Congressional Record, Volume 162 Issue 36 (Monday, March 7, 2016)

[Congressional Record Volume 162, Number 36 (Monday, March 7, 2016)]
[Senate]
[Pages S1303-S1313]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

COMPREHENSIVE ADDICTION AND RECOVERY ACT OF 2015

The ACTING PRESIDENT pro tempore. Under the previous order, the
Senate will resume consideration of S. 524, which the clerk will
report.
The bill clerk read as follows:

A bill (S. 524) to authorize the Attorney General to award
grants to address the national epidemics of prescription
opioid abuse and heroin use.

Pending:

Grassley amendment No. 3378, in the nature of a substitute.
Grassley (for Donnelly/Capito) modified amendment No. 3374
(to amendment No. 3378), to provide follow-up services to
individuals who have received opioid overdose reversal drugs.

Mr. CORNYN. I suggest the absence of a quorum.
The ACTING PRESIDENT pro tempore. The clerk will call the roll.
The bill clerk proceeded to call the roll.
Mr. MARKEY. Madam President, I ask unanimous consent that the order
for the quorum call be rescinded.
The ACTING PRESIDENT pro tempore. Without objection, it is so
ordered.
Mr. MARKEY. Madam President, before I begin, as we discuss the
Comprehensive Addiction and Recovery Act, I would like to take a moment
to thank Senator Whitehouse for his role in developing the bill and
bringing it this far. I also convey my gratitude to Minority Leader
Reid and the ranking member of the Judiciary Committee, Senator Leahy,
for their excellent staffs and for urging that my amendments--which I
will address momentarily--be a part of the discussion and for managing
the negotiations on this bill. I also thank Senator Murray, the ranking
member of the HELP Committee, for help and counsel on amendments.
Let us pause for a moment and consider the causes of the prescription
opioid and heroin epidemic gripping our country. Understanding the
causes will help us focus on the right solutions. Three distinct
parties bear much of the blame for this public health crisis.
First, there is Big Pharma. In the mid-1990s, the seeds of this
epidemic

[[Page S1304]]

were planted with the aggressive, misleading, and ultimately criminal
marketing of the powerful opioid painkiller, OxyContin by Purdue
Pharma. Perdue claimed OxyContin was not addictive and couldn't be
abused. Neither of those claims turned out to be true. Purdue Pharma
built a massive marketing and sales program for OxyContin. From 1996 to
2000, Purdue Pharma's sales force more than doubled from more than 300
sales representatives to almost 700 sales representatives. In 2001
alone, Purdue gave out $40 million in bonuses to its burgeoning sales
force. As a result of these sales and marketing efforts, from 1997 to
2002, OxyContin prescriptions increased almost tenfold, from 670,000 in
1997 to 6.2 million in 2002.
Purdue's marketing of OxyContin broke the law. In 2007, Purdue Pharma
paid $600 million in fines and other payments after pleading guilty in
Federal court to misleading regulators, doctors, and patients about the
risks of addiction to OxyContin and its potential for abuse.
Second, Purdue Pharma's criminal wrongdoing did not occur in a
vacuum. The Federal Government helped to enable this epidemic. The
Federal Drug Enforcement Administration is responsible for approving
the annual production quotas for pharmaceutical companies to
manufacture oxycodone, the principal ingredient in OxyContin. From 1996
to 2016, the Drug Enforcement Administration obliged Big Pharma and
increased by almost 150 percent the amount of oxycodone authorized for
manufacture. In 1996, the DEA authorized U.S. pharmaceutical companies
to make the equivalent of 6 billion 10-milligram OxyContin pills. By
2016, that figure had increased to almost 14 billion 10-milligram
pills. That is right. Today the Drug Enforcement Administration is
telling Big Pharma it is OK to make 14 billion OxyContin pills to sell
in the United States in 1 year.
The Federal Food and Drug Administration was also complicit,
approving new opioid after new opioid. In the process, the FDA, charged
with ensuring the safety of all prescription drugs on the U.S. market,
began turning a blind eye to outside experts who were warning of the
dangers these drugs posed.
In 2013, an expert panel established to review the powerful new
opioid painkiller Zohydro, voted 11 to 2 against recommending its
approval, but the FDA approved the drug anyway, overruling the concerns
voiced by experienced physicians on the panel.
In 2014, in the wake of the Zohydro decision, the FDA twice skipped
the advisory committee process altogether when it approved two new
prescription opioids.
Then, in August of 2015, the FDA did it again. This time it bypassed
an advisory committee of outside experts on the question of a new use
for OxyContin for children aged 11 to 16. The FDA even ignored its own
rules that specifically call for advisory committee advice when a
committee of pediatric dosing is involved. It was clear that the FDA
was intentionally choosing to forgo advisory committees in order to
avoid another overwhelming Zohydro-like vote, recommending against
approval of a prescription opioid and in order to avoid any impediments
to new opioids being sold in the United States.
Finally, the medical profession must bear its fair share of
responsibility for this crisis. Doctors are prescribing opioids at an
alarming rate. In 2012, America's doctors wrote 259 million
prescriptions for opioid pain relievers, enough pills for every single
American adult to have a bottle of opioid pills given to them in the
year 2012.
And America's doctors are dangerously uninformed about the drugs they
are prescribing. A recent survey of 1,000 physicians nationwide found
that ``only two-thirds correctly reported that the most common route of
abuse was swallowing pills whole.'' It is unconscionable that our
doctors are so ill-informed. Nearly half of the doctors surveyed also
erroneously reported that so-called abuse-deterrent formulations of
opioids were less addictive than their counterparts. Abuse-deterrent
opioids are supposed to be harder to crush, so they are harder to snort
or to mix with liquid and inject, but abuse-deterrent formulations of
opioids are just as addictive as non-abuse-deterrent opioids. Whether
an opioid is abuse-deterrent or not hasn't prevented tens of thousands
of people who have had their wisdom teeth removed or experienced lower
back pain from getting addicted to these painkillers simply by
swallowing them.
So what is the result of the combination of Big Pharma's marketing of
prescription opioids, the Federal Government's repeatedly approving
them in ever-increasing numbers, and our doctors writing millions of
prescriptions for them? Today, the United States is less than 5 percent
of the world's population but we consume 80 percent of the world's
opioid painkillers. We have become the United States of Oxy.
When prescriptions run out or the price of Oxy pills on the street
become too high for those who have become addicted, they turn to
cheaper heroin, which shares the same molecular structure as OxyContin.
Eighty percent of the people suffering from heroin addiction started
with opioid pain medications approved by the FDA and prescribed by
doctors.
In 2014, nearly 33,000 people died of an opioid overdose in this
country. Almost 1,300 of those deaths were in my home State of
Massachusetts.
I had hoped to offer amendments to CARA to address both the causes of
this epidemic and to provide treatment for those suffering from the
results. One of my amendments would have required the FDA to convene
advisory committees for all prescription opioid approval questions.
After I placed a hold on the nomination of Dr. Robert Califf to serve
as FDA Commissioner, the agency announced it would only commit to
convene advisory committees for non-abuse-deterrent opioids. The FDA
refused to agree to convene advisory committees to inform all of its
opioid-approval decisions.
We need legislation requiring the FDA to seek expert advice about the
risk of addiction before it approves any and all opioids, and I will
continue to fight to require advisory committees at the FDA.
We also need legislation requiring doctors to get and stay educated
about the dangers of the pills they are prescribing in record numbers.
Stopping the overprescription of opioid painkillers is a critical step.
We need to ensure that all prescribers of these opioid painkillers
are educated in the dangers of these drugs, how easily individuals can
become addicted, and when and how to appropriately prescribe. The
doctors say that they do not want education to be mandated, that it
should be voluntary. Well, the FDA has had voluntary education for
opioid prescribers in place since 2013 and has been actively
encouraging doctors to take these voluntary education programs, but in
more than 2 years, only 12 percent of prescribers have actually
completed FDA's voluntary education program.
It is imperative that any provider who is applying for a Federal DEA
license to prescribe opioids have completed mandatory education on the
basics of opioid prescribing and the inherent risk of addiction. My
amendment would have done just that. It would have required basic
education as a condition of a DEA license to prescribe these
painkillers, and I will continue to fight to require prescriber
education.
Finally, we need to remove the barriers to effective treatment,
including outdated Federal restrictions on medication-assisted
therapies such as Suboxone. Medication-assisted therapy for opioid
addiction is cost effective, decreases overdose deaths, and reduces
transmission of HIV and hepatitis C. Unlike other treatment regimens
for any other disease, physicians are severely limited in the number of
patients they can treat with medication-assisted therapies such as
Suboxone, contributing to long wait-lists and an inability of patients
to get treatment for their addiction when they need it. Of
approximately 2.5 million Americans who abused or were dependent on
opioids, fewer than 1 million received treatment for their condition,
partly because of the already existing Federal instructions.
Senator Rand Paul of Kentucky and I have a bipartisan bill, the
Recovery Enhancement for Addiction Treatment Act, or TREAT Act, which
has broad stakeholder support, including the American Medical
Association and nurse practitioners. It emphasizes quality of care and
closes this gaping

[[Page S1305]]

hole in our addiction treatment system. We had hoped to offer TREAT as
an amendment to CARA. We will continue to fight for it and are hopeful
the HELP Committee will include it in the substance abuse legislation
the committee will soon consider.
My collaboration with Senator Paul shows that whether it is the
Commonwealth of Massachusetts or the Commonwealth of Kentucky, this
crisis is the same. It doesn't discriminate by geography, by age, by
race, by socioeconomic status, or by employment. It requires a
bipartisan effort.
Thirty years ago, Nancy Reagan told us to just say no to drugs. Today
we have to go further. We have to say enough is enough. We have to
recognize what has worked and what hasn't worked. In the past, we
believed we could incarcerate our way out of the problem. That did not
work. So instead of ignoring and incarcerating, let's avow and act.
Let's destigmatize, not criminalize. Let's treat, not retreat. Let's
have a comprehensive plan which we put in place that deals with the
pharmaceutical companies, the physicians, and the kinds of treatment
patients need across our country so that they get the help they need.
That is our job.
I continue to believe we can do this in a bipartisan fashion as long
as we understand the magnitude of the problem and what the causes of it
were and continue to be and will be into the future unless and until we
put these safeguards in place. So I am looking forward to continuing to
work with my colleagues on the other side of the aisle. I compliment
them for the work they have done so far in bringing this bill to the
floor of the Senate this week, but I do believe there is more to be
done.
As long as this many Americans are addicted, as long as this much
OxyContin and opioids are put into our system, then we are going to
find that this heroin epidemic we have in our country, which is
directly related, will continue to spiral out of control.
I want to work with all my colleagues. I thank my colleagues for all
the work they have done so far, but there is much work to be done in
the future.
Madam President, I yield the floor.
The ACTING PRESIDENT pro tempore. The Senator from Alabama.
Mr. SESSIONS. Madam President, I would like to talk for a few minutes
about the crime problem we have in America today, the dramatically
increasing problem of heroin abuse. Over the last week, we have had a
lot of discussion about this crisis, which I am afraid we are just on
the cusp of. I think it is going to get worse, based on my experience
and my best judgment, but the effort to understand and address it has
been going on for a while.
In January, we had a good hearing on this issue in the Senate
Judiciary Committee, and I want to mention a few things I think we
ought to keep in mind as we address this very important problem.
Just as background, I served 15 years as a prosecutor, 12 as a U.S.
attorney, a Federal prosecutor, and 2\1/2\ as an assistant U.S.
attorney. So that was my background when I came here. I was very active
and studied the drug and crime problem in America, and I learned some
things.
There are cycles in this, and people wrote about it over the years. I
think we are, unfortunately, moving into another cycle, and we have to
be very careful. It is so painful to have a large prison population. We
don't want to have that. Year after year, everybody wants to look for
alternatives to prison, and we have tried, but if you go too far, you
end up not having sufficient consequences for crime, not detaining
dangerous offenders, and you end up increasing crime, increasing deaths
of Americans from murders and other things, increasing heroin and
serious drug problems that destroy families, destroy lives, destroy
communities, and result in violence and death. It is a very real
problem.
A lot of people think, well, if you want to use heroin, so be it.
Well, these people can't function. How are they going to survive? They
either steal or they get on welfare or they have to go to treatment.
And who pays for it, since they do not have any money?
We have proven and seen for decades that drug use can be brought
down, fewer people can become addicted. In the early 1980s, Nancy
Reagan, as President Reagan's wonderful wife, formed the ``Just Say
No'' program, and hundreds of thousands of volunteers nationwide in
every community in America got together in their communities--they got
the treatment community, the law enforcement community, the prevention
community, the education community, and the schools--and they worked
and worked and crafted policies that would create a climate of
hostility for the use of dangerous drugs. The idea was to bring down
the use. As a result, the use of illegal drugs dropped by half. It took
us 15 or more years, but it dropped by half steadily. What a tremendous
victory.
In 1980, half of our high school seniors admitted they had used an
illegal drug sometime in that year. What an unbelievable number. It had
been going up steadily, it peaked, and then it began to go down under
this sustained effort.
What I have been worried about for some time, and have warned about
it, is that if you don't maintain that but start going in the other
direction, you can expect drug use to increase. It is that simple. And
it is happening. Lives--and young people's lives--will be destroyed by
this, families will break up, and children will be scarred.
Drug use is no fun, innocent thing. It is destructive. If this Nation
is using half as much illegal drugs as before, it is a better nation.
It just is. And if we double the amount of drug use in America, it will
be a more dangerous Nation and not as good a nation.
According to the Centers for Disease Control and Prevention, over
47,000 people died from drug overdoses in the United States in 2014. In
2014, 47,000 died. That is one drug overdose death for every 12
minutes. And 61 percent of those overdoses involved opioids. The rate
of all opioid overdoses in the United States has tripled since 2000.
Overdoses have tripled since 2000.
Heroin overdose deaths specifically have increased sixfold since
2001--600 percent--and have more than tripled in just the past 4 years
alone. According to the National Survey on Drug Use and Health, there
were approximately 169,000 new heroin users in 2013.
According to the Substance Abuse and Mental Health Services
Administration, in 2004, approximately 589,000 people in the United
States had an opioid use disorder. We used to call that addiction--a
problem. It is affecting their lives.
The Drug Enforcement Administration's 2015 National Drug Threat
Assessment noted that ``drug overdose deaths have become the leading
cause of injury death in the United States, ahead of motor vehicle
deaths and firearms.''
This is a significant matter. As DEA Acting Administrator Chuck
Rosenberg, a bright, young mind appointed by President Obama, noted
last July that ``[a]pproximately 120 people die each day in the United
States of a drug overdose.''
Some argue that the increase in heroin abuse is due to over-
prescription of opioids from prescription drugs--you get addicted from
a prescription drug, and then you move to heroin. I am sure that has
some validity, but according to a January 14, 2016, study published in
the New England Journal of Medicine, one of the premier authoritative
medical journals in the world:

In the majority of studies, the increase in the rates of
heroin use preceded the change in prescription-opioid
policies, and there is no consistent evidence of an
association between the implementation of policies related to
prescription opioids and increases in the rates of heroin use
or deaths, although the data are relatively sparse.
Alternatively, heroin market forces--

Please hear this, colleagues--

Alternatively, heroin market forces, including increased
accessibility, reduced price, and high purity of heroin
appear to be major drivers of the recent increases in rates
of heroin use.

So it is purity, price, and accessibility. While treatment and
accountability are critical to breaking the cycle of addiction, it is
not the whole solution. We must also reduce the availability of
heroin--we simply have to do that--and other illicit opioids.
In December of last year, the Centers for Disease Control and
Prevention Director Tom Frieden said it is important ``that law
enforcement''--a lot of people don't want to talk about this. We have
police officers, sheriffs' deputies, Federal agents, drug enforcement

[[Page S1306]]

agents, and Border Patrol agents. He said it is important ``that law
enforcement intensify efforts to reduce the availability of heroin,
illegal fentanyl, and other illegal opioids.'' Similarly, Drug
Enforcement Administration Acting Administrator Rosenberg said in the
DEA's National Drug Threat Assessment that, in addition to providing
treatment to addicted opioid abusers, ``law enforcement must continue
to have the tools it needs to attack criminal groups who facilitate
drug addiction.''
I have been there. I was part of law enforcement's efforts. I
invested a tremendous amount of my time in the Coalition for a Drug
Free Mobile, the Partnership for Youth, Bay Area Drug Council--groups
like that--working on a volunteer basis to change the use of drugs in
the community. Law enforcement was always a critical part of it, and
law enforcement does have the capability in ways that others don't to
reduce the availability, make purity levels less, and otherwise
restrict, raising the price of an illegal drug. The DEA's 2015 National
Drug Threat Assessment confirms this. They studied the price of the
drugs. One thing that tells us whether or not law enforcement and
interdiction are effective is to discover if the price is going up or
down.
Mexican drug cartels are flooding the United States with cheap heroin
and methamphetamine. When I was a young prosecutor, it was coming from
Turkey, the Middle East, and that was pretty much shut off. President
Carter did some good things. I was an Assistant U.S. Attorney and came
back a few years later as a U.S. Attorney, but during that time they
somehow reduced the supply of heroin from the Middle East. As a result,
heroin addiction dropped all over the country, and very little heroin
was in the heartland of America--mainly just in the big cities.
We are also getting cheap methamphetamine from across the Mexican
border, which is wide open. The statistics from the DEA Drug Threat
Assessment confirm that, from 2010 to 2014, the amount of heroin seized
every year at the southwest border has more than doubled. Well, are we
catching that much more? No, we are not catching, I am sure, any
substantially larger percentage. We are just having a larger amount
moving across the border. The price has fallen, so we know we have
more. If prices stay low, more people will try it more often, and as
the purity level is higher, more people will get addicted sooner and
often die quicker.
These drug cartels are partnering with criminal gangs and fueling
violence in our cities and communities. According to DEA's 2015 Threat
Assessment, Mexican drug cartels ``control drug trafficking across the
Southwest Border and are moving to expand their presence in the United
States, particularly in heroin markets.'' They import, transport, and
are now actually selling it in our cities instead of just bringing it
in across the border.
In 2013, the heads of the Chicago Crime Commission and the Chicago
Office of the Drug Enforcement Administration both named El Chapo
Guzman, the infamous leader of the Sinaloa Cartel, as Chicago's
``Public Enemy #1.'' So a man in Mexico, moving heroin and
methamphetamine into the United States and hammering Chicago with it--
Chicago named him as their No. 1 public enemy. It cannot be a
coincidence, as the FBI's uniform crime statistics show, that the
murder rate in Chicago increased by approximately 18 percent during the
first 6 months of 2015. At that rate, it is a 36 percent increase in
murders in Chicago in 1 year. This is an unbelievably dramatic surge in
murders.
Another example is Atlanta. DEA's Atlanta office reported an increase
of heroin availability from a rating of ``stable'' in the first half of
2013 to ``high'' just a year later. According to the FBI's uniform
crime statistics, the murder rate in Atlanta increased by approximately
15 percent in the first 6 months of 2015. This is an unsustainable
thing. The old rule is a 7-percent increase and your money doubles in
10 years. When you get 15- and 18-percent increases in 6 months--that's
30 percent in 1 year--you are doubling the crime rate, the murder rate,
in 3 years.

At a November hearing of the Senate Caucus on International Narcotics
Control, I asked DEA Deputy Administrator Jack Riley about these drug
distribution networks and the people in local communities pushing the
drugs, selling the drugs, and collecting the money. This money
eventually ends up back in Mexico, Colombia, and South and Central
America, funding the evil, violent drug cartels that are destabilizing
whole nations. He responded that it is ``almost as big a problem as the
cartels themselves.''
When I asked him whether these drug traffickers are the ones causing
the violence and death on our streets, he responded that ``they are the
ones that regulate themselves by the barrel of a gun.'' If you want to
collect a drug debt, you can't file a lawsuit in Federal court. You
collect it by the barrel of a gun.
By its very nature, drug distribution networks are violent criminals.
It has always been so, and it will always be so. Conducting an illegal
enterprise, they have to maintain discipline, and they use threats and
violence to maintain it and collect their debts. We must not forget
what became obvious in the early 1980s, when I was a U.S. Attorney:
Drug dealers and their organizations are not nonviolent criminals.
These are violent crimes.
Rather than enforcing the law and making it tougher on drug cartels
by keeping our border secure, the Obama administration has done exactly
the opposite. Our unsecured borders make it easy for the cartels to
flood our country with cheap heroin, and the administration has made it
clear that officers are not to deviate from the President's lawless
immigration policy. They are blocked from doing their job and following
their oath.
Just last week--and as someone who has worked closely with Federal
Drug Enforcement officers and immigration officers as a Federal
prosecutor--Customs and Border Protection Commissioner Gil Kerlikowske
testified before the House Committee on Appropriations that ``if you
don't want to follow the directions of your superiors, including the
president of the United States and the commissioner of Customs and
Border Protection, then you really do need to look for another job.''
Do you hear what he is saying there, colleagues? What he is saying is
that if you want to do your job and enforce the laws as the laws are
written, which we have ordered you not to do, and you go on and do it
anyway, then look for another job. It is one of the most amazing things
I have seen in my entire law enforcement career. ICE officers--
Immigration and Customs Enforcement officers--who enforce drug laws,
along with immigration laws, these officers sued their supervisors.
They sued their supervisors, alleging that they were being ordered to
violate their oath to enforce the immigration laws of the United States
by these restrictive policies.
It is hard to overestimate the destruction the Obama administration's
policies--their Executive amnesty, their refusal to sufficiently fund
and man the border--are causing to law enforcement. A big part of this
now is the openness to heroin, methamphetamine, marijuana, and other
drugs that are being imported. I take that statement by the
Commissioner of Customs and Border Protection as a direct threat to
those officers who want to follow their oath and do their duty.
In August 2013, a dramatic event occurred that was too little
appreciated. Attorney General Holder, the Attorney General of the
United States, ordered Federal prosecutors not to charge certain drug
offenders with offenses that carry mandatory minimum sentences that are
in law. If you have so much drugs, you have a minimum penalty. You can
get more than that, but you at least have to serve this minimum
penalty. He ordered them not to charge those crimes. This is directing
prosecutors not to follow the law. It has contributed to a decrease in
the number of traffickers being prosecuted and convicted. According to
data from the Executive Office for United States Attorneys, at the end
of 2015--in December--the 6-month average of drug prosecutions was down
21 percent compared to 5 years ago. And what are we seeing? A surge in
crime, particularly drugs. Excluding prosecutions in magistrate courts,
the 6-month average was nearly 32 percent lower at the end of 2015 than
5 years ago. We haven't cut the number of drug prosecutors. We haven't
cut the

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number of DEA agents. This is policy that softens the enforcement of
drug crimes against what we have been doing for 25 years, and it is
having an impact. I am afraid it is going to continue.
Meanwhile, State and local law enforcement agencies are not given the
tools they need to continue taking these dangerous drug traffickers off
of the streets.
On December 21, 2015, the Department of Justice chose to stop all
equitable sharing payments to State, local, and tribal partners under
the Asset Forfeiture Program. These are seized proceeds, moneys that
are seized from drug dealers, big fancy cars and boats that they seize.
For the last 20 years, Federal and State officers worked together. The
Federal Government has a good system for forfeiting the money. Then,
when the forfeiture is over, it is divided among the agencies. As a
result, State and local people are willing to commit law officers to
participate in these local task forces because they are helping clean
up drugs in their community, helping identify and prosecute nationally
significant drug dealers, and they get some compensation back from it
when they find a truck full of money.
I personally have seen cases where $1 million, $500,000, $800,000 in
cash was seized from these people. Some people think, oh, this is
wrong; you shouldn't take their cash. This is the ill-gotten gain of an
illegal enterprise and they should be able to keep it? They have no
proof of any lawful source of this money. Virtually every time, in
addition, there is evidence to prove it is connected to drugs. Half the
time, they don't even show up to contest the seizure because they know
they have no defense to it. This stops this sharing, and it is
undermining the unity of effort that we really need to be successful.
A joint letter signed by the International Association of Chiefs of
Police, the National Association of Police Organizations, the Major
County Sheriffs' Association, the National Sheriffs' Association, the
National District Attorneys Association, and the Major Cities Chiefs
Association, pointed out that ``the suspension of equitable sharing
payments may cause some agencies across the country to reconsider their
ability to participate in joint task forces with the Federal
Government.''
In other words, they are going to stop participating.
``The effects of this decision are far reaching and not only a
disservice to law enforcement, but also to the public they are sworn to
protect.''
Mr. President, if there is a limit on my time or others are waiting
to speak, I will wrap up. Otherwise, I have about 5 minutes to wrap up.
I see my colleague Senator Leahy, the ranking member of the Judiciary
Committee. I don't want to block him. If my time is up, I will yield
the floor.
The PRESIDING OFFICER (Mr. Coats). There is no time limit in place.
Mr. SESSIONS. While law enforcement resources are being cut off, law
enforcement officers are being blocked from doing their jobs, and drug
prosecutions are being reduced, the administration and some in Congress
want to push and advance a criminal justice ``reform'' bill. But these
proposals will have a tendency, I am afraid, to worsen the current
problem by allowing for more reductions in sentences than are already
occurring and early release of thousands of dangerous drug traffickers,
and the weakening of penalties for those prosecuted under our drug
trafficking laws, which have already been weakened--sending the wrong
message at exactly the wrong time.
I am very concerned about this. I love my colleagues, and I know
their hearts are in the right place, but I am convinced we should not
be heading in this direction at this time.
Make no mistake, Federal prisons are not filled with low-level,
nonviolent drug possessors. According to the Bureau of Justice
Statistics, 99.7 percent of drug offenders in Federal prison at the end
of fiscal year 2012 were convicted of drug trafficking offenses, not
drug possession. Drug trafficking is inherently violent activity, and
it only serves to fund the drug cartels while fueling violence in our
cities.
According to the FBI, violent crime overall increased across the
United States during the first half of 2015, by 6.2 percent for murders
and 17 percent in the larger cities for murder--the largest single-year
increase since at least 1960. Already this year, homicides in Chicago
are double what they were all of last year.
This is a complex subject. It is too soon to know the total reason
for this increase, but it cannot go unnoticed that over the last decade
the Sentencing Commission, which sets standards for sentencing in the
United States--outside of the minimum mandatories that are set by our
law passed by Congress--has unilaterally imposed reductions in the
sentences for drug inmates currently in prison. So we reduced the
sentences for those in prison and they are getting out earlier. The
most recent reduction in sentences resulted in the release of more than
46,000 drug traffickers--not drug possessors, drug traffickers--which
has been wholeheartedly supported by the Obama administration.
According to Bureau of Justice Statistics, 77 percent of drug
offenders released were rearrested within 5 years. Hear this now: 77
percent of these drug offenders were rearrested within 5 years, with 25
percent of those rearrested being rearrested for a violent crime--
somebody hurt, maybe dead. Maybe that is part of the murder rate
increase.
Take Wendell Callahan, a Federal drug felon who was convicted of
trafficking in crack cocaine and released early pursuant to the
Sentencing Commission's directives. Upon his early release, he
proceeded to brutally murder his ex-girlfriend and her two little
girls, 7 and 10. He would have been deep into a 12\1/2\-year Federal
sentence if it had been maintained, but the Sentencing Commission
reduced it. The judge granted his petition for early release because of
his ``good behavior'' in prison, and that led the judge to conclude he
did not pose a danger to the safety of the public, even though in his
background--when he was convicted and got the 12 years, he had
previously been convicted in connection with a shooting offense and
another drug offense. This is why you have to have some controls on
judges. I have been there, and I saw it before the sentencing
guidelines were passed.
The Federal prison population is at its lowest level since 2008. We
are already on a downward course of the drug Federal prison population
being reduced. There are only 160,000 inmates in Bureau of Prisons
custody today, well below its peak. The Bureau of Prisons has stated
that this ``downward population trend is expected to continue into
Fiscal Year 2017,'' bringing the Federal prisons population to the
lowest level since 2005.
The population is up. Crime is going up. The prison population is
falling rather rapidly. Admissions to Federal prison have declined
every year since 2011.
You hear: We are filling our prisons. We are doing more and more.
Actually, there are other things that are already happening. It is
happening in State prisons, too, where larger numbers are incarcerated
than in the Federal prisons. One of the reasons we are having this
large decline in State prisons is not public safety but tight budgets.
They are cutting back on the prison population to save money.
We can be smarter. Some people can be released early. I worked with
my Democratic colleague, Senator Durbin, 6 years ago, I believe, and we
reduced the crack penalties more significantly than a lot of people
know. I thought that was justified. But we are now proceeding well
beyond that, and it is causing me great concern.
The Attorney General has ordered the prosecutors to not charge
certain criminal offenses. Reducing sentences and releasing felons is
equivalent to reducing the cost to the criminal enterprise of their
criminal activity. It reduces the cost, the risk. Thus, crime--it is
already rising--would further increase as a result of the criminal
justice ``reform'' bill that would further reduce penalties.
Can we take a breath, and let's think about this? I don't say there
aren't some things we can do that will allow for some reduction in the
Federal prison population. Some people probably serve more time than is
absolutely necessary. But in truth, we have seen dramatic improvements
over nearly 30 years, 25 years, in the reduction of crime. Until this
surge, murder rates were less than half what they were in 1980 when I
became a Federal prosecutor. Drug use dropped dramatically

[[Page S1308]]

when Nancy Reagan started the ``Just Say No'' program, and drug use
began to steadily decrease. It is now beginning to steadily increase.
You have to have leadership from Washington. You can't have the
President of the United States of America talking about marijuana like
it is no different than taking a drink, saying I used marijuana when I
was in high school and it is no different than smoking.
It is different. And you are sending a message to young people that
there is no danger in this process. It is false that marijuana use
doesn't lead people to more drug use. It is already causing a
disturbance in the States that have made it legal. I think we need to
be careful about this.
What if this is the beginning of another surge in drug use like we
saw in the sixties and seventies that led to massive problems in our
communities? The solution? Well, we have to control the border. All the
heroin and a big chunk of the methamphetamine is coming across the
Mexican border. We need barriers. We need more agents. People need to
be arrested. They need to be deported. They don't get to be taken to
some city in the United States they would like to go to and get
released and asked to show up on bail, which they never do. That is an
open invitation to illegality and illegal entry.
We need to enforce our laws, and we have to make the consequences of
drug trafficking a deterrent. We can do this. We have done it before,
and it is all part and parcel with prevention programs, education
programs, and treatment programs. All that has to be done, but it
cannot be denied, in my opinion, that law enforcement plays a critical
role in it. This means supporting, not blocking the efforts of law
enforcement to do their jobs and giving them the tools to arrest drug
traffickers and be effective at the border, putting them in jail, not
giving them early release so they can commit more crimes.
In January, a woman from Ohio named Tonda DaRe testified before the
Senate Judiciary Committee at a hearing on the heroin and prescription
opioid epidemic. She shared the powerful story of her daughter, who
died from a heroin overdose. She said this:

One of the things that I see happening in our little town
that frustrates me is . . . our officers have worked so
diligently to arrest people that they know are bringing this
[heroin] in. Just [to] have them go in front of our judges
and our judges just slapped these people on the wrist and
sent them right back out the door. . . . The boy that sold my
daughter the heroin that killed her just recently went back
in front of a judge for his fourth offense for trafficking
heroin. [It was the] fourth time he's been arrested for this
and he was given five months. How [is] that possible?

We can talk about making sure we have treatment and recovery for
people who have been addicted, although many people never ever recover
from addiction--except by the grave. That is the sad truth. We should
make that a priority. But we cannot hope to solve these problems by
only treating people on the back end of addiction without reducing the
availability of those drugs and keeping the purity down and the cost
up, not continuing to fall. We have to stop people from becoming
addicts in the first place, and we can't let the fact that we have a
heroin abuse epidemic cause us to forget that we have a drug
trafficking epidemic too.

Law enforcement is prevention. Experts tell us that the price,
purity, and availability of drugs, especially heroin, fuels more
consumption, more addiction, more crime, more death, and more human and
family destruction. I wish it were not true. I wish there were more
options, but law enforcement is a central part of this effort, and
history proves it.
I thank the Chair and yield the floor.
The PRESIDING OFFICER. The Senator from Vermont.

51st Anniversary of Bloody Sunday

Mr. LEAHY. Mr. President, today is the 51st anniversary of Bloody
Sunday--a horrible abuse of American citizens that occurred in Selma,
AL. Each year we commemorate the events of that fateful day, because it
helped transform our Nation and proved to be a catalyst for the passage
of the Voting Rights Act. For the last two years, this commemoration
has been a sad reminder of what five justices did to that cornerstone
civil rights law. In Shelby County v. Holder a narrow majority of the
Court drove a stake through the heart of the Voting Rights Act when it
struck down the coverage formula for its preclearance provision in
Section 5.
I mentioned that because under section 5 of the Voting Rights Act,
the Federal Government has the authority to examine and prevent
racially discriminatory voting changes from going into effect before
those changes disenfranchise voters in covered jurisdictions. By
striking down the coverage formula that determined which States and
jurisdictions were subject to Federal review, the Court rendered
Section 5 unenforceable.
Unfortunately, even though almost every single Republican and
Democrat in the House and Senate voted for the Voting Rights Act, the
Supreme Court, by a 1-vote margin--notwithstanding that 535 of us had
voted--drove a stake through the heart of the Voting Rights Act by
striking down the coverage formula for its preclearance provisions in
Section 5.
Since then Republican Governors and State legislatures have exploited
Shelby County by enacting sweeping voter suppression laws that
disproportionately prevent or discourage black Americans from voting.
This includes the State of Alabama, which not only enacted a burdensome
photo identification law after the decision, but then they made it even
harder for many of its black citizens to obtain identification when the
State closed more than 30 DMV offices in mostly poor, minority
neighborhoods last October.
It is hard to fathom that in 2016, well over 100 years after the
Civil War and passage of the 13th, 14th, and 15th Amendments to the
Constitution, and after transformative moments, such as Bloody Sunday,
that States would continue to pass laws and take actions that would
undermine black Americans' rights to vote.
This past weekend, Congresswoman Terri Sewell, who represents the 7th
District of Alabama--which includes Shelby County, Birmingham, and
Selma--held a public forum in Birmingham to examine the harm caused by
the Supreme Court's Shelby County decision. Several witnesses at that
forum testified that the State had made it harder for their citizens to
vote, and that a disproportionate number of those citizens were
minorities. They also spoke about the urgent need to restore the
protections of the Voting Rights Act. Congressman John Lewis, our great
civil rights hero, was in attendance, and it is heartbreaking to
realize that so many of the gains that he was able to help secure
through his civil rights activism are being undone today.
Despite the compelling testimony about the urgent need for Congress
to address voting rights, most Republicans in Congress continue to
disregard the urgency of this issue. More than two and a half years
since the Shelby County decision, and despite the introduction of two
separate bipartisan bills that would restore the protections of the
Voting Rights Act, the Republican chairs of the Judiciary Committee
from both houses of Congress refuse to even hold a hearing on this
issue. Instead, Republican leaders have only paid lip service to the
issue, supporting the award of congressional medals for brave civil
rights leaders. That is not enough.
Recently, the Speaker of the House stated that he was supportive of
one of the bipartisan voting rights restoration bills. In the same
statement he explained that nothing could be done because the
Republican chair of the House Judiciary Committee refuses to take up
the bill or to have a hearing. This is not leadership. The American
people expect more than talk.
This pattern of Republican obstruction reached unprecedented heights
recently when a few Senate Republicans declared that they would not
even hold a hearing for the next Supreme Court nominee even before the
President has even announced a nominee.
Republicans have apparently decided that rather than be transparent
and hold public hearings and votes on the most significant issues of
the day--including voting rights, comprehensive immigration reform, and
the next Supreme Court nominee--they would simply shut down the
process. Instead they are making important and timely decisions
affecting hundreds of millions of Americans behind closed doors. It is

[[Page S1309]]

not good for our democracy and it is not good for the American people.
We need hearings and a vote on the voting rights bills. And we need a
hearing and a vote on the next Supreme Court nominee. We remember what
came to be known as Bloody Sunday because the blood that was shed led
to greater democratic participation and a more inclusive union. What
Republicans are doing now undermines the hard-fought legacy of Bloody
Sunday and the Civil Rights Movement. For the good of the Nation, I
urge that Republican leaders in the Senate and the House change that
shameful course.
Mr. President, the Senate will soon vote to bring us one step closer
to passage of the Comprehensive Addiction and Recovery Act or CARA.
Last week I suggested that we stay in session and do our job on
Thursday, Friday, and Saturday so we could finish the bill, but I
understand the Republican leadership wanted to take a long weekend, so
we did not finish it, but now we can.
I am a cosponsor of this bill because it addresses the growing
problem of prescription opioid and heroin addiction that has had
devastating impacts on communities all over the country, including my
home State of Vermont.
This bill represents an important shift in the way we approach the
issue of substance abuse and addiction. It sets a comprehensive
framework to reduce opioid deaths, prevent addiction, and improve
treatment. It will also help those who suffer from opioid use disorders
achieve recovery, and perhaps most importantly this bill reflects the
consensus of this body that the Nation cannot arrest or jail its way
out of this addiction problem.
Since my first field hearing in Rutland, VT, on this topic in 2008, I
have been inspired by how my fellow Vermonters across the political
spectrum have shaped the discussion about this public health crisis and
how they have served as a model for communities across the Nation.
I certainly feel this bill represents important progress, but we
cannot be satisfied with just passing this one bill. We also need a
significant commitment of targeted funding so we can carry out and
implement the programs authorized by this bill.
It is one thing to say we are going to authorize these great programs
even though we are not going to pay for them, but don't you feel good
that we authorized them. Now we can all go home and tell our
constituents we care. We authorized it, but we will not pay for it.
At least Senator Shaheen stood and proposed an amendment that would
have provided emergency funding to do just that. Her vital amendment
had the support of a majority in this body, but Republican Senators
blocked it from being considered and adopted. It is unfortunate because
Senator Shaheen's amendment would have provided the resources to
strengthen both the law enforcement and public health components that
would have delivered the necessary resources to health care
professionals all over the country who are overwhelmed by a need they
cannot meet.
I believe there is bipartisan agreement that we have to stop the loss
of life caused by opioid abuse. There should be a bipartisan agreement
to provide the money necessary to do so.
There is an opportunity to make the bill better. Many Members have
filed amendments to improve CARA. A number of amendments were filed by
both Republicans and Democrats. Unfortunately, the Republican leader
has not allowed us to have an open amendment process, and contrary to
what he said earlier, a number of Senators have been blocked from
offering their amendments. I tried to work--and did in a bipartisan way
with Senators Grassley, Whitehouse, and Klobuchar--to consider this
bill and report it to the Senate floor. We have continued our
bipartisan effort to reach agreement on a number of amendments that
could improve the bill. I hope those important bipartisan efforts will
continue this week so we can consider these amendments and have final
passage this week.
Let us have an open process. These amendments can be voted on up or
down or adopted by consent. It is one thing for us to talk about what
we want to do, it is another thing to have the courage to vote for it.
If we do not vote for it, we are just voting maybe. Let us vote yes or
no.
As we work toward Senate passage of CARA, our goal should be to make
this the best bill possible. Addiction is nothing less than an epidemic
and CARA treats it like one. This bill demonstrates that Congress now
sees addiction for what it is--a public health crisis all over our
country. We need to equip our communities with both the programs and
resources they need to get ahead of addiction.
CARA will save lives. It is worth putting the money in there to make
sure it works.
Mr. President, I see the distinguished senior Senator from West
Virginia on the floor, and I yield the floor.
The PRESIDING OFFICER. The Senator from West Virginia.
Mr. MANCHIN. Mr. President, I ask unanimous consent to speak for up
to 10 minutes.
The PRESIDING OFFICER. Is there objection?
Without objection, it is so ordered.
Mr. MANCHIN. Mr. President, I wish to thank the senior Senator from
Vermont, who is a dear friend of mine. As he knows, this is a problem.
It is an epidemic all over this country. No State is immune from it. It
doesn't matter whether you are a Democrat or Republican. It has no
home. It attacks and literally eradicates all of us, and it causes
extreme hardships for all the families.
I know the Presiding Officer, who is from Indiana, is aware of this
problem. Every week I have come to the floor to read letters from
people who have been affected by addiction in West Virginia and other
States. I have a letter from the Presiding Officer's home State of
Indiana, and I have a letter from my State too.
This is something we have been fighting. The CARA Act is a bipartisan
piece of legislation. It is not going to be a cure-all, but it starts
in the right direction for us to start looking at opioid addiction and
prescription drug abuse, not as much as we have in the past as a crime
but as an illness, and an illness needs to have treatment. I think we
are moving in that direction. Politically we are accepting this, and we
are going to basically meet that need of treatment which is so few and
far between.
We have 51 people dying every day. In my little, beautiful State of
West Virginia, just last year we lost over 600 lives to prescription
drug abuse, and I have a State with less than 2 million people. From
1999 to 2013 there has been an increase of over 700 percent.
This is a product which has come on the market that is greater than
anything we have ever seen. We hope the FDA gets serious about this.
They are hearing us loud and clear. Dr. Califf was not someone whom I
supported. I am very hopeful he will do a great job, and I will support
him. He needs to step up to the plate and change the culture of the
FDA. The reason I say that is because the FDA has to take their role
seriously and not just approve drugs because it meets a certain
criteria but also needs to realize the impact it has on the well-being
of the families who have been addicted and affected. They need to
consider the devastating public health impacts of its repeated
decisions to approve all of these drugs that don't need to be on the
market. We are very hopeful for that.
The thing that brings that to mind is that it took us forever to get
Vicodin and Lortab from a schedule III to a schedule II. It took us
over 3 years. Once we did, it took about 1 billion pills off the
market, which resulted in a 22-percent decrease in Vicodin and Lortab,
which were being passed out like M&Ms. We know it can save lives. Yet
they came right back with Zohydro, which was against the wishes of
their advisory committee.
We believe it is imperative that they have an advisory committee for
every opioid they want to bring to the market. They must listen to the
advisory committee. If the FDA--the Commissioner and his staff--wishes
to go ahead and put a product on the market that is recommended not to
be on the market from their advisory committee, they should come before
us in Congress and tell us why they believe this potent drug such as
Zohydro is needed when it is against the recommendations of these
experts and specialists.
We have been flooded with these stories. I will read a story from the
Presiding Officer's State of Indiana first.

[[Page S1310]]

The girl's name is Danielle. She says: I live in Southern Indiana and
work as a server. About 2\1/2\ years ago a customer by the name of Josh
Harvey left me his number. At the time, he told me he was living in
Chicago for school. Little did I know he was in rehab there. Granted, I
didn't know about his addiction for over a year because we hadn't
stayed in constant contact. About a year or so ago I found out about
his heroin addiction. He still told me little about it. I do know it
started out with prescription pills and later went into heroin when the
pills became harder to get. He served a month in jail in Michigan, for
the entire month of this past July, over a heroin-related charge. He
came home immediately after and overdosed that same weekend. Luckily,
his dad saved him that time. Now he got enrolled in college and was
going to an outpatient program doing better--or so we all thought.
School let out for break and I guess it all went downhill. He came to
me on November 4 telling me he had used a couple of times and wanted my
advice. I suggested an inpatient program. He went to Wellstone after he
left my house, sat for several hours and finally was given a room. I
went and checked on him two different times while he waited to make
sure he was there. Thursday I didn't receive any calls. Friday nothing
either. Then, Saturday morning, the 7th of November, his mother called
me to break my heart. He had passed away that Friday the 6th over in
Louisville and they didn't know who to contact until that Saturday
morning, I guess. He had checked himself out of Wellstone, broke into
his house, and took his Xbox, which he later either pawned or traded
for heroin. Never in a million years did I think I would become close
to anybody addicted to heroin. It doesn't discriminate. It can get a
hold of anyone and everybody. Never in my life have I been so depressed
or heartbroken. All I want is his story shared. He was my happy ending
gone way too soon.
That was from our friend in Indiana who wanted to share her story
with us.
Let me tell you about Amanda, who lives in West Virginia.
Amanda said: I walked into our new apartment. Although we had only
spent 2 nights there, it already felt like home. I was so excited to
move in with Nate. We had been on the fence between being best friends
and a couple, and making the decision to move in together had finally
settled years of uncertainty. As I turned the corner, I was surprised
to see that he was in the exact same position as when I had left for my
morning classes. I knew it had been a rough night of ``partying,'' but
I thought he would be up to start our busy day of painting and moving.
I touched his chest to feel the rise and fall, something that, as a
mother, I had been doing to sleeping children for years. There was
movement. He was breathing. I breathed a quick sigh of relief. I walked
to the back of the apartment to set down my things, and that is when I
realized I needed to go and get some things from my old apartment, and
I started to leave. My hand was on the doorknob, but something stopped
me in my tracks. To this day, I don't know why I turned around. I laid
down beside Nate, and I put my arm on his chest. He was not breathing,
and when I looked up at his face, his eyes were wide open, but it was
obvious that he was not there. The paramedics revived him to the point
that he survived in a coma for 1 week. At one point while in the
hospital, his eyes opened, and I thought that our nightmare was over,
but it was just a muscle reflex and false hope. On January 30, 2007,
prescription drugs took the life of Nathan Keith Dunn, age 24.

Tall, dark, and handsome is what the world saw. Intelligent, funny,
witty, loving, and kind were the qualities seen by those who knew Nate
best. He was my best friend, my musical soulmate, and my sounding
board. We were inseparable, and I began to experience an ache in my
heart that, 9 years later, still occasionally brings me to my knees.
But that is just who Nate was to me. He was also the older son of a
mother who had left years of abuse at the hands of her husband in order
to find a better life for her sons. He was the brother to--and the only
soft spot of--a boy who had been hardened growing up on the streets of
a town outside of Houston, TX. It seemed as if the only thing that ever
kept him grounded was Nate's love. They had one another's back in the
best and worst of times. Nate was also the instant crush of any girl
who ever laid her eyes upon him. He was the best friend of anyone who
knew him. I often wonder who and where he would be today. But I guess I
will just have to wonder forever.
I wish this was the end of my story about how prescription drugs have
affected my life, but it is not even close to the end. For longer than
I care to admit, drugs have been part of my everyday life. Shortly
after Nate's death, I became addicted to prescription opiates. At
first, they were prescribed by my doctor. Eventually, I couldn't get
through a day without them. I was what is sometimes referred to as a
``functioning addict,'' although it is fair to say that such a thing
does not exist. To the outside world, I appeared to be fine, normal
even. I held a job. I cared for my young sons. I kept a tidy home.
Meanwhile, my tolerance was building, and I began to require more and
more of the drugs just to feel normal, just to get through each day.
Can you imagine living this life in which you wake up each day
wondering if you have enough of the drug you need just to be OK for
that day?
So many people are facing this every single day. It could be the
person sitting next to you. It could be your child's teacher. Even
worse, it could be your own child.
The first thing to suffer was my financial situation. Every dime I
had was spent on the drugs that would allow me to function today,
tomorrow, and if I am lucky, the next. Then, my relationships with
friends and family began to fail. It was painfully obvious that I was
stealing from them. Next, I couldn't keep a job--a record that will
haunt me for the rest of my life. How could I go to work? How could I
continue on?
Then, a catalyst walked into my life. I met a very good man. As we
became closer, I realized that I couldn't bring myself to tell him that
I was a drug addict.
This is a silent killer. Nobody speaks; they all keep it very quiet.
Mr. President, if I may have about 1 minute to finish up, I would
appreciate it.
The PRESIDING OFFICER. Is there objection?
Without objection, it is so ordered.
Mr. MANCHIN. Thank you, Mr. President.
Very few people know what is actually happening in your life. In
order to get help, you have to be willing to openly talk about your
issues, and most of us fear being harshly judged--and rightfully so.
Trying to treat a person with addiction issues by using medication
only or therapy only is like trying to extinguish a raging house fire
with a garden hose.
She said: I was fortunate enough to have found a medication-based
treatment program in my area, which is paid for by my insurance.
She is going to move forward, and she wanted this story to be told.
She said she wanted people to know how difficult it is.
What we need to know as policymakers is how hard it is for people in
our States who realize they need help and can't find it.
So what I ask all of us to do--this CARA bill is a step in the right
direction. It is a piece of legislation that is much needed. As we move
forward today on this piece of legislation, I hope we will find
basically the support that people are needing to fight this opiate
addiction.
Thank you, Mr. President.
I yield the floor.

Cloture Motion

The PRESIDING OFFICER. Pursuant to rule XXII, the Chair lays before
the Senate the pending cloture motion, which the clerk will state.
The legislative clerk read as follows:

Cloture Motion

We, the undersigned Senators, in accordance with the
provisions of rule XXII of the Standing Rules of the Senate,
do hereby move to bring to a close debate on Senate amendment
No. 3378, the substitute amendment to S. 524, a bill to
authorize the Attorney General to award grants to address the
national epidemics of prescription opioid abuse and heroin
use.
Mitch McConnell, Chuck Grassley, Deb Fischer, John
Barrasso, Shelley Moore Capito, Roy Blunt, Johnny
Isakson, John Boozman, Mike Crapo, David Vitter, Mike
Rounds, Bill Cassidy, James

[[Page S1311]]

E. Risch, Lindsey Graham, John McCain, Thom Tillis,
Orrin G. Hatch.

The PRESIDING OFFICER. By unanimous consent, the mandatory quorum
call has been waived.
The question is, Is it the sense of the Senate that debate on
amendment No. 3378, as amended, offered by the Senator from Iowa, Mr.
Grassley, to S. 524, shall be brought to a close?
The yeas and nays are mandatory under the rule.
The clerk will call the roll.
The legislative clerk called the roll.
Mr. CORNYN. The following Senators are necessarily absent: the
Senator from Texas (Mr. Cruz), the Senator from Alaska (Ms. Murkowski),
the Senator from Florida (Mr. Rubio), the Senator from Pennsylvania
(Mr. Toomey), and the Senator from Louisiana (Mr. Vitter).
Further, if present and voting, the Senator from Pennsylvania (Mr.
Toomey) would have voted ``yea.''
Mr. DURBIN. I announce that the Senator from California (Mrs. Boxer),
the Senator from Delaware (Mr. Carper), the Senator from Missouri (Mrs.
McCaskill), the Senator from Maryland (Ms. Mikulski), the Senator from
Florida (Mr. Nelson), and the Senator from Vermont (Mr. Sanders) are
necessarily absent.
The PRESIDING OFFICER (Mr. Lankford). Are there any other Senators in
the Chamber desiring to vote?
The yeas and nays resulted--yeas 86, nays 3, as follows:

[Rollcall Vote No. 32 Leg.]

YEAS--86

Alexander
Ayotte
Baldwin
Barrasso
Bennet
Blumenthal
Blunt
Booker
Boozman
Brown
Burr
Cantwell
Capito
Cardin
Casey
Cassidy
Coats
Cochran
Collins
Coons
Corker
Cornyn
Cotton
Crapo
Daines
Donnelly
Durbin
Enzi
Ernst
Feinstein
Fischer
Flake
Franken
Gardner
Gillibrand
Graham
Grassley
Hatch
Heinrich
Heitkamp
Heller
Hirono
Hoeven
Inhofe
Isakson
Johnson
Kaine
King
Kirk
Klobuchar
Lankford
Leahy
Manchin
McCain
McConnell
Menendez
Merkley
Moran
Murphy
Murray
Paul
Perdue
Peters
Portman
Reed
Reid
Risch
Roberts
Rounds
Schatz
Schumer
Scott
Sessions
Shaheen
Shelby
Stabenow
Sullivan
Tester
Thune
Tillis
Udall
Warner
Warren
Whitehouse
Wicker
Wyden

NAYS--3

Lee
Markey
Sasse

NOT VOTING--11

Boxer
Carper
Cruz
McCaskill
Mikulski
Murkowski
Nelson
Rubio
Sanders
Toomey
Vitter
The PRESIDING OFFICER. On this vote, the yeas are 86, the nays are 3.
Three-fifths of the Senators duly chosen and sworn having voted in
the affirmative, the motion is agreed to.
The Senator from Ohio.
Mr. PORTMAN. Mr. President, that is good news. The Presiding Officer
just announced the results of the vote, and that is good news because
it means the Senate has just taken another step toward the passage of
CARA, the Comprehensive Addiction and Recovery Act.
I see my colleague Senator Whitehouse is on the floor. I thank him
and thank my colleagues on both sides of the aisle for moving forward
on this legislation that will help us to save friends, family members,
our neighbors, and communities that are struggling with addiction.
This is a very important opportunity for us to be able to move
forward on legislation that is comprehensive, that is bipartisan, and
that has a companion bill on the House side, so there is a very good
chance we could get this to the President's desk. It is the only
bipartisan legislation that is comprehensive and evidence based, and it
is critical we move forward with it.
In addition to Senator Whitehouse, I also thank Senator Ayotte,
Senator Klobuchar, and 42 bipartisan cosponsors for their support.
Frankly, more important to me is the support around the country this
legislation has. I think Senator Whitehouse and I now have over 130
groups around the country that are supporting this legislation. This
includes doctors, nurses, health care professionals, also law
enforcement, people who are in the trenches dealing every day with
treatment and recovery, and those who are focused on prevention and how
to ensure people cannot just be treated for addiction but try to keep
people out of the funnel of addiction.
We started working on this legislation about 3 years ago. We started
by hearing from experts around the country. We had five conferences in
Washington where we looked at all the issues, including criminal
justice, women and addiction, the science of addiction, youth
prevention, recovery issues, substance abuse impacting our veterans--a
number of issues that enabled us to write legislation that actually
makes sense, that will make a difference in our communities. These 130
groups around the country are focused on getting this bill passed
because they know it is going to make a difference in our communities.
If enacted, this will help States and communities develop and
implement these evidence-based practices that we have looked at from
around the country. It expands prevention and educational efforts to
prevent prescription opioid abuse and the use of heroin and increases
drug disposal sites to keep medications out of the hands of youth.
It also authorizes law enforcement task forces to combat heroin and
methamphetamine and expands the availability of the overdose reversal
drugs such as naloxone, which are miracle drugs. It provides not just
naloxone but also more training to our law enforcement officials, to
firefighters, and to other emergency responders.
In the criminal justice system, CARA will help promptly identify and
treat individuals suffering from substance abuse and expand diversion
and education efforts to give individuals a second chance. Frankly, it
is going to help to get people into treatment rather than going into
the criminal justice system. Locking up people hasn't worked. If people
are being arrested for possession alone, for using, this legislation
will help to divert those people into the treatment to get them back on
their feet.
CARA also authorizes resources to expand treatment in general,
including medication-assisted treatment--again based on the research
that has been done around the country.
It allows veterans who were discharged for a substance abuse disorder
to use drug courts as they recover. So it provides actual grants to
these veterans treatment courts. They are doing a terrific job. I have
toured these in Ohio and talked to some of these veterans who have been
through these programs. Again, it helps get our veterans back on the
right track. Rather than ending in jail, they end up in a treatment
program with other veterans helping them and supporting them, where
they can begin to deal with their addiction and mental health issues.
CARA supports recovery programs, including those focused on youth and
building communities of recovery. This happens now at our colleges and
universities increasingly. We want to support that. It also creates a
task force on recovery to improve ways to address the collateral
consequences imposed by addiction.
One of the most important aspects of this legislation expands drug
treatment for pregnant women who struggle with addiction and provides
support for babies born with neonatal abstinence syndrome, babies who
are born with addiction.
Recently, my wife Jane and I visited Rainbow Babies and Children's
Hospital in Cleveland, OH. We toured the neonatal unit. If you haven't
done this, it will break your heart because you will find there an
increasing number of babies who are born, again, with this addiction,
the neonatal abstinence syndrome. Unfortunately, when you look at what
has happened in Ohio, we have had a 750-percent increase in the number
of babies who are diagnosed with this neonatal abstinence syndrome just
since 2004--a 750-percent increase. I am told in some of our States now
10 percent of the babies are being born addicted.
I have also been at other hospitals around our State, including
Cincinnati Children's Hospital Medical Center and St. Rita's Special
Care Nursery in Lima, OH. Last week my wife went to Nationwide
Children's Hospital in Columbus. Every single one of these children's
hospitals is experiencing the same thing. What I have learned from
these incredibly compassionate nurses and doctors who take these
newborns

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through a withdrawal process is that the numbers of babies who have
been exposed to heroin or prescription drugs continue to grow. The
problem is getting worse, not better. These hospitals serve as yet
another reminder that addiction is a disease. It is a disease that has
to be treated like other diseases, and it is a disease that can impact
anyone.

It is wonderful that these caring nurses, doctors, and others are
working to try to ensure that these babies become healthy. We don't
know what the long-term consequences are, but we need to do more to
avoid the addiction in the first place and better treat it when it
occurs, and that is what this legislation does. Specifically, the
measure takes steps to help women and babies by expanding treatment for
expectant and postpartum women and authorizing the Department of Health
and Human Services to award grants to ensure that these women have
access to evidence-based treatment services. That is in this
legislation. It also reauthorizes residential treatment programs for
pregnant and postpartum women struggling with addiction.
There is a great center in Columbus, OH, called Amethyst. I had the
opportunity to visit it. It is a treatment center, and the average
length of stay there is almost 2 years. Their results are unbelievable.
They allow women to come with their babies, with their children, to go
through treatment together. So there is hope. There are treatment
centers doing a great job. We want to hold those up and encourage more
of that around the country.
Finally, the legislation also creates a pilot program for State
substance abuse agencies that allows funds to be used to target women
who are addicted to opioids and provide family-based services to those
women in nonresidential settings. So it helps on the residential side
but also with the nonresidential outpatient side.
Helping these women and helping these babies is just one aspect of
this bill, but it is a very critical one. As we work to turn the tide
in the struggle against addiction, it is one on which we should all be
focused.
The good news is that the bipartisan momentum we have seen here
tonight is building. I think the Senate is ready to move on this
legislation this week. There are other amendments that have been filed.
The deadline was today. I hope we will have the opportunity to go
through some more amendments, as we did last week, but meanwhile, we
have strong support and strong momentum, as we saw tonight, on both
sides of the aisle. Both Republican and Democratic leaders have lined
up to support this legislation. We need to pass this bill and get it
signed into law so it can begin to make a real difference in the lives
of people we represent.
As the heroin epidemic in Ohio and around the country has reached
crisis level, I look forward to working with my colleagues to get this
bill over the finish line here in the Senate and then get it passed in
the House, where there is companion legislation, and then on to the
President's desk and enable this Congress to play a role as a better
partner with State and local governments and with our nonprofits around
this country to address this growing heroin epidemic around our entire
country.
Mr. President, I yield the floor.
The PRESIDING OFFICER. The Senator from Ohio.

Miners Protection Act

Mr. BROWN. Mr. President, last week I met with Rita Lewis of
Westchester, OH, in southwest Ohio. She was here to testify in front of
the Senate Committee on Finance in honor of her late husband Butch.
Butch worked as a trucker for 40 years with the promise that the
pension he earned would be there to care for his family after he
retired.
I would also add that Butch had been drafted by the Pittsburgh
Pirates to play baseball some 45 years ago. Instead, he enlisted to go
into the U.S. Army and on to Vietnam. He was injured and could never
play baseball again competitively. He came back and became a trucker
and joined the Teamsters.
As I said, he worked as a trucker for 40 years with the promise that
the pension he earned would be there to care for his family after he
retired. But for Butch and Rita and thousands more Ohio retirees, that
promise is under threat. Truckers and mine workers in Ohio and across
the country are facing crippling cuts to the benefits they have earned.
The Multiemployer Pension Reform Act that Congress passed 2 years ago
allows pension trustees to propose massive cuts to the earned benefits
of retirees when a plan is running low on funds. This is disgraceful.
If a pension fund is in bad shape, it is our job to fix it, not break
promises to American workers who have worked their whole lives to earn
that pension. I believed that 2 years ago when I voted against that law
which allowed these proposed cuts, and I believe it more strongly now.
That is why I am calling on the Treasury Department to reject and to
reject immediately the proposed cuts to the Central States Teamsters'
pension. I am calling for us to immediately mark up and pass the Miners
Protection Act, which will protect the benefits Ohio workers earned
over a lifetime of work.
Under MEPRA, the bill I talked about a moment ago, multiemployer
pension trustees such as Central States are now able to propose massive
cuts to the earned benefits of participants and retirees if the plans
are in ``critical and declining status.'' Pension trustees for plans in
``critical and declining status'' may submit an application for
proposed benefit cuts to the U.S. Treasury Department.
The Central States pension plan trustees used the authority of MEPRA
to propose cuts of as much as 70 percent, but in their own application,
they admit that even with these drastic cuts, their plan--get this--
still only has a 50.4-percent chance of remaining solvent. In other
words, they are asking Treasury to approve massive, life-shattering
cuts to hundreds of thousands of workers for what amounts to a coin
flip. Treasury should immediately reject this application.
Put yourself--this is something we don't do well around here--put
yourself in the place of a worker who has planned for her retirement
with her family. She expected a $2,000-a-month pension on top of $1,200
a month in Social Security, and she all of a sudden finds out her
pension is cut 30, 40, 50, 60, 70 percent. That was the money she
planned to live on. She has some savings, but all that was calculated
because it was a promise from this pension plan to honor that
commitment of decades earlier.
As I said, Treasury should immediately reject this application.
The mine workers' pension plan and the others are too far gone to use
MEPRA. The United Mine Workers of America's 1974 pension plan covers
100,000 mine workers, including thousands of miners in eastern and
southern Ohio. It was almost completely funded before the financial
collapse of 7 years ago brought on by Wall Street overreach and greed,
but the plan was devastated by the recession. It has too few assets,
too few employers, and too few union workers paying in. If Congress
fails to act, thousands of retired miners could lose their health care
this year and the entire plan could fail as early as next year.
There is a bipartisan solution that is proposed by Senator Manchin,
Senator Casey, me, and others and supported by leaders of both parties.
If it were brought to the floor today, it would pass with an
overwhelming majority. It is time for the Senate to act. The Committee
on Finance should mark up this legislation this week. The Senate should
bring it to the floor immediately.
Miners worked in dangerous jobs--dangers from a mining accident, an
explosion, or a collapse every day when they went to work, and
dangerous in the sense that so many mine workers die early because of
premature bronchial illnesses and heart ailments brought on by working
in the mines. They have worked underground their whole lives to put
food on the table, to send their kids to school, and to help power this
country. Truckers criss-cross the State and country to pay their bills
and support their families and drive our economy forward. They all
deserve the full pension and health benefits they were promised and
they worked a lifetime to earn.
Butch Lewis led the Southwest Retirees Pension Committee's fight
against cuts to their earned benefits. He passed away on New Year's Eve
due to a stroke, which doctors have attributed

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at least in part to the stress he faced over the proposed pension cuts
not just to him and his family but to the workers he was fighting for
as a union activist. The benefits to his widow, his wife Rita, have
already been cut. She faces an additional 40-percent reduction because
of the proposed cuts put forth by Central States. Butch said the cuts
being forced on retirees--his words--``amount to a war against the
middle class and the American dream.'' He is right. Ohio's retired
workers have earned their pensions and their retirement savings over a
lifetime of hard work. It was promised to them, whether they worked
behind a desk, on the factory floor, down in the coal mines, or behind
a wheel.
We should honor Butch's memory by continuing his work. That means
coming together to support a bipartisan solution to protect Rita's
benefits and the pensions of tens of thousands of retired Teamsters and
retired mine workers.
Mr. President, I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The senior assistant legislative clerk proceeded to call the roll.
Mr. McCONNELL. Mr. President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.

____________________