[Congressional Record Volume 162, Number 144 (Thursday, September 22, 2016)]
[Senate]
[Pages S5963-S5966]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         PRESCRIPTION OPIOID AND HEROIN EPIDEMIC AWARENESS WEEK

  Mr. MARKEY. Mr. President, President Obama has issued a proclamation 
that this week is Prescription Opioid and Heroin Epidemic Awareness 
Week.
  As the President explained, we pause to remember all those we have 
lost to opioid use disorder. We stand with the courageous individuals 
in recovery, and we recognize the importance of raising awareness of 
this epidemic. In recognition of Prescription Opioid and Heroin 
Epidemic Awareness Week, I am here with my colleagues to convey the 
urgency of responding to this crisis.
  I want to start my remarks with a story I heard yesterday from a 
wonderful man named Patrick Byrne. I met yesterday with Patrick, as he 
was awarded the 2016 Education Award and Hero of the Year Award by the 
National Association of Letter Carriers. Patrick is from Lynn, MA. He 
lost his son James Byrne to heroin addiction. Here is their story.
  James Byrne lived a fairly normal life in many ways. The son of Lynn, 
MA, Branch 7 president and Army vet Patrick Byrne, James had a good 
upbringing and strong family ties. He had a master's degree in computer 
science and made a good living in IT, but throughout his adult life, 
James had been hooked on heroin, a drug easily found on Lynn's post-
industrial streets. James had periods of sobriety, but circumstances 
always seemed to steal them from him eventually.
  James had enjoyed 7 months clean of drugs when an old friend and 
fellow addict called him one day in January of 2014 to beg James to 
find heroin for him. After first refusing, James gave in and bought 
some for his friend and apparently couldn't resist using it himself 
instead. The friend called James on the cell phone over and over as 
James lay dying of an overdose on the floor of his sister's house just 
down the street from his father's home. That is where Patrick found 
him.
  After making his story public, Patrick heard from many other letter 
carriers about their own struggles with addiction, depression, or 
mental illness in their families. Patrick said: ``I was shocked at how 
many people are dealing with similar problems.'' Inspired by Patrick's 
experiences and his efforts to educate fellow letter carriers and the 
broader public about the need to remove the stigma of addiction, the 
Postal Service Employee Assistance Program launched the Silent No More 
Initiative. The program is designed to help postal employees or their 
families break through the stigma and shame to share personal stories.
  I thank Patrick for his leadership and service, and I pray for his 
family and for all the parents who are relying on hope and strength as 
they look for the support to achieve long-term recovery. None of us can 
be silent anymore in the face of this epidemic.
  In order to get Patrick and all the families who are suffering the 
help they need when they need it, the Federal Government needs to 
invest in funding treatment and recovery programs. So far Congress has 
failed in this task.
  In Massachusetts, I am hearing enormous frustration from people who 
don't feel adequate resources are being brought to bear on this 
epidemic of prescription drugs and heroin addiction. Countless 
individuals and families suffering with addiction cannot find a bed for 
detox. Then, when they are at their most vulnerable moment in recovery, 
they cannot find a place or provider for long-term treatment.
  In May, Senator Shaheen from New Hampshire introduced legislation for 
$600 million in emergency funding to combat this crisis. Then again in 
July, I and others argued on the floor for the need to invest $1.1 
billion into opioid treatment and recovery programs, but both times 
when Senator Shaheen made the case and others joined on the floor 
asking for additional funding, all of that was blocked so we could not 
in fact provide real funding that cities and States need to fight this 
epidemic.
  We will not save lives and stop the scourge of addiction with just 
words and promises. We will not save lives with legislation that pays 
only lip service to providing treatment. So I stand here during 
Prescription Opioid and Heroin Epidemic Awareness Week to pledge that I 
will not stop fighting for funding.
  In Boston, there is an area of our city called the Methadone Mile. It 
is approximately 1 square mile. It is the location of methadone 
clinics, safety net

[[Page S5964]]

hospitals, and homeless shelters. It is also the home to those 
struggling with addiction, those receiving treatment for addiction, and 
the litany of saints and angels who are providing the desperately 
needed services for those suffering from mental health and substance 
abuse disorders. It is a 1-mile, one-stop shop for hope and ground zero 
in the battle against addiction in Boston.
  Here, in Washington, we are at the epicenter of the Money Mile. It is 
an area where Big Pharma's lobbyists toil with the task of ensuring 
that even during the storm of prescription drugs, heroin and fentanyl 
overdose deaths, the deluge for opioid-based painkillers goes unabated. 
When pitted against the Money Mile, the Methadone Mile doesn't stand a 
chance. The Money Mile and its army of Big Pharma lobbyists are the 
reason mandatory prescriber education is not a law. It is the reason 
partial-fill prescriptions is not a law. It is the reason the Food and 
Drug Administration and other Federal agencies and State agencies 
across our country have not done the job over the years and have in 
fact been complicit in the worsening of this epidemic.
  Without real funding for opioid addiction treatment, the Methadone 
Mile and all the other areas in cities across this country will 
continue to drown in overdoses and death.
  Our cities are fighting a war, and we need to help them. With that, I 
will yield the floor to the Senator from Minnesota, Amy Klobuchar, who 
has worked tirelessly to stem the oversupply of prescription opioid 
drugs in this country.
  The PRESIDING OFFICER. The Senator from Minnesota.
  Ms. KLOBUCHAR. Thank you very much, and I thank Senator Markey for 
the work he has done and his passionate words as well as his 
understanding of the crisis this truly is.
  I think one of the ways I can explain it in my State is, every day 
you turn on the news and you hear about car crashes and you hear about 
when there is a murder. Well, in the heart of my State, deaths from 
prescription drug abuse now claim the lives of more Minnesotans than 
homicides or car crashes. It is a crisis on the rise. According to the 
department of health in our State, drug overdose deaths among 
Minnesotans increased 11 percent from 2014 to 2015. Last year alone, 
336 people in our State died from overdoses. The Twin Cities has been 
hit hard by this deadly trend. In Hennepin County, data shows that 
opioid-related deaths have increased 40 percent since 2006. But we know 
this is not a crisis confined to our urban areas.

  I see Senator Shaheen from New Hampshire is here. This is something 
that has hit hard in her State in rural areas, just like in mine.
  In one 7,000-person town in Minnesota, 3 young people died in just 6 
months. Another three were hospitalized for heroin overdoses. We know, 
by the way, that heroin overdose is no longer separate from 
prescription drugs. In fact, four out of five heroin users got their 
start on prescription drugs. They got addicted because someone gave 
them to them, or they got them out of a medicine cabinet or they went 
to the emergency room and were given 30 pills and got addicted, or 
maybe they just went to the dentist to get a wisdom tooth fixed.
  These are real stories that are happening all over the country. I was 
in Montevideo, MN--a smaller town--with some doctors. One of them 
started to cry at this event, telling the story about how a guy had 
seen him for back pain over and over and over. The next thing he knew, 
the Secret Service was in his office telling him that this person had 
gotten completely addicted and was making threats over the Internet on 
the lives of elected officials and ended up in prison. He had no idea.
  At that same forum, I heard the story of a 12-year-old who was 
courted by a pusher--a 12-year-old. They came up to him and said: Hey, 
could you go check your parent's medicine cabinet? They gave him a list 
of drugs and sent him off. They said: If you come back with those 
bottles of pills, we will give you a can of beer. That is what is 
happening in smalltown America.
  We passed a bill, the Comprehensive Addiction and Recovery Act. I was 
proud of the bipartisan work. I was one of the four lead sponsors on 
that bill. It builds on some of the work we have done to set up a 
framework. Senator Cornyn and I passed one of the first bills in this 
area, the drug take-back bill, which allows for drug take-backs in a 
way that we are now starting to see across the Nation. We were already 
seeing them, of course, in police departments and public facilities, 
but this makes it easier for drugstores and pharmacies to take back 
drugs. Walgreens has announced they are going to be doing this on a 
national basis. It also makes it easier for long-term care facilities.
  Those things are beginning, but we can't end there, not when on one 
recent National Prescription Drug Take Back Day back in April, over 445 
tons of unused drugs were collected. That is 1 day in this country, to 
give a sense of how many are out there. In the CARA bill, we made it 
easier to do drug take-backs.
  We also increased the availability of naloxone, although I will say 
on a sideline, Senator Markey, one problem with this is the price of 
naloxone has gone up 1,000 percent by the pharmaceutical company that 
provides it. So that is another issue we are going to have to deal 
with. That is, of course, for another day. But I will say that naloxone 
is something we know can save lives.
  For me, the heart of this is trying to go after these prescription 
drugs at the start, to try to stop people from becoming addicted. I 
will get to the treatment part in a moment, but we need to stop the 
addiction in the first place.
  Just this month, one Minnesota newspaper told the story of a man in 
Duluth who got prescriptions for opioid painkillers from 23 dentists 
and 15 emergency room physicians in just over 2 years.
  Back in May, in Moorhead, I heard the story of another man--this was 
from a rehab counselor. This guy had filled 108 prescriptions for 
painkillers from more than 85 different prescribers in Minnesota and in 
neighboring States.
  The Presiding Officer is my neighbor in South Dakota. We see people 
who go to South Dakota, North Dakota, Minnesota, Iowa, and Wisconsin in 
search of different doctors whom they can basically dupe into giving 
them prescriptions because they are addicts. That should not be 
happening. Doctors should not be giving out these prescriptions. That 
is why I have introduced a new bill that would require doctors and 
pharmacies to immediately report when they give out these prescriptions 
and require physicians to check this list. Many States have these 
programs in place--prescription drug monitoring programs--but they are 
voluntary. Not everyone does them. Some States, such as Florida, don't 
even share their data with the rest of the country. I truly believe the 
doctors and pharmacists on the frontlines--if they check these, we are 
going to stop people from getting addicted and get them into treatment 
the way we should.
  That leads me to the next piece, which is treatment itself. I have 
had many people tell me that they are better off committing a felony to 
get treatment. Why is that? Well, a lot of States, like mine, have good 
drug courts, and if you can get into the right program in the drug 
court, you are going to get treatment and followup and you are going to 
get the help you need. But a lot of insurance policies are not covering 
it. There is not treatment available. That is why I support Senator 
Manchin, and I am an original cosponsor of the LifeBOAT Act, which 
basically places a 1-cent fee on each milligram of active opioid 
ingredient in a prescription pain pill. That is one good way to pay for 
treatment, as well as, of course, Senator Shaheen's strong bill that 
appropriates emergency funding to address the drug abuse epidemic with 
treatment.
  We have to remember that only 1 in 10 people who suffer from opioid 
addiction actually receives the treatment they need.
  My State is a big believer in treatment. We use treatment a lot for 
low-level offenses. We use drug courts a lot. It is one of the reasons 
we have been able to keep our crime rate at a decent level compared to 
a lot of other States. That does not mean there is not horrific crime, 
but we have really focused on treatment.
  In my own life, my dad is an alcoholic. He is sober now and happily 
married at age 88. He stopped drinking a

[[Page S5965]]

while back, but he would not have done it without treatment. And that 
was after three DWIs and a lot of difficulty, but he got through it. 
From seeing that, seeing my dad climb the highest mountain but fall to 
the lowest valleys, I believe there is redemption and there is hope. 
But I don't think that treatment should be limited to just the people 
who have good insurance or can afford it.
  We in this country have created this crisis. Let's be clear. 
Decisions were made at pharmaceutical companies and everywhere across 
the country to expand the use of opioids, to tell people they can take 
30 pills when maybe they need 1 or none or maybe 2 or 3. These are bad 
decisions. They were made, and people were duped and they got addicted. 
The least we can do is give them the treatment so they can get off of 
it, and then make sure their kids don't get addicted as well.
  This is a serious epidemic, and it calls for serious action as well 
as funding.
  I say thank you, to Senator Markey.
  The PRESIDING OFFICER. The Senator from Massachusetts.
  Mr. MARKEY. Mr. President, I thank the Senator from Minnesota.
  Many have already heard these statistics: Our Nation is experiencing 
more deaths from drug overdoses than from gun violence or auto 
accidents. Nearly 30,000 people in the United States died from an 
opioid overdose in 2015. Approximately 1,300 of those were in 
Massachusetts.
  Fentanyl, the drug that killed the musician Prince from the State of 
the Senator from Minnesota, is flowing in from China and Mexico and is 
laying waste to our communities. It is 50 times more powerful than 
heroin and 100 times more potent than morphine. Approximately 2.5 
million Americans abused or were dependent on opioids in 2012, but 
fewer than 1 million received treatment for their condition.
  If we do not provide the resources and enact the policies required to 
change the momentum of this epidemic, we are poised to lose future 
generations to addiction and death. We need the money for treatment.
  With that, I would like to yield the floor to my good friend and 
great Senator from New Hampshire, who has led the fight here on the 
Senate floor for funding for opioid use disorder treatment and 
recovery, Mrs. Jeanne Shaheen.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Mrs. SHAHEEN. Mr. President, I thank my colleague from Massachusetts, 
who has seen the same tragedy we are seeing in New Hampshire. I am sad 
to have to come to the floor again today to join my colleagues, Senator 
Markey and Senator Klobuchar, who have spoken so passionately about our 
need to address the ongoing heroin and opioid crisis.
  Like them and many others, I have been coming to the floor for many 
months to describe the terrible toll this crisis is taking on 
communities across the country. I know the Presiding Officer must see 
it in his home State because it is happening all across America.
  It is ironic that we are here during Prescription Opioid and Heroin 
Epidemic Awareness Week to once again call on this Congress and the 
Senate to pass emergency funding to address what is the most pervasive, 
most destructive, and, I believe, most urgent public health crisis that 
faces this Nation.
  I certainly don't want to minimize the gravity of the other health 
challenges we are facing in America, especially the Zika outbreak, 
which I believe is absolutely critical, but by any objective measure, 
these challenges are dwarfed by the destruction and loss of life that 
is being inflicted every day by the uncontrolled epidemic of heroin and 
opioid abuse. This epidemic is raging in all 50 States. It is an 
uncontrolled public health epidemic of staggering dimensions. In 2014, 
some 47,000 people died from drug overdoses--far more than the number 
of Americans who died in motor vehicle accidents the same year.
  I am sad to say that New Hampshire is at the epicenter of this 
epidemic because we have the highest percentage of overdose deaths in 
the Nation. This year, at the rate we are seeing overdose fatalities, 
we will lose over 500 people in New Hampshire, a State of about 1.3 
million. Estimates are that over 100,000 people in New Hampshire have 
some sort of substance abuse/misuse issue. The statistics don't even 
begin to describe the heartbreak and the trauma that is experienced by 
those who have drug misuse issues and their families. Yet, despite this 
appalling death toll, despite what the statistics tell us, the Senate 
has failed to provide emergency funding to first responders and to 
treatment providers on the frontlines of this crisis.
  In July, Congress passed the Comprehensive Addiction and Recovery 
Act, CARA. I applaud Senator Klobuchar and the other sponsors of that 
legislation. It is a good, bipartisan bill that passed this Chamber 
with overwhelming support. I was a cosponsor, and I voted for it. But, 
as we all know very well, CARA is an authorizing bill, it is not an 
appropriations bill. The public may not know that because I think there 
is a lot of confusion about the difference between authorizing and 
appropriating, but the fact is, we know here in this Chamber that CARA 
is an authorizing bill and it does not provide one penny to fight the 
opioid epidemic.
  We need to fund CARA. That is probably not going to happen this year 
and may not happen for several years. We need to put actual resources 
behind all of our talk about stemming this crisis. Earlier this year, I 
introduced emergency funding that would provide an additional $600 
million for policing, prevention, treatment, and recovery. I offered 
this legislation as an amendment to the CARA bill but sadly it was 
defeated.

  The legislation looks at all of those aspects: prevention, treatment, 
recovery, and policing because I believe there isn't one magic bullet 
solution for this issue.
  We definitely need more treatment. We need to acknowledge that 
addiction is a disease. That is a critical part of it, but we also need 
to do the policing--the long-term recovery. I was at a recovery center 
in New Hampshire several weeks ago, and one of the women I met there 
who was in recovery said: You know, getting clean was easy. It is 
staying clean that is the hard part.
  Our Nation has addressed our public health crises with emergency 
funding bills far larger than the one I proposed. In 2014, Congress 
passed nearly $5.4 billion--billion with a ``b''--in emergency funding 
to combat the Ebola outbreak in West Africa. The Ebola outbreak killed 
one person in America. The heroin and opioid epidemic is killing more 
than 128 Americans every single day.
  We know treatment is the only effective answer to addiction, but 
people are being turned away from treatment due to lack of resources. 
Nationwide, in 2013, nearly 9 out of 10 people needing drug treatment 
did not receive it. It is the same story on the law enforcement side of 
the equation, a chronic lack of resources.
  As Senator Klobuchar pointed out, and as my colleagues from Vermont--
who just came to the floor--and Massachusetts understand very clearly, 
heroin traffickers expressly target rural States and counties where law 
enforcement is spread too thin and lacks the resources to respond 
effectively.
  Meanwhile, as Congress fails to act, the opioid epidemic is on the 
verge of expanding dramatically. Carfentanil is a synthetic opioid that 
is used to tranquilize elephants. It is now available on the streets, 
blamed for a record surge of drug overdoses in the Midwest.
  Carfentanil is 100 times more potent than fentanyl, which, in turn, 
can be up to 50 times more deadly than heroin. It is one of the 
synthetic additives to heroin that is causing so many overdose deaths 
in New Hampshire. Until recently, Hamilton County, OH, had four to five 
overdoses a day. Now, because of carfentanil, the county is reporting 
20 overdoses, 30 overdoses, and sometimes even 50 overdoses a day, 
completely overwhelming first responders.
  Some public health officials say the United States has reached a 
disastrous inflection point in the opioid epidemic. Going forward, we 
may be seeing more and more synthetic opioids on the market--cheaper, 
more potent, more addictive, and even more deadly.
  This is just one more wake-up call.
  As I travel across New Hampshire and talk to Senate colleagues from 
across the country, again and again I hear about the lack of resources 
to marshal an effective, well-coordinated

[[Page S5966]]

response. As new and more dangerous opioids hit the streets, this 
crisis could become exponentially worse. Our failure to act is having 
tragic consequences.
  At long last, let's give law enforcement, let's give treatment 
providers, and let's give recovery centers the resources they so 
desperately need. At long last, let's come together. Let's pass an 
emergency funding bill to combat the opioid epidemic. If we can spend 
billions to fight Ebola on a distant continent, surely we can allocate 
$600 million to combat a raging epidemic right here at home.
  When the Senate comes back into session after the election, we will 
have another opportunity to consider emergency funding to combat this 
crisis. For tens of thousands of Americans, this is very literally a 
matter of life and death.
  Let's put politics aside. Let's do the job the American people sent 
us to do. At long last, let's give law enforcement and treatment 
providers on the frontlines the resources they need to effectively 
address the opioid crisis.
  Thank you to my colleagues from Massachusetts and Minnesota for 
coming to the floor to once again point out the need we so desperately 
have.
  The PRESIDING OFFICER. The Senator from Vermont.
  Mr. LEAHY. Mr. President, I believe we had arranged for Senator 
Grassley and me to speak at this point.
  I see my distinguished colleague on the floor.
  Mr. BARRASSO. Mr. President, I have about 8 minutes or 9 minutes of 
remarks, but I don't see the Senator from Iowa yet. If the Senator from 
Vermont wishes to speak----
  Mr. LEAHY. Mr. President, he wanted me to speak, and then he was 
going to speak. If I might continue, this will be fairly brief.

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