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From YouTube: Opioids: Lessons Learned From the States
Description
This interactive session covers the latest health and human services developments in efforts to address the opioid epidemic, which continues to claim lives and affect families across the nation. State legislators and experts will discuss new data, recent legislation and policy innovations in states.
A
Welcome
to
the
session
opioids
lessons
learned
from
the
states:
I'm
Kate,
Blackman
I
am
an
NC
SL
health
program
in
Denver
and
I
want
to
do
just
a
couple
short
things
reminders
for
you
all,
so
I
did
want
to
make
sure
that
everyone
here
knew
that
this
is
this
session
is
a
collaboration
between
NC
s,
l's
health
and
human
services
program,
and
we,
like
many
of
you
in
your
states.
Ncsl,
is
really
working
on
opioid
related
policy
from
all
angles,
so
from
Health,
Human,
Services,
criminal
justice,
employment
and
labor
education.
A
We
are
tackling
it
similarly,
to
the
way
that
you
are,
and
so
I
wanted
to
make
sure
for
our
members
for
legislators
and
legislative
staff
that
you
all
know
that
we're
here
to
support
you.
We
have
numerous
web-based
resources
which
are
in
that
resources
for
your
app
for
this
session
and
we're
also
available
for
any
kind
of
research
requests.
A
Other
technical
assistance,
presentations
in
your
states
and
things
so
thank
you,
I'm,
usually
quite
loud,
so
so
I
just
wanted
to
make
sure
you
all
knew
and
I'm
gonna
have
some
of
the
NCSL
staff
in
the
room
who
work
on
opioids
raise
their
hands.
You
can
see
them
they're
all
lurking
around
the
back,
but
please
feel
free
to
connect
with
any
of
us.
If
there's
anything
that
we
can
do
for
you
another
just
a
couple
housekeeping
things
we
are
being
live-streamed,
I'm
gonna
call
that
out
now.
A
So
when
you
get
the
mic,
if
you're
asking
a
question,
we
would
love
for
you
to
introduce
yourself
boats
for
the
audience
here
in
the
room
and
for
the
audience
at
home
and
be
careful
what
you
say
and
also
this
session
was
originally
listed
for
CLE
credit
and
it's
been
removed
and
if
there's
any
confusion
about
that,
we
apologize
depending
on
your
the
requirements
in
your
state.
You
may
still
be
able
to
get
CLE
credit,
but
Meagan
in
the
back
is
happy
to
help
you
with
that.
A
If
that
would
be
useful,
so
I'm
gonna
turn
it
over
to
our
wonderful
folks.
Here
in
a
moment,
but
I
do
just
want
to
let
you
know
that
today,
we're
really
thrilled
to
be
the
four
panelists
that
we
have
are
part
of
our
inaugural
opioid
Policy
Fellows
Program,
which
was
a
program
that
we
did
this
year
with
support
from
the
Centers
for
Disease,
Control
and
Prevention,
and
it's
based
on
a
model
that
was
pioneered
by
ncsl
early
learning,
fellows
and
I
bet.
A
We
have
some
alums
in
the
room,
but
it's
a
model
that
we
do
now
in
a
few
different
policy
areas
at
NC,
SL
or
able
to
really
have
a
small
group
of
legislators
and
legislative
staff.
Take
a
deep
dive
into
a
specific
policy
area
through
in-person
meetings
and
virtual
meetings,
and
really
delve
into
kind
of
evidence
behind
various
policies,
as
well
as
share
ideas
across
their
states.
New
ideas,
things
that
are
working
challenges
and
successes.
So
we're
thrilled
to
have
four
of
those
folks
here
with
us
and
also
representative
stinger,
is
going
to
moderate.
A
Our
panel
representative
Jonathan
singer
from
Colorado,
also
sits
on
Colorado's
opioid
interim
Study
Committee.
In
addition
to
many
other
hats
that
he
wears
in
Colorado
and
here
within
CSL,
so
thank
you
all
for
joining
us
this
morning.
We
look
forward
to
a
great
conversation
where
we
can
really
dive
into
this
with
our
panelists
and
with
you
all.
B
B
Thankfully,
that
will
bounce
back
but
I'm
sure.
Now
that
this
has
been
live
stream.
Someone
will
have
taken
that
domain
name,
but
if
you
email
me
at
rep
singer
at
gmail.com,
please
don't
hesitate
to
reach
out
to
us
in
Colorado.
This
is
affecting
all
of
us
in
so
many
different
ways,
and
it's
time
that
we
get
together
on
this
and
so
I'm
really
grateful
to
see
such
a
such
a
full
room
here
and
for
those
folks
online
that
are
watching.
Please
don't
hesitate
to
also
reach
out
to
me
as
well.
B
The
invitation
is
out
there
for
everyone,
so
really
I
just
want
to
start
by
giving
all
of
you
a
little
bit
of
context.
I
think
the
reason
that
you're
here
isn't
that
you're
just
learning
about
this
subject,
I
think
that
a
lot
of
you
actually
I'll
just
ask
how
many
of
you
here
are
fellows,
so
good
number
good
number
a
few
collapse
for
that
thing.
So
that's
good
for
for
the
rest
of
you,
though,
whether
you're
in
West,
Virginia
or
West
Hollywood
or
in
Beverly
Hills,
or
you
know
somewhere
in
Boston.
B
We
know
that
this
is
not
an
urban
or
rural
issue.
This
is
not
a
rich
or
poor
issue.
This
is
not
an
issue
about
race.
This
is
the
crisis
and
addiction
of
our
time.
In
Colorado
we
have
the
Colorado
constricted
consortium
on
prescription,
drug
abuse
and
the
experts.
There
are
saying,
even
with
the
focus
that
we
have
today
to
stem
the
tide
and
to
stop
the
momentum
of
the
deaths
that
are
happening
will
take
ten
years.
B
B
Think
about
that
for
a
second.
If
we
had
more
people
dying,
we
do
have
excuse
me
more
people
dying
from
the
opioid
crisis
than
we've
had
lose
their
lives
overseas
in
the
most
recent
wars
that
have
been
fought,
I
mean
on
behalf
of
the
United
States.
If
we
were
fighting
al
Qaeda,
we
would
be
spending
a
trillion
dollars
right
now
to
stem
the
tide,
we're
not
there
yet,
but
that
is
the
severity
of
the
crisis
today.
B
I
know
that's
why
you're
here
I
know,
that's
why
our
panelists
are
here
and
I'm,
just
gonna
wrap
up
on
one
thing
before
we
go
to
our
panel,
but
before
I
was
in
office.
I
I
want
you
to
think
about
this.
This
is
a
think
about
putting
yourself
on
a
warm
spring
day.
I
was
a
social
worker
working
on
child
protection
issues
and
I
got
a
phone
call
that
somebody
was
concerned
about
a
family
and
a
huge
spread
of
ages.
But
there
was
a
elementary
school
kid
just
starting
out.
B
First
grade
kindergarten,
looked
a
lot
like
me,
not
what
I
look
like
now,
but
but
looked
a
lot
like
me
as
a
kid.
The
teachers,
when
they
first
saw
me
stop
by
the
school
thought
that
I
might
have
been
his
father
and
you
know
I
introduced
myself,
show
them
my
badge.
Let
them
know
why
I
was
there
and
then
proceeded
to
do
a
home
visit
and
then
at
the
home
visit
you
know,
I
asked
the
the
dad
I
said.
You
know
I
know
you're
your
spouse
isn't
here
right
now
she
disappeared.
B
I
know
everyone's
trying
to
find
her
right
now,
they're
worried
about
her.
She
had
started
using
pain
pills.
You
know
the
story
right
and
the
pain
pills
get
too
expensive
and
the
doctors
say
we're
gonna
cut
you
off,
so
she
finds
something
cheaper
and
now
she's
absconded
with
all
the
credit
cards
and
whatever
else
and
she's
somewhere
else,
spending
that
money,
but
not
taking
care
of
her
family,
so
I'm
sitting
on
a
curb
with
six-year-old
or
five-year-old
and
we're
just
having
a
conversation.
B
You
know
his
dad's
still
in
the
picture
everyone's,
you
know
it's,
it's
a
crisis,
mom
disappeared,
but
you
know
everyone
else
is
still
home
and
the
way
I
wrapped
up
every
conversation,
I
had
was
I,
said.
Look,
you
know,
I've
asked
you
a
lot
of
questions,
but
did
you
have
any
questions
for
me
and
he
looks
up
at
me
and
he
goes
yeah?
Why
did
my
mom
choose
drugs
over
me?
B
How
does
anyone
answer
that
question,
let
alone
a
28
year
old,
new
worker
who
would
never
met
this
kid
before,
but
looking
at
me
looking
at
somebody
that
could
have
easily
been
someone
related
to
me,
how
do
we
take
care
of
our
kids
when
these
things
happen
in?
How
do
you
have
a
good
answer
to
that
question
and
I'll
tell
you
the
answer.
I
gave
him
that
day
as
I
said
well,
your
mom
is
sick
and
she's,
trying
to
feel
better
on
her
own
and
we're
gonna
find
her
the
help
that
she
needs.
B
I,
don't
know
if
that
was
the
right
answer
or
the
wrong
answer,
or
the
best
thing
I
could
have
said,
or
the
worst
thing
I
could
have
said.
But
obviously
that
answer
isn't
enough
and
the
answer
is
we're
gonna
get
today
aren't
going
to
be
enough,
but
it's
going
to
be
the
beginning
of
a
conversation
to
make
sure
that
we
can
reunite
families
and
save
lives
and
do
the
right
thing
for
the
people
of
the
United
States
of
America,
and
so
with
that
I
want
to
introduce
you
to
our
panelists.
B
So
we
are
joined
today
by
an
pew
from
Vermont.
She
serves
as
chairman
of
the
House
Human
Services
Committee.
We
have
Assemblyman
Mike
sprinkle,
who
is
Majority
Whip
and
chair
of
the
assembly
Committee
on
Health
and
Human
Services
in
Nevada,
and
senator
Judy
Lee,
who
is
also
one
of
our
panelists
and
chair
of
the
state
Senate
Committee
on
human
services
in
North,
Dakota
and
finally,
senator
David
Wilson
in
Alaska,
who
is
chair
of
the
Senate
Health
and
Social
Services
Committee
now
are
all
of
you
opioid
fellows
as
well.
Okay,
all
right!
B
Well,
then,
I'm
gonna
learn
something
from
you,
because
I
was
not
able
to
join
that
that
fellowship
now,
it's
sounding,
like
Lord
of
the
Rings
I,
was
not
able
to
join
that
fellowship
due
to
due
to
a
new
addition
to
my
family,
who,
who
was
born
on
May,
1st
and
I.
Think
your
first
meeting
was
not
shortly
after
that,
so
I
I
figured.
B
You
know
family
first
on
this
one,
so
I
look
forward
to
hearing
what
you
what
you
have
come
up
with,
but
I'm
going
to
ask
each
of
you
a
question
and
then
we're
gonna
go
to
some
questions
from
the
audience.
But
I
want
to
ask
you
a
couple
questions.
First
of
all,
so
for
those
of
you
on
the
panel
here
who
did
participate
in
the
opioid
Policy
Fellows
program,
what
is
the
biggest
takeaway
that
you'd
like
to
share
with
our
audience
today
and
we're
just
gonna?
C
So,
thank
you.
Thank
you
very
much
for
that
kind
of
opening.
I
am
Assemblyman.
Mike
sprinkle
I'm
from
the
state
of
Nevada
I,
think
it's
relevant
to
say
also
where
a
citizen
legislature,
which
means
I,
have
another
full-time
job
and
I
work
as
a
firefighter
paramedic
been
doing
it
for
many
years,
and
so
you
know
it's
kind
of
cliched
to
say
it's.
B
C
B
C
Anyway,
well
I'm,
not
gonna,
repeat
that,
but
to
answer
your
question,
I
think
the
number
one
takeaway
for
me
is
a
lot
of
everybody.
Most
states
are
recognizing
the
issue,
as
we've
already
heard
so
eloquently
brought
forward
this
morning.
Many
states
are
taking
necessary
steps
which
are
kind
of
the
easy
answers
right
now
and
what
I
mean
by
that
are
the
the
prescribing
limits
and
making
naloxone
or
narcan
accessible
good
Samaritan
laws
for
people
that
do
actually
administer
these.
C
These
are
things
that
we've
been
working
on
for
several
years,
all
stuff
that
have
been
passed
in
Nevada.
My
takeaway
is,
and
I've
used
this
term
several
times
now.
My
panel
is
probably
sick
of
hearing
me
say
this,
but
we're
kind
of
chasing
the
tail
of
the
dog
and
what
I
mean
by
that
is
full
frontal
assault
on
an
issue
that
we
all
recognize
is
so
serious
across
our
nation
and
we're
doing
a
good
job
curving
it.
The
problem
is:
is
it's
just
going
to
something
else?
I,
don't
know!
C
If
we're
really
at
a
point
now
where
we
need
to
have
the
honest
discussion,
the
very
difficult
discussion,
including
financially
difficult
discussion
about,
what's
driving
all
this
to
begin
with
and
when
I'm
talking
about,
of
course,
is
addiction.
What
is
causing
people
to
need
to
escape
in
the
first
place
now
part
of
that
is
the
prescribing
issues
that
we've
had
with,
with
with
the
medications
that
are
being
prescribed
to
people,
but
then
also,
as
that
translates
into
illicit
usage.
Once
we
cut
that
off,
that's
all
incredibly
important.
C
But
what
comes
before
that,
and
so
one
of
the
things
that
we
talked
about.
There
was
another
session
here
early
about
early
childhood
trauma.
What
are
the
things
that
are
causing
people
to
get
to
a
place
where,
from
a
mental
health
perspective,
they
need
either
psychologically
or
ultimately
physically.
C
Their
body
needs
to
have
these
substances
in
their
body,
and
so
it's
something
that
I
have
taken
from
the
fellowship
and
something
that
I
will
be
moving
forward
with
in
the
future,
really
looking
more
at
how
we
treat
people
with
addiction,
how
we
prevent
them
from
becoming
addicted
in
the
first
place.
Nevada
just
went
back
from
from
what
I
understand
just
her
this
recently.
We
again
we
really
crack
down
on
this
about
three
years
ago.
We
are
now
once
again
I
believe
leading
the
state
in
the
amount
of
people
dying
from
methamphetamine
use.
C
D
Thank
You
representative
singer-
and
it's
very
it's
just
such
a
pleasure
to
be
here
and
see
so
many
people
caring
about
this.
As
since
we
stand
between
you
and
an
airplane,
probably
to
head
home
again,
this
opioid
fellowes
was
just
a
great
group
to
be
a
part
of,
and
we
all
decided.
We
want
to
have
a
reunion
now
and
then,
because
we
want
to
be
able
to
compare
notes
and
and
see
where
we've
been,
but
among
the
things
that
I
think
were
important.
D
That
came
out
of
that
was
the
need
for
collaboration
not
only
among
legislators,
obviously,
but
all
the
various
stakeholders
that
there
are.
We
had
group
of
well
over
400
stakeholders
and
a
behavioral
health
group
from
all
over
the
state
providers
of
medical
services,
addiction,
services,
stakeholders
who
are
also
consumers
and
a
variety
of
different
folks
who
just
cared
about
it,
might
be
members
of
faith,
communities
and
other
individuals,
and
together
we
were
able
to
figure
out
pretty
well
what
services
we
were
lacking
and
especially
in
a
rural
state
where
they
were
available
or
not.
D
D
D
They
know
that
my
name,
they
don't
always
take
them
to
the
emergency
room,
but
they
certainly
know
who
these
people
are,
and
so
they
had
names
and
situations
with
which
we
need
to
be
familiar.
My
local
police
was
very
interested
and
be
able
being
able
to
input
more
so
than
taking
out
information
from
a
health
information
hub
so
that
they
could
say.
We've
we've
had
somebody
called
because
there
was
someone
who
was
sleeping
in
the
lobby
of
an
apartment
building.
They
were
under
the
influence
of
drugs
or
alcohol,
and
we
we
know
who
they
are.
D
We
know
there's
somebody
at
home
and
we
took
them
home
instead
of
taking
them
to
the
ER.
The
prescription.
Drug
monitoring
program
is
an
extraordinarily
important
component
in
this,
of
course,
and
we
want
to
make
sure
that
everybody
is
checking
it
all
the
time
and
there'll
be
more
to
say
about
that,
but
anyway
there's
there
is
so
much
to
learn
and
so
much
to
know
and
I
look
forward
to
learning
again
today.
So
thank
you
biggest.
E
Hi
I'm
representative,
you
from
Vermont
and
I,
have
been
so
fortunate
to
be
a
member
of
the
fellowship
something
I've
wanted
to
be
for
a
long
time
and
it's
a
women
there's
there's
not
a
lot
of
fellowships
that
were
always
allowed
to
be
part
of.
So
this
was
fabulous.
I
want
to
say
the
largest
takeaway
that
I
came
away
from
this
participating
in
the
opioid
fellowship
was
one
were
not
alone.
E
Vermont
is
often
identified
as
a
leader
in
the
fight
because
of
our
hub-and-spoke
model
and
because
we've
had
a
methadone
clinic
since
2002
and
I've
been
working
on
this
issue
for
a
long
time
we
don't
have
term
limits
and
what
I
really
took
away
from
here
and
Assemblyman
sprinkle.
You
from
my
point
of
view,
put
the
thing
put
your
finger
on
it,
which
is
we're
focused
on
I,
want
to
say
harm
reduction.
We
focused
on
intervention
prevention.
E
What
is
it
that
is
causing
so
many
people
to
be
so
unhappy
that
they
and
so
unattached
to
others
that
they
in
fact
to
move
and
are
wrestling
with
addiction?
And
so
one
of
the
large
takeaways
that
I
took
away
from
the
opioid
fellowship
was
the
fact
that
this
really
is
a
four
prong
approach.
We
really.
Yes,
we
need
prevention.
Yes,
we
need
intervention
and
treatment
and
then
finally,
recovery
and
focusing
on
people
being
able
to
continue
their
life
in
a
healthy
way.
E
Like
all
of
us
here
we
bring
our
own
stories
or
our
own
background
to
this
I
am
a
social
worker.
I
now
teach
at
the
University
of
Vermont,
like
Nebraska,
we're
very
much
a
citizen
legislature
and
I
bring
the
stories
that
I
worked
with
as
a
social
worker,
as
well
as
the
stories
that
the
students
bring
to
me
who
were
in
their
field
placements.
You
will
hear
more
from
I
think
all
of
us
and
we're
here
to
answer
your
questions
about
specific
aspects.
E
F
F
You
know
the
policy
experts
that
NCSL
brought
us
the
networking
capabilities
they
have
brought
us
was
incredible,
and
one
of
the
things
that
was
great
for
me
was
that
as
legislators,
we're
always
looking
at
you
know
the
data
what's
best
practice
what's
been
evidence-based,
but
we
need
to
move
beyond
that
to
sort
of
the
promising
practices
what's
being
emerging.
This
is
an
epidemic
that
has
been
growing
and
constantly
changing
from
sort
of
the
prescription
based
opioids
to
sort
of
street
heroin,
the
cough
written
all
and
fentanyl
type
a
so.
F
We
need
to
start
adapting
and
looking
at
ways
to
to
address
these
items,
and
you
know
looking
also
and
I'll
leave
with
this,
because
I
know
we're
gonna
talk
a
little
bit
more
about
what
our
states
are
doing
and
what
we
have
done
and
what
we're
continuing
to
base
upon.
But
one
of
my
greatest
quotes
from
the
openweight
fellows
and
is
that
a
common
sense
is
not
a
flower
grown
and
everyone's
garden
I
stole
that.
B
As
they
say,
well
we're
going
to
Nashville
next
year,
where
we
no
talk
about
musicians-
and
you
know
good
artists
far
enough
are
oh
great
artists
steal,
so
so
so,
with
with
that,
we're
gonna
we're
gonna,
stick
with
you
and
go
back
down
the
line.
So
as
policymakers,
one
of
the
things
that
we
we
look
for
is
you
know
we
all?
Basically,
yes,
there's
a
problem.
Yes,
we
need
to
create,
find
new
answers
to
this.
B
F
F
It
also
requires
the
report
cards
for
physicians
and
pharmacists
to
see
whether
they're
outliers,
if
they're
prescribing
too
much
or
they're
dispensing
too
much
or
to
let
you
know
for
that,
it
required
a
seven-day
limit
supply
of
every
war
period
use
and
for
chronic
pain
users.
There
is
a
way
the
doctors
can
still
prescribe
more
than
a
seven-day
limit
within
that
as
well.
Most
importantly,
I
think
that
it
adds
a
sort
of
a
non-opioid
directive,
so
allows
patients
to
put
into
medical
records
that
they
choose
not
to
have
opioid
to
be
prescribed.
F
Opioids
and
out
of
this
became
the
sort
of
network
through
our
ers.
Have
our
major
ers
hospitals
have
created
this
compact,
where
they're
all
agreed
to
start
from
the
least
sort
of
use
of
pain,
sort
for
pain
management
and
to
increase
that
as
needed,
and
so
that
created
sort
of
a
partnership
through
this
collaborative
of
VR
physicians,
I
think
that's
pretty
much
the
majority
of
our
lasting
sort
of
legislation
that
we've
done
thus
far
and
continuing
to
work
toward
are
working
with
our
chief
medical
director
and
sort
of
the
preventative
side.
F
B
Seven
days
to
10
days,
we
got
a
lot
of
pushback
in
Colorado,
both
from
Colorado
Medical,
our
doctors
as
well
as
some
you
know,
well-intentioned
and,
and
also
very
well
thoughtful
paying
patients
that
were
going.
You
know
this
is
a
step
too
far
for
us
you're,
invading
privacy
you're
getting
the
way
of
doctor-patient
discussions.
Doctors
should
be
making
these
decisions,
not
law
makers.
F
That
piece
was
already
in
there,
so
it
allowed
doctors
to
prescribe
more
did
they
need
a
little
bit
more
documentation,
they
require
them
to
complete
and
honestly
this
bill
passed
through
I'm
trying
to
reach
over
to
reps
potholes,
the
other
my
counterpart
in
the
house.
We
probably
passed
this
in
less
than
a
week,
so
it
didn't
allow
the
lobbyist
to
interfere
in
this
process
and
I.
F
Think
most
people
in
this
room
or
in
our
legislature
has
known
someone
that's
been
affected
by
this
crisis
in
one
way
or
another,
either
through
the
use,
the
recovery
or
sort
of
the
after-effects
of
our
increase
in
crime.
So
it's
it
was
something
that
I
think
most
people
can
get
behind
saying.
We
need
to
address
this
as
a
state.
Okay,
off.
B
E
E
I
in
fact,
have
some
in
my
office
and
so
do
many
people
that
was
really
low-hanging
fruit
and
very
easy
and
I
want
to
say
that
was
because
a
police
chief
from
Massachusetts
came
over
to
room
and
was
the
spearhead
of
that,
and
so
this
was
not
a
health
issue.
This
was
not.
This
was
perhaps
what
one
might
say,
not
the
usual
suspect
in
terms
of
moving
something
forward.
E
That
was
quick.
There
was
little
controversy
that
said,
we've
been
working
on
opioid
issues
in
terms
of
a
timeline
focused
on
it
since
2002
and
to
say
that
there's
a
quick
fix
and
to
say
that
the
legislation
or
the
policy
directives
are
going
to
be
quick
and
easy,
I
think
is
potentially
to
put
forth
a
false
hope.
This
takes
work.
We
our
prescription
monitoring
system.
E
First
of
all,
we
had
a
fight
with
the
governor,
in
terms
of
who
could
have
access
to
it,
so
that
took
a
little
vehicle
timeline,
a
little
breath
for
a
year
or
two.
But
we
also
had
our
former
governor
Shumlin
on
his
first,
his
State
of
the
State
he
identified,
and
he
was
the
at
the
time
the
first
governor
to
speak
publicly
and
have
that
be
the
focus
of
his
state
of
the
state
and
say
this
is
what
Vermont
is
going
to
focus
on
in
terms
in
terms
of
that.
E
E
We
served
it
incrementally,
then
you
had
to
mandatory,
everyone
had
to
participate
and
the
rolls
did
not
become,
and
rather
than
the
legislature
setting
limits
we
gave,
although
I
have
to
say
I
wanted
to
with
some
with
some
direction.
We
had
the
Commissioner
of
Health,
who
himself
was
an
emergency
room
doctor
we
put
rulemaking
in
the
in
the
body
of
the
health
department
where
they
could
reach
out
to
the
physicians,
who
were
the
ones
who
were
most
concerned
about
the
impact
actually.
B
So
I'm
gonna
since
since
I
already
grilled
our
first
guest
here,
I'm
gonna,
do
the
same
for
you.
So
one
of
the
challenges
we,
you
know
we
had
some
low-hanging
fruit
in
Colorado
as
well.
I
think
that
you
bring
up
an
interesting
point
when
you
bring
in
law
enforcement
in
in
your
sort
of
lockstep
sort
of
Public,
Health
side,
the
and
and
the
law
enforcement
side,
it
helps
build
some
momentum,
and
so
you
know
in
Colorado
we
had
a
needle
stick
law.
B
Basically,
that
basically
says
you
know
if
an
officer
is
arresting
somebody
and
they
say
you
know,
there's
any
one
thing
in
a
poke
me
in
my
pocket.
If
I
put
my
hands
near
your
pockets
and
you
confess
that
you've
got,
you
know
hypodermic
needles
on
you-
that
if
you
admit
to
that
from
the
outset,
then
then
you
can't
be
prosecuted
for
those
things,
so
that
helps
protect
our
police
officers.
B
Our
law
enforcement
appreciates
that
and-
and
it's
also
now
a
civil
liberties
protection
for
folks
that
probably
need
help
with
an
opioid
addiction
or
another
injectable
drug
issue.
So
we
had
some
low-hanging
fruit
there.
Who
would
you
suggest
are
with
that
with
that
law,
enforcement
officer
from
Massachusetts
have
connections
and
other
states
that
we
would
be
able
to
share
with
with
folks
here
online
I'm,
not
asking
to
give
out
his
personal
number.
E
I
mean
there's
I,
mean
I.
Think
that
also
your
attorney
generals
are
the
state's
attorneys
are,
are
getting
involved
in
this
issue
and
they
have
a
national
group
and
I'm
sure
police
chiefs
have
some
kind
of
national
group
in
terms
of
reaching
out,
because
this
is
an
issue
that
not
just
Health
and
Human
Services,
not
just
education,
not
just
physicians,
but
also
law
enforcement
and
the
judiciary.
E
Burlington,
which
is
the
largest
city
in
Vermont,
I'm,
not
sure
it's
as
big
as
this
hotel
in
terms
of
the
number
of
people
who
can
be
in
the
hotel.
But
it's
a
big
city,
for
they
have
an
opioid,
a
social
worker
who's.
An
opioid
specialist
directing
the
police
in
embedded
in
there,
and
many
of
the
towns
now
have
clinicians
riding
along
and
with
with
police
officers
when
they
go
out
on
calls.
So.
E
E
I'm,
the
one
of
the
things
that
has
an
unintended
consequence
to
the
prescription
monitoring
and
how
how
good
we
are
now
getting
around
prescribing
is
that
at
least
in
Vermont
what's
happening
is
heroin.
Use
is
increasing
and
we
all
know
that
now
I
mean
there's
many
issues
with
heroin,
not
the
least
of
which
is
fentanyl
and
safe
recovery,
which
is
a
a
program
in
Burlington
run
by
the
largest
by
the
Camille
Health
Center
Howard
Center
is
now
one
of
three.
B
Okay,
all
right
so
build
on
the
low-hanging
fruit,
senator
Lee
we
can.
We
can
consider
either
an
easy
policy
lift.
Maybe
it
was
something
that
was
actually
also
just
fiscally
prudent.
So
you
know
many
of
our
states
have
to
have
balanced
budgets,
so
maybe
it
was
a
low-cost
solution.
That's
had
a
had
a
good
output.
I'll.
D
Before
I
mentioned
a
couple,
I
just
I
want
to
comment
on
that,
because
I
learned
in
the
last
year
that
veterinarians
prescribed
drugs
for
animals
that
have
marijuana
in
it.
So
you
know
somebody
wants
pot
in
North
Dakota.
They
can
get
something
for
their
dog
I
thought
that
was
sort
of
unique,
but
anyway.
D
Can
we
have
done
many
of
the
same
kinds
of
things
as
they've
already
been
mentioned
by
my
colleagues
here,
including
naloxone,
being
available
everywhere?
You
could
go
to
the
pharmacy
and
get
it.
Of
course.
Temperature
is
a
factor,
and
all
of
us
are
in
climates
that
have
winter
less
so
for
Nevada,
but
for
some
of
like
I
live
in
the
Fargo
area.
D
I
live
in
West
Fargo
it's
across
the
street
and
because
the
large,
very
capable
ambulance
service
in
that
area
carries
it
and
is
there
in
a
matter
of
very
few
minutes,
the
police
officers
are
not
because,
if
because
of
that,
it
being
susceptible
to
cold,
so
everybody's
got
to
figure
out
what
they're
going
to
do.
But
that
is
a
challenge
for
some
of
the
rural
ambulance
providers,
most
of
whom
are
volunteers.
D
Services
I
mean
they
are
the
true
angels
as
far
as
I'm
concerned
are
those
are
those
community
ambiens
ambulance
services,
but
the
easy
things
were
not
included,
not
only
the
naloxone
but
a
needle
exchange.
Where
was
easier
to
get
through
than
we
thought,
but
sometimes-
and
this
is
a
clue,
if
you
don't
already
have
this
figured
out
and
I'm
sure
you
probably
do
make
sure
you
have
the
right
person
sponsoring
it.
D
So
senator
Mather
and
went
to
senator
Anderson
and
said
this
is
gonna,
go
better
if
you
sponsor
it
and
Senator
Mather
and
co-sponsored
it
so
then
Howard
Anderson
was
able
to
stand
up
and
say
why
this
is
an
important
thing
to
have
a
needle
exchange
and
it
sailed
through
the
Senate,
because
everybody
believed
then
we
would
have
believed
Tim
also.
But
the
concern
is
moving
to
the
other
house.
It's
not
necessarily
as
easy
all
the
time
and
so
think
about
whom
you
might
have
sponsor
things.
D
I
have
given
up
bills
that
I
think
somebody
else's
name
on
will
make
it
through
easier
I,
don't
give
a
whit
about
a
brass
plaque
somewhere
I
really
care
about
getting
the
legislation
through
so
think
about
who
might
be
a
good
teammate
for
you
and
in
that
area,
but
if
all
the
things
I
think
that
we
learned
particularly
it
was
that
the
extraordinary
need
for
collaboration
among
all
of
these
entities
that
we've
talked
about
and
and
how
much
more
can
be
done.
That
way,
oh
well,
we'll
put
it
into
another
way.
B
C
Thanks
and
this
will
be
quick
because
it's
really
just
a
reiteration
of
what
you've
heard
narcan
was
one
of
the
very
first
things
which
I
find
really
interesting,
because
I
was
at
a
NCSL
conference,
probably
boy
about
five
years
ago
now
and
making
naloxone
more
accessible.
Was
the
topic
of
conversation
and
I?
Remember
getting
up
and
talking
about
this
just
asking
a
question,
and
it
was
really
controversial.
C
It
surprised
me
because
to
me
this
is
a
life-saving
drug
that
has
very
few
side
effects
and
certainly
some
of
the
side
effects
aren't
the
ones
you
would
anticipate,
and
yet
there
was
a
lot
of
very
difficult
conversations
going
on
since
then,
as
you've
just
heard
it's
evolved
to
this
is
the
low-hanging
fruit.
This
is
kind
of
like
that
minimum
standard,
and
so
that
was
one
of
the
very
first
things
we
we
did
in
Nevada,
but
I
I
really
want
to
emphasize.
C
It's
got
to
be
coupled
with
this
Good
Samaritan
type
language
as
well,
and
the
reason
why
I
say
that
and
I'll
just
wrap
up.
This
answer
is
because-
and
this
is
kind
of
personal
for
me
again
as
a
paramedic-
how
to
just
keep
in
mind
how
this
whole
thing
works.
You
give
the
narcan
it
reverses
it's
like
hey
we're
in
Hollywood
right
now.
It's
like
the
movies.
You
have
somebody
that's
literally
dead
and
within
a
matter
of
seconds,
they're,
breathing
and
talking
to
you
again,
it's
that
quick.
C
As
you've
heard,
we've
gone
to
the
point
where
it's
over-the-counter
in
Nevada,
one
of
the
things
that
I
did
when
I
passed
that
had
that
bill
passed
last
session
was
it's
over-the-counter,
but
you
still
have
to
get
it
from
the
pharmacist.
Who
has
to
give
you
a
two
or
three
minute
briefing
specifically
to
say
we
have
a
Good
Samaritan
law.
Please
call
9-1-1
if
you
give
this
to
your
loved
one.
B
I'm
gonna
give
just
one
quick
low-hanging
fruit.
This
is
not
even
legislative,
but
you
know
as
a
byproduct
of
sitting
in
these
interim
committees
that
we
have
in
Colorado.
There
was
an
organization,
the
harm
reduction
center.
That
said
that
there
is
an
app
that
anyone
can
download
it's
free,
so
I'm
not
getting
any
money
for
this.
It's
not
ads.
The
it's
called
Opie
rescue
has
nothing
to
do
with
Ron
Howard
or
whatever
show
that
was
we're,
not
saving
Opie
here,
but
but
Obie
rescue.
You
can
download
it
for
your
phone.
This
is
a
great
thing.
B
If
you
have
kids,
especially
teenagers
or
college
students,
Oh
Pugh
rescue,
you
pull
up
the
app
the
first
thing
in
big
red,
it
says
start
rescue
and
it
gives
you
instructions
right
away,
so
so
sort
of
what
you
mentioned.
Assemblyman
sprinkle
people
think
that
narcan,
which
is
a
miracle
non
non
toxic,
won't
kill
you.
If
you
were
to
administer
it
to
me
right
now,
nothing
would
happen.
B
At
the
same
time,
it
can
bring
someone
from
the
brink
of
death,
but
if
there
isn't
the
follow-up
you're
right
back
in
the
same
position
again,
so
anyone
can
download
this
app
hope
you
rescue
and
once
again
it's
an
opportunity
when
you
take
these
to
your
town
halls
wherever
you
are
to
do
these
things.
So
what
I
want
to
do
actually
before
anything
else
is,
is
break
into
some
questions
at
this
point,
we've
got
some
microphones
hovering
around
here
and
then
we'll
come
back.
B
We'll
take
about
ten
minutes
for
questions,
then
we'll
go
back
to
our
panelists
with
some
of
our
structured
questions,
but
I
really
want
to
hear
from
you
guys
and
please
introduce
yourself.
Let
us
know
whether
your
staff,
whether
your
legislator,
what
state
you're
from
or
make
something
up
since
this
will
be
live
stream
for
posterity
and
then,
if
you
want
to
direct
your
question
to
an
individual
panelist
or
set
up
panelists,
let
us
know
who
you'd
like
to
have
answer
that
question
well
field
it
from
there.
So,
okay.
H
I'm
representative
Mary
Mackenzie
from
Connecticut,
my
little
town
of
Wallingford
has
only
45,000
people,
but
we
had
15
deaths
last
year,
mostly
young
people
and
our
it's
been
going
up
every
year
and
we've
done
all
the
low-hanging
fruit
stuff
already.
But
what
I'm
very
interested
in
you
had
one
slide
up
there,
and
maybe
you
could
talk
on
it,
the
per
increasing
the
preventive
strengths
and
decreasing
the
risks.
That's
what
I'm
very
interesting,
because
I
want
to
turn
this
curve.
I,
don't
want
to
see
the
this
year's
numbers
be
20
in
next
year's
numbers.
H
B
I'm,
assuming
you
mean
that's
not
just
in
the
context
of
opioids
but
sort
of
substance
use
in
misuse
in
general
right,
so
all
right
who
would
like
to
talk
about
prevention
methods?
I
know
one
of
the
things
that
we
tried
to
do
in
Colorado.
Is
we
try
to
well
give
you
one?
Sixth,
one
quick
success
and
one
quick
failure
that
way.
You'll
give
me
some
good
ideas
here.
So
the
quick,
the
quick
success
is
we
invested
more
in
school,
counseling
programs
and
after-school
programs.
B
We
didn't
even
talk
about
drugs
and
these
after-school
programs,
but
you
give
our
youth
something
to
do
and
there's
a
less
likelihood
that
we'll
end
up
to
those
idle
hand,
situations
on
the
flip
side,
we
had
a
bill
that
would
have
reduced
certain
liability
issues
related
to
schools
carrying
narcan,
so
more
schools
would
be
able
to
use
their
own
resources
to
have
the
opioid
reversal
agent
available.
So
if
students
or
teachers
or
staff
or
parents
were
to
OD
on
campus,
we
could
save
lives
that
that
bill
was
still
killed.
C
Thanks
and
I
really
appreciate
that
question,
because
I
think
that
part
of
it
really
does
get
to
the
heart
of
this
specific
to
the
prescribing
the
prescription
part,
which
is
I,
think
what
drove
a
lot
of
this,
at
least
in
Nevada.
We
had
some
really
just
horrific
stories
about
over
prescribing
to
start
the
conversation
about
pain
management,
other
than
opioids
I
think
is
really
important
and,
and
it's
it's
it's
proven
to
be
a
little
difficult,
because
one
is
costly.
You
start
talking
about.
C
You
know
far
greater
emphasis
on
physical
therapy
or
other
things
that
maybe
are
not
quite
as
mainstream,
but
I
think
that
that's
really
one
of
those
avenues
that
you
got
to
go
down
when
you're
trying
to
get
people
off
so
that
they're
not
using
a
two-week
supply
of
oxycontin.
You
know,
maybe
they
need
a
three-day
supply
just
to
get
them
over
that
immediate
pain
management,
but
then
other
forms
of
dealing
with
of
the
pain
as
they're
in
recovery
as
they're
recovering
from
their
injury
or
what-have-you.
C
It's
one
of
the
things
we
learned
during
the
fellowship
is
that
for
people
to
truly
have
success
in
in
kicking
their
addiction,
you're,
looking
at
at
very
constant
treatment
modalities
that
take
up
to
a
year
to
do,
and
so
how
you
are
able
to
get
more
providers
in
your
state.
Another
big
problem
that
we're
facing
right
now
is:
we've
got
all
these
grandiose
ideas.
We
literally
just
don't
have
the
psychologist
to
sit
there,
the
therapists
to
sit
there
and
really
help
them.
C
B
And
also
I
have
a
whole
series
of
other
questions
that
are
specific
to
each
of
you
and
so
I'm
gonna.
Give
you
some
of
those
questions
in
context,
but
well
I'm.
Just
gonna
keep
going
from
my
left
here,
but
butts
in
early
you've
got
a
rural
state
as
well,
and
so,
if
you
can,
if
you
can
answer
this
question
the
context
of
of
dealing
with
this
in
a
rural
context
for
rural
lawmakers
out
there,
that
would
be
helpful.
Well.
D
It
certainly
is
not
true
that
we
have
less
of
a
problem
because
we're
rural-
that
is
absolutely
not
it
at
all.
The
awareness
in
some
of
those
rural
areas
was
slow
to
come
around
as
far
as
even
law
enforcement
was
concerned,
my
home
areas
in
the
northeast
corner
of
the
state,
and
they
did
not
realize
what
many
others
knew,
which
was
they
had
a
problem
there
too,
but
one
of
the
really
big
things
to
think
about
is
that
alcohol
is
for
us
at
least,
and
probably
for
you
to
lead
in
in
an
overused
substance.
D
D
Seeing
that
we
have
a
lot
of
hockey,
leagues
and
basketball,
leagues
as
I'm
sure
you
do
with
various
sports
in
your
area.
So
these
teams
travel
every
weekend
with
their
parents.
They'll
play
four
games
of
hockey
and
come
back
to
the
motel
with
the
cooler
and
the
adults
will
sit
by
the
pool
and
drink
beer
and
the
kids
think
that's
what
you
get
to
do
when
you
grow
up
come
on
folks.
D
We
have
to
set
an
example
for
these
children
as
well
and
recognize
that
that's
not
the
only
way
to
do
it,
because
alcohol
truly
is
the
Gateway,
at
least
in
our
area
and
I.
Think
if
you
look
at
the
whole
substance
use
disorder,
picture
you'll
find
it
is
for
you
as
well.
Meth
is
second
and
we've
had
a
resurgence.
D
We
can't
come
and
say
I'm
here
from
the
North
Dakota
government
and
I'm
here
to
help
you,
because
that
workforce
is
huge
for
us,
especially
in
the
rural
areas.
If
you
draw
a
line
through
our
capital,
which
is
a
little
better
than
halfway
from
east
to
west
and
Noren
and
draw
a
north-south
line,
there
is
was
one
psychiatrist
west
of
that
space
and
we're
a
400
mile
wide
state.
So
telehealth
is
a
burgeoning
thing,
and
so
all
of
those
kinds
of
things
community
supports
are
huge.
D
That's
another
way
that
we're
going
to
hope
for
more
we've
got
more
and
more
trainings
now
for
peer
support.
Specialists
to
provide
community
supports
for
people
who
are
coming
out
of
treatment,
whether
it's
residential
or,
if
they're,
having
good
treatment
in
the
communities
so
that
they
have
someone
they
can
call.
That
has
probably
been
through
the
same
kind
of
experience
and
can
really
be
helpful.
So
all
of
those
kinds
of
tools
we're
trying
to
do
in
order
to
address
the
challenges
in
the
rural
area
we're
very
much
dealing
with
licenses.
D
We
told
the
boards,
you
will
either
do
it
with
us
during
this
interim
or
we
will
do
it
to
you
in
the
next
session
and
I
say
that
only
half
in
jest,
because
we
will
there
are
a
couple
of
boards
that
have
been
absolutely
impossible
as
far
as
doing
any
changes
in
some
of
their
some
of
their
responsibilities
and
in
licensure
that
don't
seem
reasonable
to
other
people
in
their
profession
who
are
even
in
the
state.
So
that's
I've
spoken
long
enough,
but
that's
kind
of
part
of
the
picture
for
the
rural
area.
No.
B
Well,
thank
you.
Thanks
for
bringing
that
up,
was
there
anything
else.
You
want
to
be
honest
to
know
about
how
the
tribal
relationship
with
with
the
state
is
working.
It
you
know,
is
telehealth
making
it
easier.
Are
there
other
things
that
are
making
it
easier
or
the
roadblocks
that
you've
run
into
that?
That
are
that
you
didn't
expect
or
of
creating
challenges,
you're,
obviously
not
the
only
state,
even
on
this
panel,
that
has
to
deal
with
those
issues.
Well,.
D
D
So
it's
just
being
a
good
diplomat
actually
and
our
and
our
state
agencies
have
really
worked
hard
to
develop
those
relationships.
But
it's
there's
just
a
little
more
patience
required
and
a
little
more
subtlety
in
some
cases
about
a
lot
of
good
people
who
really
care
about.
What's
going
on
in
their
tribal
nations
and
and
they
recognize
terrible
challenges,
one
of
our
best
advocates
is
a
gentleman
who
graduated
from
the
und
Medical
School,
which
has
a
called
in
med
program.
It
has
slots
for
native
Native
students
and
dr.
Don.
D
B
So
represent
acute
I'm
so
glad
we
got
this
question
and
I
know
we're
getting
the
wrap-up
sign
here,
but
we're
gonna.
Let
everyone
respond
to
this,
then
we're
gonna
we're
gonna
shift
gears
real
quickly,
so
hub-and-spoke
model
prevention
services.
Everyone
here
you
know,
wants
to
take
away
something
I.
Think
from
your
state.
We
talk
about
the
hub-and-spoke
model.
You
know
keen
tell
tell
us
a
little
bit
about
within
the
context
of
prevention
services.
What
that
might
look
like
and
what
our
lawmakers
can
take
away
from
that.
E
To
integrate
health
and
addiction
treatment
and
to
better
use
specialty
providers.
So
really
what
that
means
is
that
folks,
who
are
in
initial
stages
of
treatment
and
need
methadone,
they
don't
get
methadone
in
and
of
itself.
They,
the
hub,
is
a
open
from
like
6:00
a.m.
so
to
deal
with
people
who
have
jobs,
that
they
need
to
be
there
at
7:00
or
8:00,
and
they
get
their
methadone.
There
are
nurses
there,
there
are
clinicians
there.
There
are
social
workers
there
to
help
with
the
other
aspects
that
are
all
involved
with
with
treatment.
E
But
so
the
spoke
our
dad.
Our
data
waived
physicians.
So
in
your
local
physician's
office,
where
patients
can
get
their
suboxone
or
their
buprenorphine
and
at
the
same
time
the
spoke.
The
these
physicians
have
on
staff,
social
workers
and
other
clinicians
to
assist
the
the
person
with
the
addiction
for
the
other
issues
that
they're
involved
and
that's
really
been
helpful
because
we
want
people
to
be
connected
to
their
physician.
For
everything
and
somehow
going
to
your
physician
rather
than
going
to
a
methadone
clinic
is
easier
for
a
lot
of
people.
E
B
So
Senator
Wilson,
just
to
give
you
a
little
context.
You
are
a
fellows
fellow
having
been
a
person
has
been
in
the
early
learning,
Fellows
Program,
the
child
welfare
Fellows
Program,
and
now
the
opioid
Fellows
Program
within
the
context
of
the
question
that
was
asked
about
prevention
services.
Obviously,
early
learning,
child
welfare
huge
on
looking
at
prevention
services,
any
any
thoughts
on
the
intersection
of
the
each
of
those
three
different
fellow
programs
and
where
we
might
be
able
to
go
in
prevention,
services,
yeah.
G
F
This
is
just
not
the
impact
on
the
opioid
user.
It's
a
system-wide
impact.
We
had
to
look
at
the
impact
of
the
trauma:
the
social
welfare
emotion,
development
of
children
on
the
welfare
system
in
the
child
welfare
system.
Those
off
those
caseworkers
need
to
understand
the
science
of
addiction
that
opioid
users
opioid.
E
I'm
gonna
say
something
before
you
tell
me
to
stop
one
I
think
I'm,
probably
speaking
to
the
choir
when
I
say
I'm
sure
that
everyone
here
understands
and
knows
that
addiction
is
not
a
choice.
An
addiction
is
not
a
moral
failing,
and
so,
when
we're
talking
about
prevention,
we've
got
to
figure
out.
Okay,
what
is
driving
people
towards
addiction
and
what
is
it
physical
pain?
Is
it
psychological
pain?
E
Is
it
a
feeling
of
helplessness
and
hopelessness,
and,
and
is
it
to
reduce
or
deal
with
stress
whether
it's
toxic
stress,
whether
it's
adverse
childhood
events,
all
those
kinds
of
things,
and
when
we're
talking
about
prevention
and
the
original
question
I
think
had
to
do
with
youth?
We
can't
just
focus
on
youth.
We
need
to
focus
on
their
parents,
we
need
to
connect
all
of
the
systems,
so
we
need
to
focus
on
the
parents
and
I
might
say
if
people
feel
hopeless
and
helpless
and
they
have
no
job
out
there
or
their
job
out.
E
There
doesn't
pay
a
livable
wage
or
whether
or
where
they
don't
have
health
insurance,
or
they
don't
have
the
time
from
their
job
to
be
able
to
go
to
treatment.
Those
are
other
things
that
we
can
do
to
both
prevent
as
well
as
to
to
deal
with
addiction,
and
then
there's
this
wonderful
article
about
Iceland
that
had
this
huge
addiction
problem
with
their
youth
and
they
put
a
whole
thing
around
after
school
and
connections.
E
B
I
Question:
okay,
I
am
state
representative
Teresa
MA
from
Illinois
I
represent
a
district
in
Chicago
a
couple
of
years
ago.
I
worked
on
the
acupuncture
practice.
Act
in
our
state
and
I
became
aware
of
a
protocol
for
the
treatment
of
pain
and
addiction
called
the
NADA
protocol,
and
it
struck
me
as
it's.
I
You
know
very
promising.
You
know
as
low-hanging
fruit
and
low-cost
treatment
for
addiction
and
and
and
pain
management,
but
I'm
wondering
you
know.
How
can
we
encourage
the
widespread
adoption
of
something
like
that?
You
know
which
is
considered
an
alternative
therapy.
It's
not
accepted
everywhere,
and
you
know
just
for
alternative
therapies
in
general.
Like
you
know,
physical
therapy
chiropractor,
you
know
Napper
pathy.
All
these
different
modalities,
you
know.
Have
there
been
efforts
to
you
know,
get
more
widespread
acceptance
of
those
modalities
for
pain,
treatment
and
addiction
and
and
to
address
the
opioid
issue
in
general.
B
One
of
the
biggest
struggles,
although
we
do
passed
a
bill
and
auricular
detox
with
acupuncture
or
our
biggest
struggles
we
probably
have
had-
is
this
issue
of
copay
parity.
So
if
I
go
see
a
physician,
I
can
get
well
now
only
seven
days
supply
of
opioids.
But
if
I
want
to
see
a
physical,
therapist
or
I
want
to
see
a
chiropractor.
If
I
want
to
see
an
occupational
therapist,
the
copay
is
going
to
be
two
or
three
or
four
times
as
much
so
a
huge
challenge
in
Colorado
any
any
quick
responses.
E
F
G
G
B
We
need
to
be
talking
to
our
federal
government
about
taking
off
the
federal
bans
on
research.
I
tell
people
I
mean
I've
been
a
supporter
of
marijuana
legalization
reform
nationwide,
but
we
need
to
start
treating
this
like
the
drug.
It
is
because
it
still
is
a
drug
I'm,
not
the
drug,
that
some
people
fear
it
to
be
I
will
I
will
leave
it
at
that,
because
there
is
a
lot
of
controversy
about
that
and
that
could
be
a
it's
a
whole
a
whole
other
set
of
questions.
J
C
First
question:
two
things
that
we've
done
in
Nevada
specifically,
is:
we
have
emergency
kind
of
mobile
response
units
to
whenever
something
comes
in
to
immediately
get
out
to
them.
We
couple
that
oftentimes
with
police
and
social
workers
so
that
they're
going
there
having
that
immediate
interaction
getting
people
into
the
treatment
they
need,
but
then
the
follow-up
stuff,
so
that
even
part
of
their
discharge,
once
they
get
sent
out
of
you,
know
a
residential
treatment
center.
Is
that
part
of
the
requirements
of
that
discharge?
C
Is
that
there's
constant
contact
and
then
these
same
units,
if
they
don't
hear
from
somebody
for
a
day
or
two
they'll,
go
out
and
actually
try
to
find
out?
What's
going
on
and
potentially
that's
a
better
way
of
keeping
them
on
the
the
medication
assisted
treatment
that
they're
on
or
making
sure
that
they're
getting
to
their
group
therapy
or
whatever
it
is?
Those
are
two
things
that
we
have
found
is:
is
starting
very
infancy
state,
but
it's
it's
showing
some
real
positive
signs
and
comes
at
a
cost,
always.
D
This
is
really
quick.
You
can't
make
anybody
go
into
treatment
that
doesn't
want
to
be
in
treatment
unless,
unless
the
the
criminal
justice
system
is
really
involved,
there
are
certainly
ways
to
encourage
people
to
do
that.
One
of
our
best
ways,
really
that
we've
just
started,
is
with
a
collaborative
agreement
between
the
Department
of
Corrections
and
Rehabilitation
and
behavioral
health.
We've
had
good
programs
in
the
penitentiary,
but
when
they
walk
out
the
door
they
were
fallen.
D
The
cliff
are
going
to
have
good
community
support
programs
for
them,
but
one
of
the
biggest
deals-
and
we
haven't
mentioned
that-
is
that
you
got
to
get
dentists
in
the
loop
I
mean,
if
you
think
about
it,
kid
you're
in
high
school,
it's
gonna
have
wisdom,
teeth
out.
What
do
they
do?
They
posted
on
social
media,
they're
gonna,
have
their
wisdom
teeth
out?
What,
if
dentists,
been
doing
giving
a
30-day
supply
of
hydrocodone?
What
do
they
need?
D
None
or
maybe
three
pills,
so
you
got
to
get
the
dentists
on
the
PDMP
and
you
got
to
give
them
to
realize
that
they
have
a
role
to
play
in
this
as
well,
because
they're
subject
to
theft,
they're,
subject
to
sale
and
the
kids
not
because
they're
even
depressed
will
say
hey.
This
is
a
prescription.
Drug
I
hear
it's
got
it
cool,
maybe
I
got
to
give
it
a
try,
so
include
them
too.
All.
E
J
You
Pat
long
they
have
just
a
rep
from
the
New
Hampshire
state,
rep
I'm
wondering
if
the
conversation,
if
there
is
a
conversation
on
what's
in
my
opinion,
treatment
is
planting
the
seed.
That's
all
we
could
do
we're
not
going
to
force
anybody
to
get
well
that's
up
to
them.
My
concern
is
the
traumatized
children
a
six
year
old
that
at
16
year
old
is
highly
likely
to
do
the
same
as
their
parents,
the
Korean
parents
that
are
suffering
through
bringing
up
their
own
grandchildren
without
the
means.
So
that's,
what's
gonna,
you
know
I!
J
Think
of
the
Indian
with
the
tear
it
didn't
happen
overnight.
I
was
young
when
I
started
hurting.
You
know
we
used
to
be
able
to
throw
trash
out
the
window
and
nobody
would
say
anything
so
this
took
time.
So
we
need
to
complete
the
whole
circle,
so
I'm
more
interested
in
a
conversation
about
helping
these
kids
traumatize
I'm
more
about
helping
the
grandparents
that
are
that
are
having
a
hard
time
bringing
up
their
their
grandchildren
and
suffering
through
what
their
children
are
going
through.
J
F
But
to
answer
the
other
question
that
you
know,
our
state
of
all
states
have
sort
of
got
an
increase
in
the
child
prevention,
child
abuse,
prevention
and
treatment
act
and
the
family
first
prevention
services
act
is
another
way.
So
if
you
haven't
worked
started
working
with
the
child,
welfare
offices
and
the
new
rollout
and
what's
going
to
be,
could
be
considered
additional
funding
for
prevention
and
for
foster
families
and
for
those
type
of
child
welfare
system.
Please
sort
of
having
those
conversations.
F
The
guidances
are
going
out
now,
they've
been
meeting
last
week
in
DC,
so
go
ahead
and
please
sit
down
with
the
child
welfare
office
and
see
how
they
plan
to
have
a
plan
in
place
to
use
their
additional
funding.
If
they're
gonna
use
their
additional
funding
and
look
at
ways
not
as
the
current
system
is
now,
but
how
it
could
be
in
the
future,
all.
B
Right
any
other
quick
responses
from
anyone
else
all
right.
So
how
far
over
time
are
we?
The
green
wrap-up
sign,
says:
wrap
up
I'm,
getting
the
thumbs
up
and
not
the
middle
finger,
but
what
I'm
gonna
do
is
just
I
want
to
thank
our
panel,
we're
trying
to
find
answers
to
questions
for
our
constituents,
our
kids
and
for
the
future,
and
you
all
have
done
a
yeoman's
work.
We've
got
staff
here
who
are
ready
to
answer
your
questions
as
well
and
join
you.