 Well, good morning everybody, it's nice to be here, it's nice to be here with Ambassador Brownfield. So I just thought I'd made some kind of opening comments, turn it over to Ambassador Brownfield and then we'll open it up for questions and answers. So it's really, I think, a particularly important time for us as we think about kind of drug policy and our work in the international arena. Really pleased to be joined by Ambassador Brownfield, who's a tremendous amount of expertise in diplomacy, I think has really moved drug policy reform efforts forward not just in the United States but internationally and so we're tremendously lucky to have him. You know, I think that we know that every country has experienced significant challenges as it's related to the consequences of drug use and drug trafficking. And these efforts, I think, have underscored our tremendous opportunities to both work on public health and public safety sectors in terms of working together. We also need to understand that people need access to essential medicines to relieve pain and improve their health and well-being. But we also need to prevent diversion because particularly as the United States has been experiencing significant consequence around prescription drug use issues, we have to pay attention to diversion issues. But we know that also we have to look more squarely at our demand reduction efforts for illegal drugs. I think we know that the demand has a ripple effect that fuels drug trafficking and violence and corruption. So addressing demand is one of the most important things that we can do. We're also, I think, squarely rooted in the understanding that substance use disorders are diseases. These are not moral failings. These are not bad people doing bad things. But we know that people need access to good prevention services. We can treat people and rehabilitate them and people can recover. The international community's focus on public health is really encouraging for making progress as we move forward. But as we make progress, I think each individual country really needs to do their own assessment in terms of how they have met the obligations under the International Drug Conventions and the 2009 political declaration and plan for action. I think we agree and support the three international conventions and understand that every country has a significant amount of latitude under those conventions to reform drug policy as we've done in the United States in terms of focusing on public health-related priorities, looking at criminal justice reform issues. Understanding that law enforcement has a key role to play, but that for too long we relied on punitive approaches to people with substance use disorders. I think we've all seen, particularly in the United States, the role that these punitive approaches have played as it relates to our overreliance on incarceration for people with substance use disorders and disproportionality for some of our communities in terms of the work that we're doing. So we've really, I think, made major strides in looking at drug policy reform efforts under our three conventions. In February, our government continued to put forward a plan that balances this approach between public health and public safety. As an example, for the first time in the history of the United States, when we look at our drug control budget, we have actually equally funded demand reduction efforts as supply reduction efforts, and I think that's an opportunity for not just the United States, but for all countries to look at how we appropriately finance public health strategies that we know to be important, specifically in the United States, the President has called for over a billion dollars to support additional access to treatment in the United States as a commitment to our public health efforts. But we know that each country has to make meaningful changes as it relates to drug policy, and our governments have the substantial obligation to continue to reform drug policy within existing treaties. But we also want to ensure that we know that not one size fits all, that we need to continue to adjust drug policy as it relates to particularly underserved populations in the United States and internationally. So when we think about women and children and youth, indigenous populations, those in the criminal justice system. So we know that unguess is just a little over a month away that this will be the first time in over 20 years that we have met to really, I think, review our understanding of where we are, where have we fallen short, what are the opportunities to really move forward science and evidence and research on evidence-based drug policy efforts, things like public health interventions, medication assisted treatment, criminal justice reform, alternatives to incarceration, and really strengthening the collaboration between public health and public safety are become important priorities for us. So you know, obviously CND and our movement to our unguess are really reflective of kind of our understanding of drug policy and science and research. So with that, I'll turn it over to Ambassador Brownfield. Well, I thank you, Dr. Botticelli, and let me offer just a couple of comments from the United Nations perspective. Ladies and gentlemen, we are gathered here in Vienna for the meeting, the annual meeting of the UN Commission on Narcotic Drugs or the CND. Conceivably the most important CND meeting in several decades. Why? Because in five weeks time, the leadership of the world will gather at UN headquarters for the first special session of the UN General Assembly on drugs and a review of global drug policy in nearly 20 years. There is, as we all know, an intense debate going on on our planet in terms of what global drug policy should be. I would suggest to you gentlemen that for the last 30 or 40 years, this debate has been dominated by the two extremes. One extreme which argues simplistically that if we simply legalized everything, the problem would go away. A second extreme which argues with almost the same degree of simplicity, if only we would prohibit everything, the problem would go away. As is usually the case, ladies and gentlemen, there are solutions and they are found somewhere in between the two extremes. It is the position of the United States government that there is fertile ground for serious and pragmatic reform in drug policy that the upcoming on gas can in fact consider. We can open by reaffirming the three international conventions that have governed our planet's approach toward drug policy for more than 50 years and in fact have served a very useful purpose. Within those conventions, we can find space for a greater emphasis on public health in terms of drug policy. We can find possibilities for reform of criminal justice approaches, alternatives to incarceration, sentencing reform, drug courts, court supervised drug treatment. We can find space for more development and alternative development ideas, for focus on new psychoactive substances which the pharmaceutical industry is now producing at a rate far greater than our ability as the international community to register and schedule those new products and we can find an opportunity at the on gas to recommit to combating and eventually defeating those transnational criminal organizations that traffic in the product for economic gain using violence and bloodshed as their business model. Ladies and gentlemen, there is clearly a role for civil society in this process but the word we emphasize is balance. Civil society is not monolithic, not all NGOs take the same position and on gas as well as this C and D are opportunities for us to hear both sides of the argument. May I suggest to you here in Vienna, we are in the city about which the entire United Nations organization says there is something called the spirit of Vienna and what that means in UN speak, I believe, is that unlike other headquarters for UN organizations, here in Vienna there is a tradition for finding common ground and eventually producing consensus on policy and reform. We hope the spirit of Vienna will continue through the upcoming UN gas. That's my opening comment and I throw the floor open. Thank you very much. I have one question for Mr. Botticelli, one question for Mr. Brownfield. A question to Mr. Brownfield is that yesterday Mr. Werner said from the international narcotics control board said that the legalization of non-medical use of cannabis is not in line with international conventions and as we know several states of the United States need the recreational use of cannabis legal for adults. So do you think that this is not in line with the international law and if it's not what the US government is about to do with this problem? My second question is that you mentioned there is an ongoing opioid epidemic in the US with several victims of overdose and some NGOs and even a mayor in New York state proposed the idea of opening supervised injection sites to tackle this problem. And there are several such facilities in Europe. What is your government's position on that? Let me take on the marijuana question as relates to the three conventions. It will perhaps not surprise you to learn that the government of the United States believes that we are still in compliance with the three international drug control conventions while acknowledging that four of the 50 states of the Union have in fact decided through public referendum to legalize the cultivation purchase sale production of marijuana. We believe this because it is our position that the conventions themselves provide a sufficient amount of discretion within the text of the conventions to allow this sort of approach. Our argument simply stated and as briefly as I can make it is that the conventions do not require or obligate any member state to criminalize and prosecute individuals for consumption of any particular product. The conventions recognize that member states have different constitutional systems and allow those constitutions to have an impact on how they will carry out their treaty obligations. The United States system is federal where most of the law enforcement and law enforcement authority 90% is in the hands of the individual states. The United States government has a limited number of law enforcement resources as a matter of discretion. It is the government's authority and right to determine how to use those limited resources. Our objective remains the same as it has been since we first supported the very first international drug control convention. And that is to discourage and work eventually to eliminate the harm caused by dangerous drugs on our citizens and our communities. Marijuana remains a proscribed and therefore illicit substance under the Federal Controlled Substances Act. And it is therefore our contention that we remain in compliance with our convention obligations. We acknowledge others have different opinions. We will continue this discussion into the future. Dr. B. Great. Thank you. So as you discussed, you know, we have a significant opioid epidemic in the United States. I think it's important to talk about our approach to this. So we know that this epidemic has been largely fueled by the overprescribing of prescription pain medication in the United States. I think that's why we understand our treaty obligations in other countries in terms of looking at appropriate access. But I think we want to give some caution as we look at how we prescribe these prescription pain medications in the United States. You know, we've seen a small percentage of people who transition from prescription pain medication to heroin. Newer heroin users, four-fifths of new heroin users actually started by misusing pain medication. So we really got to focus on how do we diminish the supply and misuse of prescription pain medication as a result of this. But you know, our approach to this has been in a number of different areas as it relates to not only prescription drugs but heroin use. One, wider access to medication assisted treatment. You know, we have these three highly effective medications that are underutilized in our treatment system. They're underutilized in our healthcare system. They're underutilized in our criminal justice system. So we've really been focusing on more widespread access to medications. As well as more widespread distribution of naloxone, which is an overdose prevention reversal agent. We've seen a tremendous uptake not only in the health community but in the law enforcement community to reduce overdoses. We've also been significantly concerned by the dramatic increase in viral hepatitis that we've seen associated with injection drug use and some isolated cases of significant HIV exposure in parts of the country where we haven't been doing that. We were very happy to see that Congress, after decades, reversed a long-standing ban on federal funding to support syringe exchange programs. You know, it still does not allow for purchase of needles, but it supports all the other programmatic areas to do that. You know, we have not taken a position on safe injection sites. I think we're very interested to see what happens at the local level with this. And let me say two things. I think of how we think about both needle exchange and other efforts to reduce harm that not only do we need to think about how do some of these interventions reduce harm from infectious disease but really provide a vehicle for people and motivation for people to access treatment. So I think that as we look at all of these interventions, it's really important that we focus not just on reducing infectious disease among folks, but how do we use that as an opportunity to really engage people and move them toward reduced drug use behavior. Thank you. I have a question about the use of the disability to reduce drug abuse. Yesterday also, Mr. Kedepo mentioned about it. And what is the US position toward it? And do you think that you can find common ground by the people on this? Sure. Let me take on that one, since it is directly tied to the potential on gas declaration and outcome document. The United States of America does not apply the death penalty to drug cases. 32 states of the Union and under certain circumstances the federal government does permit the death penalty, but they are applied to cases that involve the taking of life and murder. Consequently, the United States government has no concern, no problem with language in an un-gas declaration that relates to the death penalty on drug related cases. However, it is also the judgment of the United States government that there is not consensus in the international community on this issue. Therefore, to the extent we are taking a position, it is a tactical position, one of questioning how much time, effort, and resources should be dedicated to an effort if we already know it will not achieve consensus. If consensus builds on this issue, we will join it because it is not inconsistent with our own policy. It is our judgment that there is not consensus on this issue as of today, Tuesday, the 15th of March, 2016. Don't get me wrong, but I can really understand how the U.S. can reaffirm the convention and at the same time the watchdog of this convention is saying that the U.S. is not compliant with them. I can understand. And I have a second question about the Vienna State that Mr. Grumfield mentioned. And as you know, there is a draft that is being negotiated by convention. What means that if one country blocks something, this is not going to be in the draft, and it's not going to be today, maybe in Cami and New York and in New York. But indeed, it's somehow strange that there is going to be a debate about drafts, but some ideas are not going to be today. So I don't know what you think about that. I think that some ideas are just out of the table, because it's some kind of a taboo. Let me start. And then so relative to our obligation under the treaties, I think that our position under federal policy has remained the same. That legalization of marijuana for, I actually say personal use, not recreational use, is not consistent with federal policy. And that we have a constitution in the United States that allows certain of our states to be able to do that. And while it's remained illegal, our Department of Justice has basically said that we are not using limited federal law enforcement to go after people for low-level personal use, which I think is entirely consistent with our policy and consistent with our meeting, the conventions. I will say, and then Ambassador Brownfield can talk more in terms of kind of the role of civil society in our work. But I can tell you that in a wide variety of settings, we have significant consultation with many people in civil society and many folks in civil society who don't necessarily agree with the entirety of kind of U.S. drug policy issues. And I think it's important for us to continue to maintain ongoing dialogue with our civil society and with the wide variety of NGOs as it relates to their input in terms of drug policy. And we actually had a reception last night with a lot of groups that I think where we have a significant amount of consensus where we are. But I think who are advocating positions that the United States doesn't agree with. So I think we have to maintain ongoing dialogue with people who don't necessarily agree with everything that we're doing. And I think that's an important role to play. But I think as Ambassador Brownfield said, we also have to make sure that we allow for the multiplicity of voices within civil society who have a range of positions on these issues to have room for their voices being heard as well. So I think that there is an important, that we feel an important obligation to make sure that we're engaging with the wide variety of opinions as it relates to what our policy positions are. And let me just add to both of your questions, which are quite specific and let me give you a very specific answer. A gentleman that I hold in the highest esteem and respect enormously, I believe he is and has been a superb president of the INCB. The INCB, when it speaks and utters and renders a decision, there is a process by which it is communicated. All 13 members of the board discuss, debate and reach a conclusion. That conclusion is then placed in a written document and provided to whatever member state or whatever organization is the subject of the decision. When a member of the board speaks, the member of the board is offering his personal opinion, just as the president of a Supreme Court, when speaking only as an individual member is offering a personal opinion, when a court renders a judgment, there is a process by which the judgment is delivered to the larger public. That, I believe, is the difference. It is not that I do not respect Mr. Sips' views. In fact, I think his views are even a bit more sophisticated than you have suggested. I merely say the INCB as an institution, as designated by the United Nations and the UN system, has not rendered a formal judgment on this issue at this point in time. The second question is kind of a question that I submit is about 60 years in the making and that is the United Nations system and their inclination to make decisions by consensus. Is this a good thing or a bad thing? Perhaps it is a question we should have asked in the year 1945 when the United Nations Charter was first endorsed. It is a reality. But what kind of reality is it? It is a democratic reality. There is no censoring on who can express a view at the young gas in five weeks' time. If a president, prime minister, minister, or other delegation head wishes to express a view on any issue whatsoever, he or she will do so. It will become a matter of public record and if there is a groundswell of support, one assumes that that will become the decision or the policy of on gas. However, if it is a minority view in a democratic institution, the minority does not get to make the decisions for the entire organization. I know that's a simple response, but at the end of the day, that is the system of the United Nations as we have had for more than 60 years. I just wonder in terms of that, you mentioned that a minority view wouldn't be the one that results, but in effect, when a minority of countries is blocking something that the majority of countries would like to promote nation or death penalty, and obviously that's a touchy, but I still struggle to see how that is democratic. That seems to be what's going on here and four countries are standing in the way of certain aggressive things. And on that note, you mentioned it on Mr. Brown, on the death penalty that you're not going to advocate for that policy of the U.S. that shouldn't happen. Are there red lines for the U.S. in terms of what does need to be in the document or is it really kind of, you're giving it up to other countries? And for you, I was wondering federally, in terms of marijuana, something like the schedule of marijuana, do you think that it should be not listed as a schedule one drug federally? I mean, that seems to be something that is reasonable as you can imagine you could say that people that smoke weed shouldn't go to jail. So should it not be scheduled anymore? So it's not up to my personal opinion whether or not marijuana should be scheduled. There's actually a scientific process that we have to go through and that we rely on in the United States to look at where drugs should be scheduled. Let me say a couple things about the scheduling, which I think are important. One of the things that I've heard about where marijuana is scheduled is it's in the same classification as other drugs. And I think it's important to understand that scheduling is not a relative risk scale. So I think it's really important to say drugs are scheduled based on what's the therapeutic value of those drugs and what are the health harms associated with those. So there is a pretty rigorous process that the United States government looks at in terms of where those drugs get scheduled. And you know, I think that, you know, so again, it's not my personal opinion. I think we have to continue to rely on that scientific process to determine whether or not drugs meet those criteria in terms of where they get scheduled. Yep, and I'll offer a quick comment on your red line question. Of course the United States government, like every government in the world, has certain, call them red lines, firmly held positions on which it will take a strong, strong position. I've suggested to you that that death penalty as applied to drug cases is not one of those. Is there an issue in terms of minority or majority? I suppose so. I suggest you're asking the wrong person on this question. However, I have said before, I repeat right now, the United States government does not take a position on whether a language that addresses the application of the death penalty on drug cases is incorporated into the declaration. If you have a comment that is connected to that, perhaps you should be talking to some other representatives, not the representatives of the United States government. But let me go back to a point that you were making before, and I hope that's not what you were saying, that, you know, because there's a majority, because there's a minority of countries who are pushing for progressive reforms, it almost has like the rest of the kind of, majority of countries are not pushing for progressive reform. And I think that we have demonstrated and I think the vast majority of countries are saying within the existing treaties there is a significant amount of drug policy reform that we can do. And that includes things like enhancing a public health approach to this issue, of looking at criminal justice reform related issues and alternatives to incarceration. And Brownfield later today is actually hosting a side event on alternatives to incarceration. So I don't like, and I don't think that's what you're saying, this kind of polarization of views where you have kind of, you know, folks who are entrenched in terms of drug policy work and those other minority countries who are pushing for progressive reforms. Because I don't think that that's the consensus of most countries. And I certainly don't think it's emblematic of the United States position on this. Yeah, I was actually saying that, I'm not sure if that's what you meant, that there's a minority that are acted against kind of progressive laws. And they tend to have an outsized influence. I mean, I think we could all name a few, but I won't because you guys don't want to report on that. But that process, that does seem to happen here. You talk to anyone here they say, this is blocking things. So just that, I mean, I can understand how the consensus process works, but it seems like that could raise some issues. Please. Is the term harm reduction is that something that the U.S. can even in the U.S. take into declaration on it? And to use of that, the don't accept Mariana, but in the U.S. you must have control over your territorial, that in some states, Colorado, for instance, you really will allow it, they will allow it. But is this a way, like snake, you can't save, full out and stop them or not? So you have control over your territorial in the question also, Mariana? So let me kind of talk first and then I'll let Ambassador Ronfield talk about this issue on harm reduction. I've been doing public health work for longer than I care to admit. Since before I was born. I like to think. And the term harm reduction I think is challenging because it means so many different things to so many different people. And I think part of what we're trying to look at is, what is the consensus in terms of approaches to reducing the harms associated with drug use? And how do we move people toward health and well-being? And I think there is a consensus in our position is, there is a tremendous amount of consensus around kind of this principal focus on reducing the harms. And I'll turn it over to Ambassador for how that gets discussed as it relates to the processes here. But I think it's important if you look at kind of the technical consultation and if you look at the interventions that are supported or those kinds of interventions. The United States I think is very forward leaning in terms of its support for those kinds of interventions. In fact, and this is not my intention to reveal an entire negotiating strategy or negotiating process within the CND and the upcoming on-gas at this meeting, but in many ways for the United States government, the discussions over harm reduction are a labeling issue. In the United States, and I acknowledge, I am now offering a national position, not a global position. Over the last 10 or 15 years in common public usage the term harm reduction has come increasingly to be interpreted as a backhanded way to describe legalization. What we have asked respectfully, modestly and humbly in these discussions you find a new description or a new label. We are as Mr. Botticelli has just indicated. In fact, not only comfortable with but believe we play a leadership role in much of the rest of the world in terms of much of the substantive matter that the international community means when they say harm reduction. And in order to avoid the confusion that would ensue in our own country, our request is a very simple one of finding a new subject heading. If we mean reducing social damage caused by drugs perhaps we can say reducing social damage caused by drugs and in that way not contribute to both confusion and passionate debate in at least one country in the United Nations system. Briefly on the matter of international convention obligations and national territory, you are of course correct that that language appears in two of the international drug control conventions. But also the language appears in the two international drug control conventions that states that individual member states through their own constitutional processes will be permitted to enforce the conventions in accordance with their constitutions. So we have in a sense two different parts of the convention that can lead one to different conclusions. I have offered you our conclusion reasonable minds may differ at least up until this point in time there has not been a formal adjudication on that point. Of course there is debate over this issue. Of course there are disagreements on this issue this is part of what democracy whether in a national or international context are all about and in fact I think it's quite healthy for the international system if others disagree I welcome hearing your views. Having written a dissertation 25 years ago on the war on drugs in the 19th which was the time of the president of the great George Bush father I was quite astonished in the advent of this Angus conference to find almost everybody taking distance to war on drugs. Also in the interview, the television interview you were inviting us to look at in the invitation for this press conference to the past war on drugs so the question linked to it would be will we see any changes in the field of international cooperation from the United States of America? I'll get my asses. Possibly possibly linked to that back in these times there was the perception in Congress that certain drug producing transit countries would let the political world to take action against drugs. So there was a certification process established. Will certification go on? So I'll get my asses. So I like to think that we've learned a lot over the past 40 years. Our scientific evidence I think as it relates to understanding addiction as a disease I think has really influenced our approach to this. I've often talked on our over reliance on punitive approaches to this. Our jails and prisons are full of people who are there largely as a result of their substance use and I think we've really learned that we can have effective prevention, intervention treatment programs that we can divert people away from our criminal justice system without increasing crime. So there's a confluence of this. I will also say too though that there is a role for law enforcement but we need to use that law enforcement response for people who traffic drugs in our community that we still have to reduce the supply of drugs. Much of our overdoses these days are attributable to heroin and fentanyl that are just flooding the streets of the United States. So law enforcement, supply reduction does continue to play a critical role but this is all about balance. This is about making sure that we have a balance release of this and my take at least over the past few years is that there is a tremendous amount of consensus among that kind of balanced approach to this. Are there outlier countries certainly but I think that the vast overriding consensus is on this balanced approach on greater focus on public health strategies and alternatives to incarceration and reserving our criminal justice system and law enforcement for really those serious violations. Just a couple of additional points. Some historical context for you. In the year 1973 the then president of the United States Richard Dixon said publicly we were engaged in a war on drugs. He was trying to make I believe he's no longer around to consult but I believe the point he was making was that this is such an important issue for the United States of America. We will treat it as though it were a war. Twenty years later the recently inaugurated new president of the United States Bill Clinton said both in private and in public this is not a war. We do not make war on our own citizens. We have not been engaged in the United States government in a war on drugs at least since the year 1993. I understand it is a popular expression. I cannot stop others from using it but you should not operate on the assumption that it in any way reflects the United States government policy on drugs nor has it for more than 20 years. Do we have a certification process? I would use this as an example of what Mr. Botticelli was just describing which is the evolution the adjustment the modification that changes in policy over 40 or 50 years. More than 40 years ago when the United States Congress passed the International Narcotics Control Act they required the Department of State and specifically that part of it which I run today to engage in an annual exercise by which we assessed and determined whether other governments were in fact taking sufficient statutory steps to address the drug problem and the drug crisis. That is no longer the law. Why? Because we realized over time that that process which came to be known as the certification process was actually causing more damage than good. What we have now is a much more fact based annual report process called the International Narcotics Strategy and Control Report or INXER. It is factual in nature every government has the opportunity to express its own view and quite frankly they can disagree or differ in terms of the judgments reached. It is an improvement over where we were. 20 or 30 years ago it is an example of what Mr. Botticelli is describing when he says governments will learn adjust, change their policies as they deal with current and changing realities. The International Cooperation you mentioned how are we coming from Afghanistan now? Not Afghanistan. Go ahead. Go ahead. I am sorry to finish the question. Before the California Cooperation with the Russian Victorino in this matter with the International Cooperation now we have the sanction and now we have Iran it has opened up these hotliners country do you have the cooperation and we have the cooperation with the European Cooperation trafficking in the future? So let me just correct the vast majority of heroin is actually coming to the United States from Mexico and traffic into the United States and I think Ambassador Brownfield would agree that over we have always had some pretty significant positive relationships with Mexico I think that over the past particularly six months we have had a series of very positive and strategic engagements with the Mexican government as it's related to not only the increase in heroin that we see but the violence in Mexico associated with poppy cultivation Ambassador Brownfield and I were just in Mexico last week? Week and a half ago where we had significant I think productive discussions with the Attorney General with every segment of the Mexican government in terms of both their willingness to focus action and attention on this issue and our support for their work so while we want to continue to make sure that we and they are taking actions on this issue that I think we've been heartened by the conversation. I will also say too that I think it's fair for our partner nations to also come to this table understanding that there's a shared responsibility here and I think we certainly understand our demand reduction responsibilities as it relates to how that drives the drug trade internationally and I think we have very positive movement in what we've done in the United States to say this is a shared responsibility that when we continue to move forward in very very strong ways to reduce the demand for drug in the United States which has consequences not just here but internationally so I think it's a good opportunity for understanding that there is shared responsibility in this issue. I'll add a point on that because the way you frame the question was and you described it as hardline countries I would prefer to say every country every one of the 196 countries I believe that are part of the United Nations system has to deal with its own realities that one size does not fit all every country in the world does not confront exactly the same drug abuse and drug control situation as every other this is part of the United Nations reality this is part of the reality that we must deal with as we try to work our way through a final ungas declaration and decision because it must take into account the differing realities of 196 countries and their governments I for one am extremely sympathetic to a government and a country that is suffering a major drug epidemic whether it is heroin and opioids or cocaine or methamphetamine or new psychoactive substances I believe we have to take into account their own positions and their own realities as we try to formulate a global policy I believe a global policy does have to have space within it to allow all different sets of realities to be incorporated within both the conventions and the policy strategy plan that is endorsed by a special session of the UN General Assembly to this extent I think this is a response to some of our earlier questions part of the reality that we must deal with that is why consensus is not necessarily a bad thing if at the end of the day you want a policy that every nation in the world can accept endorse and support it has to have space for all of those differing realities it's a fair question but the very nature of the question leads you to this sort of United Nations solution speaking of Victor Ivanov you know since Russia annexed Crimea I'm pleased to shut down the methadone centers because in Russia methadone is illegal and more than 30 people died and we asked Ivanov yesterday what his ideas about this and he said that yeah because methadone is bad and there's proof that more people died because of methadone than there without it we have a good experience of a lot of science in research in the US about methadone so do you think he can somehow let them know that it's working or not in terms of yeah you know I'm not sure to what extent that we can kind of influence in terms of their decision I mean I think you know in terms of US policy and practice on what that is and part of it is relying on the science methadone has been around for 50 years it's been one of the most evaluated medications that we have here and so I do find it you know unfortunate when kind of other countries don't rely on science and data to look at both their policies and practice particularly in the midst of you know kind of widespread heroin and opioid use you know I can tell you that in the United States you know that's why more widespread access to all the three FDA approved medications for opioid use disorders is part of our prime strategy so because we know that you know again that people on methadone have particularly people who are maintained on methadone do far better than those who would just get no medications as it relates to their ongoing therapy I think you beat them by a couple seconds so you get to go micro seconds just following on that I was curious I'm sure it's probably difficult to declare on this stuff but in terms of policies implemented in other countries say Portugal decriminalizing how both of you make clear there's no one size it's all it's a very small country in the U.S. I don't know how many times it's larger than Portugal but I actually don't know he probably does just in evaluating the process internally for evaluating within the U.S. government how decriminalization is worth would you consider Portugal's steps and success in that national context public I mean or it bites too soon although that probably would be a success or not a strategic legalization but how do you evaluate those? So I'll start from the broadest possible framework I think we have to look at a whole host of issues not just here in the United States but internationally as they roll forward I looked at the Portugal evaluation and part of even their own evaluation as a result to some of the positive outcomes that they have been achieved by their own attribution has said well some of this can probably related to the fact that they significantly amplified their public health demand reduction strategies and so again I think we're always open to seeing where the science and evidence takes us and to look at how we can continue to update and refine drug policy based on all of the scientific information that we have in front of us to do that so again but I think looking at what other countries have done I think become equally important one of the things that I think is important and lots of discussion here internationally is let's implement the things that we know to be effective and so we know that those public health strategies demand prevention, intervention treatment, recovery supports are effective and I think what we have been doing in the United States and I think there's a consensus internationally is let's first before we start experimenting with other things let's first start implementing the things that we know to be effective so people have been talking about new approaches and a new approach is let's fully implement the things that we know to be effective and I think that's been our approach in the United States let's make sure that we're implementing those things that we know to be effective as it relates to reducing drug use and its consequences sure I would only add that from an international kind of policy and even legal perspective reinforcing the point we were making earlier of having learned lessons over the last 40 or 50 years one lesson that perhaps we as an international community have learned is that the route to success is not for one government to judge another government in its efforts but rather to accept the reality that individual nations will pursue individual national drug control policies the obligation that we all have is to comply with the terms of the three international drug control conventions that is an obligation we have because we have all individually chosen to ratify the conventions and as a consequence we have taken on that obligation to determine if a government is in compliance or not in compliance that is not a decision for an individual government to make that is a decision in accordance with the conventions for the international narcotics control board which in turn has a procedure by which it makes a judgment and issues that judgment that's my suggestion I agree with everything Mr. Botticelli has just said this does not mean we're not learning lessons we're not paying attention we're not determining what has worked and what has not worked both in the United States and in the other 195 nations in the UN system but it is not that one nation judges or renders judgment on another Okay I think that's about all the time we have so thank you very much for coming and thank you Director Botticelli and Ambassador Brownfield for joining us and taking your time to discuss everything with us if you have any further questions if you don't know how to reach me I can give you my call and we can ask them on I have a question Yes It was a tie He did have his hand up Sorry about that We're good for one more minute I know that that government is in the fourth state but is the government monitoring what's happening there just to share and take account of if the market is shrinking or if there are more people that are increasing number of people that are smoking or I don't know are you monitoring what's happening there in the national community or Sure so let me first say a couple things to answer your question simply yes so we're looking at this I also think it's important to understand that some of these states actually didn't have a tremendously good monitoring system in place to be able to do that so I think the first and foremost is do we have the monitoring systems in place to look at both the public health and public safety impact of what's happening I think that our approach to this has been ongoing monitoring whether it's state level and national level databases to be able to look at kind of both again both the public health and public safety impact of these issues I will tell you that I think it's so first of all it's not while we'll continue to be transparent about those implications it's not our intent to publish a report we will in terms of success or failure but just to be very transparent on the data as we get the data I do think at this point it's really kind of too soon to tell since many of these have not been implemented that long ago to really understand kind of what the impact has been but that's been our plan all along to continue to monitor those