Transcripts For CSPAN State Officials Testify On Opioid Epid

Journal live at 7 00 a. M. Eastern monday morning. Join the discussion. State officials discuss efforts to combat opioid addiction. Two hours, 15 minutes. Good morning, everyone. Today the subcommittee of oversight and investigation holds a hearing entitled combatting the Opioid Crisis, battles in the states. Make no mistake, the terms combatting and battles are entirely appropriate. Our nation is in the midst of a tremendous fight against death and devastation affecting over corner of our nation. In 2015 there were more than 52,000 deaths from Drug Overdose in the u. S. With 33,000 involving opioid. 23 increase. In 2015 it was almost seven times the rate of deaths from the heroin epidemic of the 1970s. In 2016, weve lost roughly 60,000 people to Drug Overdoses, more in one year than all the names on the Vietnam Veterans memorial wall. And likely that number is underestimated because much of the data will not be in until the end of this year, 2017. Its staggering. For every fatal overdose its estimated there are 20 nonfatal overdoses. For 2016 that could be near one million. More than 183,000 lives have been lost in the u. S. From these overdoses between 1999 and 2015. Thats about 500,000 will be lost over the next decade. The roots of the crisis began in 1980 when a letter to the editor published in the new england journal of medicine was misinterpreted as evidence that someone was unlikely to be addicted. 20 years later the joint commission on accreditation of Health Care Organizations followed established standards for Pain Management interpreted by doctors as encouraging the prescribing of opioids. Under the Affordable Care act. A hospital may receive more or less money. As we learned in the oversight hearing inmarch the Opioid Epidemic is an Urgent Public Health threat fueled by fentanyl. A clear and present dangerto america. Two states represented on todays panel. Rhode island and maryland were the first hit by thefentanyl wave. Fentanyl this waveertain that as itsep the naion increasingly attractive to traffickers and easy to manufacture or obtain over the internet. This is an inextremist moment requiring all the experience, resources, cooperation of our federal, state and local governments as well as the different industries, professionals and experts to curb this terrible outbreak. With this hearing well focus on the actions of State Governments to find out whats working, whats not working, how we can Work Together to save lives. As a panel we want to know the problems and please be candid with us. As you know there are millions of families being torn apart by this. As drug policy expert noted it is at the state and county levels that the Real Progress will be made. It makes sense of efforts to find inspired solutions be most concentrated there and we should learn from them. State governments have been pursuing innovative initiatives such as inventive use of incentives. Structured treatment. Prescription drug monitoring. States like maryland are making use of the guidelines to push back on overprescribing. Kentuckys allschedule reporting system, a web based Monitoring System to help prescription use across the state helpsstate regulators identify questionable prescribing practices by physicians and abuse by patients. Virginia has expanded access to the drug that can rapidlyreverse the overdose but also can have its own risks. Some states with expanding the availability of it by providing thirdparty prescribing. Much of the work of the states should help form the president s combatting commission. The subcommittee held a similar hearing on what the State Governments were doing to combat the epidemic. This helped Congress Enact provisions in thec. A. R. A. Act will help the administration. Weput one billion dollars into grants over the next two years, but we want to know if this money is being used wisely and how what is working. Were eager to learn about the programs. The state program is just a beginning. Our State Government witnesses can help the committee develop a more effective nationalstrategy to combat the Opioid Crisis in such areas as Substance Abuse prevention, education. Physician training, treatment of recovery. Law enforcement, expanded access to vivitrol while testing for drugs incorrectional facilities. Data collection, examiningwhat reforms can be made so that there is bettercoordination of care among physicians and help prevent relapses and overdose and improve patient safety. We are in one of the worst medical tragedies of our time, perhaps the worst. And although this committee this subcommittee has given attention to many other problems in the past, we recognize this is paramount among them. This is a National Emergency. We look forward to hearing from the states about what youre doing on the front lines of this. I yield to my colleague for five minutes. Miss deegette of colorado. Thank you. I appreciate this hearing on opioid addiction. As you accurately said this crisis is devastating america as all of us on the dais have seen it play out in our communities, urban and rural alike. Not a day passes without a report about children watching their parents overdose, aboutlibrarians and School Nurses being trained toadminister naloxone to overdose victims or about local and State Governments trying to respond to the myriad of issues surrounding addiction, while at thesame time trying to stay within their budgets. There is some good news. Recently the cdc reported that opioid prescriptions peaked in 2010 and have since fallen by 41 . Thats the good news. The bad news is opioidprescribing remains untenably high. I am hoping ourfuture investigations will concentrate on this. In addition, as you pointed out, mr. Chairman, is theemergence of illegal fentanyl, an exceptionally potentopioid. In 2017 fentanyl overtook both heroin and prescription opioids as the leading cause of death in many places. Each of the states who are here today, and i want to thank you all for coming, have faced alarming overdose outbreaks. This committee has done some good work. In particular, investigating the seemingly seemingly voluminous amount of pills distributed in West Virginia and were planning to do more. The attorney general in my home state of colorado has joined a Bipartisan Coalition of states nationwide looking into whether manufacturers engaged in illegal or deceptive practices when marketing opioids. Coming up with an effective solution to the Opioid Epidemic will require us to understand the actions of all actors. I hope to hear from some of the states today on what role they believe drug manufacturers and distributors may be adding to the crisis. Also, i look forward to hearing from the panel about the impact of fentanyl on the towns and communities in which they work. States really are onthe front lines of fighting this crisis, and i look forward to hearing from all of you. I know that rhode island, for example, has led the way in connecting people with Substance Use disorders to highly trained coaches to guide them through recovery. Virginia is working to implement a similar Peer Recovery Program and kentucky established a program to provide medication assisted treatment to individuals in correctional facilities and to continue supporting them after theyre released. Maryland has committed to establishing a 24hour Crisis Center in baltimore city. Mr. Chairman, i know these are all great state efforts. We have made some efforts here in congress. And i appreciate you referring to the 21st century cures legislation that mr. Upton and i sponsored and that this committee worked on a bipartisan basis to pass. As we move forward, we need to Work Together to continue to address this. And thats why i kind of hate to be the fly in the ointment and talk about what these efforts to repeal the Affordable Care act will do to the fight against the Opioid Epidemic. As you know, the aca has helped nearly 20 million americans obtain health care coverage. In addition it has enabled governors to expand Medicaid Services tools that are critical in the fight. Studies show that since 2014, 1. 6 million uninsured americans gained access to Substance Abuse treatment across the 31 states that expanded medicaid coverage. This is particularly true for states like kentucky where one report says thatresidents saw a 107 increase in beneficiaries seeking treatment for Substance Abuse. Many think that thehousepassed bill that undermines the aca will threaten peoples ability to get opioid treatment. In its assessment, the nonpartisan cbo said the house bill will cause 23 million or 22 million americans to lose Health Insurance. A lot of these people, they need opioid treatment. There have been discussions, both in the house bill and the senate discussions, about adding some money for opioid treatment. But, for example, the most recent senate suggestion of additional 45 billion to help combat opioid addiction, Governor John Kasich said, quote, its like spitting in the ocean, its not enough. Weve got to get real and understand that access to Health Care Treatment is what is going to help with the health of all americans, including treatment of opioid addiction. And weve got to move forward to work on this together. I hope we can do that. With that ill yield back. Mr. Chairman. Ill recognize chairman of the full committee, mr. Walton. Addiction is an equal opportunity destroyer. Its a destroyer that doesnt pick people based on age, race or socioeconomic status. It does not pick them based on political parties. My round tables throughout the Second District of oregon, it didnt matter if i was in a Rural Committee or a more populated city, the stories were similar. We all know someone who was impacted by this epidemic. In my state more people die from drug related overdoses than from automobile accidents. Thats not unique. According to Data Analysis Drug Overdose deaths in 2016 likely exceeded 59,000 people. Thats the largest annual jump ever recorded in the United States. And whats worse,some of the preliminary numbers from the statesindicate that their numbers within the First Six Months of this year are already surpassing last years total numbers, and over the past seven years, opioid addiction diagnoses are up nearly 500 according to recent report. Despite a report released by the control lastisease week which indicates the number of opioid prescriptions has decreased over the last five years, thats the good news, the rates are still three times as high as they were just back in 1999. And the amount ofopioids prescribed in 2015 was enough for every american to be medicated around the clock for three weeks. That report also found that counties in oregon have some of the highest levels of opioid prescriptions in the country. Of the top ten counties in my state for opioid prescriptions, five of them are in my rural district. Moreover, oregonians aged 65 and older are being hospitalized for opioid abuse and overdoses at a higher rate than any state in the union. Opioid deaths continue to escalate, and this epidemic is simply getting worse and more severe. Challenges remain, and we need to get after it. We need to improve Data Collection. A few states are requiring more specific information related to Overdose Deaths. We cannot solve what we do not know. Overdose prevention efforts, improvement with respect to the utilization and interoperability of Prescription Drug Monitoring Programs. We need to increase access to evidencebased treatment including medication assisted treatment. Combatting this epidemic requires an all hands on deck effort from federal, state and local officials and all of us, spanning from Health Care Experts to our local Law Enforcement communities. Its precisely why we are having this hearing today. Last Year Congress took action to combat this crisis by passing legislation including the comprehensive Addiction Recovery act and the 21st century cures act and states improved programs to strengthen the fight. Much more needs to be done. We need to Work Together to ensure the tools and Funding Congress created are reaching our states and localities and being used effectively. We hope to hear from state officials today to see how theyre utilizing these funds and whether these programs work or not. We greatly appreciate the witnesses who have agreed to appear before us today. We hope to have a constructive dialogue about what the states are doing, how to improve Data Collection, the initiatives that are working, what isnt working and how the federal government can be a better partner inthe collective fight. I look forward to your testimony and working with all of you and our Community Leaders to help get our hands on this horrific crisis. So thank you for being here. With that, i know i have two members that want to introduce witnesses. Ill go to mr. Guthrie and mr. Griffith. Thank you for letting me sit in for purposes of introduction. He and i served together for a number of years. He was a leader on the other side of the aisle. Always a pleasure to work with. I appreciate his work very much. He became the first secretary of Homeland Security and virginias history. Reasoned. Rally well every once in while we disagree but not always. We have worked together on a number of things. Apologize, both mr. Guthrie and i have to move to another meeting. We have two bills upstairs. I will not be able to stay but i will read with interest your testimony and the words you have tuesday say. I welcome you to our community and i apologize i cannot be here because im defending bills upstairs. I yield the balance of my time, i, too, must go upstairs. We know recognize the gentleman from new jersey. Thank you mr. Chairman. Thank you for holding this hearing on this critical issue. Our committee has held several hearings on the ongoing crisis including one in march. The appointed epidemic is not the Opioid Epidemic is not leading letting up. Recently the cdc reported that the opioid prescribing rate has peakedbut remains far too high with enough opioids to keep every american medicated around the clock for three weeks. I am glad we have the states here today to hear about what theyre seeing on the front lines, what successful approaches they have found that deserve to be replicated and what challenges they still face. I would also like to hear from our witnesses about how the federal government can help while its important the states be empowered to address the particular challenges of their communities our response to this epidemic cannot be 51 separate efforts. We must harness our National Resources data and cooperation to get the crisis under control. As we talk about a Public Health crisis of this magnitude there is an elephant in the room that needs to be addressed. Coverage for Substance Abuse treatment is how an individual in society has a fighting chance to kick the opioids epidemic for good. Health coverage is one of ourstrongest weapons in the battle against opioids, the epidemic and the devastation it causes to our families yet republicans persist in their attempt to gut the Medicaid Program by capping it permanently and ending Medicaid Expansion as part of their efforts to repeal the Affordable Care act. Repealing the Affordable Care act and replacing it with trumpcare would be devastating to 74 million americans who receive Critical Health Care Services from the program. One in five americans receive Health Insurance from medicaid, half of all the babies born in this country are financed by medicaid. To the working poor, many of whom are hit hard by the opioids epidemic and are eligible for medicaid for the first time through the acas expansion, medicaid is the only affordable Health Insurance available. And state Medicaid Programs are at the center of the opioids epidemic. In the house passed trumpcare cbo determined 23 million americans would lose coverage, the majority covered through medicaid, with 834 billion in cuts to the program. The senates version cuts medicaid by a full 35 ov