[Congressional Record Volume 164, Number 7 (Thursday, January 11, 2018)]
[Senate]
[Pages S146-S148]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                            Opioid Epidemic

  Mr. BLUNT. Mr. President, I am here today with my colleague Senator 
Capito to talk about something that is getting a lot of attention but 
needs even more attention from this Congress, which is the opioid 
epidemic--the epidemic the President has rightly called a crisis, and 
he then turned to Congress and said: Find the money to solve the 
problem. We have been doing a substantial amount of that, but I think 
we see a clear desire here and in all of our States to find a better 
solution.
  This is an issue that has hit every town in America, small and large, 
I believe. According to the Centers for Disease Control and Prevention, 
over 40,000 people died from an opioid overdose. This is a fraction of 
the people who had an opioid overdose. These are the people who died 
from an opioid overdose in 2016, 40,000 people; over 90 Americans every 
single day. It was a 28-percent increase over 2015 and a dramatic 
increase over where we were just 10 years before.
  Opioid overdoses now surpass car accidents as the No. 1 accidental 
cause of death in the country. Both of our States and our surrounding 
States, I think almost every one of them, have had more overdose deaths 
in 2016--and an increased number, I think, in 2017--than car accident 
deaths. The Centers for Disease Control estimates the economic burden 
of this epidemic is almost $80 billion a year.
  We have just gone through a tax discussion, an economic growth 
discussion. When we were talking about billions of dollars, seldom were 
we talking about $80 billion to do something with or to stop doing 
something with, but the economic cost of all of this--lost 
productivity, addiction, the crime related to that addiction--the CDC 
says $78.5 billion a year is now the cost.
  We are both appropriators. The members of the Appropriations 
Committee have looked at this carefully. Our colleagues have had a 
chance to confront this issue in our committee head-on. We brought 
bills to the floor that have passed and made a big difference in a

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short period of time. Over the past 2 years, not counting what we hope 
to do this year, the committee has increased opioid funding by over 
$900 million, nearly a 200-percent increase for the Department of 
Health and Human Services--more money for justice, more money for the 
Department of Veterans Affairs.
  This funding is focused on developing alternatives for pain 
management, giving our State, Federal, and local law enforcement 
partners the tools they need to combat opioid trafficking, ensuring 
first responders we are working to see that there are better ways to 
respond with opioid reversal.
  One of the things we have seen recently is that opioids of all kinds 
are now laced with new drugs like fentanyl, and you don't even know 
what you are taking. Narcan, the former way to deal with this and still 
the most effective way to deal with this--you think you have dealt with 
a problem, and the dose is so strong, the same person in just a few 
minutes lapses back into another seizure, attack, that has often been 
fatal. Even though people are there and the traditional way to respond 
is there, it isn't enough for what is going on now.
  One thing you would have to tell anybody doing this is, it is 
unlikely you have any real idea what you are putting into your system. 
What you think was a narcotic high the day before could easily kill you 
the next day. We have been looking for better ways to monitor programs 
so prescriptions in West Virginia and Missouri--they are both States 
where, in some counties, the number of prescriptions people have been 
walking into the pharmacist with are just ridiculous.
  The committee that funds the Department of Health and Human 
Services--that is the committee we are both on--in the last 2 years, we 
have increased funding by 1,300 percent, $745 million--13 times more 
than we were spending just 2 years ago. We have given grants to States, 
in ways we haven't before, to look at specific State needs and ideas 
they have to deal with this and then share. We have looked at 
increasing Federal surveillance on how prescriptions are being written, 
how drug stores are becoming the conduit, and how many substances are 
coming through the mail to find new ways to determine whether this is 
reasonable in the area these drugs are going into. We have looked at 
ways to increase the tools necessary to communities and first 
responders. We are talking right now to the National Institutes of 
Health about what they can do on a number of fronts. One is to work 
with the pharmaceutical companies themselves to develop alternatives to 
the kind of pain management we have had.
  Also, let me say on that front, we have gone through a period where 
doctors and hospitals were too often graded on whether people had any 
pain or not as opposed to whether they had pain they didn't understand, 
pain that was unacceptable. More and more people ought to be saying, as 
opposed to taking this potentially addictive drug, give me a dose that 
is not as addictive, and maybe I am still more achy than I would be 
otherwise, more pain than I would have otherwise, but I understand it 
and am aware of it, and I am not in some cloud of no pain but not much 
of anything else in terms of real quality of life.
  We are looking at how we can work with these companies for pain 
management. I have talked to the pharmaceutical companies. I think it 
is time for them to step up, maybe in partnership with NIH, so there is 
some Federal money to encourage more private sector money to find 
alternatives that are less addictive and better understood, to find 
more effective and affordable ways to respond. Just the amount of money 
in the first responders' kits around the country, and local governments 
paying for the Narcan, the more expensive injectable treatment--we need 
to look for ways where that can be more available and in a way that 
local governments have a better way to deal with this.
  This needs to be dealt with locally. The first responder is going to 
be a local person. If you are a fire department that also has first 
responders, your department is three times more likely to go on an 
overdose call than they are to go to a fire. That is where we are in 
this situation today.
  In trying to figure out what the impact really is at home--as we all 
are trying to do--I had a meeting not too long ago with medical 
professionals, with State officials, with emergency responders, in 
Springfield, MO, to talk about how we deal with prevention, treatment, 
and recovery. We talked about the critical partnership between local, 
State, and Federal law enforcement and the dangers the first responders 
themselves face. Sometimes what people are putting into their system is 
so powerful and so addictive that walking into the room or touching the 
clothing becomes a potentially great danger for the person who is there 
to help you. I talked to doctors and hospitals about the challenges 
they face in prescribing less habit-forming pain medications and how 
patients are still not fully aware of the danger of dealing with pain 
if you overdo it as you are dealing with pain.
  I talked to one person who talked about his daughter who had just 
gone to the dentist and got pain medicine and had no sense that the 
pain medicine could be addictive and she should stop taking it when it 
had done its job, whether or not it was when the last pill was gone.
  Then, of course, there is a new issue of underprescribing. Nobody 
likes to go back to the pharmacy twice to get the same prescription 
they just got a few days ago, but giving people more pills than they 
need to take themselves or have them sit in the medicine cabinet 
doesn't make any sense.
  In our State, there are large urban areas, but it also has a lot of 
small and remote communities and, frankly, rural communities have been 
hit particularly hard by this crisis. Certainly, West Virginia is a 
State that understands this. There has been no more vigorous advocate 
for funding and new ways to solve this problem than Senator Capito. I 
am glad to be here with her today as we talk about this issue.
  I can assure the people we work for that this is a top priority. It 
has been a top priority for over 3 years now. The first 2 years showed 
dramatic increases in the willingness we had to deal with this and the 
breadth of how we deal with it, and that is one reason we need to move 
on and get this funding bill, which should have been done by October 1, 
done right now. As we get a new number to deal with, one of our 
priorities will be the opioid epidemic, and one of the leaders in that 
discussion will be the Senator from West Virginia, Mrs. Capito.
  The PRESIDING OFFICER. The Senator from West Virginia.
  Mrs. CAPITO. Mr. President, I wish to thank Senator Blunt from the 
great State of Missouri for his leadership on this issue. He chairs the 
subcommittee that is very pivotal--the Appropriations Subcommittee on 
Labor, Health and Human Services--and has moved forward so aggressively 
to up the funding in this area. We have the pedal to the metal now.
  As he said, when we are moving and coming to a final spending bill, 
this has to be a top priority for us. It is absolutely critical. I am 
really pleased to be on the subcommittee, but I want to thank him for--
I know he works diligently with NIH, which holds big promise. We are 
always looking for solutions. Can we treat ourselves out of this? Can 
we law enforce ourselves out of this? Can we prevent ourselves out of 
this? I think we can do all of those. We have to have a component of 
research that looks at the alternatives to pain medications and pain 
management.
  The current bill we have looked at is $816 million for programs to 
combat opioid abuse issues, and that is a 440-percent increase from the 
previous year.
  I am going to go through this. It might sound a little mundane and 
detail-oriented, but people say: That is great to ``up'' the amount of 
money that you are spending, but where are you really spending this 
money?
  The Senator from Missouri, Mr. Blunt, mentioned that it has to be 
done locally, and there is a lot of emphasis on where these dollars are 
going.
  Some of them are going, of course, to the CDC, the Centers for 
Disease Control and Prevention, for prevention issues, which is 
critical, while $50 million is going to our community health centers. 
In States such as Alaska, West Virginia, and Missouri, community health 
centers are seeing hundreds of

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thousands--millions--of people every day and many more who are dealing 
with mental health and substance abuse. SAMHSA oversees the mental 
health grants that go to our States, and there is $15 million for a new 
SAMHSA program for opioid prevention. We have our drug-free communities 
program, which works well in my State. It is a total grassroots-up, 
bottom-up, when you get everybody from your local county or public 
health and others in the room to try to solve this issue. Then again, 
there are some block grant programs to our community health centers 
along with the funding to NIH. This is a broad-based look at where the 
funding is going.
  We have an opportunity here in the next several weeks to ``up'' that 
funding, to make sure that the national priority that we feel, as 
Senators from States that are highly affected, is reflected in our 
funding. I believe that with Senator Blunt's leadership on the 
subcommittee and with other members on the subcommittee, that is 
something we are going to be doing.
  I happen to chair the Financial Services and General Government 
Appropriations Subcommittee, which appropriates the money for the high-
intensity drug task forces. Our State has over 22 counties that are in 
that. Is that a branding that you really want--that you are a high-
intensity drug trafficking area? Not really. What that does is 
coordinate Federal, State, and local resources to help meet the 
challenge and face what a difficult problem you have. I work with 
funding on that, with the drug-free communities, and also with the 
President's Office of National Drug Control Policy. We have done a lot, 
and we have pushed for resources.
  The Senator mentioned resources for our first responders. He 
mentioned how dangerous it is. There have been local stories about our 
first responders who have just touched fentanyl--just touched it--and 
have gone into overdose situations. We were at the White House 
yesterday and were talking, and the President mentioned drug-sniffing 
dogs that have had reactions to fentanyl. So this is a very lethal 
substance. Actually, I saw in the statistics for West Virginia that 
more of the recent overdose deaths are attributable to fentanyl than to 
heroin itself, and that is rising. We need the money for enforcement, 
prevention, treatment and recovery, and more resources for research, 
and I have mentioned how critical that research will be.
  Nationwide, we had over 63,000 drug overdose deaths in 2016, and a 
number of these were attributed to heroin and fentanyl. In my State of 
West Virginia, we had the highest deaths per 100,000 for overdoses. I 
would like to say it is happening somewhere in which maybe we would 
have predicted that it would happen, but it is happening everywhere. It 
is happening to the children of friends of mine.
  Ryan Brown, a young man in West Virginia, lost his life. He had a 
loving home, loving parents, and had been through treatment. He just 
couldn't fight it. He went back and injected himself with a lethal 
dose. He died in a very public place too. It was very tragic. To his 
credit, his parents have taken up the mantle for Ryan to try to get 
more treatment centers in the State of West Virginia. I thank them for 
that.
  We were just at the White House--Republicans and Democrats--for the 
President to sign the INTERDICT Act. I sponsored that bill with Senator 
Rubio, Senator Markey, and Senator Brown. What it does is help give our 
Customs and Border Patrol folks the ability to detect fentanyl when it 
is coming in. We know it is coming in from across our borders, 
principally from China, maybe China through Mexico. We need to equip 
our Border Patrol agents to be able to stop that--interdict the flow of 
that lethal substance.
  Just this week, The Hill newspaper published an op-ed about the 
Martinsburg Initiative. Martinsburg is in West Virginia, in the Eastern 
Panhandle. Everybody needs to visit Martinsburg. They have an 
innovative police-school-community partnership that is spearheaded by 
the Martinsburg Police Department, the Berkeley County Schools, and 
Shepherd University, along with the Washington/Baltimore HIDTA. This is 
a comprehensive strategy of intervention and treatment for families to 
help prevent the beginning of the addiction to opioids.
  In December, I attended the kickoff of the Bridge of Hope Fund, and I 
want to highlight what some of the local communities are doing in my 
State to try to get a comprehensive spectrum of solutions. This is a 
new scholarship program that was developed by Fruth Pharmacy, which is 
a locally-owned, family-owned pharmacy, that will allow people who have 
completed addiction recovery programs to get a jump-start on their 
college educations and career training.
  The founders of the program started it because they wanted to 
encourage people who have reclaimed their lives and been successful to 
be able to get back into the mainstream. We know one of the roadblocks 
to recovery is getting back into the work environment--to be able to 
get a job. Many of these young folks who are in this position have 
already burned through their education grants and their availability of 
Pell grants. So this Bridge of Hope scholarship is an organic, from-
the-ground-up scholarship program for those who have been through 
treatment.
  We had a young man who talked about his road to recovery and how 
important getting his education and getting back on his feet was. We 
need more everywhere. I think that is essential to all of us. We have 
to prioritize our Federal funding for States like mine that have been 
the hardest hit by the opioid epidemic.
  I see my colleague from New Hampshire here. Both of us have joined 
together on the Targeted Opioid Formula Act so that those of us who 
have high statistics and greater need are able to have those funds more 
squarely targeted toward us for prevention and treatment.
  There are a lot of good ideas out there. There are a lot of things 
going on, but there is a lot of tragedy around all of us. I would say 
to the folks in the gallery and certainly to everybody on the floor 
that you probably know a family or you probably know a community or you 
probably know somebody who has been hard hit by this. It is absolutely 
crushingly sad, heartbreaking, because it is preventable. It is 
something on which we can have an impact. If we don't, we are going to 
lose another generation.
  I have great fears that we are going to look back on this moment in 
time and think we didn't do enough. So I think, with Senator Blunt's 
help and the help of others, particularly with Senator Blunt's chairing 
the Appropriations Committee, this is the direction in which we need to 
go. We need to have more targeted funding so those local resources can 
be creative in order to stop the scourge, to handle the scourge, and to 
educate the next generation as to how devastating this could be if one 
were to ever begin to go down this road.
  Thank you, Mr. President.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Mrs. SHAHEEN. Mr. President, I ask unanimous consent to speak for up 
to 10 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mrs. SHAHEEN. Mr. President, let me applaud my colleague from West 
Virginia, Senator Capito, for her work in addressing the opioid 
epidemic. It is something that I know, in a bipartisan way, we care 
about in this Chamber, and it is one place in which I think we could 
come to some agreement about increasing resources as we come to an 
agreement on the budget for the upcoming year. So I thank the Senator 
for her comments.