samsa proposes to maintain and grow investments made by kor congress in 2015 and 2016.we're providing funding for 23 more states to expand treatment capacity and preserving the behavioral safety net by maintaining increases to the substance abuse grant. we also worked to clarify and enhance the connection between mat and the criminal justice system. drug court rs the most successful criminal justice response to addiction no our nation's history. this year, we'll prioritize treatment less susceptible to aversion and make sure evidence-based practices are implemented. with all this new care, who is there to provide it? we must ensure that the substance use work force is sufficient to meet growing demand. as such, we are requesting $10 million for prescribing authority demonstration to test the safety and effectively of expanding the prescribing to nurses and physician assistants. the administration requested $20 million for our colleagues at the health, resources and services administration to grow the addictions work force via the national health core. finally, samsa is

i look to samsa for more honest assessment of their programs. they have programs supporting individuals with serious mental illness but found there's no or little lacking interagency cooperation for those programs and i have seen that firsthand. i've seen it firsthand where if someone who has a mental diagnosis is in a hospital, in an emergency room, sits in a waiting room which looks like a jail cell for days in some circumstance. then gets to the state local facility and could be there after they are maintained with their medication, therefore weeks on end wasting money in the system. that has to be changed. i would love to work with you on it. >> mr. norcross is recognized for one minute to close. >> thank you. this isn't about the responsible law-abiding citizens who own guns and we know and they enjoy hunting and all the things that go along with this. how can somebody who pledge allegiance to isis still be allowed to purchase a gun in this country? i don't think founding fathers had terrorists in mind buying ar-15s when they created the se

and samsa related to combating opioid abuse.hese dollars actually haven't been distributed yet, and so it's important that we cast cara to make sure that as we go forward with the dollars that have already been appropriated and as we go forward in the appropriations process this year, that we have the framework to properly redirect this funding to prevention, treatment, first responders, to make sure that we have the feedback of 130 stakeholder groups of law enforcement throughout the country to ensure that these dollars are appropriately spent to address the epidemic that we're facing. i was honored and i have been honored to work over the last several years again with senators portman, whitehouse and klobuchar in introducing this bill. in fact, i also want to thank the head of drug policy in the administration, director boticelli, and he really summed it up well when we asked him what he thought about cara. he said in a hearing before the judiciary committee in january there is clear evidence that a comprehensive response look

the only way this bill is funded is by robbing the accounts that samsa is now putting out to bid to fund in order to fund this bill. you can say that the money will be better spent under this legislation. i think that's true. i support this bill. i'm going to be for the bill all the way through even if it's not funded. but you can't say that there is funding. this is a very solvable problem. we've done it before. senator shaheen pointed out on the floor whep it -- when it was the swine flu on an emergency basis we appropriated $2 billion. ebola, $5 billion. if you say now something has changed, we quant do that, we have to pay for it, senator manchin has a pay-for. a penny per milligram of opioid. it raises over $1 billion. you can do half a penny that the pharmaceutical industry that is so culpable in this predicament, in this tragedy that we have could contribute. but, no, rather than allow this good program, this bipartisan program to be expedited out there to help the people who are dying, $47,000 in 2014, the last year, what we've done is protect the pharmaceutical industry from hav

. >> but i do think that it is reflection of how we have looked at and i worked for samsa and why it is so important to have the parity in the systems of care and san francisco leaps and bounds ahead of many other counties and even, states. in really trying, and we really try to put some humanity into those programs to our harm reduction approach and accepting people because there is so much stigma, like we have seen in the mental health system and sometimes, even more, and in fact, the most recently, we passed proposition, 47, where the people with addiction were being arrested and put in jail. and so, i do think that this is an opportune time to main stream and also increase the medical services which have been care driven and really medicalized a lot of those services through the medical detox to our programs for opiates under the methadone. and so i do think that this is a great opportunity to be able to create some revenue, increase the accountability, of many of our providers, and also, improve their services to the clients. and i think that some of the questions that the commi

there are samsa surveys by state and they -- you know, you can find charts that look at the increased use of marijuana and it's interesting to look at what happened in colorado between the 2002/2003 survey for 18 to 25-year-olds and the 2013/2014 survey for marijuana use in the past month for 18 to 25-year-olds and past month is not just used at once, i've used it recently. it went from 21% to 31%. 18 to 25, by my understanding, of the potential adverse affect of marijuana on brain function and development is probably the worst interval -- maybe not, maybe even younger use would be bad but certainly up to age 25 is a bad interval. the national use went from 17% to 19% so pretty clearly, i think what happened in colorado is you legalized the drug. bottom line you legalized the drug. and there's a lot of misinformation out there about what happened when you legalized the drug but honestly it changed from 21% to 31% use in a highly vulnerable population of concern to me. is it of concern to you? >> how could it not be? >> well, i'll tell you that the advocates for legalization say we sho

samsa will encourage the use for a safer, more effective course to management of chronic pain. we know the vast majority of physicians and other prescribers are dedicated, well-trained professionals committed to their patient's good health. we must give them the tools they need to deliver quality and effective care. since 2007, samhsa provided continuing education to over 72,000 primary care physicians, dentists and other health care professionals. we also reach local communities through drug-free community grants. weed administer together with ondcp. these coalitions do yoman's work to create environments that promote health and prevent drug use. the second aim of the secretary's initiative is increasing access to naloxone. it can reverse an opioid overdose. it only works if it's there when you need it. in samhsa's overdose prevention course for prescribers and pharmacists, one of the targeted strategies we promote is co-prescribing of naloxone particularly for patients with high risk of overdose. we also let states know they can use the block grant funds to purchase this, as

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 b

>> yes, i'd say it's multi faceted, and it's also with hhs in particular, through samsa and the indian health service. when we dissect the issues of suicide in indian country, so much of it ties to very deep and persistent issues in the family structure. schools are a safe place where people can come. we are looking at pilots to use schools as places for training of parents, counselling. there are a number of youth programs out there. unfortunately, where youth are the first line of defense against suicide, but in many cases, that's the safest place that kids feel they can go. we're working on all those programs, with a pilot at pine ridge, but looking at learning from that and taking it throughout indian country. >> thank you very much. i yield back my time. >> mr. thompson? >> thank you, chairman. madam secretary, thank you for being here. let me jump right into my questions. i'm pleased that the fish service recognized the whites nose sind yom was the driver behind the dedecline of the bats. and has ensured the rules allow for activities to continue that are not impacting the bat. h

. >> but i do think that it is reflection of how we have looked at and i worked for samsa and why it is so important to have the parity in the systems of care and san francisco leaps and bounds ahead of many other counties and even, states. in really trying, and we really try to put some humanity into those programs to our harm reduction approach and accepting people because there is so much stigma, like we have seen in the mental health system and sometimes, even more, and in fact, the most recently, we passed proposition, 47, where the people with addiction were being arrested and put in jail. and so, i do think that this is an opportune time to main stream and also increase the medical services which have been care driven and really medicalized a lot of those services through the medical detox to our programs for opiates under the methadone. and so i do think that this is a great opportunity to be able to create some revenue, increase the accountability, of many of our providers, and also, improve their services to the clients. and i think that some of the questions that the commi

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 b

senator that even's bill would appropriate an additional $600 million to the department of justice to samsa and to the cdc. much of it going to programs authorized in cara, the comprehensive reduction recovery act or complimentary to cara's goals. this would not be the first time that the congress has authorized emergency spending in response to a public health emergency when the swine flu epidemic hit taking i think 11,000 lives, congress appropriated $2 billion on an emergency basis with broad support on both sides of the aisle. here in the latest year for which we have the data, the body count is $47,000 -- 47,000 lives, 47,000 deaths. 11,000 to swine flu, 47,000 in one year to the opioid epidemic. so i hope that my colleagues on both sides of the aisle will join me and senator shaheen and vote not only to support the comprehensive addiction and recovery act but to also provide added resources to make those principles a reality in the lives of the people who are counting on us to come to their aid. addiction is a tough illness and recovery from it is a hard but noble path. men and women

and samsa related to combating opioid abuse. these dollars actually haven't been distributed yet, and so it's important that we cast cara to make sure that as we go forward with the dollars that have already been appropriated and as we go forward in the appropriations process this year, that we have the framework to properly redirect this funding to prevention, treatment, first responders, to make sure that we have the feedback of 130 stakeholder groups of law enforcement throughout the country to ensure that these dollars are appropriately spent to address the epidemic that we're facing. i was honored and i have been honored to work over the last several years again with senators portman, whitehouse and klobuchar in introducing this bill. in fact, i also want to thank the head of drug policy in the administration, director boticelli, and he really summed it up well when we asked him what he thought about cara. he said in a hearing before the judiciary committee in january there is clear evidence that a comprehensive response lo