dr. botticelli: let me start.is actually part of our statutory authority that we set in conjunction not just with hhs, but all federal agencies that have a role in substance use and opioid use disorders. we have been engaged with dod, v.a., bureau of prisons. chairman murphy: you meet regularly? dr. botticelli: we do. we have quarterly meetings. chairman murphy: let me move on that, too. that's important. miss hyde, let me ask you in response to our bipartisan letter of march 18th concerning the national registry of evidence based programs you noted that, quote, new submission and review procedures will improve rigor of registry and bring into closer alignment of other evidence based programs in the federal government. prior to entering into the july 2014 contract, did samhsa feel it needed strengthened? yes or no. do you feel it needed to be strengthened? ms. hyde: thank you for the question. we thought the process we used for determining what practices were reviewed needed to be strengthened, and in the process

dr. botticelli about the treatment as well as hiv therapy is. the other thing is indiana is no. 9 in the nation for prescribing and so there's a lot that can be done when you are looking at trying to stop the epidemic so looking at using the prescription drug monitoring program with better guidelines of people don't get addicted to opioids and inject them. that is the third component we need to add. >> administrator hide. >> we got caught by surprise with the indiana epidemic of hiv and this is the fastest growing incidence of hiv cases since it entered the united states but there has been an extraordinary advance in hiv that has emerged over its past few years which is if you initiate someone with antiviral therapy not only are you in improving their outcome to decrease their activity. one of the things i would have suggested to do is you immediately freed them with antiviral therapy. the activity will dramatically decrease. this is another aspect that relates to the issue of giving care. for substance abuse treatment. >> we understand there ar

dr. volkow, picking up on a point mr. botticelli made just a moment ago about way too many prescriptions, this is to you, why are so many prescriptions being written for opioids? are physicians not getting the appropriate level of training and education in pain management? responsible opioid prescribing practices? what would you say? dr. val cow: they are both. actually what happened is we have to recognize that there's another epidemic of chronic pain in our country, estimated 100 million people according to the institute of medicine. as a result of pressure of need to go address this problem, the joint accreditation required that hospitals and physicians in hospitals ask questions about pain and treat them. this was in 2000. the problem was that that was not associated with the education required to properly screen pain, but also to manage it and to manage it and use opioid medications adequately. there was a pick up between need to implement better treatment for pain, but inadequate education of that system. so that's a major pro

where the honorable michael botticelli, director of office of national drug control policy. welcome. dr. richard frank am assistant section for planning and evaluation u.s. department of health and human services. dr. nora volkow, director of the national institute of drug abuse as a nation institute of health. dr. douglas throckmorton, nobody director for the center for drug evaluation and research for the food and drug administration. doctor debra houry comfort to the national center for injury and prevention and control of essential disease control and prevention. the honorable pamela hyde come administered for substance abuse and mental health administration. dr. patrick conway, deputy administrator for innovation and quality and seen as chief medical officer for cms. welcome. >> as you are aware i went elsewhere in the witnesses, the committee is holding an investigative hearing and when doing so as a practice to give testimony under oath. do you have any objection to testifying under oath? none of the witnesses have objection. a chair with an advisor to the rules of the house on b