Dreamland the true tale of americas opiate epidemic. Senator murray and i will each have an Opening Statement and then i will introduce the witness, then with her from mr. Quinones, and then senators will each have five minutes of questions. Since his are only witness i suggested to him that if he wants to take a little more than five minutes to say whatever he has to say, we would welcome that, but who will be plenty conversation back and forth from members of the committee. Mr. Quinones, it is unusual to have a single witness at our hearing but this is an unusual topic, one you quote Washington StateResearch ProfessorGary Franklin is calling the worst manmade epidemic in history. The challenge this crisis present has captured the attention of a member of this committee. The research and writing has been acclaimed for the depth and breadth so this is what we call a bipartisan hearing, most of ours hour. One in which a a democrats and republicans agreed on the topic, its important, and on the witness. Its my hope we restate our habit of lecturing one another about Health Insurance and focus today on the topic, which is the Opioid Crisis. This epidemic kills more americans every day than car accidents. Each of our state we are reminded of that almost every day. Yesterday i drop by a meeting of the tennessee governors residence in nashville. The heads of all of our state institutions involved in training doctors were planning how to discourage the over prescription of opioids. The governor told me that in our state of the 6. 6 million people, they were 7. 6 million opioid prescriptions written in 2016. And that even though the state has reduced the amounts of opioids prescribed, that the number of Overdose Deaths is up because of the abuse of fentanyl, a synthetic opioid. Rather than spend more time establishing the crisis i want to focus today on what we can do about it. Here are two things im hoping to learn from you. First, when 100 million americans live with pain, 25 million of them with chronic or severe pain, 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 by the ultimate solution to this crisis, as you often suggest in your book, what can the Central Government in washington do that actually helps . Now, my first question come here for chapter in your book entitled searching for the holy grail, finding a nonaddictive Pain Medicine. Ive actually read your book. I think there are a number of others here who have and who have even brought it with them. This search for the holy grail began you say 75 years ago in 1928 with a committee on problems with drug dependence. That was the goal, as you described, cold, couldnt that this site is find a a way of extracting a painkilling attributes from the morphine molecule while discarding is a miserable addictiveness . This effort to find a better way to treat pain, you say, led to a revolution in attitudes toward toward pain treatment for choosing ultimates relieve pain for dying patients, then for patients with chronic pain, then multitude of helpers from mexican gangs to pain clinic him over prescribing doctors and enterprising Drug Companies spiraling into the diction and consequences we find today. At least twice before this congress dr. Francis collins, that of the National Institutes of health, 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 and a h researchers and partnership with private companies to speed up the process, and the fda commissioner dr. Scott gottlieb is on board to fasttrack the effort within the bounds of safety and efficacy. But i read at least some of your book to say that this holy grail may never be found. Even some scientist who say it should not be found. So hope you will tell us what you think about this. Should we not continue to try to find nonaddictive Pain Medicine to relieve suffering without addiction . Is that not the obvious antidote to Opioid Epidemic . The secretary of a dope to learn from you about is what we can do from washington, d. C. We have tried in a foreign waster dreads the ravages of this crisis which weve all experienced in our states, in 2016 Congress Passed a comprehensive addiction and recovery act, and the 21st century cures act to give states and communities those on the front lines the tools and resources they need to combat this crisis. For example, provision by senators warren and capital was included that made it clear pharmacies could only fill part of certain prescriptions like oxycodone, and opioid, that when a mom is going her sons pain medication could ask only for three days worth of bills instead of the 30 days he was prescribed. In addition to encouraging the development of a nonaddictive Pain Medicine, cures included more than 1 billion in state grants. We are considering additional funding for treatment, and to discover alternative Pain Medicines. Weve held hearings on wellness, lifestyle changes, which are mentioned in your book, such as exercising, eating healthier that help people lead healthier lives and what incentives would help people make those lifestyle changes. You and i appear to have at least one thing in common, i am a skeptic of washingtons capacity to solve problems that are essentially problems of communities, families and lifestyle. You say that the Opioid Crisis is a problem of society, that when we lose our sense of community we become easy prey for quick external solutions for complex problems like opioids. In your words, quote, i more strongly than ever that the antidote to heroin is community. Make sure people in your neighborhood do things together. Break down those barriers to keep people isolated, unquote. In my own experts in public life including time as governor i been increasingly convinced of the problemsolving ability of communities with good jobs, good schools, Strong Families were everyone seems to be interested in the wellbeing of everybody else. Whenever ive tried as governor or senator solve the problem come in the end it boils down to creating an environment in which communities could themselves fix problems, not sending in single shot solutions from a distance. For example, after spending years on state reforms and education as governor, i ended up traveling the state to create 140 third middle Schools Committee taskforces because i believe that communities who wanted good schools could have been, and those who did not would not. I held the same views as we fix no child left behind in 2015 when we restored more decisions to classroom teachers, School Boards and state. So exactly what does congress do from washington, d. C. About this Opioid Crisis . This committee has jurisdiction over a significant amount of what youve written about in dreamland but not the spending of money. That belongs in the appropriations committee. We are eager to hear testimony and to hear your solutions. Senator murray. Thanks very much mr. Chairman. Im glad to be continue our discussion on this important issue. I know our witness today has been following the Opioid Crisis and its growth into the fullblown epidemic, families and Community Across the country are facing today. Mr. Quinones, thank you for joining us. I also want to welcome your wife and daughter whom i assume are sitting right behind you there. 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 communities write this crisis and support all of those have been impacted, and i really appreciate the investigative work that youve done to help shed light on this challenge. Of course amateur you would agree the rise of this epidemic is broader in scope than any one book can tell. There are people from every background and every corner of the country who have stories about the harm that this is done, and they are parents of lost children to an overdose, children have lost parents to an overdose, veterans in chronic pain or struggled with addiction, doctors are treating babies born addicted to opioids, and a lot more. I have heard these heartbreaking stories firsthand traveling drama home state of washington, a meeting with doctors and families in communities fighting this disease. I was visiting a local hospital in longview, a Real Community in my state and the staff told me that almost one out of every two babies born there have mothers who struggle with Substance Abuse. It was astonishing. And heartbreaking. But its unfortunately not the only evidence of this epidemic. Since 2000, nearly 10,000 people in people in Washington State alone have died of opioid overdose. This isnt just happening in longview. Capital and local hospitals across the nation. Were losing 91 people every day to opioid overdose. When i say this epidemic affects everyone, i dont just mean the individuals facing opioid addiction. There are other victims as well. This epidemic hurts families. It leads children struggling to cope with the impact of their parents addiction. It leaves many of them in foster homes. It leaves parents who are shattered with heartbreak of their childs illness and lease many struggling with the financial cost of opioid misuse and treatment and recovery as well. And this epidemic hurts our communities as a whole. It takes up resources of Public 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 with each new tragedy and we are behind the curve on fighting this epidemic. One of the stories invested it to me in your book was about a state employee from Washington Department of labor and industries. A woman named jamie may. Jamie was a pharmacist charged with overseeing the cases of workers who were receiving Prescription Drugs for injuries pick after six months she noticed that some of these workers were dying from the same painkillers that they been prescribed. The paper she published in 2005 about the uptick in highstrength opioid prescriptions and deaths was one of the first papers in the country to document the impact of the crisis that were now facing today. But she published a paper over a decade ago which just shows weve been fighting this battle far too long, and we have to do more. Im glad we have taken some necessary steps in 2016 congress baths a 21stcentury 21st century cures act act which included nearly 1 billion of funding for states to address the Opioid Crisis through prevention and treatment and recovery efforts. And the comprehensive addiction and recovery act which supports specific outreach for veterans and pregnant and postpartum women expanded access to medicaid and assisted treatments and much more. But there is a lot more to do. Along with many of my colleagues i hope we can move more funding in the upcoming budget for appropriations agreement. First responders can stay local officials, treat the professionals and families have made it clear continued federal funding is key to addressing this crisis. And, unfortunately, we have a lot of talk from the administration on this but weve yet to see the president take the kind of serious action that this emergency demands and that he promised families on the campaign trail. The white house own Council Economic advisers released a report estimating the Economic Cost of the Opioid Crisis to be over 500 just for 2015. Addressing a problem this big will take an enormous investment of time and energy and focus and robust funding. The president thirdquarter paycheck is not going to cut it. Our communities are crying out for serious solutions, not stunts. Im eager to see this committee continuing its bipartisan approach and to take substantive action to address this epidemic over the next few months. Mr. Chairman, i look forward to working with you to have all of our members bring their ideas forward so we can work on moving policies that upper families and communities. We have to do a lot more to fund the prevention efforts and treatment programs and build on the gains weve made. This means immediately providing supplementing fun states need that can help turn this epidemic around and we need to ensure that local stakeholders and partners, the people on the ground who know what works best in the community have the resources and information they need to respond to this crisis. It means going beyond prevention and treatment and recovery. We have to work to support not only the individuals facing addiction at the families and communities who are suffering as well. Im interested to hear your perspective on this today and how we do that, and im really grateful for you coming today to testify before us. Because if were going to beat this opioid addiction, we have to find and Index Solutions that are as comprehensive as this challenge to thank you convey much for having this hearing. I look for to working with you and all our members. Thank you, senator murray, and thank you for working this week at such an important hearing. Im pleased to welcome sam quinones and his family today. Thank you for taking the time to be here. Mr. Quinones, has to use expense as a journalist and author cookies written extensively on the Opioid Crisis in Drug Trafficking, is author three acclaimed books, his most recent book, dreamland the true tale of americas opiate epidemic won the National Book critics circle award for general nonfiction. Early in his career mr. Quinones was the recipient of the maria moores cabin prize, the oldest International Award in journalism is work covering latin america, was also the recipient of a paterson fellowship awarded to outstanding print journalists who pursue stories in the Public Interest of block up again, mr. Quinones. You will have ten ten minutes o give her testimony and then senators looking forward to having a conversation with you. [inaudible] there we go. Clearly im a rookie here. Chairman alexander, senator murray and honorable members of this committee. Id like to thank you for the sins of a epidemic of opioid addiction and for allowing me the honor of addressing you. Im very happy to be with my wife and daughter who are part of producing United States and without whom the book could never have been finished jerk this is the deadliest drug scourge with known in this country hating aeries 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, indeed, urged on by us, by American Health consumers who too often wanted to, a quick and easy end to pain. Isis could not have dreamed of inciting the kind of torment and death that we visited upon ourselves to the over use of opioids. These drugs are a symbol for our era. For almost four decades we have exalted the private sector, the individual while we ridicule government as an efficient, incompetent and wasteful. We admired wealthy businesspeople regardless of whether the way they made their money produced anything of value for our country and our communities. We brought i believe a second gilded age. This epidemic of addiction to a class of drugs that tries on isolation reflects all that. This epidemic costs have been borne by the public sector, all its profits have been private. I believe this scourge is that issues far deeper than drug addiction. Its about the effects of his very cultural shift. Its also about isolation in areas of rich and poor. About the hollowing out a small town america and the middle class, of the cyclization of our society, and is about a culture that acts as if buying stuff is the path to happiness. I believe we got into this because we believe problems could be attacked in isolation, with one magical Silver Bullet, a pill for all our pain, jail cell for every addict. We exalted the private and mock the public and the communal, and in so doing we rid ourselves of thing so central to us that they have no price. We have been invaded by cheap junk as a result. We dug up dreamland pool and replace it with a strip welcome to things like that across america for years now. Heroin is what you get when you destroy dreamland. I believe isolation is heroines national habitat. I believe this epidemic is calling as to revert these decades of isolation and come together as americans. I believe more strongly than ever that the additive to heroin is not naloxone. It is community. People coming together and working in small and local ways toward solutions. No one saving the world alone. The good news and all this i believe is there is no solution. There are Many Solutions. Each small, each must be tinkered with, and proved, some may be discarded. Each must be funded fully and for a long time. But the good news is that none of them is sexy. None will do the trick alone. I believe that across America Today communities are finding these solutions. The more they band together, the more they leverage all that talent and energy bring in pdas, pastor, artists and athletes, recovering addicts and