[Congressional Record Volume 162, Number 75 (Thursday, May 12, 2016)]
[Senate]
[Pages S2717-S2719]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




               COMPREHENSIVE ADDICTION AND RECOVERY BILL

  Mr. PORTMAN. Mr. President, on March 10, this body, the U.S. Senate, 
passed legislation to address what is a growing problem in all of our 
communities, and that is the heroin and prescription drug epidemic.
  On March 10, this body voted for a comprehensive bill called CARA, 
the Comprehensive Addiction and Recovery Act. It deals with prevention, 
treatment, and recovery, helping our law enforcement, getting 
prescription drugs off the shelves of our bathrooms so they are not 
being used to get people into this addiction, and helping to stop the 
overprescribing with a drug monitoring program. This was a 
comprehensive approach intended to help our communities deal with this 
growing problem. The No. 1 cause of death now in my home State of Ohio 
is not car accidents anymore, it is overdoses. It is overdoses from 
prescription drugs and heroin.
  Since March 10, I have come to the floor four times--this is now the 
fifth time--every week we have been in session since then, to urge the 
House to act quickly on CARA, because with a 94-to-1 vote, with that 
kind of consensus built around this place, which is highly unusual, it 
shows that this is a problem in all of our communities and all of our 
States. We spent 3 years putting together the legislation. We worked 
with experts from all around the country. We sought out best practices. 
This is not just a matter of throwing more money at a problem, this is 
a matter of taking the resources in Washington, spending them more 
wisely and targeting them toward what we know works--toward evidence-
based programs, prevention, treatment, and recovery that has actually 
shown promise to be able to begin to turn the tide on this horrible 
epidemic.
  The House has begun to act, and I am encouraged by that. Obviously, I 
wish they had taken up CARA right away and sent it to the President. I 
think it would have been already helping in our communities in 
significant ways.
  During the time between when the Senate acted, March 10 to now, we 
have lost 7,400 Americans to drug overdoses. We lose a fellow citizen 
every 12 minutes on average, but the House is moving, and yesterday the 
House passed, legislation in the form of over a dozen different bills, 
smaller bills that will help with regard to this problem that I think 
are steps in the right direction.
  Today they are planning to take up a more comprehensive bill, the 
CARA legislation, that has also been reported out of the Judiciary 
Committee--as it was in this body--and perhaps a couple other bills as 
well. I am told that vote is likely to occur today, and that is great. 
I am concerned the legislation that passed in the House still leaves 
some gaps, and those gaps are in some significant areas. I am hopeful 
some amendments will be adopted today to help fill some of those gaps 
so we can indeed have a comprehensive approach to this issue.
  Sadly, this issue is not getting better; it is getting worse. The 
U.S. Drug Enforcement Administration just last week conducted their 
National Drug Prescription Take-Back Day, where you take drugs off the 
shelf and put them into a disposal unit to get rid of them so that your 
kid or grandkid or somebody visiting your home doesn't get these 
prescription drugs and misuse them. They had a record number of drugs 
turned in, 893,000 pounds of unwanted medicine; that is, 447 tons of 
prescription drugs that were not needed. I am grateful for those who 
participated in the take-back program. This is good news, to get these 
drugs off the shelves and be sure they are not being misused, but 
unfortunately that is just the tip of the iceberg, and it shows the 
severity of this problem.
  We have continued to see communities throughout my State and 
throughout the country being torn apart by this issue and families who 
are being devastated. Last week, a man pled guilty to involuntary 
manslaughter in Columbus, OH, because his infant son had ingested 
fentanyl-laced heroin and died. Last week, we also saw the arrest of 
three people who drove to Steubenville, OH, to buy heroin, and then 
while driving they used it in the car with a 4-year-old with them. This 
all happened in the last week. Last week, a 23-year-old pregnant woman 
and her unborn child were found dead of an apparent overdose in New 
Carlisle, OH. Yesterday, an Akron man pled guilty to selling heroin to 
his uncle who subsequently died of an overdose. In Cleveland, we have 
lost 148 people to drug overdoses in just the first quarter of this 
year. That is double--double--last year's rate in Cleveland, OH--one 
town in one State.
  By the way, the plurality of these deaths is that a majority were 
from fentanyl--fentanyl often laced with heroin. Fentanyl is a 
synthetic heroin that is about 50 times more dangerous. It is a growing 
problem in my State of Ohio.
  Unfortunately, these headlines are just the tip of the iceberg. We 
see this death toll rising, and it is tragic, but we also need to focus 
on the wounded, not just those who overdose but those who, because they 
have this addiction, have lost their job, cannot get their lives back 
together, are separated from their families. As one recovering addict 
told me: The drug was everything. I abandoned my kids, my wife.
  These are also people who are ending up in our jail system. 
Prosecutors back home tell me the majority of the crime--one county 
prosecutor told me a couple of weeks ago, 80 percent is being committed 
because of this issue--so theft, stealing in order to pay for a habit, 
and ending up in the prison system. All of us are paying for that of 
course.
  Everywhere I go in Ohio, people tell me about how this epidemic is 
affecting them. I had a townhall meeting the week before last, a tele-
townhall with 25,000 people on a phone call. We do these once a month. 
A gentleman called in and he wanted to talk about the CARA legislation. 
He seemed to know a lot about it. He focused on the treatment part of 
it. His voice had a quiver.
  So I asked him: Would you mind sharing? You are on the line with a 
lot of people, but would you mind sharing why you are so interested in 
this issue? Again, he was focused a lot on the treatment side, and 
there was silence on the line. I knew what he was going to say.
  When he came to the point where he could speak, he said: I lost my 
daughter. Then he proceeded to tell the story. It was of a child who 
had started with prescription drugs, ended up with heroin, had 
committed some crimes--probably theft--ended up in and out of prison. 
She had finally come to the point where she was willing to face up to 
her addiction. She was ready to go into treatment to start long-term 
recovery. She had committed this to her parents. He said they took her 
to the treatment center. There was a 14-day wait. They pleaded: Can she 
get in someplace else? No; no room at the inn

[[Page S2718]]

and a 14-day wait. During those 14 days is of course when she overdosed 
on heroin.
  His point was very simple: You guys need to do more to help provide 
access to treatment and the right kind of treatment. That is what this 
legislation does.
  Last Tuesday, I spoke at an opiate conference, the Ohio Association 
of County Behavioral Health Authority's annual meeting, with record 
attendance this year of over 1,000 people. I heard from doctors, 
nurses, counselors, social workers, attorneys, law enforcement, all 
saying the same thing to me, which is: Rob, this problem is not getting 
better. It is getting worse.
  Washington does have a role to play, to be a better partner with 
State and local government and with the nonprofits that are in the 
trenches dealing with this issue every day. The Kaiser Family 
Foundation last week released a survey that showed that 44 percent of 
the public knew someone who struggled with addiction to opioids. Of 
those 44 percent, one in five said it was a family member; one in five 
said it was a close friend; one in five said it was an acquaintance; 
two-thirds overall said they want the State government and the Federal 
Government to do more about this addiction epidemic. Of course they do. 
People are desperate to figure out how to get at this issue.
  Again, our approach is evidence-based. It is based on the testimony 
of the experts around the country. It is based on best practices, what 
is working what is not working. Is Washington going to solve this 
problem? No, but we are part of the solution. It is going to be solved 
in our communities and in our families. We can turn this tide. We have 
in the past. We can do it again. The question is whether we are serious 
about it and whether we can move this legislation through the House, 
through the Senate, get it to the President, and get it working in our 
communities.
  In countless parts of Ohio, at the State and local level, people are 
taking action. I am encouraged by that and I applaud them for it. In my 
hometown of Cincinnati, the police force at the University of 
Cincinnati is now carrying Narcan and getting training to know how to 
use it. By the way, that is in this legislation to provide training to 
ensure people aren't just getting the naloxone, that they know how to 
use it. This is a miracle drug called Narcan--naloxone--so that when 
someone has overdosed, they will be able to bring them back.
  I have been in drug treatment centers all over my State, and I have 
heard the testimony, including a man who told me: I died. I faced my 
own death. I saw my father in Heaven. I was gone. Narcan brought me 
back to life. That is why I am in this treatment center, because that 
is how I hit rock bottom.
  So it is important, but the training needs to include, as you are 
giving people Narcan to use for their loved ones, giving it to the 
police officer to use when they are responding or a firefighter--I 
would tell you that if you go to most of our firehouses around the 
country, you will find there are more runs for heroin and prescription 
drug overdoses than there are for fires. That is true in my State, and 
it is probably true in yours. But if you are providing Narcan to 
somebody, you need to give them the ability to tell these people: Here 
is the treatment center. It is not enough just to save a life from a 
tragic occurrence like an overdose; we also have to figure out how not 
to be--as some firefighters and police officers told me--saving that 
life again and again but instead getting these people into the right 
treatment and recovery programs so they cannot just have their lives 
saved but begin to lead full and productive lives.

  I am very encouraged by something that happened yesterday. Stephen 
Stack, the president of the American Medical Association, issued a 
public letter to physicians. I think this is a major step forward. I 
don't know Stephen Stack, but I read his letter very carefully because 
I think he is putting his finger on something that the medical 
profession has been slow to realize. His letter said this:

       [F]ar too often, [opiate addiction] has started from a 
     prescription pad. . . . I call on all physicians to . . . 
     avoid initiating opioids for new patients with chronic non-
     cancer pain . . . limit the amount of opioids prescribed for 
     post-operative care . . . register and use your state 
     prescription drug monitoring program . . . [and] reduce 
     stigma to enable effective and compassionate care.

  That is a step in the right direction. I hope every physician in the 
country gets a copy of this letter.
  We have incredibly compassionate, caring physicians out there, but we 
need to face the facts. There has been overprescribing, and that is 
part of the issue. Four of the five people in my State of Ohio who will 
die from heroin overdoses over this next month will have started with 
prescription drugs. There is a link here. We need to face it, and the 
medical profession needs to face it. In the Senate, we have taken 
action. A 94-to-1 vote is not the typical way things happen around 
here, as you know. That is highly unusual. That shows the seriousness 
of this issue.
  One of the things I am concerned about in the alternative to CARA 
that is being voted on in the House today is that it omits some of the 
key pillars, including a drug take-back program, which I think is 
important, and prescription drug monitoring programs.
  What we have in our legislation is very simple. It gives incentive 
grants to States to set up prescription drug monitoring programs. Most 
States have them already, but to have them so they work with other 
States, we need interoperability between the States.
  My own State of Ohio borders many other States, and what they tell me 
is this: We can have this prescription drug monitoring program for 
Ohio, but if someone goes to Kentucky, West Virginia, Pennsylvania, 
Michigan, or Indiana, we don't know. And if this is in our legislation, 
that would help. We hope that is added to the House bill.
  Prevention, recovery support services--I hope those are being adopted 
in the House as amendments. If they are not, we are going to work hard 
to get those included in conference. We are not going to send a bill to 
the President that is not comprehensive.
  With regard to prevention, there are some provisions that were 
omitted from the House alternative, including a national awareness 
program to let people know what is going on with prescription drugs. 
That connection we talked about a moment ago is incredibly important. 
It will save lives. It will bring people's lives back on track. It will 
avoid the situation where somebody goes to get his or her wisdom teeth 
pulled, they are given narcotic pain pills, they end up getting 
addicted and then move to heroin as a cheaper alternative, and sadly, 
in some cases--including a father who testified before a congressional 
committee in Ohio a week ago Friday--die of an overdose. That is what 
is happening.
  Prevention is important. The prevention grants we have are important. 
They are the most effective way to fight back against this epidemic, in 
many respects. If we can keep people from getting into the funnel of 
addiction in the first place, think of the lives that can be saved, the 
families that can be kept together rather than torn apart, the 
communities that will not be devastated by this spike in crime.
  Think of the impact on our economy and people not going to work. They 
say there is a $700 billion economic impact based on addiction.
  It is the faces of addiction we care about the most. Think about 
Marin Riggs from Pickerington, OH. She was a high school student. She 
was about to graduate. She was very smart. She had good grades. She was 
a star athlete. She was popular, full of life. It seemed like she had 
it all. She made a mistake; she tried heroin with her boyfriend. She 
became addicted. Something changed physiologically in her brain to give 
her this disease. It is a disease. Her parents started missing money 
from their wallets. Charges started showing up on her dad's credit 
card. She tried to quit. She went into rehab. She wrote in her journal 
that she was heroin's ``worst enemy.'' She was going to beat this 
thing. But she relapsed. The grip of this addiction is horrible. Her 
brother found her dead of a heroin overdose 2 weeks after her 20th 
birthday.
  This can happen to any family anywhere. It knows no ZIP Code. It is 
not an inner-city problem. It is not a suburban problem. It is not a 
rural problem. It is everywhere. Addiction doesn't ask what your 
political party is, either. That is why we kept this nonpartisan. It is 
not just bipartisan.

[[Page S2719]]

That is why I hope we can move this legislation quickly to the 
President and get him to sign it into law, because it is needed right 
now, and prevention needs to be part of it.
  Marin's mom, whose name is Heidi, is letting her voice be heard 
throughout Ohio. She is educating kids and parents about the dangers of 
experimenting with drugs. I commend her for that. I am so grateful for 
her and the other moms and dads around Ohio who are doing that. They 
are amazing.
  Tonda DaRe came to testify before the Judiciary Committee. Her 
daughter's name was Holly. Holly died when she was in her early 
twenties. She started Holly's Song. She is talking to people, working 
with people, families, letting them know what the dangers are but also, 
if they have a son or child who is addicted, letting them know how to 
get them into treatment and recovery so that other lives will not be 
lost.
  I have heard stories of these teenagers whose wisdom teeth are being 
taken out and they end up getting addicted to Percocet and Vicodin. 
Angie Trend of Lake County is one of them. She told me her son was 16 
when he had his wisdom teeth taken out. He is one of the lucky ones; he 
is now in recovery. He is 25 years old. But the pain and agony that 
family went through when he was age 16 to 25 could have been avoided.
  When I think of these stories, I cannot leave out prevention. It has 
to be part of it.
  I started my own anti-drug coalition in my home State, in my home 
city, about 20 years ago. It continues to be effective today. It is all 
about prevention, getting the entire community engaged and involved. 
That is what needs to happen on a national basis, and it needs to 
happen now in order for us to save lives.
  The approach we took in writing this legislation, the Comprehensive 
Addiction Recovery Act, was unusual around here. We spent 3 years 
pulling together experts and getting best practices but also accepting 
ideas from anywhere where there was a good idea. We didn't care whose 
idea it was; all we cared about was whether it worked.
  I know that these statistics about heroin addiction and overdoses are 
heartbreaking. They can be pretty discouraging. But I also know there 
is hope. I have run into people from our State who have struggled with 
addiction and who have found their way to treatment and effective 
recovery--usually it is long-term recovery--with support from family 
and friends and others who have been through addiction. Now they are 
back on their feet, and they are not just productive, working members 
of our communities, but they are helping others.
  I heard the story of Courtney Golden. She was addicted to oxycodone. 
She received treatment and has been clean for 7 years. She is now the 
director of an outpatient counseling center. I heard the story of Terri 
Skaggs of the Sojourner House in Portsmouth, OH. She was addicted for 
17 years, but after 17 years, she didn't give up. She has now been 
clean for 2 years. They beat this, and they are helping other people. I 
see this at every treatment center I go to.
  There is hope. We can turn the tide, but it does require this 
institution to pull its act together and get a good bill out of 
conference that is comprehensive, that is evidence-based, that is going 
to make a real difference throughout our communities, and get that bill 
to the President for his signature.
  We have lost more than 7,400 Americans since the Senate passed this 
legislation on March 10. Every 12 minutes, we lose another American, 
another one of our fellow citizens. Partial solutions will not suffice. 
We need a comprehensive approach. I will insist on it, as will others.
  I thank the Presiding Officer for the time today. I am encouraged by 
what the House is doing on the floor. I hope the next time I come to 
the floor, I will not be talking about how the House must act but, 
rather, congratulating the House for acting and congratulating the 
President for signing a legislative initiative that will make a 
difference in my home State and in our communities all around this 
country.
  I yield back my time.
  The PRESIDING OFFICER. The Senator from Indiana.
  Mr. COATS. Mr. President, I appreciate the remarks my colleague from 
Ohio made about this opioid issue and the impact it is having on our 
citizens and particularly on our young people. I support his 
significant contributions and efforts in terms of dealing with this 
problem. It is affecting my State, his State, and all of our States.
  We are passing legislation to deal with it, but it is going to take 
more than legislation; it is going to take an all-out effort by 
everybody. To watch our kids, our children, our young people, and 
Americans become addicted and victims of this scourge that is taking 
place is disheartening, to say the least. We need to do all we can to 
address that. Our State is trying to do that and making some 
significant steps forward. We all have a long way to go.

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