welcome the current medical officer for the office of pharmacologic studies at the substance abuse and mental health services administration. she is a position board certified in family medicine, with additional credentialing in addiction medicine. thank you for being with us. >> it's my pleasure. before i get down to the business of my presentation, i want to thank you. sam is supporting a new round of grantssa to improve access to high-quality medication assisted treatment. and funds to overdose prevention thanks to the budget you work hard to pass. similarly, i want to thank you for setting aside the block of time to together more information about treatment options for opioid disorders. i cannot begin to fathom the number of equally critical

issues you are faced with. i came away from the first for him a few weeks ago deeply impressed with the urgent need that i felt from the members in attendance. i am going to try to be concrete and not be too high level or reviewed too much of what dr. compton has already presented. i spent 10 years as a prescriber because i came to government. 5 years in my solo private practice. and 5 years as medical director of an opiate treatment program for western psychiatric clinic

pittsburgh. i maintain my private practice over that time. i can tell you the single most therapeutic thing i did for anybody was provide respectful medical treatment. whether that included medication or just listening and advice in coronation of ancillary services. it almost did not matter which. obviously medication was an important part. of going to spend a lot of what i talk about todahyy on that. a word about the pictures i'm showing you. one day i asked everybody i saw if they could give me their permission to take a picture. this was for me to use these photos to teach medical students about bias and disparity in health care. this is far less than half the people i saw on that date. of the people they gave me permission, i removed the

children and adults that could not fully consent. it so happens there are those i was rooting for addiction. in my private practice, you can't tell one from the other. people sat in my waiting room and waited their turn in between the kid with the ear infection and the old lady to refill her high blood pressure medicine. nobody could tell what anybody was therefore. you have been surprised to find out. subsequently, i saw some of the same people in my opiate treatment program. the know you in that environment such that iu was saw different behavior. i was often challenged. oh, now you see what they are really like because they are in this clinic. may be their behavior is a little more street. why do you think this is what they are really like? i think what they are really like is how they caved in my office being treated with respect, seen and a pleasant place where they got the care

deserved to them as human beings. not that we did not do our damnedest to do that for people in our opiate treatment program. reiterate what dr. compton said, as far as your brain is concerned, and opiate is an opiate. while the problem has its origins in overprescribing and being exposed to opiates to start with, once that horse is out of the barn, and opiate disorder is a disorder. you may have different strategies you want to apply on the prevention end. but the treatment end looks the same for anybody. in addition to the difference inherent qualities of an opiate, how intense it is, how quickly it affects you -- the individual brings risk factors to bear. their biology, genetics, and

social situation. this unfortunately is why we see worsening in their illness when the social burden of their disease increases. when they are functioning highly and getting their opiates, either by misleading a fromriber or getting pills a friend, they keep the social front intact. the consequences are usually less. unfortunately, and opiate is just as deadly weather or social side is intact whether it is not. unstable,housing is if your personal safety is at risk, if you have been subject to trauma as a result of the risk you have exposed to, then it does snowball. there is a cumulative risk that cover misys or health. -- that compromises your health

physically and mentally. while the brain in opiate parsonage rising in whatever way -- brain and opiate are synergize and in whatever way-- criminalize their behavior or medicalize their behavior. moving on from that point, i want to talk about the in central ingredient for recovery is that one be alive. no locks on is not considered a treatment for addiction. it is the antidote to opioid poisoning. it has the shocking ability to take somebody who was completely without life, no air moving in the chest, and bring that person back to alert status, not always

very happy to see you, to live again. it's astonishing the effect of that drug. it's essential to any successful treatment that people have access to the antidote to opioid poisoning when they need it. that means making this drug available to those leaving and curse ration, people that are leaving detox or rehab. -- leaving incarceration, people that are leading to talks or rehab. they are leaving in a fresh baby state. peoplemportant that likely to be on the scene of an overdose, whether that his friends and family, or other drug users, have this drug. one of the things i did in my practice was write restrictions at the overdose prevention program. i supported developing a

training offers in jail. we were not able to offer the truck at that time. some programs are not doing a training in putting this drug in your personal effects. so that when you leave jail or prison, you have it with you when you walk out the door. all sorts of innovations going result in lifel saved instead of lives lost. samsa's updating our toolkit to reflect the new products available. that should be publicly available later this month. another take-home point, detoxification is not treatment. is necessary to break the cycle of dependence, tolerance, and withdrawal.is not always necessary to begin treatment.

for example, you don't have to be detoxed to start methadone. if you are choosing to be detoxified because that is what is best for you, than being offered naltrexone should be considered an important follow-up step. it should be standard for that person not seeking and opioid agonist. detoxification is better thought of as the medical management of opiate withdrawal. it does not change the course of the disease. it does not change the risk factors for relapse or the course of the. it does increase the risk of fatal overdose, should a person relapse after detox. even unfortunately if it's followed fo -- followed by a rehab stay. medication is not a treatment by itself.

it will control the disease much the same way your high blood pressure medicine control your blood pressure. but it will not change the course of the disease itself. just like if you are diagnosed with high blood pressure, your doctor is probably telling you to lose weight or start exercising, you have to stop smoking, yo'uve got to control your stress differently/ a whole ton of behavior change that comes with most chronic illness. high blood pressure is so common. i am sure there are some of us being treated for it now. i would think what we would want is to be treated with the medication most effective for us, and be given the opportunity to change our lifestyles. unfortunately, socially and culturally the way we have looked at medication assistant treatment is that it's framed as a treatment of left -- of last resource. -- of lapsed resource.

fail rehab so many times, then gosh, you just have to go on medication. that's not how we approach high blood pressure. let's get you on this medication while you learn how to control your stress. that is the attitude we need to have towards medication assisted treatment. get on it to get your docs in a row. -- your ducks in a row. i would use that a lot in my office, are you ducks in a row yet? well, you still have work to do. dr. compton reviewed the point. i won't go into a lot of detail except to talk about the difficulty that we in those we interact with can we in understanding how you give an opiate to in opiate addict. that is intuitive, that where

you expect it to be going. as dr. compton laid out for you, if you get on the right dose. take method of -- take methadone. it is a full agonist. the more you take, the more affected has.if you get on the right dose , it controls your withdrawal so you can stay engaged in treatment and function. but it also feels up your receptors -- fills up your receptors. it keeps them on an even plane so that you are not being driven to use. but also, your receptors are full. so if you relapse and use something, there is no place for them to go. there is no receptor for that to bind to to you -- to reward you for that slip up. you can go okay, that did not pan out, and move on with your recovery instead of the whole bottom out of the top.

it's not just about getting the dose in the right range and saturating the receptors. a property of binding so tightly to the receptor that nothing else can compete with it. most of what people take on the street, if they relapse, will not be able to budge this drug. the beauty is that when it is bound to that receptor, it does not fully simulate -- fully stimulate the receptor. is working part-time. so your body goes, oh, my receptors are not so busy, i don't need as many. and it starts to downgrade. that is where it can reduce tolerance over time. that's just a cool pharmacology aspect of that drug, if you're geeky you will enjoy that aspect.

the antagonist gets on that receptor, binds it, blocks it off, makes it impossible for any opiate effect for whatever reason to happen. it gets tricky because you have to be complete free of opiates. your system has to be cleansed for you to take that blocker. if that blocker goes into your body and rips the opiates off your receptors and blocks them off, you will wish you were dead. you will not die from your withdrawal, but you will wish you did. the process of getting on it has a couple steps you have to go through. the pathway is a little bit

>> turkey's president erdogan is in washington. watch today on c-span at 12:30 eastern time. >> this week on c-span, featuring programs on the situation of the supreme court vacancy. with an apparent impasse between democrats, the white house, and republicans, over the next supreme court justice, we look at what today's leaders have said in the past concerning the nominating and confirmation process of individuals to the supreme court. >> in my view, confirmation hearings, no matter how long, how fruitful, how thorough, can lone provide a sufficient basis for determining if a nominee merits a seat on our supreme court. >> a thoughtful senator should realize that any benefits of barring an ideological opponent from the court are not likely to

outweigh the damage done to the courts to institutional standing. goes on. ideological opposition to a nominee from one end of the political spectrum is likely to help generate similar opposition to later nominations from the opposite end. >> those are some of the programs featured this week on c-span. media teaches us that the democrats and republicans are supposed to be at odds with each other. and i think that people need to beognize that, we need to respectful towards each other and we need to understand that senators are respectful towards each other, and that will be more conducive to getting more policy done -- we see oneople television, on c-span, are real people. when we saw president obama, the asng that most sit out to me

he had bags under his eyes, he was tired. he is a real person dealing with real issues. high schoolght, top students from around the country attending the 50 fourth annual u.s. senate youth program talk about their experiences in the program, plus their plans for the future. the students met with the branches of government plus military and media representatives. capheart camean to talk to us and i love the insight he gave us about being the outside source, reporting back to us and the electorate about what is going on in our government. was thebader ginsburg most inspirational person we met this week. she has been one of my idols for a long time. i either want to be in the legal profession or possibly a senator. >> i understand the need for bipartisanship that time but i also think it is important

politicians go to washington or to their state capitals with l, and theyon a goa are determined to meet that goal instead of sacrificing it in the light of money or bipartisanship. >> we need to get back to having discourse,ve respecting all americans and to make in this country are more respectful place where people are welcome to give opinions. >> sunday night 8:00 eastern on c-span's "q&a." >> white house national drug policy director michael boticelli spoke at the end all meeting of the national lieutenant governors association. the conference focused on cooperation from the federal and state government and he talked about ways to address the addiction.opioid he also takes questions from the lieutenant governors in attendance. this is 45 minutes. >> good morning, everyone, if

you will go ahead and take your seats i think we will go ahead and get started this morning. we do a pretty good job of quieting down. pretty impressed with this group. how about that? we behave. goode everybody had a evening. i thought we had some great panels yesterday and we were going to match that today. i want to thank you again for being here. this morning we are going to start with a pretty serious and compelling issue that is impacting children and families all across this nation, and that's infants with drug withdrawal. i think the national institute of health, in fact, one of the statistics they gathered one infant is born into drug withdrawal every 25 minutes. so, this is an issue that all of tomre facing and i' excited the speak of the

panel this morning. as you heard yesterday, she led the local government consolidation on unfunded mandates task force. and if you get a chance to talk to the lieutenant governor, she has a very compelling and inspirational story of her own. i'm just really pleased to have her with us at this meeting and to moderate this panel. thank you very much, lieutenant governor. [applause] you so much for that kind introduction. great to be here.a and welcome to all of you. this morning we will be tackling -- academic that touches too many lives and also too many of our states, from big cities to small towns, who are in rural communities, the heroin-opioid

epidemic is quite friendly one of the hardest, largest, immediate, pressing public health issues of our day. thisa illegal drug use to use of a prescription drug leaders at the local state and federal level raare rallying to combat this problem. this morning we will hear from the nation's drug czar about protecting infants who are born addicted. education ander about expanding prescription drug monitoring programs and more. in welcomingin me the director of national drug control policy from the white house, mr. michael boticelli. [applause] michael: you might know the bulk of my career was spent working

in state government in massachusetts. so, despite the fact that i am a heart still lies at the state level because i really do believe that -- and i want to just start off by governor.ieutenant what we are facing in terms of just significant issues,. to this issue. we have not seen -- 2014 data show that we have had about 24,000 people die as a result of opioids. that translates to 78 people a

day are die from this. and what we have seen is obviously just a kind of no geographic boundaries, no race boundaries, no economic founders to this epidemic and it has challenges because it is sitting that have not-- seen this kind of mortality related to this. we've also seen a number of other consequences we will talk about, not only neonatal -- but huge increases in hepatitis c. and we've been seeing outbreaks of hiv as it is related to needle sharing. i want to talk about a couple things. one, what we are doing at the federal level, what we see are state opportunities. i really do want for my colleagues at the federal level, i think are incredibly impressed by the leadership of governors and the tenant governors on this issue, state legislatures.

we've seen tremendous amounts of movement in terms of legislation and passage of programs that we believe are important. but one of the things i've been doing this work for the better part of my life, and i think the most essential ingredient to dealing with this issue, and quite honestly, issues around substance abuse, is really about leadership. and that is why thank you come in. -- think you come in. i want to thank the tenant governor boyd and others for spearheading efforts. i want to make sure what we're doing at the federal level response to your needs at the state level. let me talk a little bit about what we are doing at the federal level. and what i think are opportunities at the state level. e lieutenant governor talked about, we can track the beginning of this epidemic to the vast overprescribing of

prescription medication in the united states. the some facts that while united states represents 5% of the world's population, we consume over 80% of the perception pain medication in in united states, enough 2013, that we gave every adult american their own bottle of prescription pain medication. now, clearly we want to make sure the people who are in pain have access to pain management, and therapy, but it is very clear that when you look at the in mortality,ases they correlate to the volume of prescription pain medications we have. we've also seen significant variation in state-level prescribing. so, there's sometimes a threefold difference in terms of state level prescribing behavior. clearly started with education becomes really important. we are tremendously pleased that many states have implemented mandatory prescriber education.

i do not think it is unreasonable that our prescribers, however well intended, get some level of education as it relates to safe and effective opioid prescribing. there's a gao report that shows that veterinarians get more training on pain prescribing that physicians in the united states. we know we have some outlier vast majority of these medications are coming from dentist and primary care physicians who think they are being well intended. have seen thatht last week the centers for disease control released prescriber guidelines that we think are very prudent. of states have passed legislation -- massachusetts just pass legislation -- a number of other states are looking in terms of limiting the dosage in terms of first time describing which we think is important. also, moving the community away from opioid prescribing as a first line of defense for

chronic pain, that looking at alternative strategies around that. there was a report yesterday that showed that meditation is quite effective in dealing with lower back pain. but we also have to re-train our consumers away from thinking they are getting better health care when they get a pill. and that's part of the context. we talked about monitoring programs. when we started this administration, we only had 20 states that have prescription drug monitoring programs. we have 49 states now that have prescription monitoring. we continue to focus not just on supporting the establishment of monitoring programs but looking at a number of key areas as it relates to one interesting -- operability, making sure these problems can talk across state lines so we are not basically pushing consumers from one state to another based on the inability to share information. and also working on opportunities to increase the utilization of those by

integrating them with electronic health records. we want to make sure these are good programs to be able to do that. we have also been continuing to support grants to states to ofport a wide variety situations. just last week, we announced new funding -- to integrate treatment into our community health centers. we look it over dose data, we know that many parts of our country, rural parts, ubra rban parts, that do not have treatment, -- i would encourage all of you and will continue to do that to make sure that you are taking, optimizing, we're going to be having more grant calls coming out next week, so making sure you are taking opportunities for grants. just last month, president obama in part of his fy17 budget

forunced $1.1 billion funding to support and close the treatment gap that we have. the vast majority of that money, $920 million, with support two year cooperative agreements with states to support expanded treatment capacity. advances withr the affordable care act, we know that there is a big gap between how may people need treatment at how me people get it. in my job, i can't ask you to wouldte for things but i encourage you to communicate congressionalyour delegation in terms of, quite honestly, we need funding for this issue now. last year, congress appropriated over $1 billion for ebola and we had one person in the united states die of ebola. and have 78 people dying every

day of drug overdoses, and we from despite support congress of traditional funding two years, that we have -- these are people that end up in our criminal justice system, our child welfare system, our emergency department, and people that end up dying. partnershipequires and we have seen significant opportunities -- and i will talk situation.tal we are beginning to see an emerging picture in what are the things that we need to do at the federal and state level. we sent out a letter to governor's last week as a follow-up to the meeting we had in terms of what our state-based best practices that we think are

important as part of your overall plans to be able to do that. starting with prescriber education, we have 14 states that have passed mandatory prescriber education. we have gotten commitments for many of the major medical organizations to enhance their training on it, so we think that is an important priority. continued to support and fund constriction -- prescription drug monitoring programs, we have seen some really good results in states that have good prescription drug monitoring programs. we have seen in states like new , florida, a dramatic reduction in overdose and doctor shopping behavior where we have really good programs to do that. ,learly more timely data monitoring programs and requiring prescribers to check it.

i think we have 33 states now that have some level of legislation that allows them to access programs. we have seen a significant increases in viral hepatitis associated with sharing needles. many of you might have seen what happened last summer in scott county, indiana. , because of needle sharing behavior with prescription drugs, they had over 180 new cases of hiv. governor pence passed legislation to allow for a program. we have all seen remarkable own -- around the locks naloxone. making sure that every first

loxone,er is carrying na ems and fire departments, but also family and friends to be able to do that. we have also seen states passing legislation to allow for over-the-counter access to nal oxone. we have 35 states no that have passed some legislation to look at third-party prescribing and pharmacy access, and i know we have some of our partners hear and i wantcy chains, to thank them for the work they are doing. when of the things we have seen that has been great is how particularly law enforcement and public health working hand-in-hand. we have come to an understanding that we cannot continue to criminalize and diction -- addiction, and we have seen great partnerships between law enforcement and public health.

with a police chief in dayton, ohio, they are identifying people who have overdosed and working to get them into treatment. officers arent working to case management people into addiction treatment. let me just talk for a minute about neonatal syndrome. it is one of the issues we have been hearing a lot, the lieutenant governor talk about the magnitude of pregnant women with addiction. there are a number of ways that we need to respond to this issue. one, i think is looking at making sure we are having a compassionate response to pregnant women with addiction. seen quitehave thattly, as legislation, put enhanced criminal penalties on pregnant women with opiate addiction and we know that discourages women from seeking care, and ends up costing

particularly our medicaid systems for women who are afraid to access care because of increased criminal penalties. we have to make sure we are doing everything we can to encourage women to come in and get good prenatal care, make sure they are getting treatment. that pregnant women and postpartum women need access to a wide variety of support services posttreatment. so we can continue to ensure that at a federal level, we are providing grants to serve pregnant and postpartum women, giving them access to long-term residential care. we are happy that congress passed and the president signed the protecting our infants act. it make sure we have good treatment protocols in place for dealing with pregnant women. andlast thing i will say

particularly i saw this in massachusetts, we really need good, solid collaboration between child welfare agencies. that is important to look at how .hese two systems communicate while we are protecting the welfare of the children, we are working collaboratively to deal with the issues for pregnant not working at cross purposes with our child welfare agencies and substance abuse agencies, to make sure that we have a coordinated response. i was just in connecticut where the governor announced what i thought was a really interesting project using social impact bond to focus on reducing cost and reducing the magnitude of addiction on the child welfare system. ,e have representatives here the lieutenant governor from connecticut who can share that with you because i think it was

the first time that we have seen the use of social impact bond focusing on substance abuse issues and how we can leverage private equity to be able to deal with that. let me just end by saying i think you all know this is an important priority for president obama. last october he went to west virginia where we held a town hall forum for the impacted population. the president is going to be forg next week to atlanta the national prescription drug abuse and heroine abuse summit to demonstrate that this is a presidential priority that we need all hands on deck. , all oforking government federal response to this, with health and human services, the department of recognizend we also that we need strong partnerships at the federal, state, and local levels. we need all hands on deck to

make sure we are dealing with this issue. i'm pleased to be here today. i want to thank you for your leadership and continued focus on this issue and making sure that we have continuous dialogue with both states and the federal government to make sure that our policies and resources are attuned to the issues that you are facing at the state level. i want to thank you all for the work that you do and happy to answer questions or hear comments. [applause] >> thank you so much for your insight, director. the floor is open and you folks get to pepper the director with questions. first question. >> thank you, mr. director. when you open up and talk about as you mentioned our son has seen you in and out of medical school, ama grouping,

and you and inspired them to understand that when a script is written you do not need to have a 30 day script for a lot of these. for your outreach and leadership and inspiring people, it has been pretty impactful to thank you for being here and encouraging us. as we were talking to you coming in, i am background in emergency medicine as a nurse. there was a story i was told by a friend of mine who is a psychologist in our diversion program, that an individual who has a severe monkey on his back as a friend who continues to drive over his hand so that he can continue to get access. he has had his hand driven over three times. one of the points that he brought up to me at a lunch that we had in a small town where i met him is that, with all of these monkeys that people have, these demons, that we do not

have very good cross communication electronically. like what the governor has led in terms of electronic prescribing, but there is not one system and chemical dependency. we have so many credentialing issues. you cannot even get into ihs without busting down a wall. the same with these community health centers. one of those pieces is to be able to integrate, and i hope with our community health centers and federal qualified centers that there could be leadership from you and the administration to streamline this process so that we can have , regardless of the size of the cities, behavioral health support for treatment whether it is in a prison setting or community corrections or diversion. this hodgepodge is what i actually think is a huge systems fix, buthat we could other than that i do not have any opinions.

issues that i think this epidemic has really brought to light is that for a very long time -- >> one of the issues that i think this epidemic has brought to light is that for very long time we have had firewalls. part of our overall work is to look at how do we integrate substance abuse and mental health. i know that we have a long way to go to do that and one of the issues that we have heard that we are trying to deal with, is to look at confidentiality laws as it relates to sharing information, particularly within health systems and electronic health records. we want to make sure we have some level of protection but we do not want to inadvertently create, again, these systems that cannot communicate with one another to share information as it relates to that.

has opposed modifications to the confidentiality law that would help facilitate better communication between, and within health systems for people receiving both primary medical care and behavioral health care. i know that does not solve the entirety of the problem but we are to really trying to look at ways in terms of better sharing of information and better integrated care within primary care settings and within larger medical settings. >> a great question on streamlining the process, which brings follow-up to the next question. >> director, thank you. excellent presentation. i thought that was a really interesting point about having more training in prescription training, then actual physicians. i think that really goes to the point that we do not do enough

training on addiction in general. medical students have no idea what they are looking at. i think there is a lot of different ways to approach that, either we mandate that medical schools have larger blocks of training, that is one area. the key that i think you are talking about in this country, we are all starting to get over the stigma of addiction which is one of the things that gives it so much power, and we are trying to maneuver our way through this . day, treatingthe addiction gets way in the back of the line for funding whether it is at a state level or federal level. what you are trying to do i think is push it forward because it is one of those cases where you can spend the money now on treatment, or we can continue this process of spending billions on corrections and law enforcement and those things.

i really appreciate the point you are making and i would look forward to working with you and other lieutenant governors on prioritizing treatment. another issue that you are talking about that we are maneuvering our way through is the whole confidentiality issue. all these things are really important and for me, that was an important point on the issue of pregnant moms trying to seek treatment. i think most people react to that emotionally and angrily instead of seeing it for what it is, and it is a heartbreaking aspect of the need to get folks treatment. lieutenant-governor, no real questions. wolf, i knowvernor are really doing outstanding work in terms of looking at this issue. a couple of things that i think are important that you talked

of the rolee, kind that stigma plays in preventing people from getting care. substance use roughly has the same prevalence as diabetes get the treatment for diabetes is about 80% to 85%. only about 20% of people with addiction are getting the care and treatment they need. i think to your point, that is not a free pass. we know that that has resulted in an inordinate effect upon our ourcal system, certainly on criminal justice system when you look at the percentage of people in our jails and prisons as a result of it. i always say that finding addiction treatment is one of the best returns on investment that you can make here. again, i think we have a really great opportunity, reticular really looking at --

at, statesy looking have a tremendous amount of flexibility in terms of what their medicaid package looks like. typically we are generally pretty generous. i think looking at your medicated -- medicaid package is important. we see the biggest cost offsets on the criminal justice settings. i know that many of you are struggling and looking at ways to kind of, how do we diminish the jail population that we have? that is one of the greatest expenses at the state level. to be able to do that by moving people away from incarceration, we have seen just remarkable results in terms of when you implement good addiction treatment programs, when you implement things like drug court, they have a tremendous savings opportunity as well as quite honestly, a much more

compassionate and humane response to people. say,ast thing i will stigma still plays a huge role in data. anything you can do to call attention to this issue, as i have talked to a lot of people in this room, i have not met a family that has not been impacted by addiction. i think the more that you as leaders can talk about that or feel comfortable with that or hold up people in recovery in your state, we need to make sure that we are diminishing the stigma associated with it. >> i will tell you one last thing. in pennsylvania, we have a secretary of drug and alcohol and when we started that, a number of legislators were like, this is more government, and next the cabinet division, but it has worked out well. i can tell you, i own experience as a state senator, we spent a lot of time with constituents and family members finding ways

to connect to funding to get them into rehab. if you are representing people, most likely you will represent people in crisis who are trying to get help for their loved ones. thank you very much. >> next person with a query or thought. >> kathy hogle, new york state. i want to commend you for your laser focus on this issue and i wish congress could step up and do right by the people, and that the funding in place. , in 1986 cracky cocaine with the crisis of the day. i recall working at a $1 billion bill and in today's dollars i have no idea what that would be. access to the prescription drugs come from many ways.

we have prostitution up where one doctor, while he was on vacation was found guilty of prescribing 19,000 prescriptions. we need to make sure there is less access and our governor cuomo directed that all systems be occurred electronically. i think that is a way you can stop people from selling the script and creating excess. is there a central repository for the best practices of states? we are coming under a lot of great ideas and i am hearing some today. we still are leading, that there are other ideas out there as well. is that something your office is providing already? there is a state, federal, and local issue that we are desperate and we are losing people in my county.

we are losing one person per day for two weeks straight. the people that are under -- if weative, we had , we would'venarcan had 1100 deaths. >> i think we were going to try to do it for this meeting but we were not able to do it, so we will get you the letter that we sent out that listed 11 best practices we have seen, particularly coming out of the states that do that. i know many of you are already working on those kinds of issues so i would be happy to share that with you. i think new york state did something very important, to look at the enforcement of parity protection for people with mental health and substance abuse issues. one thing we have seen with private insurance, a reluctance

to treat mental health and substance abuse disorders the same way they do other medical disorders. with the affordable care act also was t passage of the mental health parity and addiction equity act that required private insurers to make sure they were administering those benefits at the same level. heardk we have all widespread reports of people feeling like they are not getting their full due as it relates to parity so i think new york state did a really great job at looking at things like parity issues for private insurance. when a private insurance at the table as well. >> next query? >> thank you very much for being here. on,thing that you touched the fact is the lieutenant governor from new york has said, prescriptions.

prescriptions are written by doctors and how do we change the to try other things besides just writing that prescription? or at least monitoring the amount of the drug that they give somebody. --i think with the release and dr. frank is here from health and human services and will probably spend more time talking about this -- the cdc release their guidelines last week focusing on chronic pain and treatment for acute pain. i think there are a number of things to look at and again, how some of this relates to further back of how do we integrate issues around addiction and medical school, as i think that becomes really important to do. we are looking at some level of mandatory education prescriber training becomes

really important to do that. checking prescription drug monitoring programs becomes really important. there are some states that require prescribers to check the prescription drug monitoring programs at least at the initial prescription and then subsequently thereafter i think it becomes really important to do that. i think to look at cdc guidelines and how you work with states looking at how might we integrate those cdc guidelines into the medicaid program. to be able to do that i think becomes really important. i do think that the vast majority of physicians and dentists, dentists are pretty high prescribers of prescription pain medicine as well, i think

the vast majority of people are well intended. i think they are misinformed by the addictive properties of these drugs. we are lobbied very heavily by pharmaceutical companies and again, we want to look at also not opioid therapy for it -- non it.id therapy for therapy,ke physical making sure that caught euro to -- cognitive behavioral therapy is important. incentivizing not opioid prescribing but incentivizing other pain management therapies is very important. >> i want to follow up on that. to give examples of a state that

has done that with the cdc, i think that would be helpful. if you can get the information to julia and she will have a central repository and we will post information on our website so we can all access it at any time. -- i wondered if you could speak a little bit about system, and ithe speaks of how we need to deal with this from federal, state, and community levels. the more that we can break it down and look at it from a holistic perspective, there is no other way we are going to be able to address the crisis. >> i can tell you my experience in massachusetts. we know that it is significant and escalating, especially with the opioid issue, increased

referrals to child welfare system as a result of the opioid addiction. these are two systems that in some respect need to work better together to ensure that quite honestly, child welfare workers have some level of education in addiction, have established partnerships with treatment programs that can treat pregnant women and women with children. that you have substance abuse services that actually support women and children accessing care. i can tell you that sometimes women have to go through this sophie's choice thing about, do i go to treatment and what happens with my children? supporting i think rehabilitation programs that do family-based treatments come really important. the federal government puts out grants to support pregnant and parenting women. i would encourage you, there is

actually a technical assistance center funded through our substance abuse mental health services administration. we will give julia information as well. itis called the national -- provides technical assistance to states to look at good communication, good protocols, good treatment with child welfare agencies and substance abuse agencies. >> wonderf. we are getting ready to wrap it up so i'm going to take the last question. we have one from vermont. >> phil scott from vermont. experiences,t our we have a number of communities -- governor reynolds to talk about, brought together community leaders, state resources, and local law enforcement and they are having some success in doing so.

my plea is if there is money that comes along, when it comes along that it remains as accessible as possible. we found some success in this community that would be beneficial. the other question i have is maybe a hotter topic in vermont at this very moment. we are considering legislation to legalize marijuana and i am wondering if you have an opinion as to whether or not -- >> leave that for the last question, well you? mind, doesn'tn have any relationship at all with the opiate discussion? >> i actually point to the assessment that vermont department of public health data as it relates to that potential impact of legalization of marijuana, it is a thoughtful report. i do have a lot of strong feelings.

i will separated from the opioid addiction first. i am a long-time public health person so this is not coming from an idea logic perspective. we made a lot of progress in may -- reducing adolescent substance abuse in the united states but not around marijuana. one of the things that we track is the perception of risk because we know if you perceive something as risky you are less likely to use it. we have the lowest levels of perception of risk. we have more 12 graders smoking marijuana than tobacco and quite honestly, part of what we have seen is the development of this billion dollar industry. it is not just legalization of marijuana, it is the commercialization of marijuana. we have seen just billions of dollars being poured into this marijuana industry that quite remarkably looks similar to the

tobacco industry. not wantand that we do to have people arrested and incarcerated, have long sentences as a result of particularly for a simple marijuana possession. bad public health policy and we will pay the price for it. the other thing i will say is it is pretty clear. all of you have had listening sessions when you talk to people that are struggling with opioid addictions. you hear time and again that they started at a young age. they often started with alcohol, tobacco, and/or marijuana. we know it is that early use that sets the trajectory for abuse. i do have some concern that while everyone is focusing on what we can do on the opioid addiction side that we are moving in the opposite direction when it comes to the legalization of marijuana.

other side, what we are trying to do on the medical side is enhanced good scientific research on the potential therapeutic value of medical marijuana. that is important. want topears that we make sure we are investigating the potential therapeutic value. there is continuing evidence to support there might be therapeutic value for a host of conditions. i want to separate the two issues. want to encourage, and we are trying to do everything we can, to diminish some of the barriers the government had in place for supporting good research for medical marijuana. >> thank you for your thoughts, questions -- director, thank you for your insights and time.

we enjoyed peppering you with questions. i move on to our next speaker. [applause] on today's "washington journal" sarah war below and tim schultz on the religious freedom rights in georgia and the backlash from opponents who saint legalizes discrimination. then, efforts from republican candidates to court unbound delegates. we will take your comments at 7:00 a.m. eastern on c-span. on c-span,tonight the supreme court cases that shaped our history come to life with landmark cases: historic cases. court

exploring real life stories and constitutional dramas behind some of the most significant decisions in history. marshall in marshall versus madison said the constitution is a political document that sets up political structures, but it is a law. if it is a law we have the courts to tell us what it means. apart is it is the ultimate anti-presidential case.- precedential it is what you do not want to do. theuncer: we will look at case that struck down state and federal regulations on working conditions that violated the 14th amendment for liberty of contract, lochner versus new york. that is tonight at 10:00 p.m. eastern the c-span cities tour hosted by

our cable partners take shoe to long beach, california to explore the history and literary culture of this city south of los angeles. learn about women's contribution to the world war ii effort. >> when the u.s. army was looking for a place to build a plant to produce aircraft, they picked long beach a wonderfulave airport that was founded in 1923. it was one of the first airport to have a takeoff and landing in different directions, which the army left. they could use military planes in a way they could not in other places. it was turning out planes 24/7. it needed a lot of people to work. went to war and the women were brought out of the house into the workforce.

, douglas was employing 45,000 people a day in the long beach area. 48% of those people were women. announcer: on american history tv we visit the port of long beach to discover the importance of the nation's second against container port. 1911.was established in we are little over 104 years old. through that time, this port started on a wooden wharf and was a lumbar terminal that used to come up from the northwest to cityumber for the growing of long beach and the region. in 1940 we had the u.s. navy naval station. naval shipyard was our naval complex. they were here until the early 1990's. unfortunately, through the base closure process, the naval

complex shutdown. we were able to take an old federal facility and turn it in it still is, one of our modern container terminals. where we are today, 104 years later, is the most modern, sustainable green container terminal in the world. announcer: wash the c-span cities tour. the c-span cities tour is working with our cable affiliates and visiting cities across the country. when i tune into the weekends, usually it is author sharing their new releases. watching the nonfiction authors on book tv is the best television for serious readers. on c-span they can have a longer conversation. author after you

author after author. it is the work of fascinating people. >> i love books tv, and i am a c-span fan. house former chair of the intelligence committee, mike rogers, spoke yesterday at a national security conference hosted by the heritage foundation. we will also hear from former national security advisor stephen hadley. this is two hours. >> i hope you enjoyed the second panel as much as i did. we will continue the

conversation. i am pleased to have former representative mike rogers to as aus his viewpoint former member of congress in a key post. we have heard from two panels giving you the view from the executive branch perspective. to thebuilding our way last panel, a view from inside the white house, how the president actually uses intelligence. for now, we have a lunchtime treat. my friend, mike allen, will be giving framing remarks, then we will hear from congressman rogers. careerarted his after law school. he worked for president bush in the white house national security area. thethree years, he was

staff correct her. i cannot think of a better person to introduce our key note speaker than mike allen. thanks for organizing such a great event. it is an honor for me to introduce my former boss and future national security leader, mike rogers, former congressman and chair of the national intelligence committee. i want to speak by way of introduction about chairman .ogers' time he was a strong, conservative voice for a conservative internationalism. and ang national defense aggressive in fair intelligence community. he was once a man in the field as an fbi agent. he knew what it was like to be be at the camp fire, to the tip of the spear.

he brought those instincts back to washington. when i was hissed after actor, staff when i was his director, and chairman rogers had a reputation for jumping on ranges and going down where our intelligence community officers might be surveying, he was unhappy when i explained the intelligence community, for reasons of security, or unenthusiastic about his ideas to go down range while he was chairman of the committee. the main point is that he was not content with the party line in washington and always wanted to go to the source to get the real story. wonugh that experience, he the confidence of the men and women in the intelligence community and was able to earn their trust, and by extension, the committee.

theirwas able to earn trust. they would give him, and by extension the committee, the real story of what was going on. , andirst example, i think a great example of what you can do when you are on the intelligence committee is a role the chairman rogers played as a member before he was chairman with regard to the war on terrorism. he became aware of a misalignment of resources in some of our direct action programs, and lobbied very hard, all the way up to president bush, to try to correct what he saw as rule of engagement issues and micromanagement that was hurting the way that national operations were running in the united states. he brought this attitude to the chairmanship. when president obama and some of his directors became weighed

down with rules of engagement and other micromanagement issues, were able to take their concerns directly to the director am a in some cases over, and over, and over again. a couple of occasions, it was over dinner and i was relieved tot there was wine served call the atmosphere. chairman rogers knew when things theed a good airing in intelligence community. history will show that he was one of the ones that broke the on chinese economic espionage. he spoke out on this. show reallyory will started the moment in which people began to talk about the thievery and pilferage of -- asationa intellectual property. chairman rogers was a friend and compatriot.

someone who listen to what people in the intelligence community were telling members of congress. in the case of chinese telecommunications giants that seem to be growing across the world, chairman rogers announced and put out aon report that i think educated people around the globe. you cannot read an article today without there being a reference to the report that chairman rogers and mr. rufus berger put out. of aarning of the element rising china. owden when so sn many people would not defend the national security agency, chairman rogers stood tall and help to explain to the american people the need for great intelligence and why it was so critical to our national security, diplomacy, and are giving indications and warnings across the globe.

this was at a time when it was not popular to stand up, and certainly at a time when the president was not doing all he could have been doing to back some of our men and women in the intelligence community. he was a tough critic of the intelligence community and went after them on budget matters and authorities, in areas where you thought there was too much micromanagement. his chairmanship will be regarded as one that tradition of the aggressive, but fair, oversight of the intelligence community. i am pleased to introduce the chairman. chairman mike rogers. thank you. [applause] i wish mike was that nice to me when i was chairman. i'm fortunate that i see former

staff folks here. i think we have assembled some of the most able national security people in this town, in this country, to help. any success that i had was led by my staff director and the able team that he put together. i was honored to not only called and colleagues, but friends, in what i thought was very serious course work in trying to get the intelligence business right. to one oft i ever got these was when david called me and asked me if i wanted to participate. his integrity is impeccable. i had the great privilege to work with him the entire time i was on the intelligence community. it was a loss when you left. there is still a hole that is left to be filled with your experience and intellect to you apply to the cia and dea. i wanted to say "well done." other day i was with

the former secretary at an event. asked, what is the biggest threat facing us today? you have to stop and look at the world. it has certainly changed. structure, the threat matrix, has significantly changed in the last few years. thingaid, one issue, one scares me more on all of the land, air, sea, ciber, space --eats that we face that is miscalculation. what if we get it wrong on north korea? what if we get it wrong on some conflict in the south china sea? what if we get it wrong on the new missile testing program they are proud to show

the rest of the world? what if we get it wrong? what if one of our allies gets it wrong? they make a mistake? the japanese are eager to push back on the chinese in the south china sea. when you are having meetings, they were aggressive about wanting to show they could push back against chinese aggression with the united states' help. they wanted to lead that charge. we are seeing the chinese airplanes brushing up against our airplanes and ships. what if that calculation cannot be put back into the bottle and you have a conflict that rages out of control? spend two hours talking about the threats. i give cyber talks all across the country, and apparently my job is to scare the the -- us out of people about what is coming.

diplomatic corps that is engaged everywhere in the world all the time. secondly, it is good intelligence. intelligence has taken a beating by reputation. i think, completely undeservedly. you think about where we are and what kind of problems have been nationstates deciding intelligence services are bad. europe is suffering under the hangover of world war ii. they cured laws on what the activities of intelligent services based on what they witnessed and suffered under intelligence services whose business was to impress the populations. you cannot blame them, how they got there. when you look at what happened in brussels or paris, even the united kingdom, you can see where those rules, laws, and restrictions are pushing into the strategic value of

intelligence services protecting his populations. intelligence services are bad was their fundamental building lock. that is not going to work. let's look at an example. belgicom was restricting law enforcement to do the operations it needed to keep russell safe. the information we needed on a counterterrorism threat for sure. other european intelligence services decided there were lots of threats to this particular country. these folks were coming through great britain according to public reports, going to places across europe. they needed information on these individuals as they traveled across europe. they decided that they were going to go in to get those

communications, follow those individuals across europe, i going into one of the telecommunications companies that have lots of access to those targets. it was belgicom. the snowden leaks come out. is spying on europe, how awful and terrible. we need to close it down. what happens is all of the information that the u.k. was collecting was dispersing -- there is a great article you can read in some british reporting -- talked about the value of the information they were getting that they could go back to brussels intelligence services and say, you have a problem and you don't know it. here it is. they could go to places like paris, germany -- say you have a

problem, here it is. that went away. the european union decided to target the intelligence service's ability to collect information that was lawfully appropriate to protect both their country and the added benefit was across the european union. inc. about that debate. -- think about that debate. in that same time period there was a ramp up a fake passports. in late 2015 there was an iranian individual that travel to thailand on a fake passport. he stayed in thailand for 20 years on a fake passport. his sole purpose in thailand was to engage in the production of lake passports. his number one clientele were seekingastern clients

passports to get into europe. when they arrested him, and it was a fluke that they arrested it was not a big intelligence operation. someone found a case of stickers going to a random place. that is how they found him. came in the door, they had 1000 passports ready to go. id.were already named and they also had visa stamps. they were exceptionally good. was operatingring in greece for the past five years. they broke up a ring recently. how did they get that? same way. someone in syria was mad athe competition. they were sending a case of

these resident stickers that were immaculately close. they were so good, so detailed, so accurate. it you had to do was take out of the box, put it on your passport, you are ready to go. your legal in greece. if your legal in greece, you can go other places as well. the reason they got onto it was not a great intelligence network and people trying to figure out what bad things are trying to happen to these country, it was someone got jealous because another ring had opened. someone said, i have a case for you going into greece. you should look at where it goes. we used to love those cases in -- in the fbi. you want that cooperation. but that is not the way when you are under siege to protect your nation. strategic intelligence can help

you. unleashing the power of these services to find out what they can do, versus the time and energy we spend telling them what they can't do. we missed that boat. president issued a directive in the u.s. that restricted collection activities in the united states. we will pay a price for that. i argue in many ways we have already paid a price for that restriction. the political debate was how do we restrict the big, bad intelligence agencies from doing something awful? everything was legal and appropriate. even the president's review teams wound they were legal and appropriate. the congressional operations found they were legal and appropriate. we may not have likes it, but that is a different topic. in the nsa contractor leak of massive amounts of information, we got a hangover

and decided our intelligence agencies were bad. i can about the threats. what is going on today. certainlyns are changing their policy on cyber. they have fundamentally changed for their coming at us. we will get that miscalculation effort somewhere. they have gone into a place like ukraine and shut down their electric grid. ukraine was not connected the way that our electric grid may be connected. they went back and, i got in trouble for this, i love my ukrainian friends, they pulled the lawnmower start for transfer stations and personally man them . they got power in short order after this attack. we could not do that. it would take a very long time. on russian policy change being more aggressive in cyber in ways that we have not seen

before, especially when it comes to distract of attacks overseas, and doing activities in the united states were it doesn't mind their signatures are found, that tells you we have to pay attention. we have a strategic problem in cyberspace. they have launched sophisticated nuclear submarines with more runs to the arctic. we will cut our standing army by 40,000 troops. they announce they are sending 40,000 to a training exercise in the arctic. strategically, we need to understand what the world is thinking. that is how you avoid miscalculation. what are the chinese thinking announcing by parliament last year they will allow chinese troops outside of their defensive region? when they passed it in the parliament they announced they are sending troops out for the first time ever. they have military components outside of their defensive region.

they have upped their silent -- toine cashe two and a level that is disturbing. they have developed counter ship make our navy folks very nervous. they are basing their strength on what our strength is. they're trying to go after our shield. they are concerned about how russia and china have militarized space in a way that could disrupt our gps. you think of the strategic advantage of the united states of america -- it is smart weapons, smart ships, smart aircraft, and everything else that is pretty smart. the navy worries about this. worried about it, you should worry about it, but every new naval officer after 2014 has to learn to use the sextant developed in 1724.

every new naval officer will have to use it. why? because the military is concerned what happens when the carrier gps goes out? many of you are thinking, how do i get to starbucks? can you imagine 30 million very cranky non-caffeinated americans have amorning? we will problem. if you look at the strategic threats and how that has happened, many will start to argue and a lot of circles in this town and around the world, about america's lost of -- loss of strategic advantage. ameone say it is little, some with a lot, some would say it is 10 years out. our adversaries are working that every day they get better and we don't. every day they engage in strategic espionage and we don't.

the cia director said the cia does not steal secrets. ofon't know about the rest you, that scared me to death. as an fbi agent, you do not want to fbi agents stealing secrets, but you want your cia agents stealing secrets. that might be a problem in how we are approaching the strategic intelligence. if you are not stealing secrets, how do you know what chinese military leadership's intentions are? we need to know, what are their intentions. you do that to avoid miscalculation. sometimes people are upset, i was not one of them, but they be we are looking at our good friends and allies on occasion. he do that because sometimes your allies can get you into more trouble you can do yourself. what if japan decides they want to be aggressive with the

chinese convoy? we ought to know that. what if the filipinos decide they are going to be aggressive on pushing back without coordination? we have a defense pact with the philippines. shouldn't we know that? shouldn't we know that germany had relationships with iran? if i'm a policymaker whose finger is on that button, we as aggressive asgrap we can. we are still on the over. we are trying to figure it out. apple, apple up beats up the fbi. completely inappropriate in my mind. there is no path forward.

they've found a solution that doesn't mean they have to go to court. fair enough. all those policy discussions have to happen. most.s what worries me big problem inn, the u.s. intelligence collection. for really not great reasons. not because we find anything illegal, but because it didn't feel right. bad call, interesting decision, not great for our strategic value in trying to avoid miscalculation. when you look at the alliances of economics and security in the world, some of them are starting to part. why does apple say, we are for encryption, we don't care, fbi, go stuff it. we don't care that we have the ability to get into a phone that can lead to the full investigation of the death of 13 americans because their economics have not

aligned with their national security. they need to sell these devices in europe, china, asia. the security and economics of that problem did not online. some changes in world demographics, one of our allies in asia is australia. about 25% of their gdp is related to exports to china. now, every time you have a national security discussion with australia about how we're going to push back the chinese in the south china sea, they pause for a minute. they are still one of our greatest allies. but you can imagine the challenge of trying to get to a place where we have a common decision matrix on how to push gdp comes25% of their from the nationstate at question.

the national security posture in our economics didn't quite align. so i argue the reason strategic intelligence, the reason an aggressive intelligence posture is important and why we ought to go through every line and every personal and presidential directive when we get the opportunity -- i know they debate it. i think there are some restrictions that we can improve on. we ought to go back and say, what serves u.s. interests, and what serves the world's interests? we should stop apologizing for helping europe because we had an aggressive intelligence campaign that may have found the culprit for a new cell, or the fact that the taiwanese were able to get passports used in thailand, packaged through syria to get people into europe. we call that a good day's work in the intelligence business. but none of that happened the cause of self-imposed restrictions. -- we took a at

major resource of finding bad guys traveling through europe and took it off the table in 2014. how many in belgium today would like to have the ability to get an intel share sheet that said you have a problem brewing in belgium? we found them because we are talking to people in france who are talking to people in great britain who are talking to people in syria. we lost that. for what reason? caused a lot of problems. spending a lot of time beating up the intelligence services. not a lot of time catching folks with face passports -- fake passports. the residence permits case was fascinating. when they got it through customs, remember those stickers i was telling you about, they do the ruse at the customs inspection. i used to love that. i know there's ab=b fbi guy in

fbi guyewhere=n -- an in here somewhere. you follow it back. there were 4000 of these residents stickers in this one box. 4000. when they got to the place, there was something on the order of 20,000 documents being inpared in a forgery factory the back shop of a front operation. 20,000. one operation. it gives you this magnitude about how important it is that we stop beating ourselves up and look at the things that we need to do right as we work through this process. example, then i want to take some questions, michael mentioned what i thought was a fairly groundbreaking investigation on the committee into huawei.y --

we had pretty good information that the chinese working engaged in espionage craft of trying to get a chinese company into markets where they could collect information. it was one of the largest operations to collect information against both u.s. targets, asia, europe, you name it. recently, and i don't know if michael, you saw this, pretty interesting that the commerce department -- this is why that strategic investigation -- by the way, that report freed up some of our intelligence services to be more aggressive in their investigation. on the entities list because of a very complicated conspiracy to in everyxport rules country you don't want things going on. iran, anda, somalia,

other places around the globe. what was interesting in that investigation, and you can find these papers on the department of commerce website, and if you really are interested, do it. read the chinese version first. that is how i know you are really serious. then they have the english interpretation of the document. the chinese company was working under a code name of another particular company. in these documents it is called f7. furthere working to this conspiracy on trying to get these units in two places where they could own the pipes. when you own the pipes, you get to look at everything in it. they were trying to do this in the united states very aggressively. they were trying to do it in australia, canada. zealand.

all five nations. they were very aggressive. still trying to get to the united states. they found out that f7 was huawei. so much for the denial that these were not intelligence platforms. without aggressive intelligence and strategic thought in how we apply our resources, we going to get behind the eight ball. there are more spies in the united states today than at any time in our history, including the cold war. are stealing everything. if it is not bolted down, it is gone. them is bolted down, give about an hour. they are doing it through human operations, cyber operations, stealing intellectual property, stealing government secrets. anyone look at the recent chinese fighter? i think it is that j31.

to me. lot like an f35 one of the great fbi cases was trying to catch chinese companies stealing technology on submarines, caught them trying to export material through a long-term spy operation on the west coast. very fascinating case that i would highly recommend you go to the fbi website. they have a lot of these listed. they are aggressively using their espionage networks against the united states. think of the debate in the last six months. the government is bad. i think the casey said it best. pretty interesting that we think these private companies are going to handle your private information better than your government. we always joked in the intelligence base, we would love to get 1/10 of what google has on you.

unbelievable. the fight has been i think in the wrong direction. how do we protect privacy? you can do that. it is the fourth amendment. now is not the time to curtail our strategic value and intelligence. you want to avoid that miscalculation, we better know what zte is doing. we better understand what they are trying to do in the arctic. we better understand what putin is trying to do in syria. not just on paper, but what are his intention? -- what are the iranians trying to do? how far will they push the united states on missile testing? we better know that or we are going to pay a horrible national security price. thanks for having me. i think i went over a little bit. questions, comments, concerns? lunch? [laughter] --on the iran deal

[inaudible] mr. rogers: look at the time. [laughter] mr. rogers: no, and let me tell you why. -- things that i thought obviously i didn't support it. there are some good components in the iran deal. the problem is we have given away every ounce of leverage we have. there's a provision in the deal that talks about grandfathering any contract not specific to the nuclear program. doch means if it doesn't with aluminum tubes and has to do with car parts, that contract will stand. that is why you see this huge flood of contracts. we have a great american company trying to ink a contract as fast as they can. it would he a huge deal to this company. notionat is signed, some that the united states is going

to undo those contracts when the deal says it had to be related to the nuclear program, the argument -- i had this debate last week on the west coast with one of the -- who by the way is a great diplomat, wendy sherman, we just passionately disagree on the arrangement of the deal. willesponse was, we reclassify those contracts. i know some lawyers in the room. somebody help me through that. the deal says one thing. they want to reclassify them. with luck with that. part of my fear is that we lost leverage to contain them, which is why they stepped up their missile program. they have weaponization, enrichment, and missiles. they just ramped up their missile testing very clearly. they get to have an enrichment program now. it is legitimized. any centrifuges spinning at

one time. went, you can do this through computer modeling in a way that you don't have to have the trigger test. you still want to do that at some point, but you can go a long way under weaponization. if that was our goal, i think we missed. i don't see a way now to get it back. what we have to do is continue to put pressure. the next president says he's going to rip it up. that is not realistic. yes sir. >> do we have enough information on north korea, because of the nuclear weapons they are developing? mr. rogers: anybody in the intelligence business will tell you we never have enough. no, i don't. we were able to do some things -- that happened under the

nose of many intelligence services. they had some advancements, i think that caught our intelligence services a little bit by surprise. you that they have been very, very good about making sure those operations are the cover of those operations is pretty intense. can go some things they through on checklists. you have to do these five things, let's say. a lot of times you would see one or two or three, but never four or five until this last hydrogen bomb, so will hold hydrogen bomb -- so-called hydrogen bomb explosion. i think that caught a few people off guard. it is a very hard target to penetrate, which is why the investment in the strategic intelligence component, all of the avenues we have available,

satellites, has to have a human component. these are big expensive programs. if you want to avoid something big and nasty down the road, you better invest in this. hopefully, that woke china up a little bit. they have economic leverage in the black market on their northern border that never gets talked about. if you want to hurt north korea, you have the chinese cooperate with us on closing down the black market for goods and services crossing the border. china's in an economic downturn, so i would argue, good luck with that. i'm a lawyer here in washington, d.c. spiesid that we have more from foreign nations in this country than ever before. how do you know that? mr. rogers: that is what the intelligence business is designed to do, determined that

we have individuals here who are engaged in espionage. everybody does it a little different. the russians tend to have professional intelligence officers. the chinese recruit people that aren't necessarily intelligence officers to perform intelligence thevities when they get to united states. if you look at the rash of indictments and prosecutions thently, especially on chinese program, it starts to highlight how they go about doing their business and how these folks are not necessarily trained agents and officers. they might be engineers. they might be scientists of some sort and for a very specific goal of stealing a very specific piece of intellectual property. it is a difficult thing for our fbi to get their arms around. it is huge. the numbers are a little bit overwhelming. you can see it on the russian front. you can see it on folks from

iran. if you start adding up the numbers, it is clear that their activities against the united states have increased. i'm not sure we have adjusted quite correctly on the way we're going to respond to those activities here in the united states. i'm a lawyer also, but i was a former naval reserve intelligence officer. i thought your comments about were very interesting. zte wasas you noted, put on the denied parties list majorgress, but retractions occurred. at least, they were perceived to be major retractions. could you talk a little bit about maybe some solutions, some ways forward to repair what has happened to the intelligence

service and the role congress can play to rein in some of the executive branch takes that seemed to be shooting us in the foot? mr. rogers: this is a problem, when your largest banker, you know, never punch your banker in the nose is the expression -- this is a problem for the united states. if you want to take a holistic approach, it is important that we get to a balanced budget. over time, we stop borrowing money from people who have ill intentions. not necessarily an aggressive one on one. they are just going to be aggressive in pursuing their interest around the world. and they don't have the same restrictions we do. some of ourand that weaknesses are also our strength. we have a wide open free-market oriented economy. it is a strength for us and they see that as a weakness, which is

why i argue zte would come in, and they are still up to it. they've repurposed some companies that are trying to go into small municipalities and offer the services where they say, we will do it for free. there was a sports team recently that was going to get free wi-fi by huawei. it is a pretty expensive operation. you start coming to the conclusion that this is not a for-profit enterprise. how do you do that? i think congress needs to step up and push back a little bit. the fact that they made it on the enemies list, there's lots of reasons for that. my argument is, for the investigators that went through that process, they ought to be up at congress, laying out the

facts. you can't let the administration get away with saying, it was not so bad. it is man. if you allow them to control the types of information, they win, we lose, and of story. that data is that important. it doesn't mean you call for a trade war. it doesn't mean you don't like engagement in china. you have to be careful about people saying this is just about setting up walls. absolutely not. i want to teach china to be good business partners today so that when they are an explanation, we have leverage. when they become a consumer nation, we no longer have leverage. let's get them to act now. catching them when their intelligence services are doing bad things, like they were. we aggressively push back from a congressional perspective on the administration that says there might be financial implications.

feel that pain now won't we will definitely feel that pain later. i think we can get through this. transparency is a great thing. are show the world who they and what they are doing and why it is free. normally, when something is free, there is a reason. show up withnd zte that great offer, remember who controls that information. thanks for having me. i appreciate it. [applause] yet, but youdone get to eat. food and drink are provided in the interim. 2:00 to hearne at the view from the national security advisor on how the president uses intelligence. see you after lunch.

let's try to set the stage for our discussion. if you could, paint a broad picture for us regarding how the president gets intelligence information. obviously he doesn't just turn on the news and watch it, although i assume the president since youe news, but served president bush, let's focus on your time in the white house and president george w. bush routine. what was his intelligence routine, the daily routine that he had? what was your role in that? my sense is that it varies president to president. george h.w. bush and

george w. bush even better. president bush and vice president cheney, you had two people who were avid consumers of intelligence. believed in importance of intelligence. it was how each of them would start their day. vice president cheney would have his briefer in, and david addington can talk in more detail, and he would get an intelligence briefing before he walked in to sit down with president bush to hear the intelligence briefing presented to president bush, and would comment on that and sometimes add items that had not been covered. people who were avid consumers of intelligence. we tried to get intelligence to him and to them in different ways. the one everybody knows about is the president's daily brief, which is a book with a series of

intelligence pieces that a briefer comes in, hands to the president of the united states, and walks the president through peace by piece. some presidents get the briefing book before and dispense meeting with the briefer. some presidents talk about it with the briefer. president bush was someone who could actually read and listen at the same time. i have trouble doing either one, but certainly doing both at the same time. he could listen and read at the same time. and he started his day six days a week with that briefing. meansing intelligence that you are not necessarily passive. he would ask questions and push and he would many times say, i'm not pressing you to change your

test you.ut i want to i want to know what you know. i want to know how confident you are in what you are telling me. that allows the president to know how much weight the president gives to what they are being told. there would be a back and forth. most intelligence analysts i think liked that. one of the things we started late in the administration was trying to get -- usually a president has a briefer that briefs all the elements in the pdb, but they are written by other analysts. we would try to get the analysts to brief the president and the vice president and the rest of us so that the analysts could hear firsthand what was of interest to the ultimate consumer of that intelligence. mr. stimson: i'm sure that was somewhat unnerving for some of these first-time analysts. mr. hadley: it was unnerving,

but the blowback we got from it was that they loved it. and it really showed them in vivid terms the value of what they were doing. that's what we really are like. we like being valued for what we do. that was a real affirmation. we did a couple other things. there is a tendency when you brief the president on intelligence, the president would then say, what are we doing about it? let's talk about policy initiatives. the problem is, he's talking policy without any of his national security principles who are supposedly is policy advisers sitting in the room. one of the things we started to do is, those intelligence pieces that begged for a policy discussion, we would schedule on wednesday and invite the secretary of state, secretary of defense, to join that meeting.

so everybody could hear the intelligence presentation and have initial policy discussion if there's something to be done. we then put it in the process for further work. other thing we would do is on tuesday, we would have a threat briefing. i think it was tuesday. the director of homeland security and the fbi director were there. we would talk about the threats that were a problem for the country. and the president could again interact directly with those people responsible for dealing with those threats. thursday, the cia director would talk about cia operations so the president could hear directly from him. we tried to mix it up.

in some sense, half an intelligence week, if you will. is, ist thing i will say started working with mike mcconnell in the dni, and we would look to or three weeks ahead and look at the president's calendar. what trips was he taking, what foreign leaders were in town, and what issues were coming up to him for decision through the interagency process. we would map intelligence briefings against those so the president would get an intelligence briefing on egypt if he was meeting with the president of egypt, or on china if he was going on a trip to china, or on some issue if he was going to be asked to make a decision. so thed to structure it intelligence would support the policy process. mr. rogers: you described -- mr. stimson: you described the

battle rhythm. what time in the morning are we talking here? mr. hadley: 8:00. mr. stimson: and who was in the room? mr. hadley: the president, vice president, chief of staff, national security advisor, the director for national intelligence, that was the core. then it would be supplemented on wednesday, tuesday, and thursday as i described, with other actors. that was the core group of people. david, have i missed anybody? mr. stimson: negative response. mr. hadley: david addington is back there. he's going to correct me as i go. mr. stimson: did you know personally governor bush? when did you first meet president george w. bush? mr. hadley: it was in the campaign period, probably late 1998, early 1999. i was asked by condi rice and paul wolf would to come down to

sit in on a meeting and brief then governor bush, and that is how i got to know him. i made a big mistake we were talking about a speech he was going to give on defense and we were talking about how we were going to revise it. i told him you better not get into the details governor because there are a lot of experts that will show you you don't know what you're talking about. and he said -- who are you anyway? whaton't understand elections are about. if i want to reform the pentagon, and i don't say anything about it in the campaign and i go to the joint cheese and say we are going to but if ie pentagon -- campaign on it and i come in with the mandate. i go into the chiefs and say