an interactive constitution and the landmark cases podcast at c-span.org. a look at hearings in meetings this year on combating opioid addiction for it then, president trump talking about tax reform. in former mexican president debating nationalism versus globalism. >> over the next couple of hours, a look at federal efforts to combat the opioid epidemic. we will show you portions of events that c-span has covered in 2018 featuring state

an maybe buy some quinones. >> i'm pleased to welcome sam quinones and his family today. the queue for taking the time to be here. mr. kenyatta's past 30 years experience as a journalist and author. he has written extensively on the opioid track -- crisis and trafficking. he is the author of three acclaimed books. he won a circle award for general nonfiction. early in his career, he was the recipient of the maria morris prize. he was also the us -- recipient of the alicia patterson fellowship to print journalists who pursue stories in the public interest. welcome again. you will have 10 minutes to give your testimony and senators

looking forward to have a conversation for you -- with you. >> clearly, i'm a rookie here. honor all members of this committee. these thank you for hearings and for allowing me the honor of addressing you. i'm very happy to be here with my wife and daughter, who are part of producing dreamland and the book never could have been finished. this is the deadliest drug , hittinge have known areas 11 everything this drug problem. it is the person modern america to be spread not by mafia or street dealers but by doctors pain pills,ing

convinced we are doing right, urged by pharmaceutical industries and medical establishment and urged on by us, american health consumers and an easyo quit end to pain. isis could not have dreamed of inciting the kind of torment and death we have consumed upon ourselves lose use of opiates. these drugs are a symbol for our era. from us for decades we have exhausted the private sector, the individual while we ridiculed government as an efficient, incompetence and wasteful. we admired wealthy businesspeople, regardless of whether going we made their money produce anything of value for our country and our communities. we brought a second gilded age. the seven demographic diction to a class of drugs

in the tribe on isolation reflects all that. this has been borne by the public sector was profits have been private. i believe this is deeper than the drug addiction. it is about the efforts of the shift and isolation and rich and poor. ugly problems can be if i could isolation with one magical foldable everyday bill for all our jail cell for every attic. we exalted the private and not the public in the communal and in so doing we rid ourselves of things so essential to us that they have no price. we have been invaded by cheap

junk as a result. andon't have dreamland replace it with a strip mall. heroine is what you get when you destroy dreamland. is theve isolation natural habitats. i believe this epidemic is calling on us to revert these decades of isolation and come together as americans. everieve my strongly than that the antidote to heroine is not naloxone. it is community. people coming together and working in small and local waste for solutions to know one thing the world alone the good news in all of this is that there is no solution. there are many solutions. must be tinker with an improved spirit each

must be funded fully and for a for the good news to us that that of them is sexy that will do the trick alone. i believe that across america today, communities are finding more solutions, the more they been together the more they leverage all the talent and during npt is, pastors, artists and athletes, librarians and chambers of commerce. this is cabinet and counties across america. it is my opinion that supply has ignited all this. we do not have this demand, this widespread addition, until we release a large supply of narcotics for the last two decades.

essential that doctors reassess how and to whom and in what quantity they prescribe these drugs. that does not mean just cutting people off that are on high doses of these drugs and leaving them to fend for themselves. this has been strategies that do not allow the narcotics allowing a larger array of pain strategies and pain pills. more med school in pain management and addiction treatment. i have to say that i think it is a little fun time and money on -- delusional spent time and money along another wall. these drugs are coming in with areas with authority and a wall will corrode anything that will really help. these drugs from pouring into our country and

benefiting the respectful of also forthright, from once, certainly honest relationship with mexico that will leave to it finally becoming the kind of neighbor and partner we can work with effectively. in so doing become the kind of neighborhood country needs a bus me isother wall seems to just like heroine. us in a worse place in the long run. another civil proliferate complicated adult problem. ametimes the solutions are problem of funding. we should expand our national force of forensic pathologist, which is dangerously dwindling. this epidemic spread because so many of those offices are so poorly funded. i believe we must and treatment

options in this country. one place to do this is jail. will be how the country helped. transforming jail into nurturing recovering. this becomes an asset that of a particularly, in a state of kentucky. i would also like to add that all across america are families who are suffering due to the addiction of a loved one or the loss of that loved one. i believe they are a raw material to be harnessed in this fight. many want to be involved and needs to be involved to help solve the last rating wounds that will last a lifetime. i believe u.s. senders can help by recruiting and recognizing and giving conference with should tell their story. many it is because i am a reporter by believe that through

their stories, thoughtful stigma of addiction will be reduced. i'm happy to elaborate on any of this. before i do that, i want to urge you to view this as an opportunity. view this as an opportunity to revive those regions hammered by globalization and free trade. the roots of the epidemic of narcotic additional light there while the epidemic stand in the way of the revival. many of these regions cannot revive and tall enough of their people can pass a drug test to fill new jobs. this is not a story of a drug addiction. this is a story of economic addiction. as politicians and a natural response to this, it is to look about for things that continue quickly. i believe that is entirely understandable. i would caution against believing in short-term responses.

this makes up at star and i thank you for its but it is only a start. everything i've learned about this issue has taught me the importance of long-term community responses and commitments. i believe american history offers of -- offers to templates in which you might take guidance and inspiration. versus the marshall plan to second is our graham. each involved in government and the private sector acting in concert over a year's money money, brain, energy and long-term focus to bear. each achieved and unallocated good for our country. those were about doing things far beyond our own short-term interests. this is about building of

regions to allow them to function independently while maintaining the spread of communist. a allowed countries to prosper and contribute to the world again. reprshall plan for american -- focused on building those regions that have been caught on independence and to contain the viral spread of addiction. for a and come over were inspired at the people to spend years and dollars all to achieve something no previous generation ever thought possible we ended up far the on the moon. that spillover increase in humandge and in simple inspiration is beyond calculation. seems like we might profitably applied these examples. and the spacelan programs to region of forgotten americans with problem began to let us do it not because it is easy that because if they said

because it is hard and that is why american do. and have always done at their greatest. these efforts have to last for years to become effective and focused far beyond the immediate goal of drug edition and the problems of community destruction and the hollowing out of stretches of this country i'm here to urge you to see this not only as the catastrophe that it is but also as the gift that it can be. it offers an opportunity to reinvest in areas and most. it is an opportunity to bridge thatolitical polarization is so nodded at our country is not few issues that you do miss this opportunity and is not

from around often it is calling that got him reflecting relatively near when it has been and will be remembered for having been acting was not easy to do i believe your hometowns will thank you. , your think and we countrymen and women, will think gone,ng after you are conference in > washington with diverse on the pensions that will be an epidemic during his 2014 stray of the state address. this is moderated by greater in th >> good afternoon. good afternoon.

very happy to be here today to moderate this panel about a very distressing issue. bipartisan. myaffects everybody, and my panelists,. as well i want to get started quite right away. we honest think about this and talk about it. the louisiana governor of ohio. why is this topic important? we can be here talking about jobs in a ohio? . >> this impacts every family and has been impacting my family. i also see it in the state of ohio. i've talked to parents who have lost loved ones. i've talked to people were suffering the crisis that is the addiction issue, it has touched everything the person i've come across. someone to stand up and

provide wrist solutions to give hope and help and healing to so many individuals today that are suffering. this cannot solve every problem. government can help solve problems and lead. but can you see in the script is nationwide in the health epidemic? >> thank you and i want to say how they fly them to be back here. i love coming every year. working for president trump who campaigned vigorously on this helpdesk understand why it is an issue. government has a legitimate role to play in tackling certain issues. we love living in a free society.

this is something president trump talks as a candidate and lead on this last year. talking about the need for states and localities for the medical professional and law enforcement public of this crisis in our community. easy would've involved a long time ago. 64,000 people died and car accidents took the lives of 40,000 people. this is not easy. this is a challenge. destroyed?been >> thank you having me because this is a bipartisan issue.

i think this is an easy solution. through most people do not say that. this is amazing what does all that we have occurred requiring this best? why are we on this must?what have we lost more folks to opioid addiction since the year 2000 that we have lost in world war ii and vietnam combined? what changed? health care professionals and the fda, we have the first nonaddictive regular, and we all were so rejoice for. it turns out they were wrong and not only were they wrong but they pleaded guilty. the lying to the fda.

they got fined for lying to the fda. 85% of the folks, will start with fda approved pills. we build out treatment are get docue treatments and we all the same things but it is after folks who have become addictive. this is the worst disease to have that one can contract in terms of the fight, the struggle, what is is your family members, but it is your lips. my answers are a simple once. there are two things you can do in this is not hard. shouldone, the fda revisit the decision they made about passing out painkillers like candy. now that we have admitted that they have lied to and the first place. [applause] >> second, just like what happened with tobacco, they have governors like me and attorney

general's and i know you lieutenant generals, neighbors, we all suing the folks that put us in this mess to try to get money for treatment and change behavior. why do not only do what he did with tobacco? get them all in the room president trump has the ability to be the winner on this. i can say president obama must this one of when he reduced the burden of proof for the pill mill. having these for the pill mills. that is worth folks yet a lot of these bills. borland john gold up to be here today but just end up because i

want for pseudo-vur. or. is., president trump hav the ability to, be a here and here and put them in her methods do not have -- come out as a use that will listen that is some protect voters to stopping for treatment because you guys have to pay. that is the opportunity of the president of the united states. >> i have a two-part question for you. >> we are trying to come up with some sort of activity. they say get to that, do not think may my pain pills and we do need to keep the ball out of pain. there is another element.

>> there is a conservative solutions of this and i believe there is a role that government is on the solution. we need comprehensive care and we need to make a available to us citizens living in addiction today. there is a role for government to play two incentivize to private sector, to build out the several care necessary, to restore lives but we also have to foster and encourage looking for alternative ways to treat pain. annexations, we should not accept these addictive pain .ills as the best we can do we need to open up the opportunity for these alternative ways to treat this. >> let me ask you this.

>> people had think was there an adequate pain management, or do we have something that helped that was not quite as addictive? >> my understanding based on what i have read -- >> and to jump in -- \ > you probably know as much about this of anybody but when they started training pain is a vital sign, in my opinion it community our medical are being judged and rated based on how well they were treating e pain.at >> i am afraid if you do not say 10 i will say to him you will be in pain. >> writes but it all started -- it also decisions of a point.

government had a wrong that. they said we will treat pain like a vital sign. it became the fifth vital sign. it was not venture a bowl. it created this crisis. >> the me give you another specific, which i find quite stunning. >> this population of 20 1000 and play summing all that is possible to me. >> law enforcement. we saw the last administration president attorney general who do not fully respected the rule of law, respected due process light or enforced the law. we now have a president and in attorney general -- [applause] >> who is vigorously enforcing the law, and enforcing and companies that have broken the law.

also going after people on the streets pushing drugs. andis ok to do drugs downplayed it as an issue. telling a better job our young children not to go down the path of it -- of addiction. many people this room had family members are struggled with an addiction and had treatment in one way or shape or form. the muslim represses we need to do is ensure people do not start of the road of doing drugs and leaving down this path toward addiction that is so hard to come back from. the best thing we can do for me treatment standpoint is a preventsn action that

people from using drugs. >> is rapidly when you need treatment of the people do treatment, university lost her job and family, you completely been terrible to your friend. it is related to everybody. beginning,t at the realizing we have to do with that? we need to have pain pills for those who have that -- how do we start at the beginning so that we do not have this whole universe of people? >> let us just back up a second. everything being said here is true except that we are hesitant to point out that most issues i face as the governor, and i'm sure all governor safe this, and gets a little more gray and it is not black and white. this one is black and white. america did not have someone dying every 15 minutes smoking addition -- addiction before we

proved oxycontin. the facts. we passed out like candy, these are the facts. we now have thousands of thousand of good people dying every year from this disease. if they had the folks that like to them, but that we did not say you the truth, why wouldn't we simply go wait a minute, team, we have that information? the health care system based on oxycontin. the prevention should be, in my view, stop laughing it out like candy.

on the server he can with a more sane policy in drugs or america. >> there are so many political interests involving this is a nonpartisan issue. could you two work together. and if you got the congress to prevent the united states, you can ask him for help on? >> obsolete. this is a bipartisan problem, you know? nonsense this is a good idea, let us get as many folks as we can as agents of the stuff. , if youthe problem is to just go about democrat you are served as a unique position they both come from states where this has been, of course every stage hav on through

has gone through that. >> i am a conservative republican. one of the problems that we face in this country as we know where it is coming from. is coming from mexico, china. when you start talking about sentinel, i would say builds of the wall because i am a conservative republican. you may not. you may not agree with that but i bet you when i can get on the same page of how do we help reinforce law enforcement to keep the drugs out of our country. >> to that point i just want to say an important part, we have seen this skyrocketing of overdose deaths in the last three years. , suffering from the scourge of drug use for decades the reason why this has become a pleasant point percent -- potent point for so many munities and families is largely due to fentanyl and the importation by drug cartels and other criminals bringing fentanyl in from china

or mexico in four countries. it has got to stop. the last administration failed to protect americans from fentanyl, the trump administration is working day and night he and that is why we have to build a wall, increase of border security, provide homeland >> can i just make a quick point? we have always had drug problems in america. here is what has changed. who go tof folks that has the fentanyl in it and start with fda approved pills. they are net -- they are not getting that from south america, but from the quarter drugstore. that has the fentanyl in -- corner drugstore. >> we have to stop the abuse.

a uniqueent trump has whoity to be the president solves this problem because of bipartisan consensus. we want to stop the dying. victims -- the biggest victims of this disease are the children of the addict's, the most unrelenting thing you can experience. -- heartrending thing you can experience. >> what you see as the biggest impediment? >> a supply and demand issue. >> is that an ohio problem? >> the federal government and it is a state problem. drugs off keep the our streets and hold drug dealers accountable. law enforcement need additional get these guys that

are killing our kids and throw them in jail. >> what about the pharmaceutical industry, those that are producing this? how do you fight that issue? ohio,t we have done in and i am not all for regulation, this is a public safety issue. you can only prescribe a pain pill for seven days if you are an adult and five days if you are a child. this is state. >> why don't we have that federally? >> as conservatives, we recognize that state governments that -- that every problem is not a federal problem. the federal government needs to

have a response to leadership as a nation. states rights now are being smart and innovative and passing legislation that limits prescriptions in certain amounts. the worst thing we could have happen is for the federal and passt to intervene laws uniform across the country to try and solve the problem. we have good intentions and the federal government passes some law and the unintended consequences trickled down to three years and congress can never come back and fix them. as limited government conservatives, we should encourage state leaders to pass these laws. he is talking about the power of the white house to get everyone into one room.

to lock them in the room until they do this. >>to lock them in the room until they do this. let's put our hearts aside and user mastheads on this one. costs 25 thousand dollars to treat someone after they become addicted. it cost you $25,000 as a taxpayer every time someone becomes addicted to these substances. it is a huge cost to taxpayers. it is not just the manufacturers, distributors, they are all in this. they are making billions of dollars off this disease that is killing people. i think the white house has a unique opportunity to replay the tobacco tape, get folks in a room, close the door, because these players don't from this things like this best of us forever. this is about taxpayers getting -- for the disease that was

created by fda lies. i think president trump would be a hero to america if you pursue that process. greta: thank you very much. this is a problem that affects all of us. you do a huge service to the country. thank you. announcer: massachusetts governor charlie baker led a discussion on the opioid crisis at the winter meeting of the national governors association. his remarks,you followed by the health and human services secretary. [captions copyright national cable satellite corp. 2018] the governor of the commonwealth of massachusetts.

i want to welcome you to an issue we have been engaged in in a big way for the past several years. i think it is fair to say that every governor of every state has made dealing with this particular issue a significant and important priority. that has been true in the commonwealth of massachusetts. i didn't run for governor to work on this issue but it found me because were ever i talk to me people about it, and their stories broke my heart. of the pastrse several years, working on a bipartisan basis with our legislature and others, we have made progress in dealing with this terrible epidemic. years ofhusetts, after double-digit increases and oak -- and opioid prescriptions, overdoses and deaths, literally for the first time in a very

long time in 2017, we had a 30% prescriptions, overdoses leveled off and deaths dropped by 8%. the way that was referred to by people was sort of positive, but muted. the reason is because we have so far to go and so much more to do. after that news, every single year, people took comfort in the that went like this for a very long time finally -- finally started to go like that. what is working? where should be go next? some of the things i believe have worked would be the following. requirechusetts, we now everyone who graduates from medical school, dental school, , pharmacy school, and

social work school, to take a class as part of their curriculum a class and opioid therapy and pain management. are a prescriber, as part of your continuing education for getting your license renewed, you have to pass a course and opioid therapy and pain management. we are one of the first states to put a limit on first prescriptions. ours was seven days. several other states have followed. result, we finally got to the point where the vast majority of prescribers were working on that system and using it as a search engine every time they wrote prescriptions. it got to the point where they could start giving them decent information on their own prescribing patterns relative to their peers. created programming to

do assessment work in our middle schools and high schools, and created, as part of our annual program for all athletes and parents and coaches, and inclusion of the discussion about opioids, the positive and negative, along with discussions about hydration and concussions and all the rest. on the treatment and recovery we added 1100 treatment beds, increased state spending, and a variety of addiction-based programs, and made medicaid-assisted treatment a much larger part of our portfolio. the elements we pursued on a pilot basis has turned out to be reasonably effective. coaches tocovery some of our hospital emergency rooms around the commonwealth

and engage discussions with people who overdosed to see if they couldn't talk them into moving treatment. most of the folks who play that recovery coach role are people in recovery themselves. to their ability to reach out and speak to people who just overdosed and were in the throes of this addiction is pretty powerful. cases, we saw as much as 80% of those who were contacted and touched by this program find their way into treatment. the bottom line is for the first time, we found a mechanism that seemed to help nudge people, many for the first time, into pursuing treatment as a possible option for them. next, weect to what is found legislation before our act,lature called the care

which has built on some of the things we have done previously. -- takehis is to the the notion of recovery coaches and turn it into a clinical program, to make it a fundamental part of the way we deal with addiction, especially opioid addiction, where a recovery coach could be a big ,art of what helps somebody whether medicaid-assisted or another form of treatment, stay on the positive side of their treatment program and battle their way out of this terrible addiction. the legislation also includes elements that would expand some of our school-based assessment and service programming, and for the first time, we will engage with folks in the form a community to create something that will look like a blister pack, which we have in many other parts of health care, to

provide the very small number of opioids you might want to be available to someone who had their wisdom teeth out, or surgery, or spring to their, or something like that. been of conversations have weh prescribers that say, write 30 days, for a lot of the stuff associated with what we have been writing opioid prescriptions for, for a better part of the past decade, makes no sense. if we could create a delivery model to give someone the two or three pills they might need to deal with what ever particular acute pain is coming out of the minor procedure, we might be able to take a a lot of the step off the streets to begin with. the final thing i will speak to his fentanyl. -- his fentanyl. present in about 30% of the overdose deaths in massachusetts.

in 2017, it was present in over 80% of the deaths in massachusetts. if it wasn't for fentanyl, our success in reducing overdose deaths would have dropped dramatically more. but we can do a lot of things with prevention and education, and i believe we are. i believe we are doing a lot of things with treatment and recovery. together ando come chased the central issue a lot harder than we are chasing it andif we want to protect preserve the opportunity for treatment to be successful for many of the people in our states. >> am grateful to be here. azar: president trump has made the opioid crisis a top priority.

level of been a new urgency to our response across the federal government. president trump and his administration recognizes it is not the federal government on the frontline of this battle. your law of you and enforcement officers, teachers, school counselors, community leaders, doctors, emts and , and for faith-based partners. we are dedicated to empowering you and allies in this fight. we have unearthed a comprehensive strategy for fighting the opioid crisis last year. unique power and resources of the federal government to empower those on the front lines. many of you may already be familiar with the strategy, but the five points are data, pain, overdosed reversers, and access. i want to highlight a couple of

pieces of news from the fda that underscore our commitment to advancing particular access to effective addiction treatment. the first point is better data on the epidemic. the first point is better data on the epidemic. we have to understand this crisis in order to stop it, which is why hhs is working with states and other stakeholders to support more timely and specific public health data and reporting. works with state health offices into local corners in monitoring overdosed data. the second point is federal research on pain and addiction. we need more towards to help us win this fight, -- tools to help us win this fight, which is why we support tools on pain and addiction. , likesearch we are seeing nonaddictive painkillers and new methods of treatment are incredible. as they get closer to reality, we look partnering -- look

forward to partnering with state and private partners to understand how these can be put into practice. the third is pain management. we need to do a better job of addressing the problem of pain in america, which is why we have everything we do, best practices and more, promote healthy, evidence-based methods of pain management. continuing tod to work with you on disseminating a best practices with the -- best practices with our task force. fourth, overdose-reversing drugs. people all across america are alive today because of the progress that has been made in making drugs like naloxone available when and where they are needed. we are coming -- committed to working with you to make sure communities have access to life-saving drugs through

research and technical assistance. the fifth point is federal prevention, treatment, and recovery services. directly providing the services often falls on state and local governments and community groups. grants top by issuing support access, expanding coverage, and providing guidance and technical assistance. you know the president's budget proposes 10 billion dollars in funding to address the opioid epidemic and serious mental illness, on top of $3 billion in planned opioid 2018ng for fiscal year that we hope will be in the omnibus appropriations in march. budget includes a range of different investments. 74 million dollars to approve targeted distribution of naloxone, and 150 million dollars for rural substance abuse treatment. targetedthe state response grants to one billion

dollars a year, twice what we have in the 21st century. we look forward to building a base of experience from these grants, and hearing from you about how you have used this money. one particular point we want to emphasize for the 2018 grants is that states have a wide range of options for using them. this includes treatment vouchers, which allows for the use of funds for evidence-based services and faith-based providers. americans have taken a leading role in the compassionate approach we needed that -- that we have to take with this crisis, and we are eager to support their work. wetop of this grant, released guidelines to accelerate the approval of substance use disorder waivers with the medicaid program, three of which we already granted this year for indiana, kentucky, and louisiana. i want to note for our governor is that if you have a waiver request with us and eight

particular waiver from this time, we can streamline pulling those out and working directly with cms for approval around those concrete waivers, so they do not have to be cut up in broader discussions. what works? -assisted treatment. one particular piece of work on treatment is supporting access to medicaid-assisted treatment. part of the title of today's session is "what's working? " hhs is dedicated to advancing our understanding of what does work when it comes to public health challenges. we argue no important facts. one of them is a medicaid-assisted treatment works. the evidence on this is luminous and ever-growing. study found that putting survivors of overdoses on medication-assisted treatment,

along with the appropriate there be and social support, reduced further future chances of death by more than 50%. that is a remarkable number and speaks to the number of lives we could be saving by expanding access to treatment. hhs has long been dedicated to promoting access to and an --areness of medicaid at- medicaid-assisted treatment. we still have a long way to go. of specialty substance abuse treatment programs across the country offer medication-assisted treatment. for many struggling with addiction, failing to offer this treatment is like trying to treat an infection without antibiotics. given what we know and the scale of this epidemic, having only one third of treatment programs offer the most effective intervention for opioid addiction is unacceptable. we want to raise that number. towill be nice impossible turn the tide on this epidemic

without doing so. know there is sometimes stigma associated with an mhc, especially long-term therapy. --eone on medically medically assisted therapy, even one who requires long-term treatment, is not an addict. they need medicine to return to work, we engage with their families, and regain the dignity that comes with being in control of their lives. these outcomes are literally the opposite of how we define addiction. our goal as a citizens who commit to treatment should not treat them as pariahs. they are role models. announcer: c-span's program on the opioid epidemic continues with the maryland and oregon governors testifying before the senate health and education committee, as they describe the

impact on their states and answer questions on the spread of fentanyl, the role in the federal government, and lawsuits against pharmaceutical companies. gov. hogan: we have been shining a spotlight on this issue for about four years now. when i asked community leaders what the number one problem was facing the community, everywhere i went, whether in the suburbs of washington or the city of baltimore, the answer was always the same. but we me by surprise, learned about the magnitude of this problem. of my first actions of governor, we established an emergency opioid and heroine

task force -- of my first actif heroin task force, focusing on a four pronged approach of education, treatment, prevention, and enforcement. i was the first governor in america to declare a real state of emergency on this issue. we decided we needed to treat this crisis just like we would treat any natural or man-made disaster. we have already committed in our small state more than half $1 billion toward fighting the opioid and the substance abuse epidemic for all directions -- from all directions. but we still have nearly -- had nearly 2000 people died last thosefire more than killed by firearms and motor vehicle accidents added together. with our efforts, we have been able to bend the curve downward on prescription opioids and heroin, but a new and more

deadly drug is growing out of control across america, fentanyl. overdose deaths from fentanyl, they were up a staggering 70% in our state last year. a majority of this fentanyl is being shipped in from china or crossing the border and being smuggled in from mexico. without thep it federal government stepping up. this crisis is going to take an all hands on deck approach from the federal, state, and local governments, along with community organizations, based-based organizations, and others in the community. togethero be working on this issue. i need you and your colleagues to make increased funding for the opioid crisis a top priority of maryland and many other states. -- crisis a top priority. maryland and many other states are working to provide support,

but greater support would provide life-saving operations and help emergency room personnel. i would like the federal government to encourage advertising and public service campaigns to educate the public about how lethal fentanyl and these other drugs are. targeted andore aggressive federal enforcement interdiction efforts when it comes to fentanyl and these other opioids through initiatives like synthetic trafficking and overdose prevention. this crisis evolves, so must our response. murray,with senator this crisis is not only a health crisis. this is tearing apart families and communities, from one end of the country to the other, from maryland to oregon and every place in between. this is really about saving lives.

collaborative, holistic, and bipartisan approach to college that. thank you for having us and we look forward to the dialogue. governor hogan. governor brown, welcome. governor brown: thank you so much for having me here today. i am honored to be sharing the dias with my colleague, governor larry hogan. my state's, i hope we can underscore the burden of the opioid crisis that has touched every corner of every state. part of what makes opioids so dangerous is the fact there is so much of it, and it isn't hard to get. easily asbegin as reaching into the average family medicine cabinet. that is what happened to max in southern oregon. he was a poet in nation -- and a chef. he was 17 when he got into a car

accident and was prescribed opioid painkillers. what started as therapy became self and spiraled into abuse. from prescription pills, he moved on to heroin. his mother was devastated as she watched opioids consume his life. he died of an overdose at age 25. it is hard to look back on his story and wonder what could have been. what if we lived in a society where he wasn't shame for having a problem, or reaching out for help? what if he had access to better treatment? what if first responders have life-saving overdose drugs? addiction is blinded to circumstance, but the high costs of addiction are borne by our children, whose parents are unable to care for them while struggling with substance abuse. right now, the federal government recognizes the problem, that is focused on punishment.

that leaves the state to right the wrongs for the war on drugs that has done nothing to address the issues that drive this public health crisis, while our prisons and foster care systems are filled to capacity. i have seen it firsthand. prior to becoming governor, i worked as a lawyer representing parents and children in foster care. i watched children come in and out of foster care as their parents struggled with substance abuse disorders. as children struggled with the a foster family they barely knew, their parents struggled with addictions that overwhelms our treatment systems. ofthe state of oregon, 60% the foster children have at least one parent with a substance abuse issue, including opioids. if we can make meaningful change in prevention, treatment, and recovery, we can create better lives for our family.

can see more success for students in schools. we would lift the burden off our hospitals and law enforcement and our prisons. access tofamily, comprehensive behavioral health treatments change the trajectory of addiction. up usingild started drugs in high school. my husband and i watched him change and felt powerless to do anything about it. a teacher caught him using at school. instead of kicking him out, she called us. trying to stop using wouldn't work. his daily routine had become centered around getting high. he needed an immersive treatment program, but our insurance policy stood in the way. he had to go through two separate outpatient and in peace -- and inpatient treatments, before insurance would cover the residential

program he desperately needed. fortunately, our family's story turned out very differently than max's. me howcan't -- taught different recovery can look for every individual. we need to think about it as a process tailored to a person's unique circumstances and environment. turning away from a bail-first model is something we're working modeloregon -- fail-first saiis -- is something we're working on in the state of oregon. we are also working on increasing treatment resources. in addition, we need to make are focused on decreasing stigma. we must break through the to provide theme best treatments possible first and the most effective

assistance now. we need to let people know it is ok to come out of the shadows, ask for help, and help is available. at the federal level, there is so much that can be done, including at the federal and state level, making affordable generic overdose drugs more available, rejecting a punitive approach to induction. maybe this could have saved max's life. it could save millions of others. hogan: i am sure you were prescribed opioids when you had your back surgery. ofent through 18 months battling cancer my first two years of governor and have four or five surgeries. at one time, 300 doctors within a matter of weeks described me a 30 day supply of three different opioids. that can't happen anymore in our state.

we are tryingnyl, to crack down, but a body that is coming through the u.s. postal service. uses thatike no one system anymore, but drug deal is from china are because they are not checking the packages the way the other delivery services are. it is now being manufactured or transported and smuggled in from mexico. can on thedo what we local level, but the federal government has to keep it from coming into the country. it isld you agree with me not totally an addiction problem, but a one-time problem, too? fentanyl is so powerful. they are not an addict, but the one pill could do it alone. gov. hogan: if there is no question that people who have tried it once are killing themselves. it is a deadly thing, 50-100

times worse than heroin. senator: this month, as we've been telling up the numbers from 2017, we have been hit by a thees -- tallying up numbers from 2017, we've been hit by a series of heartbreaking statistics. we learned a few weeks ago that drug overdoses killed a record of 418 people in the state of maine, and 11% increase. wrong going in the direction. this week, the cdc announced that in maine, emergency visits by opioid overdoses jumped 34% last year. in the past three years, the number of people in the main who died by drug overdoses has doubled. at the same time, we at the federal level have increased funding and federal efforts year

after year to combat this crisis. is what areto you is what are we not doing right? you talk about the multipronged approach that i totally agree with, education, prevention, treatment and enforcement. committeeship of this has poured a lot of money into all four of those categories. what is it we are not doing right? hogan: we asked ourselves that same question nearly every day. i mentioned in my testimony at the beginning that we were sort of the end of the curve focusing on this issue, going back to 2014. we took every action anyone could think of, from every direction, and we put half $1

put half $1 billion into state funding. then we created the first state of emergency, where we asked our emergency operations center to coordinate every state, local, and federal agency to provide real-time assistance on these different directions. we made a slight improvements in prescription opioids and heroin, but because of these new synthetics, we still have more people died. we had nearly 2000 people die in thistate, a 70% spike in new drug no one knew anything about. things, but ifew think more coordination and more cooperation from the federal government at the state and local level, so we are all knowing what we can each do collectively to make this happen. more federal need funding, with some flexibility for each state and how they can

utilize these funds, depending on how the issue is shifting and where they are at that point. brown, with governor fentanyl is not yet a big issue in the state of oregon, but i believe it will be. we had all the nations governors together last week. there were people talking about crystal meth now reviving in their states and they are lacing that with fentanyl. they don't even have opioids and heroin. it will take all of us working together. the federal government and your committee has been on top of this issue. there was a task force working with a lot of smart people, but it is going to need federal funding, the stop actr, the -- stop act, the opioid response and enhancement act, many good pieces of legislation in the

house and senate that should be passed coming from both sides of the aisle in both houses. we have to look at these things from every direction, so they all need to be considered. families in: massachusetts and all across the country have had to bury someone they love -- warren: families massachusetts and all across the country have had to bury someone they love because of this crisis. but it didn't happen overnight. drugppened because these companies pushed these bells and light about how addictive those pills were and made billions of dollars doing it. it is time to talk about holding these companies and their executives accountable for the crisis they helped create. in massachusetts, the attorney general is helping lead a 41artisan coalition and

states to investigate drug manufacturers and distributors the opioidole in epidemic. more than 30 cities and towns in massachusetts have already filed lawsuits. tribes, including the cherokee nation, have sued in tribal and federal court. maryland is also part of this investigation. baltimore and several county governments in maryland have filed lawsuits against manufacturers and distributors. do you believe that part of tackling this crisis is holding these companies accountable? gov. hogan: there is no question. dowe have directed our attorney general to take action and sue some of these pharmaceutical manufacturing companies. is liability. some of them have knowingly pushed the sale of some of these drugs, knowing they had to these

addictive capabilities and did not disclose it. we painting this with a broad you are but the ones doing these things should be held accountable. take these actions and we should, but it won't stop the people who are dying on the streets. sen. warren: i understand. the investigation is ongoing and we should let the attorneys general to their work. -- do their work. breakdn't these companies the law and lie about it and hurt people in order to break it profits? it wasn't the first time. a corporation called instant therapeutics a few years ago made a spray out of fentanyl. the fda told the company the spring was approved only for use in cancer patients who were in such pain that other drugs like morphine were not enough to control it.

it turns out there were not enough of these peers or patience for the company to make buckets of money. marketing illegally the drug to people with mild forms of pain and bribing doctors to over prescribe it. a blood of states sued, including massachusetts. -- lot of states sued, including massachusetts. settlement forced the company to pay up. that settlement a card of a few months after you took office. has the money that oregon recovered helped the state fight the opioid epidemic? govb rown: -- gov. brown: absolutely. we received a little over a million dollars. a portion of it with to

treatment and recovery. our state university is doing incredible work and i was very pleased with how the dollars were targeted. ren: when a company breaks the law, it is because people running the company broke the law. a few months ago, department of justice announced that the thiser and owner of company, along with six top executives, has been indicted for fraud and racketeering because of their actions. do you agree that ceos deserve to be held personally accountable when the companies they run break the law and hurt people? such aown: in cases, absolutely, that they need to be taken on a case-by-case approach. this was particularly egregious and people should be held personally accountable. warren: this crisis is not

a democratic or republican issue, and neither is holding drug companies accountable. department of justice announced last week they are forming a task force to target manufacturing -- opioid manufacturing and distributors they believe should be held accountable. people of already paid an enormous price for this crisis and it is time to start holding companies and their ceos accountable. thank you both. cer: what is congress doing in response to this opioid epidemic? congress is interested in this. aboutassed the omnibus, $4 billion, with general kind of lawtment prevention and enforcement. we have a bunch of hearings happening in the energy and commerce committee in the house. they are looking at the law enforcement side and prevention and treatment side to try and come up with some bill.

they're hoping to have a package on the floor by memorial day. a bipartisan group of senators is hoping to put a billion dollars toward groups. bill under obama has some attraction in the senate, but everyone else's unsure where it might go, because this is a lot of money. announcer: let's look at the white house. they declared an opioid epidemic backannouncer: in october. where has the administration's emphasis been? online enforcement measures, or emphasizing better prevention and treatment? enforcement measures, or emphasizing better prevention and treatment? hefali: it is kind of an odd mix. law enforcement has been a big

focus, the big focus of the presidents -- of a presidential speech was on it the death penalty, seeking that for high-level drug offenders. some talk on expanding access to treatment and making sure first responders have naloxone, this anti-overdose drug. that has been talked about by a bot of public health officials. -- lot of public health officials. the emphasis on law enforcement and law and order is different from what we have seen before and has given us pause. r: what did we see before with the obama administration? infali: it was interested this public health response. there was a lot of talk about naloxone and making sure people have access to the medication to help them get weaned off of opioids. terms of howft in

we have looked at addiction from any time before, pretty much in the history of this country. it is an interesting thing to watch and see if that will continue. we have been chilling and will be showing comments from a number of state governors, including at governor baker from massachusetts and governor hogan from maryland testifying. what are states doing in response to the opioid epidemic? what do they say they need from the federal government? hefali: they need money to get supplies to first responders, to get folks into treatment. you have all of these other systems that have been burdened. last summer about the foster care system, which has cede a huge influx in kids going huge influxeen a and kids going through because their parents can take care of them. : no studies from the national manufacturers alliance

of american action -- new studies from the national manufacturers alliance of show studies on employers and united states. our employers present members of congress to do more on the opioid issue -- are employers pressing members of congress to do more on the opioid issue? ali: people are less productive in part because they are grappling with addiction, unable to work, going through other systems that leave them unable to be as productive. announcer: aside from the terrible increase in death numbers, how has the nature of this epidemic changed over time? shefali: i think this is an interesting story. 90's, doctors were talked

they should treat pain aggressively. they were told that painkillers were not that addictive and would take care of the pain needs of patients. they prescribed them and the story you heard so often, a girl falls, breaks her arm, takes percocet, doesn't realize she's addicted until she goes into withdrawal, takes heroin, it is more potent, and this continues. i would hear these stories out in the field. crackdown onn's prescriptions, so there are fewer painkillers, but people still are going through withdrawal and are trading -- craving this drug. they are switching to fentanyl. it is deadly. china andng from mexico and can tell you more -- kill you more easily, but also

gives you a much greater high. er: you write, today's version of the opioid epidemic is the -- equivalent to the 1980's aids crisis. willong do you think it take before lawmakers get a hold of this? shefali: it will take time. the public health commissioner from baltimore has talked about the importance of creating a ryan white, a separate, endowed funding for treatment. she is not alone in that argument. luthra of shefali kaiser health news, thank you. theprogram on combating opioid epidemic continues, with remarks by senior trump administration officials.

one serves in the office for national drug control policy. he spoke in march at an event on opioid trafficking hosted by the helsinki commission. kemp chester: i serve as the associate director in charge of the national heroin coordination group, responsible for synchronizing federal government activities related to the illicit opioid problem. please allow me to take a couple of minutes to address the magnitude and complexity of this crisis, and mentioned some of the things the federal government has been doing to address it. according to the senators for disease control and prevention, and 2016, the year for which we have the most recent data available, 63,632 americans died due to a drug overdose, a 21%

170 fourfrom 2015, americans every single day. opioids make up the largest category of drugs contributing to overdose deaths in america, with 15,472 overdose fatalities 19,431ng heroin, involving synthetic opioids, other than methadone, a category dominated by fentanyl and its analogues. the illicit opioid crisis is a lawlex national security, enforcement, and public health crisis. it is the nation's number one drug priority. thee fentanyl has been primary driver of the horrific number of deaths be have been seeing, we still have in a norm with heroin. it is too abundant in the market and far too available in our communities. along with the heroin crisis, we are facing the additional and related problem of illicit fentanyl and its analogues.

intoare extremely potent potentially deadly, being anywhere from 50 to 10,000 times as potent as morphine. it comes in many forms. if we truly have watched the crisis of illicit fentanyl evolve before our very eyes, from fentanyl powder mixed into heroin, often without the knowledge of the user, fentanyl pressed into pills and sold as counterfeit medications, being bought and sold over the internet, to the proliferation of the functional analogues now ylailable for sale -- fentan analogues now available for sale. drugs that areve extremely deadly, sometimes purchased over the internet with crypto currency, coming through the mail system or commercial carriers at a high volume into the country, across the borders of our land, with no signature and a variety of forms that are incredibly hard to trace.

fentanyl,cept that while a crisis in its own right, is likely a window into the future of the drug problem in america. we must reduce the size of the user population, prevention, treatment, and recovery support services, at the same time we are reducing the availability of these drugs. we must reduce the market forces pulling these drugs across the border. we could very well be seeing a move away from the plant-based drugs toward synthetics, with lower overhead on the front end and lower risk and greater profits for traffickers on the back end. must accept a more expanded image of the using population. theotypical experience, intravenous drug user is now being joined by those who think they are buying opioid pain relievers, but are actually fromg and too often dying

fentanyl, priced into pill form. the internet has made purchasing drugs much easier. the online marketplace and use of crypto currency's have power to the democratization of the drug trade. a hierarchical drug trafficking organization may no longer have a monopoly on supplying drugs to the u.s. market. rather, individuals can simply go online, to one of the many internet drug marketplaces, and purchased drugs like fentanyl for their own personal use or further sale, creating a constellation of micro-networks across the country. what we do now is not only thertant to get ahead of deadly fentanyl crisis in front of us, but also establishes the framework of relationships, laws, regulations and technologies and procedures that set the conditions to deal with the future of drug use in this country and its consequences who for years to come.

we know more now about where fentanyl and its analogues are being manufactured and how they are getting to the country more than ever before, thanks to the ,ntelligence community is law-enforcement, and our partners at the state level and below. better testing by medical examiners and corners is telling us more about the fentanyl analogs in our communities and killing our people. our international partners have internalized this problem and active measures to help us address it. here at home, the targeting experts of our law enforcement for help us narrow the universe of all inbound items to those more likely to contain fentanyl. as this crisis has taken hold in america, we have been building and sustaining the architecture, where the entire federal government is applying its time and energy to focus on this complex problem, and a network of partners is each taking its

own share and achieving, mentoring fx. when you have seen from the role congress has played in keeping this issue at the forefront of our national conscious this, i'm the president signing the interdict act recently to the announcement -- from the president signing the interdict act, to the announcement of the opioid initiative, to the energy and innovation in our communities across the nation, which speaks to the seriousness of this issue and addressing it in a meaningful and sustainable way. the drug market is vast, dynamic, and adaptive, but it is not without its own vulnerabilities. -- but it is not without its own vulnerabilities. it is not without a determination and the best haunts we can bring together against it. alents we can bring together against it.

massaro: one issue that i'm surprised it not come up is the postal service. -- did not come up is the postal service. are you the right person to talk about this? kemp: the postal service was very early to understand the magnitude of the problem, in the fact the united states postal service was a critical vulnerability we had, and is being used as a vehicle for drugs to enter the use -- to enter the united states. we are working with other federal law enforcement to do a couple of things. are getting advanced electronic data from the originating country, so that

they know the shipments coming into the united states before they get it, usually about 72 hours out, for tracked and untracked packages. aboutlumes we are talking are enormous, up to 144,000 every day. omega electronic data, it can be shared with customs and border protection, so they can give separate attention to those companies that are most related to the illicit shipment of goods. is theond thing nonintrusive detection capability, there in the international shipping center, for them to be able to detect illicit substances that are in there. the third thing is to be able to work with other law enforcement partners, whether from dhs or the department of justice, to get a prosecutorial outcome for

the things they intersect. at large hasrvice done a tremendous job in helping us to better understand the specter for drugs getting into the united states, -- the vehicle for drugs getting into the united states. shippedsaro: are drugs exclusively by the postal service, or are private delivery services used, like fedex? kemp: private delivery services are used as well. things to all who upholds law-enforcement intercept these packages before they can be received by the end-user. dhs also provided means for

the drugs can get into the country, but those companies are working hard with the federal government to intercept shipments. on march 1, the white house hosted a summit on the opioid epidemic. bys portion features remarks jeff sessions, cure stimulus him, and john solomon. -- kierstin nielsen, a point in america where we are going to make some progress. drugs,ger of the particularly they fentanyl and strength is

extraordinary. we never saw anything like me deaths we are seeing today. it is entirely unprecedented in the history of this country. we are going to be resolute. the entire administration is respond to this declaration of emergency. some sense it already with of the policies ongoing. july thened in largest medical takedown in the history of our country. 400 doctors and nurses who were involved in illegal prescription drugs. we know as much as 80% of addictions today start with

prescription drugs. that is an extraordinary number. we will continue to research it startsave no doubt that as prescription drugs. we had the shutdown of alpha bay. site thatrk web people,000 sites where could order through the mail illegal drugs. fentanyl in so small, compact and such a little bit is so powerful, it is easy to ship these drugs through the mail. we will not let those sites get future. in the

we have created the opioid fraud, abuse and detection network, which is a data ell within theem w existing computer systems of the drug enforcement administration so we can easily determine the position pharmacies and other distributors are moving prescription drugs. are extraordinary outliers. they give us indications of where fraud and abuse is occurring. target packages have been sent out to investigators and arrests have been made. one united states attorney said, i did not think much about it, but when you look at it there were six professionals in

pittsburgh and every one were on this list. that may need --that made me a believer. we sent experienced attorneys to hotspots around the country to focus on that. we indicted chinese nationals for the first time on fentanyl charges. that is coming from china and mexico directly through the mail. we have established a new program called j-code, the fbi program with dea to identify through the dark net and purchase undercover drugs in that way and to target that group. we announce the criminal prescription and litigation task force to file civil lawsuits.

we believe we can get an injunction to stop a pharmacy immediately from prescribing drugs because they have to comply with the law. we have filed litigation in support --it will be filed today--we announced our intention to file a statement of interest with a multi-litigation countryn a lot of the on that. emd -- end there to say, this is what we are doing in our department. if we do these things thectively, we can reduce

amount of depth, these and destruction these drugs are -- death, abuse and destruction these drugs are doing today. we want prevention, we need to educate people. the president has said do not ever start. kellyanne knows how to communicate well. >> i was there on tuesday when you had the press conference with the acting attorney general and was struck by the bipartisan approach that the attorneys general had torture prescription

internation -- integration announcement. going onto secretary kiersten nielsen, there are so many aspects of law enforcement's front waging the battle --secretary nelson falls under dhs. secretary nielsen: thank you for the opportunity to join you today. i think you will hear how we need to do this in partnership. i am happy to be joined by leadership from the department of homeland security. they do this work every day, day in and day out to protect our interior border from all threats.

declareddent, when he the opioid crisis as a public health emergency, he really sent a very strong statement. the statement to us as america is "fighting back." we will continue to fight with all of the tools we have at our disposal. in conjunction with our partners in the department of state and justice amongst many others. since october, dhs has very proactively assessed the current threat, determined where we might have gaps and what else we can throw at it if you will. this has allowed us to leverage our investigative intelligence efforts, which you may or may not know -- dhs is a law enforcement agency. we have 60,000 in cbp alone, and multiple agents in different departments who play a role in this. we are leveraging investigative and intelligence efforts. we also do interdiction -- international operations with

our international partners, and we have had great success on that front, particularly from our partners in mexico. we continue to look for more partners, because as you know, this dreaded drug, fentanyl, as the attorney general mentioned, continues to come in packages of all sorts of sizes and get in the hands of tcos who then use it in the drug flow. so we look at this within our borders, then we look at stumping across our borders. to prevent entry, we work with the doj and state and our law enforcement counterparts in mexico, south and central america and china as well, to prevent the flow. but, also most importantly, to share information. the sharing of information has two purposes. one, stop the drugs before they but theo our country, other is to help us as partners dismantle the tcos themselves that are the force behind the epidemic.

this information sharing helps us to stop the flow, facilitate the dismantlement and provides responsibilities across all partners to bring all that we have to bear. i wanted to use one example. we have border enforcement security task forces which has one of those good acroynms, bets. some of our acronyms that dhs are not so well done. ice's primaryand platform to investigate opioid smuggling locally. they leverage more than 1000 federal-state-local law enforcement officials and leverages over 100 law enforcement agencies. cbp also has officers at hundreds of points of entry and they not only check of billions of dollars of cargo, they are particularly focused recently on fentanyl. cbp seizures of fentanyl after

significantly increased over the last three years. we had about two pounds in 2015, we had about 1485 pounds in 2017. how this drug in extraordinarily small quantities is lethal. 1485 pounds is substantial. it is an epidemic. so, that is a substantial amount, that is an epidemic. so, to confront explosion, they have expanded the use of canines and we are happy to report that all cbp canines working that now -- working in international mail now have the ability to detect drugs and fentanyl. while we do not see yet a significant amount of the opioids being trafficked by sea, the u.s. coast guard interdictions of other narcotic are increasing. and of course, that deprives fines from the tcos who are otherwise able to use the funds to prevent the trafficking of fentanyl. to prevent the sale, we are also committed to not only preventing them at their source, but also

preventing their movement into and sale within our country. the attorney general mentioned to the dark web. we support his efforts. our united states secret service has the cyber capability on the investigation side, and they also contribute to the fight. so does i.c.e., homeland security investigations. again, dhs has a broad mission, but we do in all times work to bring everything we have to bear. the dark net, i would just add one comment -- it is anonymous. it makes it difficult to track who is doing what in terms of buying and selling. but with our partners at justice and fbi, and it dhs, we are doing just that. we also work to support the apprehension and prosecution. what i would say in closing date is the sheer magnitude of this

means that we have to partner. we have heard it said many times today and in other forums, there is not one entity that has all of the authorities, capabilities, and capacity to fight this alone, so we greatly appreciate everybody in this room. your interest, your support, your partnership. we cannot do it without you. we thank the president and vice president for their continued leadership and certainly, kellyanne for all the work you have been doing to put this all together. kellyanne: thank you very much, secretary nielsen. [applause] kellyanne: really terrific to have the state department involved in this effort and today i am happy to present to you for his remarks, the deputy secretary of state sullivan. secretary sullivan: thank you, kellyanne, it is an honor. i delighted to see everyone here.

thank you for your leadership and to general sessions and secretary nielsen, you might wonder why the state department is here. well, this is a whole of government effort. the president has made this a top priority for his administration. the state department is involved because the problem we confront is not merely domestic. the opioids that are killing american citizens are produced overseas, they are trafficked by criminal organizations that operate transnationally. the state department's role is to stop networks or criminal organizations, so-called tco s, the networks or criminal activity of trafficking drugs, address in the opioid crisis in a government effort. the state department's role is to support all of the work that the department of justice and the other cabinet departments are doing to address this problem. and, to enlist the support of our allies and partners and

neighbors in mexico in particular. this is our highest drug control priority. the bulk of the state department's counter narcotics work is focused on countries were opioids originate. opoids harvested in mexico is over 90% of the u.s. supply of heroin. the tco's that smuggle it are the targets the dhs and the department of justice are working to stop. we are strengthening cooperation with mexico through the merida initiative to interdict illegal transports, find and punish criminals involved, and cut off their sources of funding. in december of last year, secretary tillerson and i along with general sessions and secretary nielsen continued the

strategic dialogue we have with mexico on disrupting transnational criminal organizations. we are working with our mexican counterparts to find ways to disrupt the revenue streams with tcos that are responsible of -- for trafficking heroin and other illicit drugs. we working with mexico to eradicatesively poppy crops and bring drug traffickers do justice. -- to justice. over 100 of mexico's most wanted targets, have been arrested, killed, extradited. we support mexico's efforts to find, investigate and destroy clandestine drug labs. since 2008, the united states has donated and supported training of more than 500 canines who are assigned to mexican and federal state law enforcement agencies.

we sponsored training for canines and handling teams to detect weapons, cash, and drugs. this includes fentanyl specific detection training with cooperation with our neighbor to the north, canada. last fall, the human commission -- the u.n. commission on narcotic drugs put to international controls in the primary ingredients used to -- put 2 international controls in the primary ingredients used to produce fentanyl. this action was taken at the request of the united states and such measures are producing results. due to this change, dea has seen a decline in the presence of these chemicals in the drug -- illicit drug market. in the 2 weeks, again at our request, the u.n. commission will address controls on five other synthetic opioids including the deadly opioid, carfentanyl.

the state department is also building partnerships to more effectively stopping traffic of drugs sent through international mail and career systems. these efforts allow for law enforcement to more easily interdict any packages that may contain fentanyl. china is a growing area of focus on the fight against opioids. energized by president trump's visit to china last november, the united states and china have forged a productive, counter-narcotics relationship. as a result of our cooperation, china has established the domestic restrictions on the production and sale of 143 substances. including a number of fentanyl-related compounds. ofna's tightening regulations has contributed to the reduction of these absence of only street -- these

substances on the streets of the u.s.. unfortunately, we are seeing a new trend of rogue chinese chemists who are manufacturing illicit opioids, selling them online to drug traffickers, and shipping them in small quantities in the mail. as secretary nielsen mentioned, the amount of fentanyl necessary to convey a lethal dose is extremely small. we are talking about small quantities of these illicit substances. in response, we are working closely with china to improve coordination and screening of mail packages between our 2 countries. we are on an aggressive timetable to get all packages coming from china tagged with advanced electronic data and we will continue that close corporation with china and other countries that are sources of these chemicals and illicit opioids. collaboration is the only way we can tackle a problem that has no regard for international borders. the state department will continue to aggressively pursue this fight against opioids in partnerships with all other nations. thank you. announcer: the house energy and

common committee is considering a number of cells addressing the -- number of bills adjusting the opioid epidemic. they held a serues of hearing in march.of hearings severalshow you hearings. over the past 15 years, our nation has been increasingly devastated by opioid abuse. an epidemic fueled by the ever potent ing of hadn't -- opiods for prescribing pain. -- for treating pain. as a result of the increased

awareness of the opioid epidemic, prescriptions for opioid have started to decline. somewhat basic set. particular,tions in the well-positioned mexican drug cartels have filled this void by heroineg counterfeit and selling it to users pressed ills.counterfeit p isre are two parts the dea addressing with a third piece. first is enforcement. actions are undertaken every day using criminal, civil and administrative tools to avert illicit supply.

second is education. we look wherever possible to partner with leaders in prevention education. the third level is treatment. the dea is committed to providing access to drug treatment and recovery services. we utilize evidence-based strategies during this public health emergency. the only way to fundamentally --nge to this is epidemic this epidemic is to address the global illicit supply for concern --supply concerns.

a majority of new heroin users stated they started their cycle on prescription opioids. our use of administrative tools has been theon source of numerous media reports. dea continues to revoke 1000 registrations each year through administration tools such as surrenders for cause. we will use tools to protect the public from a small percentage takegistrants who advantage of the public. has the last decade, dea levied fines totaling $390 million against opioid distributors nationwide. dea has reprioritized a portion

of its criminal investigators the tactical diversion squads. we have 77 of these groups nationwide who are solely dedicated to disrupting and dismantling individuals and organizations involved in the version schemes. the control division simultaneously works to improve cooperation with the restaurant --registrar community. the dea just completed training more than 13,000 pharmacists and pharmacy technicians with instructions that they only fill valid prescriptions. the dea will start a nationwide witht to help prescribers this role.

whereill start in states we saw an increase in opioid prescribing rates. short, itave fallen is by not proactively leveraging the data available to us. i am happy to discuss what is past and i the appreciate the opportunity to today.you where we are --theilize the data from 00 result was 400 targeted leads the dea was able to send to its divisions in the states. wheil e --wally worked with our we haveues at occd --

created strong and critical partnerships with aha and ahs. we will hold a legislative hearing on over 25 pieces of legislation that underscore the nature and complexity of the opioid crisis and shows that we should take steps to address this together. >> thank you for the opportunity ofdiscuss fda's role confronting opioid epidemics. i am grateful for this committee's commitment to the in combating this epidemic. to address this crisis, threeworking across

broad domains. we are working on new paneer middies that are not as addicted to traditional opioids -- addictive as traditional opioids. things, we are taking new steps to require sponsors to provide better health care and finding ways how change how opioids are packaged. we want prescribers to provide documentation for prescriptions above a significant amount. we are ramping up our efforts aimed at the interdiction of illegal drugs including narcotics.

this includes a new authority at theources aimed international mail facilities. there is a flood of dangerous products entering the united states there mail packages that expose americans to dangerous things. primary responsibility for imported narcotics laws and border protection 0 anything believed to contai--controlled substances goes to ddt before the substance is spent to us -- is sent to us at fda. in a recent six-month period, we intercepted 158 packages -- 558 package and 330 contained opioids. than estimated that less percent are found.

we prioritize our work at the im s but there is more we must do. we increased our staffing. additional staffing is critical but to maximize what we can do, i want to focus on some additional authorities we discussed with congress. our operations at the ims receive unlabeled or partially labeled fields coming through the facilities. we are required to open every package, document the contents until he we find -- until we find evidence of the use before we destroy that article. we often refuse entry and send a package back. receivet uncommon to the same package again and

again. this process is not a deterrent. if fda had a authority to -- destroy the drugs, we could remove potentially dangerous products from the su plly --supply chain. this is a numbers game. these shipments are intended for further domestic distribution and each package may violate fda law. we are required to obtain legal proceedings against each package separately. improving the fda authority so destroyetain and individual packages, it would protect americans from dangerous substances.

when fda regulated article contains substances that do not -that have yet to be scheduled-, --this is an issue with the high volume of synthetic narcotics coming from china. we cannot destroy these products simply because they are articles of concern to dea. --we keep dangerous articles that are not easily obtained off the streets. i appreciate your interest and work in this effort. >> five minutes for an opening statement. >> good morning, chairman. members of the committee. experience tackling epidemics and i want to talk nation'skling the

opioid crisis. at cdc, we are concerned about preventing health-related consequences of opioid use including the spread of infectious diseases ike -- like hiv and hepatitis. cdc leads comprehensive prevention efforts by tracking trends and driving community-based prevention activities. america's opioid overdose epidemic affects people from every community. the problem is getting worse. 16, more than 63,000 people died from drug overdose and preliminary data indicate the trend worsened in 2017. we've seen increases in babies on withdrawing from narcotics. new data says that a baby is born with neonatal withdrawal

syndrome every 6 mintues. about 100 babies a day. for every one person who dies of an opioid overdose, over 60 more are already addicted to prescription opioid and almost 400 precede them. createng resources to evidence-based intervention so states can rapidly adjust as we learn what works best. a nimble federal and state response is critical. we improved prescription drug monitoring programs, improving prescribing practices, ti using timely, high-quality data and evaluating proxies --policies.

we're working for more effective monitoring which is effective in working with clinical decision-making. are cdc funds, many enhancing the timeliness of reporting and integrating with electronic health records. in north carolina, they've integrated reciting data within the work flow of existing health information systems across the state. improvements like that show how availablee vital data with the goal of saving lives. cdc improved the timeliness of reporting, updated luminary data on overdose deaths on our website every month. we are thinking of our efforts to get more comprehensive data

for medical examiners and corners. we're tracking nonfatal overdoses and we reported a 30% increase across the country. we released data using toxicological and death scene data allowing for a more robust overtanyl was involved in half of opioid deaths. we are making the guideline more accessible to clinicians. the campaign focuses on the risks of prescription opioids and features real-life accounts of individuals living in recovery. in addition to our partnerships s, cdc believes this

epidemic requires a collaboration across sectors. we determined risk factors for opioid overdose and target implementation plans. we drawn experts from across our agency. the comprehensive public health approach is playing a key part in addressing the epidemic. we did not get into this epidemic overnight and we're not going to get out of it overnight. we need an intensified effort to reverse the epidemic. thank you. >> from the start of this administration, president trump has made addressing the opioid epidemic a top priority. we share the president's

commitment to solving the crisis. as the department's lead agency for vehicular health, samsa has been at the front of the opioid crisis. workork focuses on -- our focuses on preventing overdose prevention with data collection and analysis annihilation to today imerging trends -- want to focus on several recent actions. distributed $485 million to states and territories in isis.nse to the opioid cri

2017, sansaof announced it was expanding efforts in states hardest hit by the epidemic. we awarded grants to west virginia, massachusetts -- we provide treatment and recovery services for vulnerable populations such as those involved in the criminal justice system and pregnant and postpartum women. --new grants to support treatment services for pregnant and postpartum women. we have been a leader in the effort to provide accessibility to naloxone.

provided resources it to first responders and treatment providers who work directly with populations at high risk for opioid overdose. oure are key goals of education, technical and training assistance efforts. million dollars to create the technical assistance progra,/ m. this is to support evidence-based practices tailored to the states -- of nationalider training and mentoring to

support clinicians interested in providing addiction care. we have provided data waiver for the fpr t =-- treatment of opioid abuse disorder. providing information to the release clinical guidance for pregnant and parenting women with opioid abuse disorder. we issued af 2018, rule commonly referred to as part two. samsa held a public meeting to obtain feedback from stakeholders on part two. leaders expressed support of --gning part two a hnd 00

and hippa. thea is standing up policy lab, charged with congress by facilitating -- with facilitating polocies, it is focusing on opiods. udespresident's budget includ monitoring opioid misue. samsa with four to working with forward to looks working with congress. announcer: the final portion of our special and the opioid epidemic features president trump. he spoke on addressing the epidemic through a combination of law enforcement and health

measures. trump: i want to acknowledge all of the families with us who have endured terrible hardships because of the opioid crisis and especially those who have lost precious loved ones. saying this for a long time and it all started here in new hampshire --i see what you are going through. about as bad as it is anywhere in the country. i said i would be back. we are pouring a lot of money and a lot of talent into this horrible problem. we promise to honor the memory of those you lost with action and determination. we will not rest until the end and i will tell you the scourge of drug addiction in america will stop. it will stop. [applause]

every day, 116 americans die from an opioid related overdose. in new hampshire, the death rate is double the national average. it has gotten difficulties like people wouldn't believe. willting this epidemic require the commitment of every state, local and federal agency. federal is not an option. addiction is not our future. failure is not an option. raise a drug-free generation of american children. october we declare the of crisis a public health

emergency. with congress to address funding in 2018 and 2019 to combat the opioid crisis and we will be spending the most money ever on the opioid crisis. [applause] president trump: on our most recent national prescription drug take that day, people across the country turned in mor e than 900,000 pounds of unused or expired prescriptiondrugs. more than the weight of three boeing 747's. our custom and border protection, the job they do is incredible. ed tons of fentanyl from chi

na. i told china, do not send it. in 2017, we arrested criminal aliens with charges and convictions for dangerous drug crimes. of the trafficking and related crimes, 3000 cases including a pharmacist, a physician's assistant and an opioid trafficker each charged with committing serious drug crimes in new hampshire. whether you are a dealer, dr., trafficker or manufacturer, if you break the law and illegally pedal these deadly poisons, we

will find you, rescue and hold you accountable. [applause] thank you. hampshire, i have t alked with the law enforcement officers who cooperated with operation agreement shield shield.ent -- granite it resulted in the arrest of 191 people. these are terrible people. we have to get tough on these people. if we do not get tough on the drug dealers, we are wasting our time. we are wasting our time. that toughness includes the death penalty. [applause]

it is an amazing thing, some of these drug dealers will kill thousands of people during their lifetime. thousands of people and destroyed many more lives than that but they will kill thousands of people during their lifetime. and they will get called and they will be 30 days in jail -- caught and they will do 30 days in jail. they may be fined but if you kill one person, you get the death penalty or you go to jail for life. if we are not going to get tough on the thousands of drug dealers that destroy thousands of people's lives, we're doing the wrong thing. we've got to get tough. this is not about nice. this is not about committees. this is not about listening to everybody and go to a blue-ribbon committee and everybody gets a metal. -- m

edal. this is about winning a very tough problem and if we do not get very tough on the steelers it is not going to happen -- on dealers it is not going to happen. i want to win this battle. i do not want to leave at the end of seven years and not solve this problem. [applause] not going to happen. thank you all. announcer: c-span's washington journal, live every day with news policy issues that impact you. coming up friday morning, we will assess president trump's decision to have members of the national guard patrolling the u.s.-mexico border with the bureau chief of the military times. virginian on meyer and

congressman on ways to make government more effective, civil and less partisan. also robert atkinson will review his piece challenging whether big business is really a bad thing for america. the trick to buy c-span's washington journal live at 7:00 eastern friday morning. join the discussion. ♪ anouncer: tomorrow, discussion about key security and political developments in somalia and the economic and political future of the country. live country from the -- live coverage from the brookings institution starts at 8:00 eastern -- 10:00 a.m. eastern on c-span. announcer: next week, facebook ceo mark zuckerberg will testify before the senate committee about user privacy. in a joint hearing before the senate judiciary and commerce committee and on wednesday at

10:00 a.m. eastern on c-span three, before the house energy and commerce committee. watch live coverage on c-span3 and c-span.org and listen live on the c-span radio app app. announcer: next, president trump's meets with west virginians to assess how they are doing after the passage of tax reform. at a roundtable in white circle whites --white circles -- sulfur springs, he spoke with families. americanroud to be an where at least i know i am free ♪ ♪ >> and i proudly stand up up -- io you and remember love this land ♪