▶ 0:00:00driven by an increased supply of synthetic opioids such as illicit fenil and its analoges last fiscal year Customs and Border Protection confiscated over 21,000 Pounds of fenil at our borders that's enough fenil to kill every American several times over and that's just the drugs we know about under the Biden Harris Administration we saw rates of Overdose and poisoning death Skyrocket peaking at nearly 108,000 in 2023
▶ 0:00:31driven by The Surge of fenil coming across our borders illicit fenil overdoses are now the number one cause of death among adults 18 to 45 each year more Americans are dying from illicit fenil than the number of Americans lives lost during the Vietnam war however I believe we have a great opportunity to make significant Su and sustainable progress in combating this crisis to do so we must continue to expand the avail a ability over of Overdose
▶ 0:01:01reversal treatments like nooon removing the stigma associated with carrying it and making it as common as a fire extinguisher every school in America should have access to the lockone we must secure our borders to stop the scor disc scourge of illegal drugs especially poisons like illicit fentel president Trump has already made progress to address the fentel crisis by forcing Mexico and Canada to come to the negotiating table with President Trump Trump's leadership we must continue to crack
▶ 0:01:31down on China Mexico and anyone who smuggles fentel and other synthetic drugs across our borders with the sole intention of prying on Americans additionally this committee is already taking action to help keep elicit fentel out of our communities and save lives later today the house will vote on a bill developed by this committee the halt all legal trafficing of fitel act which will take the critical step of permanently scheduling all fitel Rel substances as schedule one drugs
▶ 0:02:02under the controlled sub Services act these tools and solutions address today's problem but like the evolution of the opioid crisis from the overprescribing of oxycoton today to today's scge of synthetic opioids like fenil we must prepare for what's next in this hearing we'll hear from our Witnesses not just on the illicit drugs threatening our communities today but potential new threats that if left unaddressed will be driving this crisis all I look forward to that testimony
▶ 0:02:32and working alongside my colleagues on addressing these issues at this time I'd like to yield one minute to the gentleman from Pennsylvania Dr Joyce for a statement thank you chairman Carter and thank you for holding this important meeting I want to take this opportunity to introduce Mr Ray cullin who is here with his wife Deb they come from Pennsylvania's 13th congressional district and they tragically lost their son to fentanyl po poisoning Z was out with friends and they were sold
▶ 0:03:03drugs laced with fentanyl and on that tragic night Zach stopped breathing the compelling story that they brought to me and have continued to Advocate specifically for this halt fentel piece of legislation is not only important to them individually them as a family but is important to all of America and I am proud that both Ray and Deb Colin have brought this story to the house of Congress to
▶ 0:03:33be able to share it with us today thank you Mr chairman and I yield back thank you Dr Joyce I'd now like to you one minute to the gentleman from Michigan representative James for his statement thank you Mr chairman uh today I have the distinct honor and privilege of introducing a friend outstanding servant to Southeast Michigan law enforcement hero Pam's husband and Brother Rice class of 1999 commencement speaker Sheriff Mike buard I'm so proud that he's from my district and as our nation has faced an allout assault from cartels
▶ 0:04:03and adversaries like CCP the illicit drug epidemic is devastating our families and communities and Sheriff Mike bushard and his team are on the front lines he knows firsthand what's going on in our communities and he has been successful leading from Southeast Michigan in May 2024 500 grams of cocaine 50 grams of fentel and oxyon oxycontin were seized April 2024 20 ,000 in cocaine fentel and Other Drugs confiscated March
▶ 0:04:332023 41.5 kilos of fentel enough to kill all 10.3 million michiganders were confiscated because of the leadership of sheriff Mike bushard and his phenomenal team I'm grateful to him for his leadership I'm grateful for his friendship and I'm excited to hear about his leadership and lessons learned today Mr chairman with that at you thank you representative James chair now recognized the general lady from Colorado representative to get for 5 minutes for an opening statement thank you so much Mr chairman
▶ 0:05:04I'm very happy to be the ranking member on this committee and I'm looking forward to working with you and all of our colleagues on both sides of the aisle to advance strong bipartisan solutions to the issues we face and um I of course join you in in saying we need to be safe from dangerous drugs like fentanyl I do regrettably have to correct the record already even though it's just my first opening statement under the Biden Administration the Biden
▶ 0:05:34Administration was also working hard to curb Fentanyl and that's why last year the deaths from fentel were below 990,000 90,000 which was a decrease from 128,000 just the year before so I hope we can continue this but I think demagoguing on the Biden administrations uh and uh success and saying that death were higher is inaccurate something else I want to talk about is the developments that we've seen in the last couple of
▶ 0:06:04weeks under the new Trump Administration Donald Trump kicked off his term with actions that led to a daylong freeze of Medicaid funds for every one of our states last Monday Denver Health which is our safety net hospital that serves a regional area in the Rocky Mountains called saying all of their Medicaid funds had been frozen and they couldn't provide medical services to thousands of people um now in response to Donald Trump's
▶ 0:06:34executive orders then CDC removed from its website that guidance that doctors rely on to treat patients every day and data researchers use to improve Public Health I got a call from my daughter some of you guys know my daughter raphaela she's an internal medicine doctor at UCSF in San Francisco she told me that they couldn't get the CDC guidance on birth control or on vaccines and as of two days ago they still
▶ 0:07:05couldn't get the guidance on birth control and of course there's no available guidance for health care for lgbtq individuals anywhere also NIH Grant making for critical biomedical research is at a dead stop with no end in sight I got calls from some researchers at anu's Medical Center which does important life-saving res research and they were unable to access their Grant dollars for sometime last week
▶ 0:07:36and now a 23-year-old SpaceX intern has been given access to systems containing sensitive information about Medicare and Medicade Mr chairman I was just saying to you my constituents are terrified about what Elon Musk and his Lawless Doge are going to do with that access I had over 500 phone calls in my office in the last two days many of the individuals who were sobbing so as Donald Trump ground NIH to
▶ 0:08:06a halt and disrupted funding for safety nut Healthcare where is the outrage from the other side I have only heard Democrats speaking up are all of you afraid of Donald Trump do you agree with this Lawless assault on science the Constitution obliges the present to Faithfully execute the laws that congress creates and article one of the gives Congress that Authority so why aren't we exerting it the founders Envision the checks and balances
▶ 0:08:36in our constitution as necessary to curb abuses in the government quote ambition must be made to counteract ambition that's from James Madison and the government must be obliged to control itself we need to assert congress's Authority it's shameful that Republicans have sat by while Congress the first branch of government and the voice of the people has been silenced in this diminished State and allowed the executive branch and
▶ 0:09:06somebody who's not even elected or appointed to office to ignore the law so let me assure you our constituents are watching what's happening they are not happy and amidst this lawlessness this dangerous agenda to take Health Care away from hardworking Americans is not going to go we are going to fight with every fight of our being to make sure that that happens so that's pretty much how I'm feeling this morning and I'm going to tell you
▶ 0:09:37if you try to cut $2 trillion doar to Medicaid in order to pay for tax cuts for the wealthiest in this country this is not going to fly we need to have quality health care for every American we need to have biomedical research that will find cures for the diseases that we all care about and we need to continue to have adequate and full information so that everybody can get the Quality Health Care that need so
▶ 0:10:07I guess I look forward to working with you it's going to be a long two years I yeld back and with that the lady yields back I now recognize the chairman of the full committee chairman Guthrie for five minutes for an opening statement thank you uh chair chairman Carter for bringing us together in this important hearing and today we will hear from a diverse panel about existing and emerging drug threats that are infiltrating our communities thank you to all thank to all the witnesses for joining us today to talk about this unfortunately
▶ 0:10:37most Americans have a family member as we have before us today a friend or a neighbor who has been impacted by elicit drugs this could include anything from opioids such as heroin Elissa fenol phenol related substances to stimulants such as cocaine methamphetamine we have all heard heartbreaking stories and we're going to hear today which are truly heartbreaking about the toll that elicit Fentanyl and Fentanyl related substances are having on our communities and the rate at which Americans are dying from fentanyl poisoning is just
▶ 0:11:07staggering in 2023 alone the da Reed over 390 million lethal doses of elicit fentanyl in the United States that's more than enough to kill every American we've learned that most of the elicit fentel trafficked into the United States is being produced by transnational criminal organizations in from from chemicals sourced from China it's then coming across our Southern Border in mass quantities and brought into our communities
▶ 0:11:38this is why we must work together to finally get the halt finel act signed into law the halt Fel act sponsored by our good friend Reb Griffith is on the floor today and I encourage all my colleagues on both sides of the aisle to vote for this is a vitally important legislation on top of the increased prevalence of synthetic opioids xylazine or Tran is continuing to to emerge as a significant drug threat individuals who use xylazine may be at a higher risk from suffering from Fatal drug poisonings because overdose
▶ 0:12:08reversal medications cannot reverse its effects there has been bipartisan interest in making xylazine a schedule three controlled substance which will help DEA crack down on criminals who traffic the substance and hope to continue this momentum in Congress we hear we hear from families every day families who have lost a child a brother a sister and they don't want anyone else to experience their pain we owe it to them to do what we can do to prevent others from experiencing this loss we should be working
▶ 0:12:38together to punish those who make and import and distribute these poisons and help those with substance use disorder find treatment and recovery I appreciate the witnesses for being here and I will now yield the remainder of my time to my good friend from Florida Vice chairman Dunn thank you very much Mr chair I'm grateful to be serving as the vice chair of this health subcommittee in this Congress and as a doctor I look forward to contributing my expertise from more than 40 Years of practicing medicine in the Army and in private practice to the success of the committee I'm excited
▶ 0:13:08especially to work with chairman Carter and all of my colleagues on the committee to find solutions that make the United States the healthiest country in the world and that be work begins today in this hearing illicit drugs are one of the most serious issues facing the country and there are numerous contributing factors to the opioid and addiction crisis from open borders to weak on China policies of our prior Administration I'd like to underscore the latter we're in a serious competition with the Chinese Communist party and we have to take seriously what they're
▶ 0:13:38doing to infiltrate our health care System I thank the witnesses for being here and I'm hopeful that we can use your unique insights to craft effective policies to curb this epidemic and with that I Y back gentlemen yields the chair will now recognize um the G lady from Mass Massachusetts Miss Tran for five minutes for an opening statement for those of you who are unaware there was a coup last night and the ranking member of the new committee is now
▶ 0:14:08representative trean oh no Frank palone is his trouble just kidding thank you thank you thank you chairman thank you R ranking member to get and our panel of witnesses here today today we're discussing discussing existing and emerging drug threats while one existing and emerging threat unelected and unconfirmed billionaire Elon Musk is creating chaos throughout the federal government president Trump has handed control of all federal funds over to Elon Musk this is illegal
▶ 0:14:39it is dangerous I ask for unanimous consent to enter into the record a New York Times article entitled inside musk's aggressive incursion into the federal government according to this reporting Elon Musk has unilaterally seized control of the treasury payment system which distributes more than5 trillion dollar in payments annually including Social Security Medicaid and Medicare benefits he has no legal authority to unilaterally seize government payment systems and Records nor
▶ 0:15:09the private information of US citizens I am extremely concerned by a recent article in the Wall Street Journal that Elon Musk has now gained access to the centers for Medicare and Medicaid services system which help facilitate payments and provide Health Care coverage for over 160 million Americans I ask for unanimous consent to also enter into the record the article entitled Doge AIDS search Medicare agency payment systems for fraud musk has already gained unlawful
▶ 0:15:40access to the personal information of hundreds of millions of Americans and now their health care information what medical conditions they have where they receive their health care and what drugs they take this is apparently being done by some 20-some year old lackes of Elon Musk whose identities are being shielded from the public and who apparently only go by their first names musk and his minions are stealing the American people's personal information for what benefit
▶ 0:16:10to benefit his companies to go after Trump's political enemies this is corruption plain and simple and it utterly bewildering and disappointing that my Republican colleagues are silent while Elon Musk sifts through the private data of our constituents silence is complicity and I urge them to join us in condemning these unlawful actions and work with us to reign in the Trump administration's actions turning to the topic of today's hearing our
▶ 0:16:40ongoing opioid overdose crisis Public Health experts and providers know that we must do more than incarcerate our way out of this crisis they implore us to remove barriers to prevention and treatment programs for substance use disorder in partnership with other tools to crack down on illicit drug trafficking for example a public health success story is the widespread availability of the opioid overdose reversal medication noock Zone and increasing access to fenal test strips are another
▶ 0:17:10means to reducing deaths last week the Trump Administration froze virtually all federal funding stealing billions of dollars in funding for critical opioid prevention treatment and recovery programs clinicians have been left wondering if they would receive a paycheck for their work patients have been left in about whether their access to treatment and Recovery have been cut indefinitely the Trump Administration halted 6.5 billion doll in funding for programs that support a wide range
▶ 0:17:40of nxone programs treatment services and prevention efforts and it halted nearly one A5 billion dollars in funding to conduct research on substance use disorder in addition to improving Public Health I am bewildered by statements from my Republican colleagues about saving lives while there are still real concerns about Federal funding not getting out the door to help us combat the drug overdose epidemic and Republicans are also looking to undermine our efforts to combat the overdose
▶ 0:18:11crisis as they consider trillions of dollars in cuts to Medicaid so that they can give tax breaks to billionaires like Elon Musk and big corporations now Medicaid covers nearly 40% of all people with opioid use disorder Republicans plan to cut Medicaid will further limit access to care for substance use disorders leading to more deaths it doesn't have to be this way at the end of Congress of the last Congress we negotiated
▶ 0:18:42in good faith with Republicans on an end ofe package that would have reauthorized funding for the support act this bill funds opioid overdose programs first responder training and enhances access to substance use disorder treatment however after one tweet from Elon Musk the house Republican leadership went back on their promise and tanked the deal it's clear Republicans are not focused at all on addressing this crisis
▶ 0:19:12instead they're abdicating their responsibility to Elon Musk thank you I I believe the gentle lady had asked for unanimous consent iner to record two articles without objection that'll be order this concludes member opening statements the chair would like members what are the articles on I'm sorry Mr Tran represent Tran the Articles you asked to have inserted into the record was like
▶ 0:19:42the New York Times and you want to hold off until look at it yeah yeah okay we'll hold off until we can look at it and we'll move on okay this concludes member opening statements the chair would like to remind members that pursuant to committee rules all members opening statements will be made part of the record want to start and thank all of our witness for being here today taking the time to testify before the subcommittee I want to
▶ 0:20:12introduce our Witnesses now all of you are important thank you for being here and thank you for sharing your stories and your expertise Mr Raymond Cullen who is a family Advocate Mr Cullen your courage is certainly admirable thank you for being here we appreciate it very much Sheriff Michael bushard vice president of government Affairs for the major County Sheriff's Association thank you for being here Sheriff Dr Timothy Westlake an emergency medicine physician at Pro Health Care memorial hospital Miss Regina Lael professor
▶ 0:20:42and director of the master of science and addiction policy and practice at Georgetown University thank you for being here and Dr Deepa Kay the chair of the committee on substance use and prevention the American Academy of P Pediatrics thank you for being here per committee custom each witness will have the opportunity for a five minute opening statement followed by a round of questions from Members the light on the timer in front of you will turn from green to Yellow when you have one minute left I recognize
▶ 0:21:13now Mr Cullen for five minutes to give an opening statement thank you chairs Guthrie and Carter and ranking members I have colog but I I gu I did iess the microphone there you go hear me now I'm sorry there you go uh thank you chairs Guthrie and Carter and ranking members palone and theet for having me here today to speak at this hearing which based on the events transpiring this week is very timely I'd also like to thank Congressman Joyce for his support and friendship over
▶ 0:21:43the past few years I'm here today to discuss the fenal epidemic which has been targeting the targeting the young people of our country and to discuss some things that we would like to see done that some other parents do not receive a visit from the police informing them that their child is dead this is what happened just under two two and a half years ago today or two and a half years ago the state police knocked on our door and informed me that our son Zachary was dead presumably from an overdose he was the youngest of our three boys and he died just nine days after his 23rd birthday
▶ 0:22:14Zachary was a wonderful young man who was in college studying business has been working had been working at Papa John's delivering pieces for four years and was developing a technology company on the blockchain platform that was his dream that was his passion his other love was basketball especially playing a game of pickup in the driveway with me and his brothers his last year at school his inter mural team won the championship and he was so excited but even more impressive was his kind and Compassionate Heart Zachary helped numerous people during his short 23
▶ 0:22:44years his last summer at the beach he saved a friend who was caught in a rip current and on the verge of drowning and held him up until the lifeguards got there another time one of his co-workers mentioned that he was behind on his rent and was afraid that he and his family were going to be evicted having just received money from his grandfather at Christmas time Zach found out from his manager how much money was needed anonymously placed that amount of cash in an envelope and slipped it into his car that was our son he loved his family he loved his friends and he loved
▶ 0:23:15life Zachary did not suffer from substance use disorder he was not an addict however following his death we did learn that he had used cocaine on on occasion at College we were told that cocaine is a commonly used recreational drug on campus however Zachary did not die at school he and a couple of friends were in Harrisburg celebrated celebrating a birthday we were told by the detective that they were not in a bad area of town nor were they seeking out drugs they were downtown at a few restaurants and bars eating drinking and having fun
▶ 0:23:45the detective also told us that he believes the boys were targeted by the dealer why we do not know but they made the decision to purchase some coke that in itself was a poor decision but not one that should have cost him his life someone intentionally laced that cocaine with fentanyl our son did not accidentally overdose overdose he was poisoned there is a difference actually we personally feel that he was murdered we beg we beg of you to get the word out about Alysa fenel to everyone this is urgent and must
▶ 0:24:16be done immediately because we know we need to slow down the rate at which other families are losing their loved ones we feel this crisis should be attacked with the same Vigor and intensity that Co was and people need to know this statistics more than 110,000 people died from overdoses in 2024 and of those the majority involved Els fentanyl it only takes 2 milligrams of fentanyl to kill about the size of 10 to 15 grains of salt one packet of Sweet and Low is filled with fentanyl is enough to kill 500 people
▶ 0:24:46let me repeat that a Sweet and Low packet filled with fentanyl can kill 500 people so based on those metrics the 43 PBS of fentanyl C's coming in from Canada in 2024 would be enough to kill just under 10 million people parents need to know that these drugs are not just the ones being bought on the streets through dealers or from Child's friends or acquaintances but also through social media platforms such as Snapchat most kids are not addicts they're stressed out depressed and anxious kids looking for something to help calm
▶ 0:25:16them down to help them sleep or to help them Focus so they can study they have no idea that 70% of all drugs but either from a dealer a friend or online are laced with enough fentanyl to kill them is a real life game of rushan roulette and most of them don't even know that they are playing while we understand that there have been some efforts to combat The Scourge we find it difficult to understand why it took so long and why combating it would be so controversial or political some have said that there is a stigma attached to those overdosing
▶ 0:25:46on fentanyl that they are just drug addicts who will eventually die of an overdose or something or sometime while Zach did not suffer from substance AB use disorder the lives lost of those who were are just as valuable to their parents and loved ones as Zach is to us so what do you want us to do is a question we have heard from members of Congress before our answers are and have been education and awareness uh we feel strongly for PSAs parent focused on mainstream media young adult focused
▶ 0:26:16on social media make fental awareness part of high school assemblies and college freshman orientation and we really need to distinguish between poisoning versus overdose the other is treatment uh access to treatment and rehabilitation facilities for those already entangled sud I'd like to once again thank this body for taking on such a crucial topic that has forever impacted Our lives our fam's lives and the lives of hundreds of thousands of other devastated families as well and if you will indulge me I'd like to close
▶ 0:26:47with a prayer that I wrote which was read by my youngest sister at Zachary's funeral service you have broken me I am this figure beyond all recognition how can you put me back together with such a vital piece missing wait and as if you need any help from me might I offer the following less artificial anxiety less wearisome worry less Insidious
▶ 0:27:17selfishness less Foolish Pride and while you're at it add more love add more compassion add more I get it now less of me and more of you and one last non-negotiable I need the memory of Zachary Matthew Cullen knit as close to my heart as possible period amen I thank you for your time thank you Mr Cullen
▶ 0:27:48um Sheriff buard would recognize you for five minutes thank you chair Carter ranking member to get members of the subcommittee thank you for allowing me to testify today I'm Michael buard Sheriff of Oak County and I represent major County Sheriffs of America mcsa which includes the largest Sheriff's offices across the country our members collectively serve over onethird of America's population and as such we're on the front lines of the
▶ 0:28:18opioid crisis the deadliest drug epidemic in American history in 2023 nearly a 100,000 Americans lost their lives to overdose with with fentanyl as the primary driver the emergence of synthetic as uh opioids and analoges is worsening the crisis law enforcement Public Health officials and communities need to have a coordinated comprehensive response in Oakland County Michigan where I serve we are seeing very concerning new trends
▶ 0:28:48fentel remains a significant problem as we test these samples in my lab we've also seen an alarming rise of xylazine a potent tranquilizer and more cases of paror fentanyl which is far stronger than fentanyl these substances are often missed with other drugs like heroin and cocaine as we just heard making them harder to detect and increasing the risk of Overdose to address these threats we've been implementing innovative solutions
▶ 0:29:19we started a crisis response unit the team responds to individuals in crisis due to substance use and mental health issues we follow up with people that have been saved from overdoses to connect them to treatment ensuring they receive the help they need we actually did one such visit and saved a person a second time as he was actively overdosing we have also prioritized our co-responder program in partnership with mental health professionals we respond to crisis situations de-escalating and connecting individuals
▶ 0:29:50with appropriate Services while uring the public safety we were the first in Michigan to equip patrol cars with Narcan and in 2023 we became the first in the nation to deploy OPI a federal FDA approved nasal spray that can counter synthetic and non-synthetic opioids since 2015 through the end of January of this year my agency alone has saved 827 lives that's sad
▶ 0:30:20but it's important every life does matter and that gives them a second chance our jail was one of the first in the country to implement a medically assisted treatment program for incarcerated individuals struggling with substance use disorder offering personal treatment and connecting them to care after release we also have a long-standing initiative like operation medicine cabinet which helps prevent prescription drugs by providing safe disposal sites
▶ 0:30:51for used medication as well as rides to recovery which offer immediate transportation for individuals seeking help but as much as we can do at the local level law enforcement cannot do this alone we need Congress to support us by passing critical legislation specifically permanent fenel scheduling the halt fenel act would permanently classify fentel analoges as schedule one substances helping to curb the influx of these lethal drugs Congress needs to reauthorize high-intensity
▶ 0:31:21drug trafficking areas known as heida heida is vital for targeting trafficking routes and dism handling criminal networks it needs authorization increased funding and continue to be administered by the office of National Drug control policy we need stronger regulations on pill presses counterfeit pills laced with fentanyl are a growing threat we must tighten regulations around pill presses and increase the penalties for their illicit use we need more support for re-entry programs
▶ 0:31:52many people lapse into criminal Behavior due to lack of substance use treatment and support as they Reiner Society we are urging Congress to pass the second chance reauthorization act to help former offenders get the treatment they need in many areas funding for drug enforcement has been defunded Congress must provide necessary resources to help us fight fentanyl trafficking effectively it's impossible for us to tackle this crisis without a comprehensive approach that combines strong law
▶ 0:32:22enforcement with effective programming finally to combat the flow of Fentanyl and other illegal drugs we need to secure our borders strengthening border security and improving cooperation with law enforcement agencies will help disrupt the transnational drug trade in conclusion the opioid crisis particularly the surge in fentanyl requires a United and a comprehensive approach with your leadership we can make those significant strides and help combat
▶ 0:32:52drug trafficking improve public health and save lives I urge Congress to to act swiftly and I thank you for your attention to these critical issues so that we don't have any more members to a club no one ever wants to join thank you very much Sheriff uh I now recognize Dr Timothy Westlake for five minutes for his opening statement thank you chairman dun ranking member deette distinguished members of the committee thank you for inviting me to testify and for your leadership
▶ 0:33:23before I dive into the topic I wanted to tell you about the last time I used Narcan it was just days ago it was a quiet night shift in the ER I was mulling over my testimony when I had to rush out to a car that screeched into the ambulance Bay it was driven by the girlfriend of a patient who took what he thought was a Percocet it was actually a lethal dose of fentanyl he wasn't breathing and was about to go into cardiac arrest we pulled him out and quickly resuscitated him with Narcan within a minute he went from being blue and pulseless to wide awake he was lucky
▶ 0:33:53this time and went home with his family far too often the outcome is different fentanyl poisoning deaths are a Scourge in this country and will require all of us working together to solve it I want to share my perspective informed by 25 years on the front lines of emergency medicine and over a decade in medical regulation and policy work I was chairman of the Wisconsin medical Examining Board led the Wisconsin prescription opioid reform strategy and originated the idea of fentanyl class scheduling I see lethal drug thefts
▶ 0:34:23as a fire hydrant with many spigots they include but are not limited to prescription opioids xylazine nines illicit Fentanyl and Fentanyl related substances or F frs's different tactics and strategies may be needed to to be deployed to shut down each of the spigots unfortunately when one is shut down either another one gets more powerful or a different one opens up I'd like to clarify what f frs's are and why permanently scheduling them as a class is a critical policy tool f frs's
▶ 0:34:53are highly active opioids almost identical to fentanyl except for tiny difference in their chemical structure created by changing a single ingredient during synthesis the result of this tweak is a new potent opioid with the same deadly effects as Fentanyl and without class scheduling would be legal until causing numerous deaths class scheduling simply removes the incentive to create new F frs's and has been proven to do what it was designed to do halt their very creation some who Point some who oppose class scheduling point to deaths from
▶ 0:35:23elicit fentanyl as proof it doesn't work but that is a misunderstanding of the facts F FRS scheduling does not address elicit fentanyl it was never intended to do so there is no quick or easy solution to the scourge of elicit fentanyl but the solution to the spigot of f frs's is a simple legislative fix it's one the house is considering this week and voting on this afternoon the halt fentanyl act if schedule one penalties were removed for f FRS trafficking like some have proposed it would reinen divize their creation
▶ 0:35:54and significantly weaken the Law's most powerful proactive preventative effects there is a time and a place for Criminal Justice Reform but FR FRS scheduling is not it some suggest F FRS scheduling would have a negative impact on Research while theoretical it has been addressed with stakeholder input and is supported by the very agencies and organizations representing academic scientific research including the NIH HHS FDA and the National Institutes of drug abuse the halt fentel
▶ 0:36:24act would significantly loosen restrictions into studying all schedule one substances not just F frs's and open up promising areas of research into substance abuse let me also speak about the threat of nizin they are opioids as deadly as fentanyl they have recently been implicated in hundreds of deaths across the country emerging as the newest spigot that opened up after F FRS class scheduling was implemented since 2020 DEA has scheduled 10 different bioactive nizin and due to the creation of new variants has encountered
▶ 0:36:55and is in the process of scheduling multiple others this is eerily reminiscent of what we saw with f frs's 10 years ago prior to class scheduling I support working with DEA in taking a closer look at implementing class scheduling for nines due to their lethality xylazine is a potent annual tranquilizer and sedative used in cattle and horses that has not scheduled has not been scheduled federally and can currently be bought legally online it is used in veterinary medicine only and not approved for use in
▶ 0:37:25humans it is often combined by C T chemist with elicit fentanyl in order to amplify sedation and Euphoria but also causes strong respiratory suppression increasing overall overdose risk and lethality there is an urgent need for federal legislation to control it and to protect the public it's time for common sense to Prevail and for Congress to take action pass the halt fentanyl act and permanently close the spigot of f frs's you cannot die from ingesting something never created
▶ 0:37:55nor can you be incarcerated for traff in something that does not exist that is the beauty and simplicity of FR FRS class scheduling thank you again and I look forward to answering all your questions thank you Dr Westlake I now recognize Mr Regina lebel for five minutes for opening statement uh chairman Dunn ranking member to get uh and members of the subcommittee thank you for um the opportunity to testify today on this important topic I'm Regina lebel I'm professor of addiction policy
▶ 0:38:26at Georgetown University there I direct the master of science in addiction policy and practice and the center on addiction policy at Georgetown laws O'Neal Institute I'm really pleased to be joined here today by some of my students who are here to learn how to develop a bipartisan approach to reducing overdoses and improving the lives of people who have substance use disorder or who are affected by addiction I also serve in the National advisory Council on drug abuse at the National Institutes of Health however
▶ 0:38:56today I speak to you in my my personal capacity so for over 15 years I've worked on drug policy in both government and at Georgetown and I've seen by partisan efforts lean to meaningful action and I've also seen firsthand the impact of the overdose crisis The Grieving families who have lost loved ones remain always present in our mind as we work on these issues I've also celebrated with those in recovery witnessing the power of resilience strong support systems and effective
▶ 0:39:26policies now we know that since 2000 over 1 million Americans have died from overdoses and recent data from August of 2023 to August of 2024 shows a 20% decrease this is still high overdose deaths are still increasing among black indigenous and Hispanic communities and the majority of these deaths as we're talking about today involve synthetic opioids like fentanyl often mixed with dangerous
▶ 0:39:56substances like xylazine so obviously we have to take decisive action on this issue addressing the threat of synthetic drugs requires a comprehensive strategy first transnational efforts strengthening law enforcement cooperation to disrupt transnational criminal organizations elicit fentel is manufactured using precursor chemicals from China and processed in Mexico and then transited into the United States disrupting these Supply chains requires International
▶ 0:40:26collaboration operation Counter Narcotics cooperation and aggressive prosecution of financial crimes that sustain the drug trade public health expanding access across the Continuum of Care prevention so that we can equip parents and communities with the tools to recognize early signs of mental health and substance use expanding access to Noone that saves lives so as we know that states like Tennessee have documented over 103,000 overdose
▶ 0:40:57rever versals through Noone distribution Federal investment in evidence-based treatment that includes medications for opio disorder is essential and Congress took an important step by passing in a bipartisan manner the M mainstreaming addiction treatment act it removed outdated barriers to medication access but more work obviously is needed and our criminal justice system is part of the solution the federal approval of Medicaid 1115 waivers allows state
▶ 0:41:27to use federal Medicaid matching funds to treat people before they are released from a jail or prison and this improves re-entry outcomes the workforce investing in Workforce and and identifying tracking emerging drug threats so we have to equip our public health and law enforcement agencies with the ability to detect and respond to new synthetic drug threats States like Rhode Island and North Carolina are leading the way with drug monitoring programs that identify ify emerging
▶ 0:41:58substances and issue Public alerts continued support for the federal Workforce including CDC the state department The Drug Enforcement Administration and the office of National Drug control policy is also critical to ensuring a whole of response the best way to address this issue is through an all of the above strategy and one that integrates law enforcement public health and the workforce investment by working together we can disrupt elicit drug Supply
▶ 0:42:28chains expand treatment and Recovery Services and look around the corner so we're prepared for the next emerging threat this is a bipartisan issue and it affects every one of our communities and solutions have to be pursued with urgency and Unity thank you very much for your time and commitment to addressing this epidemic thank you Miss lebel and now recognize Dr Ken for her five minute opening remarks good morning chairman ranking member DEET and members of the subcommittee thank you for the opportunity
▶ 0:42:58to be here today to discuss the impact of current and emerging illicit drug threats on children adolescence and young adults my name is Dr Deepa camingay and I am chair of the American Academy Pediatrics committee on substance use and prevention today I'm here representing the AAP a nonprofit Professional Medical organization representing over 67,000 pediatricians as a physician board certified in Pediatrics and addiction medicine I've spent nearly
▶ 0:43:2920 years caring for teens I provide primary care and also care for young people who have overdosed have opioid use disorders or have started to try to use alcohol and drugs I'm experienced in prescribing medications for the treatment of opioid use disorder and conduct research on adolescent substance use prevention and interventions today I will talk about the importance of focusing on teens when addressing the ongoing overdose crisis the role
▶ 0:43:59pediatricians play in prevention and treatment and offer suggestions and how we can make progress with the help of Congress every day pediatricians see how the illicit drug epidemic harms young people today's adolescence are growing up amidst the most potent and lethal elicit drug Supply in human history the science is clear trying substances during adolescence increases the risk of addiction due to ongoing brain development during this
▶ 0:44:29period the widespread contamination of the drug Supply with fentanyl the emergence of counterfeit pills and the low availability of treatment for teens are continuing the fuel the opioid overdose and poisoning crisis some of the most important things we can do today are to prevent young people from elicit drug exposure and to treat teens with substance use disorders pediatricians are an essential Workforce for
▶ 0:44:59delivering prevention interventions and recognizing the early signs of substance use I'd like to describe some of the way pediatricians today are addressing the elicit drug epidemic in the healthc care setting first is through screening brief intervention and referral to treatment for some young people a pediatrician may be the first person to provide accurate information about the potential harms of substances espert is an evidencebased approach that we use
▶ 0:45:30in our offices we use validated screening tools brief counseling techniques and refer teens with substance use disorders to treatment unfortunately in many many communities this treatment is very hard to find second is by talking to patients and their families about nxone and prescribing it for overdose prevention third is by linking patients and family with community-based prevention programs and finally pediatricians help
▶ 0:46:00young people receive evidence-based treatment the AAP recommends buber orphen for the treatment of opioid use disorder of note adolescents with opioid use disorder often need mental health treatment alongside life-saving medications integrating Behavioral Health into Primary Care helps young people receive these treatments Congress has an important role in strengthening access to evidence-based prevention early inter prevention and treatment I will share four of aap's
▶ 0:46:30core recommendations first Congress can take up legislation to ensure Private health insurance Medicaid and publicly supported substance use Services stay in place and better support youth prevention early intervention and treatment needs second Congress can provide funding for Workforce Development and training so pediatricians and other people who work with young people can better meet the demand for care in their communities third Congress can incentivize
▶ 0:47:00the creation of integrated Behavioral Health models strengthen payment and eliminate barriers to integrated care and finally Congress can expand broad-based prevention programs support Public Health campaigns to educate about the risks of counterfeit pills and fenel and bolster drug use monitoring and surveillance efforts like the youth risk behavior survey healthc Care Professionals need access every day to this vital data and research to respond
▶ 0:47:30to current and future drug threats efficiently and swiftly thank you for the opportunity to testify today I look forward to answering your questions and working with you to protect young people from the current and emerging drug epidemics thank you thank you Dr cam Jay and thank all of you for your testimony we appreciate it um we'll begin now questioning and I will recogn recognize my myself for 5 minutes again thank you all for being here thank you for your
▶ 0:48:01testimony we all understand what's going on here we've got a poisoning problem here in America um I won't I won't bother to to udate you with all the the facts and figures we all know what's going on customs and protection Border Protection seiz more 21,000 Pounds of fentel at our borders and enough fentel to kill four billion people I do want to share a personal story with you professionally I'm a pharmacist and I was at a town hall meeting
▶ 0:48:31and I was addressing that town hall meeting we were talking about fentel and we talking about um about the problems that we're having and I made a mistake I refer to it as fentel addiction and a mother stood up and she corrected me as she should have and she said no sir it's not fentel addiction she said it's fentel poisoning she said my son took one pill and he's dead that's poisoning she was right and I was wrong it is
▶ 0:49:01fenel poisoning and it is a problem it is a serious problem a leading cause of death for Americans between the ages of 18 and 45 and everyone in this room whether you're up here on this Das or whether you're out there in the audience everyone in this room knows someone or has a family member who has been impacted by this everyone here has folks we got to do something something about this Sheriff bashard I want to ask you um do you recognize individuals
▶ 0:49:32who die because of fentel poisoning as the victims of a crime U thank you Mr chair yes we actually have prosecuted successfully individuals for murdering the individuals that they supplied the drugs to in the past thank you for that and and you know we we know that the opioid epidemic is still neg negatively affecting too many Americans but we are encouraged that the numbers are going down and we are encouraged that we're making progress
▶ 0:50:02and that is that is important however we can't stop we can't stop until we completely eradicate this we also know that um fentel Remains the threat is it crosses the border of millions of Americans and that n lockone that is now available over the county I got to share this with you I'm often critical of the FDA as I think I should be but I do applaud them for making the locks on over the counter we let I let a letter asking them to do that and they responded and they did do it so kudos
▶ 0:50:32to them it ought to be available I've said all along it ought to be just like fire extinguishers and and wherever you see a fire extinguisher you ought to see Noone available I carry it in my backpack everywhere I go thank God I've not had to use it but I've got it if I need it it is a lifesaving drug and we need to have it Sheriff bashard um what role do you see for nooon and protecting those who are are inter interdicting illicit drugs as well with
▶ 0:51:02Americans well we're on the front lines we're typically the first to receive the call typically we often beat the medical providers as well and so it's important for us to have the tools to be able to save that life in those critical moments it actually took me almost two years to get our state legislature to allow us to even carry and use uh Naran at the time and now we've added OPI to our tool chest as well because we're seeing such strength in the synthetic realm that sometimes it
▶ 0:51:32takes three four and five Doses and uh op has allowed us to have that extra tool that has reversed some of those so the front lines is really what we're seeing Dr Westlake would you agree absolutely good you know there was a a December 2024 da report that found that more than 107,000 people lost their lives due to drug overdoses in 2023 with nearly 70% of that being attributed to opioids such as fentel the locks on saves
▶ 0:52:02lives we've we've been able to get some of the companies some of the manufacturers to to donate it and we've been sending it to schools and making sure that they have it nxone should be in every school in America every school in America should have nxone it should be available Dr Westlake what steps would you take to increase access and awareness of life saving drug like n lockone well I think the key is as for a lot of the interventions necessary in this space is is through education and I think a lot of that has happened already I mean when I started
▶ 0:52:33the work in opioid prevention uh awareness 10 years ago there was it was very very little of it around and now it seems to be it seems to be becoming a thing that is much more acceptable and understood and I think a lot of lot of Physicians my myself in the ER prescribe it when I when I prescribe or when I send someone home after an over we get really that stigma exactly and it's and it's safe you can use it you don't you're not going to hurt somebody with it exactly I never understood why it was controlled before why why prescription to use it good well again thank all of you for being here
▶ 0:53:03I appreciate this very much and I will yield and now at this time I'll recognize ranking member to get for five minutes of questioning thank you so much Mr chairman and just to let you know I carry the locks on in my car in Denver and have for quite some time uh Mr Colin I I I just want to say to you on behalf of every single member of Congress up on the Das thank you for coming today today and sharing your story and your picture of your beloved Son Zachary all of us are committed to ending this Scourge
▶ 0:53:33and we want to work together to do it thank you uh Mr chairman I I I want to talk some more though about what's been going on because I I think this relates to whether we can all whe whether we really are committed to taking this all of the above approach on Tuesday January 21st HHS secretary Dorothy Fink sent a memorandum to HHS employees directing a Communications freeze and then on Monday January 27th the Office of Management and budget
▶ 0:54:04sent a memorandum across the executive branch directing a funding freeze now this OMB freeze would have Frozen a lot of the programs that our panelists have been talking about here today the lock Zone programs treatment programs um Dr kaming is that how you say it um you you you said in your testimony four things that we needed to expand and do all of those things the existing programs in those areas
▶ 0:54:35all would have been frozen uh in in in this uh om judgment you're you're nodding does that mean you agree it would I agree yeah so th all of those things would have been frozen now thankfully the US District Court in the district of Colombia and Rhode Island granted temporary restraining orders of the freeze on Federal dispersements and and and om rescinded the order but it's still having impacts for example Colorado's state office of rural Health told me earlier
▶ 0:55:05this week that the critical Grant funds that they usually get um first or second day of the month still hadn't come through you're you're you're also nodding to this have you seen experience with this these kinds of funds as well doctor I am hearing that in my local community as well in towns that um people are not able to to do their jobs um and are kind of uh confused what going people are not able to do their jobs doing what helping people um
▶ 0:55:35get to treatment helping people give treatment as a result of this Trump musk freeze people who are supposed to be doing drug treatment programs are not able to get the resources is that right that is a possibility I am hearing anecdotally that you've been hearing it yeah and my people are telling that too Miss leau I want to ask you you serve on the national advisory Council on drug abuse is that right yes now what's the function of that advisory
▶ 0:56:05Council so we have final um sign off on uh grants that are going out to researchers Nationwide uh above a certain amount of money and it's the end of the of a long process now these are grants in drug treatment there are grants for a number of areas of drug treatment and when was the most uh recent meeting of that advisory Council supposed to take place so we were supposed to have a meeting on Tuesday and what happened about that uh I received an email at 8: a.
▶ 0:56:35saying it was canceled and do you know why it was canceled we were not given a reason and do you know when it's going to be rescheduled we have not heard anything what's the impact of that advisory Council not meeting well at at it will delay sending out these needed research dollars to researchers who can do good work on many of the issues we're talking and what are they researching resarch searching uh what treatment works they'll research how to use nxone better all those types of things are funded by the so that's not happening now
▶ 0:57:05because the meeting at this time there's a delay on it right thank you now um in the conclusion to your written remarks you say the best approach to addressing synthetic drug treatments is an all of the above strategy one that integrates law enforcement public health and Workforce investment I I just want to ask you does simply rescheduling fentanyl without doing all the rest of the things you talked about going to have a significant impact on on reducing this crisis there's no one answer to this and I think we can all agree to
▶ 0:57:35that okay now um one last I have one last thing and that is I want to close to say I'm disturbed that we're having this hearing when Republicans failed to live up to a bipartisan by Camal agreement to reauthorize and strengthen the support for patients and communities Act this is why I asked you miss leel this question is because we need a comprehensive approach and I said this the other day in the rules committee
▶ 0:58:06when we talked about this bill coming up just rescheduling fentanyls not going to solve the problem but what's really going to worsen the problem is when the Trump um at Trump and musk Administration freezes the resources to go out the training the research dollars I hope we can all work together to make sure this never happens again and I yeld back the lady yields the chair now recognizes the chair of the full committee representative Guth three from Kentucky for five minutes of questioning
▶ 0:58:36thank you uh thank you and recalling uh Dr Wes's testimony before scheduling Elissa fentol it doesn't solve all the problems but absolutely I your testimony before was it does solve the problem of Alysa fentol and being able to schedule it so it's part of the fight that we have against these drugs coming into our our country and speaking of that and Sheriff brashard um I said earlier that we had enough doses of fentanyl to kill Americans captured last year 37% of that was found to be uh laced
▶ 0:59:06with xylazine as well um in April of 2023 uh the office of National Drug control policy designated fentanyl adulterate with xylazine as an emerging drug threat that indicated that people who ingest fentanyl mixed with Zine may be at higher risk of suffering deadly drug poisoning because of a just not reac to uh Narcan and the others that we've seen so sh bashard how can Congress and our federal Partners be more proactive about combating emerging drug threats before they've infiltrated
▶ 0:59:37our communities in mass quantities thank you Mr chair um as the doctor mentioned you know scheduling or blocking the things that are being developed uh it's important for us to be nimble because what they what they typically do as soon as you schedule very with specificity a particular kind of drug then they change one component in the lab and then it begins to be mailed and in fact I talked to our narcotics Commander by email last night and he said we're having a huge rise in the
▶ 1:00:07amount of things that are coming via postal and other uh package ships uh companies across the country are coming in VIA that they change one thing and then it's no longer illegal xylazine is an example I've been trying for almost a year and a half to get that scheduled in my state and we're seeing huge numbers of that in my lab in all of the different samples that were testing of other kinds of drugs so in the last hearing we had might I don't know if it's the same one with Dr weslake but it's a it's a testimony that is still in my mind I don't
▶ 1:00:37think it'll leave my mind we had a someone from the administration last Administration in da that said that they didn't want to schedule list of fentel because they would what if it's as they need to check it every time it changes because what if it's as safe as water have you ever seen any fentanyl illicit fentanyl that showed up in our country that's safe no to date as as far as uh substances that have been encountered by law enforcement every single one has been bioactive most of them as as potent as fentel one of them is 7,000 times more potent than morphine
▶ 1:01:08uh so there have been no non-bioactive fentol related substances encountered to date and his point he did use that example but his point was that well if it's if it's if it's been adulterated how do we know it's got less safe and he said safe as water or more safe or it could be you essentially sibo or could it be more deadly but my our point in scheduling this people aren't sending stuff less deadly into the country and so uh I guess that they could have F gone that direction but I don't think that's why they sent it in here to get it to
▶ 1:01:38give a placebo um so Dr weslake whatever takes someone down this in the situation where they have uh subsid disorder issues whatever starts that pathway is is is sad and it's something we want to address but just specifically I had a case of her mom and and my home in my district that I lost her daughter just it was a soccer injury she has ACL surgery and then becomes uh as far as she knew that's what led to her
▶ 1:02:08substitutes disorder from routine prescription from surgery and so we just saw the other day there's a new class of pain medicines been approved uh for nonopioid um nonopioid pain so hopefully uh we can get there and it's been a bipartisan effort to get get to that and so my question is in your experience can opioid exposure after an injury or surgery lead to misuse or prescription which in comment on what I just said about that and then uh is it important for for
▶ 1:02:38Physicians to have to to try to stay away from opioids and go to these new class of drugs if they when they become available yeah that's a great question chairman um there's a study out a University of Michigan that shows that one out of 16 kids that are exposed for the first time to Vicodin or Hydrocodone after a wisdom to surgery are using it a year later so I I I when I explain this to parents when they have a 20-year-old that comes in with a with a wrist fracture that I'm not going to be prescribing hydrocodone because it's a you know one in 16 chance that they'll still be on it and become addicted and that's the pathway
▶ 1:03:08to this I think this fentanyl crisis that we're seeing now uh fental poisoning is is the is the initial opioid overprescribing that happened I think we've addressed that uh in medicine in the house of medicine I think I you know in Wisconsin we implemented reforms and gave the Physicians the tools and strategies in just a few seconds what about this new drug do you think I just have a few seconds I think it's fantastic I there's a study that show is it as effective as opioid from what I understand yes it's brand new um okay thanks my time has expired appreciate your and I will y back the gentleman yields
▶ 1:03:39the chair now recognizes the gentleman California Dr Ruiz for five minutes of questioning thank you Mr chairman and thank you to the witnesses for being with us today for this important discussion it continues to be mind-boggling to me that we are having this hearing today while the Trump Administration continues to dismantle the very systems that exist to combat the opioid epidemic for example the substance used block grant administered by samama
▶ 1:04:09is the Cornerstone of States prevention treatment and Recovery systems it gives States the flexibility to tailor their services to meet the needs of the populations in their states the most recent data shows that this block grant allowed over one 1.6 million people to access treatment now this crucial source of funding is in danger and access to treatment is being jeopardized all because of the Trump administration's absurd power grab Miss leel thank you for
▶ 1:04:39sharing your testimony with us today and for your expertise I have several questions for you what impact would a wide reaching Federal funding freeze have on federal state and local efforts to combat the opioid epidemic well it would be devastating to States certainly and local government I mean the the grant program you mentioned is the number one source of funding for prevention in every single state in the country that's H leaves a huge gap okay and can you provide examples on how administrative actions like this
▶ 1:05:10hamper both upstream and downstream approaches to combating illicit drugs I mean I mentioned the research piece which is very important um I also think I want to emphasize how important it is that we have a trained Workforce um and you know a lot of federal workers are kind of in limbo right now uh we need to bring people in not only retain the people who who are good at their jobs who do a good job across the Continuum and work in law enforcement but also make sure that they have the skills
▶ 1:05:40and ongoing training that they need to to address this issue we heard just yesterday in a news article in VPN news uh entitled Virginia communities health centers close over Federal funding access as a result of president Trump's funding freeze that 16 Federal qualified health centers in Virginia have been unable to access Federal funding and many are closing their doors uh Mr chairman I ask unanimous consent to insert this article in the
▶ 1:06:11record we okay we'll look at it yeah it's right there um usually usually it's custom to just accept it into the record we didn't have it beforehand though so we're just going to look at it we'll be right back with you okay I can see why you guys might not want to put it in it criticizes the administration I'll get back I'll get back to my time so just and just you know just Tuesday at The Rules
▶ 1:06:42Committee hearing um my colleague Mr Griffith said while quote unquote in ARL these administrative um actions were necessary for the incoming Administration so with all due respect to my friend the gentleman from Virginia I'm not sure the people in his district who are served by two fqacs that closed and now must drive miles upon miles even up to two hours for care will think that these actions are inartful but just downright
▶ 1:07:12harmful and costly Miss lebel what unique role do fqacs play in combating substance use disorders in rural or underserved communities and how will closing them as is done in Virginia impact Partnerships between law enforcement providers and patients trying to get appropriate care yeah it affects the fqhcs are a critical component of the health care uh Continuum for people in in rural communities in particular uh and it's the the place they can go to get the type of services that they need to address
▶ 1:07:42their substance use disorder and without those we we could see increased overdoses in fact we have discussed here previously during the uh Republican effort to dismantle Medicaid as we know it that uh 70% of those who seek treatment for opioid use disorder uh H use Medicaid and so dismantling block granting limiting Medicaid and attack on Medicaid is also
▶ 1:08:12talk it reduces access to care reducing access to care either through funding freezes or going after Medicaid makes Americans unhealthy again and it raises costs for everyone uh Mr chairman I think the points made here by the witnesses point out the hypocrisies and the president's actions and the real impact on the tools our nation needs to stay ahead of Bad actors and protect our communities thank you and I yield back the gentleman
▶ 1:08:43had asked for the gentleman yields and he had asked for a an article to be inserted in record without objection proved chair now recognizes the gentleman from Virginia Mr Griffith go which one you want to go okay gentleman from Griff Mr Griffith from Virginia is recognized for five minutes
▶ 1:09:13I appreciate that and uh I'm hopeful that my team has given uh three letters that I would like to submit for the record to our friends on the other side of the aisle but if not I will certainly tender those so they can take a look at them but I would ask unanimous consent for these three letters to be introduced one letter is spearheaded by neurosurgeons anesthesiologists pain Physicians spine doctors orthopedic surgeons and others these physician organizations have been great stewards of controlled substance the control Controlled Substances Act and mention that the temporary scheduled
▶ 1:09:44classification of elicit analoges is not a sustainable or rational approach in other words not doing it temporarily is not rational the other two letters are support letters from law enforcement agencies and urge passage of the halt fentel act so after our colleagues have had a chance to take a look at that I would ask for unanimous consent that said let me also set the record straight on something that was just said and while it it is of concern that health centers in Virginia may have closed my understanding is all that's getting worked out
▶ 1:10:14but further it was said that two in my district had closed that is not accurate U and just so I just want to get the record straight we've been monitoring that situation one of my health centers did report report that they had had some uh difficulty accessing a site uh but it did not cause closure and uh we believe that they are should have that resolved shortly but it but no closure has resulted that I'm aware of in my district and so if somebody has better information Please provide it to me
▶ 1:10:44uh Dr West Lake and then uh Sheriff Bard I'm going come to you um I'm Switching gears from uh what I was talking about so I have concerns um my wife is a juvenile domestic relations district judge in the Commonwealth of Virginia she's seeing concerns so I want to know what your concerns are and your lines of work about the impact of unregulated intoxicating hemp products
▶ 1:11:14on our kids and and a followup would be what do you think we need to do to create a framework to allow lawful products to come to Market I've been working with the FDA on that so I got some ideas there but I just want to know what you all have seen uh about these unregulated intoxicating hemp products on our children we have not seen a huge number of hemp products now since we have legalized marijuana in our state but what we have seen
▶ 1:11:44is an adulteration even of marijuana products and prior to that hemp with other kinds of synthetics and other kinds of drugs like fentanyl so we've actually found outside of our supply chain if you will the legal supply chain of marijuana in our state illegal marijuana has been tampered with and has fentanyl in it um and so we've seen all of these things really need a regulated uh inspected process and I I would encourage that to happen both
▶ 1:12:14with hemp and with marijuana let me let me do a followup before I go to you U Dr Westlake let me just do a quick followup so one of the problems we've seen in in our region is uh THC Gummy Bears or gummy bears that are supposed to have CBD and then there's a unregulated unknown amount of THC in there and uh kids get a hold of them and they think they're candy and then they overdose and when I say overdose I'm not talking
▶ 1:12:44about deaths at this point but there have been some indications there may actually have been some brain damage are you all not seeing that in your region is that just a Virginia problem no no we're we're actually seeing that as well in fact there's PSAs in our region and among a number of states that have legalized uh marijuana and components like gummies advising kids and parents about that and how to store it and the dangers of it and there's some discussions about trying to make some of these gummies not look like uh little
▶ 1:13:15characters that attract a kid or the packaging that attracts children because they think it might be candy or it might be vitamins but in fact it has a drug component and it really would be helpful if we could get some guidance from the FDA wouldn't it yes sir Dr weslake same questions great yeah I personally saw a some marijuana poisonings last week uh from gummies I've seen it in the past I M kind of two or three episodes last week alone uh it's illegal in Wisconsin but comes up from Illinois and from Michigan from around and the other part we see is the fental
▶ 1:13:45laced marijuana we I've had overdoses from that um and we're also seeing that with what you're talking about with like CBD that's unregulated people come in and they don't know what's going on and it turns out that they're intoxicated from marijana that they thought they were just taking because there's no quality controls or oversight over that all right I appreciate that Dr Wesley can you I'm switching back now to Hal fenel uh can you explain because we've we've heard about the scheduling side and there's some disagreement on that but uh I really like the part of course it's my bill so
▶ 1:14:15it's natural I would like part it but I like the part that allows uh for research uh to go on on the 4,800 estimated uh anal LS or fenel related substances can you tell us what you think about that and how U you think that uh we ought to go forward with that yeah I think it's a huge thank you for your leadership on the bill it's a huge benefit to have to open up schedule one research I think there's there's not been a lot of schedule research on schedule one drugs because
▶ 1:14:45of that so this is a huge this will be a huge Boon to that and that's why it was signed off on by NIH and HHS and FDA I you know there's some initial concerns about whether it would be too restrict but because of the way we design the language it really has only affected those that are bioactiv you know with structure activity relationships bio actively likely to be active I really appreciate it it's part of why I really like the bill I yield back gentleman yields back the gentleman had asked for three um articles to be inserted into the record without objection that'll be the order can I have
▶ 1:15:15members attention for one second y'all please try to get these to us before the meeting so that we don't have to be interrupted with this and don't have any controversy about it okay thank you at this time the chair will recognize representative Dingle for five minutes of questioning thank you Mr chairman the opioid epidemic has ravaged families families across the country and quite frankly has touched many of us if not all of us personally it's an issue that requires
▶ 1:15:45serious bipartisan attention and we have to work together because we know too many people are dying of it Mr Cullen I join my colleagues and thank thanking you for having the courage to tell your personal story I want to start by thanking sheriff bashard for being here with us today Mike has been a friend for decades John James and I both share him he's the sheriff in my district but more importantly when my sister died of a drug overdose and I didn't understand it I didn't
▶ 1:16:15understand what was in her blood I didn't understand how she got it where it came from was there something more that I can do Mike bashard was there for me me so I have lived this personally with the sheriff that's with today Sheriff bashard the drug chemistry section of Oakland County's forensic science laboratory analyzes samples submitted by various law enforcement agencies for controlled substances and illegal drugs I introduced legislation to reauthorize the support xlab
▶ 1:16:46pilot program to improve coordination between Public Health Laboratories and those operated by law enforcement to better detect ventano and other synthetic opioids can you tell us more about the Oakland County lab's efforts and ability to detect fentanyl Fentanyl analogues and the emergency threat of exy design and what challenges come up in conducting this testing and what Congress can do to provide further support thank you and
▶ 1:17:16I appreciate our friendship too um in terms of our lab you know sometimes we are un un even aware W of some of these changes that are being seen in the street and we hear about it from the medical profession or elsewhere so I learned about xylazine happening I believe in the state of Pennsylvania was where some of it um really started to catch fire so I asked our lab to figure out a way to test for it then come back and tell me what they were seeing and I was shocked as they were how much were in all of the test samples that were
▶ 1:17:47on their bench so the communication between public health and uh crime Labs is very helpful for us to know what we're looking for and what we should be anticipating on the street and what our folks that are touching and coming into contact that need to be aware of you know we had to change all of our field testing kinds of things because just coming into contact with certain drugs is as you know caused overdoses for police agencies in those situations so I think that would be very helpful and important
▶ 1:18:18thank you in your testimony you mentioned Oakland County's crisis response unit and the co-responder program which both partner Health Care Providers and law enforcement to implement preventative measures find treatment sources and deescalate crisis situations can you tell us more about the success of your partnership with the Oakland Community Health Network the importance of a comprehensive approach that includes both law enforcement and health care providers
▶ 1:18:48and are you being impacted by F current potential Federal grant non payment thank you at this point uh none of our staff have said there have it any Interruption but the partnership is critical we work hand and glove with our health department uh with the community of coalitions a group that focuses on substance use disorder and all of the associated preventive both educationally uh free Naran kits uh visits to school I go to schools
▶ 1:19:18with this one group called fentel fathers that tragically are in that club they never want to join that one one father talked about his daughter taking what she thought was a half an Aderall pill and it had fentel and it killed her and so that's why we adopted the one pill can kill in some of our discussions and the pill press thing is very front and center with us as well um I I think it's important that you know we we do those preventive things and Partnerships with all of those agencies we're not going to rest our way out of
▶ 1:19:48it but we can punish the folks that are profiting from the suffering and the death of others thank we know more than when my sister died but Dr kamaga your work focuses specifically on addressing adolescent substance use and substance use disorders your research has explored development of Novel technology enhanced interventions to reduce drug use and Adolescence in young adults can you share more about the status of these interventions and their funding sources as part of my
▶ 1:20:18research I develop uh interventions for Vaping prevention in middle school students um students love technology it's a way to communicate important education to them um we are we've been developing these uh interventions for years right now we're on hold um not knowing um you know how to continue to build them out until we understand funding a little better thank you we need funding I yield back Mr chair G lady yields back the chair
▶ 1:20:49now recognizes the gentleman from Florida Dr Dunn for five minutes of questioning thank you very much much Mr chair and thank you again to our Witnesses for being here with us today I'm Gravely concerned with this illicit drugs that have been pouring across our Southern border for years it's clear that this problem requires significant attention and resources from us uh for years the drug cartels have exploited our Southern border and uh they're working with the Chinese Communist party to poison Americans but alarmingly recent reports show that these cartels
▶ 1:21:19are mobilizing along our northern border as well they're creating super labs and illegal distribute drugs throughout our communities I'd like to submit an article for the record that highlights these crimes titled British Columbia organized crime expanding export of Fentanyl and Other Drugs published in the Vancouver Sun and yes it was early so thank you Mr chair uh Sheriff bushard uh can you speak to how the drug cartels actually move drugs across our board specifically
▶ 1:21:49how the drugs get from their facilities into the hands of our citizens thank you um they move it in a variety of ways they're much like any private company that's looking for efficient effective routes sometimes it's muled across the border and then has Transportation routes up into every community and other times we see it shipped in or come across in different Fashions we've seen it both in parcels and in vehicles moved across the boorder so
▶ 1:22:20in followup to that question uh have you seen the cartels adjusting their operations in response to how we adjust at the border 100% yeah they're very Nimble they look for every that we do they look for counter measures one of the largest seizures in the history of our state uh happened in a dump house where they were storing drugs about a mile from one of our substations and we took over policing that community and uh within a month we found that and it
▶ 1:22:50it was staggering the amount of drugs and it was definitely directly tied to car activity I appreciate your insights uh it's critical that we do everything we can and we need to know the things that you know to to respond intelligently Dr Westlake as a medical doctor I'm interested to hear from you about how this issue presents in the emergency room can you speak from your own experience uh uh how the presentations of drug overdoses have evolved over the last few years I'm sorry I didn't understand the question how
▶ 1:23:20how have the presentations in the emergency room how are they changing over last few years yeah so you so I think when when we kind of saw this starting it was with prescription opioid epidemic and there were overdoses on prescription pills because of the overprescribing issue that has pretty pretty much at least in Wisconsin and my understanding across the country is pretty much stopped and now it's moved on to the elicit substances and then once they became the counterfeit sub counterfeit substances you know initially it was people that knew they were using and were taking risk and now it's moved into people that don't even know that they're that they're using
▶ 1:23:50and and the majority of overdoses that I see are people that are not aware that they're taking now the last 10 overdoses that I've seen in the last couple of months all thought they were taking heroin and when we tested it there was no opioid it was all pure fentanyl that was they were overdosing from so it's it's been a huge shift again it's fire hydron spigot it morphs off into different things so I think that's an important key point there the people like think they're taking something else maybe they think they're just smoking some marijuana or something and what they what they get exposed to is a really really dangerous substance and even
▶ 1:24:20microscopic amounts of it can kill so that that's a thank you very much uh this threat uh is uh obvious to all of us we can't sit back and watch the cartels poison our society so I look forward to working with with all of you and all my colleagues here to address these uh these problems thank you very much Mr chair you back gentleman yield say is there a question on the article to be answer chairman what's what's the source of this article Vancouver Sun thank you I have no objection van cver sun it's a regular
▶ 1:24:51newspaper without objection that the article is included in the record the chair now recognizes the Gent lady from Washington Dr SAR for five minutes of questioning thank you chair Carter and thank you ranking member toet and thank you to all of our Witnesses today uh in my state of Washington uh like every other state Fentanyl and other illicit drugs have had a profound and devastating uh impact last
▶ 1:25:21Monday Washington state had a 155 point .6 million dispersement Frozen due to president Trump's halt of fenel spending excuse me a federal spending and to be clear that amount of money included grants uh for samsa which is the federal agency responsible for Substance Abuse Prevention and treatment and I just have to point out the real ramifications that a trump Federal fending spending freeze not opposed by a single Republican
▶ 1:25:51so far has on overdo dose deaths in this country I know everyone here is committed to stemming the flow of elicit Fentanyl and Other Drugs but supporting a funding freeze that guts substance use prevention and addiction treatment programs is antithetical to solving this problem and is absolutely Reckless um Mr Cullen and others sitting in this room are family members of people who have died from feny poisoning and freezing treatment programs
▶ 1:26:22will only add more grieving fam ways I want to Pivot to xylazine it was later in coming to the state of Washington um I am hearing from our state narcotics investigators that uh this use of xylazine as a cutting agent in fentanyl is very much increasing locally there is currently no known treatment for xylazine overdose and so Naran of course if you have a mixed overdose may not save a life in that case um m leel
▶ 1:26:52in light of the recent uh and be funding freeze I wondered if you could speak to the impact of withholding NIH funds especially when it comes to developing xylazine detection tests and potential xylazine reversal agents yeah I mean there I I can't speak to specific grants that we've approved at at naida or will approve at some point um but I know that having worked closely with people at University of Washington there's a lot of ongoing research that has to be funded and the only people
▶ 1:27:22who have that type of fed funding is the federal government through the National Institutes on drug abuse that's right thank you very much I'd like to Pivot to to China's role in all of this for a moment the People's Republic of China ships the precursor chemicals needed to make fentel to Mexico the United States or elsewhere in the world where uh that is then assembled into fentel or fentel analoges by criminal groups and then it floods into the US market uh I grilled
▶ 1:27:52uh representatives from the ch Embassy about this and they so proudly claimed that they were addressing this problem seriously um but then I pressed them on this uh and it turns out that while they are supposedly curtailing the shipments to Mexico they are sending fentel precursors to very suspect places uh around the world for example uh they are they showed me a list they're sending to clinics and to hospitals and as a physician I can assure you that there are no clinics or hospitals in this country
▶ 1:28:23Manufacturing fentel um it is still making its way to the cartel so um Sheriff bushard I I was wondering what steps you think the federal government should take to stem this flow of fentanyl precursors from China well obviously that's solely within the purview of the federal government is pressure on nation states especially ones that are dealing this into our country obviously intentionally um and I think that great pressure has to be
▶ 1:28:53brought to bear because they're the origin of a lot of what we're seeing across the country in terms of death and misery any specific recommendations that you would make that would get into policy things on how the federal government deals with a nation state but you know I I again go back to anything that would strongly enough discourage them or let them know there would be consequences for them to continue to traffic this into our country I mean you
▶ 1:29:23can get Zine mail to you direct right now from China it certainly uh is to their advantage to weaken the United States and this is part of what we'll do that absolutely I just want to mention in these last 30 seconds I'm a pediatrician and so I am very concerned about the poisoning of kids they think they're buying something else it and 60% is Tainted with fentanyl and so many of these are are deadly amounts um we have so many youths who overdose
▶ 1:29:53they're now fill filling our emergency rooms there aren't enough uh treatment facilities for them and so um just last Quick qu oh I I don't have time to ask the question but I will just point out that Dr kamanga and I both know that we need more resources for kids and treatment I yield back gentem lady yields the chair now recognizes the gentleman from Florida Mr bakis for five minutes of questioning thank you Mr chairman uh for holding our first healthc care subcommittee hearing
▶ 1:30:23on this very critical topic the illicit drug threats that are plaguing our constituents through fmall related substances that have flooded through our borders unfortunately I'm thankful that President Trump has taken quick action to address the Water Crisis I'm proud to join the representative Griffith and L in support of the halt fentol act which would finally classify finol related substances as a class one drug and give
▶ 1:30:54law enforcement the certainty it needs to fight back against uh drug traffickers long overdue and while we're uh trying to keep Pace with this evolving landscape new threats continue to emerge unfortunately I'm proud to co-lead the combating illicit xylazine act with my good friend August fluger and Jimmy Panetta uh which would schedule xylazine as a schedule three drug under the controlled substance act while while the animal
▶ 1:31:24drug xylazine has horrific side effects in human use it prolongs the effects of fentanyl making it extremely dangerous on the streets our bipar and legislation strikes a key balance to provide more tools while maintaining legitimate use for veterinarians and others who use this drug safely without diversion and large animals so my first question is for Sheriff bushard uh you touch upon the emerging
▶ 1:31:54threat of xylazine and other new drugs in your testimony can you elaborate why it's critical from a law enforcement perspective to keep as you say and I quote a more agile regulatory framework so we can address these threats faster and more effectively thank you well I I guess it also touches on what we just talked about when you have a nation state involved that has the resources and the capability to create Laboratories
▶ 1:32:25and factories that can quickly change one component of what they're making in a lab and then suddenly make it legal or have a different kind of thing that they can send in suddenly we're dealing with something we're not aware of because they changed it in a lab and it's Landing in our laps and that's how I found out about xylazine hitting a different state asked our lab and it was already there and that's that's the kind of nimbleness we need to be capable of dealing with when you have somebody that's intentionally of a nation state status
▶ 1:32:55allowing that to occur thank you very much uh over the years during this overdose crisis we sadly seen time and time again parents were described prescribed opioids for legitimate purposes I said parents I meant patients but still parents and kids what have you uh La a surgery or injury but often go down on paths towards elicit or diverted pills and even INF fentanyl once uh they're addicted
▶ 1:33:26and you know this is the majority of the cases in my opinion our committee has worked on policies that incentivize nonopioids and I've long been interested in encouraging alternative therapies to pain management I'm glad to see that last week the FDA approved the first in-class nonopioid alternative for acute pain so Dr weslake uh you testified about your inspiration after the tragedy of your friend's son
▶ 1:33:56who was a victim of this trend of getting hooked on legitimate prescriptions which led to worse elicit options such as heroin I believe this contributes to further uh illegal fentol crossing our Southern border and we should work towards methods to cut off the demand here wherever plausible would you agree that patient access to additional pain management tools Beyond opioids are an important
▶ 1:34:26component of addressing the illicit drug threats in a comprehensive way and we've made some changes in the VA uh so but we've got to do more so if you can answer that question appreciate yeah absolutely I think opioid should be the last last medication used I used normally tell my patients to you know use Tylenol ibuprofen at prescription strength which which has been shown as effective as oxycodone for acute fracture pain uh and then at night time only to take opioids if needed that they have they're going to be in pain from the surgery or from the fracture
▶ 1:34:56got to kind of get through that but they don't want to end up Hooked on opioids because half of the people that got hooked on opioids didn't start by trying to get thank you sir uh Mr Colin thank you for being here to tell your story and I'm so sorry to hear about Zachary I want to highlight an important part of your testimony when you say most kids are not addicts I believe that they are stressed and anxious and that social media provides a platform for kids to easily purchase drugs online
▶ 1:35:27which get laced with fentanyl and lead to overdose poisoning I'm committed to holding big Tech social media accountable uh for enabling this on their platform can you share your perspective on this and what suggestions you might have to curve this horrific Trend because we are going to refile kosa and I want as much input as please yes thank you for your question uh yes yes we we talked to several of of Zach's friends afterwards
▶ 1:35:57and they told us how easy that it could be that you could order prescription pills prescription strength pills uh off Snapchat Tik Tok Instagram that sort of thing delivered right to your house uh I think what I spoke about in my testimony was that we would like to see PSAs uh but the PSAs need to be directed at the platforms that they're utilizing not ABC News NBC news that that's not where they're getting their information from I think it needs to be Target it um and I've seen some Ad Council uh ads for uh
▶ 1:36:27drunk driving in the past week or so I I think that it needs to be something that needs to be um elevated good suggestion thank you very much that yield back Mr the gentleman yields the chair now recognizes the Gent lady from Massachusetts representative Tran for five minutes of questioning uh thank you Mr chair thank you ranking member thank you especially to our our Witnesses I appreciate the subcommittee's focus on an issue that affects americ an across geography demographics and politics uh
▶ 1:36:57however I would like to understand how um broad funding Cuts backed by my Republican colleagues would undermine the efforts to combat this addiction and overdose crisis overdose Trends show a rise in fenel mixed with xylazine a powerful animal sedative known as Tran dope First Responders in my home state of Massachusetts have seen it spreading across communities and what's particularly concerning is that experts warn that Narcan is ineffective against xylazine uh and the FDA has stated
▶ 1:37:28it's unclear if today's Narcan can reverse its effects we can't be caught flat-footed when the next dangerous substance like xylazine emerges Additionally the recent drop in overdose deaths is largely due to increased Narcan access which has been critical for those with opioid use disorder so miss lebel uh how does significant NIH research funding Cuts undermine our to develop more effective overdose reversal medications and keep Pace
▶ 1:37:58with evolving overdose uh crisis I mean the Nida is the number one source of funding for research worldwide there's no there's no philanthropy that can make up for that so it could have a devastating impact thank you Miss LEL it seems like we all agree that strong support for the research landscape is key to finding new treatments and life-saving antidotes uh the opioid crisis continues to devastate communities across the country and Medicaid has been a vital Lifeline for those struggling with substance use
▶ 1:38:28disorder providing access to essential treatment and Recovery uh Services however my Republican colleagues supporting Medicaid proposals that would cut Federal funding especially in Medicaid expansion many individuals with sud could lose access to Critical Care at a time when they need it most um how Miss leel again how would cutting Federal funding for Medicaid expansion affect individuals with substance use disorder who are already in vulnerable situations
▶ 1:38:59without the critical care that they rely on right I mean one one good example is you know treatment in carceral settings when people are leaving uh incarceration and need to be connected to care and about 15 states have been approved for using federal funds uh Federal Medicaid funds so that cutting back on that would devastate a population that is at heightened risk of thank you Sheriff Peter cjan the sheriff of middle sex County
▶ 1:39:29um in my state of Massachusetts has been a leader in tackling the opioid crisis through initiatives like uh the sheriff's Outreach and recovery program which helps individuals access treatment and support um Sheriff bushard could you just share an example of how you collaborate with the drug-free communities grant program um in additionally how would the potential loss of nearly seven 6 70,000 in federal funding as outlined in the OMB memo on behalf of the president
▶ 1:39:59impact your work and the communities that you serve thank you I I can speak to the partnership the actual grants and who gets them whether it's our agency or our partners that probably is more my CFO um but as it relates to the partnership it's critically important that we're hand and glove and a lot of those programs that we have our crisis response unit is in partnership with with those folks and with the grants and uh having that capability to work together
▶ 1:40:29to intervene and then connect them with the resources as I said on one of those house visits after we had saved the individual once they were checking up on them and found him overdosing again saved his life and so to connect those resources in a partnership is critically important so that we can not only save lives but put them on a on a path thank you thanks so much again I yeld back gentle lady yields back I now recognize a gentleman from Texas representative
▶ 1:41:02krenshaw thank you chairman thank you for holding this uh important hearing today and thank you to our panel of witnesses for being here and we focused on this issue as a community before I'm sure it won't be the last time and I'm glad we're we're talking about it again uh this should this is an easily bipartisan issue um I I I wish some of my colleagues AR weren't wasting time talking about a so called funding freeze that is not even in effect that's a fact it's not it's a distraction from the fact that fentanyl is pouring across their southern border it's trafficked by Mexican drug
▶ 1:41:32cartels and it's laced into street drugs and it's killing our kids this isn't just a drug problem this is a deliberate Act of poisoning against the American people and the cartels or the culprit as chairman of the cartel task force I've introduced real bipartisan solutions to battle the cartels and we have a lot of work to do to dismantle this terrorist Insurgency that is destroying both Mexican and American societies this is a supply problem whether someone is addicted or whether they were just partying and got a pill that was laced
▶ 1:42:02with fentanyl the fact is they would have never gotten fentanyl without the supply from cartels Supply creates the demand it creates the addiction that's a fact it's another fact that deterrence matters criminals and cartels will be less inclined to traffic Fentanyl and deal it to kids if the penalty is high enough this is also a very simple concept so uh I'd like to start with uh Sheriff bushard thank you for being here and you're line of work how often do you
▶ 1:42:32come across counterfeit pills regularly sir right and let's talk about how these pills are getting made uh how often are the cartels getting their hands on pill presses and who sells them it's a big problem we're our narcotics team and and teams across the country and our association of major County shs America are seeing more and more pills that look like something they're not that have fentanyl as as a component or all of fentanyl do you have any idea where they're getting them who makes them
▶ 1:43:02is it just that is it just is it just extremely easy to get them so we don't know it's extremely easy to get them right now they're not serialized or they're not uh there's not any kind of registration requirement so it's uh in essence you know super easy and it's a a pathway to bring something in under the guise of something else it's a trojan horse that's killing a lot of kids uh so it would be helpful to serialize them and be able to track these pill presses yes sir uh I appreciate
▶ 1:43:32that and that's that's one of the reason I have bipartisan legislation that requires the serialization of pill presses because we need to cut off the cartel's access to the tools they use to manufacture this poison and trick kids into taking something that's that that they they they think is something else but it's not it's laced with fentanyl Senator Corin also has this legislation in the Senate I would encourage everyone to to get on this again it's bipartisan uh Sheriff do dealers generally understand the danger of the counterfeit pills they're pushing
▶ 1:44:03the the dealers do but the kids don't I think it's uh that's why it's so deadly um that the dealers absolute understanding that Fentanyl and even small doses can kill people and there's been kind of a paradigm change over time where the old dealers of old I've been in this business a long time used to start you with a little bit to get you to be a regular customer today they don't care how many people they kill I agree with you uh I think the dealers absolutely know what they're doing uh you know in Texas I think we got it right although I think we could even
▶ 1:44:33make this law better we passed a law to enhance penalties for fentanyl distribution uh giving law enforcement the ability to go after these criminals with murder charges uh since that law went into effect overdoses in Texas are down 56% that's pretty good progress the US sentencing commission data for fiscal year 2021 released data yet last year shows that the average sentence for fentanyl trafficking was just over four years four years that's less than some people get for robbery I is that seem right no sir because
▶ 1:45:03you know they're spreading that pain well across your population before they actually got successfully prosecuted for the one they did I mean you would agree that perhaps is is would there be an argument for a similar law at the federal level to to put it on the dealers uh that that dealing fentanyl knowingly would would could could occur at a murder charge I I think that would send a very strong message it certainly would
▶ 1:45:33again incentives matter um I'm nearly out of time on um in your experience as well would you say that cartels are exploiting the fact that fenol analoges are not permanently classified as uh as schedule one substances yes have you seen a decline in fentanyl overdose since Congress extended the temporary order we've seen a decline in deaths but not necessarily overdoses because they they keep changing
▶ 1:46:04well I I hope that uh as we vote on this today that we do make that permanent thank you and iel back gentleman yields back and I repres uh recognized representative vzy from Texas absolutely thank you very much and uh I want to thank I know that chairman Carter has a step away but I want to thank him and everyone on this panel the way that they've been and uh addressing uh The Grieving parents that are here and other people that have experienced loss to the fentanyl in the ' 80s and 90s people just used to talk about people that have become addicted to drugs or were using
▶ 1:46:35drugs just talked about them like they were dirt and garbage and uh I'm just happy that there seems to be a bipartisan sense in this committee that uh that we need to get beyond that and actually try to help people do better whether or not we disagree on on the approaches I think the language that has been used here today is is really encouraging and um I want to thank Mr Cen for sharing the story about his son I have an 18-year-old son that's a freshman at college
▶ 1:47:05and I was talking to my wife the other day and I said you know even if your kids aren't on drugs they saying that you should keep a can of naram at your house just in case one of your friends kids come over and it may not even be something that's direct related you know uh a lot of the pressures that that that High School college students are under today to keep up um I will often times send them to to the black market for Aderall and ADHD related drugs and sometimes they're fake pills and they're lace with adol so it may not be anything
▶ 1:47:35that's cocaine or heroin or I want to get high related it maybe just be someone just trying to keep up in what is a very competitive Universe at our college campuses uh and and and they are absolutely uh victims um uh but I want to be clear while we disc discuss Solutions here today um president Trump just illegally seized $8.6 billion in Congress approved opioid funding uh and the Fallout has been an unmitigated
▶ 1:48:06disaster and I think due to the chaos uh that was Unleashed uh by the government freeze and I want to just you know say something uh that my colleague said that there was that there ended up not being a government freeze but before the 5:00 p.m.
▶ 1:48:23deadline there were federally qualified Health Care Centers across Texas that couldn't get into the database and so they couldn't treat people for things like what we're talking about here today uh and there is a federally qualified Health Care Center in Virginia uh just this past Tuesday that announced the closure of several locations because they still cannot access their funding to help the people that you're here talking about today and that other people are here talking
▶ 1:48:53about today and so this isn't some sort of a game this is serious and lives are at stake and so I wanted to ask the sheriff uh Trump's illegal funding freeze put critical programs like uh uh uh high intensity drug trafficking area programs at risk uh programs that help law enforcement including uh your own uh and the fight against Fentanyl and high-risk areas and even the office of National Drug policies web page has
▶ 1:49:23been wiped uh by uh president Elon and so Sheriff can you confirm yes or no that the that the programs like uh hidta and other federal grants are essential for reducing the supply of fentol in your community yes height is very important not only for our coordination but deconfliction and partnership so you agree that the uh funding freeze or any attempt uh to freeze these funds or cut
▶ 1:49:53resources uh directly end dangers Americans by weakening our efforts in the fight against fentol as I I said earlier my staff hasn't told us there's been any shutdown in terms of our operations that that we're aware of but obviously it's an important program yeah no thank you very much uh this is for the professor last year there was a bipartisan senate senate bill that would have delivered critical resources to uh the border to combat fentol trafficking and uh funding that law enfor forcement
▶ 1:50:24and and public health officials agreed was desperately needed to stem the flow of drugs into our country um uh but instead of putting Public Safety First uh the president and the Speaker of the House decided that for political gain uh that we would uh slow uh the immigration Bill uh and now a year later we're still waiting for any meaningful action from colleagues uh uh uh to help stop the poor fentol into our legal ports of entry and given
▶ 1:50:54this failure what sort of uh resources are most urgently needed to strengthen interdiction uh efforts and disrupt the supply of Fentanyl and other dangerous substances at our ports of Entry so I think there are three pieces first is investing in our Workforce so they're trained the second is intelligent sharing uh and lastly is technology so we have the best technology to identify drugs that may be coming in over the board thank you very much thank you Mr chairman y back the gentleman yields back I now recognize Dr John Joyce from Pennsylvania
▶ 1:51:24for five minutes thank you chairman and thank you for holding this hearing and thank you for all the panel for taking time out of your busy schedules to be with us I also want to acknowledge and thank chairman G Griffith for his incredible work on the halt fentanyl act a bill that I'm proud to be a co-sponsor and I look forward to seeing its Passage through the House of Representatives this week since the inauguration of President Trump we have seen president Trump take immediate action to combat the growing threat
▶ 1:51:55of illicit fentanyl flowing through our borders he designated the cartels in Mexico as a foreign terrorist organization and reached an agreement with the Mexican president to deploy her country's National Guard to help stop the transport of this deadly drug into our country unfortunately these positive steps come only a few years after the inaction of the Biden Administration and because of that delay fenel poison in has written has risen dramatically
▶ 1:52:26with seven out of 10 illicit fentanyl pills tested by the DEA in 2023 containing a potentially lethal dose of fentanyl that's seven out of 10 and go back just two years before that it was only four out of 10 why would I say only four out of 10 deadly pills R Colin thank you for being here thank you for sharing the story of your son Zach can you talk about how fentanyl poisoning is
▶ 1:52:56distinct from an accidental overdose uh yes thank you for the question so in my opinion an accidental an accidental overdose is when someone takes something whether prescribed or not more of what they were supposed to than the body could handle um a poisoning to me means that someone took something that had something in it that they were not expecting so in our case um Zach purchased cocaine bad decision
▶ 1:53:26but the coroner uh told me that there was more fentanyl than cocaine in his system so he he did not die because he took too much cocaine so The Accidental deaths that we are seeing because of this poison being mixed in to other street drugs is causing the increase of the fentanyl deaths that we are seeing in the United States and many of these are fentanyl analoges fentanyl analoges laced into as you mentioned cotan that are being created by the Mexican cartels and they use
▶ 1:53:57precursor drugs that are created by the Chinese Communist party and those are shipped to Mexico where the cartels in their labs mix these drugs up and use these pill presses or mix them in with other drugs as simple as marijuana as well these are multinational organizations that are sending thousands of pounds of deadly drugs into the United States to kill our friends our neighbors our children Mr Colin with this all of
▶ 1:54:27this in mind do you agree with President Trump's classification of the cartels as foreign organizations uh 100% uh this was something that we brought up at the round table about two years ago uh where that was one of the things that we would like to have seen happen along with declaring fentel a weapon of mass destruction Dr Westlake as an Emergency Physician can you speak to how the continued emergence of new
▶ 1:54:57and deadlier illicit drugs make it more difficult for you when you're in the emergency room which you were just this week and the patients that come in do you have to use higher doses to reverse the overdoses that you are seeing yes thanks for the question Congressman um it kind of depends so Narcan works and it works well the problem isn't that there's not a potent enough Naran although that may be partially the problem the problem is that people are exposed to these poisons to begin with and that's you know the prevention of stopping them from
▶ 1:55:27existing is is critical I also want to point out one thing going back to weapon of mass destruction n the fentanyl is more deadly than sarin nerve gas it's easier to die from from fentanyl I'm sorry from sarin nerve gas than from fentanyl it's the lethal dose is is higher in sarin so it's it's it's a it is a chemical weapons-based grade poison as we sit here and discuss the threat the cartels are working this multinational and described as being a Nimble Group
▶ 1:55:57by the sheriff here they're working to create cheaper and deadlier drugs to smuggle across our borders we have a responsibility here in this committee and in Congress to protect our communities from these ongoing and emerging chem chemical threats while the passage of the halt fentanyl act will represent a great start I remain personally committed to combating the production and sale of all of these illicit substances
▶ 1:56:28thank you Mr chairman and I yield back the gentleman yields back I now recognize gentle lady from New York miss or Casey orz thank you uh Mr chairman um and thank you all to all of our Witnesses here today sharing their expertise and their story and uh Mr Cullen thank you for for sharing your son's story with us here in the committee and I think it's tremendously important that we communicate to you that what happened to your son will not happen in vain and that we are going to fight to make sure that
▶ 1:56:58there is real change that happens to ensure that victims across the country are protected uh from this happening ever again um I represent the South Bronx and the South Bronx uh historically if it were its own state would have the second highest per capita rate of overdoses in the entire country second only to West Virginia and so this is is a a wellknown issue in our community I like uh the ranking member keep
▶ 1:57:28Naran in my car we have communities that have been ravaged by Fentanyl and one thing that's also in New York's 14th Congress congressional district is Riker's jail we've seen uh the impacts of schedule one on uh certain drugs and substances and these scheduling differences matter schedule two schedule one schedule 3 Etc um when
▶ 1:57:58we look at at the impacts of these things what I think is very important when we look at schedule one is the presence of mandatory minimums and what happens in mandatory minimums is that many of the victims of fentanyl distribution drug distribution themselves become incarcerated while many of the Upstream Distributors go off scot-free if we want to address this this issue we need to look at Financial crimes and in fact many of the industries
▶ 1:58:28responsible for supercharging the distribution of fentanyl are getting off without enforcement and one such uh industry is crypto and I think it's very important that if we want to make sure that we take an important approach on this we need to go after the folks who are responsible for the Upstream distribution of this but I want to put that aside U Miss lebel in your testimony you named some very
▶ 1:58:58key different factors in this crisis and how we can address it first you named transnational efforts uh which I think are tremendously important and to that extent addressing Financial uh the financial choke choke points that actually reward fentanyl trafficking but then secondly you talked about prevention and treatment and one thing that I thought was very uh very significant in your testimony is you naming the
▶ 1:59:29healthcare agencies that are responsible for helping reduce uh Fentanyl and Fentanyl use and one of the things you that you named was not just the CDC the NIH we also named Medicaid would it be fair to say that Medicaid is actually one of the most important and strongest protections we have in the opioid crisis in the United yes it it it treats a lot of people with addiction who would not otherwise uh be able to receive
▶ 1:59:59care and cutting off Medicaid and cutting off access to Medicaid could potentially increase the fentanyl crisis in the United States and certainly result in deaths from the fenol crisis I have I I think it's safe to say that if uh Medicaid were significantly reduced more people would die of overdoses so we're talking about the prospect of cutting Medicaid as exploding the fentanyl crisis in the United States and I imagine you see in many communities
▶ 2:00:30where there are fentanyl when there's widespread fentanyl use there's also large interplays with the Medicaid system correct yes can you explain that a little bit further what you see so I mean people are especially in Medicaid expansion States I mean one area that I keep bringing up but it's so important and we've done a lot of work on this at Georgetown is people upon leaving uh incarceration are are at 10 times greater risk of Overdose and so cutting off Medicaid for that population uh will leave
▶ 2:01:00them not only um probably more mortality but also increase their risk they're just going to end up back in prison so one of the things you were saying very importantly someone leaving incarceration is at 10 times higher risk Overdose demand and so incarcerating people too broadly can also create a demand on fentanyl because these are people who are struggling with a lot of these issues uh and I think one
▶ 2:01:30of the things that is important for us to see here is in those threats to Medicaid just last month in our continuing resolution we had bipartisan efforts to address fentanyl including expansion of Medicaid to address F the fentanyl crisis treatment that would that the Republican majority stripped on or ERS of Elon Musk people are dying because of this and we have to make sure that we
▶ 2:02:00are protecting our Medicaid system not cutting it because cuts to Medicaid are going to expand our incarc are are going to expand our fentanyl crisis and with that I yield back lady yields the chair now recognizes the gentleman from Ohio representative balderson for five minutes a question thank you Mr chairman thank you all for being here today um my first question is for Dr Westlake um and Dr Joyce touched on a little bit I know your experiences in the emergency emergency room but I'm
▶ 2:02:30interested in hearing how Wisconsin has approached provider education for opioids I know that your experience is largely with the ER but I would like to ask what you believe can be done regarding posttop monitoring to reduce the number of Americans that come away from surgeries with an opioid addiction yeah it's a great question Congressman so I actually was the medical examin board chairman and led the Wisconsin prescription opioid reform effort uh and started doing that in 2014 over 10 years ago so I I led and and my strategy was
▶ 2:03:00was with implemented and it was key for there to be prescriber education so we we looked for a cultural shift in prescribing I mean honestly the derivation of the opioid Crisis began with the pain is the fifth Vital sign uh you know mandated treatment of of pain patients have a right to have their pain treated kind of forced our hand uh as Physicians uh and we released that and then we mandated uh prescribed education through the medical Examining Board so we got to be careful medical reg regulation and education needs to go at the state level through the medical Examining Board there's you know the federal government is great
▶ 2:03:30at providing grants to the the the municipalities and localities that can then implement the strategy that they need so education is key but also education of the entire populace that that you don't need opioids for pain and I think that's happened I think we've seen a significant decrease but you're right we need to make sure that we don't overprescribe continue to overprescribe and use other treatments other methods I I can validate I had a hip replace I've had a surgery replacement and uh they cut me way back so um um thank you uh Sheriff uh thank you for being here today and
▶ 2:04:01thank you for your service um I represent a district in Central and Southeastern Ohio which is largely rural uh the op opioid epidemic has devastated the state of Ohio and Ohio's 12th congressional district for years Ohio has the second highest opioid overdose rate with a whopping 39.2 desk per 100,00 th000 people the state's opioid use rate is twice the national average uh encompassing 1.4% of the state's population and unfortunately
▶ 2:04:31opioid related deaths have continued to increase over the past four years can you talk to me a little bit about what policies are being employed in rural areas to reduce the opioid use misuse thank you yes um you know we have in my County both urban and rural and so a big part of that obviously is education to try to make sure that people are aware of the dangers again that's why we use the one pill and kill kind
▶ 2:05:01of thing to explain that so many people are unaware when you tell most P parents that they get this blank look on their face and they're horrified um and to have that communication with their kids so we try to go into schools and we have a lot of our SRO our school resource officers uh talking to kids about that we partner with the folks that unfortunately like Mr cullin is a is a part of a club he never wanted to join we have some of those I believe Rebecca from our County
▶ 2:05:31testified she lost two of her sons in one day when you have parents that are willing to rip off the scab of something that's so horrific to explain it to others it makes a deep impact on them so we we do a lot of Education partnership with our prevention our coalitions our health department and then we're vigorous in our enforcement to go after after those that are making profit off of again other people's misery and death my daughter played soccer with a lot of girls on her team and three
▶ 2:06:02of those girls have perished from overdoses and it's primarily the pathway that they got into it was through sports injuries and so the pasts alter and are varied but the outcome is typically the same thank you I like the SRO the resource officers in the schools um I another question for you sheriff in in 2022 Ohio ranked third in the country for the highest total fentanyl deaths while the number of Ohio deaths caused by fentanyl have decreased since 2022
▶ 2:06:32there are still far too many lives lost at the hands of fentanyl what steps whether it be through policy or enforcement do you believe must be taken to better combat the risk of accidental fentanyl use both from a law enforcement and a public health perspective well I think the step of permanently scheduling is is a good step and and it's important um I think a continuation of the Partnerships with health and law enforcement and and all across the different disciplines is critically
▶ 2:07:02important the communication between the labs of Trends and what they're seeing and how we get in front of it and prepare for it and respond to it um you know all of those are critically important components and I think a lot of the facts that we're seeing a reduction in deaths isn't necessarily because we've won it's because we have more people out there with Naran or OPI who are saving lives and giving folks a second chance and uh that you know we have broad distribution we have vending machines all across
▶ 2:07:33the the county I have a vending machine that's free when you leave the jail for Nar can in it they can take it with them um and I think that's in part why we're bringing it down we definitely have not won the war on this all right Mr chairman thank you very much I Y back gentleman yields the chair now recognizes that gentleman from Massachusetts representative Ain Charles for five minutes at question thank you chair there's no policy issue more personal than the opioid crisis
▶ 2:08:03I think to the exhibit I went to in my own District of parents telling the stories of their children who had had their developing brains hijacked by the most addictive chemical in history and hearing about these bright promising kids who descended into a spiral of lying and stealing and addiction and broken relationships and at the end so many of the parents said that their their focus was on just letting
▶ 2:08:33their kids know that they were loved before they died and we all have an obligation to stop this epidemic and I appreciate and applaud each of the five of you for the work that you are doing there and in particular you Mr cullin for your bravery and coming forward with your wife on this issue uh there's there's none of us up here on the deis whose decisions as a as 23 year-olds would survive Congressional scrutiny and and coming forward with this with this story is so powerful because the word you use poisoned
▶ 2:09:04is exactly the right word he was poisoned and it is not just the cartels as the gentleman from Texas pointed out rightfully it is also the Chinese Communist Party who are engaged in the state sponsored poisoning of the American public 98% of fentanyl precursors are coming from the Chinese Mainland these chemical manufacturers are being facilitated and subsidized by the Chinese Communist Party often times to the profit of individual CCP members and as co-chair of the fentel working group last term I introduced three
▶ 2:09:34pieces of bipartisan legislation to interdict the supply of this fentanyl directly on the Chinese Mainland because as all five of you have said prevention preventing this chemical from reaching the US Mainland is the best way to stem this tide and I would implore my Republican colleagues instead of taken a buzz saw to samsa and to Medicaid and to the program and to biomedical research to the programs that we know help treat people with substance use disorder work with us on the three pieces of bipartisan
▶ 2:10:04legislation already introduced to create a Joint Task Force counter Opa to sanction the Chinese manufacturers of fentanyl to uh imp Place fines on Chinese shippers that whose manifest do not recognize that they have fentel on these ships these are things that we can work on right now uh if the GOP would come under the thumb from Elon Musk Dr weslake I want to transition uh to the other side of the problem which is not on Supply but on demand uh
▶ 2:10:34a couple of other colleagues have mentioned jourova which is the new drug that has been introduced for acute pain that is nonopioid based and this is the fruits of two decades worth of biomedical research biomedical research that my Republican colleagues are trying to cut um and it is going to be I think a game Cher 40 million Americans are diagnosed with acute pain every year 85,000 of those develop opioid use disorder and this drug uh
▶ 2:11:05is similar in its efficacy for treating pain without being addictive um now the problem is the commercial health plans are creating the generic level co-pays for this drug but on Part D where millions of Americans access their prescription drugs and a lot of people with acute pain will get their drugs the co-pay is at $50 more or less whereas the opioid co-pay is at about $2 based on your experience dealing with patients with acute pain do you think that difference in out-of Pocket cost might disin
▶ 2:11:35the use of the less addictive painkiller yeah I I always when I when I prescribe medications for people I always just start with something even more simple than that than anything prescription Tylenol and ibuprofen together if you can take them are as effective but I think yeah the definitely cost is a driver of What patients take if they can get something for Two Bucks versus you know 50 bucks um there's going to be a shift towards the less expensive Miss leel would you agree that a higher co-pay is disincentive exactly the behavior we want to see sure I mean you know people are cost sensitive and
▶ 2:12:05that's a lot of money that's a lot of money and we know that anything particularly above $35 co-pay tends to really rapidly disin patient adherence this is an example again of the pharmacy benefit managers the health insurance owned drug pricing middlemen uh not enacting and enforcing their formularies in a way that is actually helpful to Public Health they're they are directly undermining Public Health by pushing the opioids and by the way there's huge evidence that the pbms profited off of the overprescription of these opioids
▶ 2:12:35they are continuing to push these opioids on dep party beneficiaries despite the fact that there is a brand drug out there that is non-addictive that treats pain similarly and that they could easily put forward at the same co-pay tier if they wanted to I will yield back gentleman yields the chair now recognizes the youngest and the prettiest pharmacist in Congress representative har Barger from Tennessee you're so sweet thank you Mr chairman thank you to the witnesses for being here today uh
▶ 2:13:05I am the other pharmacist in Congress um and Mr Colin I condolences to you and your family for the loss of your son and only someone who's lost a child can understand what you've gone through and U I'm sorry about that and I'm glad glad you gave us a list of things to look at and prioritize uh it's going to help us quite a bit um I want to start with a question to Dr Westlake uh you know in my view we need to be as bold as possible when it comes to taking
▶ 2:13:36steps to protect our children and our families from these Alysa fentel overdoses and I you know you've talked about um the F FRS the opioids the nines the xyzin the things that you're seeing in the ER in in East Tennessee I've talked to my Healthcare Providers and my law enforcement and they're saying it's taking multiple doses of nxone to bring these people out because you know as well as I do noxon and fitel bind to different receptor sites and I know they're working on some um
▶ 2:14:06I think it's a canab BAL modifier to to reverse that so I guess the thing is my question would be what are you seeing how many doses is it taking to these people when you see them in the ER or law enforcement so what I see in Wisconsin is that you know again the issue is is having the Naran in in law enforcement the first First Responders on the scene I you know sometimes people do come in and then they they have too much opioid
▶ 2:14:36in their system and so that Naran wears off yeah but my experience is that the critical access point is getting them the intervention ofal agent so we're not seeing that but that's not to say that that's not an issue nationally it's just we're not seeing it Wisconsin well even um Sheriff even with some of the drug sniffing dogs they have to carry the naram because the dogs will get you know they'll be overdosed as well is that what you're seeing in your area yes ma'am we um actually have Naran we have changed our our procedures for handling and evidentiary
▶ 2:15:07rules for our narcotics team and our our road deputies because of the risk that they can overdose from Mere contact with some of these components probably triple gloving aren't you even the the uh switching evidence you know when I was on Homeland Security they would have to to double or triple glove just to transfer the evidence because the Skin's the biggest organ that will you know take that fenel up I I'll go along with this one Sheriff uh you mentioned the challenges of those pill presses those
▶ 2:15:37tablet machines uh that we need better regulation around the possession of those I'm a compounding pharmacist so you know a lot of those Compounders will use tablet presses to do re you know prescription drugs but most of those from China if I'm not mistaken when they ship those in but it's the dyes that make those drugs look like the Xanax or the Percocet or the adderal um I guess where are you finding out that are you looking to see who's making
▶ 2:16:07those dyes for the tablet machines if if that we find them in our AO we are but sometimes you know we get a bag of pills and and we don't know where they were pressed into being if you will yeah um obviously you know everybody can go online and look up the numbers and say oh this is the pill I have yeah but that's not the pill they have and they're using a Fen nail as fillers just to uh you know it's easier to make Fen nail than it is cocaine or heroin you can make it in a few hours
▶ 2:16:37it's easily transportable and that's why they're you know and they sell it for 100 times more than what the cost of the drug is so there you go um I want to continue along that line and ask about the Haida um I saw some St statistics and in 2022 we had 134 criminal organizations that were dismantled by Haida we had over 80 8,700 kilograms of drugs that were removed nationally and the Appalachian Haida because I'm in East Tennessee uh task force was operating in
▶ 2:17:07Tennessee was responsible for removing uh drugs off the market that had a street value of 51 million and I just want you to tell us a little bit more about why it's important to continue that program sir it's important to continue the program because there's so many layers to this that are outside our own individual Circle so I have one of the largest counties but they're not just making it and distributing it in my County so where it's coming from can be anywhere in the world so that's why
▶ 2:17:38coordination and communication and deconfliction are all critical components and that's where heida comes in yeah you know I've got people assigned to the DEA they have people assigned to me but we all have to do that systemic to Target a problem that is coming from other countries yeah it's inter agency collaboration and I guess with that Mr chairman my time is up and I'll yield back the gentle lady yields back I now recognize the gentleman from Louisiana Mr Carter five minutes
▶ 2:18:08thank you Mr chairman and thank you to our Witnesses um particularly Mr Colin our heart goes out to you for your great loss as a father of two sons uh I I I can only imagine the pain that you and your family um suffers and know that that that we care and that we're desperately trying to find a way to address this epidemic that we have with
▶ 2:18:38fentanyl laced um drugs that are taking the lives of far too many of of of our people um I'm I'm concerned about the president's proposed freeze and I know our our colleagues suggested we shouldn't talk about the freeze because the freeze has been blocked because it is in fact unconstitutional my fear is that there may be another attempt or another approach used to slow reduce or cut
▶ 2:19:09resources that would Aid in the slowing and hopeful elimination of these uh uses of fentanyl um we know that samama the office of national drug policy Federal funding makes up 60% of the budget in New Orleans uh which goes a long way to addressing the concerns uh it's important to tell the real story about the lives of people who are impacted by these Cuts people who depend
▶ 2:19:40on resources that will Aid them in uh getting off of illicit drugs or having education so they never get on them in the first place Odyssey House in Louisiana currently operates several samama funded projects of regional and National significant including a rural area drug court which diverts individuals with drug rated offenses in the treatment and case management aimed at reducing recidivism
▶ 2:20:10freezing or eliminating these grants could result in some 600,000 dollars a year loss for the organization staff reduction and loss of idal services this directly impacts the people who need the resources the most um I'd like to ask Miss leel and thank you for your testimony with us today as a former official of uh on DCP I was hoping that you can speak to the negative ramifications of
▶ 2:20:41this proposed freeze or any other freeze that may take dollars away from this vital um action thanks thank you sir so I mean for too long we've had a bake sale approach to addiction and we we put scraps together to fund uh the nation's addiction treatment prevention program and and supporting recovery now Congress has been very generous in the last several years uh through also through Medicaid expansion to make sure that that we no longer have to scrap
▶ 2:21:11for pennies to put together the type of comprehensive approach so cutting it further will set us back and and and real quick I've got a little bit of time Dr Kena um I'd like to to to thank you for the incredible work that you've done as with all of the witnesses bless you for the great work that you do this is really all handson deck bipartisan effort to cure a horrible ill a horrible stain um on in in our country um but you
▶ 2:21:42you if we were to look at the disturbing actions in taking down critical public health information on government websites agencies such as CDC have taken down Pages such as the youth risk behavior surveillance system how does removal of this critical information impact the work of providers such as yourself these are places where people can get information on how to get help removal of that information really has real-time impacts on
▶ 2:22:12healthc care providers as well as public health professionals um there are we look to that to to to say how we should be focusing our clinical care overall how we should in communities be directing um resources and not having that available makes it very difficult for states in real time to know how to direct um funding for programs um on the clinical front the removal of clinical
▶ 2:22:42information as was described is can have direct clinical impacts in real time and the longer they're down and speak from a different perspective is our as a medical educator our trainees who will be taking care of us as Physicians as we age are not learning that because those are the the foundational documents that we use to teach new healthc care providers how to provide care the longer we can't access it think about it they may lose
▶ 2:23:12the opportunity um to learn about standard evidence-based practices um so yes the removal of that information definitely has real-time clinical impacts and well impacts on public health and and my time is up but I'll close real quick by saying if ever there was an issue that was that called for a bipartisan effort to fix the epidemic of fentanyl in our country certainly is that uh Mr President Mr chairman I yield the gentleman yields back uh and I now recognize
▶ 2:23:43Dr Miller Meeks uh for five minutes for questioning uh thank you uh very much Mr chairman and thank you to the witnesses for testifying before the subcommittee today this hearing could not come at a more important time with the house considering HR 27 the halt fental let me repeat that fenil not fentol the halt fenil act which I proudly co-sponsor let me also say that it it's critically important uh that it is a bipartisan hearing and it would have been very helpful
▶ 2:24:14to have bipartisan support for securing our Southern border and reducing the flow of fentel fenel precursors into this country especially through Mexico and as you've heard uh incentivized by the Chinese Communist party uh to uh send fenal precursors to this country according to the CDC data we lost more than 110,000 Americans to drug overdose deaths in 2022 it's estimated that 75% of these deaths involved opioids meaning that 226 Americans died every
▶ 2:24:44day to opioids while many cases of drug rated deaths are poisoning where the individual does not know the product they about to use as laced with another substance like fenal more needs to be done to prevent addiction including minimizing unnecessary exposure to opioids and as a director of Public Health and as a state senator I was very influential in getting substance use disorder treatment as well as reducing pre-authorization to Medicated assisted treatment for substance use disorder as well as trying to stim the flow of of
▶ 2:25:14opioids 90% of acute pain patients receive opioids to manage their pain whether they need them or not between 2011 and 2019 opioid prescriptions decreased by 40% from approximately 250 million to 150 million prescriptions dispensed this is true across most paay audiences Medicaid private and cash patients however among Medicare patients opioid prescribing actually increased Medicare share of opioid prescribing during this time increased substantially from approximately 20%
▶ 2:25:44to the country's opioid prescriptions in 2011 to 35% in 2019 this represents a 75% increase in just under a decade we clearly have more work to do in Medicare to make sure that patients have access to effective pain relief agents while also not unnecessarily exposing them to narcotic painkillers one way to do this would be to the increase access to nonopioid pain management medications which I'm plow to accomplish with my legislation the alternatives to pain act this
▶ 2:26:14legislation when I which I thank congresswoman baragan for co-sponsoring and co-leading would decrease barrier to accessing nonopioid pain management Alternatives that are FDA approved Dr weslake thank you for testifying today do you agree that prevention needs to be part of our strategy to combat illicit drug use and addiction absolutely do you believe that our current reimbursement policies appropriate align incentives to ensure patients have access to opioids and nonopioid paid management
▶ 2:26:44Alternatives yeah I think it's important to make sure that they're cost effective solution and do providers have the the education and resources available to know what other Alternatives could be available I think so I think so um do you agree or think that patients should be should not be forced to fail first on an opioid before being given the option to use a nonopioid to treat their pain if a nonopioid is prescribed by their doctor yeah that seems counterproductive and how would you suggest
▶ 2:27:15Congress work to appropriately align incentives to ensure seniors have access to novel non-opioid pain management Alternatives especially in the postacute um hospital care setting or as their discharg from the emergency room right I think you you again try to encourage nonprescription um you know Solutions nonprescription drugs but also to make sure that there's a some parity in the in the cost pricing structure thank you Switching gears I'd like to focus on another critically important issue that pertains to people purchasing uh
▶ 2:27:45drugs over social media applications especially our youth the US centers for uh Disease Control and prevention recently published an analysis finding a 182% increase in elicit fital um poisoning or overdose deaths among 10 to 19 year olds between 2019 and 2021 again our condolences Mr Cohen counter Fant prescription pills were present in nearly 25% of deaths the DEA released an updated public safety alert finding that six out of 10 fitel lace
▶ 2:28:15counterfeit prescription pills contained a potentially lethal dose which was an increase from the agency Labs analysis from 2021 when the rate was four out of 10 um Sheriff bushard as a result of online sales do you think a framework like the one I outlined um in in platforms uh directing social media such as the Cooper Davis and uh Devon noring act would be helpful in reducing these deaths yes I I think we have to look at the component of what technology
▶ 2:28:45and social media companies are doing and taking part now especially as many of them moved or have already moved to end to end encryption U we know that that's that's a big Challenge on so many levels and and many of them are resistant if not outright obstructionist to law enforcement even with a valid search warrant thank you so much I see my time has expired I yield back gent lady yields the chair now recognizes a gentleman from Ohio representative lansman for five minutes of questioning
▶ 2:29:16uh thank you Mr chair and thank you all for being part of uh today's hearing uh to the cins um thank you for sharing your testimony as my colleague said it's couldn't have been easy uh sitting here today I have a 13-year-old son and um well I'm just repeating what he said which is I can't possibly imagine but what you're doing obviously is making a difference uh in raising awareness
▶ 2:29:46and getting those of us who are already passionate about this even more passionate because of Zachary's life and and you all being here to tell that story so thank you um a couple things one is and this is across the board anyone can answer it but there are obviously concerns and and I I think in some ways they are bipartisan concerns about the funding issues hopefully they'll be bipartisan
▶ 2:30:18concerns because we've talked about all these you know critically important Investments Federal Investments um recovery investments in cinnati where I where I represent we have the Addiction Services Council they do incredible work so much of their resources come from the federal government uh the education work that we've all talked about or you all have talked about uh prevention first in in our district does incredible work half their budget is federal dollars
▶ 2:30:48we have a quick response um team that's been incredibly successful was uh featured in The W um Washington Post uh a couple weeks ago um the worry is that yeah the freeze was uh put on hold or it was stopped but there's concerns and Reporting about work workarounds there's also you know potential looming budget cuts so I want to get to a place where sort of there is this
▶ 2:31:18bipartisan uh appreciation for what could be taken from us and I was wondering if each of you could just say what the one or two most significant Investments Federal Investments are that we have to protect starting with you Sheriff I don't I think um heighta is critically important on this front uh Partnerships um on that level deconfliction
▶ 2:31:49and a variety things but also um how we fund task forces and the kind of methodology you know there's a lot of discussion which we've been part of and we look forward to a partnership on that about forfeiture and Equitable sharing uh that does impact our work in that space contrary to a lot of information that's out there there's no law enforcement agency in America that's making money on forfeiture um it just helps with some of the an I'm glad you brought that up because there is some discussion about you know changing those
▶ 2:32:19rules that the for forfeiture money is critically important um and then as you mentioned how these task force get set up and funded uh um it's hard to answer just one um because I think they all work together um but you know obviously um you know the Affordable Care Act Medicaid expansion the block grant from uh samama um the S Grant from Sansa which
▶ 2:32:49is the State opord response Grant which provides you know money to every state those are all critically important and they work together there's a whole host of law enforcement grants and and Investments that go along with those two that I'd i' add to the list um any others that you want to point out or the the last thing I'll mention is the on the budget the policy questions there hopefully will be a bipartisan border agreement uh and
▶ 2:33:20the work to stop uh these drugs from coming in has to be way more robust than it is today there is this question that about getting in front of how does Congress stay in front of the the synthetic uh drugs and I we are you may have mentioned it but I'm curious just very quickly what is it that we should be doing that we're not I mean obviously we're going to pass this bill today but in general how do we is it just the way which
▶ 2:33:50the legislation is written that matters most uh or should we be sort of approaching this differently and I only got 20 seconds so I I think it's important to uh understand that that to make sure that there's no innovation that's being harmed by regulation so to make sure I know there's discussion about testing strips and things and there's been you know to just make sure that the that what the oversight that's being done isn't hampering the critical research because it it has the problem is it has to be nimble xylazine was an issue we talked about this two years ago um and you
▶ 2:34:20know it's still an issue I started fent related substance eight years ago uh and so I think that that's the you know is is to watch for the unintended consequen yeah thank you I before I yeld back I think that's one thing I hopefully we can get after this hearing is a better sense of thank you gentleman yields the chair now recognizes gentleman from Michigan representative James for five minutes of questioning thank you Mr chairman and uh I also appreciate the opportunity you gave me to introduce uh my friend and uh American
▶ 2:34:50hero sheriff buard for uh and uh for having this hearing uh opioid addiction has impacted every Community Across America and it's especially hit the residents of my district in Oakland and mcom counties the previous administration's policies left a trail of Destruction heartbreak and broken families in its wake and now it's up to us to clean it up simply going from 100,000 deaths per per year to 90,000 deaths per year is not a success we should be applauding the number is zero
▶ 2:35:20and we will work continuously across the aisle to continue to move in that direction recent data from the CDC demonstrates that in 2931 lives were lost in Michigan in Michigan alone that's the number of US service members died in 20 years in Afghanistan 200 I'm sorry 2352 is how many people we lost in Afghanistan 20 years more than a War's worth of death in one year in my estate alone previous years data shows us a trend a
▶ 2:35:50trend of failed border policies from a president that failed American families the rising tide of fentel related tragedies has made it evident that something is not working when it comes to stopping the flow of illicit drug trafficking and families in Oakland and mome counties continue to experience personal loss highlighting this urgency for Innovative investigative approaches is essential however one feels about tariffs president Trump is right our neighbors in Canada and Mexico must help us stop the flow of illicit
▶ 2:36:20drugs entering our borders no amount of scapegoating and retaliatory tariffs is going to stop our people from dying Sheriff bushard can you please speak briefly to the experiences that your officers have gone through in dealing with the Fentanyl and instances of overdoses and opioids that seen thank you um we've seen an increase in difficulty in bringing them back um that's part of the reason we added OPI to our tool chest because we were seeing multiple people people we tried to
▶ 2:36:51resuscitate weren't responding on one or two or even three doses of Naran as you wait for the prescribe time things like that um we know that communication um and some of the prevention programs have been helpful I think I opening especially when we're doing them in high schools U but it's important that we don't minimize or reduce our focus on holding the people that are killing people intentionally for profit accountable for what they do that's why in that one case we
▶ 2:37:21U I mentioned earlier we prosecuted the individual for causing the death murdering the the the person that died from the overdose it's a poisoning it's it's something they did not anticipate did not ask for and did not want and that's murder in my board 100% um there are considerable drains on your resources which inhibit your ability to fight trafficking and confront emerging threats as well what are some of these on your resources what are some of
▶ 2:37:51those emerging threats and what can Congress do to assist well now we're getting into a broader question specifically above and beyond fenel and that goes to counterterrorism and the threat Matrix that we're facing the threat picture that we see and uh former director Ray testified multiple times that we're seeing more bells and whistles now than we did on 910 um as a member of The Joint terrorist task force and and very involved in that space we're
▶ 2:38:21very concerned and obviously that's drawing more and more of our resources and attention to what things we may be facing that we're not communicating about and I would encourage all of Congress to reexamine what we're doing it seems on many fronts we've lost some of the lessons of 911 we're communicating less sharing Intel less we don't have a real time ability to even communicate on a even a secret level where you've got terrorists that are communicating on encrypted apps and I'm having to go find a
▶ 2:38:51skiff to get a brief on something that's emerging we need to figure this out and get back to understanding there's a real threat facing this country on lots of levels so it is easier to conduct criminal activities in this country than it is to conduct law enforcement operations in this country absolutely and we need to fix that I totally agree um what specific resources funding streams or inter agency coordination mechanisms do you believe Congress should prioritize to strengthen fentel trafficking
▶ 2:39:22and trafficking enforcement sir um I think it's important to again focus on some of the programs that have worked uh we're good with with examining and auditing programs to make sure that the money is being properly and wisely spent because in our agencies we do that we know that there's limited pool and it's got to be spent appropriately and on the priority Mission um but for us and specifically the fentel space it would be the The Joint teams and he um that partnership and that relationship
▶ 2:39:52grants to Labs that can be maybe getting out in front of some of these things and protocols and what our folks should be doing on the street not only to save people but how to handle anything they recover thank you uh I would like a couple seconds uh I would like to recognize Miss Christine Zabo who I witnessed Save a Life on a Detroit Street Corner uh for all of those who are invisible who are saving lives we see you we appreciate you thank you for your service thank you all the gentleman y back I now recognize the general lady from Illinois
▶ 2:40:23M Kell thank you Mr chair I want to thank chair Carter and ranking member to get for holding our first subcommittee hearing of the new Congress on today's critically important topic I want to thank all the witnesses and like my colleagues especially to you Mr Cullen uh in Illinois the leading cause of pregnancy related deaths is due to mental health conditions including substance use disorders which comprise 32% of these deaths United States States is facing a maternal mortality Health crisis there's been a bipartisan
▶ 2:40:53focus on addressing and reducing all causes of maternal mortality and morbidity and I've been pleased to work with SE several of my colleagues across the aisle to pass important legislation to address this maternal Health crisis that is why I am deeply troubled at this administration's action since last week when we witnessed a halt on federally funded programs I won't go through them because my colleagues you know have talked about them but I did want to talk about my concerned for deep cuts to the Medicaid Program including the maternal opioid
▶ 2:41:24misuse model or the mom model which is intended to address fragmentation in the care of pregnant and postpartum Medicaid beneficiaries with opioid use disorder Dr kaminga in your work as a pediatrician have you seen that fragmentation of care can contribute to obstacles for patients who seek recovery and support resources from opioid use disorder and other and other excuse me substance use disorders thank you for that question I have definitely seen
▶ 2:41:54the impact of fragmentation of care um both with children and teens and young adults and actually with uh mothers um they you have to go one place for mental health care a completely different system for substance use disorder care a completely different system for um obstetric care and then another you know a completely different system for the newborn baby um so you know as a pediatrician I'll say access
▶ 2:42:24to resources for parents to improve their mental health is into is part of what we do um in the clinic for example I do have a poster in the clinic for our local state uh Mental Health Asset line for parents the reason pediatricians give this information out is they come to us with newborns and asking us about their mental health and we love being being able to connect them with Community Resources um so having these resources available
▶ 2:42:55as as a pediatrician we we support because healthy moms healthy children and access is such an issue my district is urban suburban and Rural and in some of my more rural areas there there is not that access and even in some of my urban areas but it's harder for people that live in rural areas to to get to places uh whether you're are in a program receiving Federal funding in a blue Red State the consequences of deep cuts and funding freeze will be very detrimental Miss leel
▶ 2:43:25can you discuss what disruptions and access to treatment and Recovery Services mean for patients and particularly new moms yeah well I mean new moms have a higher rate of Overdose um and you know the the it's it's often hard for um mothers or parents to seek out treatment so when they do we shouldn't make it harder for them to access that treatment and disruptions and confusion will make it harder for them to access the treatment
▶ 2:43:56and then how important is funding for HHS agencies like the CDC and NIH and informing our understanding and response to access immediate threats as they occur at the state and local level yeah I mean these funding sources are life saving to you know hundreds of thousands of people Millions across the country I want to thank you for your responses and hopefully my colleagues will recognize and we can work in a bipartisan way to make sure that the funding that is needed will happen thank
▶ 2:44:26you and I Y back the gentle lady yields back and I now recognize a gentleman from New Jersey Mr Kane for five minutes thank you Mr chairman and thank you to all of our Witnesses for being here today the increasing prevalence of xylazine in the United States is a dangerous Trend Public Health official have warned of the skin wounds that can occur from repeated use of xylazine and the risk of worse
▶ 2:44:56Health complications if the wounds are left untreated how much are healthc care providers aware of the dangers of these Health complications and how best treat them Dr Westlake yeah so I just actually saw a patient with ulcers from xylazine about two weeks ago um and I asked him why he was doing it and he knew the risks associated with it and he just couldn't stop himself because he liked the high too much I mean that that's the issue is is that the xylazine is available um and you know it's not scheduled you it's legal to get it
▶ 2:45:26shipped in now and so that needs to change you know whether whether it's placing it as a control three scheduled drug or placing the same uh the same restrictions that schedule 3es have on it as as far as being imported and monitoring it um treat treating it is you know treating the the ulcers aren't it's difficult but it's it's the problem is that it's there that it's happening so what steps can policy makers make on the state or the federal level to increase the awareness of zyline
▶ 2:45:57associated wounds and treatment options amongst healthc Care Professionals yeah I think just encouraging the awareness I think there's a pretty broad awareness of it of of it now but I think and the way to the way to get that done is to get it thread spread through the the local uh like specialty organizations like American Academy Pediatrics American board urgency medicine you know it's not necessarily through Federal it's it's spreading it out through the through the networks that that that the doctors listen to okay thank you uh Sheriff buard um in my district the Morris County
▶ 2:46:27Sheriff's offic partners with the county health department um the Mental Health Association the Morris County prevention uh to operate hope one which is a vehicle that travels to sites throughout the county to provide services and supports for those struggling with addiction at these sites the vehicle provides immediate access to services to treatment facilities and Narcan training and kits in fact at least 177 of these Narcan kits have been used to Save a Life in New Jersey
▶ 2:46:58the sides are staffed by Sheriff's officers licensed mental health professional and certified peer support Specialists can you speak to the vital role that law enforcement has in these holistic approaches to treatment yes sir thank you um it's critically important that we're all connected whether it's Health prevention or law enforcement as I mentioned earlier we're typically the first one on scene at any situation um CBS I believe National did a story on one of my
▶ 2:47:28deputies uh saving a woman in a Dollar General you know typically we are around and spread through the community fire departments or EMS comes from a station lots of times we get there first and those first two or three minutes may be critically important to saving that life so that partnership and then the handoff to followup care and to uh PR prevention in the future that's where our crisis response unit and our partnership with the health department comes in okay um can you speak to how do um
▶ 2:47:58drug trafficking contributes to violence in communities and how law enforcement is an essential component in combating illicit drug threats yes um you know when you think about an establishment let's say let's say a McDonald's if an armed robbery there they're going to K cash when you've got even a legal licensed facility whether it's a Pharmacy or a medical uh uh or medical marijuana or a marijuana facility they both have cash and drugs and so what we're seeing is
▶ 2:48:28the violence that are are directed sometimes at armed robberies or situations there are must much more escalated we had a homicide about a week and a half ago at one of our licensed marijuana grow operations where they came in just barely creased the door and shot the individual in the face and killed them and then stole 50 pounds of marijuana so they they tend to draw attention for armed robbery and for ancillary drug activity and earlier
▶ 2:48:59in this hearing you you responded that today Americans can get xylazine mailed to their house from vendors in China can you walk me through how that process works or any current barriers that exist to this emerging danger at this point I'm not aware of any barriers we've been trying to get a state law passed to deal asine it's still not scheduled uh on the national level so there's not a barrier to shipping or mailing something direct to a in consumer that's not prohibited
▶ 2:49:29by either state or federal law and do you have any advice how to combat this International flow asine in the United States I I think it needs to be scheduled I think we need to a whole of government effort to is as I said Nimble enough to deal not with xylazine but what's the next iteration that's going to come down the pike thank you I you back my time thank you gentleman yields back and I now recognize the gentle lady from Texas Miss futcher for five minutes thank
▶ 2:49:59you Mr chairman uh and thanks to Chairman Carter and ranking member to get I am glad to be back on the health subcommittee this Congress and I thank all of the witnesses for your testimony today uh it has been very helpful and important and I appreciate your perspectives your passion and your purpose so thank thank you all during this hearing I've heard my colleagues on both sides of the aisle Express concerns about the overdose epidemic and about combating illicit drugs in this country and
▶ 2:50:29I think that these concerns are sincere um Miss leel I think you provided a really important overview of the interplay of complex challenges and the many fronts on which we must combat the existing and emerging illicit drug threats um but what we have seen in just the last few weeks from the Trump Administration undermines efforts to address this challenge as you described them undermines isn't actually a strong enough word what the administration has done in the last few
▶ 2:51:00weeks is really decimating our efforts and our ability to respond and address these complex challenges certainly efforts to disrupt International Supply chains requires robust collaboration with law enforcement Partners so firing FBI and CIA agents and Outing them is making us all less safe and L able to combat these elicit drug threats gutting the federal Workforce of course affects not only those and other law enforcement officers uh it also affects the entire Health Care
▶ 2:51:30System across the United States halting all federal funding including funding for the NIH the largest fun of biomedical research in the world which funds critical research on substance abuse and addiction also impedes our ability to respond and as Dr Ruiz noted the Administration has Al also halted funding for samsa Substance Abuse and Mental Health Services Administration the main government agency tasked with improving mental health across the country and addressing substance use disorders and following up on some
▶ 2:52:00prior exchanges today the only reason These funds are now available to grantees is because multiple federal courts have blocked the administration's actions and even though that freeze of funding has been blocked we are hearing reports today that the samsa website ite has been inaccessible this website has critical resources that can help our constituents find the help and support that they need and our job as members of Congress and as members of this committee is to tackle
▶ 2:52:30these complex issues thoughtfully to tackle the things that we're talking about today and craft legislation that helps address them to find a legislative solution to address the supply of drugs entering the country illegally to take measures to make the public aware of the threats of these illicit drugs to address substance abuse disorders by expanding access to prevention and treatment programs and to find research to fund research for new treatments and new innovative ways to address the crisis we say we are doing that today with
▶ 2:53:00this hearing but what is this committee doing what is this Congress doing to assert its Authority here over congressionally appropriated funds and congressionally established agencies and programs as president Trump and Elon Musk stop payments eviscerate programs and fire qualified Personnel ranking member to get noted that in the last Congress Republicans failed to bring the support act to the floor and as a reminder the support Act was a bipartisan agreement that
▶ 2:53:30would have extended scheduling for fentanyl related substances and reauthorized programs for the prevention and treatment of addiction it was included in the bipartisan continuing resolution last December but then Elon Musk tweeted that he didn't like the CR and that was that there was no support act so why are we here if Elon Musk can at any time substitute his judgment for all of ours at a moment's notice without any meaningful
▶ 2:54:01objection from the House Majority if we pass a bill to address the overdose crisis or any Bill how do we know that the Trump Administration or Elon Musk won't just cut off any programs or any funding that we authorize I hope this committee will assert its jurisdiction to the executive branch I hope that this Congress will assert its its authority to the executive branch as we have seen from the testimony today the stakes are too high
▶ 2:54:31for us to do anything else now with the time I have left which isn't much I do want to turn to something that we expect this committee to take up and that is Medicaid and one of the current attacks on federal funding Republicans have outlined in their budget reconciliation is to is a proposal to cut 2.
▶ 2:54:48$3 trillion in cuts from Medicaid so uh Dr Dr konga in your testimony you talked about how we should increase funding for Medicaid can you just discuss with the time left how you think significant cuts to Medicaid May harm our efforts to combat this epidemic cuts to Medicaid harm children that's that's the period in the sentence 50% of children are insured by Medicaid that's how they receive healthare so AAP is very concerned about cuts to Medicaid
▶ 2:55:19well thank you I've gone over my time I have a few more questions I will submit for the record but I thank you all again for your testimony and your time here today and your work thank you I yield back the gentle lady yields back the chair now recognizes the gentleman from Oregon representative bin for five minutes of questioning thank you Mr chair and thank thank you panel for your patience um so I have a question on demand and a question on Supply I'll go to demand first I'm from Oregon and in November of 2020 Oregon and passed a ballot
▶ 2:55:49measure 110 which reduced the penalties for most possession of controled substances down to a mere violation between that year 2020 and 2022 the number of overall overdose deaths in Oregon increased by 75% from 797 to 1392 people nationally over the same period overdo deaths grew by only 18% deaths in Oregon from opioids specifically increased 101% between between 2020
▶ 2:56:19and 2022 compared to 33% nationally over the same period a prior to implementation of measure 110 emergency Department's visits for non-fatal overdoses decreased 4% but afterwards it was one of three states that reported an increase rate of such visits between February 5th 2023 and February 4th 2024 Oregon had a rate of non-fatal overdoses more than 200% above the national average and
▶ 2:56:49Moma County home of Portland has the highest rate of non-fatal overdoses in nation so Dr Westlake would you recommend legalization of drugs as a way to address the demand issue the demand side of the opioid problem similar to that in Oregon obviously of course not and do you I noticed you were on several U groups that trying to figure out what to do
▶ 2:57:19about the supply side it appears that education is the answer is that correct is education the best thing we can do it's a key component to it definitely and you're doing that in your state correct prescriber education and then just a cultural education I think even more about in toxicant in general throughout our entire you know American culture the way we approach alcohol and and you know legal drugs illegal drugs I think we have we have a drug issue in America that needs to be looked at societally now the we I'm
▶ 2:57:49happy to say that Oregon recognizes that it's not done it right but they have not corrected at all the damage being done by the failure to have a control mechanism in place that gives you some way to prompt people if that's the right word to actually go get care because we used to have drug courts we don't anymore we used to have people actually arrested we don't anymore because the law enforcement justifiably says why bother it's supposed to be small amounts no one knows no one cares because no one's going to be prosecuted for it there is a law enforcement
▶ 2:58:20component to it for no other reason than to force people to get treatment is that your thought because we can't seem to get back to where we actually were with drug courts many of the many of the patients that I see that are in recovery are thankful that law enforcement had to intervene and got them to the to the the bottom that their bottom wasn't their death but their bottom was was an encounter with law enforcement and Drug courts right well thank you for that I'm going shift back to the uh to the supply side Sheriff U should thank you for being here I have the Good Fortune of having a younger brother who was sheriff
▶ 2:58:50in Oregon now retired and happy to be AWA from the politics of the office not that that's an issue today before us but let me just ask this question the uh Trump Administration just filed a lawsuit against Illinois and Chicago for being a sanctuary uh state and city indicating that under the supremacy clause their Sanctuary status is interfering with uh what federal government needs to do in Oregon back
▶ 2:59:20in 2020 actually it happens all the time but I'll use an event in 2020 uh in my District Two cartel member drug Runners were picked up by State Police and were held until released on bail but they were they were not the state police allowed because Oregon is a sanctuary state to contact ice they they promply disappeared this was the third time they had been apprehended and there was no doubt they they they were arrested with drugs in
▶ 2:59:50their car my question to you is do Sanctuary State status interfere with your ability to try to address this issue drugs well I I'm speaking hypothetically since we're not one but you have some cities in your in your state I think that are but go ahead so absolutely if someone is not cooperating and sharing information about who they have in custody they may not know who they have in custody we don't have access to some of the federal database so we may not know
▶ 3:00:20um you know what that person is or what they're wanted for and that goes to my earlier comments about Homeland Security and communication and post 911 how that was one of the key findings of the 911 Commission is we have to share information we have to partner better we have to communicate better now I don't think immigration enforcement is a local Law Enforcement issue but sharing information and cooperating with other law enforcement agencies on their lawful mission is important I appreciate that yield back thank you
▶ 3:00:50gentleman yields the chair now recognizes the Gent lady from California representative Bon for five minutes of questioning uh thank you Mr chairman I just wanted to follow up on an exchange earlier with uh Mr Griffith there Contin continues to be a concern about uh the freezing of the the dollars the federal funds that community health centers um have either not have act access to and some that have shut down or poorly shut down we did follow up to call the new River Valley Health Center uh which is in Mr Griffith's
▶ 3:01:21district and we did not get an answer we did hear that they were one of many Health Centers at risk of closing their doors so just wanted to recommend um that uh the member reach out and actually connect with them uh to get that information and with that I want to turn um uh to what we've been talking about here um I have the majority memo in my hand and it says the hearing is to combat existing and emerging illicit drug threats part of the memo says according to the DEA
▶ 3:01:51the Mexican caloa and halisco cartels are the transnational criminal organ organizations primarily responsible for manufacturing and trafficking elicit fentanyl do you agree with that assessment that they're a key component absolutely yes and so do you think that one step to combat alistic drug threats like fentanyl should include weakening the drug cartels weakening the cartels absolutely yes great well thank you um are you familiar with the organized
▶ 3:02:21crime drug enforcement task force which is part of the Department of Justice um I don't have anyone assigned to that so I don't know the inner workings of that particular test okay well I'm going to read from the Department of Justice website about the ocdf which is the short version of the organized crime drug enforcement task force it's an independent component of the US Department of Justice it was established in 1982 it's centerpiece of the Attorney General's strategy to combat
▶ 3:02:52transnational organized crime and to reduce the availability of illicit narcotics in the nation by using a prosecutor L multi-agency approach to enforcement and they investigate transnational organized crime and money moneya laundering and major drug trafficking networks it sounds to me like this would be pretty important in our combating the flow of Fentanyl across the southern border and elsewhere yet we have and these are going to go
▶ 3:03:22into evidence in a second into the record a January 21 2025 memorandum from the justice department that's changing policy and priorities and lo and behold this organized crime task force is now to prioritize immigration effect enses instead of this so very important work of
▶ 3:03:52combating the drug trafficking of being those to combat the transnational organizations so miss label despite the facts President Trump has redirected federal drug enforcement particularly officers on this organized crime drug enforcement task force to prioritize immigration offenses over gangs that deal with the drugs how do you you think this will impact our law enforcement's ability to fight the opioid epidemic
▶ 3:04:23well when I was at the office of National Drug control policy we we gave the grants for the high-intensity drug trafficking areas program and we worked very very closely with oadf um and oadf is a key component of drug trafficking efforts in the federal government so um deprioritizing and kind of changing their priorities obviously would have a big impact on our ability to go after drug trafficking organizations but thank you um the other thing that I have heard to weaken drug cartels would be for the United States to
▶ 3:04:53stop the trafficking of guns going to the drug cartels because in Mexico it's very hard to find and they're hard to get actual arms and drugs and there's article after article and I actually have a justice department ATF report talking about the US to Mexico pipeline um we also have plenty of Articles of how the United States arms the Mexican cartel CS Sheriff do you think the cartels would be weakened if they didn't have access
▶ 3:05:23to guns and arms would would they be weakened if that's the question if they didn't have any guns or arms would they be weakened I think if you could eliminate their access to weapons absolutely they would be less lethal but I'm not sure we thank you sir that's what I was getting at is if you don't have access it's another way to weaken the cartels um I just want to end uh and and by the way there is no action being taken my by my
▶ 3:05:53colleagues or the majority on doing just that to stop the flow I want to just uh take a moment as I end to thank representative Miller Meeks on our work together on having alternatives to opioids and having alternatives to pain act which we um are working on closely together in a bipartisan fashion thank you IO back gentle lady yields the chair now recognizes the gentleman from Ohio representative Ry for five minutes of questioning well thank you chairman and uh this this uh question will be directed at Sheriff
▶ 3:06:24board and I appreciate you all and all the time that you donated today so um I've listened for last couple hours of all my honorable friends on the other side of aisle and uh they're immediately point of focus to say let's just throw a lot more money at this problem it was an overall theme for the last three or four hours throw more money at the problem throw more money at the problem and uh Medicaid expansion was broughten up so I was in the Ohio senate for almost six and a half years and in
▶ 3:06:54Ohio we have the sixth largest Medicaid expansion there is we operate on a general assembly of about 93 to 94 billion dollar uh by anual uh general assembly and about $44 billion dollar goes to Medicaid expansion and the drug problem in Ohio is running crazy um I don't think that throwing money at problems is ever the answer I think you got to get to the core root of it and there's a lot of hard work that's involved with that one side of my district last week Sheriff's
▶ 3:07:24in my district pulled over a man who had discovered fentanyl in his trunk that would be enough to kill 30,000 people uh small little County sent shock WS to the county that that much fentanyl was being trafficked right in their you know below their noses right to be honest with you that's more than twice the population of that County Sheriff what other tools can we give to locate these drugs when they're moving through these small counties and is there some advice that you could get with your expertise to help these small County Sheriffs
▶ 3:07:55get a better grip on this and and instruct their deputies how to proceed forward and keeping in mind their safety yeah the the detection is a tough one because of the the components they're not as prone to let's say a canine detection and some of the things that we historically have used on corridors of trafficking um in terms of Education we try to share we're again we're major County Sheriffs America so we try to help the
▶ 3:08:25smaller agencies whether they are a sheriff's office or a police department with our partnership and with our expertise and that then goes back to what we talked about whether it's a um heida or other kinds of things we need to work together share information share resources share capability and and Technical knowledge um and we do that a lot but it's such an involving landscape so sometimes they may not know what they've got as I mentioned even me being one of the largest sheriff's office in the country
▶ 3:08:55I heard about a number of years ago now but xylazine I was like I hadn't heard about that and so went and had our lab go back and test things on the bench and lo and behold it was there so that's that's where robust communication in the public health space law enforcement uh and cooperation communication is critical is is there any websites or any um period Arles that a sheriff that that is in a small town in Ohio that you could perhaps because I think a lot of them are watching this today that you could recommend for them
▶ 3:09:25well I know the NSA the national sheriffs uh which represents all of them they have a publication and then again we share information the major County Sheriffs of America we have a website and we partner and share information regardless of whether you're a member or not so I would encourage him to either reach out to NSA or to check some of the resources that mcsa has really appreciate that information and I'm going to have a quick question for Mr Colin um the halt fenal act I support uh I lost my cousin to addiction he was only 23
▶ 3:09:55years old uh I was in a rock and roll band I lost one of my uh band mates to addiction it's very personal I can't find a single family in this country that doesn't have somebody close to them or related to them that has perished through this uh fenon and other airs ravaged our district um any opinions from you and sorry for your loss sir that you could get give Mom and Dad especially when you hear like Mom and Dad's doing testimonies on Instagram or Tik Tok and they're talking about uh a son of theirs that just
▶ 3:10:26tried to get a perco set in the mail and they checked on in the morning and they found him dead is there anything you could my daughter's going to college next year it scares us to death any advice from Mom and Dad oh thanks for that question so we are raising awareness as much as we can and and and that's what we want this body to do you know I've said before that I feel like we're screaming underwater at times because the message is not just not getting out uh we speak to people at gas stations we speak to people everywhere um
▶ 3:10:56don't be afraid to have the conversation I I think a lot of times parents are afraid to have a difficult conversation um but it could be a life or death uh conversation so just just talk that's all I can say do you think you think talking like you know having that adult conversation hey you know I know you don't want me to think that you're doing drugs but even a little pill can literally kill you you know and that's that's such a different thought process that didn't exist 5 years ago so what I often say to a lot of parents is
▶ 3:11:27or or even to to kids is look I don't I don't mean to presume that you're doing drugs but you're going to be in a situation you may be in a situation where someone is about to do something that could kill them so now I make it more personal saying now it's not a news item you know somebody who lost somebody uh and I make it more personal that way and and just tell them that's I don't presume that you're doing drugs but you could be in a situation to save somebody appreciate that thank you chairman gentleman yields the chair now recognizes the gentleman
▶ 3:11:57from New York representative Langworthy for five minutes of questioning thank you very much to the chairman and the ranking member and to all of our Witnesses for their incredible testimony here today uh it is hard to find someone in America who has not felt the devastating impact of fentanyl or other synthetic drugs whether it's a family member friend and neighbor um this poison is tearing through our communities at an unprecedented rate I have sat and had roundtables with law enforcement officials and health
▶ 3:12:27professionals throughout my district uh which I represent the western part of New York State and the Southern Tier counties along the Pennsylvania line and they all say the same thing that we are losing ground in this fight uh police officers responding to overdoses several times a week uh it's having a great impact on on you know their Mental Health Community leaders are witnessing fentanyl lace drugs killing people at an alarming rate even showing up in things like gummies as you've talked about here today poisoning children
▶ 3:12:58enough is enough and I am very grateful that we have finally uh have someone in the White House whose's laser focused on securing our borders and holding foreign entities accountable and providing our law enforcement with the tools that they need to combat this epidemic and passing the whole fentanyl act uh today is is a huge step step in that direction but with that um in the area of lab Innovation Dr Wes Lake last year the Biden FDA issued a final rule that would regulate lab develop tests as
▶ 3:13:28medical devices which would severely hamstring definitive drug testing by stifling The Innovation needed to keep Pace with what we're seeing in the streets the additional regulatory burdens could delay the detection of emerging substances allowing dangerous drugs to circulate longer and putting more lives at risk and potentially disrupting patient care with the rapid rise of these deadly substances it is critical that our Labs have the ability to quickly adapt and stay ahead of evolving drug
▶ 3:13:58Trends so Dr Wesley can you speak to the importance of lab tests and the innovation in this area when it comes to detecting novel illicit compounds yeah I think it's critically important for for labs and for science in general they'll be able to to combat the new emerging threats you know they talked about the fire iron spigot there's new spigots popping up all the time if you have to wait and go through a burdensome regulatory environment to be able to to detect those and to combat those then that that doesn't do any good my experience as at the state level coming up uh and seeing what the regulatory
▶ 3:14:29burden at the state level is you know at the federal federal level is is as much or more and so I I encourage any type of of Regulation that it encourages Innovation when it comes to that because it's it's a significant risk of of a delayed response and we need to be nimble we can't be you know it can't be a battleship that turns it's got to be a speedboat thank thank you I I think it is critical that we don't stifle Innovation and that goes to many facets of the federal government when we stifle Innovation we deny ourselves the potential of life-saving new technology that would revolutionize a way
▶ 3:14:59we can combat this epidemic uh pivoting here to emergency room screening Dr weslake we have heard tragic stories of young people dying from fentanyl overdoses because they were not tested for fentanyl uh the detection of fentanyl in overdose patients who go to the emergency departments uh is critical to saving lives in combating this opioid crisis uh as an emergency medicine physician do you agree that there needs to be greater use of fentol screening in overdose patients yeah absolutely I think I I it pretty
▶ 3:15:29much should be the standard of care for fentanyl be to be the sixth there's a f there used to be a five penel drug screen you in drug screen you would get at every facility when a patient came in if they were concerned of Overdose and now most of them have have gone to to Fentanyl and if they haven't then they're behind the times and they should and that you know definitely that's that's a critical I the major I have I don't think I've seen a heroin overdose in a couple of years but I've seen you know dozens of fentanyl overdoses that thought it was heroin and I knew that because of the drug screen very important to know uh do you also agree that it would be
▶ 3:15:59helpful for the Health and Human Services uh Department to study the current frequency and benefits of fentanyl testing in the ER and provide guidance on how ERS Implement fentanyl testing in overdose cases yeah I just I would be cautious with with kind of regulatory involvement at at that to make sure that it didn't get in the way of something in the future a lot you know there's unintended consequences but I think looking at and making sure that that that the the ground level should be you know the state-of-the-art science should be including Fentanyl and it should be definitely should be reviewed
▶ 3:16:30well thank you to all the witnesses for your expert testimony and and the role that you all play in combating this opioid crisis and and my uh my thoughts and prayers are with your family for your terrible loss uh it is clear we must take a stronger action uh across the Congress across the federal government to uh combat this evolving threat of illicit drugs uh support our law enforcement and ensure that our Health Care system is equipped to save lives and with that I yield back Mr chairman the gentleman yields the chair now recognizes
▶ 3:17:00the Gent lady from Florida representative cck for five minutes of questioning thank you Mr chairman I would like to uh make a point of order and move to take down words spoken earlier today the committee will suspend the general Elman will state the words she wishes taken down thank you Mr chairman uh our colleague Mr VC stated that quote the office of National Drug policy's web page has been wiped by Elon that was his words
▶ 3:17:31and I would like to remind the committee as well as the chairman and our colleague that no matter what Mr VC has read on the internet that his statement is false this committee should set the record straight and finally the president of the United States is Donald J Trump he would be correct to State the facts instead of having hurt feelings so with that Mr chairman I would like to have his words taken down okay in the gentleman's absence
▶ 3:18:01I'm going to recognize and the gentleman's absence I'm going to recognize representative deette for her response uh Mr chairman first of all under rule 17 Clause 4 this um motion is out of order because under that rule it must be made at the time secondly um I find it extremely amusing that Miss kamik feels compelled to come come all the way back at the end of this very important hearing on
▶ 3:18:31fentanyl to to let us know that Elon Musk is not in fact president of the United States and in fact the rules do not allow uh the words to be taken down um except for quote personal abuse inuendo or ridicule of the president well as she herself says Elon Musk is not the president so there's no basis uh for for these words to be taken down and I I would urge the um
▶ 3:19:01chairman to overrule her okay the chair asked the general lady if she wishes to seek unanimous consent to modify or withdraw remarks no Mr chairman no no chair is ready to rule chair finds the words of the gentleman from Texas are not parlamentary because they constitute personalities toward the president however committee rule 17 Clause 4 requires the point of order be made immediately therefore I overrule the point of order
▶ 3:19:32I ask that members please remain respectful and refrain from this type of rhetoric and I now recognize representative cic for five minutes of questioning thank you Mr chairman and thank you for recognizing uh that this commit should be above any attacks or on uh our president thank you for the opportunity to be here to discuss uh these existing and emerging drug threats as a representative from the Sunshine State in Florida we are all too familiar uh with
▶ 3:20:02the consequences of open borders and how every town in America has been turned into a border town and state as a result of open borders over 100,000 or 100,000 individuals have lost their lives to fentanyl poisoning every single year and should this have been a airline incident where 100,000 people were going down it would have never taken as long in order to start addressing it it is absolutely infuriating and sir I I want to express as many of my colleagues have here today
▶ 3:20:32our tremendous sympathies and condolences for your loss never should have happened in the first place the opioid epidemic remains persistent crisis claiming lives at an alarming rate synthetic drugs like fentanyl have become increasingly potent and pervasive exacerbating the public Emer Public Health Emergency and new substances continue to emerge often faster than our Regulatory and enforcement framework can adapt to these substances not only threaten Public Health but also strain our Health Care Systems and law enforcement
▶ 3:21:02resources this hearing has been a fantastic opportunity to look at the full scope of the threats and to talk broadly about strategies that we can put together to address them now my first question is for you Sheriff I am actually the wife of a first responder my husband Matt is is a uh 18-year career firefighter SWAT medic um so he has been on the front lines dealing with this and we collectively have understood for the past 10 years it is an a matter of when of if but when he himself becomes a victim of Fenty poisoning
▶ 3:21:33because of how many people he encounters on a daily basis that are um overdosing so given the rapid evolution of the synthetic drug analoges what technologies does law enforcement have to detect the substances if you could touch on that very briefly but more importantly address if these mechanisms are sufficient to detect the new and emerging threats as these drugs continue to evolve different strains new new additives it becomes very tough to test for them so can you talk about if we are keeping Pace um with the molecular
▶ 3:22:03changes in the drugs and what strategies are in place or what do we need to adopt in order to have timely identification to keep our first respond safe and then we can properly schedule them um that's a complex layered question I think a lot of that goes to the difficulty of us understanding what has changed in a lab that's a basically a nation state lab that has abilities and Facilities Way Beyond ours and they're trying to dial in
▶ 3:22:34what is no longer scheduled or what they think will be profitable or deadly or whatever the you know adjective is so I think a big part of that is for us as a country to put pressure on the countries in whatever way you and the president deem is appropriate to to let them know there's consequences for doing that for for constantly sending things to America whether it's China or through Mexico with the cartels that there's real consequences for them to intentionally do that and keep
▶ 3:23:04trying to stay one step ahead of our regulating or our scheduling of what they just used to make a big profit on um in terms of the technology and Equipment it it's hard to say what we need because we don't know what's coming at us and and that's that's a big challenge for us on the local level as I said uh brought up earlier I did not know we had xylazine in our lab until we specifically went to look for it because I had heard it being found in other states
▶ 3:23:34a number of years ago so sometimes we don't even know what we don't know until it's upon us because we have very well-funded nation state ad U adversaries or cartels that are obviously very flush with cash that can do these things and then they end up in our lap before we even know it comes down the pike thank you and I I'm going to have a bunch of follow-up questions for you but in the interest of time I'm going to turn to you Dr Westlake given the increasing prevalence of fentanyl its analoges
▶ 3:24:05and other synthetic opioids in overdose cases could you discuss the differences in treatment protocols for fentanyl related overdoses compared to other opioid analoges and again I know um we need to be sensitive to Fentanyl and car fentanyl being used in medical settings so if you could address that sure the there the the receptor that the the U antidotes use are the same for whether it's synthetic opioid or natural opioid um the problem comes when there's when they're flooded with
▶ 3:24:35massive amounts and and in that case you just need to use more of of the Aran they sure there's some there's some space for a more potent antidote the antidotes Narcan works you just have to get it to the person before they're dead from not breathing so the issue is getting the interdiction of the Narin to the patient or stopping the patient from taking the the the poison and the deadly opioid to begin with now what challenges do emergency Personnel face in quickly identifying the specific substances involved in an overdose and how would
▶ 3:25:05this ultimately impact outcomes the reason I'm where I'm going with this is to our Point originally how can we get ahead in making sure that when emt's medic are on site are on scene that if they're dealing with a patient they can test quickly so they know what to to test for but how they can best protect themselves as well at the level in the emergency department you just treat for the respiratory suppression that's there A lot of times we don't even know what people are have what people are overdosing from so we you know we treat the we treat the symptoms that cause the the respiratory
▶ 3:25:35suppression so you just you treat symptomatically so it's it may be difficult to it doesn't kind of matter what your what Your opioid you took what matters is that we got your breathing again and that we got okay thank you I gentle lady yields the chair now recognizes the gentleman from New York representative tonco for five minutes of questioning thank you chair Carter and thank you to all of our Witnesses for being here today and my condolences to the Cullen family um you all bring an important perspective we're in the midst of an overdose crisis and we need to treat
▶ 3:26:05it as such now is not the time for half measures that make us feel good or for outdated and substantiated stereotypes and stigmas that hold us back it is not the time to freeze iCal funding for treatment and prevention I continue to hear from local providers that people are anticipating cuts and in turn limiting expanding programs or care that would offer life-saving treatment for addiction or access to Public Health Resources like nxone or fentanyl testing strips that save lives I've heard from programs
▶ 3:26:35that are afraid that funding will dry up and they will be forced to lay off staff and in turn serve fewer people or shut down entirely we know the cost of such Cuts would be lives lost families R ripped apart by poison seemingly beyond our control the American people are watching Congress to see if we still consider treatment for addiction and overdose prevention a priority and I would say a high priority let's not turn our back on them so we know that our justice system is a revolving door for those struggling with addiction
▶ 3:27:05and mental health issues over half of people in state prisons and two-thirds of individuals in jails have substance use disorder by allowing inmates to receive addiction treatment and other services before returning home my re-entry act would bring targeted treatment to those at the highest risk of Overdose the re-entry act would be a game Cher for reducing for reducing overdose deaths and suicides by allowing all states to provide pre-release care to Medicaid eligible individuals up to 30 days
▶ 3:27:36prior to release from incarceration I thank the M the major County Sheriffs of America and National Sheriff's Association for their strong support of the re-entry react Sheriff bushard U thank you for your efforts and many people uh that have joined in the effort uh many people don't think of sheriffs as playing a role in treatment for addiction how do you approach that the role thank you and thank you for that legislation as you know our organization
▶ 3:28:06does strongly support that we appreciate that um you know we have a role in treatment uh prevention and um kind of the next PATH for forward on lots of levels because we're the typically again the first to respond when someone out in the community is having an overdose and then once somebody for whatever reason on a different level is incarcerated with a substance use disorder we have medically assisted treatment in our facilities we have a Narcan vending machine as you go out
▶ 3:28:36if you can take that for free we try to connect them with resources um to the extent we can with programs and funding we have for after care because when you drop them back in the same environment that's when they're most at risk to recidivism in that behavior and as was mentioned earlier the the likelihood of an overdose is very magnified to that population when they come out without anything in their system and immediately go back sometimes to look for that
▶ 3:29:06thank you I and I know that Oakland County Jail's medication assisted treatment mat program has been praised for its comprehensive approach to treating opioid use disorder in jail including medication access therapeutic services and post-release support how has the availability of FDA approved medications along with the support services impacted the effectiveness of the program and what measurable outcomes have you observed in terms of inmate recovery and recidivism yeah it's it's helpful to have you know a
▶ 3:29:36Continuum and choices that the medical professional can decide based on that individual rather than one prescribed route and so we leave leave that to our medical professionals and the individual and the treatment and care that gives us the best path forward um and we have seen not noticeable results in how outcomes are achieved especially when paired with Partnerships outside the building thank you um I see my time is near up and I did have questions for Regina lebel
▶ 3:30:07we'll forward those to the committee and uh and appreciate your response that I yield back Mr chair the gentleman yields chair now recognizes the general lady from Virginia representative melen for five minutes of questioning thank you chairman Carter and ranking member deette for holding this very important hearing uh thank you to our Witnesses particularly Mr C Cullen I add my condolences um but I also want to commend you for turning tragedy into advocacy
▶ 3:30:37and make sure that no one suffers uh the same tragedy that you did I I really want to commend you alone 2,400 uh Virginia have lost their lives to drug overdoses each year um Community Health Center stand on the front lines of this opioid academic response providing essential Services of preventing and treating substance used disorders delivering primary care and dental care
▶ 3:31:08offering lowcost prescription drugs and for many families especially in rural areas like the southern end of my district community health centers are the only option for accessing health care and uh prescription I'm sorry uh substance use disorder treatment these centers can't operate without critical Federal funding from the health resources and services Administration to pay their healthc care workers and keep the doors open on
▶ 3:31:38his first day in office president Trump issued executive orders silencing federal agencies and halting all communal external communication then Trump and Elon Musk Unleashed a sweeping unconstitutional freeze on funding for programs including those supporting federally qualified Health Centers and despite several courts blocking this action chaos and confusion have ensued in Virginia the
▶ 3:32:08funding freeze abruptly cut 16 of our 31 community health centers off from federal funding summer still struggling to regain access to these critical resources and just yesterday the capitol Area Health Network which operates seven facilities around Richmond was forced to announce the closure of at least three locations and the transfer of patients to other sites increasing the workload on those other sites and impacting their access to
▶ 3:32:38care this was entirely unavoidable um but Trump handed Over Control to an unelected billionaire and let him work without thinking through the consequences to our communities of rash action I am glad to see bipartisan agreement on addressing the substance abuse disorder crisis but we have to make sure that our Health Care Systems have the ability to rapidly respond we have to demand accountability when
▶ 3:33:08they can't we have to assure that the damage that has been done on this important Health Care safety net isn't done again so miss leel I wonder if you could please explain the role that Community Health Care Centers play in helping patients access the full Continuum of Care including on fighting substance abuse disorders yeah I mean you know Nationwide we need to make getting care uh and treatment easier than getting illegal drugs and that's one
▶ 3:33:39key role that these community health centers play uh is that they meet people where they are uh they provide a Continuum of Care for People wrap around services and you know play an important role in reducing overdose debts and can you explain how the backlog over accessing Payment Systems uh paying the health care workers and has impacted our community health systems and what we can do to address the the backlog of of care that patients particularly in
▶ 3:34:09rural areas need I mean there's obviously a a real dire Workforce shortage in a lot of parts of the country particularly in rural areas uh and and these types of kind of starts and stops cause a lot more confusion and and people who could potentially work in those areas be recruited are likely not to come uh if there's confusion or or a lack of funding for their services um thank you and I'll just note in my last 43 minutes seconds
▶ 3:34:39um this impacts urban areas this impacts Suburban areas it especially impacts our rural areas and in my district uh which is 2 hours in the end many people in the southern part of the district have to go to the Southside uh Community Health Center which now is closed and sending patients even further north and trying to get time off from work uh to travel long distances to get the care that you need only to be told your appointment now
▶ 3:35:10is transferred further north uh has a real impact that we can't afford that kind of delay um I thank you for sharing the importance of Community Health centers and Mr chair I yield back gent lady yields at this time I'm going to ask unanimous consent to inser the record the documents included on the staff hearing documents list without objection that will be it I want to
▶ 3:35:40thank all the witnesses again for being here today especially you Mr colen thank you so much you're you and miss Colin your your bravery your courage is admired and and we all extend our our heartfelt condolences for your loss hopefully that your testimony today can can help to save at least one life and if that's the case and it's worth it so thank you very much members uh may have additional written questions for all of you and if we do
▶ 3:36:10we appreciate it if you would um if you would get back with us as soon as possible with that I'll remind me that they have 10 business days to submit questions for the record I ask the witnesses to respond to questions promptly members should submit their questions by the close of business on February 20th without objection the subcommittee is
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