From six I news this is connections I'm Evan Dawson.

Our connection this hour was made in a federal budget cut a proposal that could easily get lost in all the noise coming out of Washington.

I'll let the New York Times explain, quote, the opioid overdose reversal medication, commercially known as Narcan, saves hundreds of thousands of lives a year and is routinely praised by public health experts for contributing to the continuing drop in opioid related deaths.

But the Trump administration plans to terminate a $56 million annual grant program that distributes doses and trains emergency responders in communities across the country to administer them, according to a draft budget proposal in the document.

The grant is among many addiction prevention and treatment programs to be zeroed out.

End quote.

For weeks, those who work in addiction services have been cautioning the Trump administration not to go after the many different kinds of funding that help with addiction, and they believed that they had an ally in Robert F Kennedy Jr, who has been public about his own recovery from heroin addiction.

But the administration is ready to cut at least parts of this kind of funding.

And the Trump team says it will be up to individual states to address addiction in many ways.

The New York Times notes, quote, States and local governments have other resources for obtaining doses of Narcan, which is also known by its generic name naloxone, one of the main sources, a program of block grants for states to use to pay for various measures to combat opioid addiction does not appear to have been cut.

But addiction specialists are worried about the symbolic as well as practical implications of shutting down a federal grant designated specifically for naloxone training and distribution, end quote.

So it's not clear if states are going to just simply absorb federal cuts when it comes to dealing with addiction and still provide everything that they've been trying to do on their own with things like Narcan and training and addiction resources and response.

This hour, we're going to talk to guests who can explain what is likely to come next on various levels during a time when tens of thousands of Americans are still dying of opioid overdoses every year.

And I want to stress this.

We will talk about the numbers.

Yes, there's been a decline in opioid deaths, but we're still talking about tens of thousands of Americans, just under 100,000 a year, still dying of overdose.

It is a big, big problem.

Let me welcome in studio Rob Kent.

Nice to see Rob Kent in studio.

We've had a chance to talk to Rob in the past on this program.

Is the president of Kent Strategic Advisors.

He's a former general counsel for the white House Office of National Drug Control Policy.

That means he was a pretty big deal in the Biden administration.

Rob, welcome.

Thank you for being here.

Thanks for having me.

I saw your face.

You were a big deal.

Yeah, well, it's nice to have you ask my wife.

She would tell you otherwise.

We appreciate you being here in Rochester with us.

And let me welcome as well the president and CEO of Heather Doyle.

Kelly Reed is with us.

Thank you for being here.

Kelly.

I'm glad to be here.

Lori Drescher is the founder of Recovery Coach University.

Welcome back to the program.

Thank you for being here.

Thanks for having me.

And remind listeners a little bit about your own story and your connection to this issue, Lori.

Sure.

I'd be happy to.

my story is that I started advocating for services in New York State as an affected family member, in 2014 when I almost lost my son for the first time.

Fast forward seven years.

I lost my son in 2021 to a fentanyl poisoning, and continued to advocate and started Recovery Coach University as a solution to the problem to get peers out there in the communities, trained and certified to be effective as a resource and support to folks who are struggling to find recovery or sustain their recovery.

We appreciate you being back with us and, listeners this hour, a lot of different ways to communicate with us.

You can send emails to connections at Cyborg.

You can join the chat on YouTube if you're watching on the Sky news YouTube channel there.

You can call the program toll free.

844295 talk.

It's 8442958255263 WXXI.

If you call from Rochester 2639994.

Now we're going to talk about what are we talking about right off the top here from The New York Times, this idea that the Trump administration is going to try to zero out this $56 million program that looks at naloxone.

We'll talk about that.

But we're also going to look at a longer list of what is happening.

Reuters recently examined the DOJ's cuts to see what's actually been eliminated and what the effect could be.

And that list is a little bit longer.

We'll talk about that.

And then we will talk about what states are doing, what the federal government still may or may not do, and the possible effects on what's going on locally.

Heather Doyle's got a big event tomorrow that Kelly Reed would probably love to see everybody at what's happening tomorrow.

Lutely.

So we do, an annual breakfast.

It's called friends for Hope.

Breakfast.

It is a fundraiser.

It's our largest fundraiser.

And, this year we have Chris Herren coming.

Chris was a former basketball player for the Boston Celtics.

But I'm sorry.

Boston Celtics and, lost his, career to his addiction.

He was addicted for many, many years.

and, well, I've traveled around, several countries playing basketball.

Found someone to supply him with heroin and every one of those countries, had a couple of his children.

I was in recovery at that time.

Someone from his past called him and said, I'll give you a deck for free if you want to meet me at a certain street.

He did, and he overdosed.

and his wife eventually said, I can't let you do this to the kids.

you either need to get clean or you need to go away.

And, he got clean, and, since then has been an absolutely amazing, advocate, uses all of the money that he makes from his, traveling around the country to tell his story to open, wellness centers particularly has an attachment to young people.

We have some city school district and some Fairport School District youth coming to our breakfast to talk about, addiction.

I'm very excited about that as well.

It's, it's a very important topic.

And, you know, the message is hope.

as you entered the the start of the program, one of the things you mentioned is all the things that we're facing right now in terms of crisis, and the uncertainty of where we sit with funding and those kinds of things and the continuing opioid epidemic.

But, there's still hope, in the message and hope in the process.

People can still attend tomorrow morning.

Absolutely.

So I would welcome them.

8:00 Am Eagle Vale Golf Club for the sixth annual friends for Hope breakfast.

We'll have information in our show notes if listeners want to register and learn more.

Thanks and be there tomorrow.

Now, Rob has never been shy about being critical, and that's part of what Kent Strategic Advisors does, is looking at what states are doing, like New York State when it comes to drug policy.

And Rob worked at the highest levels on national policy.

So let me start with this story out of the times, Rob, when we hear that the Trump administration wants to zero out this program that, provided training for emergency responders and distributed doses of Narcan, you think what?

So first off, it's a proposal.

So the process, the Office of Management and Budget goes to all the agencies and says to them, we want you to propose cuts so we can put a budget together, that spends less than what we're spending now.

And it's in the process of going back and forth.

It's not a proposal yet.

It's something they recommended.

I just tell you my work.

We'd recommend stuff we knew they'd never take just to do that, to have stalking horses, if nothing else.

So I don't know that they'll cut it in what they propose.

But here's the important thing is the president proposes a budget and it's they're done at that point.

It's it's totally Congress's, prerogative.

you know, you read the Constitution and it's being read frequently right now.

The, you know, Congress has the power of the purse, not the president.

And so is that what you think?

All right.

It's what I know.

I and we're going to have the courts reaffirm it for us all over the you think this Congress is going to stray from what this president wants?

I think the House has three votes they can afford to lose.

And I think they've got three votes that they would lose on most of these proposals.

And and I will say as well, addiction issues, unlike most other issues in Congress, there's actually some bipartisan work.

And so there's this there's I mean, so many have been affected.

It doesn't as we know, it doesn't play political favorite.

So I question whether there's the votes in Congress to do things like that.

Okay.

A couple of things here in the room.

I understand your point that when you were working in national government, you throw out proposals knowing it's probably not going to get all the way there.

It's like a kid who asked his parents for 20 bucks when you know what really needs ten, I get it.

Why is anybody talking about zeroing out this program in the white House?

Why is that anything that would be considered the direction they want to go?

I think there are people involved who don't understand these programs, and I'm trying to be polite about that.

I just really think there are number crunchers involved and they've got to make the math work, and they don't understand the policy or the impact of, of the program.

So I think it's more than that.

It's more of that than anything else.

And you did point out they also have proposed to keep the two major grants, basically at the same funding level, the block grant, which goes to all the different states, New York gets about $100 million from that every year in the state.

Opioid response funding, which has been in place since the end of the Obama administration through Trump, through Biden, they propose in New York, gets another, I think, 50 to 60 million from that as well.

And at least what they're proposing at least what I've seen in the past back, which is still not final, they're keeping them at the same levels.

Okay.

And I also take your point that this may be one of the the more unusual places where there is bipartisan agreement, a lot of bipartisan work for a lot of different reasons.

When you say there's, three votes, at least on the Republican side, who have a slim majority in the House, that you think would block this, is that just based on the years of work that you have done that says when you talk about addiction, when you talk about opioids in the last decade, it becomes less of a red and blue issue.

Yeah, absolutely.

And I you know, I've talked to a few of the Congress congresspeople and this impacts their districts.

And, you know, their districts are not the state in New York.

They're a small little component of the state in New York.

And and they're all running next year.

That's the other thing is.

Right?

Yeah.

A third of the U.S. Senate is up for reelection or election, and all the House and every seat in New York states up for election next year.

Yeah.

And this is where my mind lately draws a lot of parallels to the proposals to cut things like the Corporation for Public Broadcasting and the debate about whether that's going to happen.

I cannot speak without bias on that issue.

I think listeners should understand that.

But some of the conversation we've had recently is like, well, listen, there are states where there would be just devastating impacts if they don't have their PBS, if they don't have, because in Rochester, I mean, it would be, you know, 18% of the budget in Philadelphia, maybe 8% of a budget in some of these communities, it's 60, 80, 100%.

And then in Arkansas and in Georgia.

So you think, well, they're not going to vote for that.

But I don't know that they won't I don't know, well, but you're hitting on, I think, a broader theme within, within all of this, which is the impact of these cuts, probably impacts red states and red districts and blue states more than anything else.

It certainly is.

On addiction issues.

If you eliminate programs, I'm guaranteeing most of that money goes to rural communities that don't.

The locks own money and where there's a lot of addiction.

Yeah.

And and the lack of access to, to, you know, you need transportation if you can find it to get to treatment.

Treatment's not there.

So a lot of people die and so and alcohol's as much a problem is opiates worse actually than opioids.

But we shouldn't be doing policy based on whether more people will die in a red county or a red state.

Right.

Oh, I agree, but, you know, it's like there's what I wish it would be.

And then there's what it is.

And so you have to deal with the realities.

And I think that, with so much of this right now, you got to put pressure on people who are going to run again or want to run again next time.

And because and you see all across the country, these town halls aren't going all that well for both parties, by the way, people are pissed off and they're not.

You can see it and react to it now, or you can feel it next year when you try to run for reelection.

In my opinion, I was watching Kelly Reid's reaction, Kelly's president, CEO, future Doyle when when Rob said the people involved who want to zero out some of these programs are don't really understand the issue.

And you were nodding along with that.

Why why?

You know, I think that, a lot of the situation and I was in little politics for a period of time in my career, you aren't an expert on everything, and you can't be, they're really designed to help, the elected officials achieve, what they have recommended as a budget target.

And, they don't necessarily always understand the bottom line impact that it's going to have.

And the bottom line impact is extraordinary.

in, in these situations, for all the reasons that Rob pointed out, for me, you know, we have, experienced the Dodge cuts, that has come home to roost for us.

And I take the position that, you know, think globally and act locally.

is where we're at right now.

I can tell you, I just read an article this morning that the U.S. economic policy uncertainty Index is the highest it's ever been, except, during the pandemic.

and I think a lot of it for someone like myself or anyone running an addiction facility or working in this field, uncertainty is, is, the name of the game.

But here's the deal.

so is commitment.

That's the name of the game for us.

I will not let federal, the threat of federal policies determine, the manner through which youth or Doyle delivers or delivers its services or the amount of commitment that we place on these roles in our community.

But what do you mean when you say you've experienced the dodge cuts?

So two of our, grants were cut.

and, you know, they were, cut.

They were both, grants that were scheduled to end one in June and one in September.

there was a reinstatement that was subsequent to that, but we had already taken the action, to, eliminate, the, the, programing and redirect our staff.

So we chose not to participate in the redirection.

You know, the decisions and the decisions can really, move you back and forth so much.

I have to tell you, though, that one of, the folks that did outreach because you and you started the program on, the outreach and the Narcan and getting, it to folks, one of our staffs, who is retired but is a per diem with us, said, I'll continue.

I'm going to continue to work for you as a volunteer, because this is just too important to let go of when you say that.

Okay?

I just want to make sure I understand here that one of the positions are going to end in June.

One was going to end September.

and the Dodge cuts eliminated those, those right away.

One of the grants, one of the grants was going to end in June, and one was going to end in September.

And when we received the notice, it was effective immediately today, effective to today to do what though to they were just going to stop funding both of the programs.

They were both outreach programs.

Okay.

so a lot of what you talked about in terms of outreach, getting to the streets, getting to the people that are are most impacted and most likely to suffer from an overdose, are where we where we receive the cuts.

We want to end of that.

yeah.

So, I think March 24th and I want to say in that range, HHS notified all the states that they were terminating funding contracts that distributed funding.

It was Covid stimulus funding.

It was from both Trump one and Biden one, and, it was immediately challenged in court.

and it's it's been enjoying they've stopped them from making the cuts.

So states are still actively trying to spend the funds.

and it's the same legal argument that's going to fly with most that the president, at least for most lawyers like myself, does not have the authority without an act of Congress to stop paying for something that Congress appropriated.

And then beyond that, with the contracts, one of the other arguments is that there's a there's this thing called process.

And notice, which seems to be a missing thing right now, that, contractors entitled to before cuts made.

Now, that being said, you know, Kelly as a CEO has to make decisions if these if this was already going to end in the summer, in the fall, do I continue to work at this or do I make decisions for the best, you know, interest of my organization?

And it's the same thing that's going to, I don't suspect that that's the end of us seeing these kinds of terminations of grants and awards.

what I do into, you know, what I do think is going to happen because this case and the case when OMB issued the spending freeze, which was stopped as well in February, I think the federal district court in Rhode Island is going to be very busy, because that seems to be where all the state attorney generals are going to file litigation.

And I think they're going to win ultimately, because, you know, when you follow our Constitution, it's beyond that as well.

I'm trying to give an a legal lecture here, but there's another law called the Empowerment Control Act.

And Trump would not be the first president to try to oh, everyone's tried to challenge empowerment.

Yeah, but they haven't won.

Trump seems to think that he can successfully compound.

Well, he's tried in the courts.

The courts are going to you know, what I would say is on so many things that we just assumed and followed terms of what you can and can't do doesn't seem to be part of what's going on right now.

so we've got three branches of government.

Congress, and the courts are probably going to tell us a whole bunch in the next four years.

Well, before I bring in Lori, let me just, one other point that I wanted to ask Kelly about here.

I'm going to read from Reuters list here.

So Reuters put out a piece examining the DOJ's cuts to see what has actually been affected already.

This is from their report, quote, government drug researchers have been sacked.

One of the nation's premier narcotics testing labs has furloughed chemists who test the potency of illicit drugs.

A Pennsylvania outreach center that distributed thousands of doses of overdose reversal medication has closed its doors.

And Illinois, a nonprofit that works to reduce overdose deaths in communities of color, is slated to lose grants and about 60% of its budget.

The Office of Federal Workers, who conduct the nation's only annual survey on drug use, has been gutted, and The New York Times added to this list with the following.

Other addiction related grants on the chopping block include those offering treatment for pregnant and postpartum women, peer support programs, typically run by people who are in recovery, a program called the Youth Prevention and Recovery Initiative, and programs that develop pain management protocols for emergency departments in lieu of opioids.

That's a list of nine things, and it's probably longer than that.

so I guess what I want to ask you, Kelly, is when you talk about the positions you've already cut, when policy really matters in this way, it is not just about, did you cut 3 million here or 30 million here?

It's are people dying?

Are people not getting access to treatment?

Do you think that's going to happen or.

Oh, 100%.

you know, one of the things is that we're still there's such a stigma attached to, to, drug use.

and we're still struggling to re reenter folks who used to come to treatment, pre-pandemic.

We're only 60% of the folks that we served pre-pandemic at this point.

so we're already struggling to keep folks alive and, to pull against the, you know, the pull of the drug is, is sometimes deeper than the pull of our caring hearts.

And that's a tragic story.

so when you cut things like the studies of, the analogs for what is in the drugs, it's it's just so frightening to me because people are dying, and right now we're celebrating.

you know, we were up 23% in 2023.

The the, the Monroe County report indicated that we were up 23%.

And we do have a slight decrease in opioid deaths right now.

But there's a stark increase for, black and African Americans and Hispanics.

We cannot stop the work we're doing.

We have to remain diligent.

And that's what frightens me, about what we're talking about here.

I do want to clarify that we cut our program, we cut our grant, the grants were cut, but, we did and we did.

Won't lose one position, but we redirected everyone else to, to actual counseling services.

Okay.

So, Lori, how do you see everything that's going on in terms of the allocation of resources, the prioritization?

A lot of the a lot of the buzz is on and here it is right here, I think I, I think I printed up for myself, where's the number.

Every time I see a story on opioid deaths lately I'm seeing, the numbers that are down.

The CDC said last month the trend line around opioid deaths is encouraging 24% decline in overall U.S drug overdose deaths.

Provisional data showing 87,000 drug overdose overdose deaths from October 2023 to September 2024.

And that's it's a huge number, I think still, but it was 114,000 the previous year.

We've talked to Rob in the past on this program about you know, don't over celebrate, you know, year to year trend line numbers when you've got tens of thousands of people dying of overdose.

How do you see everything right now?

That's exactly how I see it.

I think, for a lot of people, they look at those numbers and it just defies the bias that already exists.

Or cutting resources, like for cutting resources, we're doing better.

Like this is easy.

Whatever we've done, it's working.

It's going to continue to go down.

And there are a lot of myths out there, and Rob's probably the best person to address that.

about why some, you know, some of the opioid data is showing a reduction, which is terrific, but it doesn't change the fact that in the last ten years, we lost a million people to overdose deaths and 87,000 or 100,000 something ain't working.

And it doesn't mean that we should be turning back, dialing back the dollars.

we've gotten better.

We've gotten more strategic.

I can say we have more peer advocates out there on the street doing things like Kelly's program outreach.

And I hope to God they didn't cut the mobile van.

No.

Thank God.

but this is what's saving lives.

Having people in the right place at the right time, when people are ready to face their addictions, and then being supported in a very specific, loving, compassionate way.

And then we've got folks who are making decisions based on their own personal biases and numbers that are, superficial at best.

but there's I think, two kind of justifications I'm hearing from the federal government.

Lori, the one sounds like this.

There's just too much waste in government in general, and that people want the waste gone and we're going to target waste and that that's the first step.

The second thing I hear is that the DOJ's team really believes that you cut, cut, cut.

And then when you see something really hurting, then you will have revealed something that should not have been cut and you restore it.

What do you make of that approach?

You think that?

I don't think it's a very strategic approach, and I don't think that we should be spending three years analyzing a problem before deciding, you know, what the solution should be.

But the fact that these people come in and they make decisions and, and make jokes about it, you know, Elon Musk with, whatever the the chainsaw tool is, I never used one.

But, yeah.

You know, it's it's insulting to our greater intelligence.

And yet there are people out there who really buy into that, the theatrics of it.

The truth is this was a what is it?

Ready, fire.

Aim.

process.

you can't come into office one day and begin cutting huge programs that affect many, many lives at the speed that they did without having any kind of a plan or doing any kind of analysis about what the fallout is going to be on those programs.

And that's exactly what they did.

You've seen it yourself up close, and you've gone through the the most painful kind of lost.

You try to help families prevent that.

What is needed most right now, specifically to try to take it from a situation where we're not celebrating that it was 100,000 deaths last year, now it was 95.

Did we get those numbers down to something very, very small?

How do you get there?

What is needed most?

We need to stay focused on the programs that we know are providing positive outcomes.

When I hear about things, you know, I can't speak as eloquently about it as, as as this one.

Beside me can.

But, you know, it doesn't take a rocket science scientist to look at some of the programs that are being cut.

And I'm thinking about the ones where we're able to test the drugs that are on the street and see what's in there, know how bad it is, and what we need to do to either get to get it off the street and to treat people who are coming in, being affected by it.

Why would we cut something like that?

Why would we cut naloxone, from being in people's hands?

How many people in our country today are saving lives because they're carrying naloxone?

Our police officers will probably stop carrying it.

If if this is the direction and the message that is being sent, it must be sent that it's not saving lives.

And the fact is, it is saving tons and tons of lives.

Okay, so here's what I want to do.

We have to take our only break.

We're going to come back and we're going to look at what then happens at state level.

One of the things we heard from state representative like Jen Lunsford, for example, a member of the New York State Assembly a couple months ago on this program was as these kinds of events unfold with the federal government, you will see a lot of states adopt their own strategies to try to, in their view, perhaps mitigate some of the effects.

So what's happening on the state level?

What do Rob, Kelly and Lori want to see at least happened there?

We'll talk about that and the other side of this break on connections.

Coming up in our second hour, we turn our attention to cancer news and some good and bad.

Over a recent 30 year period, the cancer mortality rate went down significantly in this country.

But at the same time, a significant spike in younger adults getting diagnosed with cancer.

So what's going on there?

What do we know?

What does the research tell us and what support services are there for younger people getting cancer?

We'll talk about it next hour.

After college death, students are less likely to find jobs in the sciences, health care or teaching, and government grants that aim to change that were just ended by the Trump administration.

I definitely feel like if things had been different, I wouldn't be feeling so lost and unsure about my future.

I'm Ari Shapiro.

The uncertainty ahead for students on the next All Things Considered, from NPR news.

This afternoon at four.

This is connections.

I'm Evan Dawson.

Cy writes to us to say, I thought, I think a large part of the conservative mindset is that people, families and individuals and communities and states should manage their own business.

And it's not the federal government.

It's not the federal government's job to get involved.

It's not a one size fits all approach.

So that's why they would be in favor of cuts, even if it's too successful.

Existing programs.

That's from Cy.

What do you think, Rabkin?

So you know, what I learned at the federal level is we don't make as much policy as people think.

What we do is we drive money to drive policy and and so I think these massive cuts that have been proposed would be, you know, they would cause a lot of havoc, a lot of lost lives.

If you want to take that approach, good.

Give the states the money and let them manage it and get completely out of their way.

Don't tell them what to do on policy and then judge them at the end of it.

Did they reduce overdose deaths?

Did they reduce alcohol related deaths?

You know, if they did, they keep the money.

If they don't, then I guess you go back and look at what they do.

But, you know, the the overarching thing that I keep, you know, because I'm being asked to talk to groups all over the place, right?

Because they think the world's coming to an end, and I don't agree with that.

But, you know, if you feel a particular way, including C, why go advocate, you know, your members of Congress and meet them when they're home.

Don't do it.

Don't go to Washington.

It's too expensive and it's not worth it.

Everyone's trying to see them in Washington.

Meet them where you live, where they live, where you vote and they vote and let them know you care about issues.

And I keep telling folks, do you know your congresspeople?

If you don't, why not?

And if you do, that's great.

Are you a resource for them and their constituents?

But get there and tell them what matters to you, and then hold them accountable.

And you can do it, by the way.

I'm not a big fan of people showing up and screaming and yelling, because then I think all that happens is everyone focuses on the screaming and yelling, and it makes good theater for MSNBC and all these 24 seven news shows.

I don't know that it's all that productive and effective.

Be respectful, but be straight and hold them accountable.

And if they don't do what you think they should do, vote them out.

You're hearing Rob Kent, who is the president of Kent Strategic Advisors, former general counsel for the white House Office of National Drug Control Policy during the Biden administration.

Kelly Reed, president and CEO of youth or Doyle, what do you make of C's point that, you know, maybe the mindset is everybody's kind of on their own.

We're not going to set a top down policy.

Figure it out for yourself.

So I think that, it's really important that we stay the course.

I find it's so offensive to hear something like, let's cut it and see if, if, if the concern rises, then we'll know it's a big problem.

for Lori Drescher, it failed 100% of the time, and she's lost the, the, future of her life with her son.

We can't measure our policies, our practices, and our funding based on their kind of decision making.

We need to base it on, solid research and expectations that we will change the trajectory of, overdose and drug and alcohol use.

We have to stay the course, and we have to be committed to it.

And I think if I had an expectation of New York State, I would say that we need to use the opioid settlement funds.

Well, and we need to get it to the communities.

There's a lot of conversation.

I have a, favorite saying that it takes government an hour to make minute rice.

We get in our own way, government gets in its own way, and we we don't have time, for that, we need to look at what is working.

And there's plenty of studies that demonstrate what is working.

And we need to get the money, to the people that are delivering the services and get it onto the streets and into the programs and start to make, a more powerful difference with them.

If you give us the money, we do make a difference.

We have demonstrated that over and over and over again.

We are saving lives and we are changing the trajectory of people's lives.

So I would ask that that happen.

I would ask that that the state be more responsible in making the managed care organizations pay us the rates that we are entitled to.

They do not.

They are slow to pay us when they're even.

When there's an increase, they often don't unless you apply, pressure to them.

And I would ask also that the state have someone who coordinate all of the efforts.

Certainly.

No, no shade on those that are working at the state level right now.

I think they're doing, really great job.

But I think, someone who's kind of a drug czar who focuses on, what needs to be done in our state, especially in this time of uncertainty, would be a great position for the governor to create or address or anything you want to add.

Laurie is the founder of Recovery Coach University.

I agree 100%.

and in fact, I'm part of a group of family members who are advocating for exactly that.

to find a more efficient way of, generating resources, bringing resources together.

It's complicated.

It's it's a complicated system.

And then you have, you know, the substance use disorder side of things, you know, and then you've got the behavioral health and mental health.

And we all know that these things are connected.

However, our systems are not so well connected.

And that requires a great deal of coordination.

And when we spend that much time coordinating, we are losing time and we are losing, people.

So I fully support the idea of having a drug czar.

We know it's very successful in other states.

It was successful at the federal government.

when this guy was was there, the Office of National Drug Control Policy.

And, you know, people are very focused and have their own areas of expertise.

We need somebody who really knows this subject and knows the players and can make it all happen.

So what happens, Rob Kent, if that is in place, at least on a state level, what might happen?

So let me tell you one specific thing where it would matter.

And I worked on this when I was in state government as the counsel at Oasis.

So we made a big effort to create one set of rules for outpatient programs to treat mental health and addiction and basic primary care in one place, wherever the person.

When we got so far.

And then he'd hit a hurdle D.O.A.

had an issue or whatever, age had an issue.

Oasis.

And, you know, what happens is every day you're putting fires out to start with, when you work at that level of an agency, somebody dies in a program that's going to take a bunch of your time.

That day.

So you you stop doing the stuff that you've hit roadblocks on, and you go back to doing all the other stuff you do every day.

And eventually, you know, months down the road, you're like, hey, we we totally forgot about this.

So and, and I can speak from it now from this unique perspective that I was at the state level at an agency.

And, and then I was at the federal government where there's this oversight office.

And it matters because the simple fact that you can force people to the table in a centralized drug czar approach is, is one of the most critical things.

You got to get them in the room to get them to agree.

And so having that would be huge.

And there's no integrated mental health addiction, basic primary care in inpatient programs.

And so people ping pong all over the place.

We waste a ton of money on it as well.

So getting all these agencies in the room that impact drug policy and funding related to drug policy, we are going to create one set of rules for all of treatment.

Wherever you show up in this state in an Oasis program, ohm h d o h, you could get all those services.

And because right now the approach, people fall through the cracks through, I call it a canyon.

It's more a canyon than it's so crack.

And so people die because they can't get everything in one place.

And so if you had one person dedicated and charged and reporting directly to the governor, this is what I want you to do, right?

And I give specific examples.

We, in President Biden's first state of the Union address, we, our chief of staff, spent like a month in the West Wing right before state because everyone's throwing ideas at the president.

Same thing.

State of the state in New York.

And so you really got to work.

And it's got to be something.

It's got to mean something for him to talk about it.

And he celebrated the 23 million Americans in recovery in his first state of the Union.

And he mentioned the term heaven forbid, harm reduction.

It didn't happen just as he was sitting at the Oval Office, you know, at the Resolute Desk.

Well, I think I'll talk about Ukraine, the economy and harm reduction.

It happens because people report to him and they push the issues, but they they push him in a way that his policy people at the higher levels understand.

So if we're making progress right now, and I think we are now, you know, there's a million reasons why, to be honest.

So there's certainly more than it was harm reduction.

It was naloxone.

It is everything.

Right.

And to waste time trying to take credit for what I do is the reason the numbers are going down is such a wasted effort.

Go do more if it's working right.

But let me.

But Rob, I wanted to ask about this.

When you talk about watching the buzz around the Oval Office and what gets into a state of the Union, what gets a president's attention?

What gets a president's priority, what gets a governor's priority?

President Biden, very famously has a son who has suffered from addiction and, you know, all of our guests today have talked about the struggle of working on a very hard issue in which policy is often set by people who don't understand the issue very well.

I would have presumed that President Biden has a maybe a little bit more of an opening to understand it.

Do you find in general that political leaders, state level, federal level, they're more open to the message?

If they have had someone in that situation in their family?

Generally, yes.

But but they also have other people around them, right, who were chirping in their ear, who know nothing about this stuff and think about it, other issues, and I can't tell you to working at the state and federal level, how many different policy wonk people I had to explain our stuff to all the time.

It's why why I when we made real progress in New York, the best thing that happened is the governors folks trusted me, trusted us, and they just let us go do what we were doing.

And they didn't ask me to explain everything to them.

They trusted because they verified that what we did worked and it made an impact.

And we we reduced overdose numbers in 2017 and 2018, which, by the way, we now know fentanyl was already in the mix at that point in time.

Yeah.

And why?

Because we threw everything at it.

Everything.

We're not doing that.

But right now we're just not.

But people, you know, take credit for these reductions.

And look, I mean, I read quotes all the time.

And so I saw this quote from Indira Gandhi.

She said, you know, my grandfather told me there's two kinds of people, one who do the work and one who take credit for it.

And he said, try to be in the first group.

There's less competition.

So on that note, let me ask all three of our guests.

When we look at the state level, what is happening, Rob, that is working?

What is happening?

What is not happening that still needs to happen?

I mean, I'm reading that back in January, Governor Kathy Hochul signed legislation designed to help combat the opioid and overdose epidemic.

and the new legislation requires the state Department of Health to distribute fentanyl test strips along with opioid antagonists, which are medications that block the effect of opioids.

and the legislation would also require that an informational card or sheet distributed along with the opioid antagonist contain information about fentanyl test strips and their uses as well.

So that's that's one example.

How are they doing what is not being done.

Give me I want all three of you kind of way and I'll start with you.

Room one naloxone.

It's simple.

The state only buys one.

One version of the.

There's multiple versions of knocks on there.

Buy one and tell me when you go to the market and you buy only one product and use no competition in procurement, that you're getting your best price is just not not the case.

So and I've talked about going out and doing an open procurement.

There's like 4 or 5 different versions, different strengths to why are they you know, I'll be polite and say it's simple to keep things the way they are than it is to go do something.

Don't be polite.

Well, it's a very peculiar arrangement with the company that makes the one product in the state of New York, and many others think monopoly is profitable.

Certainly, yes, but but those decisions to buy that product, I was part of it in that oasis.

They were made when there was one product.

There's multiple products now.

And so that that in and of itself, we've been handing out test strips for years.

So, you know, and as we should and Laurie mentioned drug testing.

The state invested a couple years ago in putting really sophisticated machines at certain locations, which, by the way, it's not a police department.

No disrespect to the police.

People aren't bringing their drugs to a police department.

Can you test these for me?

I can do a few other things while I'm while you're here.

They go to harm reduction programs where people who use drugs go to get supplies if they're doing that.

And so and they work because the drug supply we're, we're beyond now it was for a while, when April 23rd is when I left on DCP, we had just declared an emerging drug threat fentanyl adulterated by psilocybin and animal tranquilizer.

Yeah, they're on a new animal tranquilizer that's showing up everywhere.

And so, you know, the people who make the drugs will always be ahead of us, and they'll never stop creating new drugs, because there's always if there's a demand for their product, they will figure out how to meet the demand.

So, and, you know, Kelly and I put there are tens of millions of settlement dollars sitting unspent.

You know, we keep hearing from the state, you know, we've we've made available all these dollars more than any other state.

And what's made available is the checks in the mail.

It might be in the mail.

The contract might be somewhere.

The money needs to be out on the street.

You know, the people like Kelly, the people like Lori.

But the one thing about this system, when people talk about fraud, waste, abuse or overspending, this system makes $2 out of a dollar.

It always has had to do it that way.

So an investment in this system keeps your loved ones alive and keeps your family intact.

And in up against enormous odds.

The money's tied up in red tape.

The settlement dollars.

Well, they got to go through the normal procurement process.

I would streamline the procurement process.

Yeah.

The economics writer, Noah Smith, has a term called check ism that, is, it's the celebration, as if on the day that you hold the big oversize check that you got it done.

And no, Smith is on the political left, and he is mostly critical of Democrats in this way.

The Democrats love to have those news conferences, and they hold up the big check.

Well, so but what happens after that?

Where's it?

What's going down?

So 2014, the Senate put extra money in the Oasis budget.

That's when we just started to like, hey, we got a problem.

Maybe we ought to do something about it.

And by the way, it happened because families, people like Lori started telling their legislators, you better come home having done something, or I'll send someone else to Albany.

Yeah.

So they put money in our budget.

I told them we wouldn't spend it.

It takes like 12 to 18 months to get a procurement to contract and money in the in the bank account of that provider.

I told them that was going to happen.

They said, okay, show us.

Let's see.

It did the next year and for like the next six years, they gave us procurement relief.

We still had to do a competitive solicitation, but we didn't have to go through all these other processes with the state comptroller and with the Attorney General's office.

We got all the money out in the year it was appropriated, so that that has not been put in place for the settlement funds.

And so look at the governor's budget, you know, 500 million has been received by New York State.

they spent like 40% of that money by her own budget.

They reappropriated almost $300 million.

let me ask the other guests then.

All right.

Kelly Reed president, CEO, future Doyle, what has to happen on the state level now?

So I'm going to say two things that are good news.

the state is funding us for, at Heathrow.

Doyle, for a methadone clinic.

the DEA arrives on Wednesday to do the final evaluation of, everything we have set up, and we anticipate there will be opening very soon.

Why is that important?

there are folks from, Rochester, New York that are driving to Syracuse and Buffalo every single day to get their methadone because we don't have enough available here in Rochester, New York.

It is a critical piece of the process when the, Rob talks about, you know, do everything for the for the process.

Opening more methadone clinics is one of them.

The second is, another piece that that, has been raised here is, the co-occurring issues and, getting behavioral health to coordinate with one another.

We are, also up for funding a mental health clinic that will open in late fall.

at this point, 48% of our clients, 48% of our clients have a co-occurring mental illness.

So they're be able to get one stop shopping, and be able to be served in one spot for multiple needs.

And those are really good, things to be done.

I agree that we need to have a streamlined process for getting more money to, local.

it places where we can put that money on the street.

Lori Drescher what has to happen in the state?

Oh, large.

So much to say here and so little time.

first, I love the the word check ism.

and it just makes great.

It makes me think of all of the press conferences that I've been invited to attend or speak at, where those giant checks were, you know, front and center and breaking their arms, patting themselves on the back.

But I'm thinking about the opioid saddle fund settlement funds when did that start?

Three years ago.

Yeah.

And I was at that.

And it was so exciting.

And Letitia James was there and all of our politicians locally, and it was hurrah, hurrah, you know, we did it.

And here we are three years later, and we still haven't spent any of the money that's been allocated in the budgets.

Yeah.

So we we need to get to the root cause, which in this case I do believe procurement is a big, big piece of it.

It needs to be simplified, streamlined.

that's the that's the truth for most of the state processes that I have issues with.

but.

I just want to say that, And I this will not make me popular, but I don't care.

When did I ever care about when we did get stuff done.

And we.

There are a lot of laws that were passed between the years of 2014 and 2000 and before, before, the pandemic.

Yeah.

Cuomo was in office for, a part of that time, a big part of that time.

And I remember standing beside him as he signed in many bills.

There were many laws that were changed during that time.

So we do need politicians who are willing to actually listen and understand, you know, what the data is showing and what changes need to be made.

And you're saying Governor Cuomo did.

He actually did.

Yes, quite a bit.

so and I would like to take this moment to invite, if there are family members who have experienced what I've experienced, and you have a voice and a heart for advocacy, please join me.

How do they find you?

I'm Laurie at Recovery Coach university.com.

Lori is Lori recovery coach University is the organization.

Lori.

You're welcome here anytime.

And I hope that you'll all come back as the year goes on here, because we will see what does come out of the final federal budget.

We'll see what happens at the state level.

And frankly, we'll see if, how we're dealing with preventing death in our communities.

So thank you for being here, Lori.

Thank you.

Thank you for being here, Kelly Reed, have a great breakfast tomorrow morning.

Big event in Eagle Vail, 8 a.m.. More information on our website there with you there.

Doyle, thank you for being here.

And Rob Kent always good to talk to you.

Thank you Rob.

Great talking to you.

President of Kent Strategic Advisors.

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