dr. wen, with the baltimore health department, city health department. welcome. you're recognized. >> thank you very much, chairman, ranking member and members of the committee. thank you for calling this important hearing. i'm here as an emergency physician who has treated hundreds of patients with opioid addiction. i'm also here as the health commissioner of baltimore, where i've declared the epidemic to be a public health emergency. last year, baltimore launched our three-pronged approach to fight this on the front lines. first, we have to save lives. that's why we're making the opioid antidote naloxone available to every single resident. in the er, i have given it to patients who are about to die and have watched them revive within seconds. naloxone should be part of everyone's medicine cabinet. in 2015, we trained 8,000 people in the city on how to use it. including our police officers, who within six months have saved 21 citizens. in october, i issued a blanket prescription for naloxone

record, i am seeing everybody say yes except for dr. wen. dr. wen: it is one contributor. a lot of people who start using heroin begin with using perception painkillers. walker: sometimes a first introduction is through purchasing marijuana. his effort to say? usingn: and also through other prescription drugs. representative when -- representative walker: i want to make sure that we are not representing doctors as the bad guy. they have learned to become master manipulators, as far as going into doctors offices and emergency rooms. mr. cummings talked about the different pain levels and threshold. obviously, there are scoring systems by customer satisfaction indexes that dr. -- that hospitals have to work with. ? is that the dissent? dr. wen: -- is that fair to say? are triedost doctors to do the right thing and most patients are getting -- i tried to get the care that they want. amber is my knee and i will have some pain. but that does not mean i should be prescribed an opioid. representative walker: we need to continue to be -- to do better. i think of richard and jennif

but, dr. wen, do you agree that one reason we're seeing an uptick in heroin overdose is because of the abuse of prescription opioids? yes or no? >> yes. >> the op-ed has a startling stat. it says, and i quote, with only 5% of the world's population, we are consuming over 80% of the world's painkillers. the op-ed explains that drug companies are actively promoting this problem. it says, and i quote, prescriptions for opioids have been traditionally limited to cancer pain and comfort measures. but in the mid-'90s, drug companies began marketing these pills as the solution to a new plethora of ailments. in their efforts to expand the market, producers understated and willfully ignored the powerfully addictive properties of their drugs. end of quote. that sounds like drug companies are almost like drug pushers. the op-ed cites several examples. it says this, quote, the promotion of oxycontin by a purdue farmer was the most aggressive marketing of a schedule 2 drug ever undertaken by a pharmaceutical c

dr. wen, there are bad doctors. you cannot paint with a broad brush. is totallyf action of acceptable. especially when you have someone come to your pharmacy bearing guns, that is unacceptable. i hope you look at that. it is westchase pharmacy. i hope you'll research that. i want to ask you, dr. wen, we have talked about opioids being drug forhe entry-level pain control. one of the is the fdasee here medicines off the market. much i imagine how dispensed in my career. when they took it off, what did he do? and lead people into opioids. it was the only choice -- it lead people into opioids. it was the only choice. the practicing pharmacists, i can tell you, you try to get a patient to take something that is available without a prescription, you are not going to be up to convince them that it is going to work. that is just the way it is. it is not right. i will try as hard as i can and i cannot convince them. -- don't the oxygen give me the white one. the pink one, that is the only one that wor

i want to ask you, dr. wen especially, you know, we talked about opioids being used as the entry-level drug for pain control. one of the problems i see here, and mr. bout, we were together before -- and mr. botticelli, we worked together before. one of the problems i see is the fda taking products off of the market. specifically, i want to talk ropoxin.r coxon -- p when they took it off, what did it do? it led people and opioids. that the only choice that doctors had. what do you do now? you had ibuprofen and acetaminophen. as a pharmacist, i can tell you. you try to give a patient something that is available without a prescription, you are not able to convince them that it is going to work. and i will tries hard as i can and i can't convince them of that. thejust like the oxygen -- porpoxiden. problems.t he had its i'm not trying to question that. what i am trying to point out is that we need more entry-level dogs -- drugs, some bit -- drugs, something in between ibuprofen and acetaminophen and opioid. for doc

how would you react to that, dr. wen, to having guidelines that really stemmed access to very severe pain levels, because what we are doing is for someone to become double for a week, we are turning them into attics. -- into addicts. this is a crisis. this has got to stop. iwas take my colleagues -- would say to my colleagues, we should not leave here until we vote that 600 main dollars that is needed -- that $600 million that is needed for the program. what they need is the treatment and the field. i would like to ask dr. wen, what do you think about reversing it? . just education, but giving doctors help in knowing what threshold of pain would be necessary before this dangerous addictive drug is allowed? >> dr. -- congressman -- congresswoman maloney, i think you for that point. doctors need guidance and tools in on to make the best decision for the patients. having guidance would be useful because you do not want to punish doctors who are doing the right thing. when reimbursement is tied to getting the doctor or patie

cummings. >> dr. wen, you know, one of the things that is so disturbing to me is there are certain areas in baltimore where people are getting methadone treatment. and when you see the number of people and whose lives have been destroyed, and when you see the masses of them, and i would say to the gentleman from south carolina, i would invite you, scotty, i would invite you at some point just to come with me to baltimore. and when you see the masses of people who are not -- who are using, it is painfully painful, i'm telling you. and i agree that there are those who are selling drugs and are not using. i agree with you that there are folks who are going out there and committing a lot of crimes. as a matter of fact, probably most of the crime in baltimore has something to do with drugs. in one way or another. but there are also a group of people who are truly addicted. and they're dying at 78 a day. that's major stuff. and so i just would invite you, i think when you see it like that, because the chairman

so dr. wen, where do you and the chairman from south carolina made a lot of good points -- where do you draw the line and say, okay, i've got these addicts, but these addicts, some of them are committing crimes. go ahead? and what do you think of the methadone treatment? because a lot of people question whether you just are keeping people continuing to be addicted to a substance. >> thank you very much, congressman cummings. the first issue is that we know in baltimore that there are 20,000 people who use heroin. and many more who are addicted to other drugs. and most of the drug arrests that are happening, there are 73,000 arrests that happen in our city every year. the majority of the arrests that happen are for individual whose are only selling drugs to feed their own habits. what they need is not incarceration. what they need is treatment. we have to make sure they have treatment, while if they are incarcerated, they have to get treatment in jail as well. >> can you pause for one second? one

dr. wen, what happened? in other words, this was not a problem, not as much of a problem. then something happened. can you tell me what happened? e numbers the gentleman cited, and i realize people are moving from the opioids to heroin. what happened with regard to opioids to get so many people on them that they moved to heroin. my understanding is there was aggressive marketing by drug ispanies so the pain scale something that is up during the course of a hospital stay. the goal should be appropriate treatment. but an expectation is placed on patients and doctors. doctors are put in a hard place of satisfying those requirements. >> doctors have a tough time. in other words, the patient keeps coming in, and the pain -- be a 2, being the mildest the patient has a 2. then he or she comes in and does not tell the truth and says i am at a 9. is that the kind of thing that happens? >> that definitely happens. doctors feel they have to get zero,tients pain to which includes overprescribing painkillers in order to do so. >> would you like to say something? >> i agree we set up an

dr. leana wen.e are joined by maia szalavitz, a journalist who's covered addiction for almost 30 years. her recent piece in the guardian is headlined, "curbing pain prescriptions won't reduce overdoses. more drug treatment will." she has a new book out called, "unbroken brain: a revolutionary new way of understanding addiction." michael collins is also with us deputy director of national , affairs at the drug policy alliance. michael, your assessment of what president obama is proposing right now? >> what we can say about the proposal, two steps forward and one step back. there's a lot of positives in the announcement, inferences on harm reduction, treatment, overdose prevention, but at the same time, the obama administration is still beholden to the criminalization of drug users and we see that in the announcement, there is funding and there for law enforcement, for heroin task force, and we know that is the academy of the failed war on drugs -- if it of the failed war on drugs. there are parts of

dr. wen, what happened? in other words, this was not a problem, not as much of a problem. then something happened. can you tell me what happened? the numbers the gentleman cited, and i realize people are moving from the opioids to heroin. what happened with regard to opioids to get so many people on them that they moved to heroin. my understanding is there was aggressive marketing by drug ispanies so the pain scale something that is up during the course of a hospital stay. the goal should be appropriate treatment. but an expectation is placed on patients and doctors. doctors are put in a hard place of satisfying those requirements. >> doctors have a tough time. in other words, the patient keeps coming in, and the pain -- be a 2, being the mildest the patient has a 2. then he or she comes in and does not tell the truth and says i am at a 9. is that the kind of thing that happens? >> that definitely happens. doctors feel they have to get zero,tients pain to which includes overprescribing painkillers in order to do so. >> would you like to say something? >> i agree we set up

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