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Jump to main content. Jump to navigation. President, I'm going to start with you. Obviously you have a lot going on, and this is a significant commitment. You flew down here. You're attending this conference. You're going to make comments here. Why this particular topic for you, sir? And I want to begin by thanking Congressman Rogers for helping to put this together and the leadership that he has shown. We very much appreciate him and his staff for making this happen. I want to thank UNITE, and the organization that has been carrying the laboring oar on this issue for many years now. We are very grateful to them. And I just want to thank our panelists -- especially Crystal and Justin. Obviously we greatly appreciate the work the doctor does, but part of what's so important is being able to tell in very personal terms what this means to families and to communities. And so I am looking forward to hearing from them. This is something that has been a top priority of ours for quite some time. My job is to promote the safety, the health, the prosperity of the American people. And that encompasses a whole range of things. It means that we're tracking down ISIL leaders, and it means that we're responding to natural disasters, and it means that we're trying to promote a strong economy. And when you look at the staggering statistics in terms of lives lost, productivity impacted, costs to communities, but most importantly, cost to families from this epidemic of opioids abuse, it has to be something that is right up there at the top of our radar screen. You mentioned the number 28, I's important to recognize that today we are seeing more people killed because of opioid overdose than traffic accidents. I mean, think about that. A lot of people tragically die of car accidents, and we spend a lot of time and a lot of resources to reduce those fatalities. And the good news is, is that we've actually been very successful. Traffic fatalities are much lower today than they were when I was a kid because we systematically looked at the data and we looked at the science, and we developed strategies and public education that allowed us to be safer drivers. The problem is here we've got the trajectory going in the opposite direction. So in , which is the last year that we have accurate data for, you see an enormous ongoing spike in the number of people who are using opioids in ways that are unhealthy, and you're seeing a significant rise in the number of people who are being killed. And I had a town hall in West Virginia where -- I don't think the people involved would mind me saying this because they're very open with their stories -- the child of the mayor of Charleston, the child of the minority leader in the House in West Virginia, a former state senator -- all of them had been impacted by opioid abuse. And it gave you a sense that this is not something that's just restricted to a small set of communities. This is affecting everybody -- young, old, men, women, children, rural, urban, suburban. And the good news is that because it's having an impact on so many people, as Hal said, we're seeing a bipartisan interest in addressing this problem -- not just taking a one-size-fits-all approach, not just thinking in terms of criminalization and incarceration -- which, unfortunately, too often has been the response that we have to a disease of addiction -- but rather, we've got an all-hands-on-deck-approach increasingly that says we've got to stop those who are trafficking and preying on people, but we also have to make sure that our medical community, that our scientific community, that individuals -- all of us are working together in order to address this problem. And I'm very optimistic that we can solve it. We're seeing action in Congress that has moved the ball forward. My administration, without congressional action, has taken a number of steps. Concentrating on physician education in terms of how they prescribe painkillers to prevent abuse. Making sure that the treatment -- Medication-Assisted Treatment programs are more widely available to more people. Making sure that the -- not antidote, but at least means of preventing people once they have overdosed from actually dying is being carried by EMTs. So we're taking a number of steps. But, frankly, we're still under-resourced. I think the public doesn't fully appreciate yet the scope of the problem. And my hope is, is that by being here today, hearing from people who have gone through heroic struggles with this issue, hearing from the medical community about what they're seeing, that we've got the opportunity to really make a dent on this. And I just want to thank all the people who are involved here today, because I know we've got people who are much more knowledgeable and are doing great work out in the field each and every day. My hope is, is that when I show up, usually the cameras do, too, and it helps to provide us a greater spotlight for how we can work together to solve this problem. First of all, are you comfortable talking about your story? Wonder if you could tell me what sort of happened at that stage in your life? How did things progress from there on? They start out with the Vicodin, low milligrams, not knowing how addictive it can be, using it recreationally until then they need it. It slowly happened from weekend to then needing it throughout the week, needing something to go to work. Eventually I needed something stronger than the Vicodin. I was doing OxyContins, Dilaudid, things like that, until that eventually led into me doing heroin. When you say it eventually led to heroin, what does that mean? And the higher milligram things like Oxycontin and Dilaudid to me are pretty much like heroin. So heroin -- where were you using it? In the bathroom -- while my kids were there, while they were at school. It was so much a part of my life -- it was a part of my life. What did you do when you started to get help? How did you -- where did you even begin? I know some people can. This last time has been the most successful recovery for me. Thank you. So, yeah. Is that right? Is there something that worked this time? You and I had dinner a few months ago, and I mean some of the stories you shared were pretty remarkable. How did you get into this? Why is this issue so important for you? I saw a patient who I got to know over the course of her getting treated in the ER. But this woman was in her late 20s. She was a competitive swimmer. She tore disks in her back and started out with prescription pain pills, but then got addicted to them, and then switched to heroin. And this was a woman who was in a downward spiral. And she recognized -- she was losing her job; she was about to lose her kids; she was homeless. And she came to us basically every week in the ER. And she knew that she needed help. I mean, this was someone who came to us every week saying, I want help for my addiction. It's one of the most humbling things and the worst feelings as a doctor to know that you can't help them; that what this patient needed, what so many of our patients need is treatment -- addiction treatment at the time that they're requesting it. But we couldn't get it. I mean, we would never say that to someone who has a heart attack. We would never say, go home, and if you haven't died in three weeks, come back and get treated. Laughter and applause. So that's what we faced. And I remember that I talked to her this one time about getting into treatment -- she really wanted to do it. We set her up with an appointment, but it wasn't until two weeks later. And she went home that day and overdosed, and came back to us in the Europe. We tried to resuscitate her, but we couldn't save her. And I think about her all the time because she had come to us so many times requesting treatment. And, yes, clearly, there is a difference between how we treat her and how we treat everybody else because we need to recognize that addiction is a disease. If we treat addiction like a crime then we're doing something that's not scientific, that's inhuman, and it's, frankly, ineffective. President, you've heard these sorts of stories before. When you hear it so lucid in terms of what the situation was like in the emergency room, the woman wanted help, what is your reaction when you hear this story? And the fact is that for too long, we have viewed the problem of drug abuse generally in our society through the lens of the criminal justice system. Now, we are putting enormous resources into drug interdiction. When it comes to heroin that is being shipped in from the south, we are working very aggressively with the Mexican government to prevent an influx of more and more heroin. We are now seeing synthetic opioids that are oftentimes coming in from China through Mexico into the United States. We're having to move very aggressively there, as well. We're staying on cutting off the pathways for these drugs coming in. But what we have to recognize is, in this global economy of ours that the most important thing we can do is to reduce demand for drugs. And the only way that we reduce demand is if we're providing treatment and thinking about this as a public health problem, and not just a criminal problem. Now, this is a shift that began very early on in my administration. And there's a reason why my drug czar is somebody who came not from the criminal justice side but came really from the treatment side -- and himself has been in recovery for decades now. Because this is something that I think we understood fairly early on. Now, I'm going to be blunt -- I hope people don't mind. I was saying in a speech yesterday, your last year in office, you just get a little loose. But I said this in West Virginia as well, and I think we have to be honest about this -- Part of what has made it previously difficult to emphasize treatment over the criminal justice system has to do with the fact that the populations affected in the past were viewed as, or stereotypically identified as poor, minority, and as a consequence, the thinking was it is often a character flaw in those individuals who live in those communities, and it's not our problem they're just being locked up. And I think that one of the things that's changed in this opioid debate is a recognition that this reaches everybody. So there's a real opportunity -- not to reduce our aggressiveness when it comes to the drug cartels who are trying to poison our families and our kids -- we have to stay on them and be just as tough -- but a recognition that, in the same way that we reduce tobacco consumption -- and I say that as an ex-smoker -- applause -- in the same way that, as I mentioned earlier, we greatly reduced traffic fatalities because we applied a public health approach, so that my daughter's generation understands very clearly you don't drive when you're drunk, you put on your seatbelt, and we also then instituted requirements for things like seatbelts and airbags and reengineered roads, all designed to reduce fatalities -- if we take the same approach here, it can make a difference. So when I'm listening to Crystal and I'm thinking, what a powerful story, I want to make sure that for all the other Crystals out there who are ready to make a change that they're not waiting for three months or six months in order to be able to access treatment. Because, Crystal, I think you'd agree that if all we were doing was dispensing the drug that is blocking your cravings for an opioid but you weren't also in counseling and working with families, et cetera, it's shown that it doesn't work as well. We've got to make sure that in every county across America, that's available. And the problem we have right now is that treatment is greatly underfunded. And it's particularly underfunded in a lot of rural areas. Our task force, when we were looking at it, figured out that in about 85 percent of counties in America, there are just a handful or no mental health and drug treatment facilities that are easily accessible for the populations there. So if you get a situation in which somebody is in pain initially because of a disk problem, they may not have health insurance because maybe the governor didn't expand Medicaid like they should have under the ACA -- applause -- they go to a doctor one time when the pain gets too bad, the doctor is prescribing painkillers, they run out, and it turns out it's cheaper to get heroin on the street than it is to try to figure out how to refill that prescription, you've got a problem. And that's why, for all the good work that Congress is doing, it's not enough just to provide the architecture and the structure for more treatment. There has to be actual funding for the treatment. And we have proposed in our budget an additional billion dollars for drug treatment programs in counties all across the country. And my hope is, is that all the advocates and folks and families who are here and those who are listening say to Congress, this is a priority. We've got to make sure that incredibly talented young people like Crystal are in a position where they can get the treatment when they need it. I mean, you're still young, but this started at a very young age. Can you share with us a little bit of -- when was the first time you started taking some of these drugs? I never felt good enough or liked who I was or how I sounded or anything of that nature. And being kind of just in my own skin was something very, very uncomfortable for me. And that started around 3rd, 4th grade, where I was consciously very disappointed with who I was. And for those of you who have ever been a 3rd-grader or know a 3rd-grader, that's a sad statement. That the future of our country -- at such a young age, it's so sad and hopeless. But the other side of that, though, and where we really come into play -- and I'll start to sound a little bit like a broken record -- and if you don't mind, sir, I'll take a leaf out of your book of being blunt, but even more important than when that started, how that started, what that looked like -- even though that's important to understand -- is that people can and do recover. And there are millions -- there are millions and millions and millions of people that can and do recover. I am very fortunate to be able to be up here and to represent, and to be an example. I am not special or unique. I have worked very hard, and I can appreciate that, and I would challenge others to also work hard. But those of us who are in recovery and know people that can and do recover, that's -- and even to me -- as important as this part of the conversation is. And we have to have this part -- is what's even less talked about and even more underfunded is that people can and do recover, and they do that in a lot of different ways, and they're extraordinary. That's, what, seven, eight, nine years-old? Hi, mom. So I had a precarious allergy and still do -- I was allergic to poultry. And so I learned at a young age, you take Benadryl, and Benadryl then makes you sleepy. And then if you also know you don't want to deal with life, just sleep through it. So for me -- and they didn't fly me in because I'm the Benadryl guy, but that was part of my early journey. But that stopped satiating that hole in the soul, and I literally couldn't sleep through all of life, so eventually that did manifest into other things, of course. I mean, you're still pretty young. I mean, if you don't mind me asking, how did you even gain access to some of these other drugs at that age? And amazing parents, amazing family, but it's pretty commonplace to have alcohol and other drugs in the home. My parents raised me exceptionally well, but that feeling of inadequacy, searching for something to fill that space was pretty strong for me. GUPTA: You eventually were in recovery, and you were in and out of recovery seven times is my understanding. Did you pursue it on your own? Was your family -- did they help nurture this for you? RILEY: I think the true first attempt at recovery for me -- which was to no surprise when you have such an amazing family and parents -- was my parents took me to my pediatrician, and they said, Luke -- they call me by my middle name -- Luke is struggling. He's doing the sports thing, doing leadership stuff in school, but we found out that he's been drinking. Instead of water in his Nalgene for tennis practice, there's vodka in there. What are we going to do about that? And culturally -- which I think speaks to what we brought up earlier and what you articulated so well -- was, culturally speaking, that bias or that lack of understanding that there's got to be something bigger going on here -- before this gets into what we now know today is proportions of an epidemic -- but it was chalked up to boys will be boys. And it was one of those very rare moments when I decided to be open and honest around some of the things that I was doing. But again, having -- and I mean, it's a pediatrician, right? I mean, I'm not a doctor, clearly, but very, very much -- almost without knowledge. I mean, there was just nothing that that doctor at that point in time could do other than, well, you know, he's doing good in sports, doing good in school, I'm sure this good-looking young guy will be okay. And that wasn't the case. How bad did things get for you? I've met a lot of individuals that went through things that, frankly, I don't know IF I could have gone through. But for me, again, even more so than how bad did it get or how many stories could I go into to articulate the hopelessness or the things that my family went through, is truly the reverse of that -- the recovery, the power of those stories of when I did start to get well. And when I was allowed to be in my parents' home, when my father was the best man in my wedding, when my dad called me when I was a couple years into recovery and he said, because of what you have done, I want to be in recovery. And he's still in recovery to this day. And those stories to me -- applause. And the connection between mental health, drug abuse is powerful. And one of the things that we tried to do through the Affordable Care Act was insist on parity in insurance policies. Because people talk about mental health parity and they say this has been around for some time but the impact has not been felt the way that a lot of people would like to feel it. And this is where, though, the public education and employer education around these issues is very important, as well. Because 85 percent of folks still get their health insurance through their job, through their employer. Crystal, when we spoke earlier, you talked about the fact that you wanted to describe to the President some of what you experienced in the criminal justice system. And I think what you were talking about was some of the stigma you faced. I wonder if you could, again, describe some of your experiences and what that stigma really felt like. But there still is a stigma. Armed Forces. Some doctors even. One doctor I went to -- and I talked to some of your people today about the Parity Act. Everything is paid for. But I have gone to doctors before that would only take cash. When we talk about, for example, Naloxone, the overdose medication, there are people who would question whether giving someone Naloxone will make them more likely to use drugs. But we would never say that about somebody who has a peanut allergy. We see that stigma in Baltimore, where I am. I mean, we have a city -- if we look at the numbers in our city, we have 73, arrests made every year in a city of , And when we look at our individuals who are in our jails, four out of 10 have a diagnosed mental illness; eight out of 10 use illegal substances. So we are criminalizing people without giving them the reentry resources to get their lives back in order. GUPTA: You provided your own name as a doctor at all the pharmacies, I understand, in Baltimore, a certain area, so that anybody going in could get their Narcan, their Naloxone, if they wanted. We actually started training our police as well. And within six months, our police officers have saved the lives of 21 citizens. And so I issued the standing order. And now anyone who takes a very short training -- they can get training at a street corner, public market, public housing, in jails -- if they do a short training, they can get a prescription in my name. So , residents of our city have access to Naloxone. President, Dr. Syringe service programs -- are they more likely to enable or foster continued usage of these drugs? Do these discussions come up as part of trying to pass some of these recommendations? The good news I think is that we base our guidance and our policy on science. This is a straightforward proposition: How do we save lives once people are addicted so that they have a chance to recover? And if we can save a life when they are in medical crisis, then we now are in a position to make sure that they can also recover so long as the treatment programs are available. And I think what Leana said with respect to our populations in prison and the lack of systematic programming for them and support when they get out is a critical issue. Because if somebody has gone to jail for a nonviolent drug offense, and they are not getting treated and provided with some baseline of skills and some hand-holding when they are released, they are going to get back into trouble. And the Department of Justice is working very closely with our Office of Drug Policy to find ways that we can improve -- at the federal level -- reentry programs, drug treatment, and so forth. Now, keep in mind that the vast majority of the criminal justice system is a state-based justice system. The federal government is not responsible for the majority of drug laws, the majority of incarcerations, or how the reentry works upon release. What we are hoping, though, is if we model best practices based on evidence, that more and more states will adopt it. If you can reduce the amount of recidivism, then you are saving money. The same is true, by the way, preventing people from getting addicted in the first place. We wait until people get sick and then we treat them. And that requires I think a reimagining of how our health system works. Very specifically, when it comes to opioids, the training of doctors for pain and pain relief, and how they help their patients manage pain -- this is an area where I was shocked to learn how little time residents in medical schools were spending just trying to figure this stuff out. It is not emphasized. Wen, you can share your experiences -- that pain relief was talked about a lot but only in the context of giving out drugs. The literature would all suggest, if you look back at those small reports, that there was no concern for addiction. And every single time someone came into an emergency room, even for a non-pain-related thing, they would be asked about pain and perhaps given narcotics. And we then developed this culture also of a pill for every pain. But somehow we have said that our goal is to make people pain-free. And I know that doctors are trying to do the right thing. We need the resources to help us to then support us -- whether they are the guidelines as issued by the CDC, or whether they are other efforts by our medical societies to assist us, to make better decisions for our patients. But we also need our patients and we need society to change, too. But the over-prescription of antibiotics has led to increased resistance among the bacteria that need to be treated. And so the doctor is right. We have to have a chance in the medical profession and the drug companies, and we have to hold them more accountable. We, as consumers and as parents, have to be more accountable, as well, in terms of how we approach keeping our families well in order for us to be able to prevent this massive gateway into addiction that can cause real problems. Frieden is here from the CDC. The CDC has released some of these new guidelines regarding opioid prescriptions saying that, look, pretty plainly stated -- I listened to you closely -- saying that these opiates should not be a first-line treatment for chronic pain. The FDA now talking about black-box warnings on these medications as well to say there is a risk of abuse, of addiction, and even death from these things. So there are some solutions, some things that are changing as a result. One of the things you said, Mr. And I want to ask you, Justin, about that. Outside of this room, people talk about the fact that, is this a choice? Is there a component of moral failure? All those things. Your experience, and also how do you counsel the people and -- young people in recovery, the organization? My sister is the doctor. But what I really am, what I would consider myself an expert in is opportunity and hope. President, which this is good for everybody. Giving people an opportunity to get the resources and the tools that they need so they can and will and do recover all over the place. Friends of mine who ended up battling addiction were not less worthy or more morally suspect than I was. For whatever reason, things broke that way. There may end up being genetic components to how susceptible you are to addiction, and addictions may be different for different people. And it is affecting everybody. And I now have kids in high school and I am well aware that their access to -- their ability to access legal or illegal substances is very high. They are just less likely to get in trouble, get thrown in jail, and have a permanent felony record than the kids who live in those inner cities. And the same is true for addiction. But truly, though, I mean -- right? Hal Rogers, I just want you to take note. RILEY: So to continue to put a bow on the correctness, if you will, is, you know what -- again, you are absolutely correct. I used to think -- and even I think my family went through, well, what do we do? Tell me what to do for him. If we did this or if we did that, will the result change? This is an all. And it is -- I mean, for us, the way that we talk about -- you asked, which is why I wanted to pipe back in, right -- is that what do we do with our members? I mean, what are we doing that is so exceptionally, extraordinarily different than other places? Because I was given great opportunities. I was given amazing, different types of programs and treatment. But it was in a single moment in time when somebody look eyeball-to-eyeball with me and said, you have value; that regardless of maybe some of the choices you made, whether you put those claws there, whether somebody else did, is that you have value. And one day, you've got a lot to learn and you've got to listen and stop talking so fast -- laughter -- but you've got to focus up, and you have to know that you have value so you can give other people hope and help equip them and empower them. And the way that we do that is through employment, housing, education, and other recovery-related resources. And those first three -- that is not unique to young people or even when I was even younger, right --or people of any age or of any recovery pathway. Those are things that individuals -- all individuals in this country need. And when we start to have that conversation, that's how we go all in, and we support adequate recovery resources and employment, housing, and educational resources. We can do this thing together. GUPTA: I'm so glad you said that, because this is a multidimensional issue and we have to address all these things. I want to ask almost about the next step. And this is s a story, Mr. President, I know is very personal to you -- the story of Jessica Grubb. Somebody goes in, they've gone through recovery now, they're in recovery, and they go in the hospital for something unrelated, and they're given a prescription for narcotics, for opiates again. They tell the doctors, look, I'm a drug addict, I cannot take this stuff -- if I do, I'll be right back on the road to addiction again and I could even die. That is what happened with Jessica Grubb. President, the stigma exists at all levels, even within the medical establishment -- after someone has been treated, someone is in recovery, even then, eh, you'll be fine, I'll still give you these opiate pain medications. There's been some controversy in this discussion around making this education mandatory, and I think the medical community worries about their independence over regulation of the medical communities. We have been getting some good volunteer efforts going, and I applaud those. We have to see how good the take-up is, because if, in fact, the training is not sufficient, then we may have to take a look at the possibilities of mandatory training. I will tell you that within the federal government, for example, we have said, if you're going to treat somebody who is a federal employee or part of the federal health insurance program, you need to get trained. And so far, I think we have about 75 percent of the medical community that treats federal employees. I was able to do that through an executive action. But I'd just go back to Crystal's point. I don't want Crystal -- if she is ready to get treatment and to do right by her kids, I want somebody who is fully supportive who she is interacting with on day one. I don't want somebody who has got an attitude. I don't want somebody who is misinformed. I don't want somebody who is not familiar with the best options that are available. I want somebody who is going to embrace her and say, let's go, let's see what we can do for you. And I want to make sure that those doctors -- and perhaps nurses as well -- because in some communities, there aren't going to be enough doctors, and one of the issues that we have to address is, can we use -- and I just happen to love nurses as a general rule -- applause -- because they are overworked, underpaid, and are really just the foundation for so much of our health care system. But all the providers, I want to make sure that they're getting the resources and the reimbursements through whether it's third-party insurance, or Medicaid, or Medicare, in order for them to be able to do right by Crystal. Because it's hard. And when somebody is ready to make that change, I want somebody to be right there with them, welcoming them -- not turning them away. WEN: And, Mr. President, I would also add that we need people like Crystal and Justin and other people in recovery working, as well, and, specifically, working with individuals with addiction. In Baltimore -- so I'm very proud to represent the Baltimore City Health Department, and on behalf of our mayor, Mayor Rawlings-Blake, as well, who really care about addiction as a public health issue. And we have individuals in our health department working at 24 needle-exchange sites across the city. Which, our needle-exchange program -- I'll tell you one statistic that continues to really surprise me, but also this is why we do the work that we do -- the percentage of individuals with HIV from IV drug use has decreased from 64 percent in to 8 percent in And these individuals who work in our needle-exchange vans, most of them are in long-term recovery themselves. And for them to say to people coming -- to their clients and patients coming that you should think about quitting, and this is what we can do, we can help you with it, we can guide you through -- that's so much more powerful than me as a doctor saying to someone that recovery is possible. And we do the same thing when it comes to violence prevention as well. We also believe that violence, just like addiction, just like other diseases, can spread. So we have a program in our city called Safe Streets -- that actually came from Chicago -- from Chicago's Cure Violence program -- where we hire individuals who were recently incarcerated, who were recently released from incarceration to walk the streets of Baltimore and interrupt violence. And these people are true heroes, and we need to find a way to reimburse and pay for peer-recovery specialists, who are the most credible messengers, who have walked in the shoes. But really we've seen -- that excitement, that person that you described, Mr. President, that when they're ready to get help, I mean, imagine them meeting me. If I can't encourage you, your encourager is broken. You meet me on your day of need and help and you meet other young people and other people who are in recovery that have walked that journey -- who better to do that along with other professionals? Again, it's not either-or. It isn't just simply now only fund peers. It is also fund massive and massive amounts of them. And one of our recent success stories is we said a long time ago -- and, again, I'm going to go back to that blunt thing -- is we decided to say we're just going to put our money where our mouth is and we're going to be the solution, in the meantime, until all these policies change. And so what our chapter leaders and members have been doing is they've been providing those direct services and hosting our recovery support meetings, helping build recovery schools, collegiate recovery communities. And that action has been able to attract enough attention, because we're doing it, we're not waiting for things to change. Our amazing leaders are literally changing the communities, regardless of buy-in stigma, buy-in straight out discrimination against our own population. But what has happened is even big insurance companies and other providers have come up and said, we will literally even pay you to further build out your own infrastructure, to put chapters around our communities. And this is a win-win. Again, this is good for everybody. So now big insurance says, we're going to pay you to go do what you were already going to do anyway. It helps the people in recovery. It helps the people that need recovery. And we're saving a ton of money -- not like Geico -- but, like, insurance because we're making sure that we're getting the money and the cost savings back because they're not going through that system again and again and again. If we equip and empower, and not handcuff and jail people that are not well, and we focus on their wellness, that's part of the change. Is there a way to describe -- now that you've heard Crystal's story, for example -- a way to describe how her life will change, or a future Crystal's life would be different? So I want to be very clear about that. We've been able to reallocate some existing dollars for, for example, the community health centers. But this is still an area that's grossly under-resourced. So we're going to have to work with Congressman Rogers and other members of Congress to support policies that they've already embraced that's already reflected in legislation. But the way Congress works, sometimes they'll say this is a good idea, but until the money comes through, it's just that -- just an idea. It doesn't actually get done. Crystal, remind me where you live. Where were you during this time where you entered into recovery? THE PRESIDENT: I mean, one of the ways I would hope it would change -- and I don't know how easy or difficult it was for you to identify when you were ready to really make a change, where you could get treatment, and how long the waits were -- but I think the most basic thing that I'd like to see is that there is greater coverage of terrific programs like Justin is describing, good work that's being done by Leana in Baltimore. I want to make sure that there's sufficient coverage everywhere. Part of what is troubling about the opioids epidemic is that we're seeing significantly higher spikes in rural areas. And part of that is because there has been a lot of under-resourcing of treatment facilities, mental health facilities. There may be, in some of those cases, more stigma than there might be in big cities about getting help. If you're in a small town, everybody kind of knows you -- you may be more hesitant, right? I don't know if that's an experience that you felt. So part of what I think our goal is, is to make sure that we have, in counties all across the country, at least some resources that can get things started. Because as great as the work that Justin is doing, volunteer organizations are not going to be able to do it all. And I want to emphasize -- there's wonderful work being done by the nonprofit sector and the philanthropic center, and we applaud that. For some, a faith-based approach is going to be critical to being able to get the wherewithal and the courage to be able to get through this thing. Say, you got an amen? Community health centers are a very efficient way to do it, but there are -- we have to make sure that local hospitals, individual providers, insurance companies, Medicaid expansion are all part of this as well. And this takes me back to why I pushed so hard for the Affordable Care Act. I understand. I understand the politics of it. Even within the VA system, which has coverage all across the country. And it discourages people from using it. They start feeling isolated and they start self-medicating. Money is not the entire issue. Very rarely is money the solution alone. But money helps. And without it, without the government, without us, collectively, as a society, making this commitment, what we will repeatedly end up with is being penny wise and pound foolish. That affects their schoolwork. That, in turn, has an impact on our economy as a whole. And I hope that this conference will help underscore that. The White House. For Immediate Release. EDT DR. Thank you very much. I mean, was this -- MS. What do you think, Doctor Wen? How did we -- how did that happen? I live in Shelby, Ohio. President, thank you very much. END P.

HRB National Drugs Library

Malia buying Heroin

The Lounge: Chat. Comments Showing of 42 42 new post a comment ». Aug 11, AM. I'm nowhere near legalization camp, but I thought weed should be part of international protocol. Maybe with Obama and Putin sharing one joint in Oval office or Kremlin the antagonizm could be a bit less acute? After he leaves office who knows how he will unwind - especially at Oprah's lavish Hawaii estate! It is funny what the Presidency, and more broadly politics, does to people. Al Gore lost in because he was seen as stiff and boring, but he did a fair bit of voice work on Futurama after the election, and listening to him on that show, he sounds like an entirely different person. A commentary on one of the episodes, they talk about how he threw himself into the work, diving into a couch during one of the sessions. Beneath that stiff appearance, there was a fun side to the man that his career in politics had suppressed. On a side note, his daughter had joined the writing staff during the show's initial run on Fox The title of this thread Pot's gonna be legalized here 'soon' 3. No comment. I'm definitely for legalization, mainly for economic reasons. But I think nationwide, decriminalization needs to happen. I lived in Ontario for most of my wife where decriminalization happened. Now I live in BC, where weed is practically the provincial flower! And yet, the law remains mired in the previous century. Police use their discretion when it comes to enforcement though, clearly. There's a weed dealer on the block near to where my wife works at a Ministry, no less! There's no secret as to what he's doing, but I have yet to see police attempt to shut him down. Matthew wrote: 'There's no secret as to what he's doing, but I have yet to see police attempt to shut him down Or could they be partners in some of those cases? Aug 11, PM. Yep Nik, it may help global relations no end if they pass a joint round and chill out a bit. They decriminalised possession, and put the money saved through reduced policing costs into drug rehab. Drug use in Portugal decreased as a result. I agree with decriminalisation for the reason that buying drugs enriches criminals. It scares me how rich and powerful they are becoming. I'm for legalisation. Feb 25, AM. How do you think the retirement goes for Obama's family? Do you think they enjoy free time or are concentrated on writing a memoir? Feb 25, PM. I think Michelle was never ok with public life, and Obama is probably enjoying having his less stressful life back. Sure, there will be a memoir, a library, and further public service, but if I were in their shoes, I'd take a long vacation from all of it. What would you do? Scout wrote: 'What would you do? After the rehab - just enjoying life and lecturing seems sufficient, but if a person manages to find something very meaningful to engage in - it's even better. Mar 01, PM. I guess they've found something to do, and it's very lucrative. Something about this just doesn't jibe with their devotion to public service. Scout wrote: 'I guess they've found something to do, and it's very lucrative. Something about this just doesn't jibe with their devotion to pub If it were an unannounced severance pay, that would be kinda problematic Mar 04, PM. This doesn't meet the definition of public service by any means. I know other presidents have had book deals, but nothing like this. Mar 04, AM. Legalization or not, nobody's waiting it seems Mar 05, PM. I'd guess Republicans would be against legalization because their base is conservative. I consider myself a conservative regarding immigration and government spending, but I'm liberal in my ideas on abortion and pot. A candidate who thinks like I do would never be elected. Sep 28, AM. As I understand the legalization of marihuana marches on state level in the States, but not on federal one. Is it on the agenda at any level in coming elections? Sep 29, AM. It's still illegal according to federal law, but that's not enforced. If Bernie had been elected, it would have become legal. Who knows what Joe will do? As with everything else, he's not taken a stand. Scout wrote: ' If Bernie had been elected, it would have become legal Um, he was too high to get the nomination. No hurry, maybe in another 4 years :. For what it is worth, in the coming NZ elections, there is also a referendum question on legalizing marijuana. No idea how it will go because the actual election is swamping it. Medical marijuana is legal here already. Oct 01, PM. Has your opinion changed at all? Not really, Scout. I know there are valid arguments both ways, but I don't think at least here it will stop the black market, which is the main reason for having it, because governments like to put on a tax. I think there is evidence that, with lower probability, there can be unfortunate long-term problems. As an aside, here medical CBD is legal already, and I am happy with that. Oct 06, PM. I don't think anything will stop the black market, but if it's legalized, at least you know that what you're getting is free from harmful additives such as PCP, and you know the dosage you're getting, which seems like a plus to me. And it can be taxed, which helps the economy. People will use it whether it's legal or not, and I think I've made a practical case for legalization. Oct 11, AM. Nik wrote: 'As I understand the legalization of marihuana marches on state level in the States, but not on federal one. If passed, 21 or over, you are allowed to have 1 oz of marijuana for personal use and grow up to 6 plants in a locked, non-public area. It sets up the Department of Health to regulate it, including licensing stores and production facilities. We have medical marijuana approved already, but have to jump through hoops of doctor appointments, forms, and fees, along with the right amount of cash for each. I see this issue in the same way as prohibition of alcohol. To take the crime out the only successful route is legalization and regulation. The government and society gains by tax revenue and reduced costs of crime fighting prevention. As with alcohol and tobacco there will be a medical cost There is now for addiction or side affects. Logically legalizing drugs Not just pot makes sense but sense is not common especially in politicians. Noting slow changes in many countries e. Canada, Netherlands and elsewhere. AZ proposition seems sensible. NZ has an election next weekend, and on it are two additional referenda, one for the legalization of marijuana, under a battery of regulations. We shall see what NZ thinks then, although I gather it may take a few days to count the referenda votes counting MPs votes takes precedence. Oct 11, PM. Philip wrote: 'I see this issue in the same way as prohibition of alcohol. The government and society gains by tax revenue and red I advocated for make it legal and tax it when I was 13, at which age I had not tried it, it just seemed sensible given what happened with prohibition. Interestingly, there is a lot of cigs sold around here for cheap that have no tax stamp. Smuggling them in for a clientele from across the border is pretty common. Oct 15, PM. I'm all for legalization, yet I've had the opportunity to acquire some pot and haven't done it yet. I think it may help with my back pain, but I'm not sure about the psychological effect it may have, as I have a low tolerance for all types of drugs. I don't like losing control. I do think I will eventually try it, but will be careful with dosage. If it were legalized, I'd be able to control the dosage instead of taking a chance on street pot, which is unregulated. Oct 18, AM. Scout wrote: 'I'm all for legalization, yet I've had the opportunity to acquire some pot and haven't done it yet. I think it may help with my back pain, but I'm not sure about the psychological effect it may hav Read up on it or find a friend who can tell you about the differences. Sativa vs. I gather when buying it with a medical card that the amounts are somehow determined and listed, at least it's what I was told in AZ. Ultimately, it comes down to our individual responses. Stoned paranoia is never a good look for me, which I gather from my reading is related to the amount of THC. At the same time, it's the THC they say that helps with the sleep issue. I guess like many things in life, it's about finding the right balance. I gather THC is the 'stoning' component. Oct 20, PM. Ian wrote: 'I gather THC is the 'stoning' component. Our proposition on the ballot is to make personal use legal - no med card needed. Up to 1 oz and you can grow 6 plants. Oct 21, AM. That is something like our referendum. The voting here is over, but it will take a week or so to count them, as sorting out the politicians takes precedence. Oct 22, PM. Let us know how it turns out, Ian, and what you think about the results. I shall. Right now they are carefully sorting a couple of close electorates, and this is a long holiday weekend coming up, which will slow things. Nov 03, PM. I have a lot of friends who suffer with pain and sleep problems that don't want to be on medical card list who are pleased to now have options. I have other friends, also suffering, who will not ever try alternatives to prescription medications. My doctor's preference is to try it and reduce the dosage in the fentanyl patch. I do find it surprising that so many people in my age group are anti-legalization even for medical use only while being quite willing to continue paying big pharma for a medication with so many warnings of negative side effects. Nov 04, PM. You guys know I'm for legalizing marijuana, although it hasn't passed in my state. I wonder what you think of this recently-passed legislation: 'A nationwide push to relax drug laws took a significant step forward Tuesday as voters made Oregon the first state to decriminalize the possession of small amounts of street drugs such as cocaine, heroin and methamphetamine. The way I read that, the proposal is to send small users to a rehab facility rather than jail, which if that is the case, I approve. It is not legalizing the drugs, on my reading; merely trying to help the unfortunates to get a life back. It probably will only have modest success, but it is still worth the effort. Nov 05, AM. Allowing for its price, calling coke a 'street drug' doesn't do it justice.. I kinda suspect many would be surprised how much of it is consumed by politicians, top tier biz, celebs, justices, law enforcement, lawyers and others :. Nov 05, PM. Nik wrote: 'Allowing for its price, calling coke a 'street drug' doesn't do it justice.. I kinda suspect many would be surprised how much of it is consumed by politicians, top tier biz, celebs, justices, law Scout wrote: 'You guys know I'm for legalizing marijuana, although it hasn't passed in my state. I wonder what you think of this recently-passed legislation: 'A nationwide push to relax drug laws took a signifi Overall, I think we as a nation need to recognize that addiction is beyond race, gender, income, vocation or anything else and that our young people will continue to be lost to what is a disease and not simply a moral failing. To do that, we need treatment facilities that are not tied to whether we have health insurance to cover inpatient and outpatient treatments. Sadly, it was those who could afford it that benefitted as those who couldn't and whose insurance didn't cover it rarely benefitted from it. I hope Oregon is able to put in place a program that works. Jun 20, AM. Wonder whether Malia and Hunter enjoyed same suppliers and shared moments of 'happiness? Add a reference: Book Author. Search for a book to add a reference. World, Writing, Wealth. Group Home Bookshelf Discussions. Photos Videos. Send invite Members Polls. Welcome back. 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Malia buying Heroin