hayden on national security. in about 45 minutes on "washington journal," daniel raymond policy director for the harm reduction coalition talks about combating drug abuse. and then megan mccarthy on the federal and congressional response to the heroin and opioid epidemic. >> it has been described by hillary clinton as a quiet epidemic. it was a major issue in the new hampshire primary and the cost of the heroin epidemic is estimated to be about $34 billion in crime, health care, and economic costs. this morning on "washington journal," we're going to focus on the heroin abuse issue and as with all c-span programs, your call and voices are central. here is how you can participate this morning.

we have divided our lines a little bit differently. if you have been impacted in some fashion by heroin use, we want to hear from you. 202-748-8000 is the number for you to call. if you are a medical professional and you have been involved with heroin in some fashion, 202-748-8001 is the number for you. all members can call in and voice your opinion at 202-748-8002. you can also make a comment on social media on twitter. you can also join the conversation on facebook at facebook.com/cspan. this week on capitol hill, there was a hearing on the heroin use in this country. the director of the office of national drug control policy is spoke there. >> if you look at the overdoses we have seen, there is a direct correlation between the amount of prescriptions we are giving out and overdose deaths.

has been going on for 10 years. and i think the medical community has a role to play and that is a good start. >> what about liability? what about adding joint liability for the drug companies and the doctors who pushed this stuff out? these people are unsuspecting and getting addicted. >> there has been legal action against pharmaceuticals for that reason. they have a role to play, not only in terms of making sure they are following the letter of the law by marketing, but also creating abuse. the duty to work with the da and others to go after outlying prescribers who are vauntingly ignoring the law. that you are right, we need prescriber education, good prescription drugs monitoring program's soap physicians can identify people who might be going from dr. todoctor to doctor. if we are going to reduce the magnitude of the problem, we have to scale back on the

prescribing and identify people who are developing problems. host: from our facebook page this morning tracy asays in my small town we have had four heroin overdose deaths. alder female. high school aged kids are becoming hooked on not illegal drugs, but legal described medications. this is a shame and it is going on on a much larger scale than most would like to admit. that is tracy on our facebook page. here is how you can participate through the phone lines as well. "202" is the area code for all of our numbers. if you have been impacted by heroin use, 202-748-8000. if you are a medical professional, 202-748-8001. and all others, 202-748-8002. elijah cummings is the ranking member who held the hearing. >> people are dying in baltimore, orlando, salt lake city manchester, and cities all

across our nation. we can no longer ignore this public health emergency. congress needs to put its money where its mouth is and actually help. help our states find a treatment programs to stop this epidemic in its track. drug treatment facilities without adequate funding are like firemen trying to put out a raging inferno without enought water. last week, leader pelosi sent out a letter urging speaker ryan to schedule a vote on $600 million in emergency funding to help states address this epidemic before this recess week. our colleague from connecticut is already introducing this bill in the house.

the senator has been pushing this legislation in the senate. congress did not leave town until we take emergency action to increase funding to helps sta states combat this epidemic. we must also fully fund president obama's request for $1.1 billion in 2017. >> opioid addiction is one of the most pressing public health and safety challenges facing the u.s. today. according to the centers for disease control and prevention, prescription painkillers and heroin are driving one of the deadliest drug epidemics in the nation's history, claiming the lives of 78 and americans every day. randy is calling in from long beach, california. go ahead and make your comments. caller: hello, i am a longtime viewer and i am very interested to tell you about the fact that i learned this from c-span and "washington journal," one of my

favorite shows. i am in california. what i saw on c-span, "washington journal," it was actually a map up on the back of the wall and it was showing afghanistan, the city of afghanistan with a little bit of pakistan on the side, but it had all the green areas where they were growing heroin. and they said the hair wheneroin is three times the amount of heroin before it used to be before we actually got there with our cia and our war. i am quoting what you said on "washington journal." host: what you think that means? caller: i feared it was starting in europe about two or three years ago it was hitting them pretty bad. now it has hit the shores of the united states. we have the atlantic ocean dividing us. obviously, there was a two or three year wate.

we are getting here, all 50 states from what i understand. host: this is frederick in blakesley, pennsylvania. caller: good morning. look, i was raised in brooklyn. in the early to late 60's or early 70's, use of people who overdosed on heroin. the problem that is bothering me back then there was a crime problem. now all of a sudden when people are overdosing in massachusetts new hampshire now all of a sudden you are hearing people talk about it as a medical problem. i think it is unfair that now it is going out into the states i have seen a lot of programs. nobody is really talking about back then when i was growing up. host: frederick, are you referring to the fact that it's affecting white people? caller: yes, that is what i in saying. host: there is a different attitude towards it now.

caller: i am here in cummings talking about it. like i said, in of the late 1960's or early 1970's, it was running all through my neighborhood. i had friends who overdosed on heroin. and nobody talked about it. at that time, it was a crime problem. now that it is in the suburbs it is a medical problem. my here them talk about all the clinics and programs they want to use. what to use more money and more money because they call it a "medical" problem. back in the 1980's, it was a crime problem. host: this is earnest in hollywood, south carolina. caller: on because of pennsylvania. i am an addict now and i have been recovering since 1995. when i came back from overseas all of the heroin addicts came from vietnam. is in thing the guys that in pennsylvania.

-- it is the same thing the guy in pennsylvania was saying. if we have a disease in africa sooner or later, it will come overseas to america. and that is what is happening now. it is beginning to affect tehhe shiwhite people and now something is being done by it. it is a shame but this is what is happening and i am glad that something is being done, but it should have been done way back then. host: ernest, you said you are an addict. what kind of addict? caller: i was addicted to cocaine. i used heroin and i have been recovering since 1995. host: what was your addiction like? what were some of the impacts of it? caller: well, most of my addictions happened to me when i was in the military. everything happened to me when i was in the military. i had seen some traumas and i

had seen a lot of addicts shooting up. it was like a shooting gallery right there where i was stationed at. and you know, these guys are just sitting around and shooting heroin all day long. nothing was being done. they just let them out on the street. and the devils came home. no program or nothing was being done for these guys that came back from overseas. and we still have the impact right now. host: do you see the impact of heroin use in hollywood, south carolina? caller: it is being used here, yes. i know it is. host: is easy to get? caller: if you wanted to, you could get it. host: thank you for your time. water is calling in rum new jersey. -- from new jersey. caller: this heroin problem like the gentleman was saying, it should never have been dealt with as a criminal justice issue.

but as you go on you learn more and you know how to better deal with things. it should have been dealt with always as a medical issue. host: thank you sir. warren is a medical professional in a windsor mill, maryland. look at of medicine are you involved with? caller: i work in substance abuse, basically. host: so, in your view is there a heroin epidemic in this country? caller: well, i actually live in baltimore and work in washington dc. i get to see both sides of how of what you call the problem has -- i mean, i see the affected people. [laughter] but it is a big problem. my thinking is, a lot of the support staff available to help treat this problem like

counselors and substance abuse counselors and all the social workers, do not get paid a lot and are overworked. as a result, a lot of the people who come in for treatment and of being managed and not actually treated. so they just go back to using. they make progress and that they go back into doing the same thing. and i also, i agree with the last two callers. it would be better with this as a medical problem and not -- i mean we can't just put people in jail for doing the same things. whatever, i mean, the court system is doing, it is not quite a help at this point. it is just making the whole situation bad for everyone.

host: warren, a lot of the research we did for this program says that heroin abuse began as prescription drug abuse. do you see that? caller: yes, i agree with that. a lot of the people who i actually work with, started with what you call prescription drugs and then moved on to heroin and other things. they have different drugs that they use now which are basically opioid-based drugs. but you know if we just can -- i mean, we need more of a budget. so people can actually have a little bit more care and can actually take their time and reduce the amount of caseloads for a lot of tehsehese

counselors who in some cases have 40, 50, 60 patients. it would reduce, i mean, it would increase what you call the success rate. host: what is a defective way to treat heroin addiction? caller: the effective way to treat heroin addiction to me is basically well, you have to address the entire person as a whole, which means the medical aspect has to be addressed. the physical aspect -- the mental aspect of the person. it takes the entire treatment team to actually get that person off the substance. you can say well, let's just focus on the heroin and then we

think we are going to get some results. they are just going to go back to the same behavior. the most effective way to me, is to handle all aspects possible of the individual. we have support for them. for example, if they are homeless we might have to find them, what you call, a home. if they have mental aspects going on, they have to get treatment for their mental situation, whatever is going on. and mabye we can also provide medical treatment after we have addressed those other issues because a lot of times what we do is something whichat you call a patchwork. they come in and we put them on methadone and send them out. and no further aspect is followed. we will follow-up on how they leave and how they get food to eat. how they live with their families, or their partner. we need the entire structure to

be inside to treat them. host: thank you for your time. mike is in ohio. mike, we are talking about the heroin epidemic in this country. caller: good today peter. how are you? host: i'm fine, how are you? caller: a flashback to the iran scandal under bush one and we had that cocaine epidemic. remember that? i think they were trading machine guns for cocaine in south america and we had that cocaine epidemic in the 1980's. that was under bush one and reagan. and he is telling more stories now on the fox channel. but anyway, now we are into the heroin epidemic. and you know, we have been to afghanistan and their production is three times as much as what it was before we went in, like

what it was 15 years ago, and here you have got the state department and all of this stuff going on and here a while back on c-span i heard that one of our top senators, his brother-in-law, a man from china in charge of the shipping containers coming into this country. so, there was mention of that. so, i think we need to connect the dots here on what is actually going on. and you know, paul ryan the other day said we should not lose faith in government. host: mike, we are getting a little off course there a little windy. let's give back on course to talk about what we are talking about this morning, which is the hair went epidemic in your community. eddie from new york go ahead. caller: good morning, peter. how are you? host: please, go ahead. we are listening. caller: i am just commenting on

heroin and this war on drugs. it just doesn't work. you know? we talk about how we demonize addicts and what do we do, we throw them in jail? like before this call, i totally agree with the other three ok? that we have to build the infrastructure for these addicts. they are ending up on the street with nowhere to go ok? like you take the you know, sweden profile, what they did over there. they legalized all of the drugs ok? host: are you in favor of that? scott wong: -- caller: yes, i am. as people who would read this book "chasing tehhe screen" they

would have a different outlook on how far back we are. host: that is eddie in a new york. here is the first page of yesterday's "new york times." town's antidrug plan, a safe site to use heroin. the mayor of ithaca, new york has opposed a legalized open area, or an area for people addicted to heroin to be able to use it legally. rogers represents a lot of rural kentucky and he was at this week's hearing on heroin and opioid abuse in the united states. >> without for years, we end the countries and others, have fought for years to get the pharmaceutical companies to develop abuse deterrent formulations, to make opioids so they cannot be crushed and take

away the time release of the drug to just a split second. and now we've got i think five abuse deterrent opioid pills on the market. but doctors are not prescribing them. i don't know whether they don't know about them, or don't care about them, or whatever, but the bottom line is, they are not using what we have developed as an of these deterrent strategy -- as an abuse deterrent strategy. what you think about that? >> there are different reasons they might not be using them. one that is important for us to be aware of is that we have to be certain because this abuse deterrent requires development. they tend to be more expensive than the old opioid medication. you want to be mindful that there are insurances that when a physician prescribes it, the patient will be reimbursed for the cost associated with it. with have to create a system

that incentivizes the utilization of these abuse deterrence formulations. they will be more expensive. host: here is a cover of the most recent "national review." ground zero in the opiate epidemic is not in some exotic coffee field or in some cartel boss'compound. it is right there in walgreens and the middle of every city and town in the country. this is kevin williamson, who went to the country and reported this story, including going to drug corners. hear is a little bit of what he wrote. in 2013, walgreens made the second-largest fine ever imposed for being so loosey goosey and handling oxycontin at its distribution center. it enabled untold quantities of the stuff to reach the black market.

a typical sells 73,000 oxycodone pills each year. six walgreens in florida were going through more than one million pills a year each. a few years before that, perdue pharma was fined for misleading the public about the addictive miss of oxycodone. kentucky, which has been absolutely ravaged by opiate addiction, is still pursuing litigation against purdue, and it has threatened to take its case all the way to the supreme court if it comes to that. we have a herbert calling from georgia. caller: good morning, peter. i am 65 years old. i have been off of heroin for about 30 years now. i started when i was 18 years old. they are talking about oxycodone and everything else.

it is differntent. i have not had oxycodone since i have been off of heroin. those guys don't even know what they are talking about. i was on, up until 1991. but what made me get off of heroin. i am ita black guy. i've been through everything. all of my friends, a whole flood of my friends, died up of air when. we used to have shooting galleries. let me tell you, when you get those physical withdrawals that's what makes them go to the heroin. i am telling you, every part of your body, from your toes, to everything else aches when you are heroin addicted. that is what those guys feel. that is what makes them go out there, just to maintain, just to relieve the pain of the heroin. you don't get the high no more.

you just are trying to relieve the pain, to not be sick. you start vomiting and everything else, man. you try sipping on through ruenals. they are talking about the codon. i have been through it and gotten off of it. i have scars of my arms right now, peter after 30 years that you can see that i a injected heroin. i injected heroin in my neck and in my foot. i saw a white couple one day a mcdonald's. i seen them with the spoon. i kept looking at them. i try to stop them because i saw them at the beginning. they were going to shoot some heroin. i try to relate to them. i said you don't want to get this happy. when you get is happy, you just

want to relief from the aching pain. it is different than oxycontin and things. i have got to the experience and came out of it. most of my friends are dead. i can count maybe three friends who are still living. i have a teacher friend who recently retired. these to shoot heroin together. -- we used to shoot heroin together. he is active in the ministry. me, i tried to talk to people. these people they need to talk to, to went to the window. a lot of them got on methadone but they did not give them a high dosage. they started breaking down there dosage. but thank god, through the glory of god, i did not need needone of that. i went through my job for 20 years and i retired. i went through the physical and everything, but doing that time. host: herbert, why did you start

using it in the first place? caller: well, it started as a conventional drug because we were 18 years old. it started off as a conventional drug. back then they were calling it smack. we were starting at first, right? when we started snorting it, then you start off skin po lopping. i was scared of needles, peter. i was scared. so, i started skin popping. and then one day i got with some dudes and they were mainlining. and they got more high than i did. it went from there all the way to the addiction. it started as a nodding sensation. is a feeling that gives you. it makes her body like, it makes

it like -- it relieves everything in your body. it does something to you mentally. i mean, like a trance. is like you are in a trance. host: herbert, do you miss that sensation? caller: no, no. peter, i remember. i had back surgery too, right? when i had back surgery -- that is why i am retired too -- they had the morphine right at the beginning. i didn't like that feeling. and then when the doctor did give me the oxycontin and the hydrocodone, i did not like the old funny feeling. you feel a funny feeling in your knee. and i just did not like that. it was like a heat feeling all around in your head. i didn't like that feeling no more.

host: how did you support your heroin habit? caller: i went to jail. like that guy said, i was burglarizing i was stealing. i used to go in the storesi in, miami in the shopping centers. i would steal everything. if you look at my record, a lot of it came from the drug use. i went to prison because of my druggies. -- because of my drug use. i had to cry to the druge judge monday and i said, man, i need some drugs. when i got out i sent, god take this away from me. i don't want to live like this no more. i looked at myself and through the support of myself -- there are eight of us -- they showed so much love for me. that is what made me want to get off of it. i said, i can't be like this.

i don't want to be like this. that helps you too when you see love coming from either your family members and some outside guys who try to embrace you and you just a want to live like that no more. you don't want to live for the high. i wish i could be an as set to help somebody. if something called my number four whatever. -- or whatever. man, i can relate to these people. i can tell them how to get off of it. i can let them know, this ain't you. you were not born with this habit. you don't need to get high. and you know what i always make a joke of? it was a good time to get high. and i just look and i left now. i don't want to see nobody on durgs. i don't care if you are black white, spanish, whatever.

i have seen women destroy themselves through this drug. i haete to see this. i had a couple and i hate to see that man. i'm seeing good girls, talking about, i have a couple of white friends named mike and lois, some white guys from new york. and i used to talk to them and we used to kick it around and stuff, and we shared stories and stuff like that, man, and -- host: thanks for your time this morning, and thanks for sharing your experience. ken is in capscale new york, a medical professional. what kind of medical professional are you, ken? caller: i should clarify in 1970 and '71, i worked for a new york state agency called the narcotic addiction control commission. i was trained to some degree to be a substance abuse counselor. i was very young, early 20s, with no personal drug experience. i had never used any drug.

not even tobacco. but we were given case loads of people who had been certified by the state. new york state was attempting to solve the heroin problem by considering heroin use a medical issue and not a legal issue. so if you were arrested for burglarizing an apartment and could demonstrate that you were a heroin user instead of going to a conventional jail you would go into a treatment facility. most of them were very well intentioned facilities. under the state, some were set up old-school, some were set up in prisons. one of the problems, we had people started declared themselves addicts because it was much easier time to do to commit a crime that was the problem. and it was also the beginning of

a cycle of self-pity, if i may. people started seeing addiction as an illness that befell them when really, it was a choice they made. and then when they would detox, they would hit the street and a lot of the guys would say, wow, i feel great. i think i'll just get high once or twice more. and then i'll illustrate life, and then they would get back into it. and here we are, 40-45 years later and we're going into another cycle. but let me just sum up by saying that i'm personal appalled that the open opiods they're selling now are so readily available now. i had used oxycottin.

i had surgery about eight years ago and i experienced the feeling you get from those drugs and it's an interesting experience. i don't recommend it to anyone especially if they're inclined to addiction. but i also want to point out many people are addicted to behavior such as gambling. it's a mysterious problem. host: we're going to leave it there and hear from ryan in houston, texas. ryan, how have you been impacted by heroin? caller: i want to start by saying that heroin is really a sucker's drug, you know what i'm saying? i come from new orleans. these people here, i hear a lot of people saying, you know, it was this and it was that. in new orleans a lot of guys, we started loving using heroin because we thought it was cool. we was wearing high fashion, you know what i'm saying? you would see us on the street and you wouldn't think that we

was on heroin, you know what i'm saying. we were high-fashion, we were looking good, feeling good, you know what i'm saying? so to us it was like cool to do. but we all found out that it wasn't, you know what i'm saying, and in new orleans you go, you know, it was cool you see all the people was doing heroin, they was the coolest you know what i'm saying, so we thought that was cool. host: how long did you -- caller: in the long run, people would still look us and not know that. we would come out looking like a million bucks and go get high but we was addicts. we would go to work every day. i'm not trying to put that like heroin is cool but heroin was, you know, you go to work, you know what i'm saying, you go get you a bag of joy do your bag and you just chill. it's just like drinking a beer.

host: ryan, how long did you use heroin? caller: it's the devil. don't get me wrong. but we didn't look at heroin as something like the rest of these people looked at it, you know what i'm saying. it took a lot of lives and a lot of people, but we, you know, it's a sucker's drug. host: ryan. i'm going to move on to dan in exet exetter, new hampshire. dan, how have you been impacted by heroin? caller: good morning, peter. i had two sons. when my youngest son was 18, he started using heroin. my oldest son was living in florida. we were up here in new hampshire, and after two years of spending about $150,000 in treatment, my oldest son moved back and was going to help with his younger brother. after about a year, he got

addicted and he overdosed and died. my youngest son is still addicted. i believe the drug industry who reached huge profits -- he did start with oxycontins off the street, and it rose to almost $70 a pill. he went to heroin, which was $10 a bag. so two things i would love to see happen as you showed a photo of the overdose drug while you have to get a prescription and blah blah blah i would like to see one of those hanging around every addict's neck. my oldest son when he od'd what happened was, he was in a car and this happens often is the people when somebody overdoses, they don't want to ruin their high.

they pulled up and threw him out onto the sidewalk. so he was found dead on the sidewalk. now, if they had that drug, norcan or whatever, around his neck, anybody could use it, and the drug company should pay for it. and then there's another drug testing now, which is new, an injection drug. it lasts a month. but the patient is -- but the problem is, the patient has to be clean for 10 days and an addict cannot stay clean for 10 days, so that has to be an in-house program. so it's impacted me. it's funny because i remember the day sitting in my bedroom when my son told me that, and as it came over his lips, i saw my

future of what it was going to be like, and in an instant but i never realized how hard it would be. host: dan, why do you think they started? caller: they start like anybody else, the kids, they get it in the schools. you know another interesting thing, my youngest son, when he was in the sixth and seventh grade, he was hard to handle at school, blah, blah blah, and the school told us, okay, he's got to go on riddlin and if not, you got to take him out. so had to put him on a ritalin. i caught him crushing up the ritalin and snorting it, and i believed that's where his drug interests started. so it's tough, peter.

host: where is your youngest son living today? caller: he lives with me in my basement in my house. he cannot live on his own. he's on the methadone program, and as far as the last guy that called, it's a typical republican response, it's a choice. you know nobody's saying to all the crimes that the addicts commit, stealing robbing, or whatever should be -- no it's only the crime of possession of drugs that should be treated as an illness. host: has he stolen from you? caller: oh, my god, he's stolen from me. yeah, he's stolen checks from me. he's stole enn thousands of dollars. host: so dan, i know this was an issue in the new hampshire primary and a lot of the candidates talked about it chris christie hillary clinton,

et cetera. is there, in your view, a head-rolling response to this issue? caller: yes, there is. there's federal funding. and again, i go back to the tremendous profits of the drug industry. host: and what's being funded exactly? what should be funded? caller: in-house treatment is the only thing. i live in new hampshire. this is how screwed up new hampshire is. my son has to get a massachusetts address, or a friend of his, so he can get on mass health to have this stuff covered. if he didn't have access to the massachusetts healthcare system, he'd be dead by now. host: how clean is he right now? caller: he's clean now because he's on methadone. every day, he's got to go down to the clinic. that takes away the urge. as the other addict was telling

you, it's not to get high anymore. it's to stop the withdrawals, which is all-encompassing. so he's on -- he's counseling. this is all through mass health. host: the comprehensive program that he's on, is it effective on a day-to-day basis? caller: yes, it is. but the long -- the underlying problem that addicts have with their personality, that has to be resolved. now, he's got the guilt now because his older brother overdosed, and he feels it's his fault. so all the pressures of life for drug addicts to the drugs. host: thank you for sharing your story with us this morning on the "washington journal" as we talk about the heroin epidemic

in the community and in the united states. it's estimated that 700,000 or so people are addicted to heroin at this point in the u.s. anthony is in wilmington, illinois. go ahead anthony. caller: i'd like to make a comment why there's no mention of no mention of that new heroin called crocadill. host: what is that. caller: i just saw it on netflicks. it's like a flesh-eating disease where the bones are coming out of these people. host: from using heroin? caller: it's a new heroin called krokodil, and there's no mention of it right now. host: we appreciate you bringing that to our attention. michael is in lancaster california. hi, michael. caller: good morning. you know, krokodil is something they use in the ukraine. they mix it up and shoot it. it has nothing to do with

heroin. but you know, the way to get off these drugs is you just have to stop. that's it. just like coffee. you drink coffee. i quit coffee, and it was hell, i tell you but there was two years of driving by, and every time i smelled coffee, it would kill me. but if you just stop, you just got to stop, go through the sickness you know, congress wants to spend billions of dollars, it's just -- and the guy who's got his son living in the basement, you know sometimes you just got to kick them out and let them go on their own, and then they stop. but if you keep, you know -- methadone is one of the hardest things to get off. it's way worse than heroin. you don't use another drug to get off a drug. they use -- methadone, i hear it will about kill you to get off of that. host: do you have personal experience with that, michael? caller: yeah, i -- and i got on

some pills and i was on pills for a while, and some heroin, and about two years, and finally, i just said, man, i've had about enough of this and just quick. host: michael, again, back to the research for this program. a lot of what we saw said a lot of people who are on heroin today started with prescription pills. they couldn't get any more, so they went to the alternative, which was heroin, and it was cheaper, et cetera. caller: i started -- me and my friends started getting into the medicine cabinet of our parents and stuff and heroin just came in. the heroin is coming over from mexico like you wouldn't believe. but but it's a different high. the pills and the heroin are different highs. so you just -- you can't

be -- my family had to let me go. i was on the street. there was no choice. i laid down by a bush in long beach and i stayed there for about four days, this old lady came out and gave me water. i was determined to get off of it. and it took about five days. host: michael, you said your family let you go. our previous caller dan has his son living in the basement. caller: he is not going to get any better if he can just stay there like that. and he's on that methadone, which my god, to get off that, it's like twice as hard as heroin. it's five times as hard. so you know, pick another drug. methadone is the worst thing they ever made. it's a synthetic heroin. host: michael, as far as federal policy, state policy, what kind of treatments or policies could

be effective in treating? caller: you know, first, the person has to be sick and tired of it. you have to just be tired of it. and then you've got to want to quit. people come in, and they go in these rehabs. in a rehab, they'll get 90 days or whatever rehab, they get out and go do it again. they go hang around the same person. you've got to change. you've got to change your whole life, change your friends, change your people. and it's really not that difficult. and you've got to get up every day and you've got to say today, i am not going to use, today. not i ain't going to use for the whole week. just today. host: michael, are you in a 12-step program? caller: i did go. i'm holding my narcotics anonymous. those places are getting to be now, oh, there must be some

underlying cause why you're getting high. well, no, there's not. anybody would get addicted to heroin or pills if you abuse them. you know, your body needs it. you start feeding it and your body loses, like cigarettes or something. but it's just -- anybody, it's not a sickness. i mean, it's sick, but it's not a sickness. and i don't know, in congress, well, congress has come out with a bunch -- well, you know, that's the taxpayers' money. it's not their money. and they spend it like --i mean it's just crazy. you know what they're going to do is get all these rehabs going and these guys are going to come in and out, they might want to clean up for a little while, go back out, clean up, go back out, and it's just going to cost the american people billions of dollars and, you know, sure it will help some people but those

people probably would have been saved anyway because they were tired of it. you've just got to be sick and tired. host: michael from lancaster, california. well we've got a couple of guests coming up. we're going to continue this conversation. if you're on the phone line, just stay there because we're going to continue to take your calls throughout this program. coming up, we're going to talk with daniel raymond. he's with a group called the harm reduction coalition, and we'll talk about what his group is doing to cut the number of heroin-related deaths nationwide. after that megan mccarthy will be here. she's chief of a newsletter called "morning consult" and we'll talk about state and federal governments and what they're doing in response to this heroin epidemic. first, back to the hearing from this week on capitol. this is representative john micah of florida talking about

the death toll and the toeth of drug overdoses.death toll of drug overdoses. * death toll. rep. mica: unfortunately, america is experiencing drug overdose deaths. today, drug overdoses are the leading cause of accidental death in the united states. in 2014 -- i don't have the 2015 figures in yet, but in 2014, listen to this, there are 47,055 deaths caused by drug overdose deaths. that means that this hearing lasts for two hours, 10 people will die in the next two hours in the from drug overdose death. for americans -- and this is a little chart showing the increase since 1999. remember, i chaired criminal

justice policy oversight committee from '98 to '99, and we thought we had an epidemic back in '99 with 16,000, and i can show you some of the headlines from my local newspapers, where we had people dying over -- many people dying over a weekend. unfortunately, that's what we're seeing again in my community and across the united states. unfortunately, more americans have died from drug-related overdoses in one year than all that were killed in the lengthy korean war. if the current trend continues, the annual death rate could climb beyond those killed in vietnam over that multi-year struggle in one year. the graph from the washington post illustrates the disturbing

rise in drug overdoses between 1999 and 2014. of the 47,000 more than 10,000 americans died of heroin-related overdoses. heroin use is increasing at a faster rate. you want to talk about a war on women and war on our young people, the heroin deaths are killing our women twice the rate of men and 109% more with our youth. unfortunately, we've seen, according to the centers for disease control and prevention that again heroin use among -- the deaths among our youth between 18-25 in the past decade have soared, and again,

lead the statistics, the deadly statistics. host: and joining us from our new york studio is daniel raymond. he's the policy director of a group called harm reduction coalition which is what, mr. raymond? guest: good morning. the harm reduction coalition is a national organization working to address the health issues associated with drug use. host: how did it get started? guest: we got started about 20 years ago. this was back in the early '90s in the height of the aids epidemic, and we came out of the movement to start exchange programs across the country to prevent hiv from spreading among people who inject drugs and bring them into healthcare and other services. host: how are you funded? guest: we have some state and city contracts who do training and education, and we have some

grants from private foundations. host: any federal monies? guest: currently we don't have any federal funding. in the past, we've had funding from the centers for disease control for education. host: how did you personally get involved in this issue? guest: i got involved back when i was in college in new york city, and this was ground zero for the aids epidemic, and it was all around us. it was also a huge moment in the history of drugs in new york city, where there was a lot of drug use, a lot of drug dealing, and it was the perfect storm, the perfect environment for hiv to spread, so i started getting involved as a activeist doing syringe exchange and found out it was extremely rewarding, the connections you can make with people that use drugs, the

conversations you can make, and getting healthier was a powerful motivator for me doing this work. host: do needle exchanges work? guest: they absolutely do. it's not just been my own personal experience. that's been born out by years and years of research. they definitely work to prevent hiv and also work to help get people into treatment, people who have often been using, then struggling for years and years, and need that helping hand. we have a lot of examples of needle exchange programs across the country that are on the front lines of fighting overdose, of providing healthcare, of getting people connected to addiction treatment and recovery services. so there's no question these programs work. host: daniel raymond we have been talking with our viewers for the last 25 -- 45 minutes

and we've heard incredible stories about the power of heroin addiction. in your view, what's the best way to get people off of heroin or simply to manage the addiction? guest: well, when you look at what works most effectively, there's no solution that's going to work for everybody. i think your last caller was talking about how he quit, and that's a path that works for some people. the best evidence says that if you use medication, such as methadone, alongside with counseling and other support services, people stay in treatment for longer and get better results. everything we know tells us if you've got a heroin problem, the best chance of success and recovery is to work with a doctor to get treatment and work with counseling to get support to help you stay on that path.

host: heroin deaths according to the c.d.c. are up 286%, overdose deaths, over the last 15 or so years. are you seeing a big increase in new york city? host: we've definitely seen an increase in new york city. we've started seeing increases in different parts of the city around prescription pain killers, opiods in places like staten island, and also seen these rises in heroin deaths in a lot of different parts of the city. staten island but also the bronx, parts of brooklyn. it's a phenomenon that is hitting all parts of the country. host: daniel raymond, you're at our studio on 42nd street in new york. you know very commercial, nice neighborhood. could you go out in 15 minutes and get some heroin from where you are right now? guest: well, i think one thing to understand is how the heroin market has changed. the image that a lot of us have

is from back in the '70s and the '80s, that you find some dealer on the street corner, that you go into what seems like a bad neighborhood and you score some drugs. but right now, a lot of heroin dealing is much more subtle, much more invisible. you have a contact that you text. they arrange a meeting location. it could be a parking lot outside of a coffee place. so it's not so much that visible street scene that we've been used to seeing from the '70s and '80s. it's almost like an uber or seamless model that you have a connection, you meet your dealer some place, and you get heroin. host: if you want to participate in our conversation this morning about the heroin epidemic in this country, 202-748-8000.

if you have impacted by heroin use, 202-748-8001 for medical professionals, and 202-748-8002 for all others. we want to show you this map and this is the -- the redder parts of the map is where there's been an increase or higher percentage of heroin deaths and overdose in this country. you can see the impact, a lot of appalacia there, florida, out in the west, a lot of red areas out in the west as well and up in the northeast. john is in philadelphia. a medical professional. john, you're on with daniel raymond of the harm reduction coalition. guest: good morning, peter, and thank you for c-span. i'm 64, i'm retired now. disabled actually. i feel three stories and broke my neck and broke my back.

thank god i can walk and everything, i was a stroke victim. i was a substance abuse and mental health counselor in north carolina. i put myself through grad school and i was working. this was in '90,' 91 and it was the crack cocaine epidemic that was happening then in north carolina. it was working its way up and down the east coast, and i -- so i worked weekends when i was in grad school, and i worked alternating weekends at the county treatment facility, and the other alternating weekends, i worked at charter hospital. there was a different level of care in each one obviously. back in '91, it cost $1,000 a day at charter hospital and what you had was professionals and

people with good insurance. the rest of the people who didn't have insurance, you know, they went to the county treatment center. the county treatment center was pretty good, but it didn't have the facilities, and it just -- they couldn't take people. they couldn't take enough people in. host: so john, as a masters level counselor, is there a solution to what's going on in your view? caller: well, that's a long story, peter but i'll try to make it real short. yeah, there's a solution. i'm a recovering alcoholic, and also, i was on oxy for four years, and i came off oxy with no problem. so different people are affected differently by different drugs. people have their different

forms of triptonite, okay. i've tried a lot of different drugs. nothing affected me but alcohol that was my personal. my kriptonite. here's what i think. people have a biosocial model. what that means is you've got to treat medically, socially. in other words, they have social problems, people don't have work. you know they're living on the street. that's a social problem. psychosocial. you've got to treat the psychological problems. host: john, i think we got the point. daniel raymond, any response for that caller? guest: john, thank you for your observations and your insights from the field and from your own experience. i think the point that you were making about the limited treatment capacity in north carolina when you were working in the early '90s is what we're seeing play out in states across

the country right now, that there are waiting lists for treatment. there are shortages of beds, of facilities, of trained physicians, of trained counselors. and we're confronting this crisis in the midst of the big gap in our treatment capacity. we just don't have the capacity right now to get everybody into treatment tomorrow. so i think that's going to be an issue that congress and the white house are going to be looking seriously at over the next several months. host: daniel raymond, can you be a functioning citizen if you are addicted to heroin? guest: yeah, definitely. you can hold down a job, you can hold down a relationship. at some point, most people's trajectory starts to escalate. they need more and more heroin to function. that means that they need more and more money to support their habit. so not everybody can sustain that indefinitely. but i think what you've heard

this morning is that addiction cuts across all walks of life, whether it's the functional alcoholic, or the person who's getting arrested or losing their home. a lot of it has to do with the circumstances in which you're able to maintain your habit. if you've got a job, if you've got an income, if you've got some money. if you've got more social support, then you have more of a cushion around you. whereas, if you're exposed to situations which are going to lead to getting arrested, then you might be spiralling further into harmful patterns. host: in your view, mr. raymond, why do you think the heroin epidemic the use of heroin in this country has increased so

exponentially recently? guest: i think there's a very simple answer to that, that over the last 20 years, we've seen a dramatic increase in the use and availability of prescription pain killers, opiods. there's been a brought effort to use opiods more widely that was supported by the pharmaceutical companies and manufacturing them and some people who felt understandably that maybe we were undertreating chronic pain but the consequences have been devastate devastating. millions of people have been exposed to opiods and some of them have gotten dependent on them and it's created this market for heroin that did not exist before. we've had heroin in this country for decades but not at the level we're seeing at. it's the people who first got exposed to opioids, whether they

were prescribed or found them in a friend's medicine cabinet. it's the prescription of opioids that started it. host: a box of rocks knows that heroin is bad but people use it anyway. how much money can fix that? people will abuse drugs or anything until the end of time. guest: i hear that sentiment a lot, and there's a couple of pieces there, that people will use drugs, that we're not ever going to get to a place where we've finally solved our drug problems once and for all. it's a part of whatever you want to call it, human nature, culture, that our goal is not going to be let's imagine a time where there are no more drugs and no more people using drugs. at the same time, pretty much everybody has made some bad choices or hard choices at some point or another in their lives.

it may not be drugs. it may be something else. a bad business investment, a bad relationship, a bad argument, and i think that we have to think about what our role is in helping to mitigate the consequences of people's choices. that doesn't mean they're not capable of making choices. that doesn't mean they're not responsible for the choices that they made. but when we see people getting into problems with drugs, i think we need to step back and say is it in society's best interest to keep following, or is it in society's best interest to say we don't want to see families torn apart. we see potential in these people. we see potential for recovery, their potential for growth, their potential for contributing to society, and we want to help them fulfill that. host: wayne is in jonesboro, georgia. go ahead, wayne. caller: good morning, sir. 5 been -- i've been around this

almost all my life, prescription drugs and street drugs. i've seen both sides of the fan. and to me, it looks like the major problem is it starts off with the pharmaceutical companies. which are making trillions of dollars off of these people getting on heroin. if they have to go in for surgery or something and they have to have opiates when they come out and there's no movement to get them off, and they want to switch them over to other drugs like methadone and say that they'll -- host: wayne, is that what happened to you? caller: no, sir, no, sir, that's just what i've seen from friends that, you know, i would never have thought of -- never tested in the world.

my brother though at 42 died of some kind of chemical imbalance, of some kind of methadone, and some kind of other pill. i don't know what it was. but i know methadone was involved. host: thank you, wayne. daniel raymond any response? guest: yeah, raymond, thank you for your story, and i'm sorry to hear about your loss. i do think that that speaks to an experience that a lot of people have had. and national surveys are bearing this out. a lot of people know somebody who developed a problem with this prescription pain killers. they might have gotten prescribed after a surgery, after an accident, for chronic pain. and i think that collectively, we're starting to see, we have overprescribed these pain kill ers and maybe miscalculated who's most going to benefit and who's more likely to suffer harm from them. so that's why we saw a couple of

weeks ago, the centers for disease control put out guidelines for primary care providers to say if you are considering using opioid pain killers to treat chronic pain, here's some principles. don't use them as your first line of therapy. try other things first. go slow, and stay slow. stay the low dose. and monitor people closely to see if they're getting into a problem and then look at tapering, look at strategies to reduce the risk for developing a serious problem. so we're seeing a concerted effort to saying we've been too generous, too liberal with our opioid prescribing, and that's creating this crisis now where people are getting dependent on opioids, people are overdosing. we need to start to recalibrate that, reign that back in make sure people who do benefit from the opioids and who do need them for pain still have access to them but at the same time say

we can't keep writing prescriptions for opioids when there are better ways to manage pain. host: recently in the washington post was this information over 900,000 physicians in the united states, nearly every one of them can write a prescription for opioid painkillers but to prescribe treatment drugs, doctors must take an eight-hour course and apply for a special license and fewer than 32,000 doctors have received such a license. what is that treatment drug, daniel raymond, that can be used? guest: it's called sabaxone. it is derived from the same -- it's an opioid drug that can help transition people off of heroin, off of the painkillers they're addicted to and it also has a lot of

benefits. it's very hard even if you take too many doses and overdose on it. it's been very successful in treatment, but when it was introduced back about 15 years ago, the way it was set up was requiring that you have to go through a special training course. so it's a much higher standard than doctors need to actually write prescriptions for painkillers. we're also seeing that there's a limit to how many patients a doctor can treat. you can only treat 30 patients in the first year, up to 100 after that. so congress has taken a look at this. the white house has taken a look at this, and we're starting to say if we want more doctors treating addiction then we cannot impose these constraints that disincentives them from becoming prescribers who are qualified to prescribe buprenorphine and support

peoples' treatment and recovery process. host: do you agree with that? guest: i absolutely agree with that. it's been alarming to me to hear the stories of people who have been seeking treatment, who have tried other things, who have tried detox and rehab and trying to quit on their own, they haven't been successful, so they tried desperately to find a doctor who can prescribe them buprenorphine so that they can get on that path to recovery they're trying to seek. and you hear these stories of people who have to call doctor after doctor who says, i'm sorry, i'm not taking new patients, i've reached my cap, who have to drive hundreds of miles to find a doctor to take them. the most tragic of all, who die of an overdose while they're waiting for a slot to open up for a doctor who could prescribe this drug to them that could have prevented the overdose in the first place. it's really serious -- overdose we need more doctors who are able to prescribe buprenorphine.

host: daniel raymond, earlier this year, congress lifted the ban on needle exchanges. was that a positive development? guest: absolutely. congress took a look at what had been a long-standing prohibition on use of federal funds for syringe exchanges. back in the late '80s when these programs were very new there was a lot of concerns about, are they going to send the wrong message? are they going to encourage drug use? and there wasn't a whole lot of research on them yet in this country. so 25 years later, we've learned a few things. we've learned that these programs work so there's no more concerns about research, they're not encouraging drug use. they're actually helping people. but we also have seen that as the drug problems have spread into outside of urban areas and really into suburban rural areas across the country, that the big cities were prepared, because states like new york have needle

exchange programs but places like rural appalachia don't have needle exchange programs and that's where we're seeing it spread the fastest. so the process that limited these federal funds was contributing to the spread of hepatitis c, and when congress recognized that, they revised their policy. so this is a very positive sign and we're hoping for some good news in the near future around more guidance about how states and communities can redirect their federal funds if this is a solution that makes sense for them. host: wendy in hedgesville, west virginia. you've been very patient. you're on the "washington journal." caller: hello, good morning. i just want to say that i am almost 90 days clean from heroin. i got clean on january 6th and i just don't understand why no one's talking about the aa/na program, because that's what saved my life. methadone, suboxone and subutex took me back to addiction.

i got my suboxone and sold them for heroin. i kept going up on my dose until i got the same effect i was getting from the heroin so it led me back to active addiction, and i had to lose everything to want to get clean. i lost my house, my cars, my driver's license and ultimate, cps stepped in and took my kids. so i came to west virginia, got clean, detoxed myself, was sick as could be for 30 days. went to aa every day. got a sponsor, read the big book, and i'm working the steps and this is the only thing that has worked for me. almost 90 days clean is the longest i have been clean in 10 years. host: wendy, how did you get started on heroin? caller: oxycodone. i went to a pain management doctor in the baltimore, washington, area and all i have is arthritis in my lower back. they made me do an mri and he

gave me 120 milligram oxycodone, and it just escalated. fent fentanyl patches. i was getting discharged and doctor shopping. and when maryland caught onto that, i just got discharged and went to heroin. host: and how did you find the heroin? caller: well, daniel raymond, one thing i disagree with, you can find it everywhere. an addict can spot another addict. you can spot a dealer. it's everywhere. it's all over. i could go to the 7-eleven or sheets or whatever and i could spot somebody. it's that common. it's not subtle. it's out there. it's everywhere. and also, i disagree with daniel raymond on you cannot function as a heroin addict. you wake up every morning, you're dope sick. you can't get your kids on the bus. you can't go to work and that's just how it is. host: wendy, did you lose your

job? caller: i lost everything, yes. i lost my job, my house got foreclosed, my driver's license, my car broke down on the side of the road. i was so dope sick, i left it there. they towed it. i never got it. you don't care about anything. i went to get my kids from school one day, cps came to my car and said you're not taking them. this was just in october 2015. you can't get them here on time. they say you're a mess every morning, and that was the day god interfered in my life and i came up here and i got clean. and i still used from october to january, even though my kids got taken, i still used. overdosed three times. and finally just had to get clean. host: wendy, why did you go to west virginia? caller: because my parents, i lost everything. my sister had my kids and i called my parents and said give me one more chance. i tried all the rehabs, the clinics, kept relapsing,

relapsing. they gave me one more chance. i came up here fought through the withdrawals, to the emergency room, swore i was dying. the doctors kept being positive go home, suck it up, stick it out, and you'll get through it, and i did. host: you detoxed mostly at home? caller: at home, in a bedroom, with immodium ad and benadryl. host: and your parents? caller: and my parents. host: and you go to a meeting every day? caller: every day. host: wendy, thanks for sharing your story. daniel raymond. guest: wendy, i want to thank you, too and congratulations, i'm glad you're doing well, and congratulations on coming up on your 90 days. i understand what you're saying. i do think that you've said you've tried methadone and buprenorphine and it didn't work for you. aa and na were the only things that worked for you. i know a number of people that said aa didn't work for me. na didn't work for me.

methadone was what worked for me or buprenorphine was what worked for me. i think like any other kinds of medicine, if we're treating this as a serious disease, that it's not one size fits all, but we have to find the right treatment for the right person and it's not a question of having enough options for people, it's about making sure that all the options are available and that we find people ideally before they've lost everything. i hate hearing stories about people who had to lose everything before they got help. and that's got to be something we've got to intervene in earlier, wherever possible. host: john is in waterbury, connecticut. you're on with daniel raymond at the harm reduction coalition. caller: yes, good morning, and thank you for the program. i would like to also say to wendy, blessings and good luck on your recovery. i'm not one of these people who's going to sit here and think that this is all great and all. , that it's just a simple

problem. it's a huge problem. it's a self-induced problem. and i truly feel the only cure is being clean. wendy made it perfectly clear. i can't speak on it, i've never been addicted to it. the problem i have is you guys guys -- not particular people, but programs for recovery are taking money from senior citizens who are healthy and worked their whole lives and also children who are in schools who could be benefitting from sports and music and other school programs, and you want to take those taxpayer dollars and put them towards people who don't want to be clean which is the simple truth. you can't put poison in your system and think you're going to be able to function normally. and you know, how do you go about justifying that you could go on one drug from another when i bet you $100 you're not going to go and put swamp water in your car and think you're going to be able to drive it to work. i just don't understand how you're justifying this problem by trying to say, well, we have drugs that will bring you back

to life and these people are going to live on the street and cause how many millions of dollars, whether it be through hospital care, psychiatric care the problems they caused for families and society in general. host: i think we got the point. daniel raymond, a response for that caller? guest: i think there's a certain point where we have to ask, are we going to treat people who suffer from addiction different than we would treat people who suffer from heart disease? are these all medical problems? you talk about them being self-induced. some people develop physical problems that are related to lack of exercise nutrition obesity, things like that, smoking, all of these things. where do we start to draw the line about who's deserving of health and who's not deserving of health? i think an illness is an illness. addiction is an illness, and recovery is a very difficult process. ultimately, investing in

treatment actually saves money. we're not necessarily taking away from here or there. if we make these investments we know that that every dollar we spend will come back to us many times over as people become more stable, more economically productive, pay taxes, support school, support all of those things that i think that we all care about. so i don't think that it's an either/or situation. host: daniel raymond what's the role of insurance in treatment? guest: i think that's a big issue right now. we have typically had a treatment system that has, you know, for decades operated outside of the rest of the medical system and insurance has always treated addiction as something of a second-class citizen, that insurance companies have not covered provided the same level of

coverage for addiction treatment as they have for treatment of physical diseases and conditions. so there's been a big push that's been part of federal law now, but also worked with some attorney generals who are saying, listen, if you're an insurance company and providing an insurance policy, health insurance doesn't just mean physical health. it means behavioral health. it means mental health treatment. it means treatment for substance abuse disorders as well, and you have to show parody. you have to * parity. you have to show the same. you can't say we'll treat your physical conditions but not your mental health. that gap is starting to close, but it's been a slow process. so i think there needs to be a big push around getting insurers to take their responsibility seriously in providing coverage in helping to manage both mental health and substance abuse disorders.

host: tracy is in cambridge, maryland. go ahead, tracy. caller: how are you doing today. i'd like to touch on a couple of points. i started doing heroin back in the early '90s. of course, went through the problems with the family, not wanting to listen. i'm only 43 so i haven't really been a long time. so going in and out of jail, not wanting to listen. been through rehab, serenity lodge in chesapeake, virginia. heroin was just as easy to get in there if not on the street. got out of there, went right back to it. ended up, you know traveling around doing whatever in the late '90s, ended up getting into a lot of trouble in a bad dope deal. went to prison for eight years and actually had easier access to better heroin in there than i did on the street. what it took and what i've seen, i i've sat with my friends for

days, on their death bed trying to come off of heroin on their own. i've seen them addicted to methadone, trying to come off of methadone and not wanting to go through it and getting back on the methadone because it was harder than coming off the heroin. like the guy said a minute ago, making new drugs to counteract a drug, i mean, you can throw money at things as much as you can until you search for the source. i'm not hearing anybody talk anymore like years ago about fighting the influx of drugs. where are the drugs coming from? who is -- you know, i believe it was cnn years ago during the afghan wars, 70-80% of the world's heroin came out of afghanistan, the majority -- the rest of the heroin, i believe, came out of southeast asia. here again speaks to a point, if we've got a vested interest in afghanistan, we've got more troops in afghanistan now than

any other middle eastern country, yet that's where the majority of their heroin comes from, and it takes a lot of poppies in a huge poppy field to get the sap from them to produce the heroin. these should be able to be seen by, you know, satellite imagery, things like that. i mean, i'm just -- i'm seeing throwing money at the programs, and i understand. the help, some people get the help. some people use that help to get on other dope that's given to them such as methadone. do you see where i'm going with this? host: we'll get a response from daniel raymond in just a second. do you think -- what about legalization from your point of view? caller: oh, no. no, no. the devil is already on earth. you don't want to make him president. that's what you would be doing with heroin. host: how do you manage your sobriety today? caller: i'm sitting here talking about it, getting shaky. i remember when i first got

locked up after i was about two years clean. we went on lockdown in prison and they brought the cart in to give the diabetics their shots and just seeing that gave me knots in my stomachs and sweaty palms. it's an everyday thing. you have to say no. i don't hardly drink anymore, because i know if i do it's going to mess me up. it just comes a time in a person's life where you just have to say enough is enough. i can quote you the serenity prayer and everything in the world, and that does me no good unless i myself want to stop what i'm doing. host: that's tracy in cambridge, maryland. daniel raymond. guest: yes, i think tracy was talking about looking to the source of these drugs. mentioning afghanistan. afghanistan has been a major producer globally of heroin. but much of the heroin in the u.s. doesn't come from afghanistan, and i think the challenge here is what i was saying earlier, that we wouldn't have today's heroin problem if we hadn't had the levels of

prescribing and levels of availability of prescription opioids which some of your guests and callers have talked about as being the path that led them down the road to heroin, that if we're talking about going back to the source then i think -- we've never had a world where heroin doesn't exist, and we've spent millions and hundreds of millions of dollars trying to eradicate poppy cultivation, trying to get farmers to use different crops instead of growing cocaine or opiates opiates. we have not had enough success with those strrpgategies to keep saying we need to keep doubling and tripling down on them. we have not shown where that's going to solve our problems. instead, we're seeing more heroin use now than we were 10 years ago. and i think we need to look at the underlying drivers differently. it's not just the availability of drugs. it's the desire and demand for

drugs and the lack of treatment options for people that are going to work for them, and not all treatment options are going to work for all people, but if you don't have any treatment options, then we never -- we're going to end up with more overdose and more addiction. so i think it's really that demand side rather than the supply side that we haven't done enough on, that demand in terms of the prevention level and in terms of supporting treatment more smartly and more effectively. host: daniel raymond is with the harm reduction coalition. thank you for your time this morning, sir. we're going to continue this conversation about the heroin epidemic in the united states. up next is meghan mccarthy, who is chief of a newsletter called "morning consult." we'll talk about state and federal efforts. [captioning performed by the national captioning institute,

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and c-span.org. >> for this year's student cam contest, students tell us issues they want the candidates to discuss during the 2016 presidential campaign. students told us equality, economy, education and immigration were all top issues. thanks to all the students and teachers who competed this year and congratulations to all of our win ers and every week day in april starting on the 1st one of the top 21 winning entries will air at 6:50 a.m. eastern on c-span. all entries are available for viewing online at studentcam.org. >> "washington journal" continues. host: our conversation on the heroin epidemic in the united states continues with meghan mccarthy. she's the chief of a newsletter called "morning consult" what is what? guest: it is it we're one of

the largest newses in d.c. covering capitol hill and we have a poling division that helps us get at what americans actually think about the issues we're covering. host: and your background is as a health reporter, correct? guest: yep. host: so in that background, is congress addresses the issue of heroin epidemic, and if so, how? host: yes, as someone who covers health policies for about five or six years, this has been a unique time, especially passing of the affordable care act and how much fighting has gone on and on with obamacare. you know, the center has a bill that sets up new programs to address the opioid epidemic. host: what kind of programs though? guest: a lot of it is helping states coordinate efforts or helping states get more federal

funds to monitor the prescription drug use, to help educate doctors about prescribing factors and things like that. host: this bill passed this year. has it been passed by the house or signed by the president? host: no tjust passed the house a few weeks ago. they have had hearings about different legislation. they haven't moved the bill to the senate yet. house speaker ryan staff said it's something they are moving towards and there's some things that could happen by the end of may. host: how much money? guest: that is a question that is still a sticking point. there's obviously bipartisan action to address this issue, but how much money to spend on it is the question. still something that separates democrats and republicans. and the senate wanted to spend $600 million to bolster the

effort to fight the epidemic. republicans voted it down and hopefully it will play out in the house. host: we spend about $50 billion a year on the war on drugs. we spent about a trillion dollars in the last four years on the war on drugs. what do we spend in the macro on treatment type issues? host: that's a good question. and i think both sides might disagree on exactly how much money gets spent on that, and it's not a large portion of the federal budget. there's a couple of different agencies involved in these efforts, the cdc. these are smaller items in their budget. host: is this a partisan issue, democratic or republican issue? guest: in health policy, there's bipartisan cooperation before something gets done. the biggest sticking point remains whether or not to appropriate more money to do that, or if there's existing funds you can call from to fight this epidemic.

host: what about the states? guest: in the state level, you see -- and i think this is kind of common but because it's such an acute regional issue in certain states you see a little bit more activity you see more activity between democrats and republicans in passing legislation or spending money on prevention or treatment programs. host: 202 is the area code for all of our numbers as we continue our discussion this morning on the "washington journal" about the heroin epidemic in the united states. 202-748-8000 if you've been impacted by the use of heroin. 202-748-8001 if you're a medical professional and all others can call in at 202-748-8002. we want to begin with a call from carl in martinsville, west virginia. carl, meghan mccarthy out of "morning consult" is our guest. caller: hello. i have a child that has a heroin addiction, and we have been to

princeton house in new jersey. we have driven to suboxone clinics, which are 50 miles away, and these last -- it's impossible. i mean, if you have someone who works, they cannot get treatment 50 miles a, drug back home, and then try to go to work. the one thing that did seem to have an effect is a drug called vivitrol. it's a shot. it lasts 30 days. however, it sometimes wears off early. but we understand that ohio is trying the program where they use the vivitrol shot in conjunction with vivitrol pills so that when the shot wears off

early, the person can then take these pills. and this has to be available in every single community. you can't expect people to drive 40, 50 miles to get this treatment. and then get back home and go to work. because you have to realize that a lot of addicts have families and jobs. and you know, we need to provide something so that they can continue to function and hopefully conquer their addiction. host: carl has heroin addiction cost you money personally? does your insurance cover any of this, and what would you suggest as potentially a federal policy?

caller: well the vivitrol shot itself i believe was something like $1400 for the shot. which you know, i think that the federal government got involved in this, they could bring the cost of that shot down, you know providing that it actually does work. we need to do some more research on all of these things. host: all right. we're going to leave it there. carl thanks so much. meghan mccarthy. guest: carl, you bring up a lot of points that are being highly debated right now. the cost of drugs is something that has really become a huge topic on capitol hill and for the federal government. the issue that you're talking about also, specifically you know, is that the different state guidelines for what kind of medication assistance and treatment people can receive so it is kind of a patchwork where

you'll have a different treatment in one state versus another state so that's something that the committees on capitol hill are looking at as well. host: in the past, congress has funded what they call demonstration projects, which are kind of experiments done in different areas of the country. are they doing any so-called demonstration project funding for treatment in the united states? host: if so, you know, the agencies do have authority to try to fund things out. the center for medicare and medicaid services was trying to look at medicaid and limiting beneficiaries who they thought were the high risk of being prescription painkiller abusers limiting them to one prescriber and one pharmacy they could actually go fill those prescriptions at, and that's something that, you know the senate finance committee has looked at expanding to medicare so there's activity on that front. host: jeff is in gaithersburg,

maryland. go ahead, jeff. caller: good morning. i want to ask if anybody is doing anything to make sure we don't throw out the baby with the bath water. there are people in chronic pain that need these drugs and you know, this whole situation is lumping them in with drug abusers. i think it's unfair. it creates a stigma that's unfair. people in pain didn't do anything to get that way. people that are hooked on heroin and opiates, obviously went outside the prescribing instructions to get hooked. it's an action they took on their own. and they really have no one to blame but themselves, but it's hurting people in pain. and i wonder if you have any comment on that. host: thanks, jeff. guest: yes that's a point that the pharmaceutical industry definitely makes, that there are people out there that these drugs are a life-changer, and

they really help and eradicate pain that otherwise might not be addressed. you know i think a lot of the efforts are to educate doctors or to have the prescriptions that used to be, you know, 30 days, to maybe limiting it to seven days. that's what massachusetts just did and other states are looking at efforts like that as well. host: jody tweets in it seems heroin addicts are becoming white kids in the suburbs, but not inner city kids. it's a big problem to be solved. caller: so you know, i think the statistics you have already cited on the program today shows us how widespread this issue isg: so you know, i think the statistics you have already cited on the program today shows us how widespread this issue isu: so you know, i think the statistics you have already cited on the program today shows us how widespread this issue ises: so you know, i think the statistics you have already cited on the program today shows us how widespread this issue ist: so you know, i think the statistics you have already cited on the program today shows us how widespread this issue is and it is certainly hitting senators and members of the house on the campaign trails and they're hearing about it from their constituents.

host: thomas in fairlong, new jersey. go ahead, thomas. caller: hi, how are you? thank you for taking my call. well, let's see. most of this problem actually starts when the little children and even babies, unfortunately, we have doctors prescribing rit lin and adderall which leads to meth later on, but these children are taking these drugs especially babies, inhibitors, they don't do the drugs anymore. what are they looking for meth amphetamine, heroin. as a parafactor, i treated people in pain for over 30 years without drugs, without surgery. why isn't the government, the pharmaceutical industry and the insurance companies telling people go see a chiropractor when you're in pain. it's safe. there's no drugs. we actually help these people even chronic pain people. we do get results, and i don't hear anybody talking about this. throwing more money at the problem, not going to make any difference. we've already spent $300 billion on illegal drugs and now we've got more people taking prescription drugs. host: meghan mccarthy. guest: so, you know, your comment makes me think of the

c.d.c., which just came out with guidelines last week or two weeks ago that basically suggest that doctors, you know, should try anything else before they prescribe these intense painkillers to patients, so look for other forms of treatment, perhaps choir oiros or other forms of treatment that aren't addictive. host: a story in the recent national review about dope sick tour through heroin usa. looking at walgreens. how monitored, has there been an increase in monitoring of drug sales, etc.? are they monitored pretty closely? guest: that's one piece of the bill that the senate passed recently is really trying to address, and a lot of these issues, again, is a state

patchwork, so different states are doing more to monitor which doctors might be prescribing a lot more of these prescriptions and others, so the databases really vary on a state-by-state level level. host: randal, stephenville texas, go ahead. caller: yes, ma'am. i'm a veteran. harm reduction was introduced into our classes two years ago and it's really relieved a lot of us that were total absentence and don't have the discipline to walk the line and stay clean and sober. the question i want to ask is with relation to your comments on legislation. we're going to speak to our county attorney and we have a state representative here, returning dignity to the addict. addict addiction is terrorism. it's self-induced terrorism. i know. but my view is, couldn't we start a national guard 2?

not just a national guard, but a national guard 2 that was a community service. the other day in my home town, we had about 2,000 yards from me we had a tornado lift the roof off of a college apartment and a laundry and some other damage in town. is there any way a panel could study a national guard 2, return these guys to the community service when they come out. host: out of stephenville, texas. guest: this is how to address people that are already addicted and how to get people into treatment, something that obviously getting on the discussion right now. democrats on the presidential campaign trail hillary clinton specifically are calling for maybe not a national guard, but would volunteer, participate in, but allowing the number of doctors that can participate in medicated assistance and treatment to be vastly expanded

from what it is now. there are caps placed on the number of doctors that can use this kind of therapy and that is definitely one of the ways people are talking about addressing this epidemic. host: sea of tranquility tweets in, is there enough funding for medical detox? guest: i think the answer to that question would depend a lot on which side of the aisle you fall on. so democrats wanted to spend $600 million to, you know, buffer the bill that the senate passed. the president has called for $1.1 billion in his fiscal 2017 budget to address the opioid epidemic. republicans say there's already money line items in this for a budget, and senate majority leader mitch mcconnell specifically pointed to $400 million in the omnibus package that passed last year that could actually be for this. host: next call for meghan mccarthy of "morning consult" comes from virginia in langhorn

pennsylvania. hi, virginia. caller: hello. i think we are avoiding the whole issue. we have to seal our border. we have to declare war on drugs. we have to limit what our president can spend. our president has spent trillions and trillions of dollars that could have been used for these drugs. everything has to be limited. it's out of control. host: thank you, virginia. the war on drugs. is there any talk of -- in congress about what to do with that? whether to maintain or. host: so this is something that's coming up specifically in the house judiciary committee, as you know, the focus could be on stopping the flow of illegal drugs. it's something that's come up on the presidential campaign trail as well as how donald trump and ted cruz have kind of addressed this issue, talking about stopping drugs from coming in illegally from mexico. host: but that doesn't do

anything to the demand. host: well, it's definitely a point that they like to hit on that i think speaks to some of the supporters but yes certainly democrats make the point that is not actually stopping the flow of prescription drugs that are, perhaps, getting people hooked on heroin down the line. host: is there any talk at this point, about the legalization of some or all drugs? guest: there's been a huge debate on the legalization of marijuana. you know the issue here is a little bit different and unique because prescription painkillers are what are viewed as the big gateway into heroin and how the epidemic has grown so significantly and quickly over the past few years. so it's kind of a separate track. host: patrick in vincenttown,

new jersey. go ahead patrick. caller: yes, i definitely wanted to state first off that i was a therapeutic addict. i had back pain and ended up being on up to 600 milligrams of morphine a day, but you just have to have the will to come off of it. i came off of it within two and-a-half months. my point is within the medical professional, i think there's a disservice to the patients when you have pain management physicians that are putting patients on narcotic contracts or agreements where if they, you know, go over, you know do one little thing of a violation, you know, that they are completely dropped from being taken care of by the physician. i think that's a medical injustice. you don't see that in heart failure patients which heart disease and heart failure is a huge killer within the united

states. you don't see patients coming in that have eaten chinese food and have gone into heart failure because they didn't follow the treatment or you don't see diabetics that are kicked out of treatment because their blood sugars went out of whack for a month or so. so i think that the focus and stigmatization has forced medical professionals to push them out of their offices due to minor violations as opposed to treating them as patients, and like the caller said before, the stigmatization of this, within the medical profession, is a big factor. they have -- physicians have to realize that they are creating it throughout this thing, and they have to follow through and not abandon the patient, putting them out into the streets, going into it to get heroin access and

i think that one part of it, if we can -- when we're talking about the opioid factor, and the prescription of it by the medical professionals, is they have to change their mind-set. host: all right, i think we got the idea. meghan mccarthy. guest: yes, so you know, the issue that i think is two-fold, first, is that there are so many more doctors out there that can prescribe opioids than are actually trained to treat addiction. as we've been talking about, the different caps on medicated assisted therapy. it varies by state. and then, you know the point you may have is something that people have pushed back on in massachusetts, where you know, it's limited to a seven-day prescription and the hardship that might place on certain patients after a major surgery, if they're dealing with a terminal illness. and so policymakers are trying to figure out a way to write these laws that will help

address this epidemic that they're still figuring out as it's going on. host: 900,000 doctors in the u.s. most all can prescribe opioids. but only about 32,000 can prescribe the treatment for heroin addiction. and you have to take an eight-hour course, et cetera for that. nathan is in dayton, ohio. hi nathan. caller: good morning. i am currently and will always be on opioids. i have a disability i was born with. it's a peripheral neuropathy that gets worse with age. they've alloweded me to function every day. i don't take it to party. i don't take it to feel good or forget things. i take it to function and i've got to say in the state of ohio it's really disappointing that they have set up a random drug testing and pill counting for pain patients. i'm waiting for the next step

for them to start tracking my movements. i mean, this puts me in a situation where i feel like a criminal and i have done nothing wrong. i have done everything by the book, and they don't need to treat me like this, because they're already tracking my medications medications through my pharmacy. i've been questioned by my pharmacy before about why i need a particular prescription or do i need the amount of the prescription, but i was forced into a situation where i signed a release that would allow my doctor to share my results with the government. so now you've got the government who has access to my medical records, as well as her entire staff doing drug testing in the middle of hallways and you also have the fact that i'm disabled i'm going to be dealing with this for the rest of my life. and there's so much injustice in that. and i don't understand how this doesn't violent civil rights.

i don't understand how this doesn't violent and become discrimination against the disabled, and i really don't understand how this isn't a direct violation of hipaa. my government leaders i called in the state of ohio most of them aren't even aware that this is happening. i had to call for about two months before i talked to the pharmaceutical board, because not even a medical board understood what this was. host: all right, thank you. let's hear from meghan mccarthy. guest: so you know, i think what you're bringing up, why this is so hard to address this policy, you know, healthcare is so personal, and it really, you know, hits people in places they don't want other people knowing about, and particularly, the government. it also kind of highlights how this is strange bedfellows in some ways for democrats and republicans, because this is -- it's often stepping up government involvement and, you know, the monitoring of people's healthcare, and that's not

something that philosophically republicans are typically behind, but the issue is so acute in certain states that you see that effort and republicans saying that there is a role for the government in this. host: and john kasich, the governor for ohio, has talked about this quite a bit on the presidential campaign trail, hasn't he? guest: he has, yes, and it's been an issue that a lot of the candidates, some of whom have dropped out now, have talked about on a very personal level and, you know, it's a way for republicans, i think, too, to talk about healthcare where they don't have to get into obamacare, necessarily, and repealing health insurance for millions of americans and what they're going to replace with that. this is a place where they can be seen as actually helping and addressing an issue that is allowed to... host: about $34 billion a year in costs in theft, economic, and healthcare costs is the estimated cost of the heroin

epidemic in the united states. mark's in ben salem, pennsylvania. go ahead, mark. caller: good morning. thank you for taking my call. i don't think we have to reinvent the wheel and the statistics you said about the costs of this is staggering. the insurance companies is being overwhelmed with how many kids go back and forth to rehab. rehab has been a great tool but also hardly unsuccessful in treating this because heroin, we have two heroin addicts in my family, and they've been in and out of treatment facilities and halfway houses, recovery homes 16 times in the last year. i mean it just doesn't work real well if the addict is not ready for it. but what we have found is that addicts that have consequences and treatment for the parents and helping them understand, it doesn't work to be just a good parent like you used to. this disease takes on a whole different parenting skill set that we don't have as parptsents and get them educated so they know how to handle addicts. the consequences is what leads to cures, and that's free pretty

much to get them into treatment. they have to be broken and not want to use drugs anymore before they'll even accept treatment and there's nothing out there like a transitional period from when they go into rehab, they can walk out whenever they want. the legal system doesn't provide any type of forced situation where they have to stay in for a period of time. and i think we can do something on that that would be really cost effective and also talk to the insurance companies about letting kids stay longer, the ones that are getting the benefits from them instead of letting them walk out the door after a week or 28 days, which seems to be the protocol right now. there's a lot they can do. host: mark, has your insurance covered a lot of the rehab costs for your family members? caller: yes, it's been really good but when you're in state sometimes, it covers a portion of it, and if you go out of state, it's better for some reason. i guess it's the out-of-state benefit but i've seen a lot of families that have been cut out after the first five days of retox and they're always saying oh, you've been denied, like the weekend, two weeks in.

so there's no set protocol it seems like for the treatment. the max you can usually stay is 28 days and that's nowhere near long enough for an addict in recovery. host: what's been the impact on your family? caller: it's horrifying. it destroys more families than you can even imagine. i've seen thousands of families coming in broken, not knowing what to do, completely and emotionally destroyed. you don't understand the impact it has on the families. the addicts, you can see it visually but what's behind the doors is even much more damaging. host: if you could come up here and testify, mark, what would you suggest for the 535 men and women to do? caller: well, i would suggest that there is some sort of thing where the addicts can't leave the treatment on their own. actually, it sounds cruel, but they need to be broken and have to reach their bottom. i would suggest when they get

caught with a dui drug related, incarcerate them for a period of time but not ruin their whole life. give them a chance to get it that they're ruining their whole life. a lot of family members enable it, and it's hard for a parent to throw the child out on the street and say you can't live here anymore or i'm not paying anything anymore. it's very difficult. it's a combination of the education for the family members who are suffering from this disease, maybe even shows on television have to do it because they just glorify the drug use and everything else these documentaries i've seen. they don't really talk about what really works and i've seen first hand what works. they have to want to do it and the only way they want to do it is the consequences get so great in their lives that they can't stand it anymore and they want to change but that's sometimes a really dark place. host: that's mark in ben salem, you heard what he had to say. go ahead, meghan mccarthy. guest: mark, what you're talking about reminds me of another big

debate on capitol hill which is mental health legislation and some of that is coming from republicans and from democrats. it's another area where there's bipartisan coordination. they're all looking at going as far as suggesting, you know, and requiring people to be committed for a certain amount of time but making it easier to get people into rehab, and to have sustained treatment instead of just going in and out every couple of days. so it's not moving as quickly as the opioid legislation did but it is something that they are talking about, and it is something unique that's happening. host: valdez is calling in from mapleton, illinois. hi. caller: good morning. this might sound callous and i don't mean it to be. i'm retired law enforcement from california, and i told your screener that i'm not expecting anyone to inject the racial component in this but there were

a lot of sick people we were putting in prison in the '80s and '90s and early 2000s when i was working and now all of a sudden, this is a sickness, a disease, it's an epidemic, and the reasons is because it's hitting a segment of society it never was intended. if this had been confined to the lower classes and the minorities, we'd only be talking prison. and i do believe that, yes, we do need treatment but there is a crime in california called 11550. it's called under the influence, health and safety code, and possession of is a crime. so unless we go and do this across the board i am not in favor of any kind of treatment until they start treating everybody. but if we go according to what we always do, we'll put the lower classes in prison, and we'll put johnny suburb in rehab. so i'm sorry to put it that way, but that's just the way things are. so if you can address this for everyone, i'm right with you. otherwise -- host: valdez, when you talked about previously were you referring to the crack cocaine

epidemic of the '80s and '90s. caller: a number of things. we called them junkies, users. i was assigned to the jail bus at one point, every thursday transported them down to california rehab, and they were just in and out. but, i mean, there was never any indication that they were going to get any kind of treatment. it was strictly incarceration. and they were heavy mexican population, so a lot of them were mexican people. but we didn't have this issue of suburban people being under the influence as much as you're hearing now. host: thank you, sir. so inner city poor people versus johnny suburb. guest: i think there is an argument to be made that the reason this is getting attention is because it is hitting people that are making their -- or their families are making their needs heard on capitol hill in a way that perhaps, you know, poor er populations struggle to do,

and you know, what you're talking about also makes me think of criminal justice reform legislation which, you know, is similar to the mental health bills that i was discussing a little bit earlier. there is actual discussion about and there are democrats and republicans working together on that, but it is not happening nearly as quickly as the opioid population. host: this is from joe davidson's federal insider column in the "washington post" this morning about the hearing earlier this week in congress. the color of addiction, war then, the treatment now. representative elijah cummings, of maryland, has seen the effects of drug abuse in his neighborhood in west baltimore pointed to the difference in the way heroin addiction is dealt with now compared to years ago. the difference between the war on drugs and drug treatment is like the difference between

black and white. quote, in baltimore, where many of the victims were poor and black, our nation treated this issue like a war rather than a public health emergency, said cummings, a democrat on the panel. we incarcerated a generation rather than giving them treatment they needed. now things are changing, he noted, between 2006 and 2013, the number of first-time heroin users nearly doubled and about 90% of those first-time users were white. elle marie in birmington, vermont. hi, ellemarie. caller: hello. host: your governor in vermont has spoken out about this issue quite forcefully, hasn't he? caller: yes, he has. host: go ahead. caller: my story is rather simple. i was working as a med tech, had been in the medical professional for a few years, decided to get my rn license. went back to school, 2008, i was

assaulted, did damage to my spine, and i am now on disability. i refused to take anything stronger than codeine, although my doctor was amazed that it was still being offered. but having seen patients coming in and drooling to get their prescriptions, it horrified me. then on february 19th of this year, i went to fill my codeine prescription, and my pharmacist told me it has been rejected by my insurance company and they wanted me to take either hydromorphone or morphine sulfate. now, i've been managing since 2008 on codeine. my pain tolerance has increased. i wake up, it's an average of a 3. if i work around the house and do other things, it can go up to a 5 or 6 or 7 and that's when i start, you know, hitting the

codeine. but i have maintained since 2008 roughly the same amount of pills that i have started with, because i -- host: so why do you think your pharmacy or insurance company flagged your account? caller: i have no idea. i had a fight with them, because i was in a lot of pain, to give me seven days of codeine, and then i had to go back to my doctor the following monday, and speak to her and have her fill out these ridiculous forms explaining why i couldn't take hydromorphone or take morphine sulfate because i had a deathly fear of it. i do not want to become one of those people who sits at their doctor's office drooling because they need to take something that wasn't necessary. host: is it kind of like our caller from ohio, a little bit.

guest: right, so i think this -- one of the things about this, health insurance and prescription drug coverage is complicated already. so it's already difficult for people to understand or figure out, navigate what tier a certain drug is in versus what's not and whether you're going to pay a generic copay, you're going to get a brand name prescription that's going to cost you a lot more. so that might be what's happening there, in your case, but you know, that's already what people are doing just to get any kind of prescription drug. so when we add another layer of, you know government regulations, tracking, it just gets all the more complicated. host: you've mentioned this a couple of times but as far as legislative efforts actually becoming law, it's an election year. what are the chances? host: so one thing the senate passed the house can move things faster than the senate

often. it does seem like the bill could actually make it to the president's desk and be signed in law, which is pretty remarkable. it's an election year and with the fight going over the supreme court nominee right now. so it's actually one of the few things that might make it to the white house. host: and with funding? guest: there will be no money attached to it additionally. it's an authorization of programs, so it's not directing funds to it yet. host: so would there be any immediate impact? guest: you know i think that we have to ask the attorney general, because he's the one that will get the additional power through this bill. i don't think democrats would have acted on this if they thought it was pointless without funding, so it's a step. i would think they would make judgments that it's a step in the right direction. and there is federal funding that exists for these programs now, so you might see agencies get creative with how they

budget to treat this endemic and you might see the appropriations committee kind of moving money around from different pots to address it. host: thomas tweets in talking about valdez, our caller from illinois. caller was right. johnny suburb goes to rehab while johnny city goes to jail. drug war is a political war. richard is in west bloomfield, michigan. go ahead, richard. caller: hi. i work with a company that makes a cbd oil from colorado-grown industrial hemp, and we've been seeing a lot of promising results for a lot of different nerve and muscle pain. it's an antiinflammatory with no side effects, and that cbd, there's a lot of scientific data and lab result tests for the products that we have. so for people that don't want to have -- take the road to get to

heroin that are in pain, i think that's a nice alternative, so i just wondered what your thoughts were. host: richard in west bloomfield, michigan. we won't make you comment on that commercial product. meghan mccarthy, in all these discussions, is there talk about the colorado experiment on legalization? guest: you know, pain management is what these drugs are prescribed for, and that's a big argument that people who support the legalization of marijuana make that this is something that could help people and not be, you know, as addictive or a pathway as the caller said to heroin. there are other people that would say it's just another drug, and it can be addictive as well. host: has there been a discussion of, we've been through this before. we went through this with the crack epidemic of the '80s and

'90s. we went through this with alcohol throughout our history. we had cocaine back in the 1920s. i mean, is this -- has there been any discussion in the historical, putting this in the historical perspective? host: i think you're absolutely right, that it's a drug indicator, and perhaps this is the one of this time but i think what's unique about this is the element of the medical community being involved in it, and that people are getting hooked on some of these drugs or heroin because they got prescribed something by a doctor. and so it's just a -- it adds in a different element, and it's honestly, i think, why the federal government can get more involved or that you see more legislation than you might have for crack cocaine, which was obviously focused on the judicial system. here, you have the cdc coming out with guidelines, you have the fda just coming out and

saying there are going to be new blackbox warnings on these prescription drugs. you know, you have medicare and medicaid looking at different ways to control the prescribing. host: then we're hearing from the viewers who say look, i need my drugs, my pain pills. tim, flatrock, michigan. please go ahead with your question or comment about the heroin epidemic in the united states. caller: thank you, c-span. i just wanted to put my few cents in on this heroin epidemic. it's really hit hard in our family mainly because my father was a heroin addict. he still is. he worked a great job, made $80,000 a year, took a buyout, for about $100,000 a year. and he spent it basically all on heroin in one year. and that's when my parents got divorced, we tried the treatment, inpatient, and was

not successful with the results and he would come out within an hour or two, be back in detroit trying to find more heroin, and it just completely devastated our family. he's homeless because of this. like i said, he had a great job, and this drug is just killing everybody. he's been hospitalized, i would say, probably five or six times for heroin-complicated infections, you know, from using dirty needles. i have a granddaughter who's -- i have a daughter who's eight years old. he's never even met his granddaughter. host: so do you have any contact with your father anymore? guest: no, i do not. he is homeless living on the streets, you know, he had a great $80,000 a year job. host: has he stolen from you? caller: he's stolen not from me but from my brother. he took all the savings bonds

and right before my parents got divorced, you know, it just ramped up and, you know, he would actually be offering me to take him to detroit to go get his drugs, because he would get so sick. host: what would you like to see the federal government do if anything? caller: it's a very complicated issue. i would like to see, you know, forced in-treatment. he would get out within an hour. he'd be there 28 days. host: when you say forced treatment. if he's 28 days and within an hour he's already back out on the street, where is the enforcement? caller: that's where we're kind of lost. host: right. caller: i thank you, c-span. host: what has this done to your family? your mother, your brothers, your relationships?

caller: oh, we don't even talk to my dad anymore. he's homeless in detroit. host: does it occupy your emotional bond anymore? caller: what do you mean by emotional bopped? nd? host: well, the family. how has the family dynamic changed being so close to this vortex? caller: well we went through counseling, you know, when it first started, and it's been a pretty rough ride over about the last eight years, because it seemed to really ramp up from just using it every once in a while, and then at his peak was about $100,000 a year he spent on it. host: thank you, sir. guest: i think that's a tough story and, you know, there are a lot of americans that are in the same boat as you. we did some poleling sponsored by

cbs health that found that 41% of americans know someone that has struggled with heroin or opioid addiction, so it's definitely a growing issue. it cuts across party id, it cuts across income across the country. host: maria tweets in: more people die from alcohol than all other drugs combined. pat, i think you're going to be hit for our guest, meghan mccarthy huntington west virginia, hi. caller: hello, good morning. and let me tell you about my family, sir, i'm from huntington, west virginia. this is the ground zero for drug use. just look at the map. it's covered, the state of west virginia, by red. i was a user, had hep c, was one of the people that went through the treatment for seven months injecting myself in order to get rid of it in the early stages of

this ongoing epidemic from drug use back in the '70s. my daughter and son-in-law had $150,000 from my mom's death, and now thank god for two years, they've been clean. my sister spaded her heart by the use of cocaine back in the '80s. i've had 18 friends die from use of drugs directly or from od or from complications. this is called moneyton. huntington is call moneyton by the cartels in detroit and columbus. they've got it set up almost like a business model. but the reason for this is the hypocrisy that comes from the top part of our government. you ask what our government can do. our government could have nixon

planning on using blacks using heroin and marijuana on the hippies, to make the news every night in place of the deaths and the drug use from the people in vietnam we were sending to die. and we had the reagan and the bush administration selling drugs under the counter invading our cities out west during the conquer. and we have people walking across the borders with drugs nowadays, and we've blinked our eyes saying, oh, we're taking care of the drug problem. and we have people over there in afghanistan walking by fields of poppies while the drug lords and the tribal chiefs continue to grow their poppies and send them here to destroy our youth. and you say oh, our government wouldn't do that. surely they're not that hypocritical. but i say they let the drug companies sell all the drugs they can and distribute them to make money out of greed, and you

have -- host: all right, pat. got your point. meghan mccarthy, what were you hearing? guest: well, you know, people want action on this issue and the caller just mentioned, you know, we found that 52% of voters want presidential candidates to come out and actually have a plan for this and that includes 59% of independents, 59% of republicans. so it's something that the voters are definitely keenly interested in, and i think a lot of people share your concerns. host: meghan mccarthy, editor in chief of the newsletter "morning consult." thank you for your time this morning. guest: thank you so much for having me on. host: we have about 40 minutes left in this morning's "washington journal." we're going to continue this conversation. here are the numbers that we've been using all day, if you've been impacted by heroin use, if you are a medical professional, and all others, and we'll continue hearing from you in just a minute.

>> book tv has 48 hours of nonfiction books and authors every weekend. here are some programs to watch for. this weekend join us for the 22nd annual virginia festival of the book in charlottesville starting saturday at noon eastern. programs include author bruce hillman who discusses his book, "the man who stalked einstein", how nazi scientists believe he changed history. and saturday evening at 7:00, patricia bell-scott, professor emeritus at the university of georgia on the firebrand and first lady portrait of a friendship. the struggle for social justice. the book exmroerz the relationship between civil rights activist pauly murray and first lady el norroosevelt. patricia bell-scott speaks with author and historian at

roosevelt house in new york city. on sunday beginning at 1:00 p.m. eastern, more from the virginia festival of the book, including george carlin's daughter, who talks about her life growing up with the comedian in her book, "a carlin home companion." and sunday night at 9:00 afterwards with historian nancy cohen, author of breakthrough, the making of america's first woman president. as cohen looks at women political leaders and the advances they are making in the political arena. she's interviewed by kim azarelli , cofounder of conel law school's central for global justice. >> for a woman to be at the head of the most powerful country in the world when one of our key allies doesn't allow women to drive and, you know our most significant enemy at this time, isis, is literally executing women and girls simply for being women and girls, i think this sends a powerful message from

the bully pulpit, about what america stands for. >> go to book tv.org for the complete weekend special. >> "washington journal" continues. host: in the last 15 years, there's been a 286% increase in heroin overdose deaths in the united states. it's estimated to cost -- the heroin epidemic is estimated to have an economic impact of about $34 billion a year in theft, economics, and in healthcare costs. hillary clinton has described it as a quiet epidemic. it was a major topic of the new hampshire primary. that's been our topic this morning, all morning, on the "washington journal," talking about heroin use, abuse, epidemic, whatever word you want to use. and how it's impacted you, how it's impacted communities, and how it's impacted or impacting public policy, and that's where

we want to hear from you as well. we want to hear your story. we also want to hear what you think can or should or should not be done to combat this. and we're going to go back to your calls. this is sandra in seattle. you've been very patient sandra. go ahead and tell us your story. caller: all right, well, thanks. yeah my experience with heroin was through my brother, and in the late '90s and up to 2003, i was living in boise, idaho, and my brother at that time was a heroin addict, and i was incapacitated because i had been prescribed ristradol, so i'm sitting there in my home with my brother living with me and all i hear is heroin addict friends going back and forth through my house so i'm observing their behavior.

and it's horrifying. they're not having any fun, first off. anyone who thinks heroin addicts are having a fun, they don't know. they're not having any fun. the entire life is about getting that next fix. they can't work, so it's all about shop lifting, you know, and all the ways they can figure out to steal money to come up with the money for their fix. and it's just tragic. he would get -- first off, he would be in prison for a month or six months, and come out and go immediately right back to it. it just amazes me. and the thing is, you know, my brother, back in the early '60s, he had a problem because he was born premature and was behind in school, and a doctor prescribed him some medication, and they

called it happy pills. and that is what launched him into his -- host: is your brother dead? caller: what? host: is your brother dead? caller: yes, he finally died of an overdose in 2009. but from -- host: we want to get some other calls in here so i'm going to ask you one more question. we appreciate your story, but is there a role in your brother's life and his issues that the federal government, in your view, should have addressed? and i know that's a very awkward phrasing, but i think you know what i mean. caller: yeah, well see, i i -- it's kind of a state thing more even than federal because in idaho at that time, he and his friends actually tried to get off of it by using -- i forget the name of the stuff,

the substitute. idaho didn't allow it. they had to drive all the way to nevada to get that substitute legal drug. so you know, that was relief right there. before you cut me off, let me say, he did actually get clean for six years, and the way it happened is, he got busted in a sting, so he was facing at least 10 years in prison. and they offered to put him on seven years probation, and he, of course, took that, and so he was subject to random u.a.s, and that kept him on the straight and narrow. he was required to go to a.a., he got rid of all his druggy friends, made friends in a.a. he was truly a happy person for six years. and then his old friends came around and he fell off the

wagon, and he overdosed and died. host: sandra, thank you from seattle. and if you look at the map that we showed earlier, the national map, this is from the new york times, and it shows where heroin overdose deaths have increased, and you can see up there in the left-hand corner, the state of washington, she was calling from seattle in the state of washington. and the state of washington has a lot of red and orange counties up there. the whole west essentially, looks like there's been a big increase. over 8,000 heroin overdose deaths per year. it's being called an epidemic, a quiet epidemic. matthew is in georgia. go ahead matthew. caller: yes, good morning, peter. i am very, very upset. please don't cut me off. i've been trying to get on for quite a while and haven't gotten none, so give me a couple. this is a very racist idea, the

whole thing. there are so many black people who have gone to jail. some of them i think, three strikes, you're out. they're in jail for life now, okay. they're in jail for life. i just watched something on youtube where black people can't get dispensaries in colorado because you can't have a felony and own a dispensary. so now, they fill the jails up with blacks and hispanics and the white boys from wall street can go in and make a lot of money off of drugs that are supposed to be illegal. okay i understood it wasn't illegal now. we fought the war. remember iran contra? okay supposedly, they were selling drugs for guns. where did they sell those drugs? big banks. i know, you can look it up. big banks, loaned billions of

dollars. not one bank executive have gone to jail. this is a very racist thing going on with this heroin stuff going on here. they filled up the jails. if obama can do anything, is to write an executive order to empty out the jails for people who are in there for drugs. for a few pounds of drugs. lots of black people have died. cops have shot people because they stop them to search them for a few ounces of drugs. okay, this is racist. it is extremely racist. it's no other way to call it. host: that's matthew in georgia, and this is lisa in burlington, north carolina. go ahead lisa. caller: good morning. oh, my goodness, that man just shook me up. okay perhaps we are a racist

country, we're finally trying to get a handle on everybody's problem, and i hope that it isn't just a suburban trying to treat white people and not help black people now. maybe they ought to look at everybody's record in prison, in jails, try to do this, but that's not the reason i called. i'm very shook up about i can see why everyone says we are a giant racist country. hosed: we are talking about the heroin epidemic on your community. >> you can see where i live in north carolina. it is good friday. there is a reason people

actually start to get on drugs. they are not happy with their lives. i grew up in the 70's and 80's. people were asking me to try this and try that. i think i'm a high on life, i don't want to alter my brain to be something other than i rem. host: lieutenant governor of the state of maryland, he is a task force chair for the governors association for the united states. what is the situation in maryland? guest: it is a challenge throughout the country.

we have been grappling with it for several years since it took off a year ago. as we were campaign in in 2014 throughout the state -- campaigning in 2014 throughout the state, we were hearing from small communities, that the biggest issue at the local health and law enforcement and providers had was heroine? -- was heroine. once elected we would convene an emergency task force to come up with recommendations to try to address this particular challenge. host: what are some of the recommendations? guest: we had 33 recommendations that ranged from prevention and education.

we included treatment options. we talked about quality of care and had proposals and terms with quality of care, because it is often the discussion of treatment, which means inpatient treatment. not everybody needs inpatient treatment. so we have recommendations in that area. we are still in our legislative/ -- legislative session. we are it mandatory for prescription drug monitoring. the reason for this is the new date wage rubbed to heroine is prescription opiates.

70%, 75% of new heroine users are coming off of prescription medications. and that is the real distinction between a lot of the drug problems we have had in the past and what we are facing now with heroine. host: is there an estimate what the use causes the state of -- what they use costs the state of maryland? guest: when you look at emergency rooms, when you look at the response from emts, we had over 400 deaths from heroin overdoses and anecdotally there is pretty much an assumption for everyone heroine death. there are eight or nine that survive in overdose.

they are still being treated in emergency rooms and expenses associated with that. and then of course the lack of production, the potential crime the petty crime that comes from it. host: was there anything that surprised you? guest: what surprised us early on, and before we even convened a task force, was how pervasive the problem is. particularly in some of the small towns, i'm not sure how many listeners are familiar with the geography of maryland, the eastern shores is a rural area. some of those towns may have less than 1000 people in them.

they were maybe 1000 people 2000 people in the town. host: have you shared or learned anything from other states? guest: we are constantly looking at other states and what they are doing. i was with the national governors association this week and talking with some of the other governors and what is going on in their states. vermont has been aggressive in that area. that is a good example of how it has extended to small states, a small new england state talking to the massachusetts new -- massachusetts governor.

host: lieutenant governor of the state of maryland and also the task force chair on heroine and opioid addiction. thank you for your time. fred is in toledo ohio. we are talking about the arrow -- talking about the heroine epidemic. caller: some of people were on heroin that became impossible to live in that area. one of their biggest clients were college professors. it has always been there. i moved down to toledo. everything was good until we had the collapse.

a lot of people lost their homes. we had drug dealers moving to them. i have been working for the past five years. we had so many deals and so many cars being broken into. it is like the walking dead. my 96-year-old father accidentally overdosed on oxycodone. host: is there something you would like to see done in washington or can be done in washington? caller: i have never done any of

these drugs. i would never take oxycodone if it was prescribed to me. i accept -- i accidentally lived it for so many years, the drug use is something else. their racism is involved in it classes him. i know my neighborhood we are lower and middle class working folks. we had to make a big noise to get anything done in our neighborhood. why is it ok for prisons to be a for-profit? incarcerating a man subcontracted out. these people are stuck, they are satisfied, they can't get out. host: this is in ohio near

cleveland, this is kathy. caller: i called because in the last three weeks i have been to two family friend funerals. one kid was 21, 1 kid was 23. we appear to be happy and healthy, we are not area i also work in a dental office where we prescribed opiate drugs to patients and received notifications when it appears there are problems at the pharmacy. i have thought about the situation in the last three weeks. i think there has to be a philosophical discussion. there has to be a legislative process involved.

i feel weird talking about it, but i feel like they should legalize marijuana and it will make an impact on the heroin problem. host: where do you see the connection? caller: i think our society does not generate a -- generate an easier lifestyle. he will have to work their whole life to pay for car and food and children. part of the reason why a lot of people aren't happy. marijuana is different. i have tried it myself in the past. i recently beat cancer and take cancer preventing drugs that i'm not doing well on. i found that cbd oil helps me

with my not sure and weight loss. i think marijuana would be an enter to several of our philosophical problems of a modern society. i'm 45 and i'm scared of this heroin epidemic. i'm scared of anybody who is having trouble with it. i honestly feel like legalizing their lana would help. host: matthew from georgia. caller: i'm disabled, i'm on hydrocodone. i was in constant pain and as

soon as i started the hydrocodone i was able to live a more productive and better life without pain. host: is hydrocodone oxycontin? caller: it didn't do anything for me. they gave me hydrocodone. host: is it addictive? caller: i don't think it is at the diff. for that officer to say if you take these drugs you are ending up taking heroin, i think that is ridiculous. it is people that have a mindset to do drugs anyhow. they get hurt and all of a sudden they are taken these drugs.

i find that ridiculous. i saw some of the people there that seemed to be very smart. they have to do something about it. they are going to give you oxycodone and i was thinking any doctor i don't know one of them that would prescribed a medicine or take a chance at losing their license over something that is

in need. host: to some tweets -- buddy is calling in from asheville north carolina. caller: i have been listening to your program for about half an hour. i'm a product of the 60's in california. i had a real rough time with heroin. i am now 69 years old. in california i eventually ended up going to prison. i went to the california rehabilitation center. it was a place where i got treatment.

i had a very good therapist, dr. underwood. and it was a bunch of convicts in this program. heroin is a drug that covers up all your mental, physical, and imo in a pain. it would last depending on how long i will inject. if i injected a $50 bag of heroin, it would be six hours. i funded it by stealing, by working sometimes. anyway that i could i would lose jobs because of stealing. i would lose lots of

friendships, i was a musician at the time. i was just a mess. when i went to a state-funded program in california, that is what i learned what it was that was driving this. and it was all these emotions beside myself and my up ringing. it was the abandonment issues i felt the fear i felt from these abandonment issue. when i started tapping into that, i got to remember this was 69 years ago. i got clean and sober and i have never used heroin since. i have a doctor, a severe injury from falling off of a building on the job. my doctor prescribes the oxycodone. what i do is i take it exactly the way she prescribes it.

to me that is taken responsibility. people get out there and they get these prescribed drugs from their doctors and they don't take them responsibly, they are going to become addicted. if the doctor stop prescribing it or the pharmacies would not give them that drug, they are going to cover that area all the other pains that are inside of them mentally and physically are going to be covered up. host:'s josephine -- this is josephine in manchester, new hampshire. caller: good morning, america. thank you for taking my call. i'm an old timer. i was a nurse in world war ii.

i saw this problem in 67, when i was working on my -- in nursing. i had to write a paper about a problem that would harm america in the future. i saw this drug problem crawling out of the ghetto. as long as the white people in america saw how they could make a buck coming out of the ghetto they started it. first they went into the colleges as the person before me stated. and then they went to the professional areas. doctors, lawyers, teachers nurses, who at one time or another have either tried this

drug or are still trying it. the only thing that will happen is once we stop making money on it, and i know a few users -- or i didn't know it. what we need is treatment, but not mandatory treatment. if the person says it is time to get off, there should be a bed available for them. which means more money. i have not been affected by this drug. i am a cancer survivor. i have used marijuana for a very

short period. to get over the nausea. host: did it help? caller: it definitely helped. host: how old were you win you used it? caller: 92. i just got over the cancer treatment. hopefully i'm cancer free at 94. i lived through the polio epidemic. i flipped through world war ii, i lived before that through the depression. -- i lived through world war ii, i lived before that through the depression. it was tough and people made it. we helped each other. the problem was family breakup. people do not communicate.

and their stupid phones everybody is going to lose their voice. i remember an old time movie, and i don't remember what the name of the movie is, but the ending was this big old computer that filled the theater. and this big sad old man was the last survivor because everybody lost their ability to communicate a kate -- to communicate with each other. america, the world is coming to that with all the instant communication. stop that. host: thank you for your time this morning. we very much appreciated. -- appreciate it. a tweet -- --

and she is with us -- angie is with us from cuyahoga falls. caller: i would like to talk about what the government is doing in this drug war. i live in a community where six years ago, the federal

government put up a $15 million drug rehab center near the school and the playground. we tried to prevent it but we have someone coming in from the fda, telling us our city would be sued again if we try to prevent it. my next-door neighbor's has od to several times -- od'ed several times. my whole family was involved in the manufacture -- their whole family was involved in the manufacture of crack cocaine. my complaint is the federal government is involved in providing housing and rehabilitation in governments

where there are schoolchildren. we are retired in our late 60's, taking care of four children that are victims of the heroin addiction. i look at what the federal government has done. they removed the children from homes, and they are put in foster care. my children was put in foster care for almost three years. the state of ohio has a very limited view as to how we can help the children affected by the drug conditions at it -- drug addictions of any kind. i have a seven-year-old and a five-year-old who have witnessed their parents, one is a bot relative of mine. they have told me about the

fights and the doctors bags with the needles. one parent is incarcerated for only five years. he was found with a major supply of heroin and several thousands of dollars. host: if you could change the public policy angle, what would you do react: -- what would you do react to -- what would you do? caller: i would have the federal government stop making -- start making -- we are talking about eliminating the drug addiction. we need to purchase one of those uninhabited islands in the pacific and take people who have been convicted to that island.

host: that is angie in ohio. trina is in florida. caller: thank you so much for taking my call. i would like to share with you both personally and professionally, i have a daughter who struggled with addiction. she struggled for 14 years. she is originally from canada. she was five years clean and five years ago she relapsed. it got progressively worse until a year ago. she started shooting heroin because she no longer could get a prescription. both working in the field and having a daughter, i think just

about everything. when you see a daughter struggling with heroin addiction -- they absolutely love them of their soul. i think we need a comprehensive plan. addiction is not a one size -- one-size-fits-all. just to bring this into scope. my daughter almost died of a heroin overdose. the pain is beyond what any of us can imagine. i was called to the hospital and fortunately for us we ended up with a doctor whose nephew had

recently died of a overdose. i was told to go home and get some rest. she was taken a first step treatment. long story short, my daughter had been on methadone. i absolutely believe in harm reduction. we need a long-term plan. host: where is your daughter today? caller: my daughter is in a 30 month intensive treatment program. there are very few people coming

off of heroin within 28 days. it is a revolving door. i hear a lot of people talking about obama care. people can only get obama care insurance if they have done their taxes last year. i know very few drug addicts focused on doing their taxes. host: who is paying for that treatment? caller: i wrote a book which details my journeys -- my journey through my daughters drug addiction. host: i apologize but we are out of time. thank you for sharing your story. we might have time to get kenny and