[Congressional Record Volume 163, Number 91 (Thursday, May 25, 2017)]
[Senate]
[Pages S3173-S3174]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                             Opioid Crisis

  Ms. DUCKWORTH. Madam President, I would like to take this time to 
discuss a critical public health crisis affecting constituents in 
Illinois and all across the country. Each day, 46 people die from 
overdose of prescription painkillers in the United States. In Illinois, 
that number is only growing.
  Overdose deaths in Illinois from opioids rose about 275 percent from 
2008 to 2014. There are an estimated 460,000 nonmedical prescription 
opioid users in Illinois alone. A major portion of the total number of 
drug-poisoning deaths between 2013 and 2015 were a result of opioid and 
prescription drug abuse. Over 4,000 people died as a result of opioids 
and prescription drugs, and 2,000 people died due to heroin. Illinois 
also had the third fastest rising death rates from synthetic opioids in 
the Nation, with overdoses rising by 120 percent from 2014 to 2015. 
Unfortunately, Illinois is third from the bottom for treatment of 
substance abuse because of lack of funding and resources to healthcare 
providers and law enforcement partners in the State.
  These numbers are alarming, but I would like to share a story behind 
those numbers--a face. Laura Fry is a mother whose family has 
experienced the worst of the opioid epidemic. Her son, Alexander, is 29 
years old and in remission from heroin use disorder.
  Alexander was just a normal kid growing up in Wauconda, IL. He had 
his entire life ahead of him. Then, when he was 17, he had a 
snowboarding accident and was taken to the emergency room after he lost 
consciousness. That is when doctors found a mass on his cerebellum and 
he had to undergo major brain surgery. It was after this surgery that 
Alexander became addicted to morphine, and his drug abuse began.
  When Alexander graduated from high school, he began working at a 
hospital, where he was able to steal drugs to fuel his abuse. Over 
time, his drug abuse spiraled out of control. He was fired from his job 
for stealing narcotics and was arrested for possession of heroin. But 
because this was his first offense, he was given a very strict 2-year 
probation. Over the next 4 months, he tested positive for heroin 
several times, and then he simply disappeared. Laura did not know where 
her son was or whether he was even alive for 10 months. Finally, he was 
arrested and taken into custody.
  In Lake County, IL, we thankfully have a criminal justice system that 
recognizes addiction is a disease. The court gave Alexander the 
opportunity to continue his probation, and he was allowed to perform 
hundreds of hours of community service and to attend an intensive 
outpatient program.
  In the spring of last year, Laura and her son Alexander appeared in 
court for the last time. Alexander is now a volunteer for Live4Lali, a 
substance abuse program in Illinois. He attends community outreach 
events, shares stories, and offers trainings in naloxone use--a 
lifesaving drug that reverses opioid overdoses. He has gone from being 
a user to someone who is transforming lives.
  Alexander's story is a reminder that Congress must focus on enhancing 
recovery efforts, and we are beginning to take steps in the right 
direction. For example, I was a proud supporter of the Comprehensive 
Addiction and Recovery Act, also known as CARA, when I served in the 
House. CARA, which passed with overwhelming bipartisan support, 
establishes, supports, and strengthens a number of programs to fight 
the opioid crisis in communities. It provides opportunities for 
rehabilitation, like the outpatient program Alexander attended, and 
expands access to drugs like naloxone, which are saving lives on the 
frontlines of this epidemic.
  I applaud these efforts, but I have serious concerns about the 
majority's commitment to actually funding these essential programs to 
rehabilitate our fellow Americans who are suffering from opioid 
addiction because, while we can all agree that CARA's intent was to 
transform our opioid crisis, the bill failed to provide any actual 
funds to enact these effective programs.
  I, along with many of my colleagues, have asked for CARA to be fully 
funded and to provide additional funding to the drug courts and veteran 
treatment courts, which essentially reduced crime, saved taxpayer 
dollars, and saved the lives of more than 1.25 million civilians and 
veterans. In addition, we must also make sure families have access to 
medicine that can save lives during an overdose by calling on 
manufacturers to offer naloxone to rein in the costs.
  I share this story because the turmoil that the Fry family faced is 
not unique. Millions of Americans are experiencing the impact of opioid 
abuse, and many of these American stories have much more tragic 
endings. We can and must do more for these families.
  I ask that we take the time, consider the story of Alexander and his 
family, and step up and do the right thing. Let's fund CARA fully.
  Thank you. I yield the floor.
  The PRESIDING OFFICER. The Senator from Rhode Island.
  Mr. REED. Madam President, let me thank my colleague, Senator 
Manchin, for arranging the time to talk about the ongoing opioid 
epidemic across the country. I know his home State of West Virginia--
much like my home State of Rhode Island--has been hit particularly hard 
by this epidemic.
  This is not happening in some far off place or some distant country. 
It is happening in Rhode Island, West Virginia, and, indeed, every 
State throughout the Nation. Last year, over 330 Rhode Islanders lost 
their lives due to opioids.

[[Page S3174]]

  Rhode Island is a small State, so let me talk about a national 
statistic that shows the extent of this crisis. Last year, drug 
overdoses killed 50,000 Americans. That means more people died last 
year because of drug overdoses than due to car crashes or gun violence. 
These numbers are staggering, and it is happening in all of our 
communities.
  Since 2011, the number of overdose deaths has increased by more than 
90 percent. Unfortunately, year after year, Rhode Island continues to 
top the Nation in terms of rates of overdose deaths. We must work to 
turn this around and get more people access to treatment for opioid 
addiction.
  In 2008, almost a decade ago, Congress enacted the landmark Paul 
Wellstone and Pete Domenici Mental Health Parity and Addiction Equity 
Law. For the first time, the law required insurance companies to cover 
behavioral health services in the same way that it would cover physical 
health services. This was a critical step, but it ultimately did not 
solve the problem, as some insurance companies have continued to find 
ways to avoid complying with the law--or at least its spirit.
  It took passage of the Affordable Care Act to improve access to 
behavioral health services. For the first time, critical consumer 
protections, like banning discrimination based on preexisting 
conditions, ensured that individuals with substance abuse disorders 
could not be denied coverage.
  Further, the ACA established a set of essential health benefits that 
all insurance plans must cover, including mental health and substance 
abuse treatment. Gone are the days when consumers would pay steep 
prices for health insurance that in actuality did not even cover basic 
health services, such as mental health care or maternity care.
  In addition, the ACA prohibits lifetime annual limits on care. Before 
the ACA, many people with chronic health conditions, such as substance 
use disorders, would hit their annual cap just a couple of months into 
the year and then would have to pay all other costs out of pocket for 
the rest of the year.
  Lastly, the expansion of Medicaid has made a tremendous improvement 
in access to behavioral health services. In States like Rhode Island 
that have expanded Medicaid, we have seen a sharp drop in the 
percentage of people with substance use disorders who seek care in the 
emergency department because they are uninsured. Medicaid is the single 
largest payer of substance use disorder services and pays for one-third 
of all medication-assisted treatment in the country.
  TrumpCare would reverse all these gains. According to the Center on 
Budget Policy and Priorities, repeal of the ACA would mean 2.8 million 
people with substance use disorders would be at risk of losing their 
coverage. Repeal of the Medicaid expansion would cut $4.5 billion from 
mental health and substance use disorders for those with low incomes, 
to say nothing of TrumpCare's broader goal of ending Medicaid as we 
know it. TrumpCare would all but eliminate this critical safety net.
  TrumpCare goes even further to turn back the clock on consumer 
protections like preexisting conditions. People with substance use 
disorders would be disadvantaged immediately, as their disorder could 
be considered a preexisting condition. This has the double effect of 
pricing people with mental and behavioral health issues out of the 
market entirely and encouraging people not to seek care out of fear of 
being labeled by their insurance company as having a preexisting 
condition.
  On top of that, TrumpCare would gut the essential health benefits in 
the ACA. This means that there would be no rules about what health 
insurance must cover, such as preventive health services and mental and 
behavioral health services. Even with coverage, people will have to pay 
out of pocket for the services they need. For substance use disorders, 
which could add up to $20,000 a year in out-of-pocket costs alone.
  Over the last couple of years, I have worked with my colleagues on 
the Senate Appropriations Committee to include historic funding 
increases for programs that help the opioid crisis. In fact, the fiscal 
year 2017 omnibus provided $511 million for prevention, enforcement, 
treatment, and recovery across various agencies, including over $300 
million for the Department of Health and Human Services, $50 million 
for the Department of Veterans Affairs, and over $160 million for the 
Department of Justice. Last year, we passed the 21st Century Cures Act, 
which directed $1 billion to States to combat the opioid crisis. We 
must continue these efforts.
  However, this week, the President released his budget proposal for 
next year, and it does the exact opposite. First of all, the 
President's budget doubles down on his plan to decimate Medicaid. The 
President has proposed cutting hundreds of billions of dollars from 
Medicaid, block-granting the program with no protections for the most 
vulnerable. In fact, his budget offers no details on how it plans to 
structure Medicaid--just that he intends to cut the program beyond 
repair.
  On top of that, the President's budget makes enormous cuts to the 
Substance Abuse and Mental Health Services Agency, SAMHSA, which 
implements many of our most effective substance use disorder prevention 
and treatment programs, such as the Community Mental Health Services 
Block Grant Program, which President Trump has proposed cutting by over 
20 percent.
  Further, President Trump has proposed cutting the National Institutes 
of Health by nearly $6 billion, which would interrupt critical research 
into new and better ways to treat substance use disorders, along with 
research into how we can better treat pain without the use of addicting 
opioid painkillers. Coupled with TrumpCare, this budget proposal would 
only worsen the opioid crisis.
  I am committed to continuing to work with my colleagues to prevent 
that from happening. I am heartened to see so many of my colleagues 
talk about these very issues this afternoon.
  It is my hope that we will be able to work together over the coming 
months to ensure that the gains we have made in the fiscal year 2017 
omnibus and the Cures Act are not lost. We have much more work to do, 
and people in my State and across the country are counting on us to do 
that for them.
  With that, I yield the floor.
  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. LANKFORD. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.