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CNN Live Event/Special

Cooper: Fentanyl Is A Destroyer, Of Our Children, And Our Families; Erin Rachwal: There's A Stigma Attached With A Drug-Death; DEA Administrator On The Fentanyl Crisis. Aired 9-10:17p ET

Aired March 07, 2023 - 21:00   ET




We're looking tonight, at a drug, invented in 1959, and first approved in 1968 that went from a mainstay, in hospital settings, and a godsend, to people, with severe chronic pain, to an illegally-produced synthetic killer, of Americans.

Many of them young people, who were not hardcore drug users, not addicted, but handed a pill they thought was a Xanax, or a Percocet, at a party, or by a friend. One pill that may have only had a tiny amount of fentanyl, the size of a pencil tip, but it was enough to kill them. Fentanyl is a destroyer, of our children, and our families.

I want you, at home, to take a look, for a moment, around the room that we're in, right now, tonight. Every one of our guests and all of our studio audience has, in some way, been touched, by this crisis.

And again, we want to make it clear, that doesn't just mean by addiction. Accidental poisoning by fentanyl is a major, major problem as well.

According to the Centers for Disease Control, more than 70,000 people, in this country died, in 2021, from fentanyl, and other synthetic opioids. 70,000 Americans, a year, up from nearly none, just 20 years ago.

One reason why, take a look at these two vials, in one, a lethal dose of heroin. In the other, so little, you can barely see it, is a lethal dose of fentanyl. It is cheap to make. It's easy to smuggle, simple to mix into other drugs.

And though and no fentanyl abuse and deaths are a nationwide problem, some states are especially hard-hit. The darkest colors on the map represent the greatest number of deaths per 100,000 with ground-zero being Appalachian, West Virginia, in particular. And we'll talk to a medical professional, from there, tonight, as well.

And throughout the hour, we'll be talking about ways of addressing this deadly public health crisis. One is the helpline you see there, from the Federal Government's Substance Abuse and Mental Health Services Administration, 1800-662-HELP, that's 1800-662-HELP, someone to talk to, a resource to draw on perhaps, it's certainly not the only one.

So tonight, we'll talk about the government response, with Anne Milgram, who heads the Drug Enforcement Administration; also Senator Lindsey Graham; and a public health specialist handling cases up close.

But again, just about everyone, here with me, tonight, has been affected by the crisis, in their own ways. And those stories, we hope, will be at the heart of the hour, ahead.

With me here tonight is Erin Rachwal. Two years ago, her son Logan died. He was a college freshman. She's here, also with her son Caden, who joins us.

Also, April and Owen Martin are with us. Their 21-year-old son, Jordan, died, the day after Father's Day, almost three years ago.

And in the audience is Rick Rachwal, Logan's dad, and Jada Martin as well, Jordan's sister.

Thank you all. Thank you for being with us.


COOPER: I really appreciate it.


COOPER: If we could just start by, when you got the call about Jordan, did you -- you're a police officer. You work at a small university. You had heard about fentanyl. But did you know it could be in pills? Did you -- when you got that call, did you know what happened to your son?

APRIL MARTIN, SON DIED FROM FENTANYL POISONING, LIVELIKEJORDAN.COM: No, at the time, we didn't -- we didn't know what happened to him, exactly. There was -- he was with his girlfriend. And she did tell us that he took a pill.

COOPER: They went to a friend's house, who sold him a pill that--


COOPER: --he thought was a Percocet?

A. MARTIN: Yes. She said they took a Percocet. And we went to the house. And he was there, and the medics were working on him.

COOPER: You went there immediately when she called you?

A. MARTIN: Yes. She had called. And the guy, who was at the house wasn't letting her call the ambulance. So, it delayed it a little bit because--

COOPER: He would not let them call an ambulance? A. MARTIN: No, she was, like my husband heard him in the background, yelling and telling her to hang up the phone, and not to call anybody.

COOPER: He turned out to be a dealer?

A. MARTIN: Yes. And we went to the house, and the medics were there working on Jordan. And there was a -- there was a police officer there that I knew. And whenever I saw Owen (ph), he asked me, "Was that my son?" And I said, "Yes," and I could tell by his face that it wasn't -- it wasn't good.

COOPER: It's remarkable to me that the person who gave that pill to your son, you didn't know who he was. But you got a call a little bit later on that month from another parent. What did that parent tell you?

O. MARTIN: They informed us that a month before my son passing that the same person sold their son, a pill, and cost their son's life also.

COOPER: At the same house?

O. MARTIN: It wasn't at the same location, but it came from the same person. It wasn't at that the building that my son was in. No, it wasn't.

COOPER: And that person, the drug dealer, who sold the pill, to your son, and to Nathan, who's the other young man, who got killed, he was arrested. What sentence did he get for selling two pills that killed two people?

O. MARTIN: Well, for my son, he got four to nine -- I'm sorry -- four to 10 for my son. And then, for Nathan, he got four to nine. But they're letting him run it together. So, he could be out in four years.

COOPER: And he admitted that he knew it was fentanyl that he was selling?

O. MARTIN: He knew.

COOPER: After Nathan died. So, he knew the pill he was giving to your child was fentanyl?

O. MARTIN: Yes. He admitted it in the courtroom, to the judge, and every -- and a prosecutor.

COOPER: Erin, tell me about Logan.

E. RACHWAL: Yes. Thank you for having us.


So, Logan was -- he was a good kid. He was a vulnerable kid. He was very sensitive. I described him as kind of that sensitive kid, who would come home from school, or just, he got made fun of, or he'd be bullied a little bit. So, he was vulnerable.

Him and Caden were very close. As they were younger, we did a lot of things, with the family. I would just -- I like to kind of use the example of where we're the kind of the Classic American family, not perfect. No family is perfect. But we did things with our kids. Fentanyl was not in our toolkit, so that--

COOPER: You hadn't really heard of it?

E. RACHWAL: I mean, I had heard of fentanyl, like, as we started, through the years, wrestle with some things with Logan, just he did struggle, definitely, with some mental health, anxiety, depression issues. And we're really open about that. I think that there's so many families, out there, who have kids, struggling. I mean, after COVID, the crisis, the phones, the social media?


E. RACHWAL: All that stuff. So yes, absolutely did he struggle, for sure. But fentanyl, it was something I had heard of, but not something I would have ever thought would have killed our child, ever.

COOPER: The pill he took, he was on a FaceTime call, with his girlfriend, when he had actually took the pill. She actually saw him.

E. RACHWAL: Yes, correct.

COOPER: Did she know about fentanyl?

E. RACHWAL: She did not know. She saw him take something. She knew he was distraught. They were arguing that night. It was the early morning of Valentine's Day.

And so, she knew things, but didn't put them all together, in terms of those were all signs of an opioid, body shutting down, which is one of the reasons what, triggered us to really start speaking out, because these kids have to know what to look for. This is not going away, and we have to do something.

COOPER: Caden, how much younger were you from Logan?


COOPER: 14 months?


COOPER: And you're in college now?

C. RACHWAL: Yes, I am.

COOPER: How are you doing, I mean?

C. RACHWAL: With everything that's happened with Logan, I mean, obviously, it's been a struggle, to go to school, and still try to carry on a normal life. Because after something like this happens, nothing ever is the same.


C. RACHWAL: Especially with how close Logan and I were as kids. At times, he was my only friend. So, that makes it pretty hard.

COOPER: Do you see -- I mean, is there a lot, on campus, is there a lot of knowledge about fentanyl?

C. RACHWAL: Not really. Recently, though -- I go to Grand Canyon University. They have been putting up some signs that I noticed about fentanyl. And I actually just noticed them, a few days ago. But other than that, there's not much knowledge that I know about. I try to tell my roommates, my friends and everyone that I do keep Narcan with me, like I usually carry it on me at almost all times.

COOPER: You do? You carry it with you now?

C. RACHWAL: Yes, yes.

COOPER: Do all of you do that?




COOPER: Narcan, can you tell people what Narcan is, for those who don't know?

A. MARTIN: It stops the effects of opioids.

COOPER: Police officers, EMTs now have it. And that's -- there's a big push, to try to get Naloxone, and Narcan, in as many places as possible. That's something you all support?

E. RACHWAL: Absolutely.



E. RACHWAL: Absolutely.

COOPER: I mean, what do you want to see change? And what do you think how -- what can be done?

A. MARTIN: I mean, awareness, because I think a lot of it is that people just don't know, they don't understand that it's -- the fentanyl is in everything. And then, a lot of people don't understand what to look for, when people were, having those effects of fentanyl. So, I think, it's just awareness, letting people like, just getting the word out about it.

COOPER: The ease with which -- I'm sorry. What were you going to say? E. RACHWAL: No, I was just going to, to piggyback off of what April said, a couple things that are really important, right now, is that, there's a stigma attached with a drug death. There's always been.

And so, but we're not in, 20 years ago, where some of these kids are not going to the 30-years-old, 40-years-old, with strong addictions. And even then, there shouldn't be a stigma with it. I mean, these people are struggling. It's a disease.

But there needs to be a very distinguished difference between poisoning and overdose.

Overdose is when you take too much of something, and you know, you took too much of something, and then something happens. Sometimes, people don't die from that.

Poisoning is different. It's like, I like to explain like if I put something, in someone's drink, and they die from it, that's a poisoning. They didn't know they took, what they took. And that's a very big thing, I want our country, to embrace, all around.


And the fact that it's not a red, white and blue issue, like this is a bipartisan issue, it is so important. That's why this is so important. You know that everybody embraces, this is a crisis. We're losing kids every, you know, every -- well Americans, every eight minutes, right now.

COOPER: How -- what is -- what do you think can be done? What would you like to see?

O. MARTIN: Tougher laws, more prosecution, on the dealers.

COOPER: Four and a half years is for you?

O. MARTIN: I feel like it's a slap on the wrist for him. I feel it like it's a smack in my face every day that that's what he got for taking my son's life.

COOPER: Caden, was fentanyl something you had known about? I mean, obviously, your brother had some struggles, with substances. But was that on your radar?

C. RACHWAL: No, not at all. Not -- never had heard about it, before my brother passed away.

COOPER: It's interesting to me that, at colleges now that it's not so widely discussed, because, college people think, "Oh, they know a drug dealer, and oh they trust this person. This person is giving you a pill. It's a Xanax. It's a Percocet," when in fact, they have no idea what this pill -- what this pill is.

The dealer, from what I understand, who killed your son said that this was from his own personal prescription. Is that right? O. MARTIN: Yes, he said it was from -- is his own personal prescription. He also said he was my son's friend, which I -- he's not my son's friend, because all of my children's friends, we have met. Majority of my kids' friends come to our house, eat dinner, stay the night. I never met this kid.


O. MARTIN: Didn't know what he looked like until that day.

COOPER: What was Jordan like?


COOPER: Your eyes light up, when you -- even when you think about him!

A. MARTIN: I mean, he was -- he was a typical kid. He was an athlete. He was an entrepreneur. He was -- he had the biggest smile.

COOPER: Wait. I don't know many typical kids, who were athletes and entrepreneurs, I got to say!

You guys were going to a business flipping houses together?

O. MARTIN: Yes. At the time of his death, Jordan worked at Amazon. He had a gutter-cleaning business. We wanted to start flipping houses. And he was planning for a future. He wanted to -- he came to me, he said that, "Six months from now, I want to get engaged." He planned on asking his girlfriend, to marry him, a year from now, he said he wanted to have his own house. So, I mean, he was planning for the future. And it just it hurts every day.

COOPER: What was Logan like?

E. RACHWAL: I mean, Logan loved baseball. He was a big baseball player. He loved our cats. He loved magic tricks. He was -- I would definitely describe him, as like the funny kid in the family. He loved his brother, for sure. They were very close, in age, when they were little. People would think they were twins.

COOPER: He's Logan (ph)?

E. RACHWAL: Yes, yes. Probably me dressing them alike did that (ph).

COOPER: Uh-oh!

E. RACHWAL: But I -- the biggest -- one of the other biggest things I guess I'd like to mention that is the brother part, because the siblings are grieving. And that is something that is so critical to me. These kids get attention. They're forgotten. And so for you, to have kids here, and Caden here, it's, that's critical. There's just a very big absence in that.


E. RACHWAL: And so, this is a life-changing, as you know, life- changing thing, to lose a sibling. So, that is a huge part of, you know?

COOPER: It's so interesting you say that, because people don't really talk about that. And my brother died by suicide, when he was 23--

E. RACHWAL: Right.

COOPER: --and I was 21. And I think about you, Caden, going to school. My senior year was a blur. I mean, I don't remember, you know? So, yes.

I'm so sorry for your losses. And I appreciate you talking with us, tonight. And I hope it helps. I hope it helps people out there to at least know about the dangers, and some parent out there, or some child out there, will see this, and think twice before somebody hands them something and they take it. So, thank you.

E. RACHWAL: Thank you.

O. MARTIN: Thank you.

COOPER: Right now, a closer look at how fentanyl, and products laced with it, actually get into this country, starting in China, by way of Mexico.

CNN's David Culver joins us now from San Ysidro crossing, on the California side of the border.

So, why is it like that location's -- why is that location, where you're at, so important, in the fight against fentanyl?

DAVID CULVER, CNN CORRESPONDENT: I think it's rooted, Anderson, in the stories that you just heard there. I mean, this is incredibly personal, and devastating for so many. And it's increasingly becoming a reality, for so many. And it starts with stopping fentanyl.

And for law enforcement, borders like this one and, really, across the San Diego area, it is crucial. They're seeing this major influx in fact, out of all the fentanyl that's seized, across this country, at U.S. borders, within half are seized in the San Diego area. So, it is significant here. And border crossings, like this one, are continuing to see that pressure.


But they're also saying, and this is coming from U.S. officials that I've been speaking with, it's not just the U.S. law enforcement that has to do something here. China plays a role in this, because that's where the chemical ingredients come from, as does Mexico, because that's where the cartel members, are cooking this all up.

And so, it brought us to question the Mexican law enforcement, and the military, there, in particular. And they say, despite allegations of corruption, and that they're not doing enough, that they are doing something. So, said, "Show us," and here's where they took us.

(BEGIN VIDEOTAPE) CULVER (voice-over): Culiacan, in the state of Sinaloa, Cartel country, as some see it.


CULVER (voice-over): Here, the Mexican army is on the hunt for drug labs.

With 50 soldiers, and in a convoy of six armored vehicles, we travel out of Culiacan, into a rural and mountainous landscape.

U.S. officials estimate fentanyl makes Mexico's criminal organizations, billions of dollars, each year. The cartels, determined to eliminate anyone or anything that might threaten their profit.

Colonel Alfredo Gonzalez Cuevas (ph), our guide.



CULVER (voice-over): Taking us to the scene of their latest fentanyl bust.

CULVER (on camera): They're securing the perimeter, right now.

CULVER (voice-over): Days earlier, he says cartel members opened fire, on him, and his soldiers.


CULVER (on camera): He said they started shooting at them, hitting their vehicles. And then, the four guys started running.

CULVER (voice-over): The Army's Intel led them to this unassuming home.

In a quiet, family-friendly neighborhood.

CULVER (on camera): That white building, right there, that's the fentanyl lab.

CULVER (voice-over): The Army says they seized 270,000 pills here, all containing fentanyl.


CULVER (on camera): He said, they had all sorts of machines to make the pills.

CULVER (voice-over): In his nearly 35 years, in the Army, working to dismantle drug operations, the Colonel tells me fentanyl has been far more devastating, and difficult to control than cocaine, heroin and meth.

They test substances, to know what exactly they're seizing. CULVER (on camera): So, it shows it here. It's a breakdown of what the chemical is, and what makes it up. And then they even (ph) has here listed the HAZMAT component to it.

CULVER (voice-over): Crucial in understanding how fentanyl is made is knowing where the chemicals are sourced.

CULVER (on camera): A lot of them, he says, come from the port, which came in from Asia. Higher-ranking military officials have told us most of them come from China.

CULVER (voice-over): China's vast chemical industry is where experts say many of the ingredients, to manufacture fentanyl, known as precursors, are sourced.

And with worsening U.S.-China relations, working with Chinese officials, to stop the flow? Increasingly challenging.

MATTHEW DONAHUE, DEA CHIEF OF FOREIGN OPERATIONS, 2019-2022: With China, it's extremely difficult, because you don't get information, from them. You don't get cooperation from them.

CULVER (voice-over): Matt Donahue, worked for the DEA, for more than three decades, retiring last year, as its Deputy Chief of Foreign Operations.

DONAHUE: Mexico is intentionally making these drugs, known to killing Americans, and it's still shipping them up there, without putting anyone in jail, without seizing any properties, or going after all their drug assets.

CULVER (voice-over): High-ranking Mexican officials adamantly push back on that claim. Instead, they point to the U.S., to do more, on its soil, a sentiment echoed by China.

On Monday, the Foreign Ministry, responding to our questions, saying in part, "The accusation by some people from the U.S. that China is 'Not further controlling the export of fentanyl precursors because of geopolitical influence' is a desecration of the spirit of the rule of law and is completely groundless," adding "Using China as a scapegoat will not solve the drug crisis in the United States."

Back in Culiacan, the Army keeps a presence at these busted labs, 24/7, preserving the scenes, for prosecutors, and preventing cartel members, from restarting production.

They also conduct random inspections, at package facilities, around Culiacan, searching for fentanyl, and the precursor chemicals needed to make it, even setting up checkpoints, working to prevent the distribution of drugs, made here.


CULVER (on camera): Wow! He said, in one of the searches, for example, it's not uncommon to find that fentanyl, or other drugs, will be stashed, in places like the car wheel, or within the car, but even in the gas tank.

DONAHUE: Fentanyl, it's sad, it's dirt-cheap. You can take a life, for probably $0.05, $0.10, what cost them to make a pill that they're charging $15 for. What's a human life worth now?

CULVER (voice-over): Just days after our visit, Mexican army officials sent us this video. From the back room, of this small home, they seized 600,000 fentanyl pills. Countless lives potentially saved.

But the cartel-fueled production is seemingly endless, and so too the devastation that awaits.



COOPER: So David, at San Ysidro, where you're at, I assume, what, it's coming mostly through, in trucks, in vehicles? Or is it people bringing across, as they cross, illegally, either that border point, or at others?

CULVER: It's interesting to realize that this is actually happening using American citizens. Officials have told us both in Mexico and here in the U.S. that some American citizens have been among those, who are driving across, just like you see that -- the backlog here, and bringing with them, hidden in their vehicles, fentanyl pills.

And it's something that is increasingly challenging, for U.S. officials. But at the same time, they're making some progress.

I'm going to show you this, actually, this tweet, if we can put it up on the screen.


CULVER: This was just in the past week, Anderson. And what you're looking at, in this image is 232 pounds of fentanyl, estimated to be about $3 million worth that were seized last week. And they arrested three people in connection with that. But the potential deaths from that are estimated to be around 50 million people. I mean, so that shows you what a small amount has the potential to do, and how devastating this is.

So, how do you stop it? I put that question to now officials in Mexico, and here in the U.S. And ultimately, it comes down to international cooperation. This is far bigger than just the U.S. This has to involve Mexican law enforcement, as well as officials in China.

But, to get that level of cooperation, as of now, Anderson, seems next to impossible.

COOPER: Right. China's not cooperating now, on the precursor chemicals.

David Culver, appreciate it. A little less than a year ago, the Drug Enforcement Administration created an exhibit, at its Arlington, Virginia headquarters. It's called "The Faces of Fentanyl." The Agency invited families of fentanyl victims, to send photos. So far, they've received more than 5,000.

DEA Administrator, Anne Milgram, joins us now.

David goes out on a raid, with Mexican military. Clearly, they're trying to do something. But, I mean, the problem -- the problem is in many places. But Mexico, that's where the cartels, they're the ones making the money off this. They're the ones getting this in here, aren't they?

ANNE MILGRAM, DEA ADMINISTRATOR: So first, thank you for having me. And if I could, I wanted to address, before I started, the tragedy that's been unfolding, in Mexico, today, and over the last few days and just say that--

COOPER: Four American citizens were kidnapped by cartel.


COOPER: Two of them were killed. Two of them are still lost.

MILGRAM: Yes. DEA is actively working with our law enforcement partners, and we will continue to do everything we can, as part of that investigation.

Last year, in 2022, DEA seized 57 million fake fentanyl pills, in every single state, in the United States. We seized more than 13,000 pounds of fentanyl, for a total that equals about 410 potentially deadly doses. It is a level of devastation, and that is almost hard for us to quantify.

So, we're seeing this, and it's playing out, in the unspeakable tragedies, every single day, across our country. It starts in China with the precursor chemicals that are coming from these Chinese chemical companies.

COOPER: But even if you're able to stop in China, India is already starting to make some precursor chemicals, aren't they also?

MILGRAM: So, the second -- the second country that we think about is India. But predominantly, right now--

COOPER: It's China.

MILGRAM: --it's China. And India is incredibly cooperative.

COOPER: And is China cooperating?

MILGRAM: China is not working with our law enforcement teams, at this moment.

And part of what's really critical to understand is that we're talking about fentanyl, which is a man-made drug. And so, the only limit, on the amount of fentanyl that the two cartels, in Mexico, Sinaloa and Jalisco can make? And those are the two cartels responsible, for the fentanyl that's killing Americans. The only limit on how much fentanyl they can make, is the amount of precursor chemicals, they can get.

COOPER: It seems like you chop off the head of the Sinaloa Cartel, El Chapo is in prison, in the United States. He was Sinaloa, right?

MILGRAM: He was Sinaloa.

COOPER: He's in prison. His son's running it. And other, you know, they just keep going though.

MILGRAM: So, in this moment in time, the question I ask every day is how can we save lives. It is not a war on drugs. It is a fight to save lives.

And so, we have shifted completely how we operate. We've gone from targeting high-value targets, we call them, HVTs, like El Chapo, the head of the organization, to now targeting the entire criminal networks. And we are now tracking thousands of members of those two cartels, associates, facilitators, in more than 40 countries, around the world.

COOPER: So, it's not just gang -- cartel gangs, in Mexico itself. It's lawyers, and business people, and people, who are working for the cartels, in the United States, and elsewhere.

MILGRAM: We are actively investigating the entire supply chain. So, starting with Chinese precursor chemical companies, to the cartels, in Mexico, making the fentanyl, to the people that are selling it for them, in the United States, on social media, and then the illicit finance, the money that's going back to the cartels.

COOPER: Explain the precursor chemicals. Because originally, China used to just -- fentanyl was coming directly from China. Then, China did act on that with the U.S.--

MILGRAM: That's right.

COOPER: --in cooperation with the U.S. But precursor chemicals, which are used to actually make fentanyl, those are now being sent from China to Mexico?


MILGRAM: That's exactly right. So, China scheduled fentanyl -- finished fentanyl in 2019. At that point, the cartels started bringing these precursor chemicals, which are essentially the chemicals, you need, to make fentanyl. And you can do it with a number of different chemicals. They started bringing them into Mexico. They now run secret labs throughout Mexico, these two cartels.

COOPER: And they've simplified the formula, so that it's pretty easy to make. You don't need a very experienced chemist as a cook? MILGRAM: That's right. That's right. When it started, it was chemists. And now, they still have chemists, on their staff. I mean, again, they're facilitators of the cartels' work. But they also now have cooks. And they have simplified it to the point, where it's cheap to make, it's easy to make. And the same pill that costs about $0.10 for a cartel to make, in Mexico, is sold on the streets of the U.S.

COOPER: So, those who say, "Bomb the cartels, attack the cartels, get tough," what do you say?

MILGRAM: So, I would say that there's no question, our top operational priority is to defeat those two cartels, worldwide. And so, we're mapping them. And we're investigating the entire networks, to dismantle them, and degrade them. I believe that's where we have to start. Because, again, this is a limitless amount of a drug that could be on the streets of our country.

COOPER: The other thing you've talked about, which I think is interesting, is that how social media now -- social media is the highway for fentanyl, in America? Explain that.

MILGRAM: Yes. So, one of the things we've seen is that the cartels are flooding the U.S., with fentanyl. And one of the things they're doing is their traffickers, and the people selling it for them are all over social media.

So, it used to be that someone, who was purchasing drugs, would go into an open-air drug market, or have to know a dealer.

Now, every single American that has a cell phone, a smartphone, literally has a drug dealer, in their pocket. There is no more dangerous place, right now, in the United States than social media sites, where hundreds of millions of Americans are on--

COOPER: And that contributes to, I mean, the motive -- the motivation and the willingness of drug dealers to kill their clients? I mean, it's not people they know. It's somebody, who's ordered a drug on Snapchat, and paid for it with Venmo, and then some other person has delivered it?

MILGRAM: Yes. I mean, the question I get more than any other question is, "Why would a dealer kill their customer?" And the bottom line is, first of all, these are ruthless, violent cartels. And they are poisoning Americans, to drive addiction, and to profit.

And they now have social media. So, whereas someone might have had a face-to-face relationship, with a drug dealer, they're now on social media, which is largely anonymous, in many instances, and where a lot of people have a sense of safety that that they shouldn't have, but they have a sense of safety.

And the other point just on this, Anderson, is on social media, we should be clear that the cartels are not being truthful about what they're selling. This is filled with lies and deceit and treachery. They're selling these pills, as though they were OxyContin or Xanax or Adderall. COOPER: They're not saying this is fentanyl?

MILGRAM: Exactly. And those pills are actually fentanyl and filler, and they're killing Americans at devastating rates.

COOPER: And why are they using fentanyl? Just because it's a bigger high that will get more people addicted, it's cheaper?

MILGRAM: Both. The same pill that they can make for $0.10 in Mexico, sells for between $10 and $30, in the U.S. It is the most devastatingly addictive drug we've ever seen, wide-spread.

COOPER: So, those who say tougher sentencing, Owen's, the man, who killed his son, and somebody else got four and a half years, should there be -- should there be tougher sentencing?

MILGRAM: Look, we're working across the country right now, with police departments, and with prosecutors. And we've brought hundreds of cases that we call death-resulting investigations. We try to work as much as we can, through the federal system, under the federal laws, where we've gotten very significant sentences. But this is something we all have to be working on.

One of the other really important things, as I was listening to April and Owen is that we try to respond as quickly as we can. And so, we tell every police department, in America, "If you have this, call us, and we will help you understand what evidence to keep, what to do."

We believe we can stop the next person from dying, if we can respond quickly enough, and stop that dealer, from selling pills, and fentanyl that's cut into cocaine, or methamphetamine, or heroin that will kill someone.

COOPER: We got to get a short break.

Administrator Milgram is going to stay with us. I want our audience members have a chance to ask some questions, when we come back.

Also ahead, Senator Lindsey Graham is going to join us, on what lawmakers, in both parties, can do to try to strengthen the federal response, to the crisis.

And later, a conversation with two people, on the frontlines, a doctor -- a former doctor, who lost nearly everything to addiction, but battled back, and is helping others, do the same.



COOPER: And welcome back to our CNN town hall on the fentanyl crisis.

The federal help line number you see there on the screen, 1-800-622- HELP or 4357, 1-800-622-HELP.

We're back talking tonight with DEA Administrator Anne Milgram and taking questions now from our audience.

I want to introduce our audience, too, Bree O'Conner. Bree lost her nephew when he thought he was purchasing oxycodone. It turned out to be fentanyl. He found a dealer on Snapchat.

I'm so sorry for your loss.


COOPER: What is your question for Anne?

O'CONNER: How do we address the issue of dealers using platforms like Snapchat to find and sell to their customers?

COOPER: Anne, actually, before you answer that, I do just want to -- because we mentioned Snapchat before, I just want to point out, we -- we reached out to Snapchat who sent us a statement that said: We're committed to doing our part to fight the national fentanyl poisoning crisis, which includes using cutting edge technology to help us proactively find and shut down drug dealers' accounts.

I'm sorry. Go ahead.

ANNE MILGRAM, DEA ADMINISTRATOR: So, Bree, I'm so sorry for your loss. And you raise a question that we are asking every single day. Anderson showed the faces of fentanyl wall in DEA headquarters before. And if you and I walked along that wall, I could show you the faces of Americans who died from Snapchat, buying a pill on Snapchat, from Instagram, from Facebook Marketplace, and on and on. And it is absolutely devastating.

The social media companies, in my view, are not doing nearly enough to stop the harm. We have seen that there are ways that they can take action.


In the past, they had stopped terrorism videos. We've seen changes that have come in things like human trafficking, through congressional laws.

What they have not been willing to do up until this point in time, in my view, is take responsibility for what their sites are -- what's happening on their sites everyday.

So, to just address what Snapchat has said, we know that's not accurate. We are all over social media. We're doing investigations of cases that come from social media and we routinely are finding posts that are on all of the social media platforms for days, for weeks, for months. And it is unacceptable.

I believe there has to be greater accountability. I believe that, you know, even think about what you just said, that they're telling us that they're doing everything they can.

COOPER: Right. They say they are committed to doing everything they can to fight and using cutting edge technology to help us proactively find and shut down drug dealers.

MILGRAM: And they won't show us that technology, right? They won't let outside experts come in. They will not at this point allow auditors or others who could actually help them improve their platforms come in. And that can't be acceptable.

We're talking about 107,735 Americans lives lost between August of 2021 and August of 2022. Whatever they're doing is not enough.

COOPER: This is Johnine Williamson. She -- her stepson, Jeremiah Robinson (ph), died last October. He took what he thought was a Percocet which was laced with a deadly dose of fentanyl.

Ms. Williamson, you and I talked beforehand. I'm so sorry for your loss.


I have a two-part question. I would like to know what kind of training are we going to give first responders who interface with someone who had an overdose? And then what type of follow-up are we going to give to ensure that people who overdose can be connected with care?

MILGRAM: Yes. So I am so sorry for your loss as well. And I just want to say also how inspiring it is to me that all of you are taking incredible tragedies and raising awareness, because I don't think there's anything more important that all of us can be doing about talking about the harm and what we're seeing.

So in terms of training for first responders, every single DEA agent in America carries naloxone. I carry it as well.

And we are going to offer training for police officers and EMT on not only this but also how to respond to a drug poisoning. What they can and should do. The first moments matter enormously. And so we want to do that.

The other question you asked, I think one of the things that we are very focused on at DEA is how do we expand access to treatment as well across the United States for people who have substance use disorder. So, we've been working to medication for opioid use disorder. There's a recent bill that Congress passed, the president signed that removed barriers to treatment.

So we have now gone from about 200,000 medical practitioners being able to prescribe this life-saving care to every single medical practitioner in the United States. So, we have to keep working on it, but it is a vital part of what we can do. And how we have to make sure everyone is aware of the harms and what we can do to help.

COOPER: Thank you for your question.

This is Danielle Ompad. She's a professor of epidemiology. She's worked with people who used drugs for more than two decades. She's also the deputy director of the Center for Drug Use and HIV research and vice dean for academic affairs at New York University School of Global Public Health.

What's your question?


COOPER: You do a lot there. That's a very long title, huh?

OMPAD: It's a long day.

In light of the documented success of overdose prevention centers in reducing overdose deaths, what steps has the DEA taking to support the establishment of OPCs as a harm reduction strategy in communities across the United States?

MILGRAM: So thank you for that question.

We have three top priorities at DEA right now. The first is to defeat the two cartels we believe are responsible for the unprecedented and catastrophic loss of life. The second is to raise public awareness. And the third is to do everything we can to expand access to treatment so that every American who needs treatment can have it.

We are -- there's no question at this moment in time that everything -- and this is a whole of government approach. So we have partners at Health and Human Services, we work with them every single day at Veterans Affairs. Everyone in the U.S. government has to work and do what they can to make sure that we are getting Americans what they need at this devastating time.

And we also have to understand that this is different than, you know, as much respect as I have for the work that you've been doing for all these years and I'm -- I admire it so greatly, I believe that we are in the same situation in some ways but also in very different ways, where what we are now seeing is many people are taking drugs that they don't even know they're taking as well. So, this is a catastrophic moment where every part of government has to be doing everything we can to save lives.


COOPER: I mean, that's the thing. People don't know they're taking it. I mean, somebody who's a new parent like -- I mean, I've got a couple years on this, but you know, my kids -- my oldest is 3 and the youngest is 1.

But that they could be in college and somebody hands them some pill that they think is, you know, something -- like a Xanax, that's a prescription pill and it kills them. I mean, it's stunning.

MILGRAM: Yeah. I mean, that is -- what we see the cartel is doing is being deliberate and calculated with their treachery and their lies. They are making these pills to look exactly like a Percocet, exactly like an Oxy or an Adderall or OxyContin or they're hiding fentanyl in drugs that Americans may be buying like cocaine or methamphetamine or heroin. And what's happening is people are dying at these catastrophic and

unprecedented rates. And they're doing it, we believe, to drive addiction. And they're doing it because the more people who are buying, the more money they make.

And so, this is a threat unlike any we have seen before. And so, we need to bring all -- every single tool we have in the government, whether it's public health, or it's enforcement, or it's expanding the aperture to treatment, we have to be doing everything to save lives.

COOPER: I want to introduce David Frank. He's a medical sociologist who studies opioid use and treatment at New York University, and he's been on long-term methadone maintenance treatment.

You got a question for Anne.


Drug checking programs that can test for levels of fentanyl and other addel (ph) and other (INAUDIBLE) are such a common sense and evidence- based strategy to reduce overdose. Why aren't we doing more with them?

COOPER: Anne, I'm sorry, before you answer, I just want to show some video of what Mr. Frank is talking about, at least one example of it. This is testing strips can measure fentanyl found in any drugs that have been purchased.

Does that actually work?

MILGRAM: So, you know, the health and human services folks are the experts on this. What I can tell you from what we see is that it does work.

But we also have to be very careful when it comes to something like pills because you were talking before about the amount of fentanyl that's deadly. It's the amount that could be on the tip of a pencil. There's no way to just scrape off a piece of a pill and use a fentanyl test strip and know that that pill is safe.

COOPER: So you can't just rub a little bit of the pill --

MILGRAM: You cannot. You would have to crush the whole pill.

COOPER: So, you have to crush the pill and dissolve in water.

MIGRAM: Yes. Essentially.

COOPER: Wouldn't that then nullify -- I mean, somebody who wants to use that pill do that?

MILGRAM: Yeah. So, while -- these are important parts of the conversation to have when it comes to fake pills, again, we seized 57 million of them fake fentanyl pills last year, it would not be something where we could tell you with a fentanyl test trip whether or not a pill from scraping it was safe. So I think the assumption has to be that America in 2023, that any

pill that was not given to you by your doctor, prescribed directly to you, that any pill like that that wasn't given to you personally by your doctor is not safe. And can kill.

COOPER: Anne Milgram, I appreciate your time.

We are going to get more questions in a moment.

Coming up, Republican Senator Lindsey Graham is going to join us to discuss what Congress can do to control the flow of fentanyl into the country.

We'll be right back.



COOPER: And we're back with our CNN town hall, "America Addicted: The Fentanyl Crisis".

We heard from the DEA Anne Milgram before the break. Right now, what lawmakers may be able to do.

Our next guest is a Republican senator from South Carolina who's cosponsoring a bill to try to reduce the supply fentanyl and similar substances known as fentanyl analogues that would make permanent their classifications as schedule 1 drugs.

I'm joined now by Senator Lindsey Graham.

Senator Graham, appreciate you joining the conversation.

Talk about what you and Senator Cotton of Arkansas have introduced, this legislation on fentanyl.

SEN. LINDSEY GRAHAM (R-SC): Well, number one, fentanyl is a weapon of mass destruction more than it is a drug. I mean, the people in your audience have suffered terrible losses, and we're not doing enough about it.

So, schedule 1 is the highest level you can put a drug on in terms of punishment. Fentanyl is due to come off that schedule at the end of the year. That's ridiculous. So, we've got to keep it on schedule 1.

But I want to do more than that. The drug cartels that are sending this poison into our country need to be considered terrorist organizations.

The law enforcement model is not working. This is not working. So, we need to take a different approach.

Let's call these drug cartels terrorist, because they're terrorizing America, and go after them with a different model. COOPER: What does that model look like to you? Anne Milgram of the

DEA was talking about --


COOPER: -- saying that's what they're doing, not just trying to chop the head off like with El Chapo, put him in prison, because now, his son's running it, but go after the whole networks -- their lawyers, their businesses, their phony corporations.

GRAHAM: Well, what they are doing is not working because there are 14,700 pounds of fentanyl seized in 2022. We're over 12,000 already in four months of the 2023 fiscal year.

So, what would I do? Foreign terrorist designation to drug cartels allows -- allows us to have extraterritorial jurisdiction to go after them more aggressively.

What did Bill Clinton do when it came to Colombia cocaine problem? He sent the U.S. military to the country of Colombia to actually get involved in eradicating the cocaine dealers in Colombia, to stop the flow in the United States.

So, what would I propose, that we make drug cartels foreign terrorist organizations, and we use military force, if necessary, to stop their poisoning of America. Blow their lives up.

COOPER: In terms of actually drugs coming in, it seems like they are coming in through the border checkpoints, particularly, that's where they're being seized most, commercial vehicles. A lot of Americans actually even bring them in for the drug cartels, you know, drones, any possible way -- DHL, FedEx.

How do you stop that?

GRAHAM: Well, you know --

COOPER: I mean, even if you kill a lot of cartel leaders or, you know --



COOPER: -- seize them, it seems like there's an endless supply of these cartels.

GRAHAM: Well, the cost of doing business when it comes to fentanyl needs to go up. We need tougher (ph) -- stiffer punishments. FTO designation would allow us to put these people in jail longer and allow us to go after the networks all over the world.

But if you blow up a couple of these labs and kill the drug dealers, they'd have a hard time getting somebody else to come in and open up a new lab. So, what did Clinton do? He sent the American military as advisors to

have the Colombian military get on the ground to hit it at its source. You're never going to win this game at the border.

You need to tell Mexico, you're harboring drug cartels. You're giving them safe havens. They're terrorizing Americans.

They kidnapped four Americans, three of them from South Carolina, killed two of them today. Enough is enough.

So, let's use every tool in the tool box to go after them at their source.

COOPER: Anything to do on China and the precursor chemicals? Because China is now not cooperating.

GRAHAM: Absolutely. So, let's look at this way. What's the likelihood that the Communist Chinese Party is unaware of the fact that they have fentanyl precursor drug factories in China and they don't know it? Zero.

So, let's get tough on Mexico. Let's start using the military, like we did in Colombia, regarding fentanyl. Let's start blowing up some of these labs and putting these people in jail longer, and tell China that you are part of the problem, and hold them accountable and start looking at these organizations and China's foreign terrorist organizations.

Let's up the game against everybody involved in the fentanyl business, from China to Mexico, and make the cost of doing business higher.

COOPER: We've got some questions from people in the room tonight.

First is Fiona Firine. Her only son Cameron died in his bedroom of fentanyl poisoning in March 2018 after taking a pill he thought was OxyContin.

Fiona, what's your question for the senator?


How do we begin national education as early as possible in all schools and with messaging, and encourage medical providers to discuss it with young patients and their parents during wellness checks?

GRAHAM: Count me enough for making this, using the Department of Education to provide information to local schools from whatever age levels appropriate to let kids know, do not take a pill from a stranger because, you know, the people in the audience have lost loved ones who were basically tricked. They were given A, and it wound up having fentanyl in it and they're dead.

You know, young people experiment. That's just part of life. These drug cartels are really terrorists.

So, count me in on educating young people as to what not to do. Count me in on beefing up border security.

But the one thing I'm trying to stress to the audience tonight, that's not enough. We've got to go after them where they live and where they reside in Mexico. First, the Mexican government, to be a better partner, and if they won't be a better partner, start taking matters into our own hands.

TAPPER: Senator, I want to introduce you to Nora Madonick. Her son Benjamin died of fentanyl poisoning in May 2020. He was 28 years old.

Nora, I'm so sorry for your loss. Thank you for being here.

What's your question for the senator?


Senator, there are only two categories of parents of young adults in this country right now. One, like me, is devastated. And don't be a fooled by how we appear. We go to bed every night hoping we won't wake up in the morning.

The other is terrified they will become like me. I support making the illicit fentanyl ban permanent to empower our enforcement community. But we need national outreach on a scale we have not seen before, with funding and direction for the states to take action, if we are to get ahead of this thing.

What is being done stateside?

GRAHAM: You know, in my state, the governor is trying to up our game. We had a seizure in Rock Hill, South Carolina, of enough fentanyl to kill everybody in South Carolina.

So, to everybody in the audience, we're letting you down. I mean, we can talk about this all night. Our laws are not working. The law enforcement model is not working. The interdiction at the border is not working.

Let's try something new. Count me in for education, more Narcan, you know, finding out, treating people quicker, trying to get people not to take the bait of getting a pill that you shouldn't take. Learn from the mistakes that have been made.

But I can't stress enough -- we're not going to solve this problem until the cost of poisoning America, Americans, goes up. That the fentanyl drug dealers will go in a different line of business if they start getting killed and go to jail.

COOPER: Senator Graham, this is a question from Dita Bhargava. She's lost her son. Her son died, Alec, from fentanyl poisoning in July 13th, 2018.


It was on his 26th birthday. Dita, thank you for being here.


Senator Graham, anyone who has lost someone they know to overdose would turn back time to provide a safe place for their loved one to take their drug and save their life. Potentially, 100,000 precious lives save per year, and an opportunity to educate about treatment and recovery provided, especially with the scourge of dangerous and lethal fentanyl.

And all the data from Europe, Canada, and a couple facilities in the U.S. show that safe injection facilities work, prevent people from dying, and give them an opportunity to learn that recovery is real.

Senator Graham, would you support legalizing and funding safe injection facilities to save precious lives?

GRAHAM: I really don't understand the question, because we're not talking about injections here. We're talking about people taking a pill, thinking it was Percocet and winding up being fentanyl. But the bottom line is, would I support --

BHARGAVA: But they could take the pill in the safe injection facility. The whole point is they would not die if they were doing it safely, where people could help them with Narcan and watch over them and it would give them the opportunity to eventually -- my son died because nobody was there to help him. He had Narcan all around him, and nobody knew he was overdosing.

But if he knew there was a safe place to take his drug of choice, he would be alive today because he wanted nothing more than to be on a path of recovery and enjoy the love of his friends and his family.

GRAHAM: To be honest with you, ma'am, no, I don't think that's a very good idea at all. I don't think there is a safe place to do this.

BHARGAVA: That's too bad, Senator, because 100,000 people is a lot of people in our country that could be alive, if they were given a safe place to --


GRAHAM: I just -- I don't think that's the answer.

COOPER: Thank you for your question. Appreciate it.


COOPER: Senator Graham, I want to thank you for your time tonight.

GRAHAM: Yeah. Thank you.

COOPER: I really appreciate it and wish you well. Take care.

GRAHAM: Thank you. God bless. Thank you. Just ahead, we're going to speak with two people on the front lines of addiction treatment. One, an associate professor of psychiatry at NYU, the other, a former doctor in recovery himself who's helping others in their struggle.



ANDERSON COOPER, CNN HOST: And welcome back to our CNN town hall about this country's fentanyl crisis.

We couldn't end this evening without talking to the people on the front lines of this battle against fentanyl.

I'm joined now by Dr. Ayana Jordan, associate professor of psychiatry at NYU, and Lou Ortenzio, a former doctor who is in recovery after he became addicted himself while prescribing painkillers to patients. He helps others now with their recoveries, as the executive director of the Clarksburg Mission in West Virginia.

Thank you both so much for being with us.

You actually brought Narcan with you.


COOPER: So, show -- I think it's important for people to see that. I actually haven't actually seen it up closely.

JORDAN: Yeah, and thank you for that opportunity.

Before I get started, I really do just want to express my sincere empathy for the people that are here today.

It's not easy, it's more to say, I am beyond sorry for your loss. But I am committed to doing things differently, okay? My role as a physician is to save lives, all right? I don't want to blow people up. I want to stop this from ever happening again, right?

All right. So, thank you for that.


COOPER: And just -- as a physician, this is emotional for you because you see this up close all the time.

JORDAN: I see this up close all the time. And I feel like we are not concentrating on the science.

This is not a political issue. I also am a scientist, right, so I have an MD and a PhD. So, not only do I treat patients who suffer from substance use disorder, but also just misuse substances.

And as we know, it is totally expected that people are going to use drugs. That's what teenagers do. That's what adults do. We learn from COVID, myself included. The isolation, the fourth lockdown, I use substances more than I had in the past as well.

We are suffering. And so, we can't criminalize our way out of this. We need to focus on the science, what works. We know that investment in mental health services, the DEA talked about that, and I agree with them. We have to get treatment to people.

If it's harder to see somebody like me, guess what, people are going to go to the streets. They're going to take their pills from the streets. They're going to get the Ativan and benzos from the streets.

And one of the things that's important to understand, Anderson, that we really have to think through is we can't just focus on the supply. Because when we focus on supply, the people who make the drugs are just going to make something different, right? So, that's why we have something called tranq dope. Because they're cracking down on fentanyl, and you think --

COOPER: Tranq is a thing that veterinarians use.

JORDAN: Tranq -- the name is xylazine. And it is a tranquilizer that is used for animals, right. And that's being mixed in with the dope now. So, heroin, and fentanyl, and other products, because there's such harsh penalties on fentanyl that the chemist are saying, okay, let's make something else, so that we can circumvent the fentanyl. You understand?

COOPER: So, just -- you're saying just focusing on the supply, that's not -- that's not going to solve the problem.

JORDAN: It's not going to solve this problem.

COOPER: Lou, what do you think?

LOU ORTENZIO, EXECUTIVE DIRECTOR, CLARKSBURG MISSION: In West Virginia, we see supply driving demand. There's so much supply, so much for prescription pain pills and heroin and methamphetamine, now fentanyl, so much slung on the streets, it drove demand.


So, we have a high rate of addiction in our state. And so, we have to address recovery. We have to offer alternative solutions for folks to live their lives.

COOPER: You are -- I mean, you know about recovery firsthand. Tell folks a little bit about yourself.

ORTENZIO: I mean, as a physician, I had access to prescription pain medication in my sample cupboard. And when life got stressed, or when I had a headache, I would take. One and sampling that drove me heavy duty addiction. I was my own dealer. I had access to all kinds of pain pills.

COOPER: How long are you doing that before -- ORTENZIO: Probably 20 years.


ORTENZIO: But I've been sober 19 years. This is my 19th year sober recovery point.



COOPER: I'm so happy you're here.

ORTENZIO: And now I just want to give back to people. I'm in the same town that I was a contributor to in casualty of the opioid epidemic and now, I just want to give back. I want to show people that there's another way they can live and to facilitate their recovery.

At the Clarksburg Mission where I worked and the Sober Recovery Ministry that we have, I see miracles every day. I have great hope in West Virginia now. Great hope in our nation, as we're talking about this. This is a fabulous, to be talking about these things that are often held to be secret.

COOPER: But I hear what you're saying when you say, you know, supply alone, that's not going to -- that's not going to do it. But there are a lot of folks in this room who have lost their children who weren't using drugs, who weren't, you know, consciously trying to, you know, or long term drug -- they were, you know, somebody gave them a Xanax, they thought.

JORDAN: Absolutely.

COOPER: So, cutting the supply -- you know, the access to that, you're not saying don't focus on --

JORDAN: Now, what I'm saying is we have to focus on people who are experimenting with drugs as well, both sides, right? And so, one of the things, Narcan, naloxone. And this has to be part of a greater harm reduction strategy and saying, what can we do when people are experimenting.

This saves lives in the way that we had the height of the HIV epidemic, right, from 1981 to 1990, what's happening right now is blowing that out of the water. More people are dying in one year and then all of those years combined. And so, in the ways in which condoms were freely given out, you can get condoms anywhere, there's no shame in getting condoms.

Everyone should know naloxone. No one in this audience should have never seen this. There should be in every subway, every train, every pharmacy.

COOPER: It's a nasal spray, I mean, there's injectable, but this is a nasal spray that if somebody is OD'ing -- JORDAN: You can use it. And what it does is it blocks the effects of

fentanyl and other opioids. I'm glad to open it up, so you guys can see. There's nothing magic about it.

You're -- I'm not going to give it to myself. But this one I'll show you. It is an intranasal. You put it up in the nostril. And then you push and it delivers a spray. And that simple action can save lives.

COOPER: I just talked to Mike Fanone, a police officers who responded on January 6th, he was telling me that years ago on a drug bust he was on, a canine got some fentanyl. And he actually did that to a canine and it worked. He was like, I'm not sure this is going to work, but he did it, and it's incredible what it can do.

JORDAN: It's incredible what he can do. So, what I mean is we have to have all hands on board and really support programs that get naloxone out everywhere.

COOPER: I want to bring in Sarah Leibowits. She's an elementary school teacher whose daughter died two years ago at the age of 22 of an accidental fentanyl poisoning.

Sarah, what's your question?

SARAH LEIBOWITS, DAUGHTER DIED FROM FENTANYL POISONING: Doctors, thank you so much for all that you do.

I would like to know, what are we as a nation doing to address the problem with mental health care and rehabilitation not being accessible to all people who need it?

JORDAN: Yeah, again, thank you for being here. I am addiction psychiatrist, right? So that's someone that not only deals with people who are misusing substances, but also have mental health struggles.

One of the things that I think is most important is removing unnecessary barriers to mental health care. And one of the ways to do that is to scale up mental health parity, meaning that no matter what you have in terms of your diagnosis that it's covered under the insurance.

Unfortunately, that's not the case. There's so much stigma and insurance companies decide what is covered and what's not covered. That is a problem.

So, really looking for opportunity for universal health care system, that would cover mental health. Also, making it really easy for people to be able to see a psychiatrist or other mental health professional, right, via telehealth.

So, now what's happening is that you have -- you know, you have to have in person visit, you know, in order to see someone via telehealth.

[22:10:07] And we want to make sure what happened during COVID-19 is that people can see someone like me indefinitely, and not necessarily need an in- person visit.

ORTENZIO: Mental health issues often drive addiction. People are self medicating. And really, that was part of my problem, is I have a lot of anxiety. Those pills were pretty magic.

But after a while, I was just taking pain pills to stop from being sick. It wasn't a matter of getting high. It wasn't euphoria. It was dope sickness. And dope sickness is absolutely miserable.

And what happens? Your whole brain reward system gets hijacked. Your prefrontal cortex is taken out of the loop. And you'll do anything.

COOPER: So, what do you think of it -- Lou, for -- about safe injection sites? Obviously, Senator Graham does -- other -- doesn't seem to support them.

ORTENZIO: I mean, back in medical school in the '70s, the idea of methadone seemed like a wild idea. But slowly, it became accepted. And Medicaid does this treatment.

I had an issue with that at one point. But now, it fully accepted. I think we have to talk about all of those things.

COOPER: Sam Rivera runs a safe injection site.

Sam, can you just talk a little bit about what you do there?

SAM RIVERA, EXECUTIVE DIRECTOR, ONPOINT NYC: Sure, first of all, thank you so much for -- for what you shared. And again, I also send my condolences to everyone who has lost a month.

So, I first want to be clear that there are overdose prevention centers. They're not safe injection sites. And the language really matters. They're polymodalities so, people come in and use a variety of different drugs in our presence. So, that if there is an overdose, we have the opportunity to save these beautiful men and women, uncles, aunts, grandmothers, grandfathers, children -- well, children of adult, but really keeping them alive.

And when I hear your story, I think about you're here. And, Anderson, thanked -- you know, said he's happy you're here. If we don't keep drug users alive, when people talk about sending people to recovery, sending people to treatment, they'll never have that opportunity.

COOPER: But, you know -- I mean, look, you've been doing this for a long, long time. When you -- when somebody says, well, doesn't that encourage people to use, what is -- what have you seen?

RIVERA: Not at all. The good doctor said people are going to use. We know that.

What we want to do in the interim is while they're using is keep alive. All of our participants, around 3,000 we registered in 15 months, all of our participants have been to detox and treatment numerous times.

So, when you hear people from a distance say just send people to treatment and it will be fine -- yes, I agree. Let's give them more access to treatment. Let's create a system in place where people can go get the support. But in the interim, we need to keep him alive. And we know that the 3,000 people we've seen in our program have utilized our space more than 65,000 times.

I mean, 65,000 utilizations didn't happen in the street. And it didn't impact children and other people on the street. We've had 1.7 million units of hazardous waste collected on our site.

They never stayed in the street. And over 750 overdose interventions, with -- by keeping these beautiful people with us. If they're with us and stay alive, if we give them an opportunity while they're using, then they can be here.

And the other thing is, anytime anyone of our participants, because this is a misnomer with home reduction. Anytime one of our participants says they want treatment or they want detox, we're going to action immediately. And that's why the things we have to make clear, when I heard what this beautiful mother was talking about, giving people an opportunity.

You see the split. And that split hurts this country deeply. And it hurts us in a way when we're talking about someone taking a pill versus. Why do we have to have that split? We don't.

COOPER: I want to bring in Jackie Springer to the conversation. Jackie's son, Austin, died in August 2019 from fentanyl poisoning. She's active in the recovery community and is working to end the stigma of addiction.

Jackie, thank you for being here.


So, my question is, I've read recently that researchers are working on a fentanyl vaccine. And I was wondering how close we are to an approved vaccine and how would that actually work?

JORDAN: Yeah, thank you so much for that. And again, my deepest condolences.

So, unfortunately, we are not quite there yet. But the good news is, is that there has been a model tested in rats that actually worked. But you know that we are not rats, so we have to test in humans. And so, the NIH is -- the National Institute of Health -- is actually funding through the health and addiction for long term initiative to trials that I know of that are actually testing an opioid vaccine, which fentanyl is a type of opioid, in humans.

One is really focused on opioids themselves, right, but then a specifically on heroin as well. So, that's ongoing. And we have to see what the safety is.


It's not quite ready for primetime. But those studies are being done.

COOPER: How do people get Narcan or naloxone?

JORDAN: Right, exactly, so, it depends, and that's one of the --

COOPER: I mean, is it available over the counter? You can go to CVS and get it?

JORDAN: Again, it depends. When I -- and I genuinely mean that because it depends on what state you're in. And I think that's one of the issues in terms of why can't there be a national way to be able to disseminate fentanyl?

In New York, New York City, right, there is a way that you can get it. You're supposed to be able to go into the pharmacy and just go and get it. But you have to either pay for it, or have to be covered to your insurance.

And oftentimes, if I send patients to get it, some pharmacies don't even stock it, which is a problem. So, when people want to do better and be safe, then their pharmacy may or may not have it.

In other states, you have to get a physician's prescription in order to write it. But that's one of the things. It really does depend on where you live.


ORTENZIO: In West Virginia, we hope to have over-the-counter Narcan within the next few months. But in the meantime, our staff at the Clarksburg Mission have been trained to be trainers. And we have an unlimited supply of Narcan. So we pass it as much Narcan as we can to keep people alive.

And our Christian perspective, keep them alive until they meet Jesus Christ. But certainly, and you had given yourself Narcan, it wouldn't hurt you. So, using Narcan doesn't hurt anybody, even if they are not having an opioid overdose (ph).

COOPER: Dr. Ortenzio and Dr. Ayana Jordan, appreciate so much.

JORDAN: Yeah, thank you.

COOPER: Thank you.

I also want to thank all of our guests and all our -- everybody in the audience tonight.

A reminder, if you are somebody you know needs assistance, the toll free number again is 1-800-662-HELP. It's 1-800-662-4357. You can also find the help at the Substance Abuse and Mental Health Services Administration website, which you can see there on the screen.

Thanks to all our guests tonight. The news continues here on CNN.