting "bernie"]
5:35 am
[cheers and applause] bernie sanders: thank you! thank you. thank you, san diego. hoa! bernie sanders: let me thank all of you. thank you for coming out tonight. let me thank rosario dawson for that extraordinary ntroduction.
5:36 am
it is a little bit hard to follow rosario because she said everything i was going to say. the only thing she did not say, i think, is not only do we have 9000 people in this room, we have many thousands more in the overflow room. cheers and applause] bernie sanders: when we began this campaign about 10 months ago, we were 3% in the polls, about 70 points behind secretary clinton. as of today, the last poll i saw, we are five points behind
5:37 am
, and we are gaining. [cheers and applause] bernie sanders: when we began this campaign against the most powerful political organization in the country, we had no money and no volunteers. now we have hundreds of thousands of volunteers all over this country. cheers and applause] bernie sanders: when we began this campaign, we were considered a fringe candidacy. who in america, the media said, could believe in a political evolution? well, 10 months later, we have now won 10 primaries and caucuses.
5:38 am
[cheers and applause] bernie sanders: unless i am very mistaken, we will win a couple more tonight. cheers and applause] bernie sanders: when we began this campaign, we talked about the need for millions of people to become involved in the political process. tonight in utah, tonight in idaho, and tonight in arizona, there are record-breaking turnouts in terms of oters. [cheers and applause] bernie sanders: now, this ampaign is doing as well as it is generating the kind of energy and excitement we are seeing here in san diego and all over this country. cheers and applause]
5:39 am
bernie sanders: because we are doing something very unusual in modern american politics. we are telling the truth. [cheers and applause] bernie sanders: now, the truth is not always welcome in our personal or political lives, but we cannot go forward as a nation unless we are prepared o confront the real issues acing our country. let me tell you briefly what ome of those issues are. number one, in america today, we are living under a corrupt
5:40 am
campaign finance system. which is undermining american democracy. democracy is not a complicated process. it really isn't. it means you have one vote. you have one vote. you have one vote. you want to vote for me, you want to vote against me, that is fine. what democracy does not mean is that billionaires can spend unlimited sums of money to elect candidates who represent the wealthy and the powerful. that is not democracy. democracy is not about cowardly republican governors trying to
5:41 am
suppress the vote. all over this country, what we are seeing is republican governors making it harder for poor people or people of color or young people or old people to vote. and i say to those cowardly governors, if you are not prepared to engage in a free and democratic election, get another job! get out of politics! cheers and applause] crowd chanting "bernie"]
5:42 am
bernie sanders: today, the united states has sadly one of the lowest voter turnouts of any major country on earth. our job is to increase voter turnout, not lower voter turnout, make it easier for people to participate, not arder. as rosario mentioned, this campaign is not just about a corrupt campaign finance system, which is undermining democracy. it is about a rigged economy. t is about an economy in which the top .1% now own almost as much wealth as the bottom
5:43 am
90%. [crowd booing] bernie sanders: it is about an economy where the 20 wealthiest people own more wealth than the bottom 150 million people. [crowd booing] bernie sanders: it is about an economy in which one family, the walton family owning walmart -- [crowd booing] bernie sanders: this one family owns more wealth than the bottom 40% of the american eople. and what a rigged economy is about is the wealthiest family in this country paying their employees wages that are so low that many of those workers have to go on medicaid and food tamps.
5:44 am
and it is the middle class that pays more in taxes to pay for that medicaid and food stamps, so i say to the walton family -- get off of welfare, pay your workers a living wage! cheers and applause] bernie sanders: that is just one example of many of a rigged economy working people paying more in taxes to subsidize the wealthiest family in this country. that is crazy. together, we are going to end hat. this campaign is about ending a
5:45 am
situation in which millions of our people are working longer hours for lower wages. it is about ending a situation where people in america need to work two or three jobs just to bring in enough income and health care to take care of heir families. it is about an economy where mom is working, dad is working, kids are working, marriages are stressed out, kids do not get the attention they need. this campaign is about creating an economy that works for all of us, not just the 1%. cheers and applause]
5:46 am
bernie sanders: but it is not just a corrupt campaign finance system that we are going to change. it is not just a rigged economy that we are going to reform. it is also a broken criminal justice system! cheers and applause] bernie sanders: it is not acceptable to me that we have more people in jail than any ther country on earth. not acceptable that we are spending $80 billion a year to lock up 2.2 million americans, disproportionately african american, latino, native american.
5:47 am
this campaign is about real criminal justice reform, real police department reform. cheers and applause] bernie sanders: this campaign is about saying we are tired of seeing unarmed people, often inorities, shot by police. now, i have been a mayor and i have worked with police departments all over my state and police departments all over the country. and the truth is, the vast majority of police officers are honest and hard-working. but when a police officer, like any other public official,
5:48 am
breaks the law, the officer must be held accountable. cheers and applause] bernie sanders: this campaign is about ending the militarization of local police departments. it is about making police departments reflect the diversity of the communities hey serve. it is about rethinking the war on drugs. cheers and applause] bernie sanders: today, marijuana is a schedule one drug under the federal -- [crowd booing]
5:49 am
bernie sanders: schedule one drug under the federal controlled substance act, right alongside of heroin. in my view, that is nuts. and that is why we have introduced legislation to take marijuana out of the federal controlled substance act. cheers and applause] bernie sanders: in my state of vermont, in my state -- crowd chanting "bernie"] bernie sanders: in my state of
5:50 am
vermont, neighboring new hampshire, and states all over this country, we are seeing now an epidemic of heroin use and piate abuse. and we are seeing people dying every day from heroin overdoses. in my view, when we deal with drug abuse, we have got to deal with it as a health issue, not a criminal issue. cheers and applause] bernie sanders: let me just take this opportunity to say what i know is on everybody's mind. we are all aware of the terrible attacks that have taken place in brussels. dozens of people are dead, and hundreds of people have been wounded. i think i speak for everyone in expressing our condolences to the people of brussels.
5:51 am
[applause] bernie sanders: that is right, that is right. and let me simply say this. we will stand as a nation with our allies and our friends and people all over this world. we will stand with them and we will together crush and destroy isis. cheers and applause] bernie sanders: we will destroy isis through a coalition in the middle east led by the muslim nations themselves. cheers and applause]
5:52 am
bernie sanders: with our support and the support of other powerful nations. but as king abdullah of jordan said a few months ago, what is going on there is a fight for the soul of islam. and the muslim nations have got to take on isis and win that war. and we can win that war and destroy isis without getting the brave men and women in the u.s. armed forces into a perpetual war in the middle east. cheers and applause] bernie sanders: the war in iraq was one of the worst
5:53 am
foreign-policy mistakes in the modern history of this country. i voted against that war. cheers and applause] bernie sanders: and i will do everything that i can to make certain that the united states does not get involved in a similar type war in the uture. this campaign is doing as well s it is because we are listening to the people, not wealthy campaign contributors. cheers and applause] bernie sanders: and one of the
5:54 am
major differences between secretary clinton and myself is how we raise the funds we need to run a campaign. when we began this campaign, we asked ourselves -- should we have a super pac like everybody else? and we agreed with you. cheers and applause] bernie sanders: and what we did, unlike all other campaigns, is to simply reach out to the american people at berniesanders.com and say if you want to support a candidate who is prepared to take on the billionaire class, to take on wall street and corporate
5:55 am
america, this is your ampaign. join us. [cheers and applause] crowd chanting "bernie"] bernie sanders: and what happened over the last 10 months is something i in a million years would not have believed. and that is we received well over 5 million individual campaign contributions. cheers and applause] bernie sanders: and does anybody know the average contribution? cheers and applause]
5:56 am
bernie sanders: and that is revolutionary. because what we showed is that you could run a winning, national campaign without begging billionaires for their money. [cheers and applause] ernie sanders: now, secretary clinton has hosen to go a different route. what she has done is established a number of super pacs, the largest one recently reported raising $25 million -- [booing] bernie sanders: from special interest organizations, including $15 million from wall treet.
5:57 am
now, she has also, as many may know, given speeches on wall street for $225,000 a speech. [booing] bernie sanders: what i have said is that if you are going to get paid that much for a speech, it must be an extraordinarily brilliant peech. it must be a speech that could transform our world. it must be a speech written in shakespearean prose. so, i think, given what a great speech it must have been, let's
5:58 am
release that speech to the american people. cheers and applause] bernie sanders: this campaign is listening to working people throughout this country. what they are telling me is they cannot make it on eight dollars or nine dollars an hour. and that we have got to raise the minimum wage in this country to $15 an hour. cheers and applause] bernie sanders: this campaign is listening to disabled vet answer and to senior itizens.
5:59 am
and what disabled vets and senior citizens are telling me is that they cannot make it on $11,000 or $12,000 a year social security. and you know what? nobody can make it on that much a year. despite that, we have republicans in congress wantign -- wanting to cut social security benefits. well, i've got bad news for them. we are not going to cut benefits. we are going to increase social security benefits. [applause] bernie sanders: this campaign is listening to women. cheers and applause]
6:00 am
bernie sanders: what women all over this country are saying is, they are sick and tired of working for $.79 on the dollar. compared to men. cheers and applause] bernie sanders: i know every man in this huge room -- huge room -- will stand with the women in the fight for pay quity. [cheers and applause] bernie sanders: by the way, when we talk about women's rights, i when everybody to know that all over this country -- if republicans running around talking about family values.