00:00Thanks to all three of you for not only being here today, but for your willingness to serve your country
00:04and thank your families as well.
00:07I already asked Mr. Klomp this question at a different hearing yesterday, but to Dr. Sapphire, Dr. Westlake, before turning
00:15to other issues, I want to ask you a simple question.
00:18If directed by the president to take action, it would break the law. Would you follow the law or follow
00:22the president's directive? Dr. Sapphire.
00:27I have no intention of breaking the law, Senator.
00:29So you will follow the law?
00:31You will follow the law.
00:32And Dr. Westlake?
00:33My ultimate responsibility is to the American people. I follow the law.
00:38Dr. Westlake, I want to follow up on a conversation we had in my office.
00:42I recently met with groups in New Hampshire, including members of law enforcement, who work together to distribute overdose prevention
00:50kits, including fentanyl test strips.
00:51They told me that fentanyl test strips help prevent fatal overdoses and ultimately help engage people to get them into
00:59recovery.
01:00This is a small community, by the way, that hasn't seen an overdose now since 2020 because of their work.
01:06However, earlier this year, your agency released guidance that says that grantees cannot purchase or distribute test strips with federal
01:14funds.
01:15This guidance directly contradicts a bipartisan provision that I led in last year's Support Act to ensure that test strips
01:22can be purchased with federal funds.
01:24Now, because of this administration's actions, a community organization in New Hampshire is scrambling to reorganize its budget so that
01:32they can find a way to keep getting these test strips.
01:35Dr. Westlake, if confirmed, will you rescind the guidance that takes test strips away from recovery organizations?
01:42Senator Hassan, thank you for the question, and thank you for meeting with me, and thank you for the work
01:46in the past when we were working on Halt-Fentanylton.
01:48And so the thing, the question is harm reduction, you know, what is harm reduction?
01:53So harm reduction for me means eliminating the risky behaviors that lead to the devastating effects of the disease process.
01:59So when we look at the evidence on fentanyl test strips, there's no evidence that it reduces overdose.
02:04But that's not what we're hearing.
02:06You just gave very eloquent testimony about the importance of listening to people on the ground.
02:10Here's what's happening on the ground in my state.
02:12Tiny town I just told you about, they haven't even seen an overdose because the chief of police has worked
02:17so closely with families and the community to make sure that we are being evidence-based and effective and meeting
02:24people where they are as they're challenging their addiction and turning to law enforcement or to health entities for help.
02:32And one of the things that they tell me is that the fentanyl test strips build trust, among other things.
02:37In Manchester, New Hampshire, we can all celebrate today because in August, it's our biggest city, for the first time
02:44since 2015, we had zero overdose deaths.
02:47I have been to more funerals than I can count where parents have lost more than one child to this
02:52epidemic.
02:53We know that fentanyl test strips work.
02:55Also, the law says you have to provide them.
02:57So the evidence is really clear.
03:00However, I am looking for you to commit to follow the law and allow community organizations to purchase test strips
03:08with federal funds.
03:09Yes, Senator.
03:10So I've been, my first overdose that I resuscitated was more than 30 years ago.
03:15So I'm looking very, I have another question for you.
03:17So I'm looking very specifically, will you rescind this guidance?
03:21The evidence does not support that.
03:23There's anecdotal stories.
03:27My people, my people on the ground, you cannot tell me that it's important to listen to providers on the
03:33ground, that they have the best evidence, and they are very evidence-based.
03:37I am telling you, one, that the law requires it, and two, that it works, because people who are on
03:43the ground, who you say you trust, health providers, law enforcement, say it works.
03:50So I am, we will follow up, but what I'm looking for today is a commitment to rescind guidance that
03:56violates the law.
03:57I promise to follow the science and the evidence-based to the best dreams, including naloxone.
04:02How about following the law?
04:04You just said you'd follow the law.
04:06We have, the Support Act says the federal government must provide these test strips.
04:10Follow the law.
04:11My understanding is it says that they may be used for that and not shall be used for that.
04:15So we are, I believe we are following the law from what my legal counsel has talked to me about.
04:20Well, my legal counsel would differ with that.
04:23And I will likely not vote for you if you cannot commit to do that.
04:27Now, let me go on to one other thing.
04:29SAMHSA has hosted a system called the Drug Abuse Warning Network to monitor addiction-related visits to emergency departments across
04:37the country.
04:37This system has provided us with critical insight into where overdoses are rising across the country
04:43and has helped us direct resources to get people into recovery and prevent overdose deaths.
04:49One, are you familiar with this program?
04:52Two, are you aware that the program was shut down last year?
04:55And three, will you reinstate the Drug Abuse Warning Network if you're confirmed?
05:00Senator, so I was not, I'm not aware.
05:02I'm not up to speed.
05:03I've been here for five months.
05:04I'm not up to speed on every program.
05:05What I don't want to do is speak to anything that I'm not fully clear about,
05:09so I would need to get briefed on that to come up with that.
05:11And then what I promise to do is put the best policies, procedures, and practices in place
05:15to give the best mental health and addiction care to the people in the country.
05:19Okay, this is...
05:19And I look forward to working with you.
05:21This is an early warning system.
05:2360 hospitals across the country.
05:24It's been very effective, so I hope we can reinstate it.
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