Transcripts For CSPAN Washington Journal 20160325

We have divided our lines a little bit differently. If you have been impacted in some fashion by heroin use, we want to hear from you. 2027488000 is the number for you to call. If you are a medical professional and you have been involved with heroin in some fashion, 2027488001 is the number for you. All members can call in and voice your opinion at 2027488002. You can also make a comment on social media on twitter. You can also join the conversation on facebook at facebook. Com cspan. This week on capitol hill, there was a hearing on the heroin use in this country. The director of the office of National Drug control policy is spoke there. If you look at the overdoses we have seen, there is a direct correlation between the amount of prescriptions we are giving out and Overdose Deaths. Has been going on for 10 years. And i think the medical community has a role to play and that is a good start. What about liability . What about adding joint liability for the Drug Companies and the doctors who pushed this stuff out . These people are unsuspecting and getting addicted. There has been legal action against pharmaceuticals for that reason. They have a role to play, not only in terms of making sure they are following the letter of the law by marketing, but also creating abuse. The duty to work with the da and others to go after outlying prescribers who are vauntingly ignoring the law. That you are right, we need prescriber education, good Prescription Drugs monitoring programs soap physicians can identify people who might be going from dr. Todoctor to doctor. If we are going to reduce the magnitude of the problem, we have to scale back on the prescribing and identify people who are developing problems. Host from our Facebook Page this morning tracy asays in my small town we have had four heroin Overdose Deaths. Alder female. High School Aged Kids are becoming hooked on not Illegal Drugs, but legal described medications. This is a shame and it is going on on a much larger scale than most would like to admit. That is tracy on our Facebook Page. Here is how you can participate through the phone lines as well. 202 is the area code for all of our numbers. If you have been impacted by heroin use, 2027488000. If you are a medical professional, 2027488001. And all others, 2027488002. Elijah cummings is the Ranking Member who held the hearing. People are dying in baltimore, orlando, Salt Lake City manchester, and cities all across our nation. We can no longer ignore this Public Health emergency. Congress needs to put its money where its mouth is and actually help. Help our states find a treatment programs to stop this epidemic in its track. Drug Treatment Facilities without Adequate Funding are like firemen trying to put out a raging inferno without enought water. Last week, leader pelosi sent out a letter urging speaker ryan to schedule a vote on 600 million in emergency funding to help states address this epidemic before this recess week. Our colleague from connecticut is already introducing this bill in the house. The senator has been pushing this legislation in the senate. Congress did not leave town until we take Emergency Action to increase funding to helps sta states combat this epidemic. We must also fully Fund President obamas request for 1. 1 billion in 2017. Opioid addiction is one of the most pressing Public Health and safety challenges facing the u. S. Today. According to the centers for Disease Control and prevention, prescription painkillers and heroin are driving one of the deadliest drug epidemics in the nations history, claiming the lives of 78 and americans every day. Randy is calling in from long beach, california. Go ahead and make your comments. Caller hello, i am a longtime viewer and i am very interested to tell you about the fact that i learned this from cspan and washington journal, one of my favorite shows. I am in california. What i saw on cspan, washington journal, it was actually a map up on the back of the wall and it was showing afghanistan, the city of afghanistan with a little bit of pakistan on the side, but it had all the green areas where they were growing heroin. And they said the hair wheneroin is three times the amount of heroin before it used to be before we actually got there with our cia and our war. I am quoting what you said on washington journal. Host what you think that means . Caller i feared it was starting in europe about two or three years ago it was hitting them pretty bad. Now it has hit the shores of the United States. We have the Atlantic Ocean dividing us. Obviously, there was a two or three year wate. We are getting here, all 50 states from what i understand. Host this is frederick in blakesley, pennsylvania. Caller good morning. Look, i was raised in brooklyn. In the early to late 60s or early 70s, use of people who overdosed on heroin. The problem that is bothering me back then there was a crime problem. Now all of a sudden when people are overdosing in massachusetts New Hampshire now all of a sudden you are hearing people talk about it as a medical problem. I think it is unfair that now it is going out into the states i have seen a lot of programs. Nobody is really talking about back then when i was growing up. Host frederick, are you referring to the fact that its affecting white people . Caller yes, that is what i in saying. Host there is a different attitude towards it now. Caller i am here in cummings talking about it. Like i said, in of the late 1960s or early 1970s, it was running all through my neighborhood. I had friends who overdosed on heroin. And nobody talked about it. At that time, it was a crime problem. Now that it is in the suburbs it is a medical problem. My here them talk about all the clinics and programs they want to use. What to use more money and more money because they call it a medical problem. Back in the 1980s, it was a crime problem. Host this is earnest in hollywood, South Carolina. Caller on because of pennsylvania. I am an addict now and i have been recovering since 1995. When i came back from overseas all of the heroin addicts came from vietnam. Is in thing the guys that in pennsylvania. It is the same thing the guy in pennsylvania was saying. If we have a disease in africa sooner or later, it will come overseas to america. And that is what is happening now. It is beginning to affect tehhe shiwhite people and now something is being done by it. It is a shame but this is what is happening and i am glad that something is being done, but it should have been done way back then. Host ernest, you said you are an addict. What kind of addict . Caller i was addicted to cocaine. I used heroin and i have been recovering since 1995. Host what was your addiction like . What were some of the impacts of it . Caller well, most of my addictions happened to me when i was in the military. Everything happened to me when i was in the military. I had seen some traumas and i had seen a lot of addicts shooting up. It was like a shooting gallery right there where i was stationed at. And you know, these guys are just sitting around and shooting heroin all day long. Nothing was being done. They just let them out on the street. And the devils came home. No program or nothing was being done for these guys that came back from overseas. And we still have the impact right now. Host do you see the impact of heroin use in hollywood, South Carolina . Caller it is being used here, yes. I know it is. Host is easy to get . Caller if you wanted to, you could get it. Host thank you for your time. Water is calling in rum new jersey. From new jersey. Caller this heroin problem like the gentleman was saying, it should never have been dealt with as a criminal justice issue. But as you go on you learn more and you know how to better deal with things. It should have been dealt with always as a medical issue. Host thank you sir. Warren is a medical professional in a windsor mill, maryland. Look at of medicine are you involved with . Caller i work in Substance Abuse, basically. Host so, in your view is there a heroin epidemic in this country . Caller well, i actually live in baltimore and work in washington dc. I get to see both sides of how of what you call the problem has i mean, i see the affected people. [laughter] but it is a big problem. My thinking is, a lot of the support staff available to help treat this problem like counselors and Substance Abuse counselors and all the social workers, do not get paid a lot and are overworked. As a result, a lot of the people who come in for treatment and of being managed and not actually treated. So they just go back to using. They make progress and that they go back into doing the same thing. And i also, i agree with the last two callers. It would be better with this as a medical problem and not i mean we cant just put people in jail for doing the same things. Whatever, i mean, the court system is doing, it is not quite a help at this point. It is just making the whole situation bad for everyone. Host warren, a lot of the research we did for this program says that heroin abuse began as Prescription Drug abuse. Do you see that . Caller yes, i agree with that. A lot of the people who i actually work with, started with what you call Prescription Drugs and then moved on to heroin and other things. They have different drugs that they use now which are basically opioidbased drugs. But you know if we just can i mean, we need more of a budget. So people can actually have a little bit more care and can actually take their time and reduce the amount of caseloads for a lot of tehsehese counselors who in some cases have 40, 50, 60 patients. It would reduce, i mean, it would increase what you call the success rate. Host what is a defective way to treat heroin addiction . Caller the effective way to treat heroin addiction to me is basically well, you have to address the entire person as a whole, which means the medical aspect has to be addressed. The physical aspect the mental aspect of the person. It takes the entire Treatment Team to actually get that person off the substance. You can say well, lets just focus on the heroin and then we think we are going to get some results. They are just going to go back to the same behavior. The most effective way to me, is to handle all aspects possible of the individual. We have support for them. For example, if they are homeless we might have to find them, what you call, a home. If they have mental aspects going on, they have to get treatment for their mental situation, whatever is going on. And mabye we can also provide medical treatment after we have addressed those other issues because a lot of times what we do is something whichat you call a patchwork. They come in and we put them on methadone and send them out. And no further aspect is followed. We will followup on how they leave and how they get food to eat. How they live with their families, or their partner. We need the entire structure to be inside to treat them. Host thank you for your time. Mike is in ohio. Mike, we are talking about the heroin epidemic in this country. Caller good today peter. How are you . Host im fine, how are you . Caller a flashback to the iran scandal under bush one and we had that cocaine epidemic. Remember that . I think they were trading machine guns for cocaine in south america and we had that cocaine epidemic in the 1980s. That was under bush one and reagan. And he is telling more stories now on the fox channel. But anyway, now we are into the heroin epidemic. And you know, we have been to afghanistan and their production is three times as much as what it was before we went in, like what it was 15 years ago, and here you have got the state department and all of this stuff going on and here a while back on cspan i heard that one of our top senators, his brotherinlaw, a man from china in charge of the shipping containers coming into this country. So, there was mention of that. So, i think we need to connect the dots here on what is actually going on. And you know, paul ryan the other day said we should not lose faith in government. Host mike, we are getting a little off course there a little windy. Lets give back on course to talk about what we are talking about this morning, which is the hair went epidemic in your community. Eddie from new york go ahead. Caller good morning, peter. How are you . Host please, go ahead. We are listening. Caller i am just commenting on heroin and this war on drugs. It just doesnt work. You know . We talk about how we demonize addicts and what do we do, we throw them in jail . Like before this call, i totally agree with the other three ok . That we have to build the infrastructure for these addicts. They are ending up on the street with nowhere to go ok . Like you take the you know, sweden profile, what they did over there. They legalized all of the drugs ok . Host are you in favor of that . Scott wong caller yes, i am. As people who would read this book chasing tehhe screen they would have a different outlook on how far back we are. Host that is eddie in a new york. Here is the first page of yesterdays new york times. Towns antidrug plan, a safe site to use heroin. The mayor of ithaca, new york has opposed a legalized open area, or an area for people addicted to heroin to be able to use it legally. Rogers represents a lot of rural kentucky and he was at this weeks hearing on heroin and opioid abuse in the United States. Without for years, we end the countries and others, have fought for years to get the pharmaceutical companies to develop abuse deterrent formulations, to make opioids so they cannot be crushed and take away the time release of the drug to just a split second. And now weve got i think five abuse deterrent opioid pills on the market. But doctors are not prescribing them. I dont know whether they dont know about them, or dont care about them, or whatever, but the bottom line is, they are not using what we have developed as an of these deterrent strategy as an abuse deterrent strategy. What you think about that . There are Different Reasons they might not be using them. One that is important for us to be aware of is that we have to be certain because this abuse deterrent requires development. They tend to be more expensive than the old opioid medication. You want to be mindful that there are insurances that when a physician prescribes it, the patient will be reimbursed for the cost associated with it. With have to create a system that incentivizes the utilization of these abuse deterrence formulations. They will be more expensive. Host here is a cover of the most recent National Review. Ground zero in the opiate epidemic is not in some exotic coffee field or in some cartel bosscompound. It is right there in walgreens and the middle of every city and town in the country. This is kevin williamson, who went to the country and reported this story, including going to drug corners. Hear is a little bit of what he wrote. In 2013, walgreens made the secondlargest fine ever imposed for being so Loosey Goosey and handling oxycontin at its distribution center. It enabled untold quantities of the stuff to reach the black market. A typical sells 73,000 oxycodone pills each year. Six walgreens in florida were going through more than one million pills a year each. A few years before that, Perdue Pharma was fined for misleading the public about the addictive miss of oxycodone. Kentucky, which has been absolutely ravaged by opiate addiction, is still pursuing litigation against purdue, and it has threatened to take its case all the way to the Supreme Court if it comes to that. We have a herbert calling from georgia. Caller good morning, peter. I am 65 years old. I have been off of heroin for about 30 years now. I started when i was 18 years old. They are talking about oxycodone and Everything Else. It is differntent. I have not had oxycodone since i have been off of heroin. Those guys dont even know what they are talking about. I was on, up until 1991. But what made me get off of heroin. I am ita black guy. Ive been through everything. All of my friends, a whole flood of my friends, died up of air when. We used to have shooting galleries. Let me tell you, when you get those physical withdrawals thats what makes them go to the heroin. I am telling you, every part of your body, from your toes, to Everything Else aches when you are heroin addicted. That is what those guys feel. That is what makes them go out there, just to maintain, just to relieve the pain of the heroin. You dont get the high no more. You just are trying to relieve the pain, to not be sick. You start vomiting and Everything Else, man. You try sipping on through ruenals. They are talking about the codon. I have been through it and gotten off of it. I have scars of my arms right now, peter after 30 years that you can see that i a injected heroin. I injected heroin in my neck and in my foot. I saw a white couple one day a mcdonalds. I seen them with the spoon. I kept looking at them. I try to stop them because i saw them at the beginning. They were going to shoot some heroin. I try to relate to them. I said you dont want to get this happy. When you get is happy, you just want to relief from the aching pain. It is different than oxycontin and things. I have got to the experience and came out of it. Most of my friends are dead. I can count maybe Three Friends who are still living. I have a teacher friend who recently retired. These to shoot heroin together. We used to shoot heroin together. He is active in the ministry. Me, i tried to talk to people. These people they need to talk to, to went to the window. A lot of them got on methadone but they did not give them a high dosage. They started breaking down there dosage. But thank god, through the glory of god, i did not need needone of that. I went through my job for 20 years and i retired. I went through the physical and everything, but doing that time. Host herbert, why did you start using it in the first place . Caller well, it started as a conventional drug because we were 18 years old. It started off as a conventional drug. Back then they were calling it smack. We were starting at first, right . When we started snorting it, then you start off skin po lopping. I was scared of needles, peter. I was scared. So, i started skin popping. And then one day i got with some dudes and they were mainlining. And they got more high than i did. It went from there all the way to the addiction. It started as a nodding sensation. Is a feeling that gives you. It makes her body like, it makes it like it relieves everything in your body. It does something to you mentally. I mean, like a trance. Is like you are in a trance. Host herbert, do you miss that sensation . Caller no, no. Peter, i remember. I had back surgery too, right . When i had back surgery that is why i am retired too they had the morphine right at the beginning. I didnt like that feeling. And then when the doctor did give me the oxycontin and the hydrocodone, i did not like the old funny feeling. You feel a funny feeling in your knee. And i just did not like that. It was like a heat feeling all around in your head. I didnt like that feeling no more. Host how did you support your heroin habit . Caller i went to jail. Like that guy said, i was burglarizing i was stealing. I used to go in the storesi in, miami in the shopping centers. I would steal everything. If you look at my record, a lot of it came from the drug use. I went to prison because of my druggies. Because of my drug use. I had to cry to the druge judge monday and i said, man, i need some drugs. When i got out i sent, god take this away from me. I dont want to live like this no more. I looked at myself and through the support of myself there are eight of us they showed so much love for me. That is what made me want to get off of it. I said, i cant be like this. I dont want to be like this. That helps you too when you see love coming from either your family members and some outside guys who try to embrace you and you just a want to live like that no more. You dont want to live for the high. I wish i could be an as set to help somebody. If something called my number four whatever. Or whatever. Man, i can relate to these people. I can tell them how to get off of it. I can let them know, this aint you. You were not born with this habit. You dont need to get high. And you know what i always make a joke of . It was a good time to get high. And i just look and i left now. I dont want to see nobody on durgs. I dont care if you are black white, spanish, whatever. I have seen women destroy themselves through this drug. I haete to see this. I had a couple and i hate to see that man. Im seeing good girls, talking about, i have a couple of white friends named mike and lois, some white guys from new york. And i used to talk to them and we used to kick it around and stuff, and we shared stories and stuff like that, man, and host thanks for your time this morning, and thanks for sharing your experience. Ken is in capscale new york, a medical professional. What kind of medical professional are you, ken . Caller i should clarify in 1970 and 71, i worked for a new York State Agency called the narcotic addiction control commission. I was trained to some degree to be a Substance Abuse counselor. I was very young, early 20s, with no personal drug experience. I had never used any drug. Not even tobacco. But we were given case loads of people who had been certified by the state. New york state was attempting to solve the heroin problem by considering heroin use a medical issue and not a legal issue. So if you were arrested for burglarizing an apartment and could demonstrate that you were a heroin user instead of going to a conventional jail you would go into a treatment facility. Most of them were very well intentioned facilities. Under the state, some were set up oldschool, some were set up in prisons. One of the problems, we had people started declared themselves addicts because it was much easier time to do to commit a crime that was the problem. And it was also the beginning of a cycle of selfpity, if i may. People started seeing addiction as an illness that befell them when really, it was a choice they made. And then when they would detox, they would hit the street and a lot of the guys would say, wow, i feel great. I think ill just get high once or twice more. And then ill illustrate life, and then they would get back into it. And here we are, 4045 years later and were going into another cycle. But let me just sum up by saying that im personal appalled that the open opiods theyre selling now are so readily available now. I had used oxycottin. I had surgery about eight years ago and i experienced the feeling you get from those drugs and its an interesting experience. I dont recommend it to anyone especially if theyre inclined to addiction. But i also want to point out many people are addicted to behavior such as gambling. Its a mysterious problem. Host were going to leave it there and hear from ryan in houston, texas. Ryan, how have you been impacted by heroin . Caller i want to start by saying that heroin is really a suckers drug, you know what im saying . I come from new orleans. These people here, i hear a lot of people saying, you know, it was this and it was that. In new orleans a lot of guys, we started loving using heroin because we thought it was cool. We was wearing high fashion, you know what im saying . You would see us on the street and you wouldnt think that we was on heroin, you know what im saying. We were highfashion, we were looking good, feeling good, you know what im saying . So to us it was like cool to do. But we all found out that it wasnt, you know what im saying, and in new orleans you go, you know, it was cool you see all the people was doing heroin, they was the coolest you know what im saying, so we thought that was cool. Host how long did you caller in the long run, people would still look us and not know that. We would come out looking like a million bucks and go get high but we was addicts. We would go to work every day. Im not trying to put that like heroin is cool but heroin was, you know, you go to work, you know what im saying, you go get you a bag of joy do your bag and you just chill. Its just like drinking a beer. Host ryan, how long did you use heroin . Caller its the devil. Dont get me wrong. But we didnt look at heroin as Something Like the rest of these people looked at it, you know what im saying. It took a lot of lives and a lot of people, but we, you know, its a suckers drug. Host ryan. Im going to move on to dan in exet exetter, New Hampshire. Dan, how have you been impacted by heroin . Caller good morning, peter. I had two sons. When my youngest son was 18, he started using heroin. My oldest son was living in florida. We were up here in New Hampshire, and after two years of spending about 150,000 in treatment, my oldest son moved back and was going to help with his younger brother. After about a year, he got addicted and he overdosed and died. My youngest son is still addicted. I believe the drug industry who reached huge profits he did start with oxycontins off the street, and it rose to almost 70 a pill. He went to heroin, which was 10 a bag. So two things i would love to see happen as you showed a photo of the overdose drug while you have to get a prescription and blah blah blah i would like to see one of those hanging around every addicts neck. My oldest son when he odd what happened was, he was in a car and this happens often is the people when somebody overdoses, they dont want to ruin their high. They pulled up and threw him out onto the sidewalk. So he was found dead on the sidewalk. Now, if they had that drug, norcan or whatever, around his neck, anybody could use it, and the drug company should pay for it. And then theres another drug testing now, which is new, an injection drug. It lasts a month. But the patient is but the problem is, the patient has to be clean for 10 days and an addict cannot stay clean for 10 days, so that has to be an inhouse program. So its impacted me. Its funny because i remember the day sitting in my bedroom when my son told me that, and as it came over his lips, i saw my future of what it was going to be like, and in an instant but i never realized how hard it would be. Host dan, why do you think they started . Caller they start like anybody else, the kids, they get it in the schools. You know another interesting thing, my youngest son, when he was in the sixth and seventh grade, he was hard to handle at school, blah, blah blah, and the school told us, okay, hes got to go on riddlin and if not, you got to take him out. So had to put him on a ritalin. I caught him crushing up the ritalin and snorting it, and i believed thats where his drug interests started. So its tough, peter. Host where is your youngest son living today . Caller he lives with me in my basement in my house. He cannot live on his own. Hes on the methadone program, and as far as the last guy that called, its a typical republican response, its a choice. You know nobodys saying to all the crimes that the addicts commit, stealing robbing, or whatever should be no its only the crime of possession of drugs that should be treated as an illness. Host has he stolen from you . Caller oh, my god, hes stolen from me. Yeah, hes stolen checks from me. Hes stole enn thousands of dollars. Host so dan, i know this was an issue in the New Hampshire primary and a lot of the candidates talked about it Chris Christie Hillary Clinton, et cetera. Is there, in your view, a headrolling response to this issue . Caller yes, there is. Theres federal funding. And again, i go back to the tremendous profits of the drug industry. Host and whats being funded exactly . What should be funded . Caller inhouse treatment is the only thing. I live in New Hampshire. This is how screwed up New Hampshire is. My son has to get a massachusetts address, or a friend of his, so he can get on mass health to have this stuff covered. If he didnt have access to the Massachusetts Healthcare system, hed be dead by now. Host how clean is he right now . Caller hes clean now because hes on methadone. Every day, hes got to go down to the clinic. That takes away the urge. As the other addict was telling you, its not to get high anymore. Its to stop the withdrawals, which is allencompassing. So hes on hes counseling. This is all through mass health. Host the comprehensive program that hes on, is it effective on a daytoday basis . Caller yes, it is. But the long the underlying problem that addicts have with their personality, that has to be resolved. Now, hes got the guilt now because his older brother overdosed, and he feels its his fault. So all the pressures of life for drug addicts to the drugs. Host thank you for sharing your story with us this morning on the washington journal as we talk about the heroin epidemic in the community and in the United States. Its estimated that 700,000 or so people are addicted to heroin at this point in the u. S. Anthony is in wilmington, illinois. Go ahead anthony. Caller id like to make a comment why theres no mention of no mention of that new heroin called crocadill. Host what is that. Caller i just saw it on netflicks. Its like a flesheating disease where the bones are coming out of these people. Host from using heroin . Caller its a new heroin called krokodil, and theres no mention of it right now. Host we appreciate you bringing that to our attention. Michael is in lancaster california. Hi, michael. Caller good morning. You know, krokodil is something they use in the ukraine. They mix it up and shoot it. It has nothing to do with heroin. But you know, the way to get off these drugs is you just have to stop. Thats it. Just like coffee. You drink coffee. I quit coffee, and it was hell, i tell you but there was two years of driving by, and every time i smelled coffee, it would kill me. But if you just stop, you just got to stop, go through the sickness you know, Congress Wants to spend billions of dollars, its just and the guy whos got his son living in the basement, you know sometimes you just got to kick them out and let them go on their own, and then they stop. But if you keep, you know methadone is one of the hardest things to get off. Its way worse than heroin. You dont use another drug to get off a drug. They use methadone, i hear it will about kill you to get off of that. Host do you have personal experience with that, michael . Caller yeah, i and i got on some pills and i was on pills for a while, and some heroin, and about two years, and finally, i just said, man, ive had about enough of this and just quick. Host michael, again, back to the research for this program. A lot of what we saw said a lot of people who are on heroin today started with prescription pills. They couldnt get any more, so they went to the alternative, which was heroin, and it was cheaper, et cetera. Caller i started me and my friends started getting into the medicine cabinet of our parents and stuff and heroin just came in. The heroin is coming over from mexico like you wouldnt believe. But but its a different high. The pills and the heroin are different highs. So you just you cant be my family had to let me go. I was on the street. There was no choice. I laid down by a bush in long beach and i stayed there for about four days, this old lady came out and gave me water. I was determined to get off of it. And it took about five days. Host michael, you said your family let you go. Our previous caller dan has his son living in the basement. Caller he is not going to get any better if he can just stay there like that. And hes on that methadone, which my god, to get off that, its like twice as hard as heroin. Its five times as hard. So you know, pick another drug. Methadone is the worst thing they ever made. Its a synthetic heroin. Host michael, as far as federal policy, state policy, what kind of treatments or policies could be effective in treating . Caller you know, first, the person has to be sick and tired of it. You have to just be tired of it. And then youve got to want to quit. People come in, and they go in these rehabs. In a rehab, theyll get 90 days or whatever rehab, they get out and go do it again. They go hang around the same person. Youve got to change. Youve got to change your whole life, change your friends, change your people. And its really not that difficult. And youve got to get up every day and youve got to say today, i am not going to use, today. Not i aint going to use for the whole week. Just today. Host michael, are you in a 12step program . Caller i did go. Im holding my narcotics anonymous. Those places are getting to be now, oh, there must be some underlying cause why youre getting high. Well, no, theres not. Anybody would get addicted to heroin or pills if you abuse them. You know, your body needs it. You start feeding it and your body loses, like cigarettes or something. But its just anybody, its not a sickness. I mean, its sick, but its not a sickness. And i dont know, in congress, well, congress has come out with a bunch well, you know, thats the taxpayers money. Its not their money. And they spend it like i mean its just crazy. You know what theyre going to do is get all these rehabs going and these guys are going to come in and out, they might want to clean up for a little while, go back out, clean up, go back out, and its just going to cost the American People billions of dollars and, you know, sure it will help some people but those people probably would have been saved anyway because they were tired of it. Youve just got to be sick and tired. Host michael from lancaster, california. Well weve got a couple of guests coming up. Were going to continue this conversation. If youre on the phone line, just stay there because were going to continue to take your calls throughout this program. Coming up, were going to talk with Daniel Raymond. Hes with a group called the Harm Reduction coalition, and well talk about what his group is doing to cut the number of heroinrelated deaths nationwide. After that Megan Mccarthy will be here. Shes chief of a newsletter called Morning Consult and well talk about state and federal governments and what theyre doing in response to this heroin epidemic. First, back to the hearing from this week on capitol. This is representative john micah of florida talking about the death toll and the toeth of Drug Overdoses. Death toll of Drug Overdoses. Death toll. Rep. Mica unfortunately, america is experiencing Drug Overdose deaths. Today, Drug Overdoses are the leading cause of accidental death in the United States. In 2014 i dont have the 2015 figures in yet, but in 2014, listen to this, there are 47,055 deaths caused by Drug Overdose deaths. That means that this hearing lasts for two hours, 10 people will die in the next two hours in the from Drug Overdose death. For americans and this is a little chart showing the increase since 1999. Remember, i chaired criminal Justice Policy Oversight Committee from 98 to 99, and we thought we had an epidemic back in 99 with 16,000, and i can show you some of the headlines from my local newspapers, where we had people dying over many people dying over a weekend. Unfortunately, thats what were seeing again in my community and across the United States. Unfortunately, more americans have died from drugrelated overdoses in one year than all that were killed in the lengthy korean war. If the current trend continues, the annual death rate could climb beyond those killed in vietnam over that multiyear struggle in one year. The graph from the Washington Post illustrates the disturbing rise in Drug Overdoses between 1999 and 2014. Of the 47,000 more than 10,000 americans died of heroinrelated overdoses. Heroin use is increasing at a faster rate. You want to talk about a war on women and war on our young people, the heroin deaths are killing our women twice the rate of men and 109 more with our youth. Unfortunately, weve seen, according to the centers for Disease Control and prevention that again heroin use among the deaths among our youth between 1825 in the past decade have soared, and again, lead the statistics, the deadly statistics. Host and joining us from our new york studio is Daniel Raymond. Hes the policy director of a group called Harm Reduction coalition which is what, mr. Raymond . Guest good morning. The Harm Reduction coalition is a National Organization working to address the Health Issues associated with drug use. Host how did it get started . Guest we got started about 20 years ago. This was back in the early 90s in the height of the aids epidemic, and we came out of the movement to Start Exchange programs across the country to prevent hiv from spreading among people who inject drugs and bring them into healthcare and other services. Host how are you funded . Guest we have some state and city contracts who do training and education, and we have some grants from private foundations. Host any federal monies . Guest currently we dont have any federal funding. In the past, weve had funding from the centers for Disease Control for education. Host how did you personally get involved in this issue . Guest i got involved back when i was in college in new york city, and this was ground zero for the aids epidemic, and it was all around us. It was also a huge moment in the history of drugs in new york city, where there was a lot of drug use, a lot of drug dealing, and it was the perfect storm, the perfect environment for hiv to spread, so i started getting involved as a activeist doing Syringe Exchange and found out it was extremely rewarding, the connections you can make with people that use drugs, the conversations you can make, and getting healthier was a powerful motivator for me doing this work. Host do needle exchanges work . Guest they absolutely do. Its not just been my own personal experience. Thats been born out by years and years of research. They definitely work to prevent hiv and also work to help get people into treatment, people who have often been using, then struggling for years and years, and need that helping hand. We have a lot of examples of needle Exchange Programs across the country that are on the front lines of fighting overdose, of providing healthcare, of getting people connected to Addiction Treatment and recovery services. So theres no question these programs work. Host Daniel Raymond we have been talking with our viewers for the last 25 45 minutes and weve heard incredible stories about the power of heroin addiction. In your view, whats the best way to get people off of heroin or simply to manage the addiction . Guest well, when you look at what works most effectively, theres no solution thats going to work for everybody. I think your last caller was talking about how he quit, and thats a path that works for some people. The best evidence says that if you use medication, such as methadone, alongside with counseling and other support services, people stay in treatment for longer and get better results. Everything we know tells us if youve got a heroin problem, the best chance of success and recovery is to work with a doctor to get treatment and work with counseling to get support to help you stay on that path. Host heroin deaths according to the c. D. C. Are up 286 , Overdose Deaths, over the last 15 or so years. Are you seeing a big increase in new york city . Host weve definitely seen an increase in new york city. Weve started seeing increases in different parts of the city around prescription pain killers, opiods in places like staten island, and also seen these rises in heroin deaths in a lot of different parts of the city. Staten island but also the bronx, parts of brooklyn. Its a phenomenon that is hitting all parts of the country. Host Daniel Raymond, youre at our studio on 42nd street in new york. You know very commercial, nice neighborhood. Could you go out in 15 minutes and get some heroin from where you are right now . Guest well, i think one thing to understand is how the heroin market has changed. The image that a lot of us have is from back in the 70s and the 80s, that you find some dealer on the street corner, that you go into what seems like a bad neighborhood and you score some drugs. But right now, a lot of heroin dealing is much more subtle, much more invisible. You have a contact that you text. They arrange a meeting location. It could be a parking lot outside of a coffee place. So its not so much that visible street scene that weve been used to seeing from the 70s and 80s. Its almost like an uber or seamless model that you have a connection, you meet your dealer some place, and you get heroin. Host if you want to participate in our conversation this morning about the heroin epidemic in this country, 2027488000. If you have impacted by heroin use, 2027488001 for medical professionals, and 2027488002 for all others. We want to show you this map and this is the the redder parts of the map is where theres been an increase or higher percentage of heroin deaths and overdose in this country. You can see the impact, a lot of appalacia there, florida, out in the west, a lot of red areas out in the west as well and up in the northeast. John is in philadelphia. A medical professional. John, youre on with Daniel Raymond of the Harm Reduction coalition. Guest good morning, peter, and thank you for cspan. Im 64, im retired now. Disabled actually. I feel three stories and broke my neck and broke my back. Thank god i can walk and everything, i was a stroke victim. I was a Substance Abuse and Mental Health counselor in North Carolina. I put myself through grad school and i was working. This was in 90, 91 and it was the crack cocaine epidemic that was happening then in North Carolina. It was working its way up and down the east coast, and i so i worked weekends when i was in grad school, and i worked alternating weekends at the county treatment facility, and the other alternating weekends, i worked at charter hospital. There was a different level of care in each one obviously. Back in 91, it cost 1,000 a day at charter hospital and what you had was professionals and people with good insurance. The rest of the people who didnt have insurance, you know, they went to the county Treatment Center. The county Treatment Center was pretty good, but it didnt have the facilities, and it just they couldnt take people. They couldnt take enough people in. Host so john, as a masters level counselor, is there a solution to whats going on in your view . Caller well, thats a long story, peter but ill try to make it real short. Yeah, theres a solution. Im a recovering alcoholic, and also, i was on oxy for four years, and i came off oxy with no problem. So different people are affected differently by different drugs. People have their different forms of triptonite, okay. Ive tried a lot of different drugs. Nothing affected me but alcohol that was my personal. My kriptonite. Heres what i think. People have a biosocial model. What that means is youve got to treat medically, socially. In other words, they have social problems, people dont have work. You know theyre living on the street. Thats a social problem. Psychosocial. Youve got to treat the psychological problems. Host john, i think we got the point. Daniel raymond, any response for that caller . Guest john, thank you for your observations and your insights from the field and from your own experience. I think the point that you were making about the limited treatment capacity in North Carolina when you were working in the early 90s is what were seeing play out in states across the country right now, that there are waiting lists for treatment. There are shortages of beds, of facilities, of trained physicians, of trained counselors. And were confronting this crisis in the midst of the big gap in our treatment capacity. We just dont have the capacity right now to get everybody into treatment tomorrow. So i think thats going to be an issue that congress and the white house are going to be looking seriously at over the next several months. Host Daniel Raymond, can you be a functioning citizen if you are addicted to heroin . Guest yeah, definitely. You can hold down a job, you can hold down a relationship. At some point, most peoples trajectory starts to escalate. They need more and more heroin to function. That means that they need more and more money to support their habit. So not everybody can sustain that indefinitely. But i think what youve heard this morning is that addiction cuts across all walks of life, whether its the functional alcoholic, or the person whos getting arrested or losing their home. A lot of it has to do with the circumstances in which youre able to maintain your habit. If youve got a job, if youve got an income, if youve got some money. If youve got more social support, then you have more of a cushion around you. Whereas, if youre exposed to situations which are going to lead to getting arrested, then you might be spiralling further into harmful patterns. Host in your view, mr. Raymond, why do you think the heroin epidemic the use of heroin in this country has increased so exponentially recently . Guest i think theres a very simple answer to that, that over the last 20 years, weve seen a dramatic increase in the use and availability of prescription pain killers, opiods. Theres been a brought effort to use opiods more widely that was supported by the pharmaceutical companies and manufacturing them and some people who felt understandably that maybe we were undertreating chronic pain but the consequences have been devastate devastating. Millions of people have been exposed to opiods and some of them have gotten dependent on them and its created this market for heroin that did not exist before. Weve had heroin in this country for decades but not at the level were seeing at. Its the people who first got exposed to opioids, whether they were prescribed or found them in a friends medicine cabinet. Its the prescription of opioids that started it. Host a box of rocks knows that heroin is bad but people use it anyway. How much money can fix that . People will abuse drugs or anything until the end of time. Guest i hear that sentiment a lot, and theres a couple of pieces there, that people will use drugs, that were not ever going to get to a place where weve finally solved our drug problems once and for all. Its a part of whatever you want to call it, human nature, culture, that our goal is not going to be lets imagine a time where there are no more drugs and no more people using drugs. At the same time, pretty much everybody has made some bad choices or hard choices at some point or another in their lives. It may not be drugs. It may be something else. A bad business investment, a bad relationship, a bad argument, and i think that we have to think about what our role is in helping to mitigate the consequences of peoples choices. That doesnt mean theyre not capable of making choices. That doesnt mean theyre not responsible for the choices that they made. But when we see people getting into problems with drugs, i think we need to step back and say is it in societys best interest to keep following, or is it in societys best interest to say we dont want to see families torn apart. We see potential in these people. We see potential for recovery, their potential for growth, their potential for contributing to society, and we want to help them fulfill that. Host wayne is in jonesboro, georgia. Go ahead, wayne. Caller good morning, sir. 5 been ive been around this almost all my life, Prescription Drugs and street drugs. Ive seen both sides of the fan. And to me, it looks like the major problem is it starts off with the pharmaceutical companies. Which are making trillions of dollars off of these people getting on heroin. If they have to go in for surgery or something and they have to have opiates when they come out and theres no movement to get them off, and they want to switch them over to other drugs like methadone and say that theyll host wayne, is that what happened to you . Caller no, sir, no, sir, thats just what ive seen from friends that, you know, i would never have thought of never tested in the world. My brother though at 42 died of some kind of chemical imbalance, of some kind of methadone, and some kind of other pill. I dont know what it was. But i know methadone was involved. Host thank you, wayne. Daniel raymond any response . Guest yeah, raymond, thank you for your story, and im sorry to hear about your loss. I do think that that speaks to an experience that a lot of people have had. And National Surveys are bearing this out. A lot of people know somebody who developed a problem with this prescription pain killers. They might have gotten prescribed after a surgery, after an accident, for chronic pain. And i think that collectively, were starting to see, we have overprescribed these pain kill ers and maybe miscalculated whos most going to benefit and whos more likely to suffer harm from them. So thats why we saw a couple of weeks ago, the centers for Disease Control put out guidelines for primary care providers to say if you are considering using opioid pain killers to treat chronic pain, heres some principles. Dont use them as your first line of therapy. Try other things first. Go slow, and stay slow. Stay the low dose. And monitor people closely to see if theyre getting into a problem and then look at tapering, look at strategies to reduce the risk for developing a serious problem. So were seeing a concerted effort to saying weve been too generous, too liberal with our opioid prescribing, and thats creating this crisis now where people are getting dependent on opioids, people are overdosing. We need to start to recalibrate that, reign that back in make sure people who do benefit from the opioids and who do need them for pain still have access to them but at the same time say we cant keep writing prescriptions for opioids when there are better ways to manage pain. Host recently in the Washington Post was this information over 900,000 physicians in the United States, nearly every one of them can write a prescription for opioid painkillers but to prescribe treatment drugs, doctors must take an eighthour course and apply for a special license and fewer than 32,000 doctors have received such a license. What is that treatment drug, Daniel Raymond, that can be used . Guest its called sabaxone. It is derived from the same its an opioid drug that can help transition people off of heroin, off of the painkillers theyre addicted to and it also has a lot of benefits. Its very hard even if you take too many doses and overdose on it. Its been very successful in treatment, but when it was introduced back about 15 years ago, the way it was set up was requiring that you have to go through a special training course. So its a much higher standard than doctors need to actually write prescriptions for painkillers. Were also seeing that theres a limit to how many patients a doctor can treat. You can only treat 30 patients in the first year, up to 100 after that. So congress has taken a look at this. The white house has taken a look at this, and were starting to say if we want more doctors treating addiction then we cannot impose these constraints that disincentives them from becoming prescribers who are qualified to prescribe buprenorphine and support peoples treatment and recovery process. Host do you agree with that . Guest i absolutely agree with that. Its been alarming to me to hear the stories of people who have been seeking treatment, who have tried other things, who have tried detox and rehab and trying to quit on their own, they havent been successful, so they tried desperately to find a doctor who can prescribe them buprenorphine so that they can get on that path to recovery theyre trying to seek. And you hear these stories of people who have to call doctor after doctor who says, im sorry, im not taking new patients, ive reached my cap, who have to drive hundreds of miles to find a doctor to take them. The most tragic of all, who die of an overdose while theyre waiting for a slot to open up for a doctor who could prescribe this drug to them that could have prevented the overdose in the first place. Its really serious overdose we need more doctors who are able to prescribe buprenorphine. Host Daniel Raymond, earlier this year, congress lifted the ban on needle exchanges. Was that a positive development . Guest absolutely. Congress took a look at what had been a longstanding prohibition on use of federal funds for Syringe Exchanges. Back in the late 80s when these programs were very new there was a lot of concerns about, are they going to send the wrong message . Are they going to encourage drug use . And there wasnt a whole lot of research on them yet in this country. So 25 years later, weve learned a few things. Weve learned that these programs work so theres no more concerns about research, theyre not encouraging drug use. Theyre actually helping people. But we also have seen that as the drug problems have spread into outside of urban areas and really into suburban rural areas across the country, that the big cities were prepared, because states like new york have needle Exchange Programs but places like rural appalachia dont have needle Exchange Programs and thats where were seeing it spread the fastest. So the process that limited these federal funds was contributing to the spread of hepatitis c, and when congress recognized that, they revised their policy. So this is a very positive sign and were hoping for some good news in the near future around more guidance about how states and communities can redirect their federal funds if this is a solution that makes sense for them. Host wendy in hedgesville, West Virginia. Youve been very patient. Youre on the washington journal. Caller hello, good morning. I just want to say that i am almost 90 days clean from heroin. I got clean on january 6th and i just dont understand why no ones talking about the aa na program, because thats what saved my life. Methadone, suboxone and subutex took me back to addiction. I got my suboxone and sold them for heroin. I kept going up on my dose until i got the same effect i was getting from the heroin so it led me back to active addiction, and i had to lose everything to want to get clean. I lost my house, my cars, my drivers license and ultimate, cps stepped in and took my kids. So i came to West Virginia, got clean, detoxed myself, was sick as could be for 30 days. Went to aa every day. Got a sponsor, read the big book, and im working the steps and this is the only thing that has worked for me. Almost 90 days clean is the longest i have been clean in 10 years. Host wendy, how did you get started on heroin . Caller oxycodone. I went to a Pain Management doctor in the baltimore, washington, area and all i have is arthritis in my lower back. They made me do an mri and he gave me 120 milligram oxycodone, and it just escalated. Fent fentanyl patches. I was getting discharged and doctor shopping. And when maryland caught onto that, i just got discharged and went to heroin. Host and how did you find the heroin . Caller well, Daniel Raymond, one thing i disagree with, you can find it everywhere. An addict can spot another addict. You can spot a dealer. Its everywhere. Its all over. I could go to the 7eleven or sheets or whatever and i could spot somebody. Its that common. Its not subtle. Its out there. Its everywhere. And also, i disagree with Daniel Raymond on you cannot function as a heroin addict. You wake up every morning, youre dope sick. You cant get your kids on the bus. You cant go to work and thats just how it is. Host wendy, did you lose your job . Caller i lost everything, yes. I lost my job, my house got foreclosed, my drivers license, my car broke down on the side of the road. I was so dope sick, i left it there. They towed it. I never got it. You dont care about anything. I went to get my kids from school one day, cps came to my car and said youre not taking them. This was just in october 2015. You cant get them here on time. They say youre a mess every morning, and that was the day god interfered in my life and i came up here and i got clean. And i still used from october to january, even though my kids got taken, i still used. Overdosed three times. And finally just had to get clean. Host wendy, why did you go to West Virginia . Caller because my parents, i lost everything. My sister had my kids and i called my parents and said give me one more chance. I tried all the rehabs, the clinics, kept relapsing, relapsing. They gave me one more chance. I came up here fought through the withdrawals, to the emergency room, swore i was dying. The doctors kept being positive go home, suck it up, stick it out, and youll get through it, and i did. Host you detoxed mostly at home . Caller at home, in a bedroom, with immodium ad and benadryl. Host and your parents . Caller and my parents. Host and you go to a meeting every day . Caller every day. Host wendy, thanks for sharing your story. Daniel raymond. Guest wendy, i want to thank you, too and congratulations, im glad youre doing well, and congratulations on coming up on your 90 days. I understand what youre saying. I do think that youve said youve tried methadone and buprenorphine and it didnt work for you. Aa and na were the only things that worked for you. I know a number of people that said aa didnt work for me. Na didnt work for me. Methadone was what worked for me or buprenorphine was what worked for me. I think like any other kinds of medicine, if were treating this as a serious disease, that its not one size fits all, but we have to find the right treatment for the right person and its not a question of having enough options for people, its about making sure that all the options are available and that we find people ideally before theyve lost everything. I hate hearing stories about people who had to lose everything before they got help. And thats got to be something weve got to intervene in earlier, wherever possible. Host john is in waterbury, connecticut. Youre on with Daniel Raymond at the Harm Reduction coalition. Caller yes, good morning, and thank you for the program. I would like to also say to wendy, blessings and good luck on your recovery. Im not one of these people whos going to sit here and think that this is all great and all. , that its just a simple problem. Its a huge problem. Its a selfinduced problem. And i truly feel the only cure is being clean. Wendy made it perfectly clear. I cant speak on it, ive never been addicted to it. The problem i have is you guys guys not particular people, but programs for recovery are taking money from Senior Citizens who are healthy and worked their whole lives and also children who are in schools who could be benefitting from sports and music and other school programs, and you want to take those taxpayer dollars and put them towards people who dont want to be clean which is the simple truth. You cant put poison in your system and think youre going to be able to function normally. And you know, how do you go about justifying that you could go on one drug from another when i bet you 100 youre not going to go and put swamp water in your car and think youre going to be able to drive it to work. I just dont understand how youre justifying this problem by trying to say, well, we have drugs that will bring you back to life and these people are going to live on the street and cause how many millions of dollars, whether it be through hospital care, Psychiatric Care the problems they caused for families and society in general. Host i think we got the point. Daniel raymond, a response for that caller . Guest i think theres a certain point where we have to ask, are we going to treat people who suffer from addiction different than we would treat people who suffer from Heart Disease . Are these all medical problems . You talk about them being selfinduced. Some people develop physical problems that are related to lack of exercise nutrition obesity, things like that, smoking, all of these things. Where do we start to draw the line about whos deserving of health and whos not deserving of health . I think an illness is an illness. Addiction is an illness, and recovery is a very difficult process. Ultimately, investing in treatment actually saves money. Were not necessarily taking away from here or there. If we make these investments we know that that every dollar we spend will come back to us many times over as people become more stable, more economically productive, pay taxes, support school, support all of those things that i think that we all care about. So i dont think that its an either or situation. Host Daniel Raymond whats the role of insurance in treatment . Guest i think thats a big issue right now. We have typically had a treatment system that has, you know, for decades operated outside of the rest of the medical system and insurance has always treated addiction as something of a secondclass citizen, that Insurance Companies have not covered provided the same level of coverage for Addiction Treatment as they have for treatment of physical diseases and conditions. So theres been a big push thats been part of federal law now, but also worked with some attorney generals who are saying, listen, if youre an Insurance Company and providing an insurance policy, Health Insurance doesnt just mean physical health. It means behavioral health. It means Mental Health treatment. It means treatment for Substance Abuse disorders as well, and you have to show parody. You have to parity. You have to show the same. You cant say well treat your physical conditions but not your Mental Health. That gap is starting to close, but its been a slow process. So i think there needs to be a big push around getting insurers to take their responsibility seriously in providing coverage in helping to manage both Mental Health and Substance Abuse disorders. Host tracy is in cambridge, maryland. Go ahead, tracy. Caller how are you doing today. Id like to touch on a couple of points. I started doing heroin back in the early 90s. Of course, went through the problems with the family, not wanting to listen. Im only 43 so i havent really been a long time. So going in and out of jail, not wanting to listen. Been through rehab, Serenity Lodge in chesapeake, virginia. Heroin was just as easy to get in there if not on the street. Got out of there, went right back to it. Ended up, you know traveling around doing whatever in the late 90s, ended up getting into a lot of trouble in a bad dope deal. Went to prison for eight years and actually had easier access to better heroin in there than i did on the street. What it took and what ive seen, i ive sat with my friends for days, on their death bed trying to come off of heroin on their own. Ive seen them addicted to methadone, trying to come off of methadone and not wanting to go through it and getting back on the methadone because it was harder than coming off the heroin. Like the guy said a minute ago, making new drugs to counteract a drug, i mean, you can throw money at things as much as you can until you search for the source. Im not hearing anybody talk anymore like years ago about fighting the influx of drugs. Where are the drugs coming from . Who is you know, i believe it was cnn years ago during the afghan wars, 7080 of the worlds heroin came out of afghanistan, the majority the rest of the heroin, i believe, came out of southeast asia. Here again speaks to a point, if weve got a vested interest in afghanistan, weve got more troops in afghanistan now than any other middle eastern country, yet thats where the majority of their heroin comes from, and it takes a lot of poppies in a huge poppy field to get the sap from them to produce the heroin. These should be able to be seen by, you know, satellite imagery, things like that. I mean, im just im seeing throwing money at the programs, and i understand. The help, some people get the help. Some people use that help to get on other dope thats given to them such as methadone. Do you see where im going with this . Host well get a response from Daniel Raymond in just a second. Do you think what about legalization from your point of view . Caller oh, no. No, no. The devil is already on earth. You dont want to make him president. Thats what you would be doing with heroin. Host how do you manage your sobriety today . Caller im sitting here talking about it, getting shaky. I remember when i first got locked up after i was about two years clean. We went on lockdown in prison and they brought the cart in to give the diabetics their shots and just seeing that gave me knots in my stomachs and sweaty palms. Its an everyday thing. You have to say no. I dont hardly drink anymore, because i know if i do its going to mess me up. It just comes a time in a persons life where you just have to say enough is enough. I can quote you the serenity prayer and everything in the world, and that does me no good unless i myself want to stop what im doing. Host thats tracy in cambridge, maryland. Daniel raymond. Guest yes, i think tracy was talking about looking to the source of these drugs. Mentioning afghanistan. Afghanistan has been a major producer globally of heroin. But much of the heroin in the u. S. Doesnt come from afghanistan, and i think the challenge here is what i was saying earlier, that we wouldnt have todays heroin problem if we hadnt had the levels of prescribing and levels of availability of prescription opioids which some of your guests and callers have talked about as being the path that led them down the road to heroin, that if were talking about going back to the source then i think weve never had a world where heroin doesnt exist, and weve spent millions and hundreds of millions of dollars trying to eradicate poppy cultivation, trying to get farmers to use different crops instead of growing cocaine or opiates opiates. We have not had enough success with those strrpgategies to keep saying we need to keep doubling and tripling down on them. We have not shown where thats going to solve our problems. Instead, were seeing more heroin use now than we were 10 years ago. And i think we need to look at the underlying drivers differently. Its not just the availability of drugs. Its the desire and demand for drugs and the lack of Treatment Options for people that are going to work for them, and not all Treatment Options are going to work for all people, but if you dont have any Treatment Options, then we never were going to end up with more overdose and more addiction. So i think its really that demand side rather than the supply side that we havent done enough on, that demand in terms of the prevention level and in terms of supporting treatment more smartly and more effectively. Host Daniel Raymond is with the Harm Reduction coalition. Thank you for your time this morning, sir. Were going to continue this conversation about the heroin epidemic in the United States. Up next is Meghan Mccarthy, who is chief of a newsletter called Morning Consult. Well talk about state and federal efforts. [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap. Org]. Starting monday on cspan, the Supreme Court cases that shaped our history come to light with the cspan series landmark cases, historic decisions. Our 12part story brings together the most significant cases in american history. John marshall said this is different. The constitution is a political document. It sets up the political structures, but its also a law and if its a law, we have the courts to tell what it means and thats fine in the other branches. What sets it apart is the fact that its the ultimate president ial case. Its what you dont want to do. Who should make decisions about those debates. In lochner vs. New york, the Supreme Court said it should make the decisions after the debates. Landmark cases begins monday night at 10 00 eastern on cspan and cspan. Org. For this years student cam contest, students tell us issues they want the candidates to discuss during the 2016 president ial campaign. Students told us equality, economy, education and immigration were all top issues. Thanks to all the students and teachers who competed this year and congratulations to all of our win ers and every week day in april starting on the 1st one of the top 21 winning entries will air at 6 50 a. M. Eastern on cspan. All entries are available for viewing online at studentcam. Org. Washington journal continues. Host our conversation on the heroin epidemic in the United States continues with Meghan Mccarthy. Shes the chief of a newsletter called Morning Consult what is what . Guest it is it were one of the largest newses in d. C. Covering capitol hill and we have a Poling Division that helps us get at what americans actually think about the issues were covering. Host and your background is as a health reporter, correct . Guest yep. Host so in that background, is Congress Addresses the issue of heroin epidemic, and if so, how . Host yes, as someone who covers Health Policies for about five or six years, this has been a unique time, especially passing of the Affordable Care act and how much fighting has gone on and on with obamacare. You know, the center has a bill that sets up new programs to address the opioid epidemic. Host what kind of programs though . Guest a lot of it is helping states coordinate efforts or helping states get more federal funds to monitor the Prescription Drug use, to help educate doctors about prescribing factors and things like that. Host this bill passed this year. Has it been passed by the house or signed by the president . Host no tjust passed the house a few weeks ago. They have had hearings about different legislation. They havent moved the bill to the senate yet. House speaker ryan staff said its something they are moving towards and theres some things that could happen by the end of may. Host how much money . Guest that is a question that is still a Sticking Point. Theres obviously bipartisan action to address this issue, but how much money to spend on it is the question. Still something that separates democrats and republicans. And the senate wanted to spend 600 million to bolster the effort to fight the epidemic. Republicans voted it down and hopefully it will play out in the house. Host we spend about 50 billion a year on the war on drugs. We spent about a trillion dollars in the last four years on the war on drugs. What do we spend in the macro on treatment type issues . Host thats a good question. And i think both sides might disagree on exactly how much money gets spent on that, and its not a large portion of the federal budget. Theres a couple of different agencies involved in these efforts, the cdc. These are smaller items in their budget. Host is this a partisan issue, democratic or republican issue . Guest in health policy, theres bipartisan cooperation before something gets done. The biggest Sticking Point remains whether or not to appropriate more money to do that, or if theres existing funds you can call from to fight this epidemic. Host what about the states . Guest in the state level, you see and i think this is kind of common but because its such an acute regional issue in certain states you see a little bit more activity you see more activity between democrats and republicans in passing legislation or spending money on prevention or treatment programs. Host 202 is the area code for all of our numbers as we continue our discussion this morning on the washington journal about the heroin epidemic in the United States. 2027488000 if youve been impacted by the use of heroin. 2027488001 if youre a medical professional and all others can call in at 2027488002. We want to begin with a call from carl in martinsville, West Virginia. Carl, Meghan Mccarthy out of Morning Consult is our guest. Caller hello. I have a child that has a heroin addiction, and we have been to princeton house in new jersey. We have driven to suboxone clinics, which are 50 miles away, and these last its impossible. I mean, if you have someone who works, they cannot get treatment 50 miles a, drug back home, and then try to go to work. The one thing that did seem to have an effect is a drug called vivitrol. Its a shot. It lasts 30 days. However, it sometimes wears off early. But we understand that ohio is trying the program where they use the vivitrol shot in conjunction with vivitrol pills so that when the shot wears off early, the person can then take these pills. And this has to be available in every single community. You cant expect people to drive 40, 50 miles to get this treatment. And then get back home and go to work. Because you have to realize that a lot of addicts have families and jobs. And you know, we need to provide something so that they can continue to function and hopefully conquer their addiction. Host carl has heroin addiction cost you money personally . Does your insurance cover any of this, and what would you suggest as potentially a federal policy . Caller well the vivitrol shot itself i believe was Something Like 1400 for the shot. Which you know, i think that the federal government got involved in this, they could bring the cost of that shot down, you know providing that it actually does work. We need to do some more research on all of these things. Host all right. Were going to leave it there. Carl thanks so much. Meghan mccarthy. Guest carl, you bring up a lot of points that are being highly debated right now. The cost of drugs is something that has really become a huge topic on capitol hill and for the federal government. The issue that youre talking about also, specifically you know, is that the different state guidelines for what kind of medication assistance and treatment people can receive so it is kind of a patchwork where youll have a different treatment in one state versus another state so thats something that the committees on capitol hill are looking at as well. Host in the past, congress has funded what they call demonstration projects, which are kind of experiments done in different areas of the country. Are they doing any socalled demonstration project funding for treatment in the United States . Host if so, you know, the agencies do have authority to try to fund things out. The center for medicare and Medicaid Services was trying to look at medicaid and limiting beneficiaries who they thought were the high risk of being prescription painkiller abusers limiting them to one prescriber and one pharmacy they could actually go fill those prescriptions at, and thats something that, you know the Senate Finance committee has looked at expanding to medicare so theres activity on that front. Host jeff is in gaithersburg, maryland. Go ahead, jeff. Caller good morning. I want to ask if anybody is doing anything to make sure we dont throw out the baby with the bath water. There are people in chronic pain that need these drugs and you know, this whole situation is lumping them in with drug abusers. I think its unfair. It creates a stigma thats unfair. People in pain didnt do anything to get that way. People that are hooked on heroin and opiates, obviously went outside the prescribing instructions to get hooked. Its an action they took on their own. And they really have no one to blame but themselves, but its hurting people in pain. And i wonder if you have any comment on that. Host thanks, jeff. Guest yes thats a point that the pharmaceutical industry definitely makes, that there are people out there that these drugs are a lifechanger, and they really help and eradicate pain that otherwise might not be addressed. You know i think a lot of the efforts are to educate doctors or to have the prescriptions that used to be, you know, 30 days, to maybe limiting it to seven days. Thats what massachusetts just did and other states are looking at efforts like that as well. Host jody tweets in it seems heroin addicts are becoming white kids in the suburbs, but not inner city kids. Its a big problem to be solved. Caller so you know, i think the statistics you have already cited on the program today shows us how widespread this issue isg so you know, i think the statistics you have already cited on the program today shows us how widespread this issue isu so you know, i think the statistics you have already cited on the program today shows us how widespread this issue ises so you know, i think the statistics you have already cited on the program today shows us how widespread this issue ist so you know, i think the statistics you have already cited on the program today shows us how widespread this issue is and it is certainly hitting senators and members of the house on the campaign trails and theyre hearing about it from their constituents. Host thomas in fairlong, new jersey. Go ahead, thomas. Caller hi, how are you . Thank you for taking my call. Well, lets see. Most of this problem actually starts when the little children and even babies, unfortunately, we have doctors prescribing rit lin and adderall which leads to meth later on, but these children are taking these drugs especially babies, inhibitors, they dont do the drugs anymore. What are they looking for meth amphetamine, heroin. As a parafactor, i treated people in pain for over 30 years without drugs, without surgery. Why isnt the government, the pharmaceutical industry and the Insurance Companies telling people go see a chiropractor when youre in pain. Its safe. Theres no drugs. We actually help these people even chronic pain people. We do get results, and i dont hear anybody talking about this. Throwing more money at the problem, not going to make any difference. Weve already spent 300 billion on Illegal Drugs and now weve got more people taking Prescription Drugs. Host Meghan Mccarthy. Guest so, you know, your comment makes me think of the c. D. C. , which just came out with guidelines last week or two weeks ago that basically suggest that doctors, you know, should try anything else before they prescribe these intense painkillers to patients, so look for other forms of treatment, perhaps choir oiros or other forms of treatment that arent addictive. Host a story in the recent National Review about dope sick tour through heroin usa. Looking at walgreens. How monitored, has there been an increase in monitoring of drug sales, etc. . Are they monitored pretty closely . Guest thats one piece of the bill that the Senate Passed recently is really trying to address, and a lot of these issues, again, is a state patchwork, so different states are doing more to monitor which doctors might be prescribing a lot more of these prescriptions and others, so the databases really vary on a statebystate level level. Host randal, stephenville texas, go ahead. Caller yes, maam. Im a veteran. Harm reduction was introduced into our classes two years ago and its really relieved a lot of us that were total absentence and dont have the discipline to walk the line and stay clean and sober. The question i want to ask is with relation to your comments on legislation. Were going to speak to our county attorney and we have a state representative here, returning dignity to the addict. Addict addiction is terrorism. Its selfinduced terrorism. I know. But my view is, couldnt we start a National Guard 2 . Not just a National Guard, but a National Guard 2 that was a Community Service. The other day in my home town, we had about 2,000 yards from me we had a tornado lift the roof off of a College Apartment and a laundry and some other damage in town. Is there any way a panel could study a National Guard 2, return these guys to the Community Service when they come out. Host out of stephenville, texas. Guest this is how to address people that are already addicted and how to get people into treatment, something that obviously getting on the discussion right now. Democrats on the president ial campaign trail Hillary Clinton specifically are calling for maybe not a National Guard, but would volunteer, participate in, but allowing the number of doctors that can participate in medicated assistance and treatment to be vastly expanded from what it is now. There are caps placed on the number of doctors that can use this kind of therapy and that is definitely one of the ways people are talking about addressing this epidemic. Host sea of tranquility tweets in, is there enough funding for medical detox . Guest i think the answer to that question would depend a lot on which side of the aisle you fall on. So democrats wanted to spend 600 million to, you know, buffer the bill that the Senate Passed. The president has called for 1. 1 billion in his fiscal 2017 budget to address the opioid epidemic. Republicans say theres already money line items in this for a budget, and Senate Majority leader Mitch Mcconnell specifically pointed to 400 million in the omnibus package that passed last year that could actually be for this. Host next call for Meghan Mccarthy of Morning Consult comes from virginia in langhorn pennsylvania. Hi, virginia. Caller hello. I think we are avoiding the whole issue. We have to seal our border. We have to declare war on drugs. We have to limit what our president can spend. Our president has spent trillions and trillions of dollars that could have been used for these drugs. Everything has to be limited. Its out of control. Host thank you, virginia. The war on drugs. Is there any talk of in congress about what to do with that . Whether to maintain or. Host so this is something thats coming up specifically in the house judiciary committee, as you know, the focus could be on stopping the flow of Illegal Drugs. Its something thats come up on the president ial campaign trail as well as how donald trump and ted cruz have kind of addressed this issue, talking about stopping drugs from coming in illegally from mexico. Host but that doesnt do anything to the demand. Host well, its definitely a point that they like to hit on that i think speaks to some of the supporters but yes certainly democrats make the point that is not actually stopping the flow of Prescription Drugs that are, perhaps, getting people hooked on heroin down the line. Host is there any talk at this point, about the legalization of some or all drugs . Guest theres been a huge debate on the legalization of marijuana. You know the issue here is a little bit different and unique because prescription painkillers are what are viewed as the big gateway into heroin and how the epidemic has grown so significantly and quickly over the past few years. So its kind of a separate track. Host patrick in vincenttown, new jersey. Go ahead patrick. Caller yes, i definitely wanted to state first off that i was a therapeutic addict. I had back pain and ended up being on up to 600 milligrams of morphine a day, but you just have to have the will to come off of it. I came off of it within two andahalf months. My point is within the medical professional, i think theres a disservice to the patients when you have Pain Management physicians that are putting patients on narcotic contracts or agreements where if they, you know, go over, you know do one little thing of a violation, you know, that they are completely dropped from being taken care of by the physician. I think thats a medical injustice. You dont see that in Heart Failure patients which Heart Disease and Heart Failure is a huge killer within the United States. You dont see patients coming in that have eaten chinese food and have gone into Heart Failure because they didnt follow the treatment or you dont see diabetics that are kicked out of treatment because their blood sugars went out of whack for a month or so. So i think that the focus and stigmatization has forced medical professionals to push them out of their offices due to minor violations as opposed to treating them as patients, and like the caller said before, the stigmatization of this, within the medical profession, is a big factor. They have physicians have to realize that they are creating it throughout this thing, and they have to follow through and not abandon the patient, putting them out into the streets, going into it to get heroin access and i think that one part of it, if we can when were talking about the opioid factor, and the prescription of it by the medical professionals, is they have to change their mindset. Host all right, i think we got the idea. Meghan mccarthy. Guest yes, so you know, the issue that i think is twofold, first, is that there are so many more doctors out there that can prescribe opioids than are actually trained to treat addiction. As weve been talking about, the different caps on medicated assisted therapy. It varies by state. And then, you know the point you may have is something that people have pushed back on in massachusetts, where you know, its limited to a sevenday prescription and the hardship that might place on certain patients after a major surgery, if theyre dealing with a terminal illness. And so policymakers are trying to figure out a way to write these laws that will help address this epidemic that theyre still figuring out as its going on. Host 900,000 doctors in the u. S. Most all can prescribe opioids. But only about 32,000 can prescribe the treatment for heroin addiction. And you have to take an eighthour course, et cetera for that. Nathan is in dayton, ohio. Hi nathan. Caller good morning. I am currently and will always be on opioids. I have a disability i was born with. Its a peripheral neuropathy that gets worse with age. Theyve alloweded me to function every day. I dont take it to party. I dont take it to feel good or forget things. I take it to function and ive got to say in the state of ohio its really disappointing that they have set up a random drug testing and pill counting for pain patients. Im waiting for the next step for them to start tracking my movements. I mean, this puts me in a situation where i feel like a criminal and i have done nothing wrong. I have done everything by the book, and they dont need to treat me like this, because theyre already tracking my medications medications through my pharmacy. Ive been questioned by my pharmacy before about why i need a particular prescription or do i need the amount of the prescription, but i was forced into a situation where i signed a release that would allow my doctor to share my results with the government. So now youve got the government who has access to my medical records, as well as her entire staff doing drug testing in the middle of hallways and you also have the fact that im disabled im going to be dealing with this for the rest of my life. And theres so much injustice in that. And i dont understand how this doesnt violent civil rights. I dont understand how this doesnt violent and become discrimination against the disabled, and i really dont understand how this isnt a direct violation of hipaa. My government leaders i called in the state of ohio most of them arent even aware that this is happening. I had to call for about two months before i talked to the pharmaceutical board, because not even a medical board understood what this was. Host all right, thank you. Lets hear from Meghan Mccarthy. Guest so you know, i think what youre bringing up, why this is so hard to address this policy, you know, healthcare is so personal, and it really, you know, hits people in places they dont want other people knowing about, and particularly, the government. It also kind of highlights how this is strange bedfellows in some ways for democrats and republicans, because this is its often stepping up government involvement and, you know, the monitoring of peoples healthcare, and thats not something that philosophically republicans are typically behind, but the issue is so acute in certain states that you see that effort and republicans saying that there is a role for the government in this. Host and john kasich, the governor for ohio, has talked about this quite a bit on the president ial campaign trail, hasnt he . Guest he has, yes, and its been an issue that a lot of the candidates, some of whom have dropped out now, have talked about on a very personal level and, you know, its a way for republicans, i think, too, to talk about healthcare where they dont have to get into obamacare, necessarily, and repealing Health Insurance for millions of americans and what theyre going to replace with that. This is a place where they can be seen as actually helping and addressing an issue that is allowed to. Host about 34 billion a year in costs in theft, economic, and healthcare costs is the estimated cost of the heroin epidemic in the United States. Marks in ben salem, pennsylvania. Go ahead, mark. Caller good morning. Thank you for taking my call. I dont think we have to reinvent the wheel and the statistics you said about the costs of this is staggering. The Insurance Companies is being overwhelmed with how many kids go back and forth to rehab. Rehab has been a great tool but also hardly unsuccessful in treating this because heroin, we have two heroin addicts in my family, and theyve been in and out of Treatment Facilities and halfway houses, recovery homes 16 times in the last year. I mean it just doesnt work real well if the addict is not ready for it. But what we have found is that addicts that have consequences and treatment for the parents and helping them understand, it doesnt work to be just a good parent like you used to. This disease takes on a whole different parenting skill set that we dont have as parptsents and get them educated so they know how to handle addicts. The consequences is what leads to cures, and thats free pretty much to get them into treatment. They have to be broken and not want to use drugs anymore before theyll even accept treatment and theres nothing out there like a transitional period from when they go into rehab, they can walk out whenever they want. The legal system doesnt provide any type of forced situation where they have to stay in for a period of time. And i think we can do something on that that would be really Cost Effective and also talk to the Insurance Companies about letting kids stay longer, the ones that are getting the benefits from them instead of letting them walk out the door after a week or 28 days, which seems to be the protocol right now. Theres a lot they can do. Host mark, has your insurance covered a lot of the rehab costs for your family members . Caller yes, its been really good but when youre in state sometimes, it covers a portion of it, and if you go out of state, its better for some reason. I guess its the outofstate benefit but ive seen a lot of families that have been cut out after the first five days of retox and theyre always saying oh, youve been denied, like the weekend, two weeks in. So theres no set protocol it seems like for the treatment. The max you can usually stay is 28 days and thats nowhere near long enough for an addict in recovery. Host whats been the impact on your family . Caller its horrifying. It destroys more families than you can even imagine. Ive seen thousands of families coming in broken, not knowing what to do, completely and emotionally destroyed. You dont understand the impact it has on the families. The addicts, you can see it visually but whats behind the doors is even much more damaging. Host if you could come up here and testify, mark, what would you suggest for the 535 men and women to do . Caller well, i would suggest that there is some sort of thing where the addicts cant leave the treatment on their own. Actually, it sounds cruel, but they need to be broken and have to reach their bottom. I would suggest when they get caught with a dui drug related, incarcerate them for a period of time but not ruin their whole life. Give them a chance to get it that theyre ruining their whole life. A lot of family members enable it, and its hard for a parent to throw the child out on the street and say you cant live here anymore or im not paying anything anymore. Its very difficult. Its a combination of the education for the family members who are suffering from this disease, maybe even shows on television have to do it because they just glorify the drug use and Everything Else these documentaries ive seen. They dont really talk about what really works and ive seen first hand what works. They have to want to do it and the only way they want to do it is the consequences get so great in their lives that they cant stand it anymore and they want to change but thats sometimes a really dark place. Host thats mark in ben salem, you heard what he had to say. Go ahead, Meghan Mccarthy. Guest mark, what youre talking about reminds me of another big debate on capitol hill which is Mental Health legislation and some of that is coming from republicans and from democrats. Its another area where theres bipartisan coordination. Theyre all looking at going as far as suggesting, you know, and requiring people to be committed for a certain amount of time but making it easier to get people into rehab, and to have sustained treatment instead of just going in and out every couple of days. So its not moving as quickly as the opioid legislation did but it is something that they are talking about, and it is something unique thats happening. Host valdez is calling in from mapleton, illinois. Hi. Caller good morning. This might sound callous and i dont mean it to be. Im retired Law Enforcement from california, and i told your screener that im not expecting anyone to inject the racial component in this but there were a lot of sick people we were putting in prison in the 80s and 90s and early 2000s when i was working and now all of a sudden, this is a sickness, a disease, its an epidemic, and the reasons is because its hitting a segment of society it never was intended. If this had been confined to the lower classes and the minorities, wed only be talking prison. And i do believe that, yes, we do need treatment but there is a crime in california called 11550. Its called under the influence, health and safety code, and possession of is a crime. So unless we go and do this across the board i am not in favor of any kind of treatment until they start treating everybody. But if we go according to what we always do, well put the lower classes in prison, and well put johnny suburb in rehab. So im sorry to put it that way, but thats just the way things are. So if you can address this for everyone, im right with you. Otherwise host valdez, when you talked about previously were you referring to the crack cocaine epidemic of the 80s and 90s. Caller a number of things. We called them junkies, users. I was assigned to the jail bus at one point, every thursday transported them down to california rehab, and they were just in and out. But, i mean, there was never any indication that they were going to get any kind of treatment. It was strictly incarceration. And they were heavy mexican population, so a lot of them were mexican people. But we didnt have this issue of suburban people being under the influence as much as youre hearing now. Host thank you, sir. So inner city poor people versus johnny suburb. Guest i think there is an argument to be made that the reason this is getting attention is because it is hitting people that are making their or their families are making their needs heard on capitol hill in a way that perhaps, you know, poor er populations struggle to do, and you know, what youre talking about also makes me think of criminal Justice Reform legislation which, you know, is similar to the Mental Health bills that i was discussing a little bit earlier. There is actual discussion about and there are democrats and republicans working together on that, but it is not happening nearly as quickly as the opioid population. Host this is from joe davidsons federal insider column in the Washington Post this morning about the hearing earlier this week in congress. The color of addiction, war then, the treatment now. Representative elijah cummings, of maryland, has seen the effects of drug abuse in his neighborhood in west baltimore pointed to the difference in the way heroin addiction is dealt with now compared to years ago. The difference between the war on drugs and drug treatment is like the difference between black and white. Quote, in baltimore, where many of the victims were poor and black, our nation treated this issue like a war rather than a Public Health emergency, said cummings, a democrat on the panel. We incarcerated a generation rather than giving them treatment they needed. Now things are changing, he noted, between 2006 and 2013, the number of firsttime heroin users nearly doubled and about 90 of those firsttime users were white. Elle marie in birmington, vermont. Hi, ellemarie. Caller hello. Host your governor in vermont has spoken out about this issue quite forcefully, hasnt he . Caller yes, he has. Host go ahead. Caller my story is rather simple. I was working as a med tech, had been in the medical professional for a few years, decided to get my rn license. Went back to school, 2008, i was assaulted, did damage to my spine, and i am now on disability. I refused to take anything stronger than codeine, although my doctor was amazed that it was still being offered. But having seen patients coming in and drooling to get their prescriptions, it horrified me. Then on february 19th of this year, i went to fill my codeine prescription, and my pharmacist told me it has been rejected by my Insurance Company and they wanted me to take either hydromorphone or morphine sulfate. Now, ive been managing since 2008 on codeine. My pain tolerance has increased. I wake up, its an average of a 3. If i work around the house and do other things, it can go up to a 5 or 6 or 7 and thats when i start, you know, hitting the codeine. But i have maintained since 2008 roughly the same amount of pills that i have started with, because i host so why do you think your pharmacy or Insurance Company flagged your account . Caller i have no idea. I had a fight with them, because i was in a lot of pain, to give me seven days of codeine, and then i had to go back to my doctor the following monday, and speak to her and have her fill out these ridiculous forms explaining why i couldnt take hydromorphone or take morphine sulfate because i had a deathly fear of it. I do not want to become one of those people who sits at their Doctors Office drooling because they need to take something that wasnt necessary. Host is it kind of like our caller from ohio, a little bit. Guest right, so i think this one of the things about this, Health Insurance and Prescription Drug coverage is complicated already. So its already difficult for people to understand or figure out, navigate what tier a certain drug is in versus whats not and whether youre going to pay a generic copay, youre going to get a brand name prescription thats going to cost you a lot more. So that might be whats happening there, in your case, but you know, thats already what people are doing just to get any kind of Prescription Drug. So when we add another layer of, you know government regulations, tracking, it just gets all the more complicated. Host youve mentioned this a couple of times but as far as legislative efforts actually becoming law, its an Election Year. What are the chances . Host so one thing the Senate Passed the house can move things faster than the senate often. It does seem like the bill could actually make it to the president s desk and be signed in law, which is pretty remarkable. Its an Election Year and with the fight going over the Supreme Court nominee right now. So its actually one of the few things that might make it to the white house. Host and with funding . Guest there will be no money attached to it additionally. Its an authorization of programs, so its not directing funds to it yet. Host so would there be any Immediate Impact . Guest you know i think that we have to ask the attorney general, because hes the one that will get the additional power through this bill. I dont think democrats would have acted on this if they thought it was pointless without funding, so its a step. I would think they would make judgments that its a step in the right direction. And there is federal funding that exists for these programs now, so you might see agencies get creative with how they budget to treat this endemic and you might see the Appropriations Committee kind of moving money around from different pots to address it. Host thomas tweets in talking about valdez, our caller from illinois. Caller was right. Johnny suburb goes to rehab while johnny city goes to jail. Drug war is a political war. Richard is in west bloomfield, michigan. Go ahead, richard. Caller hi. I work with a company that makes a cbd oil from coloradogrown industrial hemp, and weve been seeing a lot of promising results for a lot of different nerve and muscle pain. Its an antiinflammatory with no side effects, and that cbd, theres a lot of Scientific Data and lab result tests for the products that we have. So for people that dont want to have take the road to get to heroin that are in pain, i think thats a nice alternative, so i just wondered what your thoughts were. Host richard in west bloomfield, michigan. We wont make you comment on that commercial product. Meghan mccarthy, in all these discussions, is there talk about the colorado experiment on legalization . Guest you know, Pain Management is what these drugs are prescribed for, and thats a big argument that people who support the legalization of marijuana make that this is something that could help people and not be, you know, as addictive or a pathway as the caller said to heroin. There are other people that would say its just another drug, and it can be addictive as well. Host has there been a discussion of, weve been through this before. We went through this with the crack epidemic of the 80s and 90s. We went through this with alcohol throughout our history. We had cocaine back in the 1920s. I mean, is this has there been any discussion in the historical, putting this in the Historical Perspective . Host i think youre absolutely right, that its a drug indicator, and perhaps this is the one of this time but i think whats unique about this is the element of the medical community being involved in it, and that people are getting hooked on some of these drugs or heroin because they got prescribed something by a doctor. And so its just a it adds in a different element, and its honestly, i think, why the federal government can get more involved or that you see more legislation than you might have for crack cocaine, which was obviously focused on the judicial system. Here, you have the cdc coming out with guidelines, you have the fda just coming out and saying there are going to be new blackbox warnings on these Prescription Drugs. You know, you have medicare and medicaid looking at different ways to control the prescribing. Host then were hearing from the viewers who say look, i need my drugs, my pain pills. Tim, flatrock, michigan. Please go ahead with your question or comment about the heroin epidemic in the United States. Caller thank you, cspan. I just wanted to put my few cents in on this heroin epidemic. Its really hit hard in our family mainly because my father was a heroin addict. He still is. He worked a great job, made 80,000 a year, took a buyout, for about 100,000 a year. And he spent it basically all on heroin in one year. And thats when my parents got divorced, we tried the treatment, inpatient, and was not successful with the results and he would come out within an hour or two, be back in detroit trying to find more heroin, and it just completely devastated our family. Hes homeless because of this. Like i said, he had a great job, and this drug is just killing everybody. Hes been hospitalized, i would say, probably five or six times for heroincomplicated infections, you know, from using dirty needles. I have a granddaughter whos i have a daughter whos eight years old. Hes never even met his granddaughter. Host so do you have any contact with your father anymore . Guest no, i do not. He is homeless living on the streets, you know, he had a great 80,000 a year job. Host has he stolen from you . Caller hes stolen not from me but from my brother. He took all the savings bonds and right before my parents got divorced, you know, it just ramped up and, you know, he would actually be offering me to take him to detroit to go get his drugs, because he would get so sick. Host what would you like to see the federal government do if anything . Caller its a very complicated issue. I would like to see, you know, forced intreatment. He would get out within an hour. Hed be there 28 days. Host when you say forced treatment. If hes 28 days and within an hour hes already back out on the street, where is the enforcement . Caller thats where were kind of lost. Host right. Caller i thank you, cspan. Host what has this done to your family . Your mother, your brothers, your relationships . Caller oh, we dont even talk to my dad anymore. Hes homeless in detroit. Host does it occupy your emotional bond anymore . Caller what do you mean by emotional bopped . Nd . Host well, the family. How has the family dynamic changed being so close to this vortex . Caller well we went through counseling, you know, when it first started, and its been a pretty rough ride over about the last eight years, because it seemed to really ramp up from just using it every once in a while, and then at his peak was about 100,000 a year he spent on it. Host thank you, sir. Guest i think thats a tough story and, you know, there are a lot of americans that are in the same boat as you. We did some poleling sponsored by cbs health that found that 41 of americans know someone that has struggled with heroin or opioid addiction, so its definitely a growing issue. It cuts across party id, it cuts across income across the country. Host maria tweets in more people die from alcohol than all other drugs combined. Pat, i think youre going to be hit for our guest, Meghan Mccarthy huntington West Virginia, hi. Caller hello, good morning. And let me tell you about my family, sir, im from huntington, West Virginia. This is the ground zero for drug use. Just look at the map. Its covered, the state of West Virginia, by red. I was a user, had hep c, was one of the people that went through the treatment for seven months injecting myself in order to get rid of it in the early stages of this ongoing epidemic from drug use back in the 70s. My daughter and soninlaw had 150,000 from my moms death, and now thank god for two years, theyve been clean. My sister spaded her heart by the use of cocaine back in the 80s. Ive had 18 friends die from use of drugs directly or from od or from complications. This is called moneyton. Huntington is call moneyton by the cartels in detroit and columbus. Theyve got it set up almost like a business model. But the reason for this is the hypocrisy that comes from the top part of our government. You ask what our government can do. Our government could have nixon planning on using blacks using heroin and marijuana on the hippies, to make the news every night in place of the deaths and the drug use from the people in vietnam we were sending to die. And we had the reagan and the Bush Administration selling drugs under the counter invading our cities out west during the conquer. And we have people walking across the borders with drugs nowadays, and weve blinked our eyes saying, oh, were taking care of the drug problem. And we have people over there in afghanistan walking by fields of poppies while the drug lords and the tribal chiefs continue to grow their poppies and send them here to destroy our youth. And you say oh, our government wouldnt do that. Surely theyre not that hypocritical. But i say they let the Drug Companies sell all the drugs they can and distribute them to make money out of greed, and you have host all right, pat. Got your point. Meghan mccarthy, what were you hearing . Guest well, you know, people want action on this issue and the caller just mentioned, you know, we found that 52 of voters want president ial candidates to come out and actually have a plan for this and that includes 59 of independents, 59 of republicans. So its something that the voters are definitely keenly interested in, and i think a lot of people share your concerns. Host Meghan Mccarthy, editor in chief of the newsletter Morning Consult. Thank you for your time this morning. Guest thank you so much for having me on. Host we have about 40 minutes left in this mornings washington journal. Were going to continue this conversation. Here are the numbers that weve been using all day, if youve been impacted by heroin use, if you are a medical professional, and all others, and well continue hearing from you in just a minute. Book tv has 48 hours of nonfiction books and authors every weekend. Here are some programs to watch for. This weekend join us for the 22nd annual virginia festival of the book in charlottesville starting saturday at noon eastern. Programs include author Bruce Hillman who discusses his book, the man who stalked einstein, how nazi scientists believe he changed history. And saturday evening at 7 00, patricia bellscott, Professor Emeritus at the university of georgia on the firebrand and first lady portrait of a friendship. The struggle for social justice. The book exmroerz the relationship between civil rights activist pauly murray and first lady el norroosevelt. Patricia bellscott speaks with author and historian at roosevelt house in new york city. On sunday beginning at 1 00 p. M. Eastern, more from the virginia festival of the book, including George Carlins daughter, who talks about her life growing up with the comedian in her book, a carlin home companion. And sunday night at 9 00 afterwards with historian nancy cohen, author of breakthrough, the making of americas first woman president. As cohen looks at Women Political leaders and the advances they are making in the political arena. Shes interviewed by kim azarelli , cofounder of conel law schools central for global justice. For a woman to be at the head of the most powerful country in the world when one of our key allies doesnt allow women to drive and, you know our most significant enemy at this time, isis, is literally executing women and girls simply for being women and girls, i think this sends a powerful message from the bully pulpit, about what america stands for. Go to book tv. Org for the complete weekend special. Washington journal continues. Host in the last 15 years, theres been a 286 increase in heroin Overdose Deaths in the United States. Its estimated to cost the heroin epidemic is estimated to have an Economic Impact of about 34 billion a year in theft, economics, and in healthcare costs. Hillary clinton has described it as a quiet epidemic. It was a major topic of the New Hampshire primary. Thats been our topic this morning, all morning, on the washington journal, talking about heroin use, abuse, epidemic, whatever word you want to use. And how its impacted you, how its impacted communities, and how its impacted or impacting Public Policy, and thats where we want to hear from you as well. We want to hear your story. We also want to hear what you think can or should or should not be done to combat this. And were going to go back to your calls. This is sandra in seattle. Youve been very patient sandra. Go ahead and tell us your story. Caller all right, well, thanks. Yeah my experience with heroin was through my brother, and in the late 90s and up to 2003, i was living in boise, idaho, and my brother at that time was a heroin addict, and i was incapacitated because i had been prescribed ristradol, so im sitting there in my home with my brother living with me and all i hear is heroin addict friends going back and forth through my house so im observing their behavior. And its horrifying. Theyre not having any fun, first off. Anyone who thinks heroin addicts are having a fun, they dont know. Theyre not having any fun. The entire life is about getting that next fix. They cant work, so its all about shop lifting, you know, and all the ways they can figure out to steal money to come up with the money for their fix. And its just tragic. He would get first off, he would be in prison for a month or six months, and come out and go immediately right back to it. It just amazes me. And the thing is, you know, my brother, back in the early 60s, he had a problem because he was born premature and was behind in school, and a doctor prescribed him some medication, and they called it happy pills. And that is what launched him into his host is your brother dead . Caller what . Host is your brother dead . Caller yes, he finally died of an overdose in 2009. But from host we want to get some other calls in here so im going to ask you one more question. We appreciate your story, but is there a role in your brothers life and his issues that the federal government, in your view, should have addressed . And i know thats a very awkward phrasing, but i think you know what i mean. Caller yeah, well see, i i its kind of a state thing more even than federal because in idaho at that time, he and his friends actually tried to get off of it by using i forget the name of the stuff, the substitute. Idaho didnt allow it. They had to drive all the way to nevada to get that substitute legal drug. So you know, that was relief right there. Before you cut me off, let me say, he did actually get clean for six years, and the way it happened is, he got busted in a sting, so he was facing at least 10 years in prison. And they offered to put him on seven years probation, and he, of course, took that, and so he was subject to random u. A. S, and that kept him on the straight and narrow. He was required to go to a. A. , he got rid of all his druggy friends, made friends in a. A. He was truly a happy person for six years. And then his old friends came around and he fell off the wagon, and he overdosed and died. Host sandra, thank you from seattle. And if you look at the map that we showed earlier, the national map, this is from the new york times, and it shows where heroin Overdose Deaths have increased, and you can see up there in the lefthand corner, the state of washington, she was calling from seattle in the state of washington. And the state of washington has a lot of red and orange counties up there. The whole west essentially, looks like theres been a big increase. Over 8,000 heroin Overdose Deaths per year. Its being called an epidemic, a quiet epidemic. Matthew is in georgia. Go ahead matthew. Caller yes, good morning, peter. I am very, very upset. Please dont cut me off. Ive been trying to get on for quite a while and havent gotten none, so give me a couple. This is a very racist idea, the whole thing. There are so many black people who have gone to jail. Some of them i think, three strikes, youre out. Theyre in jail for life now, okay. Theyre in jail for life. I just watched something on youtube where black people cant get dispensaries in colorado because you cant have a felony and own a dispensary. So now, they fill the jails up with blacks and hispanics and the white boys from wall street can go in and make a lot of money off of drugs that are supposed to be illegal. Okay i understood it wasnt illegal now. We fought the war. Remember iran contra . Okay supposedly, they were selling drugs for guns. Where did they sell those drugs . Big banks. I know, you can look it up. Big banks, loaned billions of dollars. Not one Bank Executive have gone to jail. This is a very racist thing going on with this heroin stuff going on here. They filled up the jails. If obama can do anything, is to write an executive order to empty out the jails for people who are in there for drugs. For a few pounds of drugs. Lots of black people have died. Cops have shot people because they stop them to search them for a few ounces of drugs. Okay, this is racist. It is extremely racist. Its no other way to call it. Host thats matthew in georgia, and this is lisa in burlington, North Carolina. Go ahead lisa. Caller good morning. Oh, my goodness, that man just shook me up. Okay perhaps we are a racist country, were finally trying to get a handle on everybodys problem, and i hope that it isnt just a suburban trying to treat white people and not help black people now. Maybe they ought to look at everybodys record in prison, in jails, try to do this, but thats not the reason i called. Im very shook up about i can see why everyone says we are a giant racist country. Hosed we are talking about the heroin epidemic on your community. You can see where i live in North Carolina. It is good friday. There is a reason people actually start to get on drugs. They are not happy with their lives. I grew up in the 70s and 80s. People were asking me to try this and try that. I think im a high on life, i dont want to alter my brain to be something other than i rem. Host Lieutenant Governor of the state of maryland, he is a Task Force Chair for the Governors Association for the United States. What is the situation in maryland . Guest it is a challenge throughout the country. We have been grappling with it for several years since it took off a year ago. As we were campaign in in 2014 throughout the state campaigning in 2014 throughout the state, we were hearing from small communities, that the Biggest Issue at the local health and Law Enforcement and providers had was heroine . Was heroine. Once elected we would convene an Emergency Task force to come up with recommendations to try to address this particular challenge. Host what are some of the recommendations . Guest we had 33 recommendations that ranged from prevention and education. We included Treatment Options. We talked about quality of care and had proposals and terms with quality of care, because it is often the discussion of treatment, which means inpatient treatment. Not Everybody Needs inpatient treatment. So we have recommendations in that area. We are still in our legislative legislative session. We are it mandatory for Prescription Drug monitoring. The reason for this is the new date wage rubbed to heroine is prescription opiates. 70 , 75 of new heroine users are coming off of prescription medications. And that is the real distinction between a lot of the drug problems we have had in the past and what we are facing now with heroine. Host is there an estimate what the use causes the state of what they use costs the state of maryland . Guest when you look at Emergency Rooms, when you look at the response from emts, we had over 400 deaths from heroin overdoses and anecdotally there is pretty much an assumption for everyone heroine death. There are eight or nine that survive in overdose. They are still being treated in Emergency Rooms and expenses associated with that. And then of course the lack of production, the potential crime the petty crime that comes from it. Host was there anything that surprised you . Guest what surprised us early on, and before we even convened a task force, was how pervasive the problem is. Particularly in some of the small towns, im not sure how many listeners are familiar with the geography of maryland, the Eastern Shores is a rural area. Some of those towns may have less than 1000 people in them. They were maybe 1000 people 2000 people in the town. Host have you shared or learned anything from other states . Guest we are constantly looking at other states and what they are doing. I was with the national Governors Association this week and talking with some of the other governors and what is going on in their states. Vermont has been aggressive in that area. That is a good example of how it has extended to small states, a small new england state talking to the massachusetts new massachusetts governor. Host Lieutenant Governor of the state of maryland and also the Task Force Chair on heroine and opioid addiction. Thank you for your time. Fred is in toledo ohio. We are talking about the arrow talking about the heroine epidemic. Caller some of people were on heroin that became impossible to live in that area. One of their biggest clients were college professors. It has always been there. I moved down to toledo. Everything was good until we had the collapse. A lot of people lost their homes. We had drug dealers moving to them. I have been working for the past five years. We had so many deals and so many cars being broken into. It is like the walking dead. My 96yearold father accidentally overdosed on oxycodone. Host is there something you would like to see done in washington or can be done in washington . Caller i have never done any of these drugs. I would never take oxycodone if it was prescribed to me. I accept i accidentally lived it for so many years, the drug use is something else. Their racism is involved in it classes him. I know my neighborhood we are lower and middle class working folks. We had to make a big noise to get anything done in our neighborhood. Why is it ok for prisons to be a forprofit . Incarcerating a man subcontracted out. These people are stuck, they are satisfied, they cant get out. Host this is in ohio near cleveland, this is kathy. Caller i called because in the last three weeks i have been to two family friend funerals. One kid was 21, 1 kid was 23. We appear to be happy and healthy, we are not area i also work in a dental office where we prescribed opiate drugs to patients and received notifications when it appears there are problems at the pharmacy. I have thought about the situation in the last three weeks. I think there has to be a philosophical discussion. There has to be a legislative process involved. I feel weird talking about it, but i feel like they should legalize marijuana and it will make an impact on the heroin problem. Host where do you see the connection . Caller i think our society does not generate a generate an easier lifestyle. He will have to work their whole life to pay for car and food and children. Part of the reason why a lot of people arent happy. Marijuana is different. I have tried it myself in the past. I recently beat cancer and take cancer preventing drugs that im not doing well on. I found that cbd oil helps me with my not sure and weight loss. I think marijuana would be an enter to several of our philosophical problems of a modern society. Im 45 and im scared of this heroin epidemic. Im scared of anybody who is having trouble with it. I honestly feel like legalizing their lana would help. Host matthew from georgia. Caller im disabled, im on hydrocodone. I was in constant pain and as soon as i started the hydrocodone i was able to live a more productive and better life without pain. Host is hydrocodone oxycontin . Caller it didnt do anything for me. They gave me hydrocodone. Host is it addictive . Caller i dont think it is at the diff. For that officer to say if you take these drugs you are ending up taking heroin, i think that is ridiculous. It is people that have a mindset to do drugs anyhow. They get hurt and all of a sudden they are taken these drugs. I find that ridiculous. I saw some of the people there that seemed to be very smart. They have to do something about it. They are going to give you oxycodone and i was thinking any doctor i dont know one of them that would prescribed a medicine or take a chance at losing their license over something that is in need. Host to some tweets buddy is calling in from asheville North Carolina. Caller i have been listening to your program for about half an hour. Im a product of the 60s in california. I had a real rough time with heroin. I am now 69 years old. In california i eventually ended up going to prison. I went to the california rehabilitation center. It was a place where i got treatment. I had a very good therapist, dr. Underwood. And it was a bunch of convicts in this program. Heroin is a drug that covers up all your mental, physical, and imo in a pain. It would last depending on how long i will inject. If i injected a 50 bag of heroin, it would be six hours. I funded it by stealing, by working sometimes. Anyway that i could i would lose jobs because of stealing. I would lose lots of friendships, i was a musician at the time. I was just a mess. When i went to a statefunded program in california, that is what i learned what it was that was driving this. And it was all these emotions beside myself and my up ringing. It was the abandonment issues i felt the fear i felt from these abandonment issue. When i started tapping into that, i got to remember this was 69 years ago. I got clean and sober and i have never used heroin since. I have a doctor, a severe injury from falling off of a building on the job. My doctor prescribes the oxycodone. What i do is i take it exactly the way she prescribes it. To me that is taken responsibility. People get out there and they get these prescribed drugs from their doctors and they dont take them responsibly, they are going to become addicted. If the doctor stop prescribing it or the pharmacies would not give them that drug, they are going to cover that area all the other pains that are inside of them mentally and physically are going to be covered up. Host s josephine this is josephine in manchester, New Hampshire. Caller good morning, america. Thank you for taking my call. Im an old timer. I was a nurse in world war ii. I saw this problem in 67, when i was working on my in nursing. I had to write a paper about a problem that would harm america in the future. I saw this drug problem crawling out of the ghetto. As long as the white people in america saw how they could make a buck coming out of the ghetto they started it. First they went into the colleges as the person before me stated. And then they went to the professional areas. Doctors, lawyers, teachers nurses, who at one time or another have either tried this drug or are still trying it. The only thing that will happen is once we stop making money on it, and i know a few users or i didnt know it. What we need is treatment, but not mandatory treatment. If the person says it is time to get off, there should be a bed available for them. Which means more money. I have not been affected by this drug. I am a cancer survivor. I have used marijuana for a very short period. To get over the nausea. Host did it help . Caller it definitely helped. Host how old were you win you used it . Caller 92. I just got over the cancer treatment. Hopefully im cancer free at 94. I lived through the polio epidemic. I flipped through world war ii, i lived before that through the depression. I lived through world war ii, i lived before that through the depression. It was tough and people made it. We helped each other. The problem was family breakup. People do not communicate. And their stupid phones everybody is going to lose their voice. I remember an old time movie, and i dont remember what the name of the movie is, but the ending was this big old computer that filled the theater. And this big sad old man was the last survivor because everybody lost their ability to communicate a kate to communicate with each other. America, the world is coming to that with all the instant communication. Stop that. Host thank you for your time this morning. We very much appreciated. Appreciate it. A tweet and she is with us angie is with us from cuyahoga falls. Caller i would like to talk about what the government is doing in this drug war. I live in a community where six years ago, the federal government put up a 15 million Drug Rehab Center near the school and the playground. We tried to prevent it but we have someone coming in from the fda, telling us our city would be sued again if we try to prevent it. My nextdoor neighbors has od to several times oded several times. My whole family was involved in the manufacture their whole family was involved in the manufacture of crack cocaine. My complaint is the federal government is involved in providing housing and rehabilitation in governments where there are schoolchildren. We are retired in our late 60s, taking care of four children that are victims of the heroin addiction. I look at what the federal government has done. They removed the children from homes, and they are put in foster care. My children was put in foster care for almost three years. The state of ohio has a very limited view as to how we can help the children affected by the drug conditions at it drug addictions of any kind. I have a sevenyearold and a fiveyearold who have witnessed their parents, one is a bot relative of mine. They have told me about the fights and the doctors bags with the needles. One parent is incarcerated for only five years. He was found with a major supply of heroin and several thousands of dollars. Host if you could change the Public Policy angle, what would you do react what would you do react to what would you do . Caller i would have the federal government stop making start making we are talking about eliminating the drug addiction. We need to purchase one of those uninhabited islands in the pacific and take people who have been convicted to that island. Host that is angie in ohio. Trina is in florida. Caller thank you so much for taking my call. I would like to share with you both personally and professionally, i have a daughter who struggled with addiction. She struggled for 14 years. She is originally from canada. She was five years clean and five years ago she relapsed. It got progressively worse until a year ago. She started shooting heroin because she no longer could get a prescription. Both working in the field and having a daughter, i think just about everything. When you see a daughter struggling with heroin addiction they absolutely love them of their soul. I think we need a comprehensive plan. Addiction is not a one size onesizefitsall. Just to bring this into scope. My daughter almost died of a heroin overdose. The pain is beyond what any of us can imagine. I was called to the hospital and fortunately for us we ended up with a doctor whose nephew had recently died of a overdose. I was told to go home and get some rest. She was taken a first step treatment. Long story short, my daughter had been on methadone. I absolutely believe in Harm Reduction. We need a longterm plan. Host where is your daughter today . Caller my daughter is in a 30 month intensive treatment program. There are very few people coming off of heroin within 28 days. It is a revolving door. I hear a lot of people talking about obama care. People can only get obama Care Insurance if they have done their taxes last year. I know very few drug addicts focused on doing their taxes. Host who is paying for that treatment . Caller i wrote a book which details my journeys my journey through my daughters drug addiction. Host i apologize but we are out of time. Thank you for sharing your story. We might have time to get kenny and