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OFFICE OF NATIONAL DRUG CONTROL POLICY: 

REAUTHORIZATION IN THE 115TH CONGRESS 

HEARING 

BEFORE THE

COMMITTEE ON OVERSIGHT 

AND GOVERNMENT REFORM 

HOUSE OF REPRESENTATIVES 

ONE HUNDRED FIFTEENTH CONGRESS 

FIRST SESSION 

JULY 26, 2017 

Serial No. 115–35 

Printed for the use of the Committee on Oversight and Government Reform 

( 

Available via the World Wide Web: http://www.fdsys.gov 

http://oversight.house.gov 


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COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM

Trey Gowdy, South Carolina, Chairman 

John J. Duncan, Jr., Tennessee 

Darrell E. Issa, California 

Jim Jordan, Ohio 

Mark Sanford, South Carolina 

Justin Amash, Michigan 

Paul A. Gosar, Arizona 

Scott DesJarlais, Tennessee 

Blake Farenthold, Texas 

Virginia Foxx, North Carolina 

Thomas Massie, Kentucky 

Mark Meadows, North Carolina 

Ron DeSantis, Florida 

Dennis A. Ross, Florida 

Mark Walker, North Carolina 

Rod Blum, Iowa 

Jody B. Hice, Georgia 

Steve Russell, Oklahoma 

Glenn Grothman, Wisconsin 

Will Hurd, Texas 

Gary J. Palmer, Alabama 

James Comer, Kentucky 

Paul Mitchell, Michigan 

Greg Gianforte, Montana 

Elijah E. Cummings, Maryland, Ranking 

Minority Member 

Carolyn B. Maloney, New York 

Eleanor Holmes Norton, District of Columbia 

Wm. Lacy Clay, Missouri 

Stephen F. Lynch, Massachusetts 

Jim Cooper, Tennessee 

Gerald E. Connolly, Virginia 

Robin L. Kelly, Illinois 

Brenda L. Lawrence, Michigan 

Bonnie Watson Coleman, New Jersey 

Stacey E. Plaskett, Virgin Islands 

Val Butler Demings, Florida 

Raja Krishnamoorthi, Illinois 

Jamie Raskin, Maryland 

Peter Welch, Vermont 

Matt Cartwright, Pennsylvania 

Mark DeSaulnier, California 

Jimmy Gomez,California 

SHERIA CLARKE, Staff Director 

WILLIAM MCKENNA General Counsel 

MARY DOOCY, Counsel 

SARAH VANCE, Professional Staff Member 

SHARON CASEY, Deputy Chief Clerk 

DAVID RAPALLO, Minority Staff Director 


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C O N T E N T S 

Page 

Hearing held on July 26, 2017 ............................................................................... 1 

WITNESSES 

Mr. Richard Baum, Acting Director, Office of National Drug Control Policy 

Oral Statement ................................................................................................. 5 

Written Statement ............................................................................................ 8 

Ms. Diana Maurer, Director of Justice and Law Enforcement Issues, U.S. 

Government Accountability Office 

Oral Statement ................................................................................................. 27 

Written Statement ............................................................................................ 29 

Keith Humphreys, Ph.D., Professor of Psychiatry and Behavioral Sciences, 

Stanford University 

Oral Statement ................................................................................................. 46 

Written Statement ............................................................................................ 48 

Mr. Don Flattery, Addiction Policy Advocate and Impacted Parent 

Oral Statement ................................................................................................. 51 

Written Statement ............................................................................................ 54 

APPENDIX 

Letter of May 16, 2017, to the Office of Management and Budget, submitted 

by Ms. Norton ....................................................................................................... 82 


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OFFICE OF NATIONAL DRUG CONTROL 

POLICY: REAUTHORIZATION IN THE 115TH 

CONGRESS 

Wednesday, July 26, 2017 

HOUSE OF REPRESENTATIVES, 

COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM, 

Washington, D.C. 

The committee met, pursuant to call, at 10:41 a.m., in Room 

1100, Longworth House Office Building, Hon. Trey Gowdy [chairman of the committee] presiding. 

Present: Representatives Gowdy, Jordan, DesJarlais, Massie, 

Meadows, Ross, Walker, Blum, Hice, Russell, Grothman, Comer, 

Gianforte, Norton, Clay, Lynch, Connolly, Watson Coleman, 

Plaskett, Demings, Krishnamoorthi, Welch, and DeSaulnier. 

Chairman GOWDY. The Committee on Oversight and Government 

Reform will come to order. 

Without objection, the chair is authorized to declare a recess at 

any time. Before Mr. Connolly and I give our opening statements, 

I do want to thank everyone, our guests, our panelists, those in the 

audience, the members and staff, and everyone, for how accommodating you were this morning. We had an unforeseen contingency 

that arose in our normal hearing room. So thank you for being so 

understanding. 

Over the past 2 decades, illicit drug use has emerged as a public 

health and safety crisis, with overdoses becoming the leading cause 

of injury or death in the United States. Opioids, specifically heroin 

and prescription pain relievers, are the cause of most overdose 

deaths in the United States, with the death rate more than doubling since the year 2000. 

In South Carolina, which is where I’m from, at least 95 people 

died from heroin in 2015, which is almost twice as many as the 

previous year. And more than 560 died from the abuse of prescription opioids over the same period of time. The epidemic is growing 

and lives are at stake, literally. It is imperative our Nation maintain a strong coordinated effort across the Federal Government to 

combat drug abuse from design, manufacturing, distribution, prescription, and consumption. 

In 1988, Congress established the Office of National Drug Control Policy as part of the Anti-Drug Abuse Act to coordinate drug 

programs across the Federal Government, advise the administration on national and international drug control policies, and create 

and oversee the National Drug Control Budget. ONDCP is uniquely 

equipped to address what role the Federal Government can play in 


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determining what kinds of clinical, social, welfare, and economic 

programs could impact and reverse drug abuse problems in our 

country. 

ONDCP was last authorized in 2006. The authorization lapsed in 

2010, but the office has continued to receive appropriations each 

year. In December 2015, this committee held a hearing to discuss 

various proposals for reauthorization. We heard from the then director who testified combatting the abuse of prescription drugs was 

a top priority for the agency. However, since then, ONDCP has 

failed to produce a formal National Drug Control Strategy and a 

National Drug Control Budget, which is supposed to be released no 

later than February 1 each year. 

In the meantime, deaths due to opioid overdoses have only increased in the U.S. in 2016. No office is perfect. God knows Congress certainly is not, but it is our responsibility, nonetheless, to 

see that deadlines are met, particularly statutory deadlines, resources are well spent, and the leadership that can be provided nationally is being provided. There is a prevention aspect, a treatment aspect, an education aspect, an enforcement aspect, a punishment aspect, and an oversight aspect, the Federal Government has 

long occupied a space as it relates to both the illicit use of legal 

drugs and the use of illegal drugs. 

Today, we will have an opportunity to consider options for reauthorizing ONDCP and learn about how this agency can work for 

the goal of reducing and ultimately eliminating our Nation’s opioid 

crisis. We will also examine how ONDCP can help mitigate the significant harm communities across America have felt as a result of 

our Nation’s opioid crisis. 

There are many areas worthy of exploration today, and we thank 

all of our witnesses for appearing before the committee. We look 

forward to your testimony as we consider next steps for reauthorization. 

And with that, I would recognize my friend from Virginia. 

Mr. CONNOLLY. I thank the chair, and I want to thank him personally for having this hearing. I also want to thank him personally for his absolute willingness to accommodate our witnesses and 

to hear the case for why we felt, especially Mr. Flattery being 

added, really would add a dimension of a personal story that Mr. 

Flattery has courageously been willing to share. And I just thank 

my friend from South Carolina. 

And this is an area where we can find common ground, where 

bipartisan cooperation must occur, and I know the chairman is 

committed to doing it, as am I. 

We’re in the midst of a national public health emergency. The 

opioid epidemic has taken thousands, tens of thousands of lives 

across America, and unfortunately, shows no signs of ending. Every 

day, every day, 91 Americans die from an opioid overdose. This epidemic doesn’t care where you live or what political party you belong to. The crisis has touched every corner of our Nation. 

Where I come from, Northern Virginia, is no exception. Fairfax 

County, which I chaired for 5 years, reported more than 100 drugrelated deaths last year. Prince William County, the other county 

I represent, reported 52. These are astronomical numbers by our 

normal standards. 


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Today, we have on our panel Don Flattery, a father from Fairfax 

County, and his wife has joined him here today too. His son, their 

son, Kevin, tragically lost his life to opioid overdose 2 years ago— 

3 years ago. Kevin was a graduate of the University of Virginia. 

He aspired to a career in film making, but he became addicted to 

OxyContin because of a medical prescription and a particular medical condition, and he died at the age of 26. 

Mr. Flattery has been an outspoken advocate for the need to address this crisis, and we all welcome his testimony here today. 

Every day, people across the country die from drug addiction. 

Families are torn apart. Americans are suffering. The crisis cannot 

wait. As Members of Congress, we’ve got to do everything we can 

to assist and ameliorate and reverse this crisis. Unfortunately, 

we’re not sensing that same sense of urgency from the administration. On the campaign trail, President Trump repeatedly promised 

action. He said, and I quote: We’re going to help. The people that 

are seriously addicted, we’re going to help those people, unquote. 

But we’re 6 months into the administration and the President 

has still not appointed a drug czar to lead the Office of National 

Drug Control Policy, nor has the administration produced a National Drug Control Strategy. Instead, what the President has done 

is propose cutting the programs that are already working. His proposed budget would cut $370 million to the Substance Abuse and 

Mental Health Services Administration, which provides grants for 

opioid overdose drugs, mental health, and prevention programs. In 

the midst of a national emergency, we cannot accept that. 

The President’s efforts to repeal the Affordable Care Act also 

would have devastating effects on Americans suffering from drug 

addiction. The latest effort to repeal the ACA would take health insurance away from 2.8 million people with substance abuse disorders. Let me repeat that: 2.8 million. Congress must not let that 

happen. Additionally, repeal of the Affordable Care Act could also 

make it difficult for individuals with substance use disorders to 

find the help they need. Legislation repealing the bill would allow 

States to waive the ACA requirement that mental health and substance abuse treatment are part of the essential health services. 

This would leave many of those seeking help without insurance 

coverage on those areas for the very treatment they desperately 

need. 

We’re here today to discuss reauthorization of the Office of National Drug Control Policy. This office plays a critical role in coordinating the Federal response to our Nation’s drug epidemic. The office manages a budget of more than $370 million and coordinates 

the related activities of 16 different Federal departments and agencies. 

ONDCP also administers two Federal grant programs. Communities in my district, for example, have been fortunate to receive assistance for what’s called the High Intensity Drug Trafficking Area 

Program, which provides grants to localities and States and Tribal 

areas to counter drug trafficking activities. 

In 2010, we saw a shift to emphasizing public health based services within the National Drug Control Strategy. I look forward to 

hearing more about the importance of a comprehensive approach to 

this challenge. Prevention and treatment are important tools workVerDate Nov 24 2008 09:02 Feb 06, 2018 Jkt 000000 PO 00000 Frm 00007 Fmt 6633 Sfmt 6633 H:\27603.TXT APRIL

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ing together, as the chairman suggested, in how we approach this. 

What is also important is ensuring that any national drug control 

strategy is based on empirical evidence and one that prioritizes results over prior beliefs or ideology. Evidence should always guide 

public policy, particularly when addressing matters of public health 

and safety. 

We’ve witnessed the perils of failing to follow that prescription 

in our marijuana policies, and cannot afford to repeat just costly 

mistakes. This committee held a number of hearings on that topic 

in the last several years, and each time I noted we have no empirical evidence that justifies marijuana as classified a Schedule I 

drug. In fact, the U.S. National Institute on Drug Abuse, NIDA, 

which for years was the sole Federal entity that controlled access 

to the Federal Government’s lone research supplier of marijuana, 

was unwilling to fund or conduct any Federal research into the 

question of whether marijuana might have positive benefits. 

This lack of empirical evidence to support our policy has lead us 

down a dark path, wherein our national drug policy has provided 

cover for arresting all too many minority Americans for nonviolent 

offenses at rates up to eight times those of White Americans, and 

filling our prisons beyond maximum capacity, scarring them and 

their families, often for life. We’ve got to rethink that approach, 

and it’s got to be empirical based. 

I want to thank our panelists for being here today, Mr. Chairman, for their contributions to the Office of National Drug Control 

Policy and their personal contributions to this dialogue. And I want 

to reiterate my commitment to cooperate with you, Mr. Chairman, 

and our mutual staffs to make sure that we are aggressively addressing this critical issue that is now afflicting our country. 

Thank you so much. I yield back. 

Chairman GOWDY. The gentleman from Virginia yields back. 

We’ll hold the record open for 5 legislative days for any members 

who would like to submit a written statement. 

I’m going to recognize our witnesses. I will recognize you from 

my right to left and then introduce you that way and then recognize you for your opening statements. I would tell all the witnesses, 

your opening statement is part of the record. I am sure that my 

colleagues have read it. So to the extent you can, keep your opening statement within 5 minutes so the members can have an active 

dialogue with you. 

Our first witness is Mr. Richard Baum, Acting Director of the Office of National Drug Control Policy. Next, we have Ms. Diana 

Maurer, Director of Justice and Law Enforcement Issues at the 

Government Accountability Office. We have Dr. Humphreys, who is 

a professor of psychiatry and behavioral sciences at Stanford University. And Mr. Don Flattery, who is an addiction policy advocate 

and a parent who has been impacted by today’s subject matter. 

We want to welcome all of you, and thank you for being here. 

Pursuant to committee rules, all witnesses are to be sworn in before they testify. So I would ask you to please rise and lift your 

right hand. 

Do you solemnly swear the testimony you’re about to give is to 

be the truth, the whole truth, and nothing but the truth, so help 

you God? 


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May the record reflect all the witnesses answered in the affirmative. You may sit down. 

With that, we will recognize Director Baum. 

WITNESS STATEMENTS 

STATEMENT OF RICHARD BAUM 

Mr. BAUM. Chairman Gowdy, Ranking Member Connolly, and 

members of the committee, thank you for inviting me to appear before you today to discuss the activities of the Office of National 

Drug Control Policy. 

Mr. CONNOLLY. Is your mic on? 

Mr. BAUM. How’s that? Is that better? 

Mr. CONNOLLY. I think it just might be old age on our behalf. 

Mr. BAUM. Do I need to get real close in there? 

Mr. CONNOLLY. That’s good. 

Chairman GOWDY. That’s good. 

Mr. BAUM. All right. I’m going to start over. Can you restart the 

clock for me? 

Chairman Gowdy, Ranking Member Connolly, and members of 

the committee, thank you for inviting me to appear before you 

today to discuss the activities of the Office of National Drug Control Policy. It’s a tremendous honor for me to be here and to serve 

as acting director of the agency where I’ve worked for two decades. 

At ONDCP, we have a dedicated team of policy experts who are 

working to address the opioid crisis and the full range of drug 

threats our country faces. Having the strong support of the President, his administration, and Congress, particularly, this committee, means a great deal to us. 

Given the state of this crisis, reauthorizing the office charged 

with responding to it is more important than ever. Thank you for 

taking this on. We’re grateful. 

As you are all aware, we’re in the midst of the worst drug epidemic in U.S. history. In 2015, we lost more than 52,000 people to 

drug overdose, including more than 33,000 to overdoses involving 

opioids. The opioid epidemic began with the overprescribing of prescription drugs and has evolved to include heroin, and increasingly, 

illicit fentanyl. 

In my time as acting director, I’ve met with parents who have 

lost children, visited communities hit hard by this epidemic. When 

I was in Johnstown, Pennsylvania, students at the University of 

Pittsburgh, Johnstown, had just found out that a star on the wrestling team had died of an overdose involving fentanyl. It’s heartbreaking to hear the stories of lost lives, and we know these are 

stories you’ve heard in your districts and all over the country. 

Most lethal drugs are not made in the U.S., and ONDCP works 

with Federal and international partners to improve international 

drug control and dismantle the organizations that traffic these 

deadly drugs into our communities. Beyond opioids, we also face a 

rapidly growing threat from cocaine, as well as serious threats from 

methamphetamine, synthetic drugs, and marijuana. I look forward 

to discussing these specific drug threats in more detail in the Q&A. 

ONDCP serves as the lead drug control agency and advisory to 

the President on drug issues. Our activities include policy developVerDate Nov 24 2008 09:02 Feb 06, 2018 Jkt 000000 PO 00000 Frm 00009 Fmt 6633 Sfmt 6633 H:\27603.TXT APRIL

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ment, coordination, and drug budget oversight, as well as targeted 

grant funding. Our position within the White House provides a 

platform to build support for proven strategies to address quickly 

evolving drug threats. 

ONDCP strongly supports a comprehensive policy approach to 

address all aspects of the drug problem, supply and demand. Reducing the drug supply is critical to our overall efforts. The U.S. 

must use every tool available, including working with partner nations on drug crop eradication, land and sea interdiction, and destroying the criminal networks which bring these substances into 

our country and smuggle illicit proceeds out. Domestic law enforcement, including State and local agencies, play a critical role in reducing drug availability and building cases against trafficking 

groups. 

ONDCP also plays a critical role in promoting the science of addiction and evidence-based treatment and breaking the stigma surrounding substance abuse so people will be more likely to seek 

treatment and to achieve and maintain lifetime recovery. Prevention is a vital component of addressing drug abuse in this country. 

I’ve, therefore, made it a priority to reinvigorate a national prevention effort to engage youth in schools and online. This is a critical 

component for preventing drug use from beginning in the first 

place. 

ONDCP is also focused on supporting ways for the criminal justice system to better address addiction within its populations. For 

many people, engagement with the law is the first opportunity to 

access treatment services. Whether through pretrial or prearrest 

diversion to treatment via drug courts or through treatment within 

correctional settings, it’s better for all of us that those who need 

treatment receive it. 

As you know, ONDCP writes the President’s National Drug Control Strategy, which provides a comprehensive and science-based 

national approach to reducing the use of illicit drugs and their consequences. This strategy is guided by input from Members of Congress and other stakeholders. The Trump administration envisions 

an action-oriented strategy, and our efforts to prepare the President’s inaugural strategy are underway. And I’m happy to get more 

into this in the Q&A. 

One of our greatest strengths is the ability to coordinate drug 

control activities across the Federal Government and work directly 

with State, local, Tribal, and international partners to further the 

administration’s drug policy goals. We use our budget oversight authority to prevent duplication and make sure Federal dollars are 

well spent. We work to lift up innovative programs at the State 

and local level, such as the Police Assisted Addiction and Recovery 

Initiative, or PAARI, where police work with public health to connect people with addiction to drug—with treatment for drug addiction. 

And we coordinate the response to specific drug threats. Our National Heroin Coordination Group and national cocaine group were 

designed to make us more nimble and approve drug-specific coordination across government, such as developing safe handling instructions for fentanyl so first responders don’t experience overVerDate Nov 24 2008 09:02 Feb 06, 2018 Jkt 000000 PO 00000 Frm 00010 Fmt 6633 Sfmt 6633 H:\27603.TXT APRIL

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dose, and prioritizing efforts to take down dark web marketplaces 

on the internet for drugs like fentanyl. 

On July 5, the Department of Justice took down AlphaBay, a primary source of fentanyl. As you’re well aware, ONDCP runs two 

grant programs that work to address the national problem. The 

HIDTA program facilitates coordination between local law enforcement, State, and Federal officials, and approves antitrafficking operations in each of the 28 HIDTAs. The DFC program provides 

grants to nearly 700 community-based antidrug coalitions across 

the country. 

Before I close, I’d like to acknowledge and thank the Government 

Accounting Office. We have been through numerous engagements 

with GAO, and I’ve found that their recommendations have been 

extremely helpful to us in our work. 

We look forward to working with the committee on a reauthorization measure that aligns with the administration’s priorities and 

provides the framework for ONDCP to best address the serious crisis the country faces on drugs. 

Thank you, Mr. Chairman. 

[Prepared statement of Mr. Mr. Baum follows:] 


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Chairman GOWDY. Thank you, Director Baum. 

Ms. Maurer. 

STATEMENT OF DIANA MAURER 

Ms. MAURER. Good morning, Chairman Gowdy, Ranking Member 

Connolly, and other members and staff. I’m pleased to be here 

today to discuss GAO’s recent work on Federal efforts to address 

illicit drug use. 

Combatting drug trafficking, drug abuse, and the associated impacts on public health and public safety is costly. The current administration has requested nearly $28 billion for a wide variety of 

activities involving several Federal agencies. It’s a truly multifaceted effort with very different missions in public health, law enforcement, intelligence, education, corrections, and diplomacy, and 

it needs to be. 

The problems from illicit drug use in the United States are complex, widespread, and deep-seated. And if there’s one thing we’ve 

learned over the past several decades, there are no quick or easy 

fixes. But more significant than the cost and complexity of Federal 

efforts is the very human, very tragic, and increasingly deadly toll 

of illicit drugs. 

According to the CDC, there were over 52,000 deaths from drug 

overdoses in 2015. That’s up more than 40 percent since 2009. It’s 

difficult to grasp numbers like that. 52,000 death in a year means 

144 Americans die every day. That’s more every 2 days than in all 

the terrorist attacks in this country since 9/11. There’s another way 

to think about it. The Vietnam Veterans Memorial here in Washington, D.C. has over 58,000 names on it. So one way to visualize 

the current human impact of illicit drugs is to picture building a 

memorial of similar size every single year. 

Given these bleak facts, it’s vital that taxpayer dollars to address 

this problem are well spent, that we’re making progress, and that 

the various agencies are well-coordinated. Those are goals to keep 

in mind as you consider reauthorization. It’s important for ONDCP 

and the various agencies to have a clear strategy to guide them, 

goals and measures to know whether they’re making progress, and 

seamless coordination and collaboration. 

And over the years, ONDCP, to its credit, has focused a great 

deal of time and attention developing strategies and using performance measures to assess the progress of Federal drug control efforts. The administration is currently updating the National Drug 

Control Strategy. Since that remains a work in progress, my comments today are based on goals and measures from previous strategies. 

In 2010, ONDCP issued a series of goals with specific outcomes 

the Federal Government hoped to achieve by the end of 2015. And 

as we have previously reported and testified, ONDCP’s goals provided a dashboard with meaningful indicators of progress and clear 

goals. The Federal Government achieved none of the seven overall 

goals established in 2010. Now, in some key areas, the trend line 

moved in the opposite direction; things got worse. For example, the 

number of drug-related deaths increased over 41 percent, rather 

than decreasing 15 percent as planned. The prevalence of drug use 


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by young adults increased rather than decreased, largely due to increased marijuana use. 

But there is also important progress in some key areas. There 

have been substantial reductions in the use of alcohol and tobacco 

by eighth graders. And the prevalence of drug use by teenagers has 

also dropped, not enough to meet the goals set in 2010, but certainly an encouraging sign. And preventing drug use is a key part 

of the overall Federal effort. 

Last year, the comptroller general convened a diverse group of 

healthcare, law enforcement, and education experts to discuss, 

among other things, high priority areas for future prevention efforts. They identified several options, including increasing the use 

of prevention programs that research has shown to be effective; 

working to change perceptions of substance abuse; emphasizing 

that a substance use disorder is a disease that can be treated; reducing the number of prescriptions issued for opioids; supporting 

community coalitions that include the healthcare, education, and 

law enforcement sectors; and improving Federal data on drug use. 

Mr. Chairman, as Congress considers these and other options 

while debating ONDCP’s reauthorization, it’s worth reflecting on 

the deeply ingrained nature of illicit drug use in this country. It’s 

an extremely complex problem that involves millions of people, billions of dollars, and thousands of communities. GAO stands ready 

to help Congress assess how well ONDCP and the other Federal 

agencies are doing to reduce the impact of illicit drug use. 

Thank you for the opportunity to testify this morning, and I look 

forward to your questions. 

[Prepared statement of Ms. Maurer follows:] 


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Chairman GOWDY. Thank you, Ms. Maurer. 

Dr. Humphreys. 

STATEMENT OF KEITH HUMPHREYS, PH.D. 

Mr. HUMPHREYS. Chairman Gowdy, Ranking Member Connolly, 

and members of the committee, thanks for your leadership, and 

thank you for inviting me to speak to you today. My comments are 

informed by my 30 years as an addiction researcher and clinician, 

and also by my service at ONDCP where I was honored to serve 

in the Bush and Obama administrations. 

As has been said, we’re losing—— 

Mr. CONNOLLY. Mr. Humphreys, I’m sorry, if we can interrupt. 

It’s very hard to hear you. You need to speak right into it like I’m 

doing. 

Mr. HUMPHREYS. Okay. Is this better? 

Mr. CONNOLLY. Much better. Thank you. 

Mr. HUMPHREYS. All right. I hope you heard me say thank you 

for having me here today. Thank you for your leadership. 

As has been said, we are losing over 50,000 Americans a year. 

To give my own comparison point, that’s more than we lost to AIDS 

in the worst year of the epidemic. 

ONDCP was set up actually to respond to the crack cocaine epidemic, but I think a modernized reauthorized ONDCP could be a 

very powerful force against this new and quite different epidemic. 

ONDCP can coordinate the Federal policy process. If there’s no 

one writing a national strategy, what happens is Federal agencies, 

some of them lose interest, not because they don’t care, but just because they have a lot to care about at the Federal level. Also, sometimes agencies have competitive programs, duplicative program, or 

programs that have no evidence of effectiveness. So ONDCP’s most 

important job is to herd the cats in Washington and get a strategy 

that is unified and effective. You can help them do that job better 

by giving out some more carrots and sticks. 

So on the carrot side, providing some money for demonstration 

projects for ONDCP could help them entice agencies to try new 

drug policies or new programs. On the carrot side, ONDCP’s power 

to review and decertify budgets could be strengthened so that the 

Director of ONDCP was the final word on that, rather than usually 

having to yield to OMB. 

Related to that, there is a notification requirement in the 2006 

reauthorization that says Congress must be notified when there’s 

a decertification. That has made directors very wary of using decertification. It hasn’t been used in years. And you might consider 

dropping that, letting the executive branch work among itself and 

get on the same page before they come to you with their ideas. 

Last, I hope you would urge the President to put the ONDCP director position back in the Cabinet. That gives a really strong message to the bureaucracy that we’re taking drug policy seriously. 

Another critical role for ONDCP is to serve as a resource to the 

White House and to Congress on the role of addiction issues in 

mainstream healthcare. Just give you an example on that, a very 

current example. Many people aren’t aware that Medicaid is now 

the lead funder of opioid addiction treatment in this country. So it’s 


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important for ONDCP to be a voice to say, if we curtail that program, we, by definition, curtail treatment for this problem. 

ONDCP would also be helpful with Medicaid and other programs 

in being the voice for procedures and policies. We have to reduce 

the likelihood that opioid prescriptions are inappropriate, which is 

a challenge for all health insurers. ONDCP has been less influential on healthcare policy than it could have been because it was created primarily as a domestic and law enforcement agency, and its 

staffing, its knowledge base, and its strongest relationships reflect 

that heritage. 

Law enforcement is extremely important in drug policy and it always will be. But health policy is also really important, and it 

might even be more important for the opioid epidemic, which after 

all, was started not by criminal gangs, it was started in the 

healthcare system. Congress could support a broader role for 

ONDCP and healthcare policy by better balancing the focus of the 

agency’s authorization. Just as one crude indicator of what the last 

authorization asked ONDCP to do, my own count is that the text 

mentions interdiction 40 times, enforcement 98 times, and 

healthcare only once. 

Congress could also mandate a bigger role in the drug policy development process for major healthcare agencies like the CDC, the 

FDA, and CMS. Congressional guidance regarding ONDCP staffing 

to ensure they have good in-house health policy expertise could also 

help. 

Finally, with Congress’s help, ONDCP could improve drug policy 

through targeted research efforts. To take a prominent example of 

why this matters, we really do not know how many people are addicted to heroin in this country. The measures just aren’t that 

good. Giving ONDCP a bit of some funding to either conduct research or commission research on critical drug policy questions like 

that would reap huge rewards for the development of policy and 

also its evaluation. 

In closing, I want to emphasize we’re in the midst of one of the 

worst drug epidemics in the history of our Nation. With the right 

support from you, the White House Office of National Drug Control 

Policy can lead the government and the country in a coordinated, 

effective, and lifesaving response to this horrifying epidemic. 

Thank you for your time, your leadership, and I look forward to 

your questions. 

[Prepared statement of Mr. Humphreys follows:] 


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Chairman GOWDY. Thank you, Dr. Humphreys. 

Mr. FLATTERY. And all the members would also like to recognize 

and welcome your wife, who is with you today as well. You’re recognized. 

STATEMENT OF DON FLATTERY 

Mr. FLATTERY. I join others in thanking you, Mr. Chairman, 

Ranking Member Connolly, at least for today, and other members 

of the committee, for conducting this hearing about reauthorization 

of the Office of National Drug Control Policy. It’s a much needed 

discussion to ensure the Federal Government is prepared to fight 

to end the epidemic of prescription drug and heroin addiction the 

country is facing. And while I strongly support, as an advocate, the 

activities of ONDCP, my purpose in this discussion today is not to 

drill down and discuss individual activities in any detail. 

My name’s Don Flattery, and until recently, I lived in Fairfax 

County, Virginia. I’m a former Federal manager; a recent member 

of the Virginia Governor’s Task Force on Prescription Drug and 

Heroin Abuse; a policy advisor to the national addiction-fighting 

nonprofit, the FED UP! Coalition; and I’m an active participant in 

my newly adopted county of Brunswick, North Carolina’s addiction 

task force. 

But I’m not here today in any of those roles. I’m addressing the 

committee solely as a grieving parent, someone who’s lost his 26- 

year-old and only son to an opioid overdose less than 3 years ago. 

In prior committee hearings, you’ve heard the appalling statistics 

about the explosion of opioid prescriptions addiction rates over 

overdose deaths. I’m intimately aware and familiar with them and 

I’ll not repeat them here, but those discussions are often far too 

clinical. 

As you, Federal officials, elected officials, State officials, and public health practitioners deliberate and consider solutions, it is far 

too easy to become detached. As you proceed, I implore you to recall the personal impacts. We are not just speaking about shocking, 

obtuse statistics. We’re speaking about my son, your daughter, and 

our neighbors. They’re real people with real lives, suffering from a 

disease, and their losses are the face of the epidemic that we must 

stop. 

Allow me to briefly share my son’s story. On Labor Day weekend 

2014, my family lost my 26-year-old Kevin to an opioid overdose. 

Like so many swallowed by this crisis, Kevin enjoyed the blessings 

of a typical suburban upbringing, attending private schools, participating in youth sports and high school athletics. He came from a 

loving two-parent home and leading the quintessential middle class 

life, enjoying all of life’s and God’s blessings. 

He was a good student and was a graduate of the local all male 

prep school, Gonzaga, right here in Washington, D.C., and later the 

University of Virginia, where he actively participated in student 

and fraternity life. Kevin came to his addiction as a working adult 

while pursuing his talent and passion working in the film industry 

in Hollywood and New York City. He’d been exposed to opioids as 

a teen after an injury, and he told me himself that he thought 

nothing of them. Like so many, he underestimated them. 


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While working, he began self-medicating issues with anxiety and 

depression with the widely available opioid prescription drug, 

OxyContin, which is a common story, as many struggling with coincident mental health issues develop addiction problems. He quickly 

became dependent and then addicted. He returned home to Virginia in the fall of 2013 to his family seeking treatment and support. Like many struggling in search of treatment, he tried a wide 

variety of pathways, including detoxification, medication-assisted 

programs, and an outrageously expensive 28-day abstinence only 

residential program. 

Some of these were covered by insurance, but others were covered out of pocket. But like others in pursuit of recovery, he experienced the painful and very common process of seeming progress followed by relapse. Days before he was to start a program of the 

medically assisted treatment drug, naltrexone, he used again and 

he did not recover. 

The short bio description I just gave you is an example of how 

the scourge of the opioid addiction epidemic before us today has no 

stereotypical victim. It’s affecting people of all walks of life, all income levels, and all backgrounds. This epidemic—and make no 

mistake, this is an epidemic—and my son’s addiction do not respect 

income, social status, or intelligence. That’s what epidemics do. 

That point bears repeating in every hearing this committee and 

others conduct which touch upon this health crisis. 

Since my son’s loss, I’ve learned a great deal about the disease 

of addiction, the current epidemic, and it’s underlying causes, and 

painfully, for me and my wife, some evidence-based treatment opportunities that offer hope, but now only for others. From the perspective of an impacted parent, as a citizen, and as an advocate, 

I would like to add my voice to thousands traveling the same journey about some imperatives needed to stem the tide of the epidemic. 

The first is the primary topic of this very hearing. The need for 

a strong well-resourced and effective ONDCP has never been more 

important. A policy office directly tied to the Office of the President 

not only sends a message to the public about the importance of effective drug policy, but it also ensures more effective development 

of integrated, cross-Federal Government programs and policies. 

ONDCP plays an essential role in being an integrator and a coordinator for the widely disparate addiction-fighting efforts of HHS, 

SAMHSA, NIDA, CDC, the FDA, as well as programs in the VA, 

DOD, Indian Health Service, and a wide variety of law enforcement 

agencies. Interagency discussions and collaborations will be ineffective without the singular collaboration entity empowered to work 

across stovepiped efforts and programs. 

The second imperative is continuous coverage of addiction treatment. Access to medication-assisted treatment already remains elusive for far too many patients. Changes to the Nation’s healthcare 

system that remove mental health and substance use disorder coverage as an essential benefit will be a disaster for many, including 

those like my son, seeking such help. We must find ways to expand, not limit, access to addiction fighting medications, and ensure insurance companies and providers do so at a reasonable cost. 


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Mr. Chairman and members of the committee, thank you again 

for addressing the need for an effective ONDCP as part of the Federal Government’s response. We need to ensure Federal entities do 

their part to appropriately protect our loved ones and the public 

health. Americans suffering from this scourge deserve no less. 

Thank you. 

[Prepared statement of Mr. Flattery follows:] 


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Chairman GOWDY. Thank you, Mr. Flattery. 

We’ll now recognize the gentleman from Oklahoma, Mr. Russell, 

for his questions. 

Mr. RUSSELL. Thank you, Mr. Chairman. And thank you, panel, 

for being here today. I agree with all of the statements that have 

been made. 

And, Mr. Flattery, you know, you certainly bring—you and your 

wife bring this issue—put a personal face on it. It affects so many. 

I have also seen the devastating effects of overmedication in trying 

to treat veterans, as a combat veteran myself, and seeing a number 

of folks as they try to come home. It seems to be the simple thing 

is just to give warriors a bag of cocktail-type of medications, and 

then now they’re on addictions. And then we wonder why the returning veteran came home and, quote, committed suicide, when it 

may have been the direct effects of overmedication and addiction. 

It seems to me, Mr. Chairman, that we all bear responsibility for 

this. It was Congress that made the decision to relax the laws that 

allowed more over-the-counter direct access to what I consider to 

be legalized heroin. 

So I guess my first question, and whoever would like to comment, but we’ll start with you, Mr. Baum. And thank you for your 

dedicated years of service in dealing with difficult issues. 

What legislatively could we do? We let the genie out of this bottle 

by relaxing the access. You know, I go home, even in the great 

State of Oklahoma, you’ll see these pain and injury centers everywhere. Somebody can walk in and the next thing you know, some 

physician may sign off and, you know, you can go off with a bag 

of pills. 

What legislatively would you like to see done with the decades 

of retrospect and how we got here? 

Mr. BAUM. Congressman, thank you for your question. There are 

a lot of things that we can do more of. And, you know, I guess I 

would start by saying, when we’re in a crisis and so many people 

are dying, we need to do more of everything. So I would love to see 

tighter restrictions on use of the narcotic analgesics. I don’t think 

the evidence is there to have these substances used as a default for 

chronic prescriptions. You know, once—the data is very clear. Once 

someone is using these substances for more than 5 days, their addiction rates go up dramatically. So tighter controls on that. 

Certainly, resources for prevention, treatment, and medicationassisted treatment. We have lots of very clear evidence that people 

do well on medication-assisted treatment. Everyone should be offered it. If you look at the data, only about a third of the people 

with a diagnosed opioid use disorder actually now have access to 

treatment. 

And let me say one last thing, and maybe turn it over to my colleagues, is that 80 percent of people with a substance use disorder 

do not come forward for treatment. So we don’t just need to get better high-quality treatment to those who are on a waiting list; we 

need to go out and find the people out there and bring them in and 

control them and encourage them to get the help that they need. 

Mr. RUSSELL. Thank you, sir. 

And anyone else who would care to comment. 


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Mr. HUMPHREYS. Congressman, I just want to give you an important piece of information about how much prescription opioids 

Americans consume. On a per capita basis, we are the world leader 

by an enormous margin, six times what European countries prescribe. We could cut prescribing by 40 percent and we would still 

be the world leader in opioid prescribing. So that is the biggest 

wheel. 

There are many good policies, treatment, prescription monitoring, and so forth, but that’s the fundamental thing, is we’re just 

prescribing way too much. 

Mr. RUSSELL. Okay. 

Ms. Maurer? 

Ms. MAURER. Yeah. When the comptroller general convened the 

panel of experts last year, that was one of the topics of discussion 

precisely, what you just asked about. And there were some common 

themes that came across from that body of experts, and one was 

exactly what Dr. Humphreys just talked about. First and foremost 

was prescribe fewer opiate medications. 

But hand in hand with that was also a theme of providing additional education to providers. The CDC has some guidelines—some 

recently updated guidelines that apparently the word has not gotten out fully on those things. Prescription drug monitoring programs are an important part of this. And as well as on the law enforcement side, continuing aggressive investigation and prosecution 

of pill mills. 

Mr. RUSSELL. Thank you. 

Mr. FLATTERY. If I may, just to add to that. The recent activities 

have been somewhat successful in reducing the number of prescriptions. The U.S. with 5 percent of the world’s population is consuming 80 percent of the world’s opioids. Voluntary prescribing 

guidelines, development of PDMP systems are having an impact. 

Last year, prescriptions in this country declined to over 220 million prescriptions. That’s still enough for every American to have 

their own prescription bottle for 30 days. These prescription drugs 

are continuing to flood our communities, our workplaces, our 

schools, and our medicine cabinets, making them available for medical overuse and for abuse. 

You asked the core question, what can you do legislatively. We 

need our State partners, because they are responsible for managing 

the practice of medicine, and we need them, and they are, we are 

beginning to see some progress in State capitals addressing the 

overprescription of opioid drugs. 

Mr. RUSSELL. Thank you. 

And thank you, Mr. Chairman, for you indulgence. I yield back. 

Chairman GOWDY. The gentleman yields back. 

The gentleman from Virginia is recognized. 

Mr. CONNOLLY. I thank the chair. And again, I thank the panel 

for their very cogent testimony. 

Mr. Baum, this is a hearing on the reauthorization of your office. 

Has the administration or has your office submitted a draft reauthorization bill to the Congress? 

Mr. BAUM. Mr. Connolly, we have not, but we do have some considered thoughts and would be happy to discuss some of those—— 


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Mr. CONNOLLY. Well, we need a reauthorization bill from somebody, even if we decide to go a different direction. Any idea when 

it might be submitted? 

I mean, the chairman pointed out, I think the last reauthorization was 2006, so it’s grown stale. We heard Dr. Humphreys point 

out, you started out originally as a crack cocaine focus, things have 

changed. Reauthorization’s got to take cognizance to that. We want 

to be supportive, but we’ve got to have some kind of timeframe in 

which you’re going to—not you personally—the office and the administration are going to interact with Congress that ultimately 

has to do the reauthorization. 

Any idea when we might see a draft? 

Mr. BAUM. I don’t want to give you a timeline, but I can tell you 

this. I’ve studied the issue very closely. We know what we need to 

do. 

Mr. CONNOLLY. Okay. 

Mr. BAUM. We can put together a reauthorization bill and work 

with our partners in the administration and get something to the 

Congress relatively rapidly. So I look forward to the—— 

Mr. CONNOLLY. I don’t presume to speak for the committee, but 

I think as you can hear, on a bipartisan basis, we’re seized with 

this mission and urgency, and I hope you’ll take it back. We want 

to see a reauthorization. We’re happy to help, but—okay. 

Mr. BAUM. We want to see it too. We’re eager to move out on it. 

Mr. CONNOLLY. Likewise, we need a strategy. Any idea when a 

strategy will be submitted to the Congress? 

Mr. BAUM. I have a very precise idea. 

Mr. CONNOLLY. Okay. 

Mr. BAUM. I’d be happy to discuss that, and I know Mr. Gowdy 

raised it as well. We’re developing a strategy now. You know, I do 

want to say that I take the deadlines that—the statutory deadlines 

extremely seriously, and I know what the deadline is, February 1. 

In the Trump administration we are developing a strategy, we have 

a draft, we’re consulting both formally in terms of letters to Members of Congress. I’ve been traveling, holding meetings. I’m holding 

interagency meetings. We are working a conference of strategy—— 

Mr. CONNOLLY. Again, I’ll stipulate to all that. Look, I only have 

5 minutes. 

Mr. BAUM. Yeah, sure. 

Mr. CONNOLLY. When can we see it? 

Mr. BAUM. The deadline is February 1 of next year, and there 

is an issue with—we are required to wait until the President’s 

budget comes out, but sometimes it is a few weeks after. But early 

next year, you’ll have a comprehensive drug strategy from the administration hovering the entire scope of the issues. 

Mr. CONNOLLY. All right. Well, let me invite you, even in draft 

form, if you can, to start, because we want to be partners. And the 

urgency of the subject, you know, I think demands executive and 

legislative branch cooperate as much as we can. So that strategy, 

you know, I hope will reflect the realities so many Members are experiencing in their respective districts. And so we’d be glad to work 

with you, but we’ve got to have some kind of draft to start with. 

Likewise, what about the appointment of a director? And I think 

you’re perfect, you’re my constituent. How can we do any better 


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than you? But we still don’t have—it’s been 6 months, and you’re 

not alone, there are a lot of vacancies in the executive branch, but 

this one’s pretty critical. Any idea when we might hear a name 

floated, let alone actually someone nominated? 

Mr. BAUM. Well, thank you for that strong endorsement. I appreciate that. 

Mr. CONNOLLY. I won’t help you with Donald Trump, but—— 

Mr. BAUM. I’m—— 

Mr. CONNOLLY. I can bad mouth you if that would help. 

Mr. BAUM. You know—— 

Mr. CONNOLLY. Donald, this man’s a loser. Don’t do it. 

Mr. BAUM. Can I take back my time then? 

Mr. CONNOLLY. Yeah, yeah, yeah. It’s actually my time, but go 

ahead. 

Mr. BAUM. We appreciate the thought. We know that they’re 

working on filling these positions. It’s a critical position, and as 

soon as we have something to report, you’ll be the first to know. 

Mr. CONNOLLY. Well, that’s so comforting. All right. Thank you. 

Mr. Flattery, I want to go back to your testimony. And thank you 

so much for being willing to share. Thank you to your wife for coming up here. 

You mentioned your—well, first of all, and I don’t—if the chair 

will just indulge me in this line of questioning for a little bit to 

draw out a little bit more the story of Kevin. 

So your son wasn’t hanging around with the wrong kind of crowd 

that was into drugs and that’s how he ran into trouble. That’s not 

how his problem began, is it? 

Mr. FLATTERY. No, it is not. My son did not, as many unfortunate 

young people do, he did not surrender his youth, he did not turn 

his back on his activities and friends and school work. He became 

addicted as a working adult pursuing what he was passionate 

about. 

Mr. CONNOLLY. But he became addicted. What triggered the 

need—or his perceived need for the use of an opioid? 

Mr. FLATTERY. In my son’s case, my wife and I believe that he 

began medicating issues with—self-medicating issues with a widely 

available drug. 

Mr. CONNOLLY. No. But why? 

Mr. FLATTERY. Because like many people who develop addiction 

problems, they often have coincident psychosocial issues that have 

to be dealt with, and that’s why pairing of mental health services 

and addiction treatment services is so critical. 

Mr. CONNOLLY. In his case, he was in New York trying—he was 

an aspiring film maker? 

Mr. FLATTERY. At that time, he was in Hollywood. 

Mr. CONNOLLY. In Hollywood. All right. 

Mr. FLATTERY. And he was exposed to widely available 

OxyContin and very inexpensive OxyContin. 

Mr. CONNOLLY. He came home? 

Mr. FLATTERY. He did. 

Mr. CONNOLLY. And he, from your point of view, made a really 

good-faith effort to try to lick this, correct? 

Mr. FLATTERY. Yeah. Sort of adding to our own personal tragedy, 

our son was completely cooperative in trying to pursue treatment. 


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He recognized that he had fallen into the rabbit hole and he was 

in over his head. He was seeking our support. He tried a number 

of pathways. And they’re common pathways. Detox, intensive outpatient support from Inova Fairfax Hospital. He was on a regimen 

of buprenorphine, also known as Suboxone, and he still struggled 

with it. He attended peer support through AA and NA. But at one 

point, he same to us and said, you know, I just—he began to manipulate his own Suboxone, because it’s a self-administered medication. And he said, you know, I think I would like to try a residential treatment program. 

And I do have issues with my son’s experience in residential 

treatment. Many, not all, residential treatment programs often use 

a detoxification, and then couple either cognitive behavioral talk 

therapy during the 30-day stay with what I consider to be reformulated step program dogma, which is available for free in church 

basements all over the country. Those programs, at least the program that my son encountered, are very expensive, $28,000 to 

$30,000 a year. Those types of programs, I think, are emblematic 

of why our treatment system is broken. 

Many families will do anything in their power to get help for 

their loved one, as we would. And many families are bankrupting 

themselves sending them to such facilities that then after the 30- 

day stay, release them to the wild. And they often are treating the 

people who attend, not as patients, but as customers. And the disease of addiction is a chronic, reoccurring issue that has to be dealt 

with over a long period of time. 

And in my son’s case, he was not ready to be released to the wild 

after 30 days. It’s not a magic fix. And our treatment system has 

to be reengineered to provide long-term care for a chronic condition, and that’s, in my estimation, where my son’s journey broke 

down. 

Mr. CONNOLLY. Thank you. 

Mr. Chairman, you’ve been gracious. I thank you. 

Chairman GOWDY. The gentleman yields back. 

The gentleman from Tennessee, Dr. DesJarlais. 

Mr. DESJARLAIS. Thank you, Chairman. And I thank the witnesses today for appearing on this extremely important topic. 

Mr. Flattery, you and your wife have become way more involved 

in this issue than you probably ever hoped to since the loss of your 

son. You’d mentioned a couple of times here to Mr. Connolly and 

in your opening statement about the ease of access of opioids, specifically OxyContin. Can you explain a little further what your understanding is of why these are so easy to get and why they’re so 

inexpensive? 

Mr. FLATTERY. Well, I’ll first start with the basic essence of the 

anatomy of this epidemic. This is, as Mr. Humphreys indicated, 

this wasn’t started by drug dealers who had built a business model 

around providing illicit drugs. This had its origins in the medical 

community, and I believe you are a medical practitioner yourself 

and understand that. 

In an attempt to be compassionate in the treating of pain, American physicians use their prescription pad. American physicians 

also have a deficiency in prior training on proper pain management 


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and addiction management. There isn’t even a whole discipline 

built yet around addiction management in medical schools. 

So in an attempt to provide compassionate care, American physicians are implicated in the overuse of opioid drugs for all manner 

of pain conditions for which they were never intended. They started 

out as a drug that was to address terminal cancer pain and recovery from acute injuries, and it drifted into the use of opioid drugs 

for migraines, arthritis, indiscriminate lower back pain. In the dental community, for wisdom tooth extraction. And they not only were 

being overprescribed, they were being prescribed in quantities that 

were completely unnecessary for the treatment of an acute condition. And as Mr. Baum indicated, long-term use of opioid drugs 

lead to addiction. 

Now, you asked the question about why so ubiquitous. And the 

answer is, in 2013, we hit the peak year in the U.S. with over 259 

million prescriptions. That’s a number in the billions of individual 

doses. And those drugs are flooding communities and workplaces, 

and they’re just widely available, and they’re available for potential 

misuse. So they’re available at low cost on the street. 

Mr. DESJARLAIS. Okay. Mr. Baum, is there currently any legal 

requirement for prescribers, physicians, nurse practitioners, to fully 

educate their patients on, not only the harms addictive properties 

of these medications, but also to educate them on the dangers and 

illegality of sharing these medications with other people? 

Mr. BAUM. Thank you for the question. There is no requirement 

from mandatory prescriber education, and frankly, I am very concerned about that. I know in the previous administration, there 

was discussion about increasing voluntary prescriber education. 

But looking at the progress, I don’t think it’s been nearly enough. 

And I think it’s something that we ought to talk about making it 

mandatory. To make sure at least those prescribers that are putting these very, very powerful drugs in the hands of our citizens, 

spend a few hours learning about the risks and about addiction, I 

think would be important, and it’s something that we should talk 

about. 

Mr. DESJARLAIS. I think it’s, yeah, probably more than something we should talk about. As a former physician and current 

holder of a DEA license, I know that I would make it a point to 

educate my patients on the power of these drugs. But, also, I think 

there’s responsibility among the patients to know that it should be 

illegal to share these drugs. I have a license, went to medical 

school to prescribe them, but patients often will just share it with 

family and friends thinking that it’s okay. That should be a crime. 

And it probably is, but it’s not enforced. 

And if one of the problems is overprescribing, that needs to be 

stopped. And physicians and medical students and all prescribers 

should be educated in medical school on this issue. Because of the 

scope of this problem, the time is ripe to do that. 

But, also, I think that it is a patient’s responsibility to properly 

handle these medications, and there should be laws and documents 

that a patient should sign when they pick up this prescription, either from the pharmacy or when physicians prescribe it. Would you 

be willing to look at that as an option? 


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Mr. BAUM. Yeah, I’m absolutely willing to look at it. But I really 

think the major responsibility is with the prescribers. When you 

have an injured kid that you’re taking to the doctor and the doctor 

gives you your prescription to take pills for 30 days or 60 days and 

you get your bottle of bills with the directions, the tendency is to 

follow the directions, and now we’re putting it on parents to ask 

the doctor, hey, should my—does my kid really need to take this 

for 30 days for a wisdom tooth extraction. And I think it should be 

the other way. The doctors are the experts. They’re the one in the 

white coats. They’re the ones with the responsibility to think about 

the powerful medications they’re putting in the hands of our citizens. 

Mr. DESJARLAIS. And I’ll promise you that the vast majority of 

all doctors feel the same way. They don’t want to harm patients 

with these medications. They don’t want to prescribe irresponsibly. 

They are always bad actors, and that’s who we need to focus on. 

I think that that door swings both ways. Physicians definitely 

should take the brunt of the responsibility. I also think that law 

enforcement should focus on people who share or sell these medications, because as a physician, that was always a concern of mine. 

If I was treating someone with chronic pain or even cancer, you 

just assume that those people are taking the prescriptions properly. 

That’s not always the case. And I have all kinds of stories where 

I found out people were being put in very vulnerable situations by 

family members to get these prescriptions so they could go out and 

sell them, and so they were forced to lie to me. I didn’t know I was 

doing the wrong thing, and I know other physicians are in the 

same situation where they get tricked or duped into thinking people have critical problems or illnesses. 

And so I do think the enforcement side of that needs to be 

ramped up as well, but there’s a dual responsibility. And the bottom line is we have a huge number of people dying every year, and 

it’s not time to think about what we should do, we should be doing 

it. And I’m happy to work with you further on this issue. 

And thanks to the chairman for giving me the additional time. 

I yield back. 

Chairman GOWDY. The gentleman from Tennessee yields back. 

The gentlelady from the District of Columbia is recognized. 

Ms. NORTON. Thank you very much, Mr. Chairman. And I want 

to first thank you for this hearing. It’s a very timely hearing. And 

I appreciate the bipartisan way in which this hearing is being held. 

This is an across-the-board problem. Already I’ve heard ideas, including from my colleague on the other side, as to the kinds of 

things we need to be thinking about, and for reauthorization. 

I thought the President had begun in a bipartisan way himself 

when early on he said he thought that we should—and here I’m 

quoting him, show great compassion about the opioid epidemic. 

And then the Office of Management and Budget virtually abolished 

your agency with a 95 percent cut. And here is where bipartisanship mattered. There was an outcry on both sides of the aisle, and 

I think in the only—or one of the few circumstances where I have 

seen the OMB take back its mark, it did. And now I understand 

only a 5 percent cut. 


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And, Mr. Chairman, could I ask that the letter from the ranking 

member, Elijah Cummings, and from Representative Johnson, a 

Republican from Ohio, was signed by 75 members asking that this 

cut be reversed. It worked. And I ask that that may be made part 

of the record. Mr. Chairman, is that a part of the record? 

Mr. DESJARLAIS. [Presiding.] Without objection. 

Ms. NORTON. Thank you, sir. 

First, let me mention the statement by Mr. Connolly. It was kind 

of a very telling critique of current marijuana policy. We all know, 

I don’t care what side of the aisle you sit on, that marijuana is, per 

se, legal in the United States, certainly by people younger than 

anyone on these panels, other than—younger than 40, let me say, 

to be gracious. 

Yet Congress has prohibited the District of Columbia from using 

its local funds to tax and regulate marijuana, tried to keep the District from indeed making possession of only 2 ounces legal, but 

Congress didn’t know how to write an appropriation rider that 

would do that effectively. So here is what we have. The unintended 

consequences of no regulation, no taxation, as eight States do, but 

you can possess marijuana. 

Ms. NORTON. So what we’ve done in the District of Columbia is 

we have expanded the underground market for marijuana. Indeed, 

it’s nicknamed in the District the drug dealer protection act. And 

The Washington Post actually identified a marijuana dealer, and 

he said it was a license for me to print money. 

Now, there are members of this committee who are from some 

of the eight States that have legalized marijuana. They are Alaska, 

California, Colorado, Maine, Massachusetts, Nevada, Oregon, 

Washington State, and Washington, D.C. 

My question for Mr. Baum is if D.C., if the District of Columbia, 

could tax and regulate marijuana, would that have the effect of at 

least partially undermining the illegal marketplace for marijuana 

in this city? 

Mr. BAUM. Well, I thank you, Congresswoman, for the question. 

I have to say, I’m a Federal official. Marijuana is a Schedule I illegal substance in the country. 

Ms. NORTON. And I understand that, and I have very limited 

time. I’m trying to find cause and effect. 

You’ve seen what’s happened in the other eight States. And I’m 

simply asking, if you make it legal, if everybody is using it anyway, 

as is surely the case for younger people—— 

Mr. BAUM. It’s not the—— 

Ms. NORTON. —would that make it less likely that you go to an 

underground peddler? 

Mr. BAUM. Ma’am, respectfully, I don’t believe that. It’s a harmful substance. Just because it’s not killing people the way 

fentanyl—— 

Ms. NORTON. I’m talking about how you buy it, sir. 

Mr. BAUM. Yeah. Everyone isn’t using it, you know. And we have 

our—I’m concerned about young people in this country and—— 

Ms. NORTON. All right. Let me ask you this. If you’re concerned 

about young people, would you be concerned that the District of Columbia can’t regulate marijuana so as to keep it out of the hands 

of people under 18, for example? Would that be a concern of yours? 


KING-6430 with DISTILLER
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If, in fact, you’re going to possess—if a jurisdiction is going to 

possess marijuana, should it not at least have the opportunity to 

keep marijuana out of the hands of children? 

Mr. BAUM. I worry that making a substance widely available and 

legal increases acceptance of it and increases use among youth. 

And I think we need to look very closely at what’s happening in 

Colorado and the other States to see if marijuana use especially—— 

Ms. NORTON. Can I ask if you are doing that? We would very 

much like you to do that. What are you doing as to the States that 

have already legalized marijuana? Are you giving us any feedback 

so that we’ll know what to do when the time comes for reauthorization? 

Chairman GOWDY. [Presiding.] The gentlelady’s time has expired, 

but you may answer her question. 

Mr. BAUM. We did have a Federal team go out to Colorado and 

talk to officials across the spectrum, and we’re trying to learn 

about what’s happening. I have to say, I’m concerned about this 

commercialized model of widespread availability of marijuana and 

very limited controls of marijuana being grown on public lands, of 

the involvement of cartels in Colorado in some of the marijuana 

production. 

I think there are a lot of challenges, and I think it’s something 

we need to really think about whether we want to make a substance that is harmful more available to our citizens. 

Ms. NORTON. Thank you, Mr. Chairman. 

Chairman GOWDY. The gentlelady yields back. 

The gentleman from Montana is recognized. 

Mr. GIANFORTE. Thank you, Mr. Chairman. 

And thank you for the panel for your testimony. This is a critically important issue. 

And, Mr. and Mrs. Flattery, thank you for putting a personal 

face on this epidemic we have here. 

As I travel, you know, I hear repeatedly the impact of drug addiction on skyrocketing kids in foster care, crime, domestic violence. As I talk to law enforcement, there are so many—in addition 

to the personal tragedies that we’ve heard today, so this is very appropriate we have this conversation. And I also am looking for solutions and seek your advice. 

I would be curious—we have 50 States where we look at solutions. I’m curious to hear from the panel of any particular examples where States have taken action that have had positive impact 

on this issue, and just so that we can learn to look at whether or 

not some of those things make sense at a national level. 

Mr. HUMPHREYS. Thank you, Congressman. I’ll give you two 

State policies that show evidence of good effect. 

One is, which has been done in Oklahoma, is called reimbursement lock-in. And what this is, is that if you are covered by an insurance program and you have three, four, five, six, seven providers writing you prescriptions, the insurer, say Medicaid, will tell 

you, look, you can get this prescription, but you have only one doctor. And if that person is doctor shopping or dealing on the side, 

then they’re constrained. But if they’re a legitimate paying patient, 

they still have one doctor. So that’s reimbursement lock-in. 


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Second one are prescription drug monitoring programs. These 

vary in quality around the country. Some are easy to use, some are 

hard to use, but the best ones allow a physician to know, before 

they write that prescription, is this person getting lots of prescriptions other places. It also can be used by the State to see, is there 

a particular provider who has really suspicious prescribing? When 

those programs are well resourced, they reduce overdose deaths. 

Those should both be used everywhere in my—— 

Mr. GIANFORTE. So in that particular case, in Oklahoma, how is 

that actually accomplished? 

Mr. HUMPHREYS. It’s done through Medicaid. So the Medicaid set 

up a rule, which they have the power to do as a payer, and said, 

you know, if you get multiple opioid prescriptions from different 

providers on Medicaid, you have to pick—one of those doctors is 

going to be your doctor, period. And they’re all going to have to 

come there. And it’s an administrative decision that a Medicaid director can make. 

Mr. GIANFORTE. Okay. And open it up to the rest of the panel. 

Are there other examples you’ve seen in States that have been effective? 

Mr. BAUM. Thank you, Congressman. And I hope to be coming 

out to Montana. Senator Daines invited us out there, so hopefully—— 

Mr. GIANFORTE. You’re welcome. We have room for you. 

Mr. BAUM. So I did want to just mention, you know, police and 

law enforcement around this country, they really understand this 

problem very well. And they’ve been innovating across this country, 

especially in the States that are hard hit. And I think that sometimes we oversimplify. But, you know, there are drug traffickers, 

drug dealers, and major violent criminals, and those people need 

to go to prison for their crimes. But there are also people that their 

only offense is using and purchasing drugs, and many of those people can be diverted to treatment. 

And there’s a lot of innovation. I mentioned in my testimony the 

police-assisted addiction program where police are actually taking 

people in, opening up their police station 24 hours. If you want to 

come in for treatment and you don’t have any serious trafficking 

or criminal offense, they will do a—an interview with them and 

consult with a health worker, and they’ll put them in the car and 

drive them right to treatment. 

And I think—you know, police are very smart and flexible, and 

getting the people in the treatment who need treatment is something that they are facilitating across the country. Fire departments are doing it as well. 

You know, you look at the people in our communities that operate 24 hours a day, police, fire, crisis intervention, they are really 

stepping up and are a critical part of the solution all across the 

country. 

Mr. GIANFORTE. And, Mr. Baum, where is that particular program being run? 

Mr. BAUM. Yeah. It started in western Massachusetts, and my office could give you more information, but now it’s in 250 places all 

across the country. Tremendous leadership by police chiefs and 

sheriffs who are stepping up to deal with this problem. 


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Mr. GIANFORTE. Okay. 

Ms. MAURER. Just real quickly to echo what Mr. Baum was just 

discussing, that was one of the main themes of the comptroller general’s panel last year, was the real importance of having these community networks at the local level that bring together law enforcement, they bring together public health, they bring together the 

education sector—our work last year was focused on prevention— 

but can have real benefits across the board with all different aspects of the illicit drug problems. 

Mr. GIANFORTE. Okay. 

Mr. FLATTERY. If I may, to sort of add on to the notion that we 

need to continue to support diversion to treatment in lieu of incarceration, one of the barriers to being effective in doing that is we 

need a Nation’s reengineered treatment system. You cannot divert 

someone to treatment if in rural areas of many States there is no 

effective treatment to divert them to. It’s an unnecessary and excessive burden to place on law enforcement. And there are a number of noteworthy programs around the country to pursue that, but 

until and unless we reengineer our treatment system, we’re only 

going to have minimal effect. 

And then another follow-on, you had asked, and Mr. Humphreys 

pointed out, a number of places where we’re having some impact 

on less in prescribing, the original development of voluntary opioidprescribing guidelines for chronic pain that CDC developed are 

being mimicked and adopted in the States. The regulation of medicine occurs at the State, not here in this panel, and we are seeing 

a number of States try and expand the use of prescribing guidelines throughout the practice of medicine in their States, and not 

only in just ER settings, and that’s where they first started, we 

need them to be applied in general practice settings where 60 percent of opioid drugs are being prescribed. 

Mr. GIANFORTE. Thank you. Thank you, Mr. Flattery. 

And I yield back. 

Chairman GOWDY. The gentleman yields back. 

The gentleman from Missouri is recognized. 

Mr. CLAY. Thank you, Mr. Chairman. 

And I thank the witnesses also for participating in this hearing 

today. 

On May 10, 2017, Attorney General Jeff Sessions issued a memorandum instructing Federal prosecutors to, quote, charge and pursue the most serious, readily provable offense, including mandatory 

minimum sentences, for drug crimes. 

The Sessions sentencing memo marked a reversal from Attorney 

General Eric Holder’s Smart on Crime initiative, which sought to 

move away from mandatory minimum drug sentences and, instead, 

focus Federal resources on the most dangerous criminals in complex cases. 

AG Sessions appears to be trying to reinstate the harsh and indiscriminate use of mandatory minimum from the failed war on 

drugs. 

Dr. Humphreys, do you think that a strict mandatory minimum 

policy will help us make progress in curbing the destruction caused 

by the opioid crisis? 


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Mr. HUMPHREYS. Thank you for that question, Congressman. I do 

not think that’s the case. What I—I work a lot with States. I travel 

a lot. And what I see all around the country, South Carolina, 

Texas, South Dakota, California, Utah, is bipartisan coalition to 

move away from mass incarceration in the way we handled drug 

problems, basically, in the 1980s and 1990s. 

And the one place that hasn’t sunk in as a perspective, I think, 

is actually in Washington. I think the States are out front on that. 

There’s strong bipartisan agreement. It’s better to treat people 

than lock them up. 

You know, there are some horrible actors out there who are 

doing terrible things, but they are a small part of who gets swept 

up, generally, in drug enforcement, and we should actually, as acting Director Baum said, be trying to, you know, restore everyone 

we can. Many of these people are just low-level people who are addicted, and they’re much better handled in the health system, not 

by giving them a, you know, 10-year stint in a prison. 

Mr. CLAY. Yeah. And in response to Mr. Sessions’ memorandum, 

Republican Senator Rand Paul wrote, and I quote, ‘‘The AG’s new 

guidelines, a reversal of a policy that was working, will accentuate 

the injustice in our criminal justice system. We should be treating 

our Nation’s drug epidemic for what it is: a public health crisis, not 

an excuse to send people to prison and turn a mistake into a tragedy.’’ 

Dr. Humphreys, do you agree with Senator Paul? 

Mr. HUMPHREYS. I do agree with the Senator that this is a public 

health—addiction is a public health crisis. And it is, as has been 

said by Mr. Flattery, a—it is a chronic medical illness. We should 

be taking care of it in the treatment system. 

And, again, I understand that there are terrible drug traffickers 

who are violent and terrorize communities, and I have no sympathy for them at all. But a huge number of people at the low end 

of the drug trade are people who themselves have drug problems, 

and we should be looking at them as people we can try to restore 

through the treatment system or through collaboration, drug courts 

being an excellent model. There are other models of probation with 

what the criminal justice is trying to do is not punish people forever, put them away in a cell forever, but instead, try to restore 

them to health by working with the treatment system. 

Mr. CLAY. Mr. Baum, is your philosophy in line with what we 

just heard from Mr. Humphreys? 

Mr. BAUM. Well, the way I would put it, Congressman, is that 

every case is different. And in the Federal system, we see primarily 

significant drug traffickers and the violent criminals. And if you’re 

a significant drug trafficker or a violent criminal, you run a network that’s bringing illicit narcotics into our country, breaking our 

laws, and putting the health of our citizens at risk, I think you do 

deserve a significant sentence. But I also agree that we need to 

sort carefully the people that come into the system. And there are 

many people whose only offense is buying and using drugs. And 

those people that are drug dependent and not involved in running 

significant trafficking organizations, those people absolutely should 

be diverted into treatment, into drug courts, into alternative sentences. 


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So I think that sometimes folks lose track that the Federal system is really charged with the trafficking issues, the major criminal groups. It’s really State and local governments that are responsible for dealing with local drug dealing and drug users that may 

commit mild/minor offenses. So we really have to learn to tell the 

difference and treat differently those with different criminal 

records and criminal backgrounds. 

Mr. CLAY. I thank you for your response. 

And I yield back, Mr. Chairman. 

Chairman GOWDY. The gentleman yields back. 

The gentleman from Wisconsin. 

Mr. GROTHMAN. Thank you. 

It’s been a while since I traveled outside the country, I think 

about 14 years. But the last time I went outside the country, I 

went to Taiwan, and they don’t seem to have this huge drug problem that we do in this country. And at least in my State, I believe, 

I might be wrong, but I believe more people die of opiate abuse 

every year than murders and car accidents combined. Certainly, in 

most counties that’s true. It’s just horrible. 

Are any of you familiar with the type of sentencing that we have 

in countries which don’t have these—like Taiwan, that don’t have 

these huge numbers of people dying from opiate abuse? 

Mr. Baum, do you know what they do in other countries? 

Mr. BAUM. Yeah. I think, you know, because of the incredible 

overprescribing we’ve had in this country for two decades, our problem is like no other. Canada is experiencing some of the similar 

problems that we have, but there’s no other country that hands out 

these dangerous, addictive narcotic analgesics the way we do. 

Mr. GROTHMAN. There’s no question. For years—I’ll have to write 

books about the horrible things our medical professionals did the 

last 15 years. I’m told it’s getting better. But does anybody know, 

if you are caught with enough heroin, that you’re caught with heroin in other countries that don’t have these problems, what type of 

prison sentences are handed out? 

Mr. BAUM. The nations in Asia tend to have very strict penalties 

and also very strong messaging about drug use. The U.S. problem 

is different. And I would simply say, in the U.S., we need to get 

back, there’s a lot we need to do on the prescription drug problem 

but also on prevention, because we need to get a very strong and 

consistent message out to our youth about the incredible risk they 

face when using drugs. Especially with fentanyl contaminating our 

drug supply, drug use is a very risky behavior, and we really need 

to prevent and delay—delay and prevent, if we can, initiation of 

drug use, especially for people, our young people, where they’re still 

growing, their body is still growing. It’s very risky behavior for 

young people. 

Mr. GROTHMAN. Okay. We have four people here. Does anybody 

know what type of drug sentences are handed out in countries like 

Taiwan that don’t have an opiate—big opiate problem? Nobody 

knows? Nobody has checked into this? 

Mr. HUMPHREYS. I have certainly been to Taiwan and other 

countries like it. They have very, very tough criminal justice sentencing. 


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Mr. GROTHMAN. Well, both you and Mr. Baum said it’s very, very 

tough. What does very, very tough mean? If you—— 

Mr. HUMPHREYS. The death penalty for dealers, even for lowlevel dealers. There’s places where even with possession, a small 

amount of possession, you can end up doing a really long time in 

prison. But, of course, we have put an awful lot of people in prison 

in this country. It’s not as if we haven’t tried that route. And I 

think we are different than those more cohesive, smaller societies, 

more freedom-loving society, a more capitalistic society, and also a 

healthcare system that is out of control on the prescriptions. 

Mr. GROTHMAN. I’m against capital punishment across the board. 

But just interesting how other countries deal with it. 

Mr. Humphreys, are all people who use opiates or maybe wind 

up dying of opiates, are they all addicts? 

Mr. HUMPHREYS. No, sir, they are not. These are valuable medications, when used properly and safely, that people use them, benefit from them, and then do not get addicted. It is not everybody. 

Mr. GROTHMAN. What percentage of people who die of opiate 

abuse do you think are addicts? 

Mr. HUMPHREYS. Of the people who die of abuse, I would say 

most of them are. There’s occasionally people who have essentially, 

if I can say, like an accidental exposure, like a kid goes to a party 

and gets an Oxy they’ve never had before, has it with a lot of alcohol and dies. But most of the people who are showing up in overdose statistics have been using for awhile and are addicted. 

Mr. GROTHMAN. I’ll tell you what goes on in my area, and I’d like 

you to comment on it. In my area, we are told that the opiates are 

frequently purchased from a dealer in Milwaukee County, and then 

the opiates are brought back to Fond du Lac County or Ozaukee 

County or more rural points north. And the thing that frustrates 

local law enforcement is they feel, because Milwaukee County is 

kind of a liberal county, that, well, if they—if people are caught 

selling drugs in these more northern counties where there are, you 

know, a little stricter judges, they are strongly deterred from selling drugs again. But in Milwaukee County and more liberal counties, they get a slap on the wrist. And I was under the impression 

that maybe if we forced liberal counties to put mandatory minimums on, maybe it would deter some of these sellers that right 

now only get a slap on the wrist. Would you comment on that? 

Mr. HUMPHREYS. Yeah. I mean, low-level dealers and many people who have drug problems—— 

Mr. GROTHMAN. Not necessarily low level, but go ahead. 

Mr. HUMPHREYS. Okay. Yeah. I’d be happy to talk to you at 

length more than we have time here for, Congressman, but I don’t 

believe that the really long sentences motivate that population because they don’t think that way. They’re not thinking about what 

they’re going to do in 11 years. They’re thinking pretty close. And 

so I don’t think when you threaten from 10 to 20, that that motivates them. That’s what I’ve seen. 

Mr. GROTHMAN. I think that’s an insulting thing to say, but I’ve 

gone over my time. 

Chairman GOWDY. The gentleman yields back. 

The gentleman from Massachusetts is recognized. 


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Mr. LYNCH. Thank you, Mr. Chairman, and thank you and the 

ranking member for holding this important hearing. And I want to 

thank the members in the panel for helping the committee with its 

work. 

Director Baum, back in 1993 till about 2009, your position as director, even though you’re acting director, Director of the Office of 

National Drug Control Policy was a Cabinet-level position. I have 

joined with Mr. Rothfus and a large group of Democrats and Republicans writing to President Trump asking him to reestablish the 

Director of the Office of National Drug Control Policy as a Cabinetlevel position. 

Could you tell the committee what that might mean if we were 

to reelevate that position? 

Mr. BAUM. Thank you, Congressman, for the question. You know, 

in my service at ONDCP, both under the Bill Clinton administration and the George W. Bush administration, I watched Barry 

McCaffrey and John Walters operate. And I see that being in the 

Cabinet, being at the Cabinet meetings, and being able to engage 

as an equal with the other Secretaries was something that’s valuable. 

I have to say, in the Trump administration, I’ve had strong support from the Cabinet. I’ve met with the Cabinet Secretaries and 

engaged with them frequently. So that political support is very 

strong in the Trump administration. 

But I do understand your point that it can be an asset to be formally included in the President’s Cabinet. 

Mr. LYNCH. Right. I want to go back to the marijuana question. 

So in my State, by referendum, the citizens of Massachusetts just 

voted to approve of recreational marijuana in my State. Now, my 

personal experience has been—I opposed to that, but we lost decisively on the ballot question. I just cannot see how flooding the 

streets with another drug is going to help. 

And part of my work as a Member of Congress has been to establish a residential treatment facility for young people, because the 

age at which these young people have been lured into OxyContin 

and then heroin and fentanyl is just—it’s a horrific situation. And 

I’ve got probably 500—500 kids that have died of a drug overdose. 

And, Mr. Flattery, I’m totally sorry for your loss, and I certainly 

empathize with your position, and I’m thankful for your courage to 

come forward, you and your wife, with your son’s situation. 

But I could find no really decisive studies on the effects of marijuana on the developing brain. You know, and obviously, when 

you—when you put something out—when you legalize recreational 

marijuana, society is putting this imprimatur of acceptance and implied suitability so that people are going to look like, hey, this is 

something that’s not harmful, and I can engage in that. 

Can you talk a little bit about what that might mean for the general population? 

Mr. BAUM. Thank you, Congressman. Let me say a few words, 

and then maybe Dr. Humphreys has a few words as well. You 

know, States have a lot of options in how they manage something 

like marijuana. And I think sometimes that we’re looking at this 

sort of all-in-or-all-out kind of policy. And if States want to alter 

and have a less severe sentencing—— 


KING-6430 with DISTILLER
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Mr. LYNCH. And I totally support that. Believe me, I don’t think 

people should be thrown in jail for smoking marijuana. That 

doesn’t happen. 

Mr. BAUM. And that’s my point. So States have options, but the 

idea that it’s going to be so legal and so accessible to young people 

really does put themselves at risk. 

And, you know, there’s a lot of research already on the harmful 

effects, physical and cognitive, caused by marijuana. And this research was done on earlier marijuana before we had these incredible high levels of THC, which we have now. The new forms of 

marijuana, shatter and wax and the liquids that are being vaped, 

these are very, very powerful substances. The super powered marijuana has not been tested. 

So I just—you know, as a parent, I just don’t want my kids and 

other kids in this country at a young age being exposed to these 

substances. And I think we really got to think about, when we 

make these policy decisions, what’s best for your youth. 

Mr. LYNCH. Mr. Humphreys, you want to add? Dr. Humphreys? 

Mr. HUMPHREYS. Yes, sir, I would. Marijuana is way more potent 

than it’s been in previous eras, and people are using it every single 

day much more. So I’m quite worried about the public health impact. I think it’s being underestimated how destructive this drug 

can be. 

And I’m also worried about the fact we’re having a commercial 

industry promoting the product with very little regulation. It’s kind 

of like tobacco industry’s fantasy of what they always wanted, the 

marijuana industry is getting. I think the regulatory framework in 

these States needs to be much, much stronger, otherwise we’re 

going to regret it deeply. 

Mr. LYNCH. Thank you. 

I yield back, Mr. Chairman. 

Chairman GOWDY. The gentleman from Massachusetts yields 

back. 

The gentlelady from Florida is recognized. 

Mrs. DEMINGS. Thank you so much, Mr. Chairman. Thank you 

for this very important hearing today. 

And thank you as well to our witnesses, particularly Mr. and 

Mrs. Flattery. We thank you for introducing us to Kevin today. 

As a former police chief, we in Florida are all too familiar with 

the devastation drug addiction inflicts on families and on every 

community it touches. First, we battle pill mills and—but now we 

see ourselves—last year, we lost 14 persons a day, higher than 

even during the height of the pill mill crisis. In Orange County, the 

sheriff’s office responded to more than 160 overdoses in the first 3 

months of this year. Is this an epidemic? I would say yes, it is. 

Too often, the criminal justice system, as we’ve heard many 

times today, serves as the initial stop for individuals suffering from 

addiction disease. The Orange County jail has become the de facto 

and is called the largest drug treatment center and mental health 

provider in the region. 

In the Obama administration, we saw a shift to a public health 

model of response to the opioid epidemic and an increase focused 

on prevention, treatment, and recovery efforts. 


KING-6430 with DISTILLER
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Dr. Humphreys, can you just give us some examples of prevention treatment and recovery efforts that were expanded under the 

Obama administration and why these efforts are so important in 

fighting the drug addiction crisis? 

Mr. HUMPHREYS. Thank you for that question. I’d be very happy 

to do so. We saw addiction as a health problem, and, therefore, we 

tried to build health services directly into the mainstream 

healthcare system. 

Historically, addiction treatment has been funded by, you know, 

a separate block grant away from all of medicine. That makes the 

services uncoordinated. It makes them hard to access. So that is 

why—wanting to break away from that is why the Affordable Care 

Act says that taking care of substance abuse disorders is an essential healthcare benefit. You go to the same healthcare system. It’s 

reimbursed the same way. It makes it easier for people to access. 

They don’t feel as stigmatized. They can talk to their regular doctor, and the doctor can get paid for intervening with it. 

Same thing in the Medicaid expansion. Covering substance abuse 

disorder as a core service, not an add-on, not a blocker, and not a 

special set aside, but a core service. Because, you know, this is a 

problem that is very prevalent among Medicaid enrollees. It’s a 

health problem that needs to be addressed, and so we try to build 

everything in. 

And if we do that in Washington, our belief, and my belief, was 

that that makes it much more likely on the ground in your community and everyone else’s community that the locals will work together too. They’ll know who each other are and they’ll work together to bring people back to health. 

Mrs. DEMINGS. Thank you so much. 

And, Mr. Flattery, earlier, we were talking about some of the creativity from local jurisdictions, and you mentioned one of the barriers to that is just the need to reengineer, I believe you said, treatment programs. I think we ran out of time. I’d love to hear a little 

bit more of your thoughts on that. 

Mr. FLATTERY. Well, I believe that the treatment, the world of 

treatment, especially for opioid substance use disorder is entirely 

broken. In many rural areas of the country, there is no treatment 

at all. In those counties, particularly in my newly adopted State 

that have some treatment, there are limits. There are cost issues. 

There are insurance coverage issues. There’s actual stigma from 

those in recovery who are judging others who are choosing medication-assisted treatment. There are prescribers who are charging 

cash on the barrelhead only and sometimes $500 to treat someone 

with buprenorphine. 

There are manufacturers of alternative medication-assisted treatment who are in every State capital lobbying and making statements about competitor medication-assisted treatment. All of those 

are creating barriers to people getting evidence-based treatment. 

And I previously had discussed some 30-day residential treatment programs who, I believe, are often treating people as customers and not patients, and they’re detoxing and releasing people 

to the wild in a short-burst attempt. A 30-day attempt is woefully 

inadequate when we’re dealing with a chronic long-term condition. 


KING-6430 with DISTILLER
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So that’s kind of what I—those are—there are a number of issues 

surrounding why our treatment system just does not work, and we 

need—we need to reengineer it with some of the enthusiasm that 

we’re using today to discuss changing our Nation’s healthcare system. 

Mrs. DEMINGS. All right. Thank you so very much. 

Mr. Chairman, I yield back. 

Chairman GOWDY. The gentlelady yields back. 

The gentlelady from the Virgin Islands is recognized. 

Ms. PLASKETT. Thank you, Mr. Chairman, and thank you for 

holding this hearing. 

The High Intensity Drug Trafficking Area program, or HIDTA, 

was created to provide assistance to Federal, State, local, and Tribal law enforcement agencies operating in areas determined to be 

critical drug trafficking regions in the United States. There are 

currently 28 HIDTA regions, which include almost 66 percent of 

the U.S. population in 49 States, the District of Columbia, Puerto 

Rico, and the U.S. Virgin Islands. To date, these regional HIDTAs 

have steadfastly worked with local law enforcement to coordinate 

efforts and share intelligence. 

Mr. Baum, do you consider the work of HIDTA integral to the 

advancement of the mission of the Office of National Drug Control 

Policy? 

Mr. BAUM. Thank you, Congresswoman, for the question. We are 

extremely proud of the HIDTA program. They are working every 

day in a partnership, Federal, State, local, collaborating on looking 

at and studying the problem they face in each of these regions and 

deciding together on the priorities. 

I think it’s important to make the point that ONDCP, we provide 

grants for the programs, but we don’t tell them what to focus on. 

Ms. PLASKETT. Right. 

Mr. BAUM. It’s a regionally focused program, and it’s designed to 

bring people together and coordinate Federal, State, and local law 

enforcements, and they’re producing very dramatic results. Actually, if you look at the amount of cash and assets they’re seizing, 

they more than pay for themselves three times over, 3–1/2 times 

over. 

So I thank the Congress for their great support of the HIDTA 

program. It’s really getting a great return on the dollar. They are 

really making a difference in our communities. 

Ms. PLASKETT. As you talked about success, HIDTA initiatives 

identified over 8,800 drug trafficking organizations, disrupting or 

dismantling over 2,700 of them, and seizing over $895 million in 

cash and noncash assets from drug traffickers in 2015. And as you 

said, these were organizations working with local law enforcement 

who identify the threats specific to those areas, identify how to go 

after them, how to disrupt and to dismantle those activities in the 

areas in which they are working. 

I’ve seen the work that they’re doing in the Virgin Islands. And 

as a former narcotics prosector, I’m just completely very—however 

I can be supportive of the work that they’re doing in those areas 

is really important. 

But in the area in which I represent the U.S. Virgin Islands, and 

Puerto Rico, where HIDTA works together, they cover—that area 


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is recognized by ONDCP in 2013 for its outstanding work in disrupting drug trafficking networks through the Caribbean destined 

for the mainland USA. 

Mr. Baum, would you agree that the HIDTA region that covers 

the U.S. Virgin Islands and Puerto Rico is integral to combating 

transit routes for drugs from South America into the U.S. mainland? 

Mr. BAUM. Yes, absolutely, Congressman. It’s a very important 

area, and it is sort of in the neighborhood of the world that faces 

a lot of drug challenges, and so we’re very pleased to have the 

HIDTA there, and we know it’s a significant threat that you face 

in the Virgin Islands. 

Ms. PLASKETT. Yes. You know, we are—right now, the U.S. Virgin Islands, according to the FBI in 2016, has the highest murder 

rate per capita in the country, higher than any other State, commonwealth, or territory. And we know that most of it is due to 

drug trafficking. Most of the drugs are not used by Virgin Islanders. The Virgin Islands was purchased because of our geographic 

importance, and drug dealers are smart people. They recognize that 

there’s an important route there as well and are using the islands 

for that. 

Nonetheless, the House today will likely appropriate over $1–1/ 

2 billion to begin building a wall on our southern border, and 

meanwhile, the Virgin Islands and places like me are facing enormous murder rates, enormous disruption to our communities because of this drug trafficking, because of what’s happening there. 

And I believe that a lot of that money, those billions of dollars that 

are being spent on that wall and appropriated there, could be better used to wall ourself from the drug trafficking that is coming 

through this country. 

Mr. Baum, is there any additional moneys that you think that 

HIDTA would need to be effective in its war against drugs? 

Mr. BAUM. Congresswoman, the President in his fiscal year 2018 budget request asked for $246 million for the HIDTA program. 

That’s the largest request ever from an administration. And so 

we’re hoping to get Congress’ support for that. 

And on the border security issue, border security is very important. We face a lot of challenges, and so there is a need for infrastructure and officials. And we’re really pleased at the incredible 

leadership of Secretary Kelly in getting CBP and the DHS folks 

back engaged and combating drugs, so there’s a lot that has to be 

done. Certainly, we think HIDTA is an important part of the drug 

enforcement solution. 

Ms. PLASKETT. Thank you. I just wish Mexico would pay for it 

instead. 

I yield back. 

Chairman GOWDY. The gentlelady from the Virgin Islands yields 

back. 

I’ll recognize myself for 5 minutes of questioning. 

Dr. Humphreys, it is currently against the law to prescribe controlled substances outside the course of a professional medical practice. It’s a pretty arcane statute. It’s not used all that often. But 

it strikes me that until you control that group that is uniquely empowered to prescribe controlled substances—and I appreciate the 


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fact that Director Baum thinks it’s an education issue. I don’t know 

that many dumb doctors. I don’t know that many—I don’t think it’s 

an education issue as much as it is a money issue. 

So how do we capture the attention of those uniquely situated 

people in our culture who have the authority to write controlled 

substance prescriptions? 

Mr. HUMPHREYS. Thank you for that question, Mr. Chairman. I 

divide doctors up as follows: The biggest group of doctors are good 

people who do the right thing, and they need to be left alone. The 

second biggest group are good doctors who do the wrong thing, and 

they need education and training. 

There is a third group. It is a small group. It’s probably less than 

1 percent of physicians who are not good people, and they do the 

wrong thing knowingly. And we saw this, my time at ONDCP in 

Florida, a massive concentration of people giving out huge quantities of OxyContin. And I think at that point, they’re no different 

than any other drug trafficker. The fact that they’re an M.D. is irrelevant. They know what they’re doing. They’re being harmful, 

and that’s why we have law enforcement to go after them, and I’m 

all for them doing that. 

Chairman GOWDY. Well, I know we do, and we certainly used to. 

It was phentermine and fenfluramine back when I was at the DA’s 

office, but DA diversion is not as active. Unless you know something I don’t know, they’re not as active as they once were. So I 

get that it’s hard to go after doctors. 

And just so the record’s clear, my dad’s a physician. I actually 

like doctors, but they are uniquely empowered in our culture. Gerry 

Connolly can’t write a prescription for an antibiotic or a controlled 

substance. Doctors can. And you can be in this specialty but write 

an analgesic prescription. 

So I’m with you. I appreciate the deference you show to physicians that it’s an education, and I do think the overwhelming majority want to do the right thing for the right reasons. But there’s 

a lot of money in this particular realm. And until there are prosecutions for physicians who prescribe outside the course of a professional medical—and what I mean by that, just so nobody thinks 

I’m getting too complicated, writing a prescription on a cocktail 

napkin at a bar for someone you just met that you’ve never done 

any diagnostic test on, you just happen to take his or her word, I 

like my chances in front of a jury of that being outside the course 

of a professional medical practice. 

So, Mr. Baum, as you write your plan, it’d be great if you could 

address DEA diversion and whether or not they’re being plussed 

up. I know it’s tough to go after doctors. Juries are sympathetic 

with them, but they are uniquely positioned in our culture, and 

somehow or another we’ve got to address it. 

Dr. Humphreys, let me ask you this: You mentioned drug court 

a couple of times. Do you have a position or is there research that 

indicates whether preadjudication drug courts or postadjudication 

drug courts work better? 

Mr. HUMPHREYS. I’m not aware of research that proves that 

point, because those populations are really different kinds of people, typically, the people who are given the option early versus 

later. I do know that both—both drug courts as well as other modVerDate Nov 24 2008 09:02 Feb 06, 2018 Jkt 000000 PO 00000 Frm 00080 Fmt 6633 Sfmt 6633 H:\27603.TXT APRIL

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els that have been promulgated, HOPE Probation is one that now 

the Federal Government supports, 24/7 Sobriety on the alcohol side 

where you use the court as a mechanism to enforce abstinence with 

regular checks and treatment backup as needed all show, you 

know, very good outcomes. We should be doing those much more. 

By good outcomes I mean you get the trifecta, the public is safer 

as the person is held accountable, substance abuse goes down, and 

then incarceration goes down. 

Chairman GOWDY. Well, I want you to help me with something, 

if you can. And I ask this respectfully. As you travel, if you’re ever 

invited to address a group of public defenders or criminal defense 

attorneys, oftentimes they will refuse the offer of drug court because probation is easier. It is not better for their client, but it’s 

easier. So we’ve got to kind of reconfigure what is in the best interest of the client. Remaining addicted but just having a shorter period of probation is not in the best interest of the client, and they’ll 

believe you and they won’t believe an old prosecutor. 

So in my remaining time, Director Baum, in case my mom is 

watching, I want to be really clear, I’m not advocating for the legalization of marijuana. I want to be very, very clear about that. However, I don’t understand why it’s a Schedule I. It’s certainly not 

treated as an inherently dangerous substance for which there is no 

medicinal value. It takes a tractor-trailer full of marijuana to even 

trigger a mandatory minimum under our drug laws. 

So is there any appetite for researching whether or not it should 

remain a Schedule I drug? 

Mr. BAUM. Congressman, the administration doesn’t have a position on that, but I’m happy to dialogue with your office. And let me 

just briefly say that we strongly support research on medical use 

of marijuana. And if there are obstacles that we see that prevent 

good research, we want to address those obstacles. Because if there 

are component elements of marijuana that could be put through 

the FDA process and turn into medicines that could help people in 

this country, we want to do that. So we do think there’s a potential 

and we support research on the subject. 

Chairman GOWDY. Well, just so everyone’s clear, methamphetamine is schedule what? 

Mr. BAUM. I believe it’s Schedule II. 

Chairman GOWDY. Cocaine is schedule what? 

Mr. BAUM. Also II. 

Chairman GOWDY. Cocaine base is schedule what? 

Mr. BAUM. A—— 

Chairman GOWDY. II. So it is scheduled lower than marijuana. 

And, again, you can schedule something and still not have it scheduled as a I? And I would encourage the powers that be, whoever 

you need to consult with in the administration, to at least explore 

whether or not it’s scheduled correctly without being perceived as 

advocating for legalization. 

Mr. BAUM. Understood. 

Chairman GOWDY. With that, Mr. Connolly, I want to give you 

a chance to—I’m reluctant to say whatever you want, but I’m going 

to give you a chance to conclude. 

Mr. CONNOLLY. Well, I thank my friend. And I actually want to 

follow up, if I may, on what you just asked. 


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So the point being made here in some ways, Mr. Baum, is if 

you—not you personally. If the government, Federal Government, 

on this subject, marijuana and how dangerous it is, has no credibility because of the lack of serious empirical work, it threatens our 

whole drug policy’s credibility. And you have seen this happen in 

marijuana in the States. They’re making decisions. Ms. Norton 

talked about eight States, but there are over 25 States that have 

in some fashion, including my home State of Virginia, liberalized 

their laws for medical reasons all the way to recreational reasons. 

I think you’d have to confess to the chairman’s point, there was 

no empirical evidence to justify putting marijuana 50 years ago as 

a Schedule I drug. Who did that empirical evidence? 

Mr. BAUM. Sir, could you repeat that? Who did what? Who made 

it schedule—— 

Mr. CONNOLLY. There was no—I am asserting, and you can feel 

free to try to contradict, there was, in fact, no empirical evidence 

to justify putting marijuana ahead of the drugs the chairman just 

listed as a Schedule I drug 50 years ago. And I would—you brought 

up the need to have empirical research before we start rushing pill 

mill to approve it for medical purposes, and I agree with you. But 

here’s the problem: As I said in my opening statement, only one 

Federal entity, NIDA, controls marijuana for legal purposes for experimentation, testing, and the like, research. And NIDA’s mission 

is all about proving the harms of something. They’ve priority determined the outcome research. Nobody thinks NIDA is an objective 

neutral place to go to look at the good, the bad, and the indifferent 

about marijuana. It doesn’t have that credibility. 

So if we’re going to do what you suggest, we need to have a different entity with credibility where we’re looking at objective evidence and science, and then we can determine, well, where does 

marijuana work? 

Mr. Humphreys made the point that there’s a more lethal or 

stronger, more fortified versions of marijuana coming out that concern us. But we put a lot of people in jail, and we’ve treated this 

like it’s more dangerous than cocaine and the other substances the 

chairman—and it’s had huge consequences based on very little scientific evidence. 

I’m not arguing for the legalization either. I agree with my friend 

from South Carolina, I’m not going there, but neither can I justify 

the current policy of treating it as the world’s most dangerous drug 

with this classification. 

You can feel free to respond, and I’m done. 

Mr. BAUM. Congressman, I understand the point that you’re 

making. I would love to go with you in your district to talk to police—police chiefs and sheriffs. I think in reality, on the street, police, sheriffs, they don’t treat marijuana the way they treat heroin 

and fentanyl. So I think in practice, there is a prioritization of the 

most deadly drug threats. 

Chairman GOWDY. I think—I actually think that’s his point, is 

that law enforcement doesn’t, our sentencing scheme does not. 

Methamphetamine and marijuana are not treated the same from a 

sentencing standpoint, but yet marijuana is considered to be inherently dangerous with no medicinal value, therefore, a Schedule I. 


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And it would just be helpful, again, to Mr. Connolly’s point, for 

us to have some consistency, or at least be able to explain why certain drugs are Schedule I and others are not. And, you know, we 

can save that for another day. And, again, that’s coming from two 

people that are not advocating for the legalization, just for some 

common sense in how it’s scheduled. 

On behalf of all the members, I want to thank all of our witnesses for your expertise. 

Mr. and Mrs. Flattery, in your case, your very tragically earned 

expertise in this area. And I cannot imagine how painful it is. Any 

and every parent—and you don’t have to be a parent to appreciate 

how difficult what you have done today is. And I salute you for 

your advocacy so other parents do not have to live through what 

you and your wife have lived through. 

I want to thank all the witnesses for your collegiality with one 

another and your comity with one another and with the committee. 

And with that, if there’s no further business—thank you, Mr. 

Connolly—without objection, the committee stands adjourned. 

[Whereupon, at 12:31 p.m., the committee was adjourned.] 


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