[Congressional Record Volume 164, Number 58 (Wednesday, April 11, 2018)]
[Senate]
[Pages S2066-S2067]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                             Opioid Crisis

  Mr. GARDNER. Mr. President, over the past couple of weeks Congress 
and the Senate had its State work period, and during that time we go 
back to our State and travel, listening to our constituents. I had the 
incredible opportunity to go to Colorado and spend time on the Front 
Range, on the I-25 Corridor, where the vast majority of the population 
of Colorado lives, and also spent some time in Western Colorado, which 
most people identify as being where they travel to Colorado, with the 
ski resorts, mountains, Rocky Mountain National Park, and the Great 
Sand Dunes National Park.
  I also had a chance to visit some of the smaller communities in 
Southern Colorado, including an area known as the San Luis Valley, 
where some of the longest living Colorado families have farms. There 
are families and businesses.
  The focus of this visit was about how we grow the economy in the San 
Luis Valley, the Eastern Plains, and the Western Slope--areas that 
haven't seen as much economic growth as, perhaps, Denver, Fort Collins, 
or Colorado Springs.
  I also wanted to spend some time getting into the community and 
talking about a couple of the issues they face when it comes to the 
opioid crisis that this country faces. Over the past several years, a 
great deal of attention has been paid to prescription drug addiction 
and to prescription drug overdoses.
  My home State of Colorado actually has an average that exceeds the 
national average when it comes to prescription addiction and overdose. 
We are losing a person in Colorado to drug overdose every 36 hours--far 
too many people. In our rural communities, it is not just the wealthy 
who are immune or the poor who are immune or the poor who are affected 
or the wealthy who are affected. It is everyone--wealthy, poor, low- 
and high-income. The opioid crisis and prescription drug addiction have 
affected every nook and cranny of our communities.
  The attention that has been paid to the addiction crisis in this 
country has resulted in some of the greatest bipartisan achievements 
Congress has had over the past several years. The passage of the 21st 
Century Cures Act will expedite new treatment methods through the FDA 
and provide research treatment dollars for the opioid crisis and the 
prescription drug crisis and addiction.
  It also led to passage of the Comprehensive Addiction and Recovery 
Act, legislation that had great bipartisan support. People on both 
sides of the aisle worked on this legislation together to pass a bill 
to address what is happening to our communities.
  Every single one of us has a story about somebody close to us, near 
to us, perhaps a friend or relative--probably both--who has fallen 
victim to prescription drug addiction and opioid addiction. Of course 
if you end up with a prescription drug addiction, that one pill might 
be $60 or $80, but you can go out on the streets and find heroin for 
$10 to $15. Now we see the rise of heroin replacing prescription drugs 
and you see the cycle. The drug dealers have figured out a way to lace 
cocaine with fentanyl so that it becomes a little bit more addictive 
and so people are hooked on cocaine more than they already are.
  You know the dangers of fentanyl, a synthetic drug so powerful that 
you can't have a dog sniff for it at the Post Office because it would 
kill the animal.
  During these roundtables that were held in the San Luis Valley about 
opioids, I learned a couple of things. In Alamosa, CO, I learned that 
about 90 percent of the jail population in Alamosa is addicted to 
drugs. At the same roundtable, we talked about the challenges that 
rural communities have in treatment. We know that if a police officer 
or law enforcement officer or paramedic finds somebody who is overdosed 
and they are revived with Narcan, yes, you saved their life. You 
brought them back, but what happens after that? They are left to their 
own devices. Do they return to that abuse? Do they return to that cycle 
of overdose? Without treatment, yes, they will.
  We learned in Swedish Medical Center Englewood, CO, the Front Range

[[Page S2067]]

suburb of Denver, that 1 out of every 10 visitors to the emergency room 
of people who are revived by Narcan or some other treatment after an 
overdose will be dead within a year. So 1 out of 10 who come into an 
emergency room will be dead within a year.
  We know that there has been great success in finding alternatives to 
opioid medication. In fact, Colorado emergency rooms and the Colorado 
Hospital Association, working together with a number of hospitals, 
developed a program called Alternatives to Opioids, or ALTO, which is a 
program that we actually introduced legislation on--Senator Booker, 
myself, Senator Bennet, and others--to try to make sure that emergency 
rooms don't just turn to opioid medication but find other alternatives 
because there are other alternatives. You don't just have to prescribe 
an opioid-based medication.
  As a result, opioid prescriptions out of the emergency room have 
decreased by 36 percent over the 6-month course of this pilot program 
in Colorado. Those are remarkable results. We introduced legislation to 
mimic the same thing and to learn best practices at the Federal level 
so that hospitals around the country can work together, share those 
best practices, identify what works, and use them.
  We have to reform the Medicaid Program so there is no incentive for 
doctors to overprescribe addictive medication. In Alamosa, physicians 
we talked to are entering into contracts with their patients. At San 
Luis Valley Health Regional Medical Center, they are entering into 
contracts with patients about the responsibility that goes with taking 
these powerful, powerful drugs.
  We found new ways to make sure that the pill mills are being 
discovered and abandoned. We try to make sure that people can 
communicate with each other on how these treatments work.
  While I was in Colorado, we talked about the devastation that drugs 
are having on their small communities. We learned about a group of high 
schoolers who are talking to other high schools about the dangers of 
addiction and prescription and drug overdose. They are trying to work 
with each other to stop the cycle and to make sure that people who need 
help find help and hopefully will avoid it in the first place.
  Perhaps, one of the most frightening things that I heard during this 
roundtable--being a parent with three children of my own, I often worry 
about what happens to them when they go to school and what pressures 
they face. Two of them are young now. Our daughter is 14, and she will 
be entering high school. I worry about the pressures they will face 
from their peers. I worry about them, and I worry about what happens to 
our community and to their friends with what is around them. But I 
never thought that I would hear what I heard in the San Luis Valley.
  We were talking about prescriptions and reimbursement from Medicaid. 
One of the providers brought up a challenge that they had with getting 
reimbursement. I later learned from a pharmacist that it may simply be 
a coding problem, and if it were coded correctly, the reimbursement 
would occur.
  This is what this provider said. They were trying to make sure 
Medicaid could reimburse for the nasal spray of Narcan so that children 
could administer it to their parents when they overdosed, because it is 
easier for a young child or a little child to administer a nasal spray 
than to give an injection.
  Kids are given nasal spray so they can revive their parents. If that 
parent goes to the emergency room at Swedish hospital in Denver, CO, 
revived by that child, 1 in 10 of those parents revived will not come 
back again because they will be dead.
  We have done a lot of work in this country, and we have a lot more 
work to do when it comes to opiate addiction and crisis. We have a lot 
of work to do in this Congress to come together and find ways to stop 
this--to break the cycle, to make sure it is easier to prescribe the 
drugs that will help instead of create addictions.
  We have talked to people who said they have to have 8 hours of 
training and certification, which makes it impossible for certain drugs 
to be administered by a physician in the emergency room because they 
don't have time to comply with the paperwork. They actually would 
rather prescribe this drug than the opiate-based drug because the 
opiate-based drug, they know, would create the possibility of 
addiction. Yet this other drug wouldn't. There are more barriers to 
prescribe the drug that wouldn't cause the harm than the drug that 
would cause the harm. So we have a lot of work to do. These aren't 
Republican issues or Democratic issues. They are our families' issues. 
They are our friends' issues. They are our communities' issues.
  I will end it with this story. One of the healthcare professionals we 
talked to told a story of their son who was a golfer--an athlete, loved 
to golf. He was injured golfing, so they wanted to make sure their son 
was cared for so he could recover and go on to a golf career or 
whatever career he had in front of him. They took their son to the 
doctor. Their son was given Vicodin to address the pain from the 
injury. At this point in the story, the mother started to cry because 
she feels guilty and responsible for the very first treatment that led 
down a path of addiction and the eventual death of their son. All this 
mom wanted to do was help, and she now feels the blame of the powerful 
drug that led to the addiction and death of their son. It is not a 
unique story. That story has been shared far too many times around the 
country, and yet here we are once again talking about it.
  So I encourage my colleagues, let's continue the great work we have 
already done. Let's do more. Let's work together, and let's make sure 
we can find solutions this country will be proud of. We will know this 
when our communities recover and people stop dying.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. McCONNELL. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. McCONNELL. Mr. President, I ask unanimous consent that 
notwithstanding the provisions of rule XXII, all postcloture time on 
the Pizzella nomination expire at 9:30 a.m. tomorrow and the Senate 
vote on confirmation of the Pizzella nomination; further, that if 
confirmed, the motion to reconsider be considered made and laid upon 
the table and the President be immediately notified of the Senate's 
action; finally, that there be 2 minutes of debate equally divided 
prior to each vote.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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