Found in this overlap with drugs with potential legitimate therapeutic use. For this Lateral Group of compound requirements using schedule one may act as a disincentive. To echo michael botticelli, we believe by performing significant review we can balance the risks posed by illicit risk of these compounds well preserving the need to develop new understanding. Theyre committed to working with other partners on science in this area to understand and enhance the timely and appropriate assessment of these. We hope that as the Committee Explores ways of addressing the problem we will continue to give the relevant federal agencies an opportunity to share perspectives including solutions that would address the threat to Public Health and safety posed by these dangerous compounds. Thank you for the opportunity to appear before you today. I am happy to answer any questions i can. I would ask my colleagues who will take five minutes and we wont have second round because we have five witnesses on the second panel and i want to make sure that they have their opportunity to testify before the committee as well. We will start with mr. R tuning in. It appears from your written testimony that you and some of your colleagues have had success prosecuting cases pursuance of the controlled substance analogue enforcement act despite the challenges opposed by proceeding under that statute. So you are to be commended for that. My question, with that in mind, despite complaints about the scheduling process being too slow and cumbersome, do you have an opinion on the utility of continued scheduled dangerous synthetic substances or should we just rely on prosecuting these substances as analogs . Thank you. I think its clear that more Chemical Substances that we schedule, the easier it is for us to do our jobs. So your act in 2012 was helpful, adding chemicals and substances to the scheduled list under the controlled substances act and that clearly makes it easier for prosecutors in a more straightforward way to present cases in court and establish that the chemical compound is something that is on a controlled substance schedule and proceed without questions about its chemical composition and its effect. When we run across synthetics that are unscheduled, we have to deal with the challenges of the controlled substance analogue act and they are well familiar to many of you through your great work with the drug as youve heard of. We have to provide prove this beyond relative doubt. They are subject to expert testimony battles and the defendants will call experts to question the effect of a substance when in fact there is testing the has been done, a lot of time that,s have to rely on Research Documents or periodicals or animal testing. That can confuse jurors make it difficult to prove. To answer your question, the quicker and faster we can get these drugs scheduled the better. We keep hearing that our current scheduling approach for synthetics just isnt agile enough to deal with it. At the same time we also hear concerns that if we move to schedule substances to quickly it could hurt legitimate research. As we look to find a better approach to address this threat, what can you tell us in the congress about how other countries are addressing it. Are they potential models for the United States and what has been the impact of research in those countries . I agree with senator feinstein that there is a legitimate pathway for research as it relates to schedule one subjects. Our challenge has been on the Public Health side in looking at mitigating the publichealth form form. I think theres a tremendous amount of conversation for partners to look like. Are there opportunities to streamline the research process. We are always open to those types of issues to deal with. I do think we have two air on how do we mitigate the Public Health in staying ahead of these substances. I think that should be our First Priority as we endeavor on that. I think we continue to monitor what other countries have done around this. The United Kingdom took an interesting approach. They looked at, the dea and fda are looking at this as well, looking at them largely based on their psychoactive effect of the brain so we can look at staying ahead of some of these as part of the psychoactive effect. I think the other piece, and again weve been hurt by conversations with the dea to look at how can we streamline this process, particularly given the information we have on some of these individual chemicals and can we really look at, based on on da information and other information that we have, really put forward a greater number of these substances to be scheduled. Im and asked my last question, something that mentioned as well. Could you tell us in more detail what the dea and other components of the federal government are doing to confront china about the living this poison to our country. Other steps china have taken enough, if not not what else would you like to see done . Back in october, mr. Chairman, i think china took an important step and a helpful stop when it regulated 116 chemicals. We been meeting with them. I met personally with senior members of their narcotics enforcement bureau. They tell us theyre going to do more and i hope thats right but we all have a larger problem which is even after they regulate, the bad guys just shift a little to the left are a little little to the right and keep on going. I tell you, so far ive been hardened. At least by what theyve done in october and what they say they intend to do to help us regulate additionally. We have to do more here as well. Senator feinstein. Thank you very much mr. Chairman. Ive listened very carefully to our witnesses and it seems to me that what we have is a battle of the experts which slows down the movement on these drugs and lets them get way ahead of Law Enforcement. For me to look at a month in sacramento which is not a big city per se in california and theres more people, somebody dies every single day of this drug. To me its like zika and theres a lot of effort going on now to speed up research here. Here weve got to speed up the ability to enforce and so the question comes to eliminate this battle of the experts. Thats in the courtroom. Would a committee made up of an Interagency Group of scientists that would convene on an ad needed basis to legally determine whether a new synthetic drug is a controlled substance analogue would eliminate the need for lengthy and repeated congressional scheduling actions for small chemical alterations to already scheduled substances. Where im going with this and senator grassley and i have many hearings, theres no drug activity thats important than this one to get a and be able to move and deal with this mutations and changes and if you have to depend on the change of the law every time this changes slightly, we are way behind. It seems to me we do need some mechanism of experts like those at this table to sit down and look at a drug, make a decision and move on. Could anybody comment on what i have just said. You dont have to agree with it, but id like very much to listen. Let me go this reverse way. Why dont we start with you. First, thank you, i agree with the importance of identifying a way a way to speed the decisionmaking in terms of the sheer number of products as others have said. The specific action that youre suggesting, changes to the analogue and decisions, this is something the decision has a large role in at present. I dont know that i would be able to comment a great deal about our particular agencys view on it other than to say we are interested in doing whatever we can. Our role on a scheduling action, as i mentioned before, so my day job is to make sure that nothing we are doing around scheduling is impeding the actions that the dea needs to take with regard to these important dangerous drugs. Mr. Rosenberg. Im going to ask each one of you. Thank you. Our processes clunky and cumbersome. Im not exactly sure how we fix it. One of the things i like is what the doctor referred to in his opening remarks, thinking holistically about how these substances bind to receptors and trying to do it molecule by molecule. In fact, weve done some of that and so far it has worked but we need to do a whole bunch more. Im open to just about anything that makes our process less clunky and less cumbersome. The devil is in the details, of course course. Im very happy to work with your staff on that. Thank you very much but i may take you up on that. The prosecutors have to deal with the evidence as we find it. We dont particularly play a role in scheduling process, we develop evidence in our cases and then we have to deal with whether the substances they scheduled or not. As i explained, the more we have on the schedule, the more straightforward our prosecutions can be. There is benefit to our partners and their work at the border in seizing substances that come into the country. If we have a substance thats not scheduled and we fall to the analogue act or other tools, then then we have to establish the case using our experience. I think like you, we probably share some concern of it for creating another layer. I know you dont want to do that. Obviously having some more discussion in terms of looking at the function. I think part of this, we been heartened by the conversation weve had among our agencies to really look at do we have the evidence. I think we need to determine whether or not the evidence can show whether these are scheduled its a cumbersome process to determine whether each of these drugs has the health Harms Associated with it. I think we need to continue to look at and work with you on the criteria to see if there are ways that we can do a better job of streamlining them as well as looking at a whole host of chemicals that we can work with congress on to work at some level of scop scheduling for those substances. I dont know if theres anything we can do within the drug caucus on this, but i view this as a real emergency. The value out there on drugs, i was talking to somebody today who had a teenager who feels very badly because she wont get involved in drugs or drinking and shes really being set upon by the youngsters that she goes to school with and works with, youre not like us, youre, youre not one of us, youve got to do all of this. Somebody has to get to the heart of it and say no and point out the death rate and the incapacity thats developing among young people from this kind of use. The fatality of this is so in order and it. I know were going to hear more about this in the next panel, but can make a suggestion to us that first of all we should Work Together and come out with something that enables this government to move rapidly. Obviously i dont disagree with you and hopefully our staffs have been talking to some extent on this because ive had a briefing from my staff and i got that impression but if that isnt right, you tell me. franken this is only one of a whole bunch of things we are trying to combat in this country. I have asked all of the special agents in charge around the country to tell me and work on the most significant threats in the jurisdiction. Prescription drugs tend to be the top rank. We are spread thin. We are down to about 800 personnel over all. We have a bunch of challenges. We are working really well, i think, i am bias but i think this is true, with our Task Force Officers and our local police departments. Almost 35 of Law Enforcement within d. E. A. Are state and local Task Force Officers. That is pretty remarkable. We are relying on them, and folks with a bunch of knowledge, to tell us where the hot spots are and trying to hit that. It shifts all of the time, changes all of the time and i have tell you we are outmanned. I should have mentioned in the beginning i want to thank you all for the work you have done in North Carolina. I have been involved in at least one series of noknock warrants that woke people up about four in the morning in the middle part of the state. Our local Law Enforcement have a lot of positive things to say and i am glad we worked on the equitable sharing and other things. Thank you for that. That was huge. We appreciate it. In the state house in 2011, we took action on actually the synthetic marijuana and the bath salts. What more can states do while we try to sort out federal policy . Can you cite any states that are particularly good and others that might be behind that we should work with try to get a handle on the state level . In terms of establishing controls . And outlawing a lot basically, what we are trying to do is not go too far. In North Carolina, we had synthetic marijuana coming on the scene, bath salts, we took action on the precursors to methamphetamine. What i am trying to do is figure out what can be positive action they can take and what could be potentially problematic and needs more federal consistency . Very good question. I dont have a state by state best practice list but i will ask folks when i get back and get that to you. That would be helpful. Learning from states that are doing well and going back to the state leaders and take action. Great question and great point. I will get back to you. One thing, again, i dont think people understand what we are talking about, these synthetics that exist today. If you take a look at marijuana that is legal in a couple states now. It is several times more powerful than it was two decades ago. So i worry about this problem really going and increasing. You have marijuana tourism and people going from states where it is illegal to states where it isnt and going back. My guess is if they had a good experience, they will try to create more potential demand. So we have to get ahead of the problem and the other problems that could be created if they go to other, even more powerful drugs. I am concerned that china is it true china is one of the largest manufacturers of these substances . Of the synthetics . Yes, sir. What are we doing to interdict them and what more do we need to do . We have to work on it if i a moment i want to talk about education to decrease the demand, but what are we doing to thwart the supply. One of the values in scheduli scheduling, even if bad guys are tweaking molecules, it gives us the ability to interdict and cease. So there is a value in scheduling but not permanent. Because they keep moving the goal post . Because they keep moving the goalpost. Any comment . I would say we try to work up the supply chain when we establish our investigation. That is always our goal and by doing that frequently we find ov overseas targets and have to do our best to identify them and follow the money when we can and establish evidence that would allow us to reach beyond our borders. I want to be clear on the china example. Are these ill illicit operations Legal Enterprises by the Chinese Government . After you answer that we will have to move on. Go ahead. To my knowledge, they are engaged you know, in the cases we have seen, they are conducting themselves in violation of our laws. Yeah, i think the answer is both. Some of these are just the sheer volume of Chemical Manufacturers in china present a problem. Part of the business is looking at these illicit chemicals. We are working with a special group focused on interdiction and precursors around methamphetamine. Admiral smith, and jt west, have taken this on in terms of looking at interdiction. Some challenges, particulary around fentanyl, is we dont have good detection and monitoring and hazardous monitoring around straight fentanyl sometimes. Thank you, mr. Chairman. Thank you all for your testimony and for your work. I want to wrap my brain around a couple things. One of which is, we are talking about synthetic drugs here and stuff that is on the street or sold in head shops and that kind of thing. I think to ask obviously we have had this Opioid Epidemic and they are prescribed. I want to just try to get my understanding of this right. Mr. Rosenberg, in your testimony you say data from the 2014 National Survey on drug use and health are finding that more than 4. 3 million americans age 12 or over reported taking a prescription pain killer for nonmedical purposes within the past month. Yes, sir. Now, how much of that was legal opioids that were prescribed and how much of those are street opioids . Specifically fentanyl, if is a street drug you dont know how much fentanyl is in it. Can i get understanding of which is which . Sure. I will start by coming at it from a slightly different direction no. I start by not admitting im coming from the different direction. We are 5 of the worlds population and consider 99 of the worlds hydro codone and 80 of the worlds oxy cotton. Most of it is legally preskri preskribd prescribed in peoples medical cabinet. Lets say you get addicted and run out of things that were initially legal. The street price is high. The substitute is heroin. It is much cheaper and the substitute for that is fentanyl which is cheaper yet. Right. But you were saying they took prescription pain killer for non medical purposes. 1. 3 million. Part of the testimony i read is they are street pills and have fentanyl in it. Yes, sir. I agree with the administrator. We know that the vast majority of people start using prescription drugs get them free from friends and family. They are not buying them on the street. As they become more addicted they turn to street purchase of these farm spharmaceuticals. One of the issues around fentanyl that is important is we see fentanyl pressed into pills that look like prescription drugs. Sometimes someone can think they are buying, on the street, an opioid when they are buying a fentanyl pill which is obviously much more powerful and has the potential impact for death far greater than just an opioid. Another thing i want to try to get into and i think we have been talking about it and this is about scheduling. My question is, a very basic question, that maybe i dont have much understanding as chairman and Ranking Member. In terms of could there be some kind of conditional scheduling where we can basically what is happening is someone creates a chemical, they sell it as a bath salt, people die, a couple people die, it takes a while to ajudicate this should be illegal and in the mean time they change the molecules. What is the barrier . This is constitutional barrier, legal barriers, legislative barriers, what are the barriers to saying schedule this additionally and no one can make this now. It is illegal to make it make and sell it now. What are the barriers . The process you are talking about is what we would call emergency scheduling. The intent of the emergency scheduling prodition is to do that with limited nfrjz we have when the fda does the afactor analysis, less information. The d. E. A. Says we have reports of, you know, people being harmed, we think this drug is a substance we want to emergency schedule. There is an expedited mechanisms and that can happen quickly. We return our review around within a week for instance. It is then followed by permanent scheduling and two or three years ago, the time that things were allowed to be emergency scheduled was made longer. So you could put something into that schedule, that emergency schedule, make it illegal to manufacturer and poses and distribute while we work on the data. We have a longer period of time to maintain the control. The question for today, i think the question the panel is appropriately asking is the question that michael bon chely and others are pressing is can we do it more efficiently . Can we make a final decision about scheduling without the twostep process. Can we reduce the mount of information we need in order to come to the final decision more quickly . That is what we are talking about the d. E. A. And fda. We are looking to see the what the bare bones are we need to make that final recommendation. Senator klobuchar . Thank you very much mr. Chairman. I appreciate working with you and senator fienstein on this issue for many years. We passed our bills. Mine was combating designer drugs like pcp and the bath salts and that helped with specific cases to get some of these substances listed. We had a number of kids die in our state. We had a head shop here in at duluth. There were many people hanging out around it and there was a major federal prosecution and they used the bill we passed, senator grassley, to show what we do matters. I am a supporter of senator fiensteins bill for the analog committee but i have also introduced the bipartisan bill with senator grassley, graham and senator fienstein that looks into what is happening and what is stopping us from prosecuting some of these cases. I think what is going on is that these drugs get listed as not intended for human consumption. They put that label on even though we all know they are intending them for human consumption. Okay. Then they use that as a defense in court. It says not intended for human consumption so you cannot prosecute us for that. What our bill does, and this comes from many discussions on the state and federal level, is it makes it easier to prove the synthetic drugs are intended for human consumption by looking at factors like are they marketing them that way, how they are trying to sell them and advertise them. That allows that evidence to be in introduced in court to fight this claim. Thank you for coming to hazel ton and betty ford based in the state. Can you talk about this and mr. Rosenberg the challenges and you as well ms. Hartunian, about how this can help if we close the loophole . I support senator fiensteins bill. You are absolutely right the way the marketing of the substance and how they react on the brain. There are enhanced tools we can give prosecutors. I know week get them out of the community. During the drug court funded for treatment, i totally get that side, it is so important and we have more drug courts but it bugs me when we cannot go after the bad guys harming people. As you know, as a former prosecutor, that intended for human consumption makes it challenging for us to work our way up the supply change because as the suppliesuppliers become insulated and the folks doing the inside work it becomes challenging we have to use circumstantial evidence. We want to keep working with your staff to find ways to prove that element. It is interesting to note our prosecutions in this area are relatively knew. We did our first case in the Northern District of new york in 20102011 and prosecution in 2012. Part of it is for the cops in the rural area. The testing and analog problem surprised you were not seeing them because they were happening and people were dying but it was a hassle to prove it. As we are doing more cases, we are learning more, gaining more experience, seeing how the courts are interpreting the evidence we are offering and that is all very instructive. Mr. Rosenberg . Mr. Hartunian stole my last point. I said i think we are Getting Better and learning more as we do it. Intent is a difficult thing to prove as you well know. I am happy to look at anything that helps us do that. Very good. Thank you so much. I think when senator fienstein has to go i will help take over with the next panel. Thank you, senator grassley. Senator blumenthal. Thank you, and thank you for you and the Ranking Member for having this important hearing. Mr. Hartunian, i had your job in connecticut for four and a half years and it is the best job in the world. Scombl yes, it is. Maybe only second to being continue general of the state but one of the things i did was actually try drug cases as United States attorney taking my lessons from the then u. S. Attorney in the Southern District of new york kyle fits. A number of the cases i tried we did with the d. E. A. I was grateful and amazed by the extraordinary courage and heroism of the d. E. A. Agents. People take for granted that the d. E. A. Agents walk into situations where gunfire is as likely as somebody opening the door. They often operate in hostile environments where they are held accountable but no one else is. I just want to thank you all of the Law Enforcement agents, federal, state, local, who do this work because it is challenging and demanding and they are on the front lines. But of course, we are not going to arrest or jail our way out of this crisis. Mr. Botticelli, you have been very articulate and an eloquent spokesman on behalf of the measures necessary to change our culture and prescribing practices which are often the way the demand for those substances are created as you know, because you visited connecticut and i thank you for coming to visit. I have done a series of round tables, 13 around the state and produce a report that makes recommendations. 23 recommendations for changes in law and practice among them changes in the prescribed practices of doctors. More training, education, so that powerful pain killers, opioid substances that often lead to addiction, are reduced. My question to you is what can be done to change the culture and training we give to our prescribing physicians so they are unaware of the unintended consequen consequences. These prescriptions are usually done with the most intentions but i know perk set and oxycotin and others can be obtained easily and be addictive. Thank you. Your innovation happening in connecticut is really important. Thank you. You know the root cause of the Opioid Epidemic starts from wellintended but overprescribing of pain medication. And i think it is for two reasons. Physicians get little training on opioid guidelines and little training on addiction. I dont think it is unreasonable in the middle of an epidemic to ask physicians to take a limits education on safe opioid prescribing and many states have moved to implement mandatory education. Lack of Treatment Services in the United States is a huge problem. Every state i hear the impact of not being able to get people into the treatment. The president has proposed a broad proposal, a robust proposal, to expand treatment in every state in the United States. We need to focus on prescribing and dealing with the root cause but we have so many people in the United States who need treatment but are not able to get it. I think it is important we look at expanding Treatment Access as fundamental and an immediate responsibility to help the public. And as a matter of fact, what we learned and i am sure it is familiar to the very experts on the panel, that the criminal Justice System actually can play a part in compelling people to seek and stay with treatment if is a condition of probation. There is an interest in investing in education and Treatment Services. They go to together. My time expired. I want to thank this panel for being here. This is an extroidinary group and making a real contribution. You brought focus to the issues senator fienstein and others are working on. Hopefully we will get resolution to move this quickly. I ask you to i say you are dismissed. I am sorry. Thank you very much. We will not have a second round of panel because we have a long second panel. I am going to start introducing the second panel while you are coming. Mike rozga, from iowa, his wife january jan and his son daniel have leading advocates to combat the threat of synthetic drugs after his son, david, a High School Student fatally shot himself in 2010 after caking k2, a synthetic marijuana substance that caused him to have severe hallucinations. They were honored as advocates by there office of National Drug control policy in 2013. Our next witness is chief kathy lanier. She began her career as a uniform officer in 1990 and served most of the time in the Fourth District rising to the level of commander. She became the Commanding Officer for the departments major narcotics branch, vehicle homicide unit, and special Operations Division where she established the agencys first Homeland Security counterterrorism branch. She holds a bachelors and masters degree from John Hopkins University and a masters in National Security studies from the Naval Post Graduate School in monterey, california. Our third witness is mr. Joseph coronato, why he is the chief Law Enforcement officer in ocean county, new jersey. Prior to his appointment, he served as prosecutor in the new jersey state attorney generals os, the Atlantic County os, and private practice. He is a graduate of North Carolina central law school. Our next witness, dr. Sullivan smith. Dr. Smith serves multiple roles as an emergency room physical and medical corrector for cookville tennessee Regional MedicalRoom Department and Putnam County medical Regional Services and Putnam County rescue squad and he is a lieutenant in the Cookville Police department and a fellow of the Emergency College of physicians, md, university of tennessee and residency university of tennessee memorial. Final witness, dr. Jim hall. Serves as epidemic for the center of applied research on Substance Abuse and Health Disparity at Nova Southeastern university. He also currently serves on Scientific Advisory panel of the National Institute of health, National DrugEarly Warning system, and the u. S. Food and Drug Administration drug safety and risk management. Substance abuse as the states representative on the National Institute of drug Abuse Community epidemic work group. I am sorry. Chairman grassley, senator klobuchar, and members of the committee, in behalf of my family, and the thousands of families that have suffered from synthetic drug use i want to thank you for allowing me to be here. Yesterday was the six year death of my on from synthetic drugs. Our investigation occurred two days after our sons death. We started learning what happened two days earlier. Friends purchased something call k2 at a local mall and david went to a friendsome and smoked it. He became agitated after smoking the drug and they took him outside. He told the boys he felt like he was in hell. I want to stress the significance of that statement because as a Christian Young man, hell represented the worst place david could imagine. This is the most evil thing he experienced. He learned rapid heart rate, increased blood pressure, feeling like you were being chased by demons or satan himself is not an uncommon experience. After a bit, david seemed to be calming down and wanted to go home and take a nap. Prior to leaving his friends, they agreed to get together and go to graduation parties that evening. Tragically after coming home, david continued to be tormented by the drug and instead of taking the nap he came home and shot himself. We saw nothing in david to indicate he was depressed much less suicidal. He just graduated high school and was looking forward to summer and attending the university of Northern Iowa that fall. The Police Investigation concluded david wasnt suicidal and had a severe reaction to the drug. We learned these drugs can fully take over your mind, body and you are powerless to do anything. I ended my testimony in front of the drug caucus in 2011 by saying we are not doing enough or moving quickly enough. Sadly the very same message is here today. We are not moving quick enough and giving Law Enforcement and prosecutors the tools they need. The New York Times ran the story on june 10t, 2010, the day after davids funeral on the problem with k2. In response to synthetic drugs becoming illegal, a shop owner responded, once it goes illegal i have something to replace it with. There are hundreds of synthetics and we go about them a couple at a time. I remember thinking how ridiculous that seemed but that is exactly what happens. We started with synthetic cannabis, then mdma, and now synthetic heroin and who knows what is next. It is quicker, easier, and cheaper to bring these synthetic drugs to marketing. Senators, the landscape, the people manufacturing, the high times has false advertising. Quite simply, these people are murderers who knowingly sell poison for their own financial gain. David was the second death in the u. S. Tied to k 2. There were struggles because we were seen as the poor family whose son committed suicide and we were trying to blame this fake pot. Imagine talking to legislatures in 2010 and 2011 saying you want to ban bath salts and other things being sold under false pretenses. No credible person doubts the tragic consequences of the drugs today or that we have an issue. As we visit schools around iowa i am continued to be amazed there are so many who have not heard about these drugs. As a parent how do you talk to kids about things you dont know about. We need to educate parents. I know the war on drugs is not a poplar phrase to use but for those fighting in the trenches i dont know what else to call it. We with in the battle for our children, grandchildren, schools and communities. Senators, i pray you move quickly to take action. Far too many families have suffered because of the drug and the criminals manufacturing and distributing them. On behalf of my family, i ask you to provide tools to strengthen the education. Thank you. Maybe i pronounced your name wrong . Please proceed. I have prepared testimony for the record. I would like to talk to you about what the synthetic cannabis and other synthetics are doing in washington, d. C. And the challenges we face. I think it would serve better to hear that. Please proceed how you would like. We have been dealing with synthetic drugs since 2009. When first arriving, they were marketed told children. Skooby snacks were being sold in gas stations. We would get calls for children who were on the way to school, stop in the stores and purchase this skooby snack, and at school they would be calling for an ambulance with rapid heart rate, vomiting, possibly passing out but nothing more serious than that as if that is not serious enough for 10 and 11yearold children. Then the chemicals started changing and the names of the packaging started to thing. The marketing to individuals began to change. We started to see proliferation of different types of synthetics as marketed in the Small Business and Variety Stores around the city. It was such a huge impact across the entire city, Public Health in particular, what we saw when we hit the peak last year in 2015 was literally as many as 20 calls a day for emergency transports by an ambulance to take a person who was under the influence of synthetic and out of control, or unconscious, to the hospital. If you think about 20 ambulance trips a day, each time it would require multiple officers to take a person into custody. Many of these individuals who they used the synthetic cunaboids their heart rate is high, very ageitated, violent, their core body temperature goes up and we are trying to get them out of the middle of the street or where they are putting other people in danger. Then we are in a position where we and fire personal have to wrestle a person in that state into an ambulance to get them to a hospital. Officers were getting injured, fire personnel getting injured, and the potential for these individuals who were in this excited delirium state to die from that struggle. Just to take them into custody and sometimes get them out of the middle of the highway. The potential for incustody death when trying to help someone in crisis. It was so significant last year, i would stop on my way home almost every day and have to call an ambulance for someone i saw who was either in a catatonic state that was under the influence, sometimes standing in the middle of a busy road in the city, or completely unconscious and people flagging me done to call an ambulance, that in one particular neighborhood, i had a person walk up to me while waiting in a neighborhood and he said i am a returning citizen, i spent a lot of years in jail for selling drugs and i would never sell a drug like this in my community. To me, that was the beginning of understanding just how significance this was in our community. I learned from talking to some of those individuals who were standing around and waiting on training. Because a lot of individuals using the synthetic canaboids were under probation or provision in the community, and the Standard Drug test didnt test them for the use of these synthetics, you had people who had been heroin addicts or using marijuana, that were switching to the synthetics because there were no Standard Drug screening picking it up when they went to see their probation officer. So you had people who would not normally using drugs like this switching to the drug so they could stay out on the street. I had several individuals tell me that personally. Because of that and many other reasons we were doing everything we can to enforce it. We had businesses that were selling it but it was just the cost of doing business with them. We would cease quanties and submit for testing, we would get it back and move on to another drug. Following the regulatory schemes but no ability to prosecute, we worked to pass another law last year that allows us to cease based on packaging, quantity and price so it goes around the scheduling but allows us to f d find fine the business up to 10,000 for selling it. I can give a 96hour emergency closure. That is a little more than ceasing your product. Now it is more cost of doing business and you can get a 10,000 fine. We take that product and get it tested to see if we can go forward with prosecution. This is an epidemic. It is not going to go away. It is continuing to change. Most recently it targets the