[House Hearing, 118 Congress]
[From the U.S. Government Publishing Office]


                     OVERSIGHT AND REAUTHORIZATION
                       OF THE OFFICE OF NATIONAL
                          DRUG CONTROL POLICY

=======================================================================

                                HEARING

                               BEFORE THE

                              COMMITTEE ON
                      OVERSIGHT AND ACCOUNTABILITY
                        HOUSE OF REPRESENTATIVES

                    ONE HUNDRED EIGHTEENTH CONGRESS

                             FIRST SESSION

                               __________

                             JULY 27, 2023

                               __________

                           Serial No. 118-55

                               __________

  Printed for the use of the Committee on Oversight and Accountability
  
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]  


                       Available on: govinfo.gov,
                         oversight.house.gov or
                             docs.house.gov
                              
                              __________

                                
                    U.S. GOVERNMENT PUBLISHING OFFICE                    
53-024 PDF                 WASHINGTON : 2023                    
          
-----------------------------------------------------------------------------------     
                            
               COMMITTEE ON OVERSIGHT AND ACCOUNTABILITY

                    JAMES COMER, Kentucky, Chairman

Jim Jordan, Ohio                     Jamie Raskin, Maryland, Ranking 
Mike Turner, Ohio                        Minority Member
Paul Gosar, Arizona                  Eleanor Holmes Norton, District of 
Virginia Foxx, North Carolina            Columbia
Glenn Grothman, Wisconsin            Stephen F. Lynch, Massachusetts
Gary Palmer, Alabama                 Gerald E. Connolly, Virginia
Clay Higgins, Louisiana              Raja Krishnamoorthi, Illinois
Pete Sessions, Texas                 Ro Khanna, California
Andy Biggs, Arizona                  Kweisi Mfume, Maryland
Nancy Mace, South Carolina           Alexandria Ocasio-Cortez, New York
Jake LaTurner, Kansas                Katie Porter, California
Pat Fallon, Texas                    Cori Bush, Missouri
Byron Donalds, Florida               Jimmy Gomez, California
Kelly Armstrong, North Dakota        Shontel Brown, Ohio
Scott Perry, Pennsylvania            Melanie Stansbury, New Mexico
William Timmons, South Carolina      Robert Garcia, California
Tim Burchett, Tennessee              Maxwell Frost, Florida
Marjorie Taylor Greene, Georgia      Summer Lee, Pennsylvania
Lisa McClain, Michigan               Greg Casar, Texas
Lauren Boebert, Colorado             Jasmine Crockett, Texas
Russell Fry, South Carolina          Dan Goldman, New York
Anna Paulina Luna, Florida           Jared Moskowitz, Florida
Chuck Edwards, North Carolina        Vacancy
Nick Langworthy, New York
Eric Burlison, Missouri

                       Mark Marin, Staff Director
       Jessica Donlon, Deputy Staff Director and General Counsel
                        Sloan McDonagh, Counsel
                       Mallory Cogar, Chief Clerk

                      Contact Number: 202-225-5074

                  Julie Tagen, Minority Staff Director
                      Contact Number: 202-225-5051
                                 
                                 ------                                
                         
                          C  O  N  T  E  N  T  S

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                                                                   Page

Hearing held on July 27, 2023....................................     1

                               WITNESSES

                              ----------                              

Dr. Rahul Gupta, Director, Office of National Drug Control Policy
    Oral Statement...............................................     5

 Opening statements and the prepared statements for the witnesses 
  are available in the U.S. House of Representatives Repository 
  at: docs.house.gov.

                           INDEX OF DOCUMENTS

                              ----------                              

The documents listed below are available at: docs.house.gov.

  * Article, The Heritage Foundation, ``Deceptive Numbers and 
    Word Games Are Hiding Continued Mass Illegal Immigration Post 
    Title 42''; Rep. Gosar.

  * Letter, July 26, 2023 to Reps. Comer and Raskin, from The 
    Unted States Conference of Mayors; submitted by Rep. Raskin.

  * Statement for the Record; submitted by Rep. Connolly.

  * Questions for the Record: to Dr. Gupta; submitted by Chairman 
  Comer.

  * Questions for the Record: to Dr. Gupta; submitted by Rep. 
  Sessions.

  * Questions for the Record: to Dr. Gupta; submitted by Rep. 
  McClain.

  * Questions for the Record: to Dr. Gupta; submitted by Rep. 
  Connolly.

 
                     OVERSIGHT AND REAUTHORIZATION
                       OF THE OFFICE OF NATIONAL
                          DRUG CONTROL POLICY

                              ----------                              


                        Thursday, July 27, 2023

                       House of Representatives,

               Committee on Oversight and Accountability,

                                           Washington, D.C.

    The Committee met, pursuant to notice, at 10:02 a.m., in 
room 2154, Rayburn House Office Building, Hon. James Comer 
[Chairman of the Committee] presiding.
    Present: Representatives Comer, Gosar, Foxx, Grothman, 
Palmer, Higgins, Sessions, Biggs, Mace, LaTurner, Timmons, 
Greene, McClain, Boebert, Fry, Luna, Edwards, Burlison, Raskin, 
Norton, Connolly, Krishnamoorthi, Khanna, Mfume, Ocasio-Cortez, 
Porter, Brown, Stansbury, Frost, Lee, Crockett, Goldman, and 
Moskowitz.
    Also present: Representative Gonzalez-Colon.
    Chairman Comer. The Committee on Oversight and 
Accountability will come to order.
    I want to welcome everyone here today to this very 
important hearing.
    Without objection, the Chair may declare a recess at any 
time.
    I recognize myself for the purpose of making an opening 
statement.
    Today's hearing is an opportunity for the Committee to 
address the plague of fentanyl flowing into our communities, 
fueling misery across the country, and leading to historically 
high level of drug overdose deaths. I am sure that every single 
Member of this Committee knows constituents and their families 
who have been tragically impacted by illicit narcotics, 
especially synthetic opioids like fentanyl. ``Fentanyl is the 
deadliest drug threat that our country has ever faced.'' That 
is a direct quote from a letter the Drug Enforcement 
Administration wrote me this past December.
    In 2021, over 100,000 people tragically lost their lives to 
drug overdose in the United States, the majority caused by 
fentanyl. In 2022, again, over 100,000 people lost their lives 
to drug overdose, again, with the majority caused by fentanyl. 
We must continue to conduct oversight of the U.S. Government's 
efforts to prevent these tragedies and must make sure programs 
are using the best available resources and targeting taxpayer 
funds where they will make the biggest impact. Director Gupta 
from the Office of National Drug Control Policy or ONDCP is 
well suited to provide this information to Congress today.
    ONDCP was formed with the mission to coordinate a 
governmentwide effort to combat the loss of life and human 
misery caused by illicit narcotics. We need to understand from 
the ONDCP what is working, what is not working, and what can be 
improved by legislation to prevent illicit drugs from coming 
into our country, entering our communities, and poisoning our 
families, friends, and neighbors.
    The DEA assesses that virtually all of the deadly fentanyl 
found in the United States is mass produced by transnational 
criminal organizations in Mexico using precursor chemicals 
sourced from China, and then smuggled in the United States 
across the Southwest border. We need to know what ONDCP is 
doing to disrupt the criminal organizations that traffic in 
human misery and smuggle enormous quantities of drugs across 
our Southern border.
    The border crisis caused by the Biden Administration's 
policies has diverted resources and manpower away from securing 
the border, and cartel criminals take every tactical advantage 
they can to cross narcotics at our ports of entry and in 
between as well. We need to know what ONDCP is doing to ensure 
that our Customs and Border Protection officers and border 
patrol agents have the technology, legal authorities, and 
manpower to intercept and disrupt the flow of narcotics coming 
across the Southern border. We need to know how ONDCP is 
working with law enforcement partners here and abroad to shut 
down the secret labs that manufacture poisonous fentanyl from 
depriving these labs of the chemicals they need to make 
fentanyl, to dismantling illicit financing networks that fund 
these labs. We need to know about the investments in prevention 
efforts, ensuring that the public is well-informed of the 
dangers of fentanyl, how to obtain treatment for drug use 
disorders, and ensuring access to life saving treatments like 
Narcan.
    We know that China is not our ally in reducing drug 
overdose deaths in the United States. Not only are they the 
precursor chemical source from China, but money laundering 
organizations operating out of China have partnered with the 
cartels to launder the proceeds of their death and destruction 
at a fraction of the cost as before. We need to know what this 
Administration is doing to combat the aggression from China and 
expose the Chinese Communist Party's complicity in the deaths 
of hundreds of thousands of Americans. I am also alarmed with 
the increasing presence of xylazine in the drug supply, which 
Director Gupta has classified as an emerging threat. I am 
particularly concerned that Narcan cannot save someone from 
overdosing on it. We need to know how this illicit drug is 
making its way into the supply chain and what authorities ONDCP 
is leveraging to respond to this emerging threat.
    Our oversight in this matter is critical not just to 
ensuring that Federal programs are working as intended, but 
this hearing will also inform authorization of that office 
beyond Fiscal Year 2023. ONDCP was last authorized by the 
bipartisan SUPPORT Act in 2018. A lot has changed in that time, 
but our resolve to put an end to the daily drug overdose 
tragedies in our communities is only strengthened. As the 
Committee of jurisdiction over ONDCP, it is up to us to make 
sure that ONDCP is equipped and directed to take all 
appropriate actions to fight this crisis. And with that, I 
yield to Ranking Member Raskin for his opening statement.
    Mr. Raskin. Thank you very much, Mr. Comer, and thank you, 
Director Gupta, for joining us today. The Committee is going to 
be facing in the coming weeks the reauthorization of your 
office, which plays a critical role in the executive branch 
coordinating a whole-of-government response to reduce drug 
addiction and to prevent overdoses, which touch nearly every 
family and certainly every community in the country.
    Overdose deaths have reached record levels in recent years, 
and while deaths remain shockingly too high, we are making 
progress reducing their frequency, partially because of the 
work of your office. Without ONDCP's coordination and oversight 
of drug policy and strategy, our public health and law 
enforcement agencies would still be working myopically in 
silos, and Federal investments to tackle the problem totaling 
$41 billion in Fiscal Year 2022 alone would be drained off into 
waste and inefficiency. Instead, because of your office, our 
Federal agencies collaborate to address the problems of 
addiction and overdose as part of a well-focused National Drug 
Control Strategy. This comprehensive approach means that we can 
better deploy Federal resources to help the communities hit 
hardest by trafficking and the staggering rates of addiction, 
including by working to keep drugs out of the hands of children 
and to make sure people experiencing overdoses have the access 
to life-saving overdose reversal medication.
    After rising for more than two decades, overdose deaths in 
America skyrocketed to historic highs during the coronavirus 
pandemic when they increased by more than 30 percent in 2020. 
The rate of increase slowed to 15 percent in 2021 and then 
again in 2022. While overdose has remained far too common and a 
single overdose is too many for our people, we have made 
remarkable strides in the last year and new CDC data show 
opioid overdose rates plateauing for the first time in many, 
many years, but we cannot continue this progress without 
reauthorizing your office.
    Democrats and Republicans should work together to address 
the underlying causes of addiction in our society. When we talk 
about the opioid crisis or the fentanyl crisis, we are really 
talking about many different social crises bearing down upon 
us, including the mental and emotional health crisis and, in 
many communities and regions, an economic and opportunity 
crisis. It does no service to our communities and our families 
harmed by addiction to completely blame opioid overdoses on a 
crisis, whether real or fake at the Southern border. We are 
talking about more than 40 million people in America who have 
substance use disorders, with many of them facing serious 
underlying mental health conditions. We are talking about 
people who lack the resources they need to treat mental 
illness, who face stigma in obtaining treatment, and who may 
self-medicate with alcohol, fentanyl, and other illicit drugs.
    More than 100,000 of our constituents, family members, and 
friends lost their lives to drug overdose last year. We must 
reauthorize ONDCP to ensure that America's young people have 
access to treatment, both for substance use disorders and other 
mental illnesses, so they do not end up overdosing or going to 
prison for committing drug-related crimes. More than 60 percent 
of children who experience depression do not get the treatment 
they need, which exposes them then to the temptation to use 
dangerous substances to self-medicate in the absence of the 
mental health support networks that could actually see them 
through to safety. We have to reauthorize your office to halt 
the flow of fentanyl into our country.
    Thanks to the work of ONDCP and the entire Administration, 
U.S. Customs and Border Protection seized nearly 245,000 pounds 
of illicit drugs at the Southern border including 21,000 pounds 
of illegal fentanyl from March 2022 through February 2023. 
Because we now have a coordinated all-of-government response, 
we are seizing more fentanyl before it invades our communities, 
and we are ensuring that law enforcement agencies have the 
tools they need to arrest illicit drug traffickers.
    We are disrupting the criminal cartel networks that operate 
from China to Mexico and have denied nearly $2 billion to the 
manufacturers and traffickers. Under ONDCP's leadership, the 
High Intensity Drug Trafficking Areas Program is working 
effectively, and in 2022, we saw a return on investment of $82 
for every dollar put into the program. The office is working 
with our Homeland Security agencies to ramp up the use of high-
tech device drug detection technology along the Southern 
border, including installing new non-invasive scanners to catch 
trucks entering with fentanyl into the country. These new 
technologies appear to be working in dramatic fashion because 
fentanyl seizures are up nearly 400 percent along the Southern 
border, and 90 percent of illicit fentanyl is now being caught 
at ports of entry and vehicle checkpoints.
    Earlier this month, your office released the Nation's first 
response plan for fentanyl adulterated with xylazine, after 
designating the substance an emerging threat. ONDCP would not 
have been able to make this designation without new authorities 
granted to you during reauthorization in 2018. Because of the 
new designation, ONDCP can coordinate a rapid response to the 
drug by surging resources to state and local entities combating 
the threat in real time at street level.
    We cannot efficiently address the addiction and illicit 
drug control problems we face without discussing both supply 
and demand. While blocking fentanyl, methamphetamine, and other 
dangerous drugs from entering America is crucially important, 
we must also address the prevalence of untreated mental illness 
and rampant drug use, which create a market for these drugs in 
the first place. And significantly, we must also ensure that 
people who experience drug overdose can get access to the 
emergency medications they need to save their lives. Thanks to 
the bipartisan, bicameral work of this Committee and others in 
Congress, naloxone and opioid overdose reversal medication is 
set to be available over the counter in just a few weeks. And 
thanks to the good work of your office, more of our schools and 
workplaces have overdose reversal medication readily available. 
We must continue our work to ensure these medications remain 
affordable and accessible where they can mean the difference 
between life and death for our constituents.
    Dr. Gupta, I look forward to hearing from you today about 
your critical work, and I thank you for joining us for this 
hearing as we work to reauthorize your office. I yield back, 
Mr. Chairman.
    Chairman Comer. The gentleman yields back. I am very 
pleased to introduce our witness today. Dr. Rahul Gupta is the 
Director of the Office of National Drug Control Policy, which 
leads and coordinates the Nation's drug control policy. Dr. 
Gupta was confirmed by the Senate and assumed office on 
November 5, 2021. I look forward to hearing from Director Gupta 
today on his office's efforts to combat the overdose crisis as 
well as the reauthorization of the Office of National Drug 
Control Policy.
    Pursuant to Committee Rule 9(g), the witness will please 
stand and raise his right hand.
    Do you solemnly swear or affirm that the testimony that you 
are about to give is the truth, the whole truth, and nothing 
but the truth, so help you God?
    Dr. Gupta. I do.
    Chairman Comer. Let the record show that the witness 
answered in the affirmative.
    We appreciate you being here today and look very forward to 
your testimony. Let me remind the witness that we have read 
your written statement and it will appear in full in the 
hearing record. Please limit your oral statement to 5 minutes. 
As a reminder, please press the button on the microphone in 
front of you so that it is on, and the Members can hear you. 
When you begin to speak, the light in front of you will turn 
green. After 4 minutes, it will turn yellow. You know the 
routine. You have done it before, and if you need to take more 
time, feel free.
    I recognize Dr. Gupta to please begin his opening 
statement.

                      STATEMENT OF DR. RAHUL GUPTA

                                DIRECTOR

                 OFFICE OF NATIONAL DRUG CONTROL POLICY

    Dr. Gupta. Chairman Comer, Ranking Member Raskin, and 
Members of the Committee, thank you for having me here today.
    I recently called a mother to express my condolences. She 
just lost her daughter, Michelle, to drug overdose. Michelle 
left behind two young children. Michelle was not the only one 
lost to drug overdose and poisoning in the family. Her sister, 
Maya, had passed away 3 years prior after becoming addicted to 
pain medications prescribed to her, and the mother I spoke to 
had been the one to find Maya unresponsive at home, every 
parent's worst nightmare. So, I asked myself, how could we as a 
Nation have saved these two young women and more than 109,000 
other Americans over the past year? Some say we just need to 
lock up everyone involved with illicit drugs, including people 
like Michelle and Maya, just lock them up and throw away the 
keys. Others say we should focus on treatment and ignore drug 
traffickers.
    With an American dying every 5 minutes around the clock, we 
cannot just focus on supply or just on demand. We have got to 
do both because we cannot treat dead people, so here is the 
bottom line: drug trafficking is a crime and must be 
prosecuted, and drug addiction is a disease that must be 
treated. And here is what we are contending with today: drug 
traffickers who are motivated only by profit, too few support 
systems for people with the disease of substance use disorder. 
These drugs are accessible right on your phone, and emerging 
threats of fentanyl mixed with xylazine, commonly known as 
tranq, has made matters worse. Tranq dope is making fentanyl 
look like a walk in the park.
    Disrupting today's drug traffickers and producers is like 
playing Whac-A-Mole. The global supply chain for synthetic 
drugs is more robust than ever, with precursors predominantly 
coming from China, which refuses to cooperate on counter-
narcotics. So, we are bringing world leaders together to 
address the global supply of precursor chemicals for synthetic 
drugs, with or without China.
    Last fall, Congress itself put a price tag on the 
staggering toll of opioid epidemic, $1.5 trillion in 2020 
alone--$1.5 trillion. So, this is a national security problem, 
it is an economic prosperity problem, and it is a public health 
problem, and President Biden and his Administration are 
determined to solve it. The President's National Drug Control 
Strategy is going after the two key drivers of this crisis--
untreated addiction and drug trafficking profits that fuel it--
and we are getting results. Let me give you an example.
    El Chapo's son is behind bars, and naloxone or Narcan is 
over the counter, and treatment for addiction is more 
accessible than it has ever been. We have the technology, the 
expertise, and the courage to stop drugs at the border. When 
almost 90 percent of fentanyl is coming through our ports of 
entry, we must put technology to work for the American people.
    [Chart]
    Dr. Gupta. I want to point your attention to the poster on 
my left. We are installing new high-tech drug detection 
scanners on our Southwest border to make sure that every single 
vehicle that needs to be scanned, gets scanned. Every single 
one.
    This is what commercial disruption of drug trafficking 
looks like in the 21st century. If you look at the post to my 
right, these images show from side-to-side and top-to-bottom 
how technology is helping seize more fentanyl than ever before. 
All the pieces in the red circle. With record-breaking 
seizures, we have denied traffickers more than $22 billion in 
profit just last year, thanks largely to the brave officers and 
the agents of Custom and Border Protection and our High 
Intensity Drug Trafficking Areas program or HIDTA.
    At the same time, we have invested $83 billion in 
treatment, 42 percent more than the previous Administration, to 
address the opioid crisis in local communities. We are tracking 
non-fatal overdoses in near real time so communities can 
respond to hotspots. And using the emerging threats authority 
granted by Congress in the SUPPORT Act, we have developed a 
Federal response to xylazine and are implementing it as we 
speak. Our Drug-Free Communities Support Program or DFC is 
preventing youth substance use in all 50 states. And our social 
media campaign warning youth about the dangers of fentanyl and 
the importance of carrying naloxone has made more than 1.7 
billion impressions: 1.7 billion. And as a result of all these 
actions and so many more, our Nation is finally seeing 
progress. In 2022, overdose deaths flattened after sharp rises 
for several years. Still, we cannot stop. We must keep pushing 
forward.
    Now, to President Biden and to me, the path is clear. We 
must double down on what works and address the challenges that 
remain to save American lives, and we must prepare for future 
threats. I want to thank Congress for your role in the progress 
our Nation has made, and I am eager to work with you to make 
sure that law enforcement and public health have the tools that 
they need. But make no mistake about it: this is a fight for 
the very future of our Nation. The American people deserve 
nothing less than our very best. Thank you.
    Chairman Comer. Thank you, and we will now begin our 
questioning phase. The Chair recognizes Mr. Gosar of Arizona 
for 5 minutes.
    Mr. Gosar. Thank you, Chairman. Thank you, Dr. Gupta, for 
your comments. One hundred and seven thousand people died of 
overdoses in 2021, as you said. It appears that 109,000 people 
died of overdoses from February 2022 to 2023. No matter how the 
Administration spins this, the problem is getting worse. There 
are many reasons for the drug crisis. Instead of dependency 
that we saw on drugs, now we are seeing tranq and fentanyl 
being put together, and we are seeing instant death. Yes, there 
are more granular policy fixes that are worthy of focus. 
However, I would like to zoom out on this one problem. Biden's 
National Drug Control Strategy is 150 pages. The words ``God'' 
and ``faith'' are not mentioned one time.
    People need a purpose to be happy. To quote Robert F. 
Kennedy and I know that is awful hard, ``Unemployment kills.'' 
The left offers endless benefits, in other words, dependency, 
because dependent population votes for the providers of those 
benefits, but a human being needs a purpose, a good job, the 
ability to provide for a family, a belief in a creator in order 
to be happy. He or she does not need lockdowns that destroy 
their small businesses. He or she does not need free needles 
and syringes so they can inject themselves with deadly drugs. 
He or she does not need lower wages and more crime to thank 
illegal alien invasion. That only raises anxiety. He or she 
does not need to fight in pointless foreign wars. Words related 
to race are mentioned 50 times in the same document. Racism and 
white supremacy have nothing to do with the fact that our 
population is being decimated by illegal drugs and high rates 
of suicide. The lack of purpose fostered by the left is the 
real culprit.
    Now, I have got some questions for you. I would first like 
to submit for the record the following article by the Heritage 
Immigration expert, Lora Ries, ``Deceptive Numbers and Word 
Games Are Hiding Continued Mass Illegal Immigration Post Title 
42,'' for the record.
    Chairman Comer. Without objection.
    Mr. Gosar. In January 2023, the Administration decided to 
abuse the parole system, which only allows illegal aliens to 
enter the United States on a case-by-case basis for urgent 
humanitarian reasons or public benefit, by allowing 30,000 
Haitians, Cubans, Nicaraguans, and Venezuelans to arrive per 
month. Dr. Gupta, does the decision to allow 30,000 individuals 
from these very poor countries to enter the U.S. every month 
exacerbate or improve the drug crisis in the United States?
    Dr. Gupta. Thank you, Congressman. I will say that the 
levels have flattened. We need to do more. We need to create a 
recovery-ready Nation, recovery-ready businesses, as you 
mentioned, and we need to have people find hope and purpose in 
their life, and we are taking all aspects of it. You mentioned 
faith. We are meeting with faith leaders across the Nation very 
soon next month.
    Mr. Gosar. But I do not see it published.
    Dr. Gupta. I am sorry?
    Mr. Gosar. It is one thing to say that you are meeting with 
these people, but it is another thing to be acknowledged, 
right?
    Dr. Gupta. I can tell you that this is an important piece 
of what we are trying to do is accomplish or bring all 
communities together, whether they are business, faith, 
treatment, public health or public safety, law enforcement. It 
is important all of us have a role to play. None of us can fix 
this problem by themselves to recognize that.
    Mr. Gosar. I agree, but allowing thousands of people who do 
not speak English and who will have a very hard time finding a 
job to enter the United States will exacerbate the crisis in 
the United States, but that is not all. The Biden 
Administration is bastardizing the use of Federal app 
originally created by the Trump Administration to facilitate 
cross-border tourism and commerce under the Trump 
Administration called the CBP One app, that allows illegal 
aliens to make an asylum appointment at a port of entry. 
Thirty-seven thousand five hundred illegal aliens can enter the 
U.S. per month. According to Ries, if aliens entering through 
the parole and CBP One app were added to the DHS official 
encounters numbers, then encounters would return to historic 
levels of 200,000-plus per month, numbers only seen under the 
Biden Administration.
    Do you believe facilitating the entry of 37,500 aliens per 
month, many of whom do not speak English and will have a very 
hard time finding a job, will exacerbate or improve the drug 
crisis in the United States?
    Dr. Gupta. Thank you, Congressman. What we are trying to do 
is put technology at the border to make sure that where the 
drugs are coming through, we are stopping every piece of that 
drug, what we can stop.
    Mr. Gosar. But you are not because I am from Arizona and we 
see hundreds and thousands of pounds of fentanyl coming across 
the border, so no matter how you try to intercept it, it is 
going to make it worse. So, I got limited time. The National 
Drug Control Strategy published by your office says advancing 
racial equity is one of the seven priorities that your office 
deems to be most important in fighting the drug crisis. Another 
is harm reduction, which means facilitating drug use for drug 
abusers. How is Congress supposed to take your office seriously 
when you espouse these positions? I do not know how any of 
these have anything to do with those circumstances.
    Mr. Chairman, I yield back, and I thank you for the time.
    Chairman Comer. The gentleman yields back. The Chair now 
recognizes the Ranking Member, Mr. Raskin, from Maryland for 5 
minutes.
    Mr. Raskin. Thank you, Mr. Chairman. I am surprised to hear 
my colleague from Arizona say some of the things he is saying. 
First of all, the purpose of our government is laid out very 
clearly in the preamble of the Constitution: ``We the people, 
in order to form a more perfect union, establish justice, 
ensure domestic tranquility, provide for the common defense, 
promote the general welfare, and preserve to ourselves and our 
posterity the blessings of liberty, ordain the Constitution.'' 
The gentleman is somehow looking for some kind of religious 
test, which is explicitly forbidden in the Constitution of 
people for public office in the drug control strategy. What 
about the free exercise clause? What about the establishment 
clause of the Constitution, which says that Congress shall make 
no law respecting an establishment of religion?
    So surely, we can make a difference in terms of people's 
individual lives and individual paths to recovery. People will 
derive sources of strength from many different places, 
including religious faith, including their friends and their 
family, including psychology, and so on, but the idea that our 
drug strategy is flawed because it does not put religion to the 
center seems, to me, to be preposterous.
    And the gentleman also said, no matter how you try to 
intercept it, it is going to make it worse. On the contrary, 
what I have heard from Dr. Gupta is that the new technologies 
of interception are working in order to reduce the flow of 
fentanyl into the country. Dr. Gupta, you say in the National 
Drug Control Strategy, saving lives is our North Star. What are 
you doing to save lives and prevent overdoses, and how is this 
different from what was happening before?
    Dr. Gupta. Thank you, Congressman, Ranking Member, for that 
question. It is really important we meet people where they are 
today because of the crisis. One of those things is to make 
sure that we have naloxone or Narcan available to people when 
they are overdosing. As a doctor, I have seen people come into 
the emergency room five times sometimes in the same day. I have 
not judged them, but I do feel that saving that life was 
important to me, make sure that they have a chance of getting 
into treatment. We are expanding treatment with telehealth, 
with expanding the ability.
    Congress was instrumental in making sure we are removing 
the X waiver that now goes from 129,000 doctors to almost 2 
million doctors in this country, and then we are making sure 
that we are putting technology. I was down in Arizona, saw a 
445 percent increase in detection. Thirty-eight million pills 
is what Custom Border Protection told me down there at the 
border----
    Mr. Raskin. So, you are saying that the technology is 
working?
    Dr. Gupta. It is absolutely working.
    Mr. Raskin. That your strategies of interception are not 
failing, and we should not surrender to the fatalism, which 
says there is nothing that can be done about it, other than 
everybody go home and pray about it. How are you addressing 
mental illness as an underlying cause of substance abuse?
    Dr. Gupta. Thank you, Ranking Member. Mental illness and 
drug addiction go hand in glove, and they overlap with each 
other. And it is really important that we address both the 
mental health, social isolation, as well as addiction as piece 
of that. Just the day before yesterday, the President announced 
the importance of parity enforcement to make sure that people 
with physical health and mental health get the same level of 
care and not discriminated against. That is one of the reasons 
for not getting Americans the help the need and the President 
is completely focused on that.
    Mr. Raskin. I read a fascinating article that I want to 
submit to the record, Mr. Chairman, called, ``How to Stop the 
Mexican Cartels? Stop Supplying Them With Guns.''
    Mr. Raskin. And it makes the point that 75 to 90 percent of 
Mexican drug cartel firearms come from U.S. manufacturers and 
U.S. gun stores. As I understand it, there is only one gun 
store in all of Mexico. There is a much stricter control on 
firearms there, and the firearms that are being used by the 
cartels that are pumping fentanyl into our country are armed by 
American gun manufacturers. Would we actually be striking a 
blow for our efforts to reduce the flow of fentanyl into our 
country if we reduce the flow of firearms into Mexico coming 
from our gun dealers?
    Dr. Gupta. Ranking Member, it is critical to have a strong, 
stable partner on the south of border. Part of that is to 
address the illegal weapons that are going on, smuggled down 
into Mexico, causing violence as part of the drug and other 
trades.
    Mr. Raskin. Twenty-thousand Mexicans were killed last year. 
They are killing thousands of people, these syndicates and 
these cartels, and they are getting their guns from America.
    Dr. Gupta. Ranking Member, the cooperation on this issue 
and as well as the drug issue has never been stronger in terms 
of making sure that the Governor of Mexico is holding 
accountable both the traffickers, but also, we are sharing 
data, e-track, and other systems so that we can go after the 
weapons trafficking that is happening in this country as well.
    Mr. Raskin. Well, thank you very much, and I yield back to 
you, Mr. Chairman. Thank you kindly.
    Chairman Comer. The Chair now recognizes Dr. Foxx from 
North Carolina for 5 minutes.
    Ms. Foxx. Thank you, Mr. Chairman, and thank you, Dr. Gupta 
for being here today. I voted in favor of the SUPPORT Act in 
2018, which created the ONDCP. And I believe in the work that 
you and your staff do to marshal our government's resources to 
keep dangerous drugs, like fentanyl and xylene, off of our 
streets. However, I am deeply concerned that the Biden 
Administration is pursuing radical, open border policies that 
invite cartels and their Chinese enablers to flood our country 
with absurd amounts of fatal drugs, making the ONDCP's job even 
harder than it ought to be. Dr. Gupta, can you tell the 
Committee how many pounds of fentanyl were seized in Fiscal 
Year 2020?
    Dr. Gupta. Congresswoman, I can get you the exact data for 
years, but the fact is we are seizing more fentanyl now than 
ever before, and----
    Ms. Foxx. I believe the official CBP data shows it is 5,600 
pounds, so can you tell us how many pounds were seized in 
Fiscal Year 2021?
    Dr. Gupta. It was certainly less than what we have now.
    Ms. Foxx. It is 11,201 pounds. I am using official figures: 
Fiscal Year 2022, 14,700 pounds. And this year, and I will 
remind those watching that we still have a few more months to 
go, in fiscal 2023, 22,037 pounds. We have seized nearly 17,000 
pounds more fentanyl in 2023 than we did in 2020. That is just 
a difference of 3 years. Dr. Gupta, could you please inform the 
Committee just how little fentanyl is needed to kill the 
average-sized man?
    Dr. Gupta. Congresswoman, as little as 2 milligrams is 
potentially lethal, but I could tell you there are two reasons 
primarily for seizing high numbers. One is the use of 
technology that we are doing and our brave women and men at the 
Custom Border Protection are working, officers in blue and 
green to stop it; and the second is to make sure that these 
drug traffickers and producers are being motivated by profits.
    Ms. Foxx. Well, we very much appreciate the work that is 
being done to seize the fentanyl. My understanding was it takes 
3 milligrams. You said 2, so my math will be off on 2. But let 
me say on 3 milligrams, the 22,037 pounds of fentanyl seized so 
far this year is enough to kill over 3 billion people--3 
billion people--so under your numbers it would be even more. 
That is nearly half the global population. So, we learned in a 
hearing hosted by this very Committee in late April the Chinese 
firms produce and sell the chemical precursors used in fentanyl 
production to South American cartels, who in turn manufacture 
and traffic fentanyl across the Southern border using the flow 
of migrants as a smokescreen.
    Dr. Gupta, I want to inform both you and the public, that 
in 2020, our Southern borders saw some 242,000 encounters with 
illegal immigrants. I should note that these are the encounters 
that were recorded and that the true number is much higher. And 
so far in 2023, there have been a whopping 783,993 encounters. 
That is over three times higher than in 2020. And while I 
appreciate the good work that you and the people who work with 
you are doing, it is very clear to me and most Americans that 
this President's open border policies are contributing to the 
deaths of thousands of American citizens and lining the pockets 
of drug cartels and illicit Chinese drugs manufacturers. This 
is a disgrace. Mr. Chairman, Congress must act. I yield back.
    Mr. Raskin. Will the gentlelady yield for just a moment?
    Ms. Foxx. My time is up, Mr. Raskin.
    Mr. Raskin. OK. Thank you.
    Ms. Foxx. Thank you.
    Chairman Comer. The Chair now recognizes Ms. Norton from 
Washington D.C. for 5 minutes.
    Ms. Norton. Thank you, Mr. Chairman, for this important 
hearing.
    Dr. Gupta, I think you would probably agree that the opioid 
epidemic is one of the greatest public health crisis facing our 
Nation today. Lack of access to treatment, and I am interested 
in my questions on treatment, is a primary driver of this 
crisis. In 2021, 24 million people in the United States aged 12 
years and older met the scientific criteria for having a 
substance use disorder, but the vast majority did not receive 
treatment. Dr. Gupta, are medications to treat opioid addiction 
effective?
    Dr. Gupta. Yes, Congresswoman.
    Ms. Norton. And are most health insurance plans required by 
law to cover medications for substance abuse disorders?
    Dr. Gupta. Yes, they do, minus sometimes the games that get 
played about preauthorization and other aspects of this that we 
are trying to address at this point.
    Ms. Norton. That is important. There is no reason people 
should face continued barriers to treatment, but tragically, 
they do. For example, a recent study indicates that Medicaid is 
one of the primary payers for medication that helps treat 
opioid addiction in the United States, also known as 
therapeutics. However, 50 percent of Medicaid enrollees with 
opioid use disorder still lack access to therapeutics. Dr. 
Gupta, based on your knowledge and expertise as a medical 
doctor, why is it important that people who experience opioid 
use disorder have access to medicines that help treat the 
disorder?
    Dr. Gupta. Thank you, Congresswoman. It is critical. We 
have less than 1 out of 10 people who need treatment today, is 
getting treatment. It is worse for communities that are 
marginalized communities of color and rural populations. So, it 
is important that when we look at telehealth, we look at being 
able to cover for these medications. There are three FDA-
approved medications that people get the help when and where 
they need it, and that is exactly the work that this 
Administration is trying to do, expand it to have the goal of 
universal access to treatment by 2025.
    Ms. Norton. Thank you. Just last week, the Biden-Harris 
Administration announced plans to distribute almost $48 million 
in grant funding for programs that expand access to medications 
for opioid use disorder. This was part of the Administration's 
overdose prevention strategy, and it has coordinated whole of 
government approach to making opioid addiction treatment more 
accessible. So, Dr. Gupta, how would these grants help ensure 
people experiencing opioid use disorder have access to 
treatment including therapeutics, such as buprenorphine?
    Dr. Gupta. Thank you, Congresswoman. The fact is that 
today, there are $24 billion more that are going into the local 
communities than in the past 4 years, and the reason for that 
$83 billion in total is to get people the help where they need 
it and when they need it. These moneys will help people access 
treatment. And one of the things that I will say is oftentimes 
people do not ask for treatment because of stigma, so it is 
important that we start to work to remove that stigma, whether 
we are working with employers, small businesses, or others. And 
that is an important piece of this work to make sure that 
people can access it. They do not have the fear of being, you 
know, punished for that, and then treatments are available and 
accessible to them wherever they live.
    Ms. Norton. Thank you. Dr. Gupta, how would reauthorizing 
the Office of National Drug Control Policy allow you to 
continue coordinating across government agencies so that people 
have access to opioid use disorder medications regardless of 
socioeconomic status or other barriers to care?
    Dr. Gupta. Congresswoman, what my office does is works 
across the $40-plus billion budget across 19 Federal agencies 
to coordinate the response to this. It is a congressionally 
created office. It is critical to saving lives that we make 
sure that treatment is available to anyone and everyone that 
needs it. It is an important tool in the toolbox to be able to 
help people save lives.
    Ms. Norton. Substance use disorders are incredibly complex 
challenges that require multifaceted solutions. I look forward 
to continuing to work with the Administration to get lifesaving 
treatment into the hands of people struggling with opioid use 
disorder.
    Mr. Raskin. Would the gentlelady yield for a moment?
    Ms. Norton. I yield.
    Mr. Raskin. Just quick question on Ms. Foxx's point. Does 
an increase in the amount of fentanyl seized indicate the 
failure of our drug strategy or the success of the policies of 
the Administration?
    Dr. Gupta. Ranking Member, obviously increased seizures 
means that more is being done at the border to hold people 
accountable, so it is an indication of the success of the 
policy and the strategy.
    Mr. Raskin. Thank you. I yield back.
    Chairman Comer. The Chair now recognizes Mr. Palmer from 
Alabama for 5 minutes.
    Mr. Palmer. I thank the Chairman. In response to what our 
measure of success ought to be, we had a record number of 
people die from fentanyl poisoning last year. It exceeded 
another record year of the previous year. And I think if we 
want to talk success and dealing with fentanyl, and 
particularly fentanyl crossing our Southern border, I am very 
appreciative of the fact that we have interdicted an enormous 
amount of it, but when the death rate is as high as it is, Dr. 
Gupta, with all due respect, that is not exactly success by 
anyone's definition.
    I want to ask you about something else. We also are seeing 
something, and I appreciate the fact that ONDCP has alerted the 
public about the use of xylazine, also known as tranq. It is, 
as you know, a non-opioid veterinary tranquilizer. It is not 
approved for human use. It depresses the central nervous 
system, and we are starting to see people to die from that. I 
just saw a report the other day with a young mother talking 
about her son. They tried to administer Narcan to revive him. 
That did not work because it is a non-opioid, and I just want 
to ask you, where is most of the xylazine produced?
    Dr. Gupta. Thank you, Congressman, for the question. A lot 
of it is coming from illicit sources from China.
    Mr. Palmer. Right.
    Dr. Gupta. It is also being trafficked through traffickers 
and mixed on the street.
    Mr. Palmer. You are ahead of me on where I was going with 
this because I want to make this point, Mr. Chairman, that it 
is not enough for the cartels and the Chinese to kill Americans 
with fentanyl. We have developed some ways to save people who 
have taken that drug with Narcan, but Narcan does not work, as 
we pointed out, and Dr. Gupta knows this. It is a non-opioid, 
the xylazine is, and it does not work. So now they are mixing 
it in with fentanyl. And I just have to ask myself and this is 
probably unfair for me to ask you this, but it seems to me, Dr. 
Gupta, that this is intentional, that, I mean, most people when 
they are selling a product they want to preserve their customer 
base, but it seems to me that the intent here is to kill as 
many Americans as they can.
    Dr. Gupta. Congressman, the intention is to make as much 
money as they can. I will say this, Narcan or naloxone does 
work, but it complicates the response. So, you got to have more 
respiratory control and all of those things, so it is making it 
difficult to save lives because of the tranq dope now, but the 
intent here is all about money. We have got to follow the money 
and that is exactly what this Administration is doing.
    Mr. Palmer. Well, if it is all about money, they would be 
producing a drug that gave the same results that the drug user 
wants to experience without killing them, but when you have 
over 100,000 people dying, there is a problem here. And I am 
almost to a point, Mr. Chairman, where I think that the cartels 
ought to be classified as non-state adversaries. I am serious. 
When you have that many people dying. And I bet there is not a 
person in this room that does not know someone who has lost a 
family member to a drug overdose.
    Dr. Gupta. Congressman, what they are trying to do, if you 
allow me to say this, is collateral damage that is acceptable 
to them and is not to us. This is what they are trying to do. 
They try to make sure that fentanyl is 50 to 100 times more 
potent and addictive than morphine. So, their goal is to get as 
much as possible to the people and not just in the United 
States but across the world. So, their population and clients 
is limitless, and we want to make sure we can stop them by 
denying them profits and operating capital, and do everything 
we can.
    Mr. Palmer. Well, don't we also know that the Chinese are 
providing not only the xylazine and the fentanyl, but also the 
chemicals for mixing these for the combinations that they need 
to produce the drugs that people are taking?
    Dr. Gupta. We are doing everything. We have asked Chinese 
to work. They are refusing to cooperate with us at this point. 
That is why we have put together a global coalition of 80-plus 
countries and 11 international organizations to go after the 
chemical precursors across the earth.
    Mr. Palmer. Well, when they are refusing to work with you, 
I do not think China needs the drug money. They are not making 
the money that the cartels are making. At some point, you have 
to realize that there is a level of intent here, of 
malevolence, that has to be taken into account. I think we are 
going to have to, I know Congressman Dan Crenshaw was involved 
with the select committee on dealing with the cartels. But when 
you have over 100,000 people dying, and that is probably 
underreported by 10, 15 percent, because so many families do 
not want it on the death certificate how their family member 
died, I think we are going to have to reevaluate how we address 
this, and it needs to be a bipartisan effort. And I thank you 
for being here. I yield back.
    Chairman Comer. The gentleman yields back. The Chair 
recognizes Mr. Frost from Florida for 5 minutes.
    Mr. Frost. Thank you, Mr. Chair, and thank you, Dr. Gupta 
for being here.
    The Office of National Drug Control Policy is responsible 
for coordinating the United States Drug Control Policy 
response. This includes policies addressing the flow of harmful 
drugs into the country, but also includes supporting our 
neighbors, who are directly impacted by substance use disorder. 
And also, to clarify, the ONDCP has been around since 1989. 
Once again, the ONDCP has been around since 1989. It was 
reauthorized in 2018, so it was not founded in 2018. It was in 
1989.
    Each year in Florida, around 750,000 people misuse 
prescription pain relievers and 165,000 live with an opioid use 
disorder, and it gets worse. In America, approximately 85 
percent of the prison population has an active substance use 
disorder or were incarcerated in connection with drugs or drug 
use. Forced withdrawal in prison can be deadly. Doctor, how has 
your office supported the expansion of substance use treatment 
for incarcerated folks?
    Dr. Gupta. Thank you, Congressman, for that important 
question. The fact is today that any given day there is 2 
million Americans incarcerated. Sixty to 80 percent of them are 
incarcerated because of either drug use or drug-related crime, 
and when they are released, they are up 120 times more likely 
to die from overdose or be re-incarcerated. It is become so 
critical to get people the help they need to get them treatment 
so when they come out, that not only 85 percent less likely to 
die, but actually go back and assimilate in the community and 
be contributing members to the community. So, we are both 
working within the Federal Bureau of Prisons to expand 
treatment so anyone who wants treatment is offered treatment. 
We are also providing Medicaid waivers to states. Fifteen 
states have already applied for the waivers to get treatment 
available for 90 days before release. Two have been approved, 
including California and Washington, which I believe was just 
approved last week.
    Mr. Frost. OK. Thank you. And you brought this up. It is 
not just during incarceration. The first 2 weeks someone is out 
of jail, they are 129 times more likely to overdose.
    Dr. Gupta. Congressman, here is the problem. We have 18 to 
42 years old, No. 1 cause of death today in America--this is 
working age population--is overdose, and these folks are being 
released and they are dying. I look at this also from an 
economic prosperity in the future for our country's standpoint, 
and this is not a 1 year, 2-year project. This is something we 
will continue to see results into the future.
    Mr. Frost. Has your office developed recommendations on 
dealing with overdose in terms of reentry?
    Dr. Gupta. Yes, Congressman. We have developed a state 
model law for prisons and jails to look at to how to measure 
because we want to make sure the taxpayer dollars are being 
appropriately used to measure what works, what does not work as 
well, and we will be happy to share.
    Mr. Frost. I also want to hear what you have to say about 
the CMS 1115 waiver. Can you explain for people what that is 
and why it is so important?
    Dr. Gupta. Yes, Congressman. As I mentioned, the numbers do 
not lie. We have too many Americans dying that are being 
released back into the community because their threshold goes 
down and they go back, and they end up dying or worse being 
incarcerated. The 1115 waiver allows states to apply for the 
ability to treat people for 90 days before they are released, 
and then the most important piece of this is connecting. 
Oftentimes when people are released, they are lost in the 
community. The next time you know it, either they are in prison 
or they are dead. This connection transition of care is so 
important that this waiver allows. It is, literally, lifesaving 
and life changing for these individuals.
    Mr. Frost. And as I understand it, my home state of Florida 
is not yet among the states making use of the waiver. Is that 
correct?
    Dr. Gupta. In my understanding as well.
    Mr. Frost. In 2022, the National Drug Control Strategy, you 
outlined specific goals and field performance goals for 2025. 
How confident are you that, if given that amount of resources 
needed, that you can hit those targets that you set for 
yourself?
    Dr. Gupta. These are goals that we have outlined of saving 
165,000 American lives by 2025 are doable, but just between 
2022 and 2021, we have avoided the death of 19,000 Americans. 
Again, to me, as a doctor, every one of these as an individual 
that is at the dinner table at the holiday party with each 
other with their family. So, we have that. The goals I think we 
are putting together, the policy that are there are working. We 
need to make sure the resource and folks get the help that they 
need.
    Mr. Frost. Thank you. You know, I think the Chair and my 
colleagues on this Committee on both sides of the aisle can 
agree that the size of our commitment should match the size of 
the challenge, and this is a huge challenge for our country 
right now. Thank you. I yield back.
    Chairman Comer. The Chair recognizes Mr. Higgins from 
Louisiana for 5 minutes.
    Mr. Higgins. Thank you, Mr. Chairman. Doctor, your 
background, you are primarily a medical doctor, correct?
    Dr. Gupta. Yes, Congressman.
    Mr. Higgins. OK. So, do you consider yourself a law 
enforcement professional?
    Dr. Gupta. Congressman, I have worked in West Virginia with 
law enforcement as commissioner of health for two Governors, as 
well as local health of public.
    Mr. Higgins. We appreciate that service. I am not trying to 
do anything other than clarify your background. The position 
you are in, as our Nation faces an unprecedented crisis of 
incoming deadly drugs across our Southern border, it is going 
to call for a great deal of coordination between the executive 
branch and your particular department which we have to 
determine if we intend to support reauthorization or not, and I 
am not there yet. So, as a law enforcement professional myself, 
I have questions about the direction that you are leading your 
department. And so, I am asking you legitimately, it is OK to 
be a doctor and not a cop, but when you are talking to folks 
about who you are, are you a doctor or are you a cop?
    Dr. Gupta. I am proud to be a physician, but also, I have 
tremendous respect for the law enforcement officers across this 
Nation.
    Mr. Higgins. Excellent and polished answer. So, the 
meetings that you have, how would you describe how extensive 
they are, the meetings that you have with the heads of CBP and 
Homeland Security Investigation?
    Dr. Gupta. I have regular meetings with all of the agencies 
and more, as you mentioned, and they are----
    Mr. Higgins. Specifically, CBP and Homeland Security 
Investigations, how frequently? You said regular meetings. What 
does that mean?
    Dr. Gupta. Congressman, I just had a phone call this week 
with the Acting Commissioner Troy Miller of CBP, and I intend 
to see him again next week.
    Mr. Higgins. How about HSI?
    Dr. Gupta. It is more or less I have detailees in my office 
every single day. They come to work from HSI, from CBP, from a 
number of law enforcement agencies.
    Mr. Higgins. OK. Let us shift from your level of 
interaction with the leading department, Homeland Security law 
enforcement and investigative forces at our border that are 
tasked with stopping fentanyl from coming into our country and 
the meth. Are you familiar with the term ``China White?'' Do 
you know what that--it was back in the 1990's. That is not a 
trick question. I will just tell you.
    When fentanyl first showed up on the street, we did not 
know what it was. It was very rarely encountered. It was called 
China White. It was known to be super powerful and deadly, but 
it was not really an issue because the issue at the time, the 
1990's and into the mid-2000's, was meth labs in America. Those 
were largely shut down by legislative action taken at the 
Federal and state level to take Sudafed and Sudafed-type 
products off the shelf, to make them all available over-the-
counter, but with an ID through the pharmacy. That pretty much 
shut down the labs, but this vacuum was filled as the fentanyl 
trafficking began building, and it largely coming through 
Mexico. We knew this.
    And this stuff was so deadly, and I am trying to get there, 
was so deadly it was killing our canine dogs and officers who 
would come into contact with it. We had to change all our 
protocols on how to deal with this stuff. And now it is so 
prevalent and so cheap, $100 to $150 a gram, and only requires 
2 milligrams as a deadly dose. It calls a point on the street 
because you pick it up with the point of a pen. That is how 
deadly it is, and it is so cheap and so readily available, drug 
dealers are giving it away in order to establish an addicted 
clientele to grow the addicted clientele. They are giving it 
away. We had 107,000 deaths in 2021, 108,000 in 2022, and your 
quote from earlier, good sir, was that you are not failing to 
intercept. So please explain.
    Dr. Gupta. Thank you, Congressman. And let me just be clear 
that I was involved in putting through the pseudoephedrine 
behind the walls. I was involved in those meth lab busts on the 
ground, actually, and the reason, if you think about it, why it 
went South of the border, the production of meth, is because of 
money. The reason that fentanyl is so profitable is because the 
small amounts affect the same amount and is so potent.
    So, I think we have to understand what persuades these bad 
guys to actually go to the verge of killing 109,000 Americans a 
year, and it is actually profits. It is money. It is important, 
and this is why this Administration is going through commercial 
disruption, going after the traffickers, but also their 
profits, pill pressers, die molds, shippers, and working with 
shippers, and express consignment carriers, and putting highest 
level of sanctions that we have on both Chinese companies, 
these companies, as well as the Mexican cartels and producing 
the indictment along with arrests of hundreds of hundreds of 
the members in recent days that you have seen. Part of that all 
reason is to disrupt and dismantle these organizations but also 
understand what drives them in the 21st century.
    Mr. Higgins. You have been very professional. My time has 
expired. Thank you, Mr. Chairman.
    Chairman Comer. The gentleman yields back. The Chair now 
recognizes Ms. Stansbury from New Mexico for 5 minutes.
    Ms. Stansbury. Thank you. Dr. Gupta, welcome to our 
Committee. Mr. Chairman, I want to start by thanking you, 
sincerely, for convening this panel today, and I do mean that 
from the bottom of my heart because I have watched as this 
Committee has devolved into a platform for conspiracy theories 
and misinformation and political theater over the last 6 
months. And I think it is notable that many of our colleagues 
do not even bother to show up when we hold a real hearing, and 
the conspiracy theories and cameras are not rolling. So, it is 
about high time that we actually turn to an issue that affects 
the American people.
    And I think, like so many Americans, these issues of 
addiction, drug trafficking weigh heavy on my heart, especially 
for so many New Mexicans, which is the state that I represent. 
The opioid crisis has hit close to home, and in fact, I will 
never forget the morning in January in 2019, when I received 
the first call. I was actually sitting on the floor of the New 
Mexico State House of Representatives. I had just been elected 
to the legislature when I received the call that one of my 
oldest and dearest friends had died suddenly of a heart attack. 
We later learned that it was a fentanyl overdose, and over the 
years that have now come since that first call, there have been 
more.
    And I think for many New Mexicans, this is a story that is 
all too familiar, and it is why I have spent a lot of my time 
in this body working on real solutions to address the fentanyl 
crisis because it is real, because it hits close to home, 
because it is affecting every single family in our communities 
and in my state. And we can sit here and yell about the border 
and talk about all of these issues, but if we are not actually 
addressing the real issues that are leading to the crisis, then 
our family members and our friends are going to continue to 
die.
    That is why I have been working with law enforcement, our 
state, local, and tribal officials, our behavioral health 
providers to help rebuild the behavioral health and addiction 
recovery systems that were gutted by a Republican Governor just 
one cycle ago. We are working to invest in the drug 
interdiction programs, the drug trafficking technologies and 
tools for a law enforcement. We are helping to support the 
border intervention programs that help to stop the tide of 
those raw materials coming in and actually helping those, 
whether they are in the homes of their family members or loved 
ones or living on the streets, actually connect with the care 
that they need to recover. That is how we address this crisis, 
not sitting in rooms screaming to cameras.
    And so, Dr. Gupta, I am grateful for your service, and I 
know that you understand that. And I am grateful that President 
Biden has actually made this a priority and a centerpiece of 
his Administration, and I think in spite of what we have heard 
here today, it is important that the American people really 
understand that. And I wonder if you could just take a moment 
to help us understand how high a priority this is for the 
President and for your office and how you are addressing the 
crisis.
    Dr. Gupta. Thank you, Congresswoman, and I am deeply sorry 
for the loss. It is something that stays with me every day. 
Every morning I wake up, this is something I think about, so 
this is very personal to me. The President is extremely 
committed to this. I can tell you that this is his top 
priority. Not only is the President's drug control strategy 
completely data driven and focused on getting resources and 
help to Americans and in an evidence-based manner, doing 
everything we can from both supply side and demand side, but he 
is personally committed.
    I spoke to him this week about this. This is how much 
committed he is, and so is the Vice President. We brought in 
eight attorneys general last week to the White House to talk 
about it, and it is important, it is bipartisan, it is part of 
the President's unity agenda. And it is something that 
109,000--a million Americans--have passed away in the last 2 
decades and tens of millions have suffered a non-fatal 
overdose. I think we have got to find a way to work together on 
this and solve this problem.
    Ms. Stansbury. Thank you, Doctor. I also want to just take 
a moment to clarify and correct some misinformation that was 
shared just a few moments ago by one of my colleagues that is 
not only incorrect, but dangerous. Now, Dr. Gupta, in New 
Mexico, our law enforcement are very clear with us. The vast 
majority of raw materials that is used for the manufacturing of 
fentanyl is actually coming across legal ports of entry. Is 
that correct?
    Dr. Gupta. That is correct.
    Ms. Stansbury. And the vast majority of those materials is 
actually being transported through those legal ports of entry 
by crime syndicates and drug traffickers, not by individuals 
who are seeking asylum in this country, correct?
    Dr. Gupta. That is correct.
    Ms. Stansbury. Thank you. And, you know, Dr. Gupta, and to 
my colleagues, I think that the propagation of dangerous 
rhetoric against those from other countries who are seeking 
asylum in our country not only threatens the lives of those 
individuals who are trying to come to our country for a better 
life, like so many of our families did, but it also threatens 
the safety of our communities and our ability to address this 
crisis. So, let us be honest with the American people, let us 
be bipartisan, and let us actually work to solve this problem, 
and with that, I yield back.
    Chairman Comer. The Chair recognizes Mr. Grothman from 
Wisconsin for 5 minutes.
    Mr. Grothman. Yes. First of all, I got to do a follow-up on 
that last thing because I have been at the border several 
times, and if you talk to the Border Patrol, what they will 
tell you is the majority of drugs caught at the border are in 
designated points of entry. We have, like, well over 30,000 
got-aways who come across the border when there are diversions 
made by the Mexican drug cartels. The got-aways, of course, we 
do not catch them with drugs because we do not catch them at 
all, right? And the guys on the ground, the guys with the 
Border Patrol, believe that most of these drugs are coming 
through got-aways, but they do not show up in the statistics 
because they got away, and the reason they are getting away is 
there are a lack of Border Patrol agents. So, you should just 
be aware what the people on the ground think.
    Now, I think to look at this problem, we have to see who is 
doing these drugs because that is where the problem is. I am 
going to ask you some general questions about the 108,000 
people or whatever died last year. Percentage wise, how many of 
those folks about had full-time jobs?
    Dr. Gupta. I do not know if we have that level of details 
on data.
    Mr. Grothman. OK.
    Dr. Gupta. I can tell you that when I did the same survey 
for West Virginia as a commissioner, we found that most of 
these people that did have job were blue-collar workers, and 
they were less than high school educated.
    Mr. Grothman. OK. There is an interesting follow-up, but we 
do not know. Percentage wise, what percentage of the people who 
died are married?
    Dr. Gupta. I can tell you, Congressman, that this problem 
cuts across all----
    Mr. Grothman. No. I know, I know, and I know it affects 
everybody and there are examples in any area, but if we want to 
reduce the number of people dying, we got to look at where most 
of the people die. And when we look at the people who are not 
dying, maybe we can get some suggestions how we can have the 
population as a whole take less of these drugs. Do we know 
percentage-wise, the people who died, about how much are 
married?
    Dr. Gupta. So, Congressman, if you want to get at stopping 
people from dying, we put up a non-fatal overdose platform for 
the whole state, the whole country at a county level. We can 
get that data, and that is available near real-time right now.
    Mr. Grothman. OK. So, do you have data? Is it available?
    Dr. Gupta. It is publicly available. All the 911 call data 
is publicly available near real-time. It is helping local 
communities right now.
    Mr. Grothman. OK. So, you know what percentage are married 
and what percent are not?
    Dr. Gupta. We know who is getting overdosed, and we know 
how to respond to them and get them into treatment.
    Mr. Grothman. OK. So, of the percent overdose, what percent 
have full-time jobs? Say, what percent are married? What 
percent are on antidepressants? These are all questions that I 
would be asking to see if we can identify how to prevent people 
from overdosing or what our target population should be. Are we 
collecting that data?
    Dr. Gupta. That data sometimes is collected by individual 
states, but here is what I can tell you, is there are 
individuals who go through a non-fatal overdose 14 times. There 
is 14:1 ratio in some places. It is, like, people are coming to 
the cliff to fall off. They are saved until they are not saved, 
then they fall off.
    Mr. Grothman. I understand, but you are not answering my 
question, which is frustrating because it means you do not know 
the answer to my question, which is frustrating because, to me, 
your job should be to know the answers of my questions. Now, I 
will ask you a question on this Narcan stuff. There are a 
variety of efforts being made to make Narcan more available. I 
mean, it is amazing you talk to your local law enforcement, the 
number of people who they have brought back compared to the 
number of people who have died. There is a bill that people are 
floating around out there saying that we should have Narcan in 
every Federal building. Do we know where most people are dying? 
Are they dying in their bedroom? Are they dying in a car? Say, 
what are the five most popular places that we find people 
dying?
    Dr. Gupta. Publicly, and let me tell you a very specific 
example. When you look at the teenagers doubling in deaths from 
poisonings from 2019 to 2021, in 2 out of 3 situations, 
bystanders were nearby, but naloxone or Narcan was not, and I 
am talking about the youngest in our country that we could have 
saved.
    Mr. Grothman. OK. So, you believe that if we were to put 
more Narcan available in the country, it would be places--where 
were these people dying? Are they dying in a school setting? 
Are they dying out in a park at midnight? I mean, where are 
they dying?
    Dr. Gupta. Public places. I would think about naloxone, 
Narcan, like a smoke alarm or a defibrillator, the more it is 
available, the more lives will be saved, and the more publicly 
available, schools, restaurants, businesses, malls, all of 
these places.
    Mr. Grothman. OK. I know I am a little bit over here, but I 
would ask you to find the answers to the questions I ask you, 
you know, because we should know if only 5 percent of the 
people that are dying are married, that is an interesting 
statistic. OK. If only 15 percent of the people that are dying 
had a full-time job, that is an interesting statistic. If a lot 
of them are on antidepressants, that is an interesting 
statistic. And if you cannot do a study nationwide, maybe you 
can just do a sample of a random 5,000 people, and the results 
might surprise you, and maybe we could use those results to 
probably solve this scourge. Thank you.
    Chairman Comer. The Chair now recognizes Ms. Lee from 
Pennsylvania for 5 minutes.
    Ms. Lee. Thank you, Mr. Chair. I would like to thank the 
Committee for holding this hearing and giving us an opportunity 
to discuss this health crisis because that is what addiction 
is, a health crisis.
    Dr. Gupta, last year, when you described substance abuse 
disorder in your testimony before our Committee, you stated, 
``One of the things we realized in the last few decades is this 
is a brain disease. Just like a lot of other disease, it is a 
brain disease. The way that we need to treat that is as a 
disease of the brain.'' We need to continue the work started by 
the National Drug Control Strategy to act on this medical 
understanding and prioritize treatment for people struggling 
with substance abuse disorders just as our society seeks to 
treat other forms of diseases. For example, the strategy aims 
to ``make evidence-based treatment as accessible and available 
as primary care.'' Dr. Gupta, how would achieving this goal 
benefit American families, like those I represent in 
Pittsburgh?
    Dr. Gupta. Thank you, Congresswoman. Really important 
because today, when someone wants to get help at 2 a.m., they 
are told that they have to wait in line for the next 30 days 
and sometimes people are not even alive for that. What we are 
trying to do is to make sure, just like we treat in primary 
care--hypertension, high blood pressure, diabetes, obesity, you 
name it--this is a problem that can be treated in primary care. 
This is the reason that we have extended telehealth, the 
ability for Americans to get the help no matter where they are. 
We made sure that people can take some of these medications 
home with them. We have removed, with the help of Congress, the 
X waiver. I am an X waiver physician, but now we have expanded 
the ability for almost 2 million doctors to be able to treat as 
opposed to 129,000, and we are committed to making medications 
more available and affordable as well. The President is fully 
committed on that to make sure that everyone gets the help that 
they need when and where they are need it.
    Ms. Lee. Thank you, Dr. Gupta. And how is the ONDCP 
centering evidence-based solutions in response to the addiction 
crisis?
    Dr. Gupta. Thank you, Congresswoman. I think it is 
important to see for what it is. As you mentioned, it is a 
disease of the brain. We are also going beyond treatment 
because the fact is, there are 20 million-plus Americans today 
successfully in recovery, 60 percent of whom are gainfully 
employed and often getting their health insurance from 
employment. So now we know that people need more than just 
treatment, need housing, transportation, food security. Those 
things are important to make sure that we are taking an 
approach that centers around success of each individual in 
their community because that spells the success of the state 
and success of the Nation.
    Ms. Lee. Thank you for lifting up the holistic needs that 
we have in our struggle to treat this disorder. The need to 
prioritize treatment in our approach to Drug Control Policy 
cannot be overstated also. Ninety-four percent of people with a 
substance abuse disorder did not receive any treatment in 2021. 
We are talking about the difference between life and death here 
as overdoses have accounted for over one million deaths in the 
United States since 1999. How is ONDCP making treatment more 
accessible for people with complex needs who face barriers to 
care?
    Dr. Gupta. Thank you, Congresswoman. I think it is really 
important to make sure that we make treatment accessible and 
affordable to anyone and everyone that needs it. When we look 
at people who are incarcerated, people in custody, it is 
important to make it available because of the high risk of 
dying or reincarceration. When we look at communities that have 
historically been marginalized, it is important to make sure 
that they are receiving treatment. We look at rural America, it 
is important to make sure that treatment is there because I, as 
a physician in rural America, have seen why people often do not 
go to treatment because it is 80 miles away.
    So, these are the few things that we are doing with 
telehealth, with extension, expansion of treatment aspects, and 
making sure we are reaching people through harm reduction and 
other programs so we can meet them where they are and help them 
move forward in getting the help they need.
    Ms. Lee. Thank you. Barriers to treatment 
disproportionately affect people of color, pregnant people, 
individuals with children, those in rural communities as Dr. 
Gupta pointed out, tribal communities, and states that have not 
expanded Medicaid. This is largely because these people may not 
have access to health insurance and may live in areas without 
access to substance use disorder treatment. Dr. Gupta, really 
quickly, how would reauthorizing ONDCP make treatment more 
accessible for people who already are marginalized within our 
healthcare system?
    Dr. Gupta. Thank you, Congresswoman. It is really important 
that the reauthorization of ONDCP will allow us to continue and 
actually be able to double down on our efforts of the progress 
that we are making. There are a lot more work to be done in 
order to save the 165,000 lives that the President is committed 
to doing by 2025, and the reauthorization will be a critical 
part of that.
    Ms. Lee. Thank you, Dr. Gupta, for your testimony today and 
your important work tackling this crisis. I yield back.
    Chairman Comer. The Chair recognizes the Subcommittee Chair 
McClain from Michigan for 5 minutes.
    Mrs. McClain. Thank you, Mr. Chairman, and thank you, Dr. 
Gupta, for being here today. We all know the stats, but they 
are worth repeating, right? In 2019, over 70,000 people died 
from an opioid overdose. In 2021, 106,000 Americans died from 
drug-related overdoses. These numbers are shocking, and right 
now, in 2023, we also know that fentanyl is the leading cause 
of death for individuals between 18 and 45, right? Again, these 
numbers are shocking and clearly deserve our attention. This is 
why I agreed to chair the Bipartisan Mental Health and 
Substance Abuse Task Force.
    I mean, to your point, it crosses all sections in all 
lines, but I think we have to take a look at, if I had a 
funnel, at really the small end of the funnel, can we stop it 
before it even gets here? Can we choke it off? To me, Dr. 
Gupta, it is apparent that China supplies precursor chemicals 
to the cartels that produce fentanyl and other drugs. Is that 
correct?
    Dr. Gupta. Predominantly China.
    Mrs. McClain. Thank you. Right. I am sure there are other 
actors, but thank you. In April, I actually held a Subcommittee 
hearing where our Committee learned that Chinese money 
laundering organizations now dominate the money laundering 
networks for the Mexican cartels. I want to focus my 
questioning around that because, again, if we can cutoff the 
money supply, and we can stop the drugs from getting in, and 
something that we may agree on, I think we might be on to 
something. Can you explain what your office has done to address 
this money laundering operation?
    Dr. Gupta. Thank you, Congresswoman. The Anti-Money 
Laundering Act of 2020 has been very critical, in addition to 
the Bank Secrecy Act, to make sure that we are flushing out the 
bad actor in the system. The Chinese underground banking 
system, as well as money laundering of illicit actors that are 
free riders, along the expansion of the PRC is a critical 
aspect that we need to be looking at very carefully. Now, we 
have also done more sanctions, double the sanctions this year 
than last year, and last year was double of the previous year 
of both the cartels, but also chemical companies in China that 
are shipping these precursor chemicals as well and individuals 
that are involved in it.
    Mrs. McClain. And I appreciate that, but I want to focus, 
and I know I am getting really narrowly focused, but we had a 
whole hearing on this, and if you follow the money, a lot of 
times we can cut it off. What specifically, and maybe we are 
not there yet, but what specific actions have you taken to stop 
and choke off the money laundering scheme? Can you talk to 
that?
    Dr. Gupta. I can talk, obviously, about some of these, 
including some of the dark web operations and cryptocurrency. 
There are 2,000 or so cryptocurrencies out there to be able to 
do, but I will also invite you to a classified briefing on 
Monday and your staff to do that.
    Mrs. McClain. OK. All right. Thank you. I mean, I think you 
would agree that China is complicit in America's drug overdose 
and academic problem here?
    Dr. Gupta. I think the refusal of cooperation on current 
narcotics of the PRC is indicative of how much they value the 
lives of the 109,000 Americans that we are losing every single 
year.
    Mrs. McClain. Right. I mean, again, follow the money, and 
if we can choke the money supply off, we know that the money 
laundering from the Chinese Government is happening. I would 
just encourage you to spend more time, effort, energy, and most 
of all resources because if we cut it off here, we can save 
deaths, we can save a lot of lives as it gets down the funnel. 
In 2022, there were almost 600,000 got-aways that crossed our 
border illegally, and there have already been 530,000 got-aways 
in 2023. As a reminder, ``got-aways'' is a term used for 
illegal immigrants who have been spotted crossing the border by 
agents on camera, but were not caught or processed by the 
officials. Is it possible that some of these got-aways are 
smuggling fentanyl into the United States?
    Dr. Gupta. Congresswoman, when we talk about what is 
killing Americans in large numbers, like----
    Mrs. McClain. No. Can we talk about my question, though, 
and my question is, is it possible that some of these over 
530,000 got-aways are smuggling fentanyl? Is it possible?
    Dr. Gupta. Congresswoman, look, tunnels are possible and 
happening.
    Mrs. McClain. OK. All right.
    Dr. Gupta. Drones are possible and happening, so I----
    Mrs. McClain. So, it is possible. The answer is yes. I 
appreciate you, and I am out of time. Thank you so much. I look 
forward to our classified briefing.
    Chairman Comer. The gentlelady yields back. The Chair 
recognizes Representative Crockett from Texas for 5 minutes.
    Ms. Crockett. Thank you so much for being here and thank 
you so much for the work that you do. I just want to talk about 
my state really quickly since we are talking about the border 
and how my colleagues have been down there once or twice, and 
so they feel like they know everything that happens at my 
border because they go on a little field trip, but I live in 
this state. I have also legislated specifically in this state, 
the state of Texas, and recently, my Governor, who seemingly 
does nothing but atrocious things, decided that he was going to 
order that migrants, and this does not say it, but specifically 
the headlines that we saw were children as well as pregnant 
mothers be pushed back into the Rio Grande.
    Currently, the DOJ is suing my Governor because he decided 
that he wanted to use razor wire. This is not fixing fentanyl 
as far as I am concerned. Because you are the expert, do you 
believe that razor wire or ordering that women and pregnant 
mothers and children be pushed into the water, do you believe 
that that is fixing our fentanyl crisis?
    Dr. Gupta. Thank you, Congresswoman, for that question. I 
would say majority of the fentanyl is coming through the ports 
of entry, and our focus should be where the problem is 
predominantly.
    Ms. Crockett. Thank you so much. And when you talk about 
ports of entry, I want to be clear, because sometimes in this 
chamber it seems like we only have one border and only one way 
to get into the United States, and somehow it is through 
Mexico. I just want to be clear, there is a Northern border. 
There are also planes. Are you of the impression that drugs 
only come from Mexico?
    Dr. Gupta. Thank you, Congresswoman. Oftentimes, machinery 
parts, like pill presser parts, die-mold parts, they will come 
through other countries to the United States and smuggle 
southwards to be built into pill pressers, so the business 
traffic goes in all directions and across all ways in order to 
produce the final product.
    Ms. Crockett. Thank you so much for sharing that with us 
because I think we need to go back to step one in this process. 
You do not know it, but I practiced criminal law for almost 17 
years in multiple states and on the Federal level. I was on the 
defense side, so I dealt with people that were arrested for 
drug crimes. One of the things that I want to talk about is the 
difference in fentanyl and, say, cocaine. Cocaine is typically 
not prescribed by somebody's doctor, but it is my understanding 
that most people that are struggling with fentanyl are people 
that have become sometimes addicted to opioids because they 
were prescribed opioids. And it may have been for a car wreck--
I also did those as well--have a back issue. And ultimately, 
the doctor takes you off, but because of the addictive nature, 
you are going out and you are trying to get it wherever you 
can, and so it sounds like we have a demand problem, No. 1. 
Would you agree with me that if we could reduce demand, then 
maybe people would not be looking to supply where there was no 
demand?
    Dr. Gupta. I think it is both sides. And I think, as you 
very accurately said, I have prescribed people who have gone 
out on the streets and then ended up on heroin and fentanyl as 
well, so I have a really direct experience with some of that 
work as well.
    Ms. Crockett. Absolutely. And so also, one of the things 
that is so frustrating to me is that we do not treat this as 
something that is multifaceted. You talked about it is not just 
the Southern border. It is all things connected. It is not just 
saying that the cartels are the problem, which I think we can 
all agree. That is one thing that we can all agree upon. The 
cartels are a problem for a lot of different reasons, and it is 
not just fentanyl. But one of the things that you talked about 
was locals. I believe that the National Drug Control Strategy 
notes that local problems need local solutions. Is that 
correct?
    Dr. Gupta. Yes, Congresswoman.
    Ms. Crockett. And ONDCP is responsible for administering a 
grant program specifically, focused on local solutions, the 
Drug-Free Communities Support Program, correct?
    Dr. Gupta. Correct.
    Ms. Crockett. All right. And I am going to agree with you. 
As somebody who has had to deal with multiple clients that have 
been addicted, and as someone who is a Black woman in this 
country, the 1994 Crime Bill was a failure, and seemingly, the 
only solutions that we ever have is more and more 
incarceration. I appreciate what you do because you are taking 
a multifaceted look. You are looking at the criminal aspect. 
You are looking at not just cash, but you are looking at 
crypto. You are also looking at more than one country, more 
than just Mexico. You are looking to try to solve the solutions 
while also making sure that those that are addicted get 
treatment instead of put into jail cells. And so, I appreciate 
the work that you do. I hope that my colleagues understand that 
it is not so simple as let us just blame the border, and we 
will fix all the problems.
    And the last thing that I will say is, in a very bipartisan 
way, I have introduced the STRIP Act. And that is to make sure 
that these fentanyl testing strips can get to the people that 
need them so that even if they are struggling with addiction, 
they have the ability to test and to determine whether or not 
this odorless, this tasteless thing is actually laced within 
the product that they receive. Would you agree with me things 
such as testing strips are invaluable to helping us fight this 
war?
    Dr. Gupta. Yes, Congresswoman, we will be happy to work 
with you on that as well.
    Ms. Crockett. Thank you. With that, I yield back.
    Chairman Comer. The Chair now recognizes Mr. Edwards from 
North Carolina for 5 minutes.
    Mr. Edwards. Thank you, Mr. Chair. Doctor, you testified a 
while ago that the precursor chemicals to create fentanyl were 
being sent to Mexico from China. Is that what I understood you 
to say?
    Dr. Gupta. Yes, Congressman.
    Mr. Edwards. So, who in China is supplying these chemicals 
to the cartels in Mexico? Is it Chinese Government? Is it 
Chinese corporation? Is it Chinese cartels? Who in China is 
providing these drugs?
    Dr. Gupta. Thank you, Congressman, for that question. There 
are Chinese chemical companies that often work with brokers, 
both on the China side and the cartel side, and the accountants 
that ship those things, so it oftentimes is these chemical 
companies that are doing it. They could be a licit business 
doing illicit work or they could just be an illicit business, 
period.
    Mr. Edwards. So, I am not sure I understood your answer. Is 
it legal for these chemical companies to provide these 
chemicals to Mexican drug cartels?
    Dr. Gupta. That is a great question, Congressman. Here is 
the thing. If someone just asks you for a ton of certain 
chemical that is precursor for dual use and that company does 
not check out who that is and is going through a broker, which 
is a questionable background, then obviously, it is not for any 
good purpose as opposed to the legal pieces of it. Are they 
just ignoring that? Absolutely, many times that they are 
ignoring. Even these legitimate companies are ignoring that.
    Mr. Edwards. What is this Administration doing to prevent 
those companies from selling drugs that you say are illicit?
    Dr. Gupta. Probably two or three things I will be quick 
about it. First, we have more sanctions that are being placed 
in these companies every single day. We have got about 100 
sanctions so far, overall, between Chinese and Mexican 
traffickers. We have put a global coalition together that is 
talking about precursors for the entire globe, not just, and we 
are watching China to put pressure. We have asked China that 
there is the three things you can do, very specific ask: know 
your customer for these companies, make sure you have shipping 
label that follow global norms, and then----
    Mr. Edwards. So, Doctor, in the interest of time, I am 
going to jump forward just a little bit. So, the 
Administration, you are saying hundreds of sanctions are being 
put in place. It seems to me like you only need one sanction. 
So, what is this Administration doing in China to prevent these 
drugs from going to Mexico?
    Dr. Gupta. We are working constantly. Our Ambassador, Nick 
Burns, in Beijing, I am in contact with him regularly to speak 
with the Chinese about this. We are working with the Government 
of Mexico to make sure that they are talking to China as well. 
We are putting international pressure.
    Mr. Edwards. So, when do we stop talking? When does 
something become actionable where the United States, where this 
Administration can put its foot down inside of China and say we 
have had enough, you are killing Americans through Mexican 
cartels? When do we hold China accountable?
    Dr. Gupta. Congressman, first of all, we will work with you 
if you have any ideas. We are working here. I would be happy to 
both share that with you. Some of those will be in the 
classified briefing that we are giving on Monday.
    Mr. Edwards. All right. I feel like you dodged the 
question, and it seems to me that we also have to cutoff the 
source at several different places. We have talked about 
reducing demand. We all agree it would be great if folks did 
not feel better as they take these drugs. We talked about the 
border, which, quite frankly, we have got evidence from many 
folks that is not being secured. I believe we also need to 
cutoff the supply of these chemicals from China. I believe this 
Administration, I believe you have to have the courage to go to 
China and say enough is enough. This is a multidimensional 
problem and that is one that I see is not being adequately 
addressed.
    In my last few seconds, I would just like to say that I 
heard you imply to another Member in questioning earlier that 
the fact that we are capturing more fentanyl than ever before 
is somehow a success story. I am not sure that I can agree with 
that. I am looking at the fentanyl deaths over the last 5 years 
ending January 2019: 68,000. And then you told us a while ago 
that ending January 2023, we had 109,000 deaths. I do not know 
how we can say that that is a success, particularly, if you are 
a family member of someone who died with a fentanyl overdose. 
Thank you, Mr. Chair. I yield.
    Chairman Comer. The gentleman yields back. The Chair now 
recognizes Mr. Moskowitz from Florida for 5 minutes.
    Mr. Moskowitz. Mr. Chairman, thank you, and thank you for 
holding this important topic. I replaced Congressman Ted Deutch 
in Congress in the last election, and he lost his nephew to 
fentanyl, and I remember when that happened to an accidental 
fentanyl overdose. And I am happy that the state of Florida has 
just recently passed the use of fentanyl test strips because 
that will obviously help us in this battle.
    And, you know, I would say to my friends across the aisle, 
very few that are here, but I would say to them that, listen, 
this is a bipartisan effort on going after fentanyl. We do not 
need to be convinced. We do not need to be educated. We know 
what is happening. We have seen the numbers. We know this is 
affecting kids across the country.
    We have heard a lot about the cartel, Doctor, and the drug 
trafficking trade that is going on in Mexico, and so I want to 
ask you a question, Doctor. These cartels, these drug 
traffickers, in addition to the drugs that they are carrying, 
do you know what else they like to carry? It is not a trick 
question. Just yell it out when you know it. Guns. They like to 
carry guns, Dr. Gupta, right? That is what protects the cartel. 
That is what protects the drug trade. Do you know where they 
get their guns? Do you know where the cartel, the guys that 
they are talking about, get their guns. Do you know where they 
get their guns?
    Dr. Gupta. From illicit illegal purchases----
    Mr. Moskowitz. That is right. And do you know where those 
illicit illegal purchases are happening and where they are 
coming from?
    Dr. Gupta. Largely from United States.
    Mr. Moskowitz. That is right. According to U.S. Customs and 
Border Control, 200,000 guns pour over the border every year 
from the U.S. to Mexico. These weapons are being used to 
contribute to organize crime. They are being used by the drug 
trade, the cartel, and 70 percent of all of the weapons the 
cartel is using are manufactured in the United States. The drug 
sales and the cartel in China, what they are doing is 
intentional. I agree with my colleagues across the aisle. I 
think what the cartel in China is doing is intentional, but so 
is what the gun manufacturers are doing. It is intentional.
    And so, all of these guns manufactured here, pouring over 
the border, we, the United States are arming the cartel. We, 
the United States, are allowing the cartel to protect the 
illicit drug trade by allowing guns manufactured here to pour 
over the border. My colleagues across the aisle are very 
concerned about things coming in, but they have no concern 
about weapons going out. And so, Mexico has even filed lawsuits 
against the gun manufacturers. In fact, just 3 days ago, Mexico 
has asked the U.S. Appeals Court to reinstate the $10 billion 
lawsuit that they have against the gun manufacturers. And the 
lawsuit specifically states, and Mexico contends it is 500,000 
guns pouring over the border every year, but in that lawsuit, 
Mexico says that the lawsuit that is against the drug 
manufacturers is specifically for facilitating the trafficking 
of weapons to the drug cartels, right?
    So right now, we have a foreign country suing the drug 
manufacturers saying that we are arming the cartel, our U.S. 
companies, and so what is even better than that is the gun 
manufacturers in this lawsuit are saying they have immunity. 
They have immunity in this lawsuit because my colleagues across 
the aisle have provided them immunity that they cannot be sued. 
Now we are fighting over whether that applies to a foreign 
government. That is what the lawsuit really is about, but we 
are with you on a bipartisan basis to try to stop fentanyl from 
coming in. But can you be with us on a bipartisan basis that 
maybe the gun manufacturers should not have immunity to sell 
guns, to have guns get in the hands of the cartel?
    I understand you are not with us on wanting to prevent that 
in this country. But maybe together we can do it to make sure 
that our guns are at least not going to the drug cartels 
facilitating fentanyl from coming in. I mean when, when, when 
are you guys going to wake up and realize that guns are a part 
of this equation? I yield back, Mr. Chairman.
    Chairman Comer. The Chair recognizes Mr. Biggs from Arizona 
for 5 minutes.
    Mr. Biggs. I was intrigued to hear the gentleman say he did 
not need to be educated, but let me educate you. For the last 7 
years, I have advocated for southern-bound vehicles and 
individuals to be searched for guns and money. I have advocated 
for that strongly. I want you to be educated. Go read a book 
called, ``Operation Wide Receiver.'' That is an ATF operation. 
Go read up about Operation Fast and Furious, and then go look 
at cross-border trafficking heading South and the few 
operations that we run. I have advocated for more resources to 
go there. We have lost our dogs that can sniff for guns and 
money. We have found millions of dollars and guns going across. 
Gun laws exist to prevent that Southern crossing, but we are 
not enforcing it. That is the biggest problem in my mind.
    Mr. Moskowitz. Will the gentleman yield?
    Mr. Biggs. No, I will not yield. Our colleagues across the 
aisle regularly cite the vast majority of drug seizures are at 
the port of entry. I love that. I love that. You know why that 
is? It is not because that is where all the drugs are coming 
through. It is because--guess what--we inspect every person and 
vehicle coming through port of entry. That is what you have 
done. Isn't that true, Dr. Gupta?
    Dr. Gupta. I am sorry. Could you repeat the question?
    Mr. Biggs. No, I cannot. We have density readers. We have 
technology that allows us to screen the structures of vehicles 
being used to transport humans and drugs, isn't that correct, 
Dr. Gupta, at the ports of entry?
    Dr. Gupta. We do have technology at the ports of entry.
    Mr. Biggs. In fact, they are examining a high proportion of 
trucks we need to be inspecting more, whether it is in Nogales, 
San Isidro, all the way down to RGV, but we inspect a 
significant number of them as well as individuals. If there is 
an anomaly in a vehicle, our density readers pick it up. We 
then take apart that vehicle, and guess what we find? Drugs. 
That is where we find more drugs in the ports of entry. Isn't 
that not true, Dr. Gupta?
    Dr. Gupta. Better screening does lead to better detection.
    Mr. Biggs. Right. I saw you went down to the Tohono O'odham 
Reservation. You went to the San Miguel Gate. I would ask you, 
did you go 3 miles east to the San Miguel Gate?
    Dr. Gupta. I did.
    Mr. Biggs. And there is nothing there, is there? There is a 
four-string barbed wire from San Miguel Gate that runs 
literally for 20 miles till you get to the port of entry at 
Sasabe. Did you see that?
    Dr. Gupta. Yes, but I did not see the 2,000 trucks a day 
that goes through there either. I did at Nogales.
    Mr. Biggs. Yes, that is right, but you know what you can 
see if you go there? If you wait, you will see lots of people 
coming through. And you went down. I asked you last time you 
were here to go down with me without the officials because the 
official is going to give you that sanitized version. I asked 
you to come down with me, and just you and I, we would drive 
along there. I could show you that. We could go to Lukeville. 
We could go anywhere around Lukeville. We could go down to Yuma 
and from Yuma and move west, and you would see massive amounts 
of trafficking coming across from drugs and individuals. So, 
you missed out a little bit on that. And----
    Dr. Gupta. With no disrespect, but I went down there with 
Shadow Wolves in the Tohono O'odham Nation.
    Mr. Biggs. Yes, I know. I have been down there with the 
Shadow Wolves myself.
    Dr. Gupta. Yes.
    Mr. Biggs. Absolutely.
    Dr. Gupta. It is a great trip.
    Mr. Biggs. Yes, but we get back to my point. You were 
watched. They took you. They had a message and a narrative for 
you to see. You need to go down without the narrative created 
for you. And the problem that you have here, is I am told that 
you guys do not need to be educated on the other side, and that 
somehow we do not care what goes South. Heavens, go back and 
watch the many times I have said we need to see what is going 
South. But moreover, pull your heads out of the sand. What is 
going on between the ports of entry? I find it intriguing that 
people from the Northeast say, oh my gosh, you guys are making 
this up. There are videos of 3 days ago watching the traffic 
just outside of Lukeville, Arizona, the Organ Pipe National 
Monument. What is going on?
    What is going on is people are moving from ports of entry. 
You know what the Tucson sector did last week? Over 9,000 
apprehensions, many pounds of fentanyl coming in. That is 
between the ports of entry. Face the facts. Between the ports 
of entry is where the drug smugglers and human traffickers 
come. Why is that? Because all of our resources are depleted. 
You have got OFO working the ports of entry, but between the 
ports of entry--when I was last down there driving east from 
San Miguel Gate, do you know how many border patrol agents we 
saw? None.
    And when we saw a group come across, we had to get on top 
of the vehicle, make a call. They could not come. They could 
not spare anybody until they said, well, we got a Congressman 
with us. OK. Next thing you know, 45 minutes later, here comes 
the six vehicles from Border Patrol. That is what is going on. 
Please wake up. The drugs are pouring through the ports of 
entry for sure, but between the ports of entry, that is where 
it is flowing, and we cannot catch them because we do not have 
anybody there. I yield back.
    Chairman Comer. The Chair recognizes Mr. Mfume from 
Maryland for 5 minutes.
    Mr. Mfume. Mr. Chairman, thank you very much. I want to 
thank you and Ranking Member Raskin for calling us together for 
this hearing, and I want to thank Mr. Gupta for his appearance. 
Mr. Gupta, I have got a lot of respect for your work over the 
years. I follow that work. It is quite creditable, and I cannot 
speak for other Members, but it is my plan and intention to 
vote for and to fully fund ONDCP.
    Dr. Gupta, you mentioned in your opening statement that the 
drug trafficking is a crime that must be prosecuted, and that 
drug addiction is a disease, it must be treated as an 
interesting intersection there. And I could not agree more and 
believe that this is a cornerstone of the Biden-Harris 
Administration's approach to drug policy because it is 
evidence-based, it is common sense, and it is long, long 
overdue. I want to talk about both of those things. I have just 
been making so many notes. There has been so much said here 
today, and as one great philosopher once said, ``Everything 
that can be said has been said. It is just that not everyone 
has said it.'' So, bear with me while I be deliberately 
redundant.
    Since its start, the Biden-Harris Administration has shown 
a robust commitment to advancing equally the sort of things 
that we need centering on recovery over punishment in our 
Federal response to the overdose crisis. And the Administration 
understands, as I said before, that addiction is a disease. And 
we actually want to see results, and we must treat it like 
that, rather than to simply over-criminalize it and the people 
who, unfortunately, find themselves using it.
    There is a part of me that believes that art imitates life 
and sometimes vice versa, and I could not help but to think of 
the movie, ``The Godfather,'' and a point in time when we did 
not have addictions in this country, that the greatest crime 
was to go make some moonshine, put a cap on it, and sell it as 
alcohol. And so, we had prohibition for a long, long time. 
Prohibition was ended, and there is the scene in the movie 
where the five Dons get together to decide how are they going 
to make money off of addiction since they could not deal with 
selling moonshine anymore. And they are sitting around a table, 
and Don Corleone asks the five of them, what should we do, and 
they said, oh, we have got this great, great, great drug, it is 
addictive. It is called heroin, and we can spread that out. It 
will triple our sales. And Corleone thinks about it for a 
minute, and he says, no, no, no, that is bad. That is bad. We 
will not do that in our communities. Give it to the Blacks, and 
in those days, the Blacks meant the Blacks and the Browns. And 
so, Latinos and African Americans in the greater New York area 
became the new marketplace, and the addiction in those 
communities, because the drug was given away free of charge at 
first to make sure there was addiction, that just grew and grew 
and grew.
    And so, we fast forward from there and we look at what 
happened in the 1940's, 1950's, and 1960's. Heroin was king. In 
the 1970's and 1980's, crack was king. In the 1990's, we all 
talked about and were afraid of meth. At the turn of the 
century, opioids became the big thing because it broke out from 
those communities, and it was everywhere in everyone's 
community, and all of a sudden it got great, great attention. 
And now we have been dealing with fentanyl, which has taken 
109,000 lives in just the last year. It is the drug of death, 
the one that we are all afraid of, but I suspect that it is 
going to take strong will to deal with this and a realization 
that it is not just guns or something else. It is cartels who 
ought to be gone after on an international level and gone after 
in the most severe way.
    It is not just the little kid on the corner that is selling 
something that he got from somebody that he got from somebody. 
We could lock him up 1,000 times. But what we used to call the 
old French connection, the people who control the drugs, the 
international cartels continue to do what they want to do, and 
they do it by buying off people left and right. And in some 
instances, buying off elected officials in one country after 
another. So, I would just strongly urge that you continue to do 
what you do, to remember that this is an addiction. Thirty 
years ago in this Committee room, Kurt Schmoke, the Mayor of 
Baltimore, came and testified that we ought to treat it as an 
addiction, he and a group of progressives, and were laughed out 
of this room by people who said no, we need a war, a war on 
drugs. And his point was, no, we need to take the profit out of 
it so that there is no war.
    So, I think I have exhausted my time, Mr. Chairman. Again, 
I have no question because I have no time left, but thanks for 
the opportunity to share some of the things that are here. And 
Dr. Gupta, thank you very much for your work.
    Chairman Comer. The Chair now recognizes Representative Fry 
from South Carolina for 5 minutes.
    Mr. Fry. Thank you, Mr. Chairman, for having this hearing. 
Dr. Gupta, we are over here on the bottom bench here, but thank 
you for being here today.
    Prior to my service in Congress starting just this year, I 
was in the General Assembly of South Carolina where I was the 
Chairman of the South Carolina Opioid Response Team, so to 
speak. There was a select committee that was tasked with 
listening to medical doctors, law enforcement, teachers, people 
in long-term recovery, grieving families, and all types of 
professionals on how we can get a hold of this. And, you know, 
we borrowed a lot of our strategies from what other states were 
doing. We did some of our own that other states borrowed. That 
is kind of the beauty of the labyrinth of democracy, if you 
will, in our Federal system, and I think that there were some 
pretty healthy policy initiatives that were passed into law, 
that were signed into law.
    But unfortunately, we have seen those numbers continue to 
climb with fentanyl coming into our country through ports of 
entry, between the ports of entry, through really everywhere. I 
mean, for a while there, you could almost FedEx it in. So, this 
is certainly important to me because I have talked with a lot 
of families. I think everybody here has. I have talked with 
families just last week. We had a county councilwoman whose son 
died of a fentanyl overdose. And so, you think about the 
stories and the human capital and casualty associated with 
them, and you really want to fix it, not only from the 
prevention side, which is where it is probably most effective, 
but from the substance abuse and treatment side, too, and try 
to get these folks back.
    So, during President Trump's tenure in 2018, they passed 
the SUPPORT Act related to ONDCP. In your mind, what 
improvements were made because of that 2018 law coming or being 
signed into law?
    Dr. Gupta. Thank you, Congressman. I testified during that 
time for this passage as a commissioner of West Virginia. I 
think a lot of work has been done to hold our Agency more 
accountable and transparent in terms of data, dashboards, and 
really having the plans to be able to get done the work of the 
American people and coordinating the 19 drug budget control 
agencies with a drug control budget. So, the value of this 
Agency in the mind of Congress, but also in the mind of 
American people, is actually being able to bring all the 
agencies together to fight this scourge, the challenge that has 
both addiction, on one hand, as a disease and the trafficking, 
on the other hand, as a profit.
    So, the SUPPORT Act has been critical, and central, pivotal 
to making the improvements. Numbers do not always reflect it, 
but we have gone through a pandemic at the same time, so we are 
in tough times right now in so many ways, but we are making 
consistent progress every single day in terms of those people. 
And again, I have treated so many people, hundreds, if not 
thousands, of people with addiction myself, I have seen some of 
them die in my hands.
    Mr. Fry. Right, and thank you for sharing that, and I think 
this was a big step forward. What in your mind related to the 
SUPPORT Act moving forward deserves an examination or 
improvement since we are going to be examining this coming up 
shortly?
    Dr. Gupta. Well, certainly we think that there are a lot of 
things in terms of emerging threats, like xylazine, that we 
could improve on how to get us there. The first time we did 
that, declared it to save more lives. We could do better on 
that. The coordination, there is some aspect of having a better 
use of taxpayer money and what positions are needed 
prescriptively or not in order to get the job done. And then 
there is, obviously, data and dashboard. I think we have had 
some questions today that the data could be very helpful if we 
were to keep that data with us to be able to answer those 
questions.
    Mr. Fry. Doctor, I think there was a Carnegie Mellon, and I 
am going on memory, but there was a Carnegie Mellon study 
several years ago that said for every $1 that you invest in 
prevention, you save either, and I am going to probably inverse 
these, but either $4 in medical costs and $7 in criminal 
justice--it is one of the two--but for every $1 that you invest 
in prevention, that you save that on the back end. The SUPPORT 
Act in 2018 allowed for some HIDTA funds to be allocated for 
prevention and treatment of drug abuse. What percentage was 
allowed?
    Dr. Gupta. We can get you the numbers exactly, but for 
HIDTA, is the best return on investment, $83 for every dollar 
invested. And the prevention of HIDTA as well as other 
departments, education, health and others, it is so critical at 
this time right now to invest more in prevention, especially 
for our youth.
    Mr. Fry. Doctor, and what types of prevention and treatment 
programs does that fund? Just curious.
    Dr. Gupta. It funds partnership with other program called 
Drug-Free Communities Program, which is focused on youth 
prevention across all communities, 50 states, 750 programs 
almost, and it helps prevent youth, both initiation of drug 
use, but also delaying in drug use sometimes as well.
    Mr. Fry. Thank you, Doctor. Mr. Chairman, I yield back.
    Chairman Comer. The gentleman yields back. The Chair 
recognizes Representative Ocasio-Cortez from New York for 5 
minutes.
    Ms. Ocasio-Cortez. Thank you so much, Mr. Chair and thank 
you, Dr. Gupta for testifying before the Committee today, and 
thank you for your tireless commitment to ending the overdose 
crisis, which has devastated so many families across the United 
States.
    ONDCP holds a unique position within the Federal 
Government, coordinating across 19 Federal agencies and 
overseeing $41 billion as part of a whole of government 
approach to address addiction and the overdose epidemic. In 
addition to that, ONDCP's unique structure also enables it to 
be both nimble and comprehensive in its response to the 
addiction crisis. Dr. Gupta, how does the ONDCP utilize its 
unique cross Agency structure to effectively combat the 
addiction crisis?
    Dr. Gupta. Thank you, Congresswoman, for that question. We 
utilize the ability to have both drug-control budget, fund-
controlled notice, as well as the ability to work through 
policy implementing and making sure that the drug control 
strategy is implemented across all 19 drug control agencies, 
and really the coordination is so critical in this area when 
109,000 Americans are dying a year.
    Ms. Ocasio-Cortez. And for emphasis, since releasing the 
2022 National Drug Control Strategy, what are some of the 
successes of the ONDCP's whole of government approach?
    Dr. Gupta. So, on the treatment side, we are seeing more 
naloxone or Narcan get out there, 37 percent increase in 
prescribing while 12 percent reduction in price. It will go 
over the counter in the upcoming days to weeks to months. We 
have seen expansion of treatment, making sure that telehealth 
provision happens. Removal of X waiver, with the support of 
Congress, we have been able to do is to expand treatment 
providers from 129,000 to almost 2 million now. We have seen 
that more resources, $83 billion in this Administration, 42 
percent over the previous Administration, go into local 
communities. At the same time, we have seen having more 
seizures at the border, but understanding the problem does not 
begin or end at the border, working across the entire global 
supply chain as well.
    Ms. Ocasio-Cortez. Fabulous. And are there any changes the 
Committee should consider making through the ONDCP 
reauthorization process to improve the office's ability to 
coordinate drug control policy and action across the Federal 
Government?
    Dr. Gupta. Thank you for that question, Congresswoman. I 
think it is important that, as we move forward, that we allow 
more ability for getting better data as well as being more 
proactive in emerging threat. The fact is today, not even 5 to 
7 years ago, the threat we faced with synthetic compounds, not 
just United States, but across the globe, we are going to have 
to be more nimble, but more proactive. And those aspects will 
allow us to do that, to remove less of the bureaucracy, more of 
the actionable parts that have more return on the taxpayer 
dollars.
    Ms. Ocasio-Cortez. OK. And just to put a finer point on 
what you just shared, when you talk about getting better data, 
what does that look like? What are the levels of data that you 
all seek in order for us to make sure that we properly address 
that?
    Dr. Gupta. Thank you, Congresswoman, for that question. The 
fact is that over 20 years today, with this crisis, 100,000 
people dying, we still do not have real-data of overdose and 
non-fatal overdoses. We know for every fatal overdose, there 
are 14 potential non-fatal overdoses. We do this with heart 
attacks, we do this with strokes, we do this with so many of 
the diseases. It is important to have that data so we can get 
people the help that they need sooner than wait for them to 
die.
    Ms. Ocasio-Cortez. And so, it is my understanding that, 
currently, you all do not have, and consequently we do not 
have, real-data on overdoses happening in the United States, 
including non-fatal overdoses. Wow. OK. With that, I yield back 
to the Chair. Thank you very much.
    Mr. Connolly. Will my friend yield?
    Ms. Ocasio-Cortez. Absolutely.
    Mr. Connolly. I thank my friend. Just clarify, Dr. Gupta, 
because you were asked about, well, why aren't we pressing 
China, and I do not think your answer fully responded. I want 
to give you the opportunity. Surely, we are pressing China. 
Surely, for example, it is on every agenda when a senior U.S. 
official, like the Secretary of State goes to visit China. 
Would you comment?
    Dr. Gupta. Thank you, Congressman. It is. This is one of 
the most important topics for our conversation with the 
People's Republic of China, with the government. Every that our 
Ambassador is talking to the Chinese, this comes up, Secretary 
of State's visit. This is a high priority item for the 
President and for this Administration to hold China accountable 
for the precursor shipments, but we are also at the same time 
not waiting on China to act. We are taking actions proactively, 
not only sanction them, create a global coalition and work with 
our partners, like Mexico and others, to make sure that we are 
holding them accountable. Thank you.
    Chairman Comer. The time has expired. The Chair now 
recognizes Mr. LaTurner from Kansas for 5 minutes.
    Mr. LaTurner. Thank you, Mr. Chairman. Thank you, Dr. Gupta 
for being here today. The ONDCP has been on the frontlines of 
our Nation's battle against drug addiction, and it has had a 
far-reaching impact on public health and safety in our 
communities. I would like to commend you, Dr. Gupta, as well as 
all the dedicated men and women at your Agency for their hard 
work.
    Today, I want to talk about fentanyl. Over the past few 
years, Kansas has seen a staggering 73-percent spike in 
fentanyl overdoses, one of the highest increases in America. It 
is hard to find a community in my district that has not been 
impacted by this epidemic. Two milligrams of fentanyl, a lethal 
dose for most people, is cheaper than a can of pop, and it is 
killing more young Americans than car crashes, suicides, and 
COVID-19 combined. Major drug trafficking routes along I-35 and 
I-70 corridors make my home state of Kansas ground zero for the 
fentanyl crisis. Over 1,200 Kansans have already died from 
fentanyl poisoning, and when I talk to local law enforcement, 
it is clear that this crisis is only getting worse by the day.
    In addition to securing the Southern border, I believe 
proper education and awareness in our schools, homes, and 
communities can be the difference between life and death. We 
need to educate parents and teens on the reality we are facing 
that a lethal dose of fentanyl in a Percocet pill or another 
illegal street drug is often just one wrong Snapchat message 
away. I have seen this tragic sequence of events play out far 
too many times in my district. The ONDCP must do its part and 
take serious action to help ensure communities across Kansas 
are educated on the dangers of one of the deadliest drugs our 
Nation has ever seen.
    Dr. Gupta, the DEA has recently reported ``a sharp increase 
in the trafficking of fentanyl mixed with xylazine.'' Can you 
explain what xylazine does when mixed with fentanyl?
    Dr. Gupta. Thank you, Congressman, for that question. 
Xylazine mixed with fentanyl, or as it is known as tranq dope 
on the streets, basically enhances the duration, the high of 
the use of fentanyl so people have to use fentanyl less often. 
It is an animal tranquilizer that was never and has never been 
approved for human consumption, so it is a terrible drug. It 
causes flesh wounds and leads to amputations like I, as my 25 
years of career as physician, have never seen, and it has its 
own addictive capacity and capability, which makes the response 
both overdose as well as treatment much worse.
    Mr. LaTurner. Are there any notable domestic sources of 
xylazine? Where is it coming from?
    Dr. Gupta. It is predominantly coming from Chinese 
manufacturers being shipped directly into U.S. or into Mexico 
and trafficked. There is some that has been diverted in other 
places as well, but at this point, it is mostly being mixed in 
on the streets or being mixed in from the cartels.
    Mr. LaTurner. Can you please briefly elaborate upon the 
High Intensity Drug Trafficking Areas, what it does and what 
your role is in administering it?
    Dr. Gupta. So, one of the two grant programs that Congress 
intended for and our office wants us to call the HIDTA program 
or High Intensity Drug Trafficking program. They are located in 
all 50 states, especially where there are high drug trafficking 
areas that work at the fusion center more or less for intel 
sharing about programs that bring the local, state, Federal law 
enforcement officials together and really process and work on 
cases. It is the best return on taxpayer dollars. For every 
dollar that is invested, $83 in return happens, and it was 
responsible for seizing domestically 26,000 pounds of fentanyl 
just last year.
    Mr. LaTurner. You talked about the fusion center. I think 
Kansas has a model perhaps for the Nation for doing that doing 
that doing it well. Thank you, and, Mr. Chairman, I yield back.
    Chairman Comer. The gentleman yields back. The Chair now 
recognizes Ms. Brown from Ohio for 5 minutes.
    Ms. Brown. Thank you, Mr. Chairman, and thank you, Dr. 
Gupta for joining us today and for continuing the Biden-Harris 
Administration's tireless efforts to eradicate the crisis of 
addiction and drug abuse, which stretches into every corner of 
this country, red and blue districts alike.
    I want to be clear. Dr. Gupta, you and I both know there is 
still work to be done to end this horrific epidemic. Just this 
week, Axios reported that Cuyahoga County, which I represent, 
experienced 343 deaths from opioid and cocaine overdoses last 
month alone. Those 343 deaths were tragic and preventable. We 
also know that many overdose deaths involved illegal synthetic 
fentanyl. That is why the Biden-Harris Administration's 
proactive, preventive, and powerful action has been so welcome.
    One of the Biden-Harris Administration strategies to 
prevent opioid overdoses is to make sure opioid overdose 
reversal medications are readily available over the counter and 
accessible to the public without stigma or shame. That includes 
the lifesaving, easily administered nasal spray, naloxone, as 
well as Narcan. Dr. Gupta, easy for me to say. Dr. Gupta, what 
steps have the Biden-Harris Administration taken to make sure 
that any person can access Narcan when they need it or can keep 
it on hand if they live or work with people experiencing opioid 
addiction?
    Dr. Gupta. Thank you, Congresswoman. The amount of 
resources that are going to states right now to make sure that 
anyone who needs the naloxone or overdose reversal medication, 
also known as Narcan, is available. We are also making sure 
that it is available over the counter later this summer. There 
will be other products what will help us reduce the price in 
the market as well. We want to make sure that anyone can get 
this medication but also proactively carry it, not just 
necessarily for themselves, for someone in their family or 
someone in their neighborhood, school, other places. So, the 
access to naloxone or Narcan is critical to reducing these 
numbers down and getting people a chance to be connected to 
care.
    Ms. Brown. Thank you for that, and those decisions by the 
Biden-Harris Administration will continue to save lives. 
Additionally, President Biden's Fiscal Year 2024 budget 
proposes a historic investment of $46 billion to combat the 
overdose epidemic, which is largely driven by opioids, like 
fentanyl. The President's budgets also calls for increased 
funding to support overdose prevention, addiction treatment, 
and care for people recovering from addiction because we know 
that addiction is a disease that can happen to anyone. So, Dr. 
Gupta, how will increased investments help your Office of 
National Drug Control Policy and Federal agencies do more to 
address the fentanyl and opioid crisis?
    Dr. Gupta. Thank you, Congresswoman. The reason that 
President is proposing an unprecedented and historic 
investments at a time into drug policy when we have an American 
dying every 5 minutes around the clock is because people need 
help right now. Expanding treatment, expanding overdose 
reversal medication is critical to saving lives. And at the 
same time, we have got to put more technology at the border, 
make sure that working to disrupt the entire global supply 
chain. Both of these things go hand in glove, and that is 
exactly the plan that the President proposes budget behind.
    Ms. Brown. Thank you again. The President's Fiscal Year 
2024 budget request demonstrates the Biden-Harris 
Administration's dedicated efforts to continue to combat the 
fentanyl crisis, which is exactly what we need to do to bring 
American families the relief they so desperately need. So, with 
that, Mr. Chairman, I yield back.
    Mr. Connolly. Would my friend yield?
    Ms. Brown. Oh, yes. I happily yield to the gentleman from 
Virginia.
    Mr. Connolly. I thank my friend. Ms. Brown just mentioned 
Narcan and other drugs to try to help wean people off 
addiction, but one of the problems documented say of Beth 
Macy's book, ``Dopesick,'' is that we do not really regulate 
rehab facilities, and a lot of them take the AA, you know, 
Alcoholics Anonymous, cold turkey approach. Absolutely lethal, 
if you are talking about opioids. You cannot just go cold 
turkey. Would you comment on the need for regulation or what we 
are doing to try to educate these pop-up rehab facilities that 
are probably doing more harm than good driving people to 
heroin?
    Dr. Gupta. Thank you, Congressman, for that question. It is 
important, like we treat diabetes, think about, or high blood 
pressure because addiction is a disease and we have FDA-
approved medication. The evidence supports utilizing these 
medications to help people, not only save lives, but be 
productive, back into the community. So, the goal here, in my 
view, and I have treated a lot of patients, is to make help 
people enable themselves to become productive members of 
society, and medication and a proper treatment system, 
infrastructure allows us to do just that.
    Mr. Connolly. I thank my friend for yielding. Thank you.
    Chairman Comer. The Chair recognizes Mr. Burlison from 
Missouri for 5 minutes.
    Mr. Burlison. Thank you, Mr. Chairman. Thank you, Dr. Gupta 
for being here.
    According to the U.S. Drug Enforcement administration, the 
Mexican cartels are the ones that are responsible for most of 
the fatal drug poisonings. In 2022, it was over 107,000 people, 
and, as you know, the data is 67 percent of that was from 
fentanyl. My question is that some people are coming in contact 
with this, some victims are coming in contact with fentanyl, 
not necessarily by taking a pill, but in everyday items, like 
cash and food. Can you elaborate on the extent of that?
    Dr. Gupta. So, the powder, if you think of the powder, it 
poorly absorbs through the skin surface. Of course, if you are 
inhaling a large dose of fentanyl, like, 2 milligrams is a lot 
of dose for unsuspecting person, it is potentially fatal. So, 
it is important for us to distinguish the ability of casual 
versus actual. But at the same time, I will say that if 
someone, anyone that thinks that they have come across in touch 
with fentanyl, it is important to get them checked out. That is 
the important piece here.
    Mr. Burlison. But do you think of the cases of overdoses, 
is there a percentage of people that are inadvertently these 
are not drug users, these are people that accidentally inhaled, 
apparently, fentanyl from a dollar bill they gained or----
    Dr. Gupta. Thank you, Congressman. If we look at the number 
of people who die, of the 100,000 and 70 percent roughly or 80 
percent of them are being fentanyl, what we find is that either 
they are still accidental oftentimes because they have taken a 
pill that they think is Xanax or Adderall, or others. Those are 
the majority of people.
    Mr. Burlison. The majority. OK. OK. So, we now know that 
the Chinese have for a long time been supplying the precursors 
for fentanyl, but they are not supplying fentanyl itself. Is 
that correct?
    Dr. Gupta. They are not. It come down to literally zero 
after 2019 May, that we had success with the Chinese to stop 
fentanyl production, but then started the precursor production.
    Mr. Burlison. So, there is an ability for the United States 
put pressure on China to curb some of this?
    Dr. Gupta. And we are doing exactly that, Congressman.
    Mr. Burlison. OK. So, with that, just can you elaborate 
what your office is doing to work with China on the supply of 
the precursors for fentanyl?
    Dr. Gupta. Every meeting, literally, that have senior high 
officials, that we have with U.S. official in China, we are 
bringing this up to them to demonstrate why this is so 
important to us. We are also making sure that every one of 
those companies that we find to be illegitimately supplying 
precursors we are working to sanction them. At the same time, 
we also created a global coalition, launched it with 80 
countries and 11 international organizations around, is 
signaling that this is the synthetic drugs are a global threat. 
With or without China, we are going to continue to do that. And 
then at United Nation, we have gotten more substances 
controlled than ever before with U.S. leadership to make sure 
that China understands that, and we still have other tools that 
we will, again, work with that.
    Mr. Burlison. So, speaking of other tools, in the 
Subcommittee meeting that we had in April, we learned that the 
Chinese money launderers have taken over the money laundering 
operations for the Mexican drug cartels. Has this been impacted 
or how have China's strict capital flight laws motivated 
Chinese individuals to aid in laundering money for the cartels?
    Dr. Gupta. We definitely feel some of the laws, overall 
policies are supporting the creation of these illegal and 
criminal networks that allow both underground Chinese banking 
cash as well as other financial institutions that are being 
created outside of the United States to launder money.
    Mr. Burlison. And so, if you will, what role do the money 
launderers play there? I guess now they are called brokers. 
These are Chinese brokers.
    Dr. Gupta. So, President Biden executed an EO 14059, I 
believe it was, to go after, beyond the Kingpin Act, the 
enablers of a drug trade. That includes brokers, accountants, 
real estate agents, lawyers of these traffickers. So, what we 
are doing is we are going after all of those individuals----
    Mr. Burlison. Everyone in the chain?
    Dr. Gupta. Everyone in the chain because it turns out 
sometimes it is these brokers, these accountants that are more 
important than just the lowest hanging fruit.
    Mr. Burlison. Are there any apps or software that they are 
utilizing that we could pull some of that data for that we are 
not able to get today?
    Dr. Gupta. FBI has a program called JCODE, the Joint 
Criminal Opioid Document Enforcement program, and HSI has 
another program as well. We are working with those, but we have 
a classified briefing on Monday. We would love to have you over 
to talk more about this as well.
    Mr. Burlison. I look forward to that. Thank you. My time 
has expired.
    Chairman Comer. The Chair now recognizes Mr. Connolly from 
Virginia for 5 minutes.
    Mr. Connolly. Thank you, Mr. Chairman. Dr. Gupta, I did not 
hear you answer the question about are you or have you issued 
guidelines and/or regulations to those entities that are 
purporting to help opioid or fentanyl addicted individuals try 
to recover, because as I understand, it is a pretty unregulated 
market.
    Dr. Gupta. I think if we are talking about the treatment 
sites of this----
    Mr. Connolly. Are you issuing guidance to those people? 
Does the Federal Government say, hey, this is not AA, you 
cannot go cold turkey? You got to allow Narcan or other drugs 
that stepped down, and by the way, you are going to have to 
allow that for a long period of time because this is a 
different kind of addiction?
    Dr. Gupta. Thank you, Congressman, for that question. Our 
grants that go out, especially Federal grants through Health 
and Human Services, do require some of these things that you 
were mentioning.
    Mr. Connolly. Require if they take Federal money?
    Dr. Gupta. Correct.
    Mr. Connolly. OK. All right. I just want to clear up a 
couple of things that were said earlier or hinted at earlier in 
this hearing, and hopefully quick answers, but the source of 
fentanyl in the United States comes through illegal border 
crossings in Mexico. Is that correct?
    Dr. Gupta. The majority of the fentanyl is coming through 
the ports of entry.
    Mr. Connolly. So, it is not on the backs of people trying 
to cross into the United States illegally?
    Dr. Gupta. I can speak over 90 percent or almost 90 percent 
are coming through the ports of entry.
    Mr. Connolly. The use of consumption of illegal substances, 
like fentanyl, is primarily an immigrant problem. It started 
there, and it really is characterized by that population in the 
United States apparently consuming drugs inordinately. Is that 
correct?
    Dr. Gupta. Congressman, of course, the fact is exemplified 
that 109,000 Americans are dying every year, that it pervades 
through all communities, all geographies, all socioeconomic----
    Mr. Connolly. But it is not factually correct or is it that 
it is primarily immigrants in that population?
    Dr. Gupta. Not factually.
    Mr. Connolly. Not fact. For example, I represent one of the 
wealthiest communities in the United States. We have addiction 
problems, and we have addiction overdose in Fairfax County, 
Virginia. Is that not correct?
    Dr. Gupta. That is correct, I am a resident of your 
community.
    Mr. Connolly. And those are not necessarily immigrant 
individuals or communities. There was also a suggestion and, 
you know, your office claims these successes. One of our 
colleagues suggested ``I am not sure I want to reauthorize 
ONDCP.'' And what would be the consequences if we did not have 
your office in this struggle to get our hands around tranq, 
fentanyl, opioids, and the like?
    Dr. Gupta. Congressman, I think it will send the wrong 
message to the American people about the seriousness that this 
Congress takes when it comes to the killing and the deaths of 
109,000 Americans each year. And, you know, just within the 
last time we have been in this Committee, we have over 25 
Americans that have been killed.
    Mr. Connolly. I take it that it is the wrong signal, but 
put that aside. Some people do not care about that. 
Operationally, what would be the consequence if you did not 
exist, if you went away and we did not reauthorize you?
    Dr. Gupta. Thank you, Congressman. It will weaken 
significantly the response of Federal, local, and state law 
enforcement as well as first responders and public health 
officials to respond to this crisis.
    Mr. Connolly. Because what? Grants would not flow, 
coordination would not happen, intelligence would not be 
shared?
    Dr. Gupta. Because coordination would not happen. 
Obviously, intelligence will not be shared. HIDTA program that 
does so much of the prosecutions and the efforts will not 
happen, and as a result of this, more Americans will surely 
die.
    Mr. Connolly. And finally, are you experiencing people 
moving from fentanyl, because of our successes and trying to 
get some control over that, to tranq? And how concerned should 
we be about that shift if, indeed, there is such a shift?
    Dr. Gupta. We should be quite concerned. There is several 
hundred percent increase in what we find tranq associated with 
fentanyl deaths right now. It is primarily happening because of 
the pursuit to make more money by the traffickers and 
producers, and that is where we have to go after. We have got 
to make sure that we are helping people who need the help, but 
at the same time, we are denying the profits and the operating 
capital of these cartels as well as transnational criminal 
organizations.
    Mr. Connolly. My time is up. I thank the Chair and thank 
him for holding this hearing. I think this has a lot of 
potential for all of us finding common ground because all of 
our communities are affected, and I thank Dr. Gupta.
    Chairman Comer. I agree with the gentleman from Virginia. 
Without objection, the Member from Puerto Rico, Jenniffer 
Gonzalez, is waived on to the Committee for the purpose of 
questioning witnesses at today's Subcommittee hearing.
    Without objection, so ordered.
    The Chair now recognizes, Mr. Timmons from South Carolina 
for 5 minutes.
    Mr. Timmons. Thank you, Mr. Chairman. Dr. Gupta, thank you 
for being here today.
    I was a prosecutor for 4 years in South Carolina, and one 
thing that my worst cases had in common was drug use. Most of 
the people that irreparably harmed themselves, someone else 
killed someone, did so while under the influence of a wide 
variety of drugs, sometimes many drugs. And, you know, I think 
historically, this country has been dealing with drugs. We have 
tried to use the stick, and that might have been a little bit 
too harsh. We have tried to use the carrot. I do not think that 
is going very well, either. So, I would argue that we might 
need to have a more balanced approach to holding people 
accountable that are perpetuating drugs and profiting off of 
drug-addicted individuals, and also help people that do, in 
fact, need help. Drug addiction is real, and we have tools in 
our toolbox to help address that. Would you say that that is a 
fair assessment of the history, we used too much of a stick in 
the 1970's and the 1980's, and now we might be a little bit too 
nice?
    Dr. Gupta. Thank you, Congressman, for the question. I 
would say this way. When we were doing what we were doing 50 
years ago, we did not know any better. I never questioned the 
intent of what we were doing. It was we did not know any 
better. Today, we know addiction is a disease, and it has to be 
treated. We also know trafficking is a crime and it has to be 
prosecuted.
    Mr. Timmons. But you would agree that when somebody 
overdoses and goes to the hospital multiple times, that, you 
know, the first time you give them some education, maybe some 
resources. The second time, maybe involuntary commitment and do 
inpatient, and try to help them help themselves. We do not 
really do that. We have recidivism, as it relates to drug 
abuse. Well, real quick, just tell you about these harm 
reduction efforts, and how do you justify some of those efforts 
relative to helping people because I do not think getting 
people needles helps them. I think giving them inpatient rehab 
and helping to get them clean and giving them resources helps 
them.
    Dr. Gupta. So, thank you, Congressman. As you mentioned, a 
person is suffering from a disease at the time, not often able 
to know what is needed, helping them with overdose reversal so 
they can stay alive because we cannot treat dead people. I want 
to say this as a doctor. Getting them the ability to check the 
drugs to see if they have fentanyl--they can make a decision 
not to use it after that--is important and smart, making sure 
the spread of chronic diseases does not happen, infectious 
diseases, and here is why it works.
    When I ran and saw the Quick Response Teams in West 
Virginia, they would go back to someone and knock on their door 
for next day, next day after that, after the overdose. We got 
30 percent people or more entered treatment eventually by just 
talking to them, and this is the kind of policy we need to be 
thinking it. How do we approach people, help them get into 
treatment? And sometimes as a law enforcement and a social 
worker going together to knock on the door and say, hey, what 
do you need.
    Mr. Timmons. Sure, I appreciate that, but it seems that a 
lot of our cities across the country are not really holding 
people accountable. We are not enforcing the criminal code. I 
will give you a great example. You walk down the street in 
Georgetown with a beer or glass of wine, you are going to get 
an open container ticket, but if you want to go smoke marijuana 
at Wisconsin and M, they knock it out. I mean, you know, 
marijuana is federally illegal, and the fact that we have this 
nebulous enforcement mechanism where in South Carolina you go 
to jail, if you are smoking in the military, you get kicked 
out. I mean, you know, we are failing. We are failing at 
creating a structure through which our society can thrive, and 
it is causing problems. What are your thoughts on that?
    Dr. Gupta. Thank you, Congressman. I can limit it to just 
marijuana. This is exactly why the President last fall took 
these actions: A, to make sure that people in Federal system 
who are for simple possession of marijuana are pardoned because 
it is about their life beyond that. Challenging the Governor 
should do the same. And then asking the attorney General and 
the HHS Secretary to work through and look at the what the 
current evidence is around scheduling in an independent way.
    Mr. Timmons. It is a very complicated issue, and I would 
argue that the Federal Government has lost the ability to 
enforce the law because it has refused to enforce the law for 
so long, and the fact that we have not addressed it in some 
meaningful way creates a lot of problems. I am a JAG officer, 
captain in the South Carolina Air National Guard, and we 
regularly remove people from the military for smoking 
marijuana, and you cannot walk a block in D.C. without smelling 
somebody smoking. So, I mean, we need to get our policies in 
line with carrots and sticks and need to have nuances to 
achieve our objective. With that, Mr. Chairman, I am out of 
time. I yield back.
    Chairman Comer. The gentleman yields back. The Chair 
recognizes Mr. Goldman from New York for 5 minutes.
    Mr. Goldman. Thank you, Mr. Chairman, and thank you, Dr. 
Gupta for being here. Quick first question. Is it the policy of 
the ONDCP and the Biden Administration to assist the Mexican 
cartels to traffic fentanyl into the United States?
    Dr. Gupta. Absolutely not.
    Mr. Goldman. So, you try to stop fentanyl from coming into 
the United States, right?
    Dr. Gupta. Correct.
    Mr. Goldman. And, in fact, we have seen some statistics 
recently that my colleagues on the other side of the aisle have 
touted that there has been more success by this Administration 
in seizing fentanyl coming into the United States. Is that 
right?
    Dr. Gupta. Yes, Congressman.
    Mr. Goldman. Well, I guess I am a little troubled by tweets 
such as this, who is a colleague of mine from New York, who 
criticizes President Biden because during his Administration, 
more than 34,000 pounds of deadly fentanyl have been seized at 
the Southern border. That means that it did not come into our 
communities, right?
    Dr. Gupta. Yes, Congressman, and if the assertion is we 
should let all of this come in and kill Americans, I will 
disagree with that every single day and every single minute.
    Mr. Goldman. Right. We are trying to stop the fentanyl from 
coming in, and there is no question and there is bipartisan 
agreement, as we have been talking about throughout this 
hearing, that fentanyl and the opioid epidemic is devastating 
communities all around this country. It does not differentiate 
between Republican districts and Democratic districts, and 
there is no question that far too many people are dying. But it 
just really surprises me when my colleagues on the other side 
of the aisle try to criticize this information for successfully 
seizing some of that fentanyl coming across the aisle or coming 
across the border rather.
    And I go back to what my distinguished colleague from 
Arizona, Mr. Biggs, had said earlier that he supports trying to 
curtail the exportation of American manufactured weapons of war 
to the Mexican cartels. There has been a lot of talk on the 
other side of the aisle that the Mexican cartels fully control 
the fentanyl trade, and, of course, they only are able to do 
that because of their possession of weapons of war. So, I do 
hope they will come around as well to support bipartisan 
legislation to eliminate immunity for American gun 
manufacturers who are knowingly exporting guns. I did not hear 
him say that.
    I would like to turn my focus a little bit to the work that 
we are doing with foreign partners to address the issues of the 
fentanyl trafficking coming across the border. There has been 
some talk of China and India and some of the component parts of 
certainly of fentanyl and synthetic drugs being provided by 
them. Is the Administration and your office finding that you 
are running into obstacles and roadblocks from the Chinese 
Government or even the Indian Government in assisting you and 
your efforts to stop the fentanyl trade?
    Dr. Gupta. Thank you, Congressman. When we look at foreign 
nations, we look at the willingness and the capacity to take 
action to prevent the diversion of these precursor chemicals. 
With India we are finding more willingness and a lot of 
capacity. PRC has the capacity but has demonstrated absolutely 
no willingness to cooperate.
    Mr. Goldman. So, in many respects, they are tacitly 
facilitating this devastating drug trade. Is that accurate?
    Dr. Gupta. Certainly, they are not engaged, and they do not 
seem to be interested in becoming a global leader on this 
issue.
    Mr. Goldman. And what, from your vantage point, has the 
United States done, has this Administration done, and should 
continue to do in the future to combat the control and power of 
the Mexican drug cartels?
    Dr. Gupta. I think it is important to have a strong and 
stable partner on the south of our border. Part of that 
involves working closely with their law enforcement and 
military counterparts, working with the President and his 
security cabinet. Those are the things that we are doing right 
now. As you know, I have noticed that El Chapo's son has been 
captured, we have Quintero and other drug cartel leader 
captured, we have the killer of Kiki Camarena, 40 years ago, a 
DEA agent, captured. So, we are getting more successes, but it 
is because of the partnership, the support that we are 
providing, but it is important to also hold the Government of 
Mexico accountable for the actions of cartels and other 
producers within Mexico as well.
    Mr. Goldman. I am out of time. I appreciate you being here 
and your testimony. And I thank the Chairman for holding this 
hearing, and I yield back.
    Chairman Comer. The Chair now recognizes Mrs. Boebert from 
Colorado for 5 minutes.
    Mrs. Boebert. Thank you, Mr. Chairman. Dr. Gupta, 
nationwide, over 100,000 people have lost their lives from drug 
overdoses. We have heard a lot about that today. Seventeen 
hundred ninety-nine of those deaths were Coloradans. Now, your 
office works with 19 Federal agencies and oversees $41 billion 
with a goal of addressing overdoses and addictions, correct?
    Dr. Gupta. Yes, Congresswoman.
    Mrs. Boebert. Your office is also responsible for 
implementing the Biden-Harris National Drug Control Strategy 
that was released over a year ago, correct?
    Dr. Gupta. That is correct.
    Mrs. Boebert. Dr. Gupta, a key component of the Biden-
Harris plan is to go after those who smuggled drugs into our 
borders, correct?
    Dr. Gupta. That is correct.
    Mrs. Boebert. Why has this Administration rolled back 
immigration policies that have a proven track record to secure 
the Southern border, such as Title 42, or remain in Mexico?
    Dr. Gupta. Thank you, Congresswoman, for that question. Of 
course, I defer all the questions to Homeland Security on the 
immigration piece. I can tell you on the drugs piece, we have 
more seizures today that we have had at any time.
    Mrs. Boebert. Do you believe that is because more is coming 
over than at any other time?
    Dr. Gupta. I think we have better technology. I think we 
have more committed men and women in uniform.
    Mrs. Boebert. Fentanyl is currently the No. 1 cause of 
death for adults 18 to 45, so this is still getting into our 
country and still killing Americans throughout our Nation. So, 
would you agree that more fentanyl is coming across and that is 
why the seizures have increased?
    Dr. Gupta. I think what I would say is this. It is 
important to seize every piece of fentanyl that comes across 
our border. At the same time, it does not begin or end at the 
border. It is important for us to look at the supply chain 
globally, as well as the profits that the traffickers are 
making often as well as producers.
    Mrs. Boebert. Dr. Gupta, you have noted that a significant 
amount of fentanyl comes through the ports of entry at the 
Southwest border, correct?
    Dr. Gupta. Yes, Congresswoman.
    Mrs. Boebert. You are aware that the Biden Administration's 
parole program through the CBP One app, correct?
    Dr. Gupta. I am not involved with that program.
    Mrs. Boebert. Are you aware of the program?
    Dr. Gupta. Just publicly whatever I hear on the news.
    Mrs. Boebert. Do you know how many inadmissible aliens were 
encountered at the ports of entry at the Southwest border in 
Fiscal Year 2020?
    Dr. Gupta. I would have to defer those to Homeland 
Security.
    Mrs. Boebert. Oh, I just happen to have that answer. In 
Fiscal Year 2020, OFO encountered a little over 57,000 
inadmissible aliens at the ports of entry. Do you know how many 
were encountered in Fiscal Year 2022?
    Dr. Gupta. I would not know.
    Mrs. Boebert. Up from 57,000 to over 172,000. Do you know 
how many have been encountered so far in Fiscal Year 2023?
    Dr. Gupta. I would still defer you to Homeland Security.
    Mrs. Boebert. So, in Fiscal Year 2020, we had 57,000 
inadmissible aliens at the ports of entry, 2022, over 172,000, 
and Fiscal Year 2023, it is over 276,000. Now is it fair to say 
that the OFO officers are much busier under Biden CBP One app 
parole program?
    Dr. Gupta. Once again, Congresswoman, I would make sure 
that I would just defer all those questions because I am not 
engaged in the immigration policy of the United States.
    Mrs. Boebert. Well, I would recommend that you possibly 
have a discussion with OFO, if you have not already, on how 
that increased flow affects officers' ability to interdict 
fentanyl at the ports. Would you agree?
    Dr. Gupta. I will continue to have those conversations. I 
have visited the border several times, and it is really 
important that we ensure that 109,000 Americans are dying, that 
we do everything in our capacity.
    Mrs. Boebert. I agree, and I think that that starts with 
securing the border since we are seeing this increase of 
inadmissible aliens at our ports of entry. We know that people 
are coming over illegally, we have hundreds of thousands of 
got-aways, and certainly the amount of fentanyl deaths that you 
just mentioned are extremely severe. And I would say that that 
is because more fentanyl is coming through our wide-open 
Southern borders, and it is because of the policies that have 
been implemented since January 2021.
    Dr. Gupta, I urge you and the Biden Administration to 
please crack down on fentanyl and secure our borders, have this 
conversation to keep Americans safe so we can put an end to 
this. I appreciate your time here today. My time has expired, 
but thank you for testifying before our Committee, sir.
    Chairman Comer. The Chair now recognizes Mrs. Luna from 
Florida for 5 minutes.
    Mrs. Luna. Thank you, Chairman. Mr. Gupta, referencing the 
prison system, has your organization done anything to set up a 
nationwide policy on rehabilitation measures for people? The 
reason I ask that is because I have personally had family in 
and out of the prison systems, and sometimes the only way that 
these people get clean is by going to jail. And when someone 
does not go through that transition, they end up back within, 
whether it is the criminal cycle or the jail system itself. So, 
can you elaborate on that a little bit for me?
    Dr. Gupta. Thank you, Congresswoman. As you have rightly 
pointed out, this is a very important population. At any given 
day, there is 2 billion Americans incarcerated, and 60 to 80 
percent of them are in prison or jails because of either drug 
use or----
    Mrs. Luna. Addiction?
    Dr. Gupta [continuing]. drug-related crimes. We have 
committed to offering treatment to everyone in custody in the 
Department of Federal Bureau of Prisons, and we have also 
released guidelines for 1,115 Medicaid waivers to states to do 
the same for the jails and prisons. Fifteen states have already 
applied, two have been approved, including state of Washington 
and California.
    Mrs. Luna. What does that treatment involve? Is it drug 
related or is it actually a step program that something like 
you would see out of Narcotics Anonymous?
    Dr. Gupta. So, these waiver applications can state what 
they want to be. They can state if they want state prisons or 
jails or both. They can state what details they want. But 90 
days before release, they will have that treatment ready and 
ready to go, and then they will have a continuity of care into 
the community, which is really important step, which is sought.
    Mrs. Luna. So just to be clear, so a system is offered 
within the jail system, a rehab that they can go through and 
then is that considered part of their releasing for sentencing? 
If they continue the program, are they given more lenience in 
it? How does that work?
    Dr. Gupta. So that might be a drug court program, which we 
also support. We also support diversion or deflection programs 
as the entire arc of the criminal justice system. But in this 
case, when they are planned to be released in 90 days, and for 
a lot of jails, that turnover time is lot shorter than that, so 
oftentimes 50, 70 days, so that will be that their Medicaid or 
whatever insurance will not be turned off. They will continue 
to have that treatment, and they can get that treatment while 
they are in custody.
    Mrs. Luna. As part of that treatment, is there any faith-
based organizations that are allowed to go in to facilitate 
that?
    Dr. Gupta. I think at this point--I can get the details for 
you--but it is going to be the states that are going to have to 
propose that to CMS.
    Mrs. Luna. OK.
    Mrs. Luna. The next question I had was to follow up on one 
of my colleagues from across the aisle over there. I heard you 
answer on China being uncooperative with basically stopping 
some of the initial, I guess, chemicals for fentanyl 
production. I did not hear you touch on India, how they have 
been effective. If you can just reiterate that?
    Dr. Gupta. Thank you, Congresswoman. We are having, since 
2020, a counter narcotics working group with India. India being 
a large chemical industry as well as pharmaceutical, they have 
been very cooperative. We are working today right now to have 
the 21st century drug policy framework developed with India to 
make sure that there are diversion protocols in place to hold 
again, bad actors accountable. The same is not true for the 
PRC, the People's Republic of China. We will be going to 
continue to press on them as much as we need to in order to get 
them to have them cooperate.
    Mrs. Luna. OK. And then just to ask for my own 
clarification, you had mentioned that the Biden Administration 
basically gave some form of forgiveness for those who were in 
possession of marijuana. Is that backdated, or when is that 
effective as of date wise?
    Dr. Gupta. That was last fall and for all those in Federal 
custody----
    Mrs. Luna. At that point in time?
    Dr. Gupta. And that is backdated as well, I believe, where 
we could certainly get you details on that.
    Dr. Gupta. There is a mechanism that Department of Justice 
has to go through to get those records removed.
    Mrs. Luna. ``Expunged'' would be the term. OK. And then my 
last question is, if you had a magic wand, what would you do to 
fix the crisis that you are currently seeing because I know 
that sometimes the legislation takes a while. So, what is your 
opinion?
    Dr. Gupta. Congresswoman, that is an excellent question. 
Two things I would say. One, attack the entire global supply 
chain with focus on money, follow the money. On the other hand, 
make sure that every American who needs to get treatment, their 
life safe, gets that opportunity to do so.
    Mrs. Luna. And you said that in the jail system, it is 
about 60 percent that are struggling with addiction?
    Dr. Gupta. Exactly. Yes. Yes, madam.
    Mrs. Luna. OK. All right. Cool. Thank you. Chairwoman, I 
yield my time.
    Mrs. Boebert. [Presiding.] Thank you. The Chair now 
recognizes the gentleman from Texas, Mr. Sessions.
    Mr. Sessions. Madam Chairman, thank you very much. Doctor, 
welcome. This is an issue that will not go away, has not gone 
away. I remember meeting with one of your former colleagues, 
General Barry McCaffrey, on this same issue. My staff, a day or 
two ago, called what I believe is your staff and asked a simple 
question, and was do you ever say it is illegal in your 
advertising. Do you ever say that this is detrimental to your 
health? I do not know if you know what that answer, what they 
told us, but I know what that answer was. Do you know what it 
was?
    Dr. Gupta. Congressman, if you are asking that we say about 
illegal drugs, that they are illegal? So, yes, we do, but I do 
not know what form and where are you asking that, that we do 
say that.
    Mr. Sessions. To the people who live in the United States. 
At least the answer that we were given, that I was told was, 
well, we do not control the message. That just is given out to 
someone else. They control the message on drug policy, we do 
not at ONDCP, and I was perhaps not surprised, but stunned that 
that would be the answer, that ONDCP outsources their message 
completely to someone else.
    I am also stunned today that, in my opinion, and thank you 
for being here, that this Administration is blaming other 
countries for our drug problems. I have heard you mentioned in 
the little bit of time I have been here ``China'' about 14 
times. I have heard you blame other people. You remind me of a 
firefighter who has shown up when arson has already taken 
place. You show me the viewpoint that you want to shift the 
blame. Well, that is an old story. That is an old story that 
came back that we had in the 1980's and 1990's. When we 
effectively dealt with this issue, it does move somewhere else. 
It moved to the Keys, from the Florida Keys. It moved to high-
speed cigarette boats. Different time, different era, but when 
there is effective law enforcement, you force criminal 
organizations drug cartels to do something different.
    Next line of questioning please, Dr. Gupta. Have you ever 
seen the series that is called ``Drugs, Inc.,'' that is on 
National Geographic?
    Dr. Gupta. I probably have.
    Mr. Sessions. Well, if you had, you would know because it 
is in its at least 7th or 8th year. I encourage you, and if you 
cannot get it, I will get you all the years. When they string 
them together, they tell the story because they look at the 
drug cartels and the people who are pushing these products over 
the years, and then they show what the response is from the 
Federal Government. Is it the cat and mouse game? Yes, it is. 
Is it one where the drug cartels knew that they had to be very 
smart and do a number of things to evade getting arrested, 
going to jail, finding out where that method of operation was, 
and the United States catching on. That is how we caught on to 
submarines. That is how we caught on to tunnels. That is how we 
caught on to things, because we forced them, meaning drug 
cartels and criminals, to do different things.
    In my opinion, this Administration and the Democratic 
Party, is openly allowing this open border policy that is 
contributing to the hundreds of thousands of people that die. 
Over the years, you have referenced 100,000 a year for a long 
period of time. That is almost equal to or larger than the 
number of men, people, we lost in World War II and any other 
war since, and yet this Administration allows them full access 
to our United States border, full access for drug cartels, to 
where they can put their marketing organizations.
    And I know you talked about HIDTAs. The HIDTA are seeing 
this, too. They are putting their marketing organization now 
instead of in the big cities, they are in the next two-tier 
cities down to where they have people in place who are called 
illegal aliens, who have come to this country illegal, been 
given a free pass to move somewhere, and they just become part 
of the marketing organization, and the DEA knows that and the 
head of ONDCP should.
    So, my recommendation to you is that I think that you 
should go back and relook at and constitute yourself to where 
you are aware of these problems and ``Drugs, Inc.'' over the 
last 7 to 10 years offers you--and it might be a good time over 
the month of August that you invest some time to look at this, 
and you will see how the drug trade and how the fight by this 
government takes place. One last question.
    Mrs. Boebert. The gentleman's time has expired.
    Mr. Sessions. When is the last time that you met face to 
face with the President of the United States to give him the 
facts of the case that you have to us today?
    Dr. Gupta. Thank you, Congressman. I just told you, first 
of all, please, that we do control our own message. I would be 
happy to talk to you about that.
    Mr. Sessions. Well, hopefully, your staff will learn that. 
I will be glad to take that. I will be glad to take that in 
writing.
    Mrs. Boebert. The gentleman may answer the question, but 
the gentleman's time has expired.
    Dr. Gupta. And then as far as the process of the drug 
trafficking cartel, we are very engaged in working with our 19 
drug control agencies, including DEA, to manage a whole-of-
government response, and they do not have full access. The 
cartels do. I just spoke to the President this week, and he has 
my cell phone number, and we talked about this, how level of 
high importance he places on this issue, and he is fully 
committed to it. Thank you.
    Mr. Sessions. Thank you, sir.
    Mrs. Boebert. The gentleman's time has expired. The Chair 
now recognizes the gentlewoman from Puerto Rico, Mrs. Gonzalez-
Colon.
    Mrs. Gonzalez-Colon. Thank you, Madam Chair, and thank you, 
Chairman Comer. I appreciate the opportunity to join the 
Committee, as you can see, the Reauthorization of the Office of 
National Drug Control Policy, and Director Gupta, it is good to 
see you. Your office is tasked with overseeing our Nation's 
drug control efforts, including through the development and 
implementation of a National Drug Control Strategy. Congress 
has required by law that this strategy also includes 
accompanying strategies to combat the flow of illicit drugs 
across the Southwest and the Northern border.
    Through appropriations report language, we have also 
required inclusion of a strategy to combat the flow of illicit 
drugs coming through our maritime border in the Caribbean. Your 
office has released this Caribbean Border Counternarcotics 
Strategy with a particular focus on drug related threats in 
Puerto Rico and the U.S. Virgin Islands in 2015, 2020, and last 
one in 2022. However, unlike the existing statutory requirement 
for the Southwest Border and the Northern Border 
Counternarcotics Strategy, your office is not statutorily 
required to develop this third strategy despite the real 
threats we face from drug trafficking organizations in the 
Caribbean. And that is the reason I have introduced H.R. 920, 
The Caribbean Border Counternarcotics Strategy Act, which is a 
bipartisan and bicameral legislation to codify the requirement 
for ONDCP to include a Caribbean Border Counternarcotics 
Strategy in the National Drug Control Strategy, just as 
Congress has previously codified the requirement to include the 
Southwest Border and the Northern Border Counternarcotics 
Strategy.
    Drug trafficking in the Caribbean continues to represent a 
major threat to our Nation. Nowhere is the risk clearer than in 
Puerto Rico and the U.S. Virgin Islands where we are home for 
3.3 million Americans, and where the illicit activities of 
drugs for smugglers operating in the region contributes to 
violent crime in our communities and higher than average 
homicides rates. In fact, in a recent hearing, a CBP Air and 
Marine Operations official testified that Puerto Rico is the 
most violent maritime threat vector of any location they 
patrol, and that was here following the events of last November 
when drug smugglers shot and killed CBP Marine Interdiction 
Agent Mike Maceda and injured two other agents during the 
interdiction off of our coast.
    Let me provide you another example of the problem. 
According to publicly available data from CBP, CBP Office Field 
of Operation and Border Patrol seized over 241,000 pounds of 
cocaine nationwide during fiscal years 2020 and 2022. 
Approximately 52 percent of that cocaine seizures were carried 
out by the San Juan Field Office and the Ramey Border Patrol 
sector in Puerto Rico and the U.S. Virgin Islands. This is 
almost 127,000 pounds of cocaine, and this should not be seen 
as a local or regional problem. According to law enforcement 
agencies, approximately 75 to 80 percent of the drugs coming 
into Puerto Rico from Colombia, Venezuela are then smuggled 
onwards to the continental U.S., specifically the Eastern coast 
of the United States, and that is why a strong border security 
presence and a counter-narcotic strategy focused on the 
Caribbean is a critical for the entire Nation, and that is the 
reason my bill will ensure we achieve this.
    In addition, to codify in the requirement for the Caribbean 
Border Counternarcotics Strategy, this bill will also amend the 
definition of ``supply reduction'' in ONDCP authorization to 
ensure the National Drug Control Strategy explicitly includes 
effort to disrupt the financial networks of drug trafficking 
organizations. And to effectively combat these criminals, it is 
essential that we hit them where it will hurt them the most, 
their wallets. So, I want to thank Chairman Comer for having me 
today here. What is your comments on this bill, Dr. Gupta, or 
the efforts to support counter drug operations in Puerto Rico?
    Dr. Gupta. Thank you, Congresswoman. We would love to work 
with you on the bill. It is critical. As you mentioned, Agent 
Macera, the three agents of Custom Border Protection, which is 
unusual to have them be fired upon in the high seas in November 
of last year, was really important. We were so saddened to see 
his demise. We actually brought his colleagues to the White 
House recently to award him with the U.S. Interdiction 
Coordinator National Award from the White House for that 
courageous work where he gave the ultimate sacrifice of his 
life. So, thank you for bringing that up, and we would love to 
work with your office on that.
    Mrs. Gonzalez-Colon. Thank you. Mr. Chairman, I yield back.
    Chairman Comer. [Presiding.] The gentlelady from Puerto 
Rico yields back. The Chair now recognizes Ms. Greene from 
Georgia for 5 minutes.
    Ms. Greene. Thank you, Mr. Chairman. Thank you for being 
here today, Dr. Gupta.
    I want to talk to you about my district in Georgia. It is 
located in the Northwestern part of our state where fentanyl is 
a very serious, serious issue. From 2019 to 2022, fentanyl-
involved deaths increased in our state by over 230 percent. 
This is significant, it is alarming, but it is also deadly. 
People are dying almost daily. In counties throughout my 
district, in the 14th District, from 2019 through 2022, 
fentanyl-involved deaths increased by over 350 percent. That is 
in my district. The Northwestern part of Georgia is nowhere 
near the border of our country.
    Fentanyl deaths in my district, here are some examples. 
There were three deaths in Walker County in February of this 
year, 37-year-old, 55-year-old, and 70-year-old, so it spans 
all ages. A 16-year-old girl in Whitfield County, who had never 
taken any illegal substance in her life, took a Xanax that she 
thought was going to help her with anxiety. Within 5 minutes, 
she was dead. In 2021, Catoosa County had nine fentanyl 
overdose deaths. In January of this year alone, it is suspected 
that fentanyl is responsible for eight overdose deaths. In 
November 2020, Corporal Christopher Jackson Dye, a Walker 
County sheriff's deputy, died after being exposed to fentanyl 
during an arrest.
    Fentanyl does not discriminate. It does not care about our 
skin color, it does not care about our age, does not care about 
our gender, does not care about our religion. It is a poison, 
and it is killing people, and it is extremely concerning. With 
approximately 300 Americans dying from drug overdoses each 
year, Fentanyl is flowing into the country at record levels. As 
a matter of fact, the local law enforcement in my district 
blame the border policies of this Administration for the 
fentanyl deaths in the increase of 350 percent.
    Your office is charged with coordinating the budgets of 
agencies to carry out National Drug Control Policy, but while 
the drug crisis in this country soars out of control, the Biden 
Administration is busy sending crack pipes, syringes, and safe 
sex kits to drug addicts in the name of harm reduction. There 
has not been any harm reduction.
    Dr. Gupta, people are dying every day, but are these so-
called harm reduction strategies really the most effective way 
of dealing with the drug crisis in America? Wouldn't it be 
easier to deal with the drug addiction and drug overdose if 
there were fewer drugs in our country?
    Dr. Gupta. Thank you, Congresswoman. Clearly, there were 
fewer drugs that would help, but at the same time we got to 
deal with a crisis we have at hand. I understand the plight of 
rural America coming from West Virginia every single day. I 
have treated patients. I know the pain. I know the suffering. I 
have seen people die in my arms. What we are trying to do right 
now is to meet people where they are. Somebody is overdosing, 
they need naloxone or Narcan. I, as a doctor, as you know this, 
cannot treat dead people.
    So, first thing we got to do is keep people alive. We also 
have to get them into treatment and go after the bad guys and 
their trafficking profits. And this is the reason that the 
President is committed to making sure we have technology at the 
border that detect every bit of fentanyl that is coming 
through. That is a commitment and top priority of the 
President.
    Ms. Greene. But, Dr. Gupta, if I may? This Administration 
and Democrats proved to us they believe in walls because they 
erected one around the Capitol when they felt threatened after 
January 6. A wall at the Southern border would stop drugs from 
flowing in. That is the fact. Walls work. We know they work. We 
lock our doors and windows at night inside when we go inside 
our homes. We protect our children with locked doors and walls. 
They work. A wall would be the best way to stop drugs from 
coming in and reduce the amount of drugs. I think that would be 
the wisest way to go, don't you?
    Dr. Gupta. Congresswoman, thank you. I went down there 
several times. The last time I saw, I saw gaps in the border 
barrier system----
    Ms. Greene. But the Biden Administration has stopped 
construction. There are gaping holes. There are broken fences. 
There are portions that do not work because the Biden 
Administration has stopped construction and stopped funding.
    Dr. Gupta. There are 68 that had been already fixed, and 
there are 62 more on the way to be fixed. We still have tunnels 
to deal with. We have drones to deal with. So, I think what we 
can do coming together on this is to build the best barrier 
protections possible. That includes those barriers.
    Ms. Greene. Yes. Thank you, Dr. Gupta. I agree. One last 
question because our time is short. I read in the news the 
Biden Admin is funding crack pipe distribution to advance 
racial equality. Is that a practice you agree? I am not sure 
how crack pipes advance racial equality? As a matter of fact, I 
will go ahead and say it for the record, I believe we are all 
equal, and I think crack pipes are probably leading to 
furthering the drug problem, not helping it.
    Dr. Gupta. I can commit to you that no Federal funding is 
going to what you have mentioned. But I will say that naloxone, 
and ability for people to check for fentanyl in drug supply so 
they cannot take it, and syringe service programs are critical 
and they are lifesaving, and that is why we are doing it.
    Ms. Greene. Thank you, Dr. Gupta. I yield back, Mr. 
Chairman.
    Chairman Comer. The gentlelady yields back. Now I will ask 
my questions for 5 minutes. So, Director Gupta, when we 
recently met in my office, discussed the issue of fentanyl 
overdose deaths, you spoke about your mission and sense of 
urgency. Would you agree that illicit fentanyl is one of the 
most urgent crises facing our Nation, especially considering 
that majority of the overdose deaths in the United States are 
happening due to fentanyl?
    Dr. Gupta. Yes, Mr. Chairman, and that is exactly the way 
we are approaching this.
    Chairman Comer. You are familiar with the supply chain of 
illicit fentanyl entering the U.S. markets, correct? You 
mentioned that.
    Dr. Gupta. Yes.
    Chairman Comer. Do you concur with DEA's assessment that 
virtually all the deadly fentanyl found in the United States is 
mass produced by transnational criminal organizations operating 
in Mexico using China sourced precursor chemicals, and then 
trafficked across the border?
    Dr. Gupta. Borders.
    Chairman Comer. It is being smuggled in both at ports of 
entry and in between ports of entry. So, can you describe for 
me and for my constituents in Kentucky, who will be watching 
this clip, what efforts Office of National Drug Control Policy 
has directed to increase the ability of law enforcement 
personnel at the border to identify and seize as much of the 
fentanyl as possible?
    Dr. Gupta. Thank you, Mr. Chairman. We have significantly 
increased the ability of law enforcement to be able to do that. 
We have some of the highest numbers of law enforcement 
officials, including Custom and Border Protection, on the 
border to make sure, and we are investing in technology that is 
known to detect fentanyl. When we have so much traffic back-
and-forth understanding, we want to be able to detect every 
vehicle that we need to detect with fentanyl, and the 
President's proposed budget is $500 million dollars. It 
includes $300 million for technology to be able to do just 
that.
    Chairman Comer. So, we have heard that the historic levels 
of illegal border crossings in the last few years has had an 
impact on the ability of Customs and Border Protection 
personnel with respect to the fentanyl crisis by diverting 
manpower and resources, and in some cases even temporarily 
shutting down interior checkpoints operated by U.S. Border 
Patrol that frequently encounter narcotics loads that made it 
past Customs and Border Patrol at the ports. So, what has 
Office of National Drug Control Policy been doing to coordinate 
with border and immigration officials to ensure that they are 
able to respond to narcotics smuggling across the border?
    Dr. Gupta. Thank you, Mr. Chairman. We are proposing and 
providing them more resources than ever before. We are making 
sure that they have what they need to protect, safeguard when 
we talk about drugs coming in----
    Chairman Comer. But they tell us they do not have what they 
need. When we talk to them and there are not any of their 
superiors around, they tell us they do not have what they need?
    Dr. Gupta. I will give you, Mr. Chairman, an example. I was 
down at the Arizona border. I talked to them same way when 
there were no superiors there. I asked them. I saw a gaping in 
the barriers, and I said why isn't this fixed. It needs to come 
through us, and we want to make sure that this gets 
prioritized. So, we are listening to the folks on the ground 
what they need. We are proud of the work they are doing, and we 
want to provide support them in an urgent way.
    Chairman Comer. So, does Office of National Drug Control 
Policy has the ability to direct agencies' funds in some cases?
    Dr. Gupta. It is there, but it is inconsistent, Mr. 
Chairman.
    Chairman Comer. So, what authorities do you have as 
director to certify or direct agencies' funding toward fighting 
the overdose crisis?
    Dr. Gupta. Mr. Chairman, we have something called the fund 
control notice, and that allows us to direct drug control 
spending on particular projects or activities to ensure that 
agencies are appropriately implementing those policies, but 
that is not consistent across.
    Chairman Comer. Do you have the authority over the 
Department of Justice or its component agencies?
    Dr. Gupta. I think that one, based on an almost 30-year-old 
appropriations piece, we do not have that.
    Chairman Comer. That is a problem. That is not your fault. 
So that would include the DEA, the Drug Enforcement 
Administration, correct? You do not have authority over DEA?
    Dr. Gupta. We have inconsistent authority across the 19 
drug budget control agencies, of course.
    Chairman Comer. So how has that affected your ability to 
respond to the opioid crisis?
    Dr. Gupta. Well, I will give you an example. During the 
Bush Administration, ONDCP frequently issued this fund control 
notice to each of the agencies, restricting a portion of their 
available budget authority until they submitted a financial 
plan for the Director for approval. That ability exists for 
most agencies, but does not exist for every Agency.
    Chairman Comer. So, my last question, I assume you would 
agree that criminal prosecutions of individuals involved in the 
illicit fentanyl trade are important at disrupting the supply 
chains, correct?
    Dr. Gupta. Yes.
    Chairman Comer. Don't you think it would be a better use of 
Department of Justice's prosecutorial efforts, instead of 
retaliating against whistleblowers or investigating parents at 
school board meetings, to coordinate with you and go after the 
individuals who are poisoning the American people?
    Dr. Gupta. Mr. Chairman, we work very closely with the 
Department of Justice and other 18 Federal drug control 
agencies. I could tell you they are very fully committed to 
going after both sanctioning and after prosecution of the 
cartel members and their enablers.
    Chairman Comer. Well, we could debate that all day long, 
but again, I appreciate you being here, and that concludes our 
questioning portion. I am going to now yield to Ranking Member 
Raskin for closing remarks he would like to give.
    Mr. Raskin. Mr. Chairman, thank you for a very good hearing 
today. I want to start by introducing for the record a letter 
from the United States Conference of Mayors, expressing their 
strong support for Reauthorization of the Office of National 
Drug Control Policy.
    Chairman Comer. Without objection, so ordered.
    Mr. Raskin. Thank you, Mr. Chairman. The fentanyl and 
opioid crisis is a nightmare for America, for our communities, 
and for our families. Every Member of this Committee has lost 
young constituents in this public health and public safety 
catastrophe. We hope and we pray that we will never have to 
call another family in our districts to send our sympathy and 
our love. In Maryland, last year, there were more than 2,500 
overdoses in the state total, more than 2,000 of them coming 
from fentanyl alone.
    Mr. Chairman, I just want to make a couple of points in 
closing to this significant hearing. As Dr. Gupta has 
explained, there has been this massive increase and 
unprecedented investment in new technologies for the CBP and 
for the DEA to crackdown specifically, on the importation of 
illicit fentanyl into the country.
    In 2022, the High Intensity Drug Trafficking Areas program 
led to the seizure of $22 billion in illicit drugs and in cash, 
which actually meant that it yielded $82 to our law enforcement 
agencies for every dollar that was spent in taxpayer money in 
the program. In the same year, the DEA seized a historic 
260,000 pounds of illicit drugs, including 15,000 pounds of 
illicit fentanyl. So, we are seeing huge increases in the 
number of drugs being stopped at the border.
    And the only real dispute I heard today was whether or not 
that was a sign of progress or a sign of failure. Some of our 
colleagues were claiming that that was a sign of failure that 
there was this massive increase in the drugs being interdicted. 
But I was persuaded very much by Dr. Gupta's testimony that 
this is as a product of the massive new influx of technology 
catching the drugs that are coming over, so it is a major 
success in interdiction.
    Now, that does not necessarily represent overall success in 
drug control, which involves not just interdiction, but also 
public health measures, combating of addiction, and so on. So, 
it was just a non-sequitur when some of our colleagues were 
saying, well, yes, there is this huge increase in interdiction, 
but why are all these people dying, and there is an increase in 
many communities and people dying. Well, it is because of a 
potentially increased use, but also the infiltration of 
dangerous drugs in other kinds of drugs that people are taking, 
for example, anti-anxiety medicine and so on. But that, to me, 
underscores the importance of doing an investment in public 
health and getting our people off of these drugs.
    My distinguished colleague from Georgia said, well, just 
build the wall. Of course, there was a promise in last 
administration that Mexico would pay for a wall. We are still 
waiting for that to happen. But my colleagues said, well, we 
build walls and fences around our houses and that works. It 
does not work if people are voluntarily bringing drugs into 
your home, and we cannot deny the demand side of this equation. 
I salute the Administration's work on reducing the supply 
coming in with all of these great new technologies. But as long 
as the demand is there, we are going to have a very serious 
problem in America. So, we need to address the demand side as 
well, and I am happy to know, Dr. Gupta, that you are equally 
invested in reducing the supply and the demand.
    Now, the other point I want to make, Mr. Chairman, that 
came up today and I think most recently from our distinguished 
colleague from Texas, Mr. Sessions, where he said, well, it is 
easy enough to blame China, but what is the role we are playing 
in contributing to this, and I appreciated his saying that we 
do not want to just blame everything on China and then just go 
home. On the other hand, it is very important. I agreed with 
Mr. Edwards from North Carolina saying we should be doing 
whatever we can do to try to get China to crack down on the 
supply of these chemicals to the Mexican narco traffickers, the 
drug traffickers in Mexico, even if they are legal. He was 
saying, even if these are legal chemicals, it is important to 
crack down if they know what it is going to be used for.
    And the exact same point applies to the trafficking of 
firearms from America to buyers, who know they are going to be 
dealing to the Mexican fentanyl dealers and when the gun 
dealers in America and the gun manufacturers in America 
understand precisely where those guns are going. At least 70 
percent of the firearms that are being used by the fentanyl 
traffickers in Mexico come from the United States, and some 
estimates are as high as 90 percent are coming from the United 
States. And so, the recipe seems to be for these drug 
traffickers and gun traffickers is guns down from the U.S. to 
Mexico, drugs back from Mexico into the U.S. Those are the two 
sides of the coin.
    And so, Mr. Chairman, I think we have got to address the 
problem, that it is American gun dealers and manufacturers who 
are supplying Mexican fentanyl and opioid dealers with the guns 
that they need to operate with impunity in complete lawlessness 
in Mexico, and they are responsible for the deaths of tens of 
thousands of people in Mexico and upwards of a hundred thousand 
disappeared people in Mexico. So, if we are going to take the 
problem seriously, let us take our own investment in the 
problem seriously, as Mr. Sessions was saying, because it is 
American guns that are making it possible for Mexican drug 
traffickers to operate in such a lawless way.
    But I am pleased that we are making bipartisan progress on 
this. I am pleased at the interdiction efforts that are taking 
place. We need to accelerate our investment in the public 
health measures to get our people off of these deadly drugs and 
to see dramatic reductions in the number of people, who are 
overdosing in our country.
    With that, I thank you for your leadership on this. Mr. 
Chairman, I yield back to you.
    Chairman Comer. The gentleman yields back. I now recognize 
myself for a closing statement.
    Again, I would like to thank you, Director Gupta, for 
appearing before the Committee today. Fighting this crisis is 
an urgent battle and it is essential that we conduct rigorous 
oversight over the government's efforts to stem the tide of 
drug overdose deaths. The drug overdose crisis is one of the 
most urgent issues our Nation faces. And as Director Gupta 
informed us, emerging threats, like xylazine, continue to make 
the situation even more dire. I agree with how Director Gupta 
framed this issue as not just an issue of public health, but a 
national security crisis as well. Getting the border crisis 
under control is an essential component of this issue, but I 
agree with my Democratic colleagues that the border is only 
part of the story.
    We know that foreign bad actors, like the Chinese Communist 
Party, are taking actions to hurt our Nation through the 
fentanyl trade. We know that because China is the source 
country for the precursor chemicals, that are making fentanyl 
in secret labs in Mexico. We know that China is involved in 
illicit financing and money laundering operations, and we know 
that the Chinese Communist Party refuses to cooperate with our 
efforts to reduce the illicit supply of these deadly narcotics. 
And we know that transnational criminal organizations in Mexico 
operate labs to manufacture these deadly poisons and exploit 
every advantage presented by the crisis on the border to 
smuggle these drugs into our communities. So, I look forward to 
continue working with Director Gupta's office as we look toward 
Reauthorization of the Office of National Drug Control Policy, 
and continue to fine tune efforts to begin to get this crisis 
under control.
    With that, and without objection, Members will have 5 
legislative days in which to submit additional materials for 
the record or questions for the witness.
    Chairman Comer. The Committee stands adjourned.
    [Whereupon, at 1:15 p.m., the Committee was adjourned.]

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