On the Opioid Epidemic and testified on his research and what he has learned in the course of writing his book. This is two hours. , our witness is sam quinones author of dreamland, a true story of americas Opioid Epidemic. Senators will each have five minutes of questions. Since he is our only witness, if he wants to take more than five minutes to say what he wants to say, we would welcome that. , it is unusual to have a single witness at our hearings and this is an unusual topic, one you say the Washington Post is going the worst manmade epidemic in history. The challenge this crisis presents has captured the attention of every member of this committee. Your research and writing has been acclaimed for its depth and rep depth and breath. This is a bipartisan hearing, one in which democrats and republicans have agreed on the topic and its importance. This is one i hope we will restrain from lecturing each other about Health Insurance and focus on the topic the Opioid Crisis. This epidemic kills more americans each year than car accidents. We are reminded of that almost every day. Yesterday i jumped by meeting at the tennessee governors wrote tennessee governors residence in nashville. Doctors were planning how to discourage the over prescription of opioids. The governor told me that in our state of 6. 6 Million People, there were seven point 6 million opioid prescriptions written in 2016. Even though the state has reduced the amount of opioids prescribed, the number of Overdose Deaths is up because of the abuse of fentanyl, a synthetic opioid. Timer than spend more establishing the crisis, i want to focus on what we can do about it. There are does go things im hoping to learn from you. Things i amtwo hoping to learn from you. Why is it not a good idea to continue to find the socalled holy grail of medicine, a nonaddictive Pain Medicine . The second if stronger communities are the ultimate solution to this crisis as you often suggest, what can a Central Government in washington do that helps . You have a question, chapter in your book entitled searching for the holy grail, finding a nonaddictive Pain Medicine. I have read your book. I think there are a number of others who have and you brought it with them. This search for the holy grail began in 1928 with a committee on problems with drug dependence. That was the goal, as you describe it. Could not the best scientists find a way of extracting the pain killing elements of the morphine molecule while discarding its addictiveness . This effort to find a better way to treat pain led to a revolution in attitudes toward pain treatment. First using opioids to relieve pain for dying patients, then patients with chronic pain, then abetted by mexican gangs, clinics over prescribing doctors, spiraling into the addiction and consequences we find today. Congress, dr. His Francis Collins has predicted that the holy grail that was first sought 75 years ago is now within reach. Last month, he said perhaps within five years. With our encouragement, dr. Collins has organized researchers to speed up the process. The fda commissioner was on board to fasttrack the effort within the bounds of safety and efficacy. I read at least some of your book to say this holy grail may never be found. You even quote some scientists who say it should not be found. I hope you will tell us what you think about this. Should we not continue to try to find nonaddictive Pain Medicine to relieve suffering . Is that not the obvious antidote to the Opioid Epidemic . The second area i would hope to learn from you is what we can do from washington, d. C. We have tried to address the ravages of this crisis which we have all experienced in our states. Passed thengress comprehensive addiction and recovery act and the 21st century cures act to give states and communities the tools and resources they need to combat this crisis. For example, a provision by senators warren and cap ito was included and o was included only fillies can parts of prescription, that way a mother filling her sons pain prescription could ask only for three days worth of pills instead of the 30 days worth of pills he was prescribed. In addition to encouraging the moreopment, cures included than 1 million in state grants. We are considering additional funding for treatment and to discover alternative pain medications. We have held hearings on wellness, Lifestyle Changes, which you mention in your book, such as exercising, eating healthier, that help people lead healthier lives. What incentives would help people make those Lifestyle Changes . You and i have one thing in common. Im a skeptic of washingtons capacity to solve problems that are problems of communities, families, and lifestyle. You say the Opioid Crisis is a problem of society, that when we use when we lose our sense of community we become easily easy prey for external solutions. Moreur words, i believe strongly than ever that the antidote to hair when his community make sure the people in your neighborhood do things together, break down the barriers that keep people isolated. It is my own erience in public life ive been convinced of the problemsolving ability of communities where everybody seems to be interested in the wellbeing of everybody else. Whenever ive tried as governor or senator to solve a problem, it has boiled down to creating an environment where communities could themselves fix problems, not sending in singles shot solutions. After spending years on state reforms for education, i ended up traveling the state to create a better Schools Community task force because i believe communities who wanted good schools could have them and those that did not would not. Same views as we fixed no child left behind in 2015, when we restored more decisions to teachers, school boards, and states. What does congress do from washington, d. C. About this Opioid Crisis . This committee has jurisdiction over a significant amount of what you have written about in dreamland, but not the spending of money. That belongs in the appropriations committee. We are eager to hear your testimony. Murray . , thankrray sam quinones you for joining us. I also want to welcome your wife and daughter. Im glad they were able to be here with you today. I look forward to hearing your perspective on how we can better help our Community Fight this crisis and support all of those that have been impacted. I appreciate the investigative work you have done to help shed light on this challenge. I am sure you agree the rise of this epidemic is broader in scope than anyone book can tell. There are people from every background and corner of the country that have stories about the harm that this has done. Have lostarents children, children who have lost parents, veterans in chronic pain who are struggling with addiction, doctors who are treating babies born addicted to opioids and a lot more. Heartbreakinghese stories firsthand traveling around my home state of washington and meeting with doctors and families fighting this disease. I was visiting a local hospital in longview, a community in my state and the staff told me that almost one out of every two babies born have mothers who struggle with Substance Abuse. That was astonishing and heartbreaking. It was not the only evidence of this epidemic. 2000, nearly 10,000 people in Washington State have died of opioid overdose. This is not just happening in longview, it is happening in hospitals across the nation. We are losing 91 people every day to opioid overdose. When i say this epidemic means everyone, i do not just me the opioiduals facing addiction. There are other victims as well. Hurts families, at least children struggling to cope with the impact of their parents addiction. It leaves parents shattered with the heartbreak of their child illness and many struggling with the financial cost of opioid recovery. Our epidemic hurts communities. It takes up resources of Public Health hospitals and Law Enforcement. It takes workers out of our local economy, it takes a toll on the morale of small towns and big cities alike. We are behind the curve on fighting this epidemic. One of the stories that stood out to me in your book was about a state employee from the Washington Department of labor, a woman named jamie. She was a pharmacist charged with overseeing the cases of workers who were receiving Prescription Drugs for injuries. She noticed that some of these workers were dying from the same painkillers they were prescribed. The paper she published in 2005 about the uptick in opioid prescription and debts was one of the first papers in the country to document the impact of the crisis we are now facing today. She published her paper over a decade ago, which just shows we have been fighting this battle far too long and we have to do more. I am glad we have taken some necessary steps. In 2016, Congress Passed the whichentury cures act included funding for states to address the Opioid Crisis. The comprehensive addiction and recovery act, which supports specific outreach for veterans and postpartum women, and expanded access to medicaid assisted treatment and much more. There is a lot more to do. Along with many of my colleagues i hope we can move more funding , firstupcoming budget responders, state and local officials, treatment officials and families have made it clear that continued federal funding is the key to addressing this crisis. Have heard a, we lot of clock from the administration but we have yet to see the president take the kind of serious action that this emergency demands and that he promised families on the campaign trail. Own counsel ofs economic advisers estimating the economic crisis Economic Cost of the crisis to be over 500 billion just for 2018. Addressing a problem this big will take an enormous investment of time and energy and robust funding. Our communities are crying out for serious solutions, not stunts. I am eager to see this committee continue its bipartisan approach and to take expansive action to a dress this epidemic over the next few months. I look forward to working with you, mr. Chairman, to have all our members move ideas forward so we can work on policies for our communities. This means immediately providing supplemental funding states needs to implement evidencebased tools that can help turn this epidemic around and we need to make sure local stakeholders and partners who know what works best in their communities have the resources and information they need to respond to this crisis. It also means going beyond prevention and treatment and recovery. We have to work to support not only the individuals facing addiction but the families and communities who are suffering. I am interested to hear your perspective. I am grateful for you coming here today. If we are going to beat this opioid addiction, we have to fund and enact solutions that are comprehensive as the challenge. Thank you for having this hearing. I look forward to working with you and all our members. Thank you, senator murray, and thank you for working in this way to have such an important hearing. I am pleased to welcome sam quinones and his family today. Thank you for taking the time to be here. He has 30 Years Experience as a journalist and author. He has written extensively on the Opioid Crisis. He is the author of three acclaimed books, and his most recent book, dreamland the true tale of americas Opioid Epidemic won an award for general nonfiction. Early in his career, sam quinones was the recipient of a of the oldest International Award in journalism for his work covering latin america. He was also the recipient of an award for outstanding print journalists who pursue stories in the public interest. Will have 10, you minutes to give your testimony and then the senate is looking forward to having a conversation with you. Go. Quinones there we clearly i am a rookie here. Chairman alexander, senator murray, and honorable members of this committee, i would like to thank you for these hearings on our National Epidemic of opioid addiction and for allowing me the honor of addressing you. I am happy to be here with my wife and daughter, who are part of producing dreamland and without whom the book could never have been finished. This is the deadliest drug scourge we have known in this country, hitting areas of the country that have never seen this kind of drug problem. It is the first in modern america to be spread not by mafias, not by street dealers, but by doctors overprescribing pain pills, convinced they were doing right by their patients, urged on by the pharmaceutical industry, by the medical establishment, and urged on by American Health consumers who wanted a quick and easy end to pain. Ofs could not have dreamed inciting the kind of torment and death we have visited upon ourselves through this overuse of opioids. These drugs are a symbol for our era. We havest four decades exalted the private sector, the individual, while we ridiculed government as an efficient, incompetent, and wasteful. We admired wealthy business, regardless of the way they made regardless if the way they made their money produced anything of value. We brought a second gilded age. This epidemic of addiction to a class that thrives on isolation reflects all that. This epidemics cost have been borne by the Public Sector while the profit has been private. I believe this scourge is about than drug deeper addiction. It is about the effects of this cultural shift and isolation in areas rich and poor, about the hollowing out of smalltown america and the middle class, ization of our society. It is a culture that acts as if buying stuff is the path to happiness. I believe we got into this because we believed problems be attacked in isolation with one magical Silver Bullet. A pill for our pain, a jail cell for every addict. We have exalted the public and the communal and rid ourselves of things so essential to us they have no price. We have been invaded by cheap junk as a result. And replacedamland it with a strip mall, did that across america for years. Heroin is what you get when you destroy dreamland. I believe isolation is heroins national habitat. I believe this epidemic is calling on us to reverse these decades of isolation and come together as americans. I believe more strongly than ever that the antidote to heroin is community. People coming together and working in small and local ways towards solutions. No one saving the world alone. The good news in all this is that there is no solution there are Many Solutions. Much bell, each tinkered with an improved, some may be discarded. Each must be funded fully and for a long time. The good news is none will do the trick alone. I believe that across america today, communities are finding new solutions. Themore they band together, more they leverage all that talent and energy, bring in pdas , pastors, librarians, the chamber of commerce. The more cops and Public Health nurses that go out for a beer bridge the cultural chasm between them. I believe this is happening in counties across america. That supply has ignited all of this. We did not have this addiction until we unleashed a large supply of powerful legal narcotics on the public for the last two decades. Is essential that doctors reassess how and to whom and in what quantity they prescribe these drugs. Cuttings not mean people off who are on high doses of these drugs and leaving them to fend for themselves. It does mean lobbying Insurance Companies to reimburse for pain strategies that do not involve narcotics, allowing doctors a wider array of pain strategies than simply pain pills. Doctors need more education in the med school in both Pain Management and addiction treatment. Delusional to spend time and money on another wall along the u. S. mexico border hoping this will stop the supply of heroin and fentanyl. These areas are coming in through areas with wall already. Corrodee a wall will the only thing that will help stop these drugs from flowing into our country. That is a deep, respectful, but also forthright and want and relationship with mexico that will lead to it becoming the kind of neighbor and partner effectively and become the kind of neighbor that country needs of us. Another wall seems just like heroin. It feels good for the moment but it will leave us in a worse place in a long run. Another Silver Bullet for a complicated, adult problem. Sometimes the solutions are about the monday and mechanics of governing. We should find new ways of and corridors expanding our National Force of forensic pathologists. This epidemic spread because some of those offices are so poorly funded. We must expand Treatment Options in this country. One place to do this, crucially, is jail. Consider how the country will be helped transform and jail into a place of nurturing recovery, instead of a place of predation and tedium. It becomes an asset instead of a liability and this is happening, particularly in the state of kentucky. I would also like to add that all across america are families who are suffering due to the addiction of a loved one or the loss of that loved one. I believe they are Raw Materials to be harnessed in this fight. Many who do not want to be involved need to be involved. To stop the wounds that will last a lifetime. I believe you senators can help this by recruiting them and giving them platforms from which to tell their story. I am at is