All right, bear with me here. I have all this technology but thank you everyone for coming today. Open to the Washington Post, im mike bowes, i cover Washington Congress for the post. Im here today to discuss the nations Opioid Crisis and i know i dont need help the people in this room about the scale of that crisis. The victims, families, doctors, Public Health officials, people that look like me and lawmakers like these have been spreading the word about whats been going on and were going to begin our program today with a discussion of the policy and government response and i invite you all to sit down. So turning me on stage and part me just a moment while i just, first we have Diana Degette of colorado, a senior democrat on the house committee, ranking democrat on the oversight and investigations subcommittee. She cosponsors or coauthored the 20th century jurors act with which put 1 billion of new federal funds into the full viewing epidemic to combat it. Chief deputy whip of the House Democratic caucus, thank you very much. Senator ed markey is here of massachusetts, democrat and member of the Senate Commerce committee which has brought jurisdiction over the pharmaceutical industry. Hes done numerous investigations and authored numerous pieces of legislation to address this crisis, hes going to talk quite a bit about that and last but not least, german ed walden is with us. Chairman of oregon. He has brought attention to the Opioid Epidemic that affected his district in rural and Eastern Oregon. He is also plays a key role in overseeing the Health Sector of our economy. He played a key role in drafting the American Healthcare act which is now going through the congressional process and we are going to give you an opportunity to talk about that legislation and the oversight that youve done on your committee, thank you very much for being here. Let me start with center markey. This is a question im going to throw to everybody on a panel today. But tell me how you First Experience this crisis as a crisis, when did you understand that this is something that needed your attention and what did you see in your state that compelled you to act . It was massachusetts, it was Martinluther King day. January 15, 2014, i was standing in the back of the room and ready to give my speech and i said to the police chief and the mayor, they are holy and taunton, with the Biggest Issue . Well, weve lost seven people to overdoses in the last couple weeks. And then i said to the chief, i said whats the issue . He said there now leasing the heroine with fentanyl. And he explained to me about fentanyl area and i brought back phil kolakowski, drugs are of the United States and the numbers are huge. In massachusetts, in 2016 we lost 2000 people to Overdose Deaths, opioid related deaths. Where only two percent of american population, if the whole country was dying at that rate that would be hundred thousand people in the year, that would be to vietnam wars every single year. All of those who died in 2000 70 percent had fentanyl in their system, that would be 1400 people in massachusetts last year. Extrapolate that to the coal country, that would be 70,000 people dying from fentanyl related overdoses in one year. That is now something that is going to hit the rest of the country, slowly but surely, massachusetts is a preview of coming attractions, only 33,000 people died from opioid overdoses in the country last year, we are three times worse than the National Rate area unless we in place the prevention and treatment programs, we are going to see this epidemic just explode even further and from that moment, in taunton when the police chief and the mayor told me about fentanyl, it has been just a predictor of this catastrophe spreading inextricably inevitably across the country. What year was that . January 2014 was 14, 15, 16, now halfway through 2017 and the numbers have skyrocketed since 2014 in massachusetts as they have across the whole country. To put it from my distinguished colleagues, if you picked up a copy of todays Washington Post, theres a story in there with an amazing statistic that illustrates the scope of this issue that in 2014 you had one point, nearly 1. 3 million emergency room visits for inpatient stays for opioid related issues in 2014 thats a 99 percent jump for emergency room treatment compared to 2005. Its a remarkable statistic. That 2014 number which is, thats a great story on the Washington Post today, that number is much much higher today in massachusetts and we were the second worst state on that list from the study the post had today. And we have a much worse problem today than we had in 2014. Chairman walden, let me ask you, you worked in oregon , is a rural community, largely rural, some of the most beautiful country in america. Whats happening, what have you seen and when was the moment you realize there was something. Ive done a series of roundtables years ago and i always remember a couple examples. There was a woman in hermiston oregon on, rural Eastern Oregon who talked about her addiction to opioids. Shes now a treatment counselor, trying to get off of it is almost impossible, she wanted to get onto suboxone that helps you get off of it, there was no physician in the immediate area that could help her so he would commute 5 and a half hours each way from Washington State where she could get treatment and finally get off. Down in bedford i did a roundtable with Law Enforcement with some people and families. In this fellow sitting in the back, he wasnt part of the roundtable but i called on him and said what brings you here . He said my son. My son wasnt actually in high school and got injured and got prescribed opioids to deal with the pain. And tragically got hooked and went to the cheaper, more potent version of that. You would know it as heroine. He said he succumbed to that. My sister was a nurse, same sort of scenario. She got hooked on it, would write her own prescriptions, forging a doctors prescription pad. Got caught, moved on somewhere else, took it up again and it overwhelmed her and she too had died. Then you begin to talk to everybody else in your community how they are affected and its this explosion. In oregon we are ninth in the country, fourth among women but we predate that with another skirt which was methamphetamines and oregon led in this, we did work here in washington on it like were doing on opioids, its a precursor to chemicals, that still remainsa big issue in Eastern Oregon. One of the leaders in trying to push back on this , a friend of mine was quoted recently in a new series about how he was trained as a physician to prescribe for keloids to relieve pain. There were never really trained in alternative pain relief practices. And now its just right to fill them so hes trying as a physician to lead an effort to turn this around. We are also seeing a dramatic increase by the way in 65 and older that are being treated in patients and hospitals because of this addiction so its affecting every age group and finally i would say there was a really troubling story as part of this series in the arkansas observer about a physician who engages in the treatment and one of his patients was a rancher who keeps preloaded syringes in the cab of his tractor so when hes out there he can just shoot up during the day. And its loaded with heroin. This is having unbelievable consequences across the country and i think we are all together trying to figure out strategies to reduce the illegal pills on the market and we passed legislation to reduce the prescription amounts that are given, let me ask you this, you represent a different kind of district, you represent a different part of denver and a suburb, the suburban district, reporting on this its a rural phenomenon. And in communities like the Eastern Oregon, the fact that the whole picture or is that not the whole picture . The opioid problem, i think people focus on rural areas because they expect that drugs and addiction issues will be urban issues though their shock when its in rural arkansas but i remember you were asking my colleague, when did this hit home . A couple years ago i was at the book club which is the annual fundraiser for the Denver Public library and i was sitting next to the Denver Public library and and i said what are the issues youre facing, here at the Denver Public library and i what she would Say Something like Cyber Security or access to books, she said we have people overdosing in the Library Every day and we need to get our librarians so they can give it to people who have overdosed. At the Denver Public library. So now there was just a story the other day in the denver post that they finally did get the nine variants noloxone but they had a guy die in the main library last year. They had a number of overdoses and the librarians run over. And i think what all three of us have recognized is this does seem to have exploded on the scene. Weve heard stories about addiction for some years and cautions about overuse of opioids but it really, the stories are just exploding. And in our committee, oversight and investigation, energy and commerce we did a whole series of hearings about a year or two ago on opioids and it was amazing how many sections there were about the next extent and nature of the problem and how much confusion there was about what you do about it. So its not always that you have hearings that really educate the members of congress but i think we all learned a lot about what were supposed to be doing and that was part of what informed the caravel last summer that we passed and the funding that you mentioned that we put in our 21st century cure. Lets talk about euros briefly. That was a really remarkable bill not only for what was in it but the fact that it came together at all at a time when parties were last year and still arent working together on a whole lot in a productive manner,but this was one area where republicans and democrats came together. You worked with fred upton , chairman waldens predecessor in energy and commerce to makethis happen. And talk specifically about the addiction part of that bill and how that got brought into this bill that was also about more including pharmaceutical development and things like that. This was a bill that we worked on for about three years and it wasnt just me and fred, it was also greg and ed and his democratic and republican colleagues in the senate so it was really an effort to focus on primarily on research dna and the fda but as the bill moved into its final stages, we realized that there were some funding issues in the healthcare space where we could really get bipartisan bicameral consent and as i said, we passed that caravel the year before and it had a lot of really good administrative programs for opioid prevention and treatment but it had no money. That was one of the biggest criticized and everybody had that time. So when we did the carousel we were able to say lets really put the boot here, lets put 1 billion in grants to state governments. Let me ask you this, talk about, pardon me for putting in the these terms but that can be difficult for republicans to spend money on anything sometimes. But this issue was one where there was a wide agreement that something had to be done, talk about what the feeling has been among your republican colleagues in trying to come together. I would suggest that in 21st century we did mandatory spending for nih because we believe in medical research and really the big increases in nih budget go back to the days of Newt Gingrich in medical research. We doubled the nih budget and did that and then there was a pause. Now were trying to wrap it back up in a bigger direction. Clearly dianas work and friends and others really are passionate about this. These issues dont pick parties. When they show up on your doorstep. And i think they help bring us all together in a common cause. So the billion dollars, we had 65 million in grants out of that so im pretty short order i would argue that money not only got in there but now its getting onto the ground in the field, fully into the hands of those professionals or community who know best what to do with them. To address this issue. So i think there are good mechanical pieces to dianas point. In terms of changing how many people can treat with naloxone. My friend from ferguson who had to go out of state to get treatment now can get more people. And that really fulfills the prescription, that gets it out of the market hopefully. These are all things we learned in the roundtables i get back home and they gave the money in their and in the ahc we put another 15 billion towards this addiction and other things but certainly in there and we will see because its not always about the money. Its about changing behaviors and finding best practices. That was part of the debate i heard at least was better understanding of physicians prescribing community about what they should do and shouldnt do because it goes back to an original study that said oh, theres no addictive natureto this. So feel free if you go back to the foundation or where we are today it was founded on the whole premise that it was okay that these bills would be addictive so now we know 90 days danger zone. And so we need to do this administration. Turns out it wasnt even a study, it was a short letter in the journal of internal medicine that the pharmaceutical industry used as an explanation for prescribing these drugs. There continue to be bipartisan efforts to address this, can you talk about what youre working on right now, the energy data and other efforts in the oversight realm as well. To take action . Im working with morgan rubio on a bill to give customs and Border Patrol the technology they need in order to detect fentanyl and other substances at our border so that before it comes in from mexico or china, they areable to do that. I actually said to Mitch Mcconnell, two years ago that lexington kentucky, lexington massachusetts doesnt make any difference. We need a Surgeon Generals report on addiction and so what i suggested to him was the smoking reports, the Surgeon Generals report, we you and i, we should act to do it and he conceded it in one year. Which laid out now the parameters of the problem and what needs to be done. So to that extent, there is a lot of bipartisanship. I was able to pass legislation with rand paul on suboxone medication assisted therapy so that became part of the law as well. On the other hand were having a big battle right now about funding. In the Affordable Care act and whether or not the slashing of that funding is going to have a profound effect on the ability of people to gain access to the treatment which they need. The centers for American Progress concluded that 91 billion on the Affordable Care act would have been spent on Substance Abuse disorders over the next 10 years and that money will not be there. If the Affordable Care act is repealed. So were going to have a huge debate over whether or not this funding is going to be there because honestly, a vision without funding is a hallucination. You got to have a funny there in order to buy these programs and this debate is now really escalating in the senate because we, the democrats are saying that this Opioid Epidemic, Substance Abuse disorder epidemic is something that is going to get seriously shortchanged the proposal as it is currently constructed becomes the law in our country. Chairman walden, this chairman of the energy and commerce committee, you know more than anybody else about whats in the American Health care act which is the Republican Health care bill now moving through the process. You certainly, that is not a bipartisan effort as we all know. Thats the republican response to the Affordable Care act. You heard senator markey and even people in your own party on the senate side talk about the potentially difficult effects this bill could have on addiction treatment. Just give us some facts as you see them of what the bill would do and whats in that bill to help people who are suffering from addiction . First, you have to bifurcate it because what we do know is the individual Insurance Market has a lot of problems on the exchange. You have a group of people who we want to make sure insurance or access to the choices of affordable insurance and right now day after state, county after county were seeing more and more limited choices, counties may have more choice so if you are in need of treatment and you cant get insurance, you have really no option, or very few options. Were trying to fix that Insurance Market, this is difficult work to do, difficult in the house and senate because we share a common goal of trying to make coverage available, make it affordable. On the other hand on the medicaid side we believe that theres enough headroom in there in the 90 million that theyre putting in under a provision to allow increased deductibility on Health Insurance costs, it was to move about 90 billionand more flexible for the sex make changes. Put specifically 15 billion in four addiction trea