[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
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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
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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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