Ladies and gentlemen, welcome to baltimore and online viewer around the world good morning and welcome. Im dean of the John Hopkins Bloomberg school of Public Health. Want to extend a special welcome from president president bill clinton [and several pile simake Elijah Cummings and. Id like to extend an especially warm welcome to senator Barbara Mccosky whom we are now proud to call one of our own. Thank you so much for being here. We are authorized work with the Clinton Foundation to bring you this submit on americas Opioid Epidemic. This is a National Crisis that demands involvement from all levels of government, public and private organizations, as well as from individual citizens. Nearly 100 every day done every day near hi 100 die from opioid overdose. Over the past 15 years the death rate from opiode overdose has tripled. The causes are complex. Millions with chronic noncancer pain are prescribe opioids instead of safer alternatives, heroin is more available and increase leg contaminated with illicit fentanyl. And far too often far too few people have access to evidencebased addiction treatment. The Bloomberg School leadership in preventing and prevent substance disorders stretches back nearly 50 years when we founds the nations first graduate training policeman for drug and alcohol counseling and advocated for the adoption of methadone in federally find dream program. That leadership has been semenned in the foundationing of two centers, one for injury prevention and control and the other for drug safety and effectiveness. Our collaboration with the Clinton Foundation to address the Opioid Crisis began in may of 2014, when president bill clinton led a town hall in this very room focuses on the rising rayings of injuries and death from prescription opioid. The ruling synergy United National leaderred from academyarch government and the private sector paved the way for herelong effort to identify best practices. Based on this initial engagement in 2015, the Bloomberg School and the Clinton Foundation produced a document that is identified a path forward and framed the problem as a severe Public Health issues. We still have a long way to go. Opioid deaths reach an alltime nye 2016 and the numbers keep rising. Despite recent announcements by the white house, our country has not yet embraced addressed the real need for urgent action and a true commitment of resources. A new report just released by the Bloomberg School and the Clinton Foundation entitled the Opioid Epidemic, from evidence to impact describes ten pillars to dress the epidemic now, including implementing prescribing guidelineson amazing Prescription DrugMonitoring Programs, advancing engineering solutions, as well combating stigma. These strategies work. They have been shown to work. And youll hear from experts and advocates working together to change the course of the epidemic by further developing and implementing these strategies and generating new evidence. But we need your help. Please lets Work Together to stop this deadly epidemic. Im honored now to introduce congressman Elijah Cummings. Born and raised in baltimore, congressman cummings has represented marylands seventh Congressional District since 1996. The ranking minority member of the House Committee on oversight and government reform, and serves on a task force on healthcare reform. As cofounder and chair of the congressional caucus on drug policy, he has helped Shape National policy on drug addiction, elicit drug tracking and access to affordable medication is. Please, join me in giving a warm welcome to congressman Elijah Cummings. [applause] good morning. Good orange. We can do better than that. Good morning. Good morning. Its my honor and brave privilege to be here and i want to thank you, dean, for your very, very kind words. More importantly i thank you for your work. I must take this moment i have to do this. On behalf of my family, and certainly on behalf of generations of cummings yet unborn, i want to thank Johns Hopkins for taking good care of me. [applause] having spent almost two months in the hospital, just a few blocks from here, after a heart procedure, i must say that i have grown to love Johns Hopkins even more, and so to dr. Risard to dr. Sisson and staff to the cleaning people to the cav fear you folk cafeteria folks, everybody associated with this campus, i thank you for changing the trajectory of my destiny. I truly, truly appreciate it. Thank you. [applause] im honored to join former president clinton and dean mckenzie in welcoming our distinguished panel to this third summit on our nations opioid cries. Certainly always good to see my good friend, my mentor, and i will always call her my senator, senator mccosky, and i understand that John Sarbanes is in the room. Congressman, im glad you are here, too. The danger we now face, and must overcome, is more virulent now than ever. Prescription opioids, heroin, fentanyl and other synthetic drugs were involved in more than 60 of overdoses last year that resulted in 64,000 deaths. Lat that sink in. 64,000 deaths. Here in maryland at least 2,089 people fatally overdosed in 2016, up 66 from 2015. This is stark evidence of how these dangers and human devastation are expanding execs oanyone exponentially. Theres a bull bipartisan opinin that the crisis exists but resistance remains in white house and congress to take bold action. This year the residents own opioid commission, led by governor chris christie, recommended that the president declare a national emergency. As all of you know, last week the president declared a Public Health emergency, which is a good first step but does not unlock any additional federal funding to confront this crisis head on. The Christie Commission also recommended Something Else. That the president authorize the secretary of hhs to negotiate lower prices for the life saving drug that reverses the effects of opioid overdoses and im sure you will hear a lot more about that from dr. Wen who has been a stark advocate for expanding its usage. Right now, our people on the front lines of the coming not afford to stock up on naloxon. Last month joined 50 house members sent a letter to President Trump asking him to adopt this recommendation. We didnt ask him. We begged im. Unfortunately the president didnt even mention the word in his announcement last week. Finally, as you all know, the president and the Congressional Republicans have spent years, year,s, trying to repeal the Affordable Care act and reverse the medicate expansion, even though medicaid provides Treatment Services to three in ten people who struggle with opioid addiction. If we are going to respond to this epidemic, we need your evidencebased research and your continued active engage independent the public debate. We must encourage the president to follow his own commissions recommendation to expand the availability of naloxon and reduce the cost. We must press Insurance Companies listen to this we must press Insurance Companies to eliminate their bias in favor of opioidbased pain killers and we must challenge our friends in congress to expand Public Health funding, preserve medicare and safeguard medicaid. Finally, let me say this. You already know that our response to this Public Health crisis is a test for our community. It is also a test for our entire society. Theres an expression that applies to the current crisis. One of to the expressions that you hear something you say i wish id come up with that but its so true. And senator mccosky issue think about these words all the time because their so true help said the cost of doing nothing is not nothing. Tweet that. Think about that. Think about it, though. The cost of doing nothing is not nothing. So let me repeat it. The cost of doing nothing is not nothing. And we have seen it over and over again. So, ladies and gentlemen, i thank all of you for being here today. We are an army and we are going to fight and we will overcome. Thank you very much. [applause] thank you very mump, congressman cummings for your leadership on this issue and congress and those inspiring words for us today. I am now thrilled to introduce and welcome back to our school, president clinton president bild chair of the Clinton Foundation and former float United States. President clinton established the Clinton Foundation to build more resilient commune biz improving global health, strengthening local communities and protecting the environment. In 2002 he lunched the initiative to negotiate prize hiv aids medication to extend access to 11. 5 Million People in over 70 countries, and an achievement that many thought was impossible. Using a similar strategy, president clinton negotiated National Partnerships with two pharmaceutical companies to provide predict, fordable supply of na nalaone. His goal is to cut prepsychiatrics drug abuse creates in half. This would be done through Strategic Partnership that raise consumer and Public Awareness, advance business practice change and mobilize communities. Please, join me in giving a warm welcome to president clinton president bill clinton. [applause] thank you very much. First of all, dean mckenzie, thank you for having us back at the Bloomberg School of Public Health. And for the Ongoing Partnership we have had in confronting the Opioid Epidemic. I want to thank congressman cummings for his remarks and his leadership on this and many other issues. He said that senator mccosky was his role model and he certainly proved it in the last couple of years. When barbara was a senator from maryland, she was on a very short lift list we kept the white house. It was called the just say yes lift. Because when she asked for something, you knew sooner or later you would cave in, because she was like a dog biting your leg. So, save a lot of time can, just figure out what she want asks say yes and we can go back to work. Im glad to see her here and glad she is teaching here. I want to say thanks to two other people. For their inspiration to me in Public Health. One is Mike Bloomberg for funding the effort. He has got a lot of money, know, and he but he could have done other things with it, and he was a great Public Health mayor of new york and this is a great school. Other person i want to thank but our foundation who is not here is my daughter, chelsea, who teaches Public Health at columbia, and is sort of my family inhouse free expert on anything that relates to Public Health policy. And who urged me for years to get involved in this, when most people werent paying anyway attention to it. I want to thank mostly all of you for being here and agreeing to take action. The cdcs latest provisional data says that in 2016, 464,000 people in this country died of drug overdoses. Well over half of them, opioidrelated. If this data is confirmed we have no reason to believe it wont be that means last year more people died of opioid related drug overdoses than the numbers of deaths from the aids crisis at the peak before it was treated, than from gunrelated homicides, or from automobile accidents. Opioid related deaths are now the leading cause of death for americans under the age of 50. Virtually all of us know someone in a family that has lost a loved one. Hillary and i have five friends who lost their children, and ive learned a great deal from these families. One of them had a son who was working for hillary when he died. And had worked for me, and was in the law and nba program at George Washington university. He was a very smart man but nobody ever told him you cant possible a pill to get a buzz after drinking five beers and go to sleep or you might never wake up. Everybodys got stories like that. And now as we know, the epidemic has grown like wildfire in small towns and rural areas with no Public Health infrastructure, where people dont know what to do or cant do it if they know. Its not only a human tragedy. The cdc estimates it cos us more than 78 billion a year to continue to do so little in such a fractured way on this problem. Healthcare costs, criminal justice related costs, addiction treatment, lost productivity. Yet for all the noise thats been made about it, and the genuine legitimate concern, and the extraordinary efforts being made by people with nothing and i mean nothing dish was in ohio about a year and a half ago, a little town in southwest ohio. And i was very proud of looking at it because it was totally rebuilt, an early 19th century town all of the beautiful building were rennovated because of investments, secured partly under the new market tax credit which was the last completely Bipartisan Initiative i signed to get people to invest in small towns in rural areas with high unemployment and low per capita income. That whats good news. The good news further was that its the most beautiful build fog town had been begin over by the city to doctors who voluntarily came there so they could practice in appalachia. It was beautiful. It was doctor born in poland, got her medical degree in new york. Who was living in one of those lovely apartments. But i walked out and across the street this woman is waving frantically at me, please come over here. So i go over, and she says, i only own one asset of any value, a used car, sold that and represented that office and your seeing the only drug Treatment Facility we have in this town. She then introduced know a woman whose husband just died of a heroin overdose, the poor mans version of opioid addiction if you travel down, and three women who were recovering heroin addicts. And she said, look, im happy to do this, i know nothing about it. I get whatever help i can, and its all we got. Im glad that one of our panelists is the head of Public Health in battedmer who has the first Public Health program in any city in the United States, going back to the late 18th 18th century. But in many places, Community Health networks have been allowed to at at at that atrophy. This is like a good news bad news story. The good news is, this is the first drug epidemic when we act like a grownup country treating it like a Public Health problem instead of a criminal justice problem. [applause] its a good thing. Some cynics have said thats because it started amongst small town and rural white people, epidemic before it spread to the cities and maybe something to that. I think the more likely explanation is that this is the first epidemic we have had killing this many people that had a nonviolent delivery chain. Now, the problem is, as we all know, the more we get into cheap heroin grown into mexico, harvested by preteens, and fentanyl, the more likely we are to see more violent Delivery Systems as people fight over guaranteed money. Its coming to them this movie is coming to a theater near you, whoever you are, whatever your color, whatever your politics are, and that brings me to the bad news. Its a Public Health problem. We recognize it. Good for us. Were going growing up as a country. Were seeing all these people as people. Bad news is, theres a wholefully inadequate Public Health response that is not properly coordinated with Law Enforcement, with the treatment community, with the insurers, with you name it. So, what were heath to do today is to figure out what to do next. The next panel after our what were going to try to do is identify what many of you already know, but the general public may not, which is where are we right now, what is being done thats good, what are the gaps. Then we go to the second panel and our panelists are here. Theyre going to discuss the report we were releasing today that Clinton Health matters initiative, along with the Bloomberg School, called from evidence to impact, which is sort of professional way of saying, we know what the heck is wrong, we know what we need to do, how about we do something. There are proven recommendations in this report for combating