tv Oversight Hearing on Drug Control Policy CSPAN December 5, 2015 4:39am-6:55am EST
>> we will come to order, without objection the chair is authorized to declare recess at any time. the the office of natural drug control policy is charged with guiding the big picture strategy for addressing illicit drug problems in this country and the consequences thereof. i think we can all agree this is a problem that merits meaningful solutions. over the years we as a nation have tried a variety of approaches to address the drug problem from the last reauthorization in 2006. still today, the o and dcp has been intimately involved in the drug control efforts. today's hearing hearing will look at the o and d.c. since its last reauthorization which expired at the end of fiscal year 2010. there ten. there are important questions for consideration, one has it
evolved into mask the drug control strategies, too, what is the value of this office and is a correctly placed an appropriately resourced to fulfill those functions? earlier this year, the agency sent a letter to chairman and ranking members and their counterparts in the senate, the letter included a proposed language for reauthorization of the o and dcp today's hearing will focus also and discuss that proposal. we'll also hear testimony of the director of drug control policy mr. pacelli on the work that is being done there. as we look at these proposed changes for the authorization of the high intensity drug trafficking areas program we are
referred to as the h idt a program. the hi dta program has been a leader in bringing together local, state, national, and tribal law-enforcement entities to reduce the supply of illegal drugs by targeting and disrupting drug trafficking organizations. my note in that particular area we are very familiar with that local law-enforcement and north carolina where we have an area that has that cooperation. the on dcp changes would allow for the use of the hi dta funds and engaging prevention and treatment efforts. previously only limited hi dta funds would be used for prevention efforts and no funds were permitted for treatment. in response to this proposal, the national hi dta members
wrote to the oversight committee suggested a compromise that would allow for the use of funds for prevention and treatment but with a cat. i imagine the congressional liaison for the hid ta directors association, mr. kelly will be able to provide further explanation on that letter and the proposed language we look forward to hearing from you and all of the witnesses today. i would now recognize mr. connolly, the ranking member for his opening statement. >> thank you and thank you for holding this hearing. it is a very important topic. the office of national drug control policy plays a critical role in coordinating the federal response to our troubling drug epidemic in which the annual debt from drug overdoses, now outnumber outnumber those caused by gunshots or car accidents. the office itself manages a
budget of $375 million, two national grant programs coordinates the related activities of 39 federal departments, agencies, agencies, programs. totally more than $26 billion. so, it is more than a little concerning that congress allows the offices formal authorization to expire five years ago. allowing is simply to subside on annual appropriations rather than a long-term authorization. it has been nearly a decade since congress seriously considered a national drug control policies and activities. as we'll hear from today's panel, a great great deal has changed in that interim period. sadly, not for the better. mr. kelly, of the national hi dta director association says the scourge of drug use has no boundaries, it does not recognize race, gender, age.
the efforts of the on dcp are vital to, and visible in each of our respective communities. mr. chairman, i appreciate the bipartisan spirit in which we approach this hearing on the on dcp's performance in its its proposal for reauthorization. i know many of us are troubled, very troubled by the spike in heroin use in our community. heroin used to be a very static, demand drug. no longer. in my home state of virginia, for example the number of people who died using heroin or other opiates is on track to climb for the third straight year. heroin related deaths doubled in my own home county of fairfax just across the river tween 2013 in 2014. that follows a troubling trend all across the national region.
i know others and share that concern as well. communities in my district have been fortunate to receive assistance from both high intensity drug trafficking program which divides grants for local, state horseman agencies to counter drug trafficking activities. the drug-free communities program which provide grants to create community partnerships aimed at reducing substance abuse especially among young people. virginia now has 20 counties out of 95 that have been designated as high intensity drug trafficking areas. four, are in part of the appalachian region, and 16 are part of the washington baltimore area. while the program has historically been more enforcement focused, we are beginning to see an increased focus on prevention and treatment and i think that is appropriate. that is reflected in the administrations proposal. current all caps at 5% the amount of funds that can be used for prevention activities. 5%. twenty-seven of the 28
designated areas of, the statute actually prohibits funds for being used as treatment programs with the exception of two grandfather programs in the washington, baltimore and northwest regions. as their efforts predate the prohibition in the previous authorization. in fact, my district benefits from that with some providing day treatment and detox services. i think that 5% limit does not make sense. especially in light of a lot of changes in the demand for opiates and other drugs. i look forward forward to hearing more from director botticelli about this in the strategy. given the language it would allow the regional drug trafficking areas, upon request
of their boards to spend funding on treatment efforts and to spend above the current cap on prevention. that would amount amount to a considerable it investment strategy such as diversion, or alternative reentry programs that have proven successful in the national capital region and other communities across the country. i appreciate mr. kelly, with your law-enforcement background acknowledging that we cannot arrest our way out of this problem. we are moving more and more towards a partnership between public public safety, public health, to create a holistic approach to the substance-abuse challenges they did so many communities across america. the director's personal story speak to the power of treatment and recovery. mr. chairman, i hope our subcommittee can play a constructive role in helping to advance this important reauthorization effort and i very much of appreciate the
bipartisan spirit in which you have approached it before the hearing and testimony this morning. thank you. >> i i think the gentleman, the chair now recognizes the gentleman from maryland, the ranking member of the full committee for his opening statement. >> thank you very much mr. chairman. as i listen to mr. connolly, cannot help but be reminded in this day and age, we are fully realizing that drug addiction has no boundaries. it has no boundaries. blacks, whites, rich, poor, from one coast to the other and statements in regards to treatment, ladies and gentlemen some of the most profound words that will be spoken here and we better wake up. we need to begin to address this more and more as a health problem because again, what we're seeing now with heroin, i
known about heroin for many years in baltimore, but now it is spreading everywhere. people are getting to understand that prevention is so very crucial. so the office of national drug control policy has a difficult but crucial mission, it is fast with leading efforts across the federal agency to reduce drug use and mitigates its consequences. on dcp is also responsible for developing and implementing strategies and budgets annually while also having long-term goals, none of these responsibilities is simple. i have been impressed with how diligently this administration has tackled the staff while being efficient with the resources that are provided. we are here to discuss reauthorization of this vital
work, which includes the drug-free communities program which i'm very familiar with, valuable grant program that mobilizes communities to prevent drug use. it also includes drug trafficking program which operates through regional efforts with state, local, tribal law-enforcement agencies to dismantle and disrupt drug trafficking areas. on dcp's overall goal are substantial. the stakes are high. they include reducing drug use among our youth, reducing the abuse of a wide range of substances, and lowering and lowering drug related deaths and illnesses. despite what are often seen as insurmountable obstacles, on dcp is making progress on many of these by engaging all of our community stakeholders from police officers, to help professionals. in 2010 the on dcp took a
crucial step in recognizing that addressing drug addiction is not merely a public safety issue. it is a public health issue. we we must tackle the demand for drugs as well as they are supplied. we must recognize recognize that prevention and treatment are crucial tools that complement the law-enforcement efforts. i have seen up close and personal the ways drug abuse have been distracted. i have often said that if you want to destroy a people, if you want to destroy a community and you want to do it slowly but surely, you can do through drugs. and miles city of baltimore i have seen entire communities fractured and broken by drug use , i have seen landmarks like our world famous like the content market become synonymous with drug trafficking, i have seen people was so much pain
they do not even know their pain. i have seen people be hard-working citizens in our community and staggering across streets slumped over from effects of heroin addiction. i have seen right now, if you went to baltimore in certain areas you see hundreds of them who have lost their way. this is not the baltimore i have grub, is not the baltimore i know. the leaders hold this conviction to over the years they have demonstrated the treatment and law-enforcement efforts. i am also encourage that we are one of five organizations that will receive $2.5 million to address our nation's heroin heroin epidemic situation through the heroine response strategy. using the wraparound approach
that encompasses law-enforcement community involvement and treatment prevention strategy, the washington has dismantled 92 drug trafficking and sees almost 12000 kilograms and nearly 3000 kilograms of cocaine and heroin all sense 2013. it is because these demonstrated successes that i was pleased to learn that the on dcp is asking to equip all of it for crucial prevention tools as well. today i look forward to learning more about the changes the on dcp is proposing and what has been doing to address recommendations for improvement provided by the government. finally, this is an issue that affects all of us, it affects all of us. if it has not affected yet, i promise you it probably will.
whether you live in west baltimore or the mountains of new hampshire, drug abuse affects every community in america. every one of them. i look forward to working with all my colleagues to ensure full and swift reauthorization of the on dcp. the program is absolutely crucial to the future success, safety, and health of our great nation. with that mr. chairman i think you. and i yelled back. >> and personal words. as it brings it home up close and personal for all of us. i i think the ranking member for that. >> i would hope the record open for five legislative days for any member who would like to submit a written statement. the chair has noted the presence of the gentleman from ohio earlier has checked in,
mr. turner, member of the pole committee and his interest in this particular topic is important. he has stepped out for an armed services hearing but will be back. we welcome you to participate fully in today's hearing. seeing no objection, so order. will now recognize a panel of witnesses, panel of witnesses, i am pleased to welcome the honorable michael bow to chile, is that correct? botticelli. i will try will try to get that better. the director of the. >> he is more famous for painting paintings. >> the the director of the national drug control policy at the office of national drug control policy, welcome. mr. david kelley, the congressional liaison at haida which is the national high intensity drug trafficking areas it director association. and and mr. david maller, director of
law-enforcement issues at the gao. welcome to all, pursuant of committee rules we would ask all witnesses be sworn in before they testify, if you you would please rise and raise your right hand. do you solemnly swear or from that the testimony you're about to give will be the truth, the whole truth, nothing but the truth? thank you, you maybe see. but the record be seated that all witnesses answered in the affirmative. in order to allow time for discussion, please limit your oral testimony to five minutes if you would, but your entire written statement will be made part of the record. mr. botticelli we will recognize you for five minutes. >> chairman meadows, ranking member connolly, and other
members, thank you for the opportunity to appear before you today. to discuss the administration's proposal for reauthorization of the national drug control policy. it is truly an honor to be in this position and to be at this hearing today. on dcp was established by congress under the antidrug abuse act of 1988. it was most recently reauthorized by the office of national drug control policy reauthorization act of 2006. as a component of the executive office of the president, on dcp establishes policies, priorities, objectives of the national drug control programs and ensures adequate resources are provided to implement them. we develop, evaluate, correlate, correlate and oversee the international and domestic antidrug efforts at the executive branch into the except possible local and state activities. on dcp is responsible for issuing the national drug control strategy which is our primary blueprint for drug policy. the strategy treats our nation substance abuse problems as
public health challenges as well as public safety once. and approaches to it dress drug control policy since this administration released its inaugural strategy in 2010. in that strategy, on dcp set ambitious and aspirational goals for reduction of illegal drug use and its consequent is. we knew advance advancing these goals would be challenging. a careful examination of the most recent data show that significant progress has been made in many areas. we know we have far to go in many other areas as well. for instance, we have moved toward achieving our
2015. >> to provide upon the request of hida executive board, the director may authorize the expenditure of hida funds to support initiatives to provide access to treatment as part of a diverse and alternative sentencing or reentry program for drug offenders. we know such programs have proven successful in jurisdictions across the country and breaking the cycle of drug dependence and crime. new language would also authorize the expenditure of hida funds for community drug prevention efforts and access of the current 5% level. note these expenditures would be driven by the hida executive board should they see a need and at their discretion. in some instances the use of a limited amount of funds to support a treatment program for drug offenders or support -- as we
discussed as a committee on dcp intends to reorganize the structure to facilitate greater collaboration among on dcp public health, public safety, international policy staff across the spectrum of policy. our new structure will facilitate the formation of broad-based, issue focus working groups bringing together staff and policy expertise. this reorganization is separate and independent from the reauthorization bill and can be accomplished through our existing authority. however as most of the major drug control issues facing our country can't be placed neatly into demand or supply reduction category, the proposed authorization would eliminate on dcp deputy director position. leadership would be overseen by the director and coordinated to staff. i'm glad to be here to discuss
these issues with you in further detail. we are continually grateful for congress in this committee support for owen d.c. work to address substance abuse in this nation. >> thank you very much for your testimony. mr. kelly kelly you are recognized for five minutes. >> chairman meadows, and ranking members i am honored to appear before you today. to offer testimony high lighting the high-end density trafficking program and to speak to the reauthorization drug control policy. specifically to the recommendation of hida to oppose the language. on dcp establishes priorities for the drug policy, the director is charged with producing the national drug control strategy that direct the nations effort. the current strategy promotes a focused and balanced approach. the hid pa program is essential.
they are and 48 states, puerto rico, u.s. ridge and islands, and the district of columbia. hida enhance coordinate drug abuse efforts from a local, regional, national perspective leveraging resources at all levels in a true partnership. at the national level, on dcp provides policy direction and guidance to the hida program. at the local level, each hida is governed by an executive board comprised of federal, state, local, tribal agencies. this provides a. this provides a balanced and equal voice and identify regional threats, developing strategies, assessing performance. the flexibility of the leadership model creates the ability for the executive board to quickly, effectively, efficiently adapt to emerging threat that may be unique to their own state. investigative support centers, and each hida create a structure
that facilitates information's sharing among law-enforcement agencies to effectively reduce the production, transportation, distribution and use of drugs. the strength of the hida program are truly multidimensional. one of the cornerstones of the program is as demonstrated below ability to bring people and agencies together to work toward a common goal. the neutrality of the program is viewed as a key to it success. hida hida is a program, not an agency. they do not have use of any one agency or hold the mandates of anyone agency. it serves to felicitate and coordinate. hida's is also involved in drug prevention activities. the fact that we cannot arrest our way out of this drug problem is well recognized in the law-enforcement community. the emerging partnership between public health and public safety has never been more important. in hida provides a perfect plat form to promote that
partnership. they seek to break the cycle of drug of abuse and crime, the focus is to reduce crime in targeted communities and change the drug habits and repeat offenders. the new england hida has partnered with the boston university school of medicine pain program, here the opiate heroin epidemic is addressed at the front and to extensive education. to an innovative innovative use of discretionary funds, five hida's have joined a heroine response strategy to address the hair would threaten their community. it provides a unique, unprecedented platform to enhance public health, public safety, and collaboration across 15 states. on dcp and the hida program currently enjoy a collaborative and cooperative working relationship that has never been stronger.
the national hida association strongly encourages congress to reauthorize on dcp during the session. the national hida supports of the existing language of the l&d cpa reauthorization act with three exceptions. first, first, the existing authorization specifies a director shall ensure that no federal funds appropriate for the program are expended for the establishment orcs mansion of treatment programs. the proposed revision of this would allow the director upon request of a higher executive board to authorize the expenditure to support drug treatment programs. we support this change. we believe the funding should not exceed a cap of 10% of the effective hida's baseline budget. second, in the past no more than 5% of hida funds could be expended for the establishment of drug prevention programs. the new wording allows the
director upon request of a higher executive board to authorize an amount greater than 5%. we support this change. again, we believe the funding should not exceed a cap of 10% of the effective baseline budget. third, and finally the language authorizes a preparation to on to on dcp of $193.4 million for the hida program. this amounts to a 22% reduction in program funding. this reduction was severely handicapped hida program. we respectfully request 245 million which was the amount and the previous fiscal year. i look for to answering your question. >> thank you for your testimony. mr. mauer. >> good miming lunch i'm pleased to be here today to discuss the
gao's findings and enhance coronation among federal, state and local agencies. combating drug use and dealing with its effects is an expensive proposition. the administration requested more than 27,000,000 dollars to dollars to undertake these activities in 2016. insuring this money is well spent, that we're making progress, and that berries agencies are well coordinated is vitally important. over the years, gao has helped iris in the american public assess how well federal programs are working. in many instances, it is hard to tell because agencies often do not have good enough performance measures. on dcp, to its credit is focused a great deal of time, tension, and resources on developing and using performance measures. five years ago they established a series of goals and specific outcomes on dcp hope to achieve
by 2015. in 2013 we reported that a related set of measures were generally consistent with effective performance management and useful for decision-making. that is important to remember especially when the conversation turned to what the measures tell us. overall, overall, there has been a lack of progress. according to a report on dcp issue two weeks ago, none of the seven goals have been achieved and in key areas the trendlines are moving in the opposite direction. for example, the percentage of eighth graders who have ever used illicit drugs has increased rather than decrease. the number of drug-related draft deaths in emergency cases has increased rather than decrease. more americans now day more and then drug overdoses than in car crashes. it's also important to my's progress. there been substantial reduction in the use of alcohol and tobacco by eighth-graders. the thirty-day the thirty-day
prevalence of drug use by teenagers has also dropped. there's also recent progress in federal drug prevention and treatment programs, two years ago we found the coronation across 76 federal programs in 15 federal agencies was all too often lacking. for example 40% of the programs reported no coronation with other federal agencies. we recommended on dcp take action to reduce risk of duplication and improve coronation. since that report have done just that. it has conducted an inventory of various programs and updated budget process and monitoring efforts to enhance coronation. another report highlights the risk of duplication and overlap among various entities. to enhance coronation on dcp funds and rate multi-agencies support centers and hida's. the centers were the centers were one of five information sharing entities we reviewed including joint terrorism task force, an urban area centers.
we found that while these entities have distinct missions, roles, the responsibilities, their, their activities can overlap. for example, 34 of the 37 field base entities we reviewed conducted overlapping analytical or investigative support activities. we also found on dcp and other agencies did not hold agencies accountable for coordination or to improve coronation. since our report on dcp in the department of homeland security have taken action to address. they have not yet sufficiently address the mechanism or looked at those that have enhanced can be implied to reduce overlap. in conclusion, as congress considers options for reauthorizing on dcp it is worth reflecting on the deeply
ingrained nature of illicit drug use in this country. it is an extremely complex problem that involves millions of people, billions of dollars, thousands of communities. there are real costs and lives and livelihoods across the u.s. gao stands ready to help congress oversee on dcp and other federal agencies as they work to reduce these costs. >> mr. chairman thank you for the opportunity to testify today look for to your question. >> thank you so much i appreciate the fact that you acknowledge may be deficiencies but also areas where performance was good. thank you for that balance. the chairs going to recognize the vice chair of the subcommittee mr. wahlberg for his five minutes of questions. >> thank you mr. chairman. i appreciate that and enjoy my time in your district over thanksgiving. i'm notifying a view of that now since you don't have a chance to call the sheriff. back to serious, like many areas
across the country areas in my district, mineral county on the toledo line, others have experienced some significant struggles of fighting against the growing tide of heroin use and abuse. also the misuse of medication, prescription pain medicines as well. i'm aware that on dcp has increased some of their efforts in this area specific to the heroin strategy, fortunately fortunately it is limited to certain regional areas. mr. botticelli, what efforts have on dcp undertaken to address prescription drug abuse and heroin use? >> thank you you for that question, i think there's no more pressing issue that faces on dcp in the country right now than that morbidity and mortality associated with prescription drugs and heroin. part of the work that on dcp does is continuing to monitor the drug trafficking and putting
resources and efforts against those. in 2011 on dcp released as prescription releases prescription drug abuse plan acknowledging the role that particularly prescription drugs were plain at the time. as it it relates to some of the issues. these included broad-based efforts to reduce prescribing of these prescription medications, call for state -based prescription drug program so that positions would have access to patients prescribing history. working with our partners with the dea to reduce the supply of drugs coming from any of these communities. also to coordinate law-enforcement action. we also simultaneously call for an increase in resources, particularly treatment resources to deal with the demand that we see for those resources. if we has seen and we have made progress we have seen reduction among youth and young adults, we have seen a leveling off of prescription drug overdoses over the past several years.
unfortunately that has been replaced with significant increases in heroine related deaths. >> is that simply where they are going of reduce cost to them, assess ability and other reasons? >> when we look at data, it appears only a very small portion of people who misuse prescription drugs actually progressed to heroin. about five percent. if you look at new or users to heroine, 80% of them started misusing pain medication. we we know to deal with the heroin crisis compels us to deal with the prescription drug use. we are also focusing on how we address the heroin issue. again from a comprehensive perspective. perspective. we know some of this is related to the vast supply very chief, very pure heroine. impreza country present country where we haven't seen it before. as we have talked about we know that heroin has been in many of our communities for a long time. we really, really have to diminish the supply that we
have. we also have to treat it, make sure people have access to good, evidence-based care. care. and we've also been working with law-enforcement to diminish and reduce overdoses through reversal drugs in lockdown. they are shepherding people into treatment, not only only have we seen our law-enforcement is responding do seen overdoses but really accelerating and coming up with i think is really innovative innovative programs to get people into treatment. >> thank you. mr. kelly, what efforts has the hida program use to address prescription drug abuse and heroin use? >> thank you for the question. the hida program has historically always identify the most prevalent threat. there's no greater threat,
certainly in the northeast and throughout other areas of the country than the use of heroin and controlled prescription drugs. it's probably the overriding issue taking the lives of so many. for that reason of the hida program has put it firmly on the radar. the hida program through its efforts of federal, state, state, local at the ground level comprise of federal agencies working together to identify the source of the heroin that is coming into this country, dealing with the drug trafficking organizations that have invaded our communities, through a variety variety of investigative methods. the hida program also embraces a holistic and multidisciplinary approach. we recognize and law-enforcement across the country each and every day that we cannot arrest our way out of this problem. for that we have reached out to the
public health community, we have made partnerships were partnerships never were before. >> international as well? >> yes, through on d.c. p where they have workedo identify where it is coming internationally. when we do that we try to interrupt that supply line. the supply line goes to distribution or threat the united states, we have hida groups that focus primarily against major trafficking organizations, not the user on the street per se, not the person that is afflicted medically that is the victim of the disease, but those organizations that are making money at the anguish of so many. we look at it in a multidisciplinary approach from enforcement, prevention, and from partnerships we have established throughout the public safety and public health community. >> thank you.
my time has expired. >> i think the gentlemen, we now recognize the ranking member of the subcommittee mr. connolly for five minutes. >> mr. chairman i be pleased to distinguish ranking member if he wishes to go. >> thank you very much. in trying to tackle druggies from all angles i understand that on dcp uses demand reduction efforts as well as the supply reduction efforts. i also understand that one dcp would like to clarify in the definition section of this new reauthorization that it is the man reduction work that can include prevention, treatment, and recovery efforts. mr. botticelli, can you give examples of what you mean by prevention, treatment, and recovery efforts? >> thank you. as you noted one of the
overriding efforts is to have a balance to drug policy. too long we have used public safety is our prime response to issues of drug use and many of our communities. under this administration we have tried to focus on a balanced portfolio of increasing her to be a effort treated it as a public health issue. our understanding of addiction has changed dramatically. from understanding that just as a criminal justice issue but as an acute condition. really understand it as a chronic disease, one that we can prevent, we have seen dramatic reduction in under age youth use but we also know that many times we let this disease progressed to an acute position. that's why we are calling for language to allow us to do a better job of screening people in intervening early in their disease before they use that
condition. and before before they intersects with the criminal justice system. we also know to treat this issue requires more than just a treatment. it's a chronic disease, it requires long-term recovery. we know people need additional support beyond treatment. things like housing, employment, pure recovery networks. part of our language change allows us to focus on that continuum of demand strategies that we know to be effective in dealing with this is a public health issue. >> it sounds like it would like to allow. [inaudible] in support, i support this this because 27 of the 28 hida's already understand the importance of using prevention focus activities. i also support this because i have seen hida treatment efforts work so well which is one of the
two hida switch currently allowed treatment. our washington hida has provided drug treatment to about 2000 individuals with criminal records today. over half of these have successfully completed their treatment program. furthermore the rate of recidivism for these hida clients after one year has been just 20% while comparables recidivism rates across many states is over 40%. in addition, the washington baltimore hida has captured over 4000 fugitives from drug charges removed over 2000 firearms from the streets in the last three years alone. mr. kelly and your witness testimony you wrote the law-enforcement community recognizes and i quote, we cannot arrest our way out of this problem on quote.
would you agree treatment and prevention efforts have augmented the washington hida's to carry out the mission and how so? >> i would agree with that congressman. how so is that the hida program traditionally has been in a porcelain base program. that is where our greatest exhaust has lied over the years and it continues to show great success from that. we also recognize as law-enforcement professionals that the multidisciplinary approach is very important as is the landscape of drug abuse has changed. treatment and prevention play crucial roles in the overall strategy. washington baltimore for many years in the treatment program well before the it was in place has shown great success. however, we also recognize that it is a very expensive proposition, the treatment ended things and prevention has been
throughout the hida program for a number of years. the flexibility of the hida program, the beauty of the hida program is our ability to bring people together to make the best possible use of resources, to tap into other treatment sources, together with some limited hida funds to make a great impact. i really believe that can continue should congress reauthorize under the current authorization language. i believe treatment does have a place at the table. i think i think most height is across the land would agree with that and the executive board would have the ability to bring that aspect of the strategy into play should they decide to do that. >> and mr. botticelli, under hide is also using tools like encouraging law-enforcement, i'm very familiar with it. one of the things that has
concerned me is they jack up the prices. the manufacturer, knowing this is a drug that can say people's lives, and it has a people's lives. they jack up the prices and i have been all over them. i'm just wondering, what efforts have you all -- i mean i know you know this and i'm wondering what if anything you have done to try to encourage the manufacture of this life-saving drug to be reasonable? >> thank you for the comments, i too is it very disturbed that the manufacturer does would more than triple the price. we know it diminishes the ability of many of our community-based organizations and law-enforcement to really expand this distribution. we have been pursuing a number of goals, i'm pleased to say just a few weeks ago the fda approved a new nasal
administration, developed by another manufacturer, so we hope that will continue to bring some competition to the marketplace and drive down to man. we have also looked at establishing part of our work over the last few years establishing dedicated grant programs either through other grant programs or additional dollars to help support additional drugs. it is particularly disconcerting to me that people took advantage of some of the incredible dire need that we had out there to significantly raise the price. thank you mr. chairman. >> i think the gentleman, the chair recognizes the gentleman from south carolina, for five minutes. >> think very much, thank you for being here today. i want to go over couple things that mr. botticelli said in his opening testimony, and mr. mark test on briefly.
i heard mr. botticelli say that they made substantial or significant products that but i've heard them say something different, let's drill down into the seven goals, could you please briefly tell us what those seven goals were. you mentioned one of them which was eighth grade marijuana use or something like that. >> this seven national goals were to look at their day use by lifetime drug use and outspoken about by illicit drugs, 30 day use by young adults, the amount of chronic users of different illicit drugs, drug-related deaths, drug-related morbidity, and then rates of drunk driving. >> if i read this correctly stop me from wrong, that in march of
2013 the gao said that on those seven goals that have been laid out in 2010 that you folks had made progress on one, no progress on for their p to be a lack of data on the other two. fast forward to a few weeks ago when your own analysis came out and he said that you had made progress on one, no progress on three, and was somewhat described as mixed progress on three others. here's my question. it is now five years, none have been achieved, you made progress on one, tell me, why are we still spending money nonetheless. wires on this. wires we still doing this if you've had five years that were actually getting worse not better? tell me how substantial progress has been made? >> let me go in detail were progress is.
>> when we look at one of the main measures particularly as it relates to you because we note youth are vulnerable, when we look at the decrease of prevalence rates among 12 to 17 years we have made significant progress toward those goals. >> 12 to 17 is the adult group? >> correct. we know substance abuse by young adult can set a lifelong trajectory pattern. when you look at eighth graders, because again, because again we know that early use predicts lifetime use, when we look at illicit drug use that is where we have not made progress. again, if, if you take marijuana out from other illicit drugs that we have made progress, not a marijuana but but on other illicit drug use. we have met the goals as it is related to alcohol and tobacco. >> let me stop you there. do you agree with that by the way? if you take marijuana out have been made substantial progress on the other? >> we did not have access to the
root data to perform that analysis. it seems to follow the broader trends that we have seen. >> one of the other issue we looked at his chronic users. this is is folks that have addictive issues. they're involved in criminal behavior, when you look at a number of those markers in terms of cocaine use, in terms of methamphetamine use, we have seen significant reductions, we are moving toward our goal. marijuana use a we are moving away from that goal. you see a dramatic increase in the use of marijuana particularly among young adults in this country. if you look at our marker that looks at reducing drug use among young adults in the country, we have seen no change, again if you take marijuana out of the young adult use, we have, we have seen significant and would have met our target for reducing drug use if it were not for increases in marijuana use.
>> if you had the access to that root data, had the ability to separate out marijuana use, may be marijuana use was different now than it was in 2010 we have states legalizing it. what it give it a better data? if we could separate out that particular illicit drug? absolutely, access to better data would mr. botticelli? are you able to do that. >> yes. >> i you'll back the balance of my time >> i think the gentleman. we recognize the ranking member of the subcommittee mr. connolly for five minutes. i think the chair. >> mr. botticelli, we're just asking about metrics, mr. moore's testimony left the impression that actually rather than progress, we are experiencing regression. are we making progress in heroin use in the united states?
>> clearly we are not search. >> are we making progress and cocaine use in the united states brush my. >> yes we are. >> and marijuana is now in legal limbo, clearly states move in the way, i think you need to desegregate that if we want accurate data. one of the things about metrics is it seems to me that even the seven metrics cited, they are little broad and we kind out want to dig down. i think all of us on a bipartisan basis, what we want to do is and the drug and that's what we want to. >> one of the concerns i have mr. kelly and by the way are you from boston? >> where you from? >> if i could have where you from? melrose massachusetts. >> okay i can talk that way if i have to. >> but i try not to now that i
represent virginia. >> currently mr. kelly we have in law and the last reauthorization of 5% cap of treatment for your program, set correct. >> that's correct. >> the new legislation would double that to 10%, set correct. >> it would allow for the current language would allow for amount greater than 5% aware recommending it be capped at 10%. >> effectively cap but not statutorily cap. >> that's nice getting it because i have a problem with the cap, and he cap is arbitrary. any given program you might determine or your colleagues around the country might determine, the prevention treatment rate is the way to go. >> so the mix may be different in south carolina north carolina, virginia, i want to
make your you have flexibility without losing the value of the program. is that the goal you're seeking as well. >> that's right congressman, the goal is to maintain integrity of the haida program as we all know it. >> the success of the program as we all know it is disrupting and dismantling drug trafficking aimed at the supply. >> we also recognize the prevention treatment of the whole approach. the haida director and trying to avoid diluting the program kinda knowing there is also 5%, which i might add no haida in the country has approach in recent memory 5% of the spending on the prevention program, yet they have that ability. where we fill allowing an open ended spending or funding for
those has the possibility of changing the structure and the integrity of the haida program or a particular hida as we know it. the strength of it all 28 or 32 pending on how you choose to view it is of unity and strategy. if we had one or more that really bent a particular way because of open-ended funding, i think would change the landscape as we know it. >> okay but you just said you cannot arrest her well this problem. let me ask, why not? why not just arrest anybody who is misusing drugs and put them where they belong and call it a day? isn't that a more effective more effective strategy. >> no, unfortunately that is not the case. >> ..
and so law enforcement across the land has had a paradigm shift and understand for that very reason it is a cliché now. can't arrest our way out of the problem, nor do they want to. addiction is a disease and needs to be treated however those that capitalizing benefit of the ones we are after. >> final question, you talked about budget reductions. can you expand on that and
what the impact has been? >> the program has historically been very valuable and using the funding appropriated. we have in the past provided a very substantial return on investment. to reduce the program would put us back many years in the progress we have made. the language in the authorization -- >> have we reduced the program? >> no comeau we have not. >> you talked about a budget reduction. >> while he is checking, i'm taking a little more time. >> the dollar amount reflected was actually taken from the president's fy 16 budget proposal and not
>> you know we discussed that judges and prosecutors have said that upwards of 75 pee individuals arrest or prosecutor suffering with substance abuse or addiction. the government has barriers in place that in heaven ability for someone incarcerated to receive treatment. i want to talk about doesn't get your thoughts. the policy, the substance abuse and mental health services administration has set a policy in place that prohibits the use of grants from the center for substance abuse treatment for treating individuals who are incarcerated. obviously we aren't talking about additional resources. our 2nd one is medicaid imd exclusion, the institution for medical disease exclusion expressly prohibits reimbursement for
services provided for individuals who are incarcerated, individuals who are entitled to receive medicaid and the treatment services they would receive are not permitted during incarceration. heroin addiction often leads to theft to feed the addiction are other types of criminal activity that results in incarceration. i have introduced hr 40 which40 which would repeal both of those and allow money to be used for treatment and for those individuals who are medicaid eligible during their incarceration from medicaid to be able to reimburse for those expenses for treatment people are not receiving treatment what they are incarcerated. i was wondering if you would speak about those exclusions and whether or not you believe lifting those
barriers might help others get treatment. >> it was a pleasure to meet with you. to your point, we want to divert people away from incarceration. really innovative program where the police chief is holding community forums. but to your point, we want to ensure they have access to high-quality treatment. unfortunately that takes a tremendous amount of resources. because of the prohibition that often goes to the state corrections or the state public health agency to help support treatment but unfortunately too few people have access. and the opportunity we have to work with congress to look at how we ensure people who are incarcerated good care behind the walls becomes important because
those people come back to our community. untreated addiction would perpetuate the cycle. >> the grants that are being made available are excluded to be used. >> we would be happy to work with you. any opportunity we have to increase the capacity of jails and prisons, to expand capacity is a top priority. >> i appreciate your interest in this. i appreciate your bringing into focus the resources that. >> and bring those comments because i'm well aware we deal with the correctional institutes on a fairly frequent basis on a number of issues. i can tell you from past experience most if not all
issues have some relation to drugs and drug abuse and there were a number of people that went into the correctional institute, came back out and without treatment they were back committing crimes. it is important from a personal standpoint. >> we have done some work looking at the federal prison system. the bureau prison has expanded the amount of resources, specifically on drug treatment programs for inmates in the federal program. one of the incentives to take advantage is if they successfully complete the program's. >> i think the gentleman for his insight. the chair now recognizes the gentlewoman from the district of columbia.
>> i appreciate this hearing, mr. chairman. we have heard from mr. marrow about the increase, and i am certainly not going to blame that on the administration, nor to see. in fact, staying ahead of the drugs law has become such a challenge that i think we ought to, that it will always be a challenge. if we can see that looking into what we can really do would make sense. i have a question on the drug is your and the district of columbia. another question on marijuana, but we certainly
remember when the drugs that the entire nation was focused on was crack cocaine. now, of course, everyone is focused on opiate and harrowing, and it will change tomorrow. i was interested in mr. turner's question. about treating people and they are behind bars because i had a roundtable last night. you know there are 6,000 federal returning citizens now all around the country because of the reduction in the sentence for mandatory minimums. this was one of the great law and law enforcement tragedies. we treated crack cocaine differently from cocaine,
and you essentially or we essentially, democrats and republicans, certainly not partisan, essentially destroyed what was left of the african-american family. most of these were black and latino in the mid- 30s, right at the prime of life. so today you hear about opiates and harrowing. and about the law enforcement approach that you have been authorized to pursue. but i must ask you, and light of prevention i don't see how you can prevent the next drug of the day.
i am cosponsor with several members on the other side of the bill to deal with that knew phenomenon. but if -- you cannot expect law enforcement to prevent new drugs or drugs from changing. i'm not sure why they change. at the very least it seems, at least by roundtable told me that once you have somebody will often find, as we did when we have these witnesses who have just been released from mandatory minimums have there mandatory minimum reduced by an average of two years command questioning them these were drug traffickers, got into drug traffickers by using drugs. i could not help but believe that the treatment have been earlier available we might
have prevented what was one of the worst tragedies and law enforcement in american history command now we are trying to make up for it. you say should not be 5%. it should be 10%. that 10 percent. that has the ring of a number pulled out of the air because you have 5 percent and because you don't think you can get anymore. is that essentially the long and short of it in terms of what is effective as you pursue new were and newer drugs every decade? where did you get 10 percent from? especially. >> we got the 10 percent, that was a figure that was derived in two different ways. using the prevention history even though 5 percent of funding has been available for some period of time
across the nation. many have never approach that. >> treatment. >> treatment has never been. >> except in this region. >> you were grandfathered in. >> the experience that the ranking member has spoken about educated you will? >> certainly. in fact, i said peak for all directors when they recognize the value of treatment. >> what is the basis? >> 10% was10 percent was based on -- >> i'm not suggesting another percentage. they may not be evidence -based. >> it was more based on the budget,budget, and the fact of the matter is that historically we have never exceeded more than 5 percent. i also spoke about the partnership and the fact
that we value that and the fact that by elevating it to increasing and almost doubling that would give the executive boards fairly wide discretion in using an effective baseline. the baseline differs across the nation. some of those, the new england baseline is 3.1 million. that would allow the executive board upon approval of the directive used upwards of $3,000 is a maximum. that is also very important to realize that that is not the only source of funding for treatment that would be available. the beauty of the program is our partnerships across the spectrum. in coordinating within coordinating with other people we can maximize that
impact, but it goes back to allowing for treatment, allowing for prevention, allowing for enforcement. we recognize that but we also recognize the fact that we are flat funded. discretionary funding sometimes varies. discretionary funding would allow them to use more money for these kind of programs. >> i think the gentlewoman for your response. the chair recognizes the gentleman from wisconsin for five minutes. >> how many people died of heroin overdose the last year in this country? >> over 8,000 people. >> that was data from 2013. >> are you sure? >> that's the best available
data that we half. there has been some estimation that because of the information variability that comes from medical examiners and corners it might be underreported. >> when i geti get around my district i talked to my sheriff's. and i don'ti don't really think of wisconsin as being the heroin center of the world. it would be higher than that by a factor of three times. are you sure it's even close? >> this is 2013 data. we expect inwe expect in the next few weeks to have 2014 data available based upon what i havei have heard i would highly anticipated the number of heroin associated deaths is far higher than that.
>> that just bothers me off the top. how are you getting that data? is every county reporting? is that comprehensive? >> so the way that the reporting work says county medical examiners or corners report the data to the state and federal level. there is probably wide variability in the reliability. we have been trying to work at enhancing the quality. again, this is 2013 data. >> why don't you give me the data folder wisconsin. and i can tell you whether it's accurate. second question, where is this coming from? >> this majority is coming from mexico. this compels us to not only work domestically with demand reduction strategies do with our colleagues in mexico.mexico.
i was just in mexico two months ago meeting with our colleagues, and one of the main agenda items was what additional actions the mexican government can take in terms of eradication of poppy fields, going after heroin labs. we are seeing a dramatic increase infant know associated deaths, this very powerful morphine like drugs , but much of it appears to be coming from mexico as well. so part of our overall strategy has to be looking at working with mexican colleagues, reducing the supply and working at our border to intersect more heroin. >> ii was under the impression a lot of these were grown in afghanistan. walking down the southern border.
how much prison time do you expect to get? is it a federal crime? >> are you sure? if i am caught, what type of prison system -- sentence can i expect? >> i don't know the exact answer. we do promote comeau we know that many people who sell small amounts of the drug largely to feed their own addiction, these are not the folks who are praying on our community. we want to make sure those folks who are doing that
largely because of their own addiction are getting good care or treatment. >> it is a little shocking that you don't know. to me and wisconsin we have money for treatment. but the frustrating thing is the cost to solo, and the reason is that people who are selling it are not paying enough of the price. heroin was around in the 1970s, but it was not abused like it yesterday. one of the reasons the cost is going down on learning today, i don'ti don't think you guys consider enforcement enough of a priority. people are killing people. i believe more people are dying of heroin overdose then murder in automobile accidents combined. that is certainly true an individual counties. something the federal government can do is make the cost go up a little bit. i am concerned that you guys
are not 250, we can't prosecute our way out of this. >> i would tell you that honestly we look at public health strategies decreasing the availability and increasing price has been a prime strategy. because of that cheap availability we know that that has prompted the dramatic increase. that is part of why we are focusing on working on law enforcement to dismantle organizations, while we continue to work with mexico on reducing the supply for how we work with customs and border protection. we know that there is a nexus between the supply and demand. i will be the 1st to admit that while we need to continue to ramp up demand reduction that will ramp up
ourwrap up our supply reduction. we have to agree how we look at how we diminish both the supply and the trafficking organizations who are moving it. >> i hope you do that sincerely because i am afraid you are just throwing up your hands and saying all we will do is education. >> vigilance time is expired >> a little shorter than the last one, but that's okay. >> thank you, mr. chairman. thank the witnesses. let me ask, director botticelli, and let's stay on the subject of heroin addiction. we are afflicting americans of every part. it's timely and urgent. i have heard you speak eloquently and powerfully
about how treatment is one of the ways that we can reduce the 17,000 deaths annually from prescription painkillers and 8,000 deaths annually from heroin. and i have seen firsthand the value of life-saving and life renewing services offered by community-based nonprofits the provider residential treatment for substance use disorder. they provide the full continuum of care for addiction from residential treatment outpatient to active care support. upon completion of the program that is essential to them staying clean and being a productive member of society. it should not be all about throw them in jail and lock them all up. i think this is a disease that needs to be treated.
and i agree with mr. turner. unfortunately, if you are poor and rely on medicaid for your healthcare, which we know a lot of states have not expanded under the aca there is an outmoded policy of 50 years old now is the institution of mental diseases exclusion. better known as the imd exclusion which bars medicaid from paying for residential treatment at a facility of more than 16 beds and the new york times coverage is extensively last year about how the imd exclusion prevents people from accessing the care they need.
they lose access to the treatment that may have been clinically indicated in medically necessary. this is wrong and must be changed, and i want to join with my friend from ohio and trying to change. do you agree that people on medicaid should have access to the same kind of treatment for substance use disorder? >> thank you for that. one of the things we know to be effective with dealing with substance use disorders is people need to be conducted have connected to a continual of care and moving people from their environment, getting the new skills and jobs is particularly important. we want to make sure people have access, that everybody
has access to the continuum of care, not just people who can afford it out of their own pocket. the administration has taken a look at the exclusion of the secretary just sent out a letter to state medicaid directors basically saying there are a number of levers that medicaid can use to help support a continuum of care but also waiver from the current imd exclusion. i know as i traveled around the country i used to administer state-funded treatment programs and many are under significant demand and that imd exclusion's exclusion's can seriously limit the ability of our treatment programs to serve more people. we should want to look at how we expand treatment capacity, how we can ensure folks who are on medicaid have access to care.
the last thing i will mention, in spite of the affordable care act to medicaid expansion in many states, there are many people who remain uninsured command ii want to make sure they have access to all that care as well. >> everybody has access to the full continuum of care. >> and i'm glad to hear about the plan. what happens in those states that don't seek waivers? shouldn't this be a national policy? >> through not only the affordable care act but the implementation of the mental health equity and addiction parity act we have to look at making sure that we treat addiction like we do any other chronic disease and reimburse for services like
we do with any other chronic disease. we need to use every tool in the toolbox whether it's parity enforcement can't block grant to make sure people have access to care when they needed not just because they can afford it. people who realize they need care often have to wait weeks before they get in the care and often get limited duration when they need long-term care and rehabilitation. >> my time is up. >> i think the gentleman. the chair recognizes the gentleman from georgia. >> thank you for being here. as you can imagine, prescription drug abuse is important. as the only pharmacist in congress i have dealt with this, experienced it. i have seen it ruin lives maroon families and it's obviously very important to me. as a member of the georgia state senate has sponsored
senate bill 36. something am very proud of. i want to ask you, can you tell me what the national drug control policy for what is your direct role in combating prescription drug abuse. >> we play a prime role. let me express my appreciation. particularly your focus on prescription drug monitoring programs. every state should have a robust prescription drug monitoring program. that was one of our main goals. we started the only had 20 states and today we have 49. firewall is to make sure they adequately resourced. data availability and sharing information becomes important. >> let me ask you. how do you fund those, through grants?
>> those are through grants that are bureau tested. >> i remember when we set up our program we were eligible for certain grants because we did not have certain programs within the prescription monitoring program that we needed, sharing information across state lines my could not get the bill passed with that included in it which made us an eligible. >> to my knowledge i am happy to work with you. if there are additional requirements that you feel like have become a burden in terms of states not having access am happy to work with you. >> that is an important element is my hope is that we can get that changed. the practice on the georgia florida line. i get prescriptions -- are used to practice.
i get prescriptions quite often from the states and the that information as well. you mentioned a while ago, legalization of marijuana in the decriminalization of marijuana, i suspect that has had an impact i was wondering if you had done any studies i always viewed marijuana, and full disclosure i am adamantly opposed to the decriminalization or legalization. for practicing pharmacist for over 33 years and i spent my career using medication to improve people's health. it is a pet peeve of mine. what i want to no is, in the states that have legalized are decriminalized, i have always viewed it as a gateway drug. have we seen a decrease or an increase or any impact at all and other drug use in this particular states?
>> we currently have a report going through final processing looking a part of the issue. it will be issued at the end of this month, and the state of colorado and more specifically with the department of justice is doing or not doing involving there use. that report may address some of your questions in terms of preparing for today's hearing i don't have any specific information, but it is right on.than an important issue that needs to be addressed. >> right. another point that was brought up i found interesting. they have done quite a bit of criminal justice reform in the state of georgia and talked about it here in congress. certainly having programs in our prison system because of prisons are full of people in there for drug abuse problems and illegal drug use. we need to have programs in our prison system that will
treat them because it is a disease. it is a disease and something that needs treatment. what are we doing to help with those type of programs? >> in the federal system inmates are eligible for a residential drug treatment program. if they have come into prison with an addiction they can get that treatment and get reductions in their sentences if they successfully complete the program. >> is voluntary. why is not required? >> why are they required? >> if you go into prison for drug dependency why are you required to go through therapy? >> that's a great question to ask the bureau of prisons the ability to have inmates have a sentences reduced creates a pretty strong incentive. for a number of years the
bureau of prisons did not have adequate resources to meet the demand. they have sincethey have since made a lot of progress in addressing that issue. i can't speak to whether every single inmate actually gets treatment. many want to those to address their addiction. >> many inmates may want to, but i suspect that they all want them to get it. thank you and i yield back. >> the chair recognizes the gentleman from massachusetts for five minutes. >> thank you, mr. chairman. i want to thank the witnesses for your excellent testimony. mike botticelli is a power mine. mr. kelly, my district is a high intensity drug trafficking area. mr. kelly has been a frequent flyer to my district trying to address the problems. most pointedly we have had a critical situation in
massachusetts in my district as well as other parts of the state, and maybe just explaining that will offer some value to what the office of national drug control policy actually does. we have had a pernicious problem with heroin coming into my district from mexico , and it was through the directors help that we figured all of this out, but it is coming out of mexico and colombia. the earlier drug trafficking network was to the dominican republic. as mr. kelly has informed us, be of the national drug control policy we were able to bring in resources. we are dealing with a system will we have local towns, cities, counties, the state.
now one of the areas was providence, rhode island. and thenand then we are dealing with the mexican border and the mexican government. elaine dcp polls all of that together. i had a number of homicides in my district that have the population full on. brutal, brutal murders directly tied to the drug trade. and so zero in dcp did a remarkable job. from member to member, they are very important part of that. that is how we bring these resources together. i want to express support for the idea. they are short funded on that end as the director pointed out.
maybe we can do something on the pilot program were county prisons were state prisons might identify a program in a certain area where we are trying some innovative stuff to deal with the potential inmate population. i appreciate the work you have been doing and thank you for your testimony. i want to back up a little bit. one of the problems i see on a day-to-day basis command i am up to my neck in the stuff, the power of oxycodone. i could tell you some horror stories about young people that we have been dealing with. one young woman had a tooth extraction. and then she tells me now she falsely claimed have persistent tooth pain. two later she is fully
addicted command then she started complaining about other teeth, having other extractions. having teeth pulled out of her head. now, when people are doing that it tells you that this is a powerful, powerful drug. because of the tolerance comeau what it does to the brain and the tolerance and resistance that develops greater dosages are needed. using that as one example, why is it that we are allowing drug companies to produce these powerful, powerful drugs by which they are building a customer base for life by getting people on this. it is overloading membranes and just grabbing them. there is a commercial advantage to producing customers for life.
if you can get these people hooked you have got them forever. and now the fda, they just expanded they used to children. it seems like we are not all rolling in the same direction. when i was 1st filed a bill to ban oxycontin. i did not have a prayer. what is it that we could do to look again at the substance that we are allowing people to sell commando not against pain management that this is ridiculous. how do we address that issue? >> if you could briefly respond. >> thank you, congressman. we are prescribing enough prescription pain medication the us to give every adult
american their own bottle of pain pills. we all want a balanced approach. we continue to work with the fda, but one of the areas we have not made enough progress is ensuring that every prescriber has a minimal amount of education around safe and effective opiate prescribing which is why we are thrilled. that is often the place where it starts. i am sure the dentist is very well intended. we have to work not only on making sure we make the medications more abuse deterrent but also that we are stopping the overprescribing that we see
throughout the country. it is critical to rein in the prescriptions. and that is often with the doctor-patient relationship. >> thank you. >> the chair recognizes himself for a series of questions. let me be brief in terms of the introduction. i think we have a bipartisan agreement that this is something we need to address. the question becomes, with the reauthorization and some of the suggestions that have been made in that, is that the appropriate place and money back i can tell you that i started a nonprofit with a good friend of mine who lost his grandson, and there is a cycle within that family of drug abuse. we went in and developed a nonprofit to work on the prevention side of things.
this is something near and dear to my heart. i want to go a little closer because this is all about coordination. we talked about this early on. there is virtually little if no coordination command yet we spend billions of dollars you are talking about increasing the authorization amount. i am willing to look at that to make sure that you have the resources necessary, but as we look at these's, i want to make sure we are not taking away from this which i consider more of a law enforcement component, and in spending the money on prevention and treatment when it would be better allocated in a different agency that already does prevention and treatment. this gets back to the mission. let me ask my tougher question 1st, that is, in
the reauthorization language there is talk about getting rid of the new performance reporting system. >> one of the things we looked at as we have undertaken this is how we achieve greater efficiency within the organization to focus on the main goals and mission. one of the things we looked at and are fully cognizant of the role to ourselves as an agency, to congress, and the american people that we monitor performance. >> you came up with this system. why get rid of it? just cut to the chase. >> part of what we are trying to do is achieve greater efficiency. >> how do you do that by getting rid of an evaluation program? >> we have existing mechanisms within our current administration the monitor performance. >> who made the mistake of doing the new performance? you created a new one and are now doing away with it
command i don't understand why. >> i want to be clear end up front. there were elements that help in the ability to continue to monitor. >> let me be clear end up front. i want you to work with gal to keep the system a performance review in place, make it meaningful measured because the appearance -- and i am willing to look at increasing the authorization the appearance is that you did not meet your performance standards and got rid of the program. that is not satisfactory. do i have your commitment to make meaningful and put it back in? >> i would be happy to work with you and the gal that we satisfy your request to make sure we are monitoring. >> performance, and if we are spending billions of dollars and not getting what
we need and we need to reallocate funds. >> if you can put up a chart , this gets back to how i opened up a little bit. i believe this chart is one that comes from the performance fy 2014 or 16 budget and performance summary that was produced by your group. we can see there the prevention and treatment across agencies is substantially higher already i guess that is 11 billion. and soand so some of the wonderful programs that have been talked about today that actually i have taken advantage of and used with grants, they are working in treatment and prevention. the drop down to the next group. let me be specific knowing
that you have a willing participant here to help you with the reauthorization. i am concerned that we are taking this and making them in treatment and prevention group when we are already spending 11 billion and other agencies to do that when just better coordination would actually address it. so what i would like us to do is look at that again and look at, and if we are not meeting the in the gentlewoman from the district of columbia and the gentleman from maryland talked about how that treatment component is effective but are still not meeting the 5 percent, what i want to do is make sure we are allocating the money with the proper agency to perform those functions and not making a law enforcement officer do treatment and prevention because i want to
give him the tools to refer, but they are not in the treatment and prevention business. and when you do that it is concerning. will you agree? >> i would agree. one of the things i want to point to is despite the fact we have significant and increased funding we know we have gaps. >> i will agree with that. is this the best place to do that? i can tell you, my biases that it is not. >> you can sell me. i am waiting to hear it. >> making sure that if they are investing that they go toward evidence -based programs. >> i understand. i have a program in three counties. mcdowell, buncombe, and henderson. and the only common thread is transportation.
we are looking at corridors coming from the south command to do away with money from the program there is not addressing the treatment or prevention aspect because it is all about transportation which goes from a democrat and republican share working in those counties, they work better together. and to reduce there funds concerns me. >> i appreciate your comments. let me reiterate, our purpose here with the language was in no way, shape, or form to dilute the main mission. >> i believe that. what i am saying is it could do that. will you agree address the reauthorizing language with that in mind? i will give you after this time because i may be going to my other colleagues. you can try to sell me. >> i think that we can.
maybe establishing better criteria. >> let me put it bluntly. will my sheriff's agree that we need to increase the amount of money going to treatment and prevention and go away? >> i honestly don't know. i will say that they probably would eject and we would object. >> if they object we will have an issue. >> they are probably on the board. >> the gentlewoman from the virgin islands for five minutes. >> thank you very much and good morning. thank you for the work that you do. i am incredibly appreciative of everything that you are putting forward in your testimony. my 1st job out of law school was a narcotics prosecutor in the bronx. ii understand this completely and the
importance of the work you do. as a member of congress representing the united states virgin islands i very much strongly support the bipartisan effort of reauthorizing the office of national drug control policy. i see how important it is not only for the nation in terms of treatment but preventatives as well in terms of stopping the flow of drugs in and out of the country and its transportation throughout. for years the otherwise peaceful communities in the us virgin islands have been experiencing elevated levels of crime and violence, much of it related to the economy which has in turn moved tremendously to a growth and illegal drug trade. we are grateful presence and would be in favor of increased presence because we are aware that much of the traffic of drugs coming
into the mainland is coming through the caribbean corridor which many people are not aware of how much drugs are coming into the country through such a small area of the united states. you can imagine if it's coming through such a small and porous border in the small community, the tremendous affected is having on the people that live there, neighborhoods, individuals completely afraid to go out only at night but even during the day where we are having drug wars and shootings occurring not even blocks away from schools in the middle of the day. although a significant effort has been made in recent years to address drug trafficking through the us territories in the caribbean , and our opinion much remains to be done to help stem the flow of drugs
and related crime as well as to diminish the negative impact of drug abuse in the community across the united states virgin islands and puerto rico. in response to a congressional directive earlier this year zero in dcp took a major step forward in helping to promote a well coordinated federal response by publishing the 1st ever caribbean border counter narcotic strategy. i would ask you as well as mr. kelly as to whether or not you believe that explicitly including the us virgin islands and puerto rico and statutory mission would help ensure the drug related issues facing the american caribbean border are fully included in aspects of your work. because we are small in numbers and population people are unaware that almost 40 percent of the drugs that come into this country come through those two areas.
>> thank you for your question and concern. we share your concern in terms of looking at trafficking and increasing crime. we have seen an increased flow in the caribbean as it relates to some of the drug flows, and we are happy to comply, to produce the 2015 caribbean counter narcotic strategy which addresses some wide-ranging issues. we will be convening the relevant stakeholders in early 2016 to review progress and have every intent going forward to include specific action items in our strategy that address the caribbean and us virgin islands. >> i will work as closely and be as supportive of you as possible. you know, families and elders and children really need your support. do you have any thoughts? i have visited the group and puerto rico about a month ago and was impressed by the
work they are doing, have been speaking with our coast guard who is doing quite a bita bit of the work as well and would like to get your thoughts. >> thank you. in fact, you have struck a number of points that are very germane. the program has been intimately involved with the caribbean, not only through our program that is there presently but on a monthly basis we have a conference call, sometimes with as many as 90 people on the call the caribbean intelligence conference call were members of all the federal agencies here in the united states talk about the transportation of drugs and the sharing of intelligence and have made some great, great progress, so much so that it has been a repetitive conference call and we will continue to do
it. to your point on including in the reauthorization and the type of border strategy, i think it is important. as we look at the drug issues we had only look inward but insulate ourselves from the outside, whether it is a northern border strategy, southwest border strategy, or caribbean border strategy with those of the transportation corridors. it makes perfect sense to me with the strategy that just came out the caribbean is a very, very important partner in this issue of reducing the supply that comes from elsewhere command we know that we have to take greater strides in protecting not only the people of the caribbean and those nations in those territories but to prevent the transportation of drugs to make that a no
go zone for these drug trafficking organizations. >> thank you very much. i will be so impressed with working with you while in that. i will be on you. i will be watching. >> i think the gentlewoman. >> mr. director, why are you requesting 22 percent less for the program? >> part of the challenge. >> you were just talking about what a good job they do. >> again, this is not reflective r-value of the program. >> my wife was a waitress. she said appreciation is green. what is it reflective of? >> it is a reflection of some challenging priorities. >> rated the other money go?
>> i can get back to the committee. >> i'm concerned. i will recognize the gentlewoman from new york. >> thank you very much. thank you for the hearing. i join the chairman and underscoring that you should not be eliminating the review processes the strengthening them, and certainly knowing the problem that we have, we should not be reducing what we are spending but maintaining it and hopefully growing. i want to get back to the conversations we have been having on opiates, that they have been described deeply and strongly. the increase of prescriptions. i.e. tracking whether the prescriptions are coming from doctors, or are they illegal? >> as we look at data, the vast majority of prescription pain medications are coming from
legitimate prescriptions. we only see a small percentage coming from internet sales or street-level purchases. 70 percent of people who start misusing prescription pain medication get them free from friends and family who often got them from just one dr.. as people progress they often do move from dr. to dr., but that comprises a small proportion of overall prescription pain medication in the supply. we know if we are going to deal with the issue we have got to diminish the prescription pain medication. >> and also, the reports are that people on opiates then become addicted to heroin. have you been tracking that? apparently helen is cheaper than opiates. is that in your database? then often harrowing goes to crime.
>> we know that about 80 percent of people, new users started misusing prescription pain medication because they are both opiates. we do know however that when you look at heroin use being much lower as a percentage of use, so we know that only a small percentage of people are progressing from prescription drug misuse to heroin. however, because of the magnitude that has led to aa significant increase in the number of people using heroin. >> is there any punishment to doctors that abuse these opiates? i thought the example from congressman lynch was astonishing. ..
do they get money for prescribing the drug? >> let me give you a telling example. in one county in florida because of lax laws and because they didn't have prescription drug monitoring program 50 of the top 100 prescribers were in one county in florida and working with the dea working with the prescription drug monitoring program. we were able to enact laws and reduce these huge pell-mells that we saw that were open for cash business.
we are working with the medical boards that have disciplinary action as it relates to physicians who are clearly outside of the range of appropriate prescribing because taking disciplinary action against those physicians and other prescribers art clearly outside the bounds of what normal prescribing behavior could be needs to be part of our overall strategy. >> my time is almost up but i just want to ask you i miss -- i guess to mr. morrow about the report on omd coordination efforts for drug abuse prevention reported an overlap of 59 to 76 programs included in the gao review and what is the possible impact and why did you raise it in your report? >> this is a report issued back
in 2013. at that time we had overlap in what we meant by that was that there were disparate programs that could potentially be providing grant funding. the good news on that we rate -- made recommendations to look across the universe of programs. they have done that. they have identified the means of greater coordination and put mechanisms in place to move backward nation and they have addressed the recommendation and closed and implemented it. >> my time has expired. thank you. >> i think the gentlewoman. just so you will know we are going to do a very very limited second round and by very limited i am going to recognize the gentleman from wisconsin for four minutes.
the gentleman from wisconsin is recognizer four minutes. >> let me come back to the rhetorical questions, but what is the expected prison term you get if you have enough heroin with you that you are with some sort of a dealer? what is the standard would give up federal prosecutors asked for? >> i don't know what the standard sentences. mandatory minimums in this particular case depending on amount of heroin. >> is there him mandatory minimum if i have enough heroin and i'm not using it for personal use? >> it's trusted editorial discretion and there are mandatory minimums associated with heroin. i don't know what those are though.
>> do you know how many people are in federal prison for selling heroin? >> i didn't know that well over half the current population is serving a sentence predominantly based on drug trafficking. >> the reason i say it is there is a big difference between heroin and other drugs. her marijuana is illegal but there's nobody dying of marijuana overdose. this is heroin and to hone the thing, much worse than the cocaine thing in much worse than anything and it's not blended with the other things. do you know how many prosecutions for heroin in their possession or selling at? >> i do not know. >> and wanted to give me those things and i think it's important for after all the federal people to familiarize
yourself a little bit about what's going on in the criminal federal courts dealing with heroin. i'm asking you these questions my buddy could give me the answers and you don't know the answers. you should know the answers. you have important jobs. i'm glad you can get the answers but if i had your job i would know the answers. we will ask more questions later when you have time. one more question though which is entirely a nonrelated thing the kind of follow-up. one of the problems we have their physicians out there who are clearly selling prescriptions for opiates that they shouldn't be selling. another problem to me is we have physicians prescribing what you would traditionally need of someone goes and berber canal
instead of getting a prescription for three days or a month. can you tell me why that practice has taken a hold? >> we would completely agree that not only are we overprescribing but in many assists people who need only limited duration of pain medication are getting up to 30 doses of it. part of what we have been focusing on not only in terms of prescriber training but the health and human services are in the process of developing clear clinical guidelines as it were relates to the prescribing of pain medications for these purposes. not only appropriate prescribing but also not overprescribing the amount of medications given out. >> i don't like to say it's a federal business that so many of these prescriptions through medicare and medicaid would it be appropriate for there to be guidelines on appropriate amount of opiate prescriptions?
>> one issue we are looking out for their medicaid programs is not only the implementation of these clinical standards but also continuing to focus on what we call auditing programs to ensure the people who might be going to multiple positions are pharmacies are locked in to one physician and one pharmacy. when looking at a wide frighted mechanisms in our medicare and medicaid programs to it but then how many might diminish the scope and the associated costs of prescription drug use. >> i want to say to the chairman mentioned we want you to take away from law enforcement function that i would agree with you in light of the fact we took them 19,000 plus packets of
synthetic drugs here in the district of columbia. these synthetic drugs, want to know how you're handling it. emergency services were called by the navy times, more than 18 times a day to respond to synthetic drug emergencies. he we have a partisan legislation they change the composition. are you pursuing the drugs in light of the fact that a criminal statute cannot be overly broad or violate the due process and do you have the tools to do your law enforcement
work with what is now growing across united states? are in public and members come from texas and pennsylvania. >> thank you congresswoman and led to have the opportunity to talk about that. one of our prime concerns is the dramatic increase in the psychoactive substances. both my job and is a resident i've seen the incredible impact it has. we have been working with their counterparts in china because we know the vast majority of precursor chemicals are coming from china. both at the federal and state level we are having to work with congress in terms of any legislation has been introduced that would give federal government additional and quicker scheduling authority.
>> you dean need -- is doing new legislation and you do need legislation. >> i believe we have not been able to stay out of these new chemical compositions. >> i have one more question before my time is up. i know the four states in and the district of columbia have legalize small amounts of marijuana and have legalize possession to the sale as well. there isn't a legal market because you can't get the sale. how much of your work goes for marijuana in light of the fact that this drug, increasingly you have 20 states that have decriminalized it. are you spending resources on marijuana particularly in light of the fact that in terms of the
mandatory minimums, the arrest records are almost entirely black as you know because the white kids are not in law enforcement areas and don't get picked up and invited that racial disparity, which of your funds for law enforcement goes towards marijuana being legalize before your very eyes? >> i can sit down with you in terms of our law enforcement efforts. >> can you send the chairman of the committee lacks. >> i was going to address one other issue the chairman would allow. >> to your point the vast majority of the resources that ondcp of the federal government looks at us for enhanced prevention and treatment programs. i think the federal government in the department of justice has issued guidance saying we are not going to be using our
limited federal resources to focus on on low-level folks who are using this for largely personal use. folks want to use every opportunity to do for people away from the criminal justice system. the implications of decriminalization and legalization mean for the people of the united states. i've been doing public health work for longtime away now aired disproportion impacts. >> i support the studies especially when it comes to children. of course we know the most people -- college. >> mr. kelly wood will give a latitude to make that last comment in the middle close-up. >> thank you mr. chairman. councilman i want to bring your attention for the record, i would certainly invite the
director to come down here knowing this is a prevalent issue. i would invite you so you would be able to speak anytime you wish. i also have with me a threat assessment that was done on synthetics in this very area and a number of recommendations which i would like to share with you that was developed by the washington -- and their initiatives that they are working very closely with the chief of police who sits on the board to address these very issues. >> thank you mr. kelly and i would like to thank all of you for your testimony and your indulgence. it's very insightful hearing. i want -- director we have a number of items for you to get doc on. it's critical that as we look for reauthorization as we get back into a normal budgeting process and the normal appropriations process some of these is been appropriated without reauthorizing as you know.
those days are growing fewer in number and it's more critical that we look at reauthorization but look at meaningful budget numbers. i am extremely troubled based on the testimony today that your request is to cut a program. if it's not working, it all out, but that's not what i heard from you and yet we are taking a program, what my local law enforcement officer say works with them. it's a critical tool and we are somehow wanting to give greater flexibility. appears that we are wanting to shift the money into prevention and treatment and ultimately do away with hidta. you're going to meet great persistence in a bipartisan way if that's truly the direction and i don't want to put words in your mouth that you are very eloquent with your words. i just want to say thank you all
for your time. i think we can make real good progress here working through, director working with gao to make sure we keep this performance reviews meaningful statistically accurate manner. if there is no further business, without objection the subcommittee stands adjourned. [inaudible conversations] [inaudible conversations]