The Senate Committee on Health Education labor and Pensions Committee will come to order. Debbie talk about the Opioid Crisis the number one Public Health changes good out witness todays sam quinones. The author of dreamland, a true tale of americas Opioid Epidemic. Senator murray and i will each have an Opening Statement and then i will introduce the witness. Then we will hear from mr. Sam quinones and senators will each have five minutes of questions. This is the only witness i suggest if you want to take more than five minutes, to say whatever he has to say, we welcome that but there will be plenty of conversation back and forth for members of the committee. Mr. Sam quinones it is unusual to have a single witness at our hearings. But this is an unusual topic. One that you quote a professor is probably 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 a claim for their depth and breadth. This is what we call a bipartisan hearing. Most of them are. One in which democrats and republicans have agreed on the topic. On the importance and on the witness. It is my hope that we senators will restrain 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 states when reminded about almost every day. Yesterday i dropped by a meeting of the tenancy governors residence in nashville. Has about 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, is. 6 Million People, it was 7. 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. Rather than spend more time establishing the crisis i want to focus today on what we can do about it. There are two things im hoping to learn. 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 . And stronger communities are the ultimate solution as he often suggest in your book, what can a Central Government in washington do that actually helps . Now my first question, you have a chapter in your book entitled searching for the holy grail. Finding a nonaddictive Pain Medicine. I have actually read your book. I think that there are a number of others here who have an even brought it with them. This search for the holy grail began you safe 75 years ago in 1928 with a committee on problems with drug dependence. That was the goal as you described it. Quote . The best scientists undulate extracting the painkilling attributes from the morphine molecule while discarding its miserable addictiveness . This effort to find a better way to treat pain you say, led to a revolution and attitudes toward pain treatment. First using opiates to relieve pain for dying patients. Then for patients with chronic pain. Then with a multitude of mexican gangsta pain clinics, overprescribing doctors and enterprising Drug Companies spiraling into the addiction and consequences that we find today. At least twice before this Conference DoctorFrancis Collins, head 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 doctor collins has organized researchers in partnership with private companies to speed up the process. The food and drug and ministration commissioner was on board to fasttrack the effort within the bounds of safety and efficacy. I read at least some of your post to say that this holy grail may never be found. Some Scientists Say it should not be found. I hope you tell us what you think about this. Should we not continue to try to find nonaddictive penn medicine to relieve suffering without addiction . Is that not the obvious antidote to Opioid Epidemic . The second area i would hope to learn about is what we can do from washington dc. We have tried in important ways to adjust the ravages of this crisis. Which we have all experienced in our state. In 2016 Congress Passed the comprehensive addiction and recovery act. In 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, a provision for sinners warren and treadwell was included that made it clear pharmacist could only fill parts on prescriptions like oxycodone, and opioid. That way a manipulative sons pain prescription after his wisdom teeth surgery can only ask for three days with the pills. Instead of 30 days he was prescribed. In addition to encourage the development of a nonaddictive Pain Medicine, cures including more than 1 billion in state grants. We are considering additional funding for treatment. And to discover alternative Pain Medicines. We have held hearings on wellness. Such as exercising, eating healthier and help people lead healthier lives. And what incentives would help people make those lifestyle changes. But you and i apparently 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 uncured crisis is a problem of society. 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 believe more strongly than ever that the antidote to ireland is community. Make sure people in the neighborhood do things together. Break down those barriers that keep people isolated. In my own experience in public like a thing time as governor ive been increasingly convinced of the problemsolving ability of communities. With good jobs, good schools, Strong Families where everyone seems to be interested in the wellbeing of everyone else. Whenever i try to step in our center to solve a problem, in the end it was doctor creating an environment in which communities can themselves fix problems. Not sending in single shot solutions from a distance. For example, after spending years on state reforms in education as governor, i ended up traveling the state to create 143rd better Schools Community task force because i believe the communities who wanted good schools can have them and those who did not, would not. I held the same views as we have fixed no child left behind in 2015 when we restored more decisions to classroom teachers, School Boards and states. 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. Not the spending of money. That belongs in the appropriations committee. We are eager to hear your testimony and your solutions. Senator murray. Thank you mr. Chairman. Im glad to be continuing our discussion on this important issue. I know our witness today has been following the epidemic crisis. Mr. Sam quinones, thank you for joining us. As we like to welcome your wife and daughter who i assume the city behind you. Im glad that they were able to be here with you today. I look forward to hearing your perspective on how we can better help our communities like this crisis and support all of those who have been impacted. I really appreciate the investigative work that you have done to help shed light on this challenge. Of course, im sure that you would agree the rise of the epidemic is broader in scope than any one book can tell. Their people from all backgrounds that have stories about the harm this is done. The arkansans lost children to an overdose. Children that have lost parents to an overdose. Veterans in chronic pain struggling with addictions, doctors treating babies born addicted to opioids and a lot more. I heard these heartbreaking stories firsthand traveling around my home state of washington. And meeting with doctors and families and communities fighting this disease. I was visiting a local hospital in longview. A community in my state and the staff told me almost 1 out of every two babies born, they have mothers that struggle with Substance Abuse. That was astonishing and heartbreaking. But it is unfortunately not the only evidence of this epidemic. Since 2000, no 10,000 people in Washington State alone have died of opioid overdose. This is not just happening in longview. This is happening in local hospitals across the nation. We are losing 91 people every day to opioid overdose. When i say this epidemic affects everyone, i do not just mean the individuals facing opioid addiction. There are other victims as well. The epidemic hurts families. It leaves children struggling to cope with the impact of their parents addictions. At least many of them in foster homes. Parents shattered with the heartbreak of the childrens illness. It leaves many struggling with the financial cost of good misuse and treatment and recovery as well. And this epidemic hurts our communities as a whole. It takes up resources, Public Health, hospitals and Law Enforcement dictates workers of the local economy. It takes a full on the morale of small towns and big cities alike with each new tragedy. We are behind the curve on fighting this endemic. One of the story gusted out to me in the book, was about a state employee for 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. After six months she noticed that some of these workers were dying from the same painkillers that they had been prescribed. The paper she published in 2005 about the uptick in high strength open prescriptions and deaths was one of the first papers in the country document the crisis we are facing today. She published the paper over a decade ago. And it shows we been fighting this battle for far too long. We have to do more. Im glad we have taken some necessary steps. In 2016 Congress Passed the 21st century cures act which included nearly 1 billion of funding for states to address the Opioid Crisis to prevent and treat and the recovery act. This sport specific outreach for veterans and pregnant and postpartum women. They extended access for treatment and much more. There is a lot more to do. Along with many of my colleagues i hope that we can move forward funding in the upcoming budget for appropriations agreements. First responders state and local officials Treatment Professionals and families have made it clear continued federal funding is key to addressing the crisis. Unfortunately we have not had a lot of talk from administration on the spigot to see the president take the serious action that the emergency demands and he promised families on the campaign trail. The white house is on council of economic advisors released a report estimating the Economic Cost of the oakland crisis to be over 500 billion just for 2015. Adjusting the problem this will be taking an enormous investment of time energy and focus and robust funding. It is the Third Quarter paycheck of the president that will not cut it. Our communities are crying out for serous solutions. Not stunts. Im eager to see the committee continue the bipartisan approach and to take substantive action to address the epidemic over the next few months. Mr. Chairman, i look forward to working with you to have all of our members bring their ideas those we can work on moving policies to help our families and communities. Plan to do a lot more to find prevention efforts and Treatment Programs and builds on the gains we have made. This means immediately providing supplementing funding states need to implement evidencebased tools that can help turn the epidemic around. We need to ensure that local stakeholders and partners, the people on the ground we know what we are best in their communities, works best in their communities will respond to the spirit also means going beyond prevention and treatment and recovery. After work to support that only the individuals facing addiction but the families and communities were suffering as well. Im interested to hear your perspective on this today and how we do that. Im grateful for you coming here today to testify before us. Because if we are going to beat this opioid addiction we have to fund and enact solutions that are as comprehensive as the challenge. Thank you again very much for having this and i look forward to working with you in our members. Thank you, senator murray and thank you for working in his way to have such an important hearing. I am pleased to welcome sam and his family today. Thank you for taking the time to be here. Mr. Sam quinones has 30 Years Experience as a journalist and author. Written extensively on the oakland crisis and Drug Trafficking. The author of three acclaimed books. Most recent book dreamland, the true tale of americas Opioid Epidemic. It won the National Book critics circle award for general nonfiction. Early in his career mr. Sam quinones was the recipient of the Maria Moors Cabot prize. The International Award in journalism for his work covering latin america. It was also the recipient of a fellowship awarded to outstanding journalists who pursue stories and the Public Interest be welcome again mr. Sam quinones. You have 10 minutes to give your testimony and then the senate is a look at both to have a conversation with you. There we go. Clearly im a rookie here so a chairman, 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 the honor of addressing you. Im very happy to be here with my wife and daughter. For part of producing dreamland. And without him the book could never have been finished. This is the deadliest drug scourge lived on 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 convince 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 quit into tranquilizers could not have dreamed of inciting the kind of torment and death that we have visited upon ourselves to this overuse of opiates. These drugs are a symbol. For our era. For almost 4 decades, we have assaulted the private sector, the individuals. While we ridiculed government was inefficient, incompetent and wasteful. We admired wealthy Business People regardless of whether the way they made their money produce anything of value for our country and our communities. We have i believe a second gilded age. This epidemic of addiction to a class of drugs that thrives on isolation reflects all of that. This epidemic since cost has been borne by the public sector. All of its profits have been private. I believe that this is about issues far deeper than drug addiction. It is about the effects of this very cultural shift. It is also about isolation in areas rich and poor heard about the hollowing out the small town america and the middle class of that civilization our society. And it is about a culture that acts as a buying stuff is the path to happiness. I believe we got into this because we believe problems can be attacked in isolation. With one magical Silver Bullet. A pill for all of our pain. A jail cell for every addict. Results of the private and not the public in the communal. And in so doing we rid ourselves of things so central to us that they have no price. We have been invaded by cheap junk as a result. We dug up dreamland and replace it with a strip mall. Things like that requested america for years now. Heroin is what you get when you destroy dreamland. I believe isolation, the natural habitat, i believe this epidemic therefore is calling on us to revert these decades of isolation and come together as americans. I believe more strongly than ever that the antidote to heroin is not an officer it is not naloxone. No one is saving the world alone. The good news in all of this i believe is that there is no solution. There are Many Solutions. Each small, each must be tinkered with, improve. 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 leveraged all of that talent and energy, bring in ptas, pastors, artists and athletes. Recovering addicts and primary care doctors. Lib