[Congressional Record Volume 164, Number 121 (Wednesday, July 18, 2018)]
[Senate]
[Pages S5049-S5050]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                            Opioid Epidemic

  Mr. President, I also want to talk for a few minutes about the 
importance of getting the appropriations bills to the Senate floor, and 
I want to do that by talking about the opioid epidemic.
  Our annual opportunity to look at that is legislative--legislative in 
terms of deciding how to spend money as we try to deal with this 
epidemic that claims more lives than any other single accidental cause 
of death. For a long time, car accidents predominated that list, but in 
virtually every State in the country, more people die now from drug 
overdoses than die from car accidents.
  There are people of every age, such as the high school cheerleader in 
my hometown of Springfield, MO, who hurt her leg and got medicine for 
that leg injury. I think it was after 3 years of

[[Page S5050]]

struggling with addiction that her mother found her dead in the bedroom 
from an overdose.
  Every age, every race--there are stories of incredibly successful 
people who received from the doctor or the dentist more pain medicine 
than they needed. It is not because that is what the doctor or the 
dentist intended to do. Doctors and dentists in the 1970s and 1980s 
were told: This is nonaddictive. There is no reason for people to have 
pain.
  People could take these opioid-based painkillers and not have pain. 
That part was true. The part that wasn't true was the nonaddictive 
part. And the part that wasn't true was what you would do when the 
doctor was no longer giving you that medicine or you could no longer 
act like you were getting the medicine because of pain when, by then, 
you were getting it for some other reason.
  The appropriations bill that our committee has voted out and that we 
are eager to get to the floor includes $3.7 billion targeting the 
opioid epidemic. It is a 1,300-percent increase over where we were 4 
years ago. Congress has become more aware of not only how widespread 
the epidemic is but also the incredible human cost of the epidemic.
  The bill includes almost half of that money, $1.5 billion, for State 
opioid response grants. One reason we are doing this with grants is we 
really don't know all of the options yet, and we haven't been able to 
evaluate the best ways to deal with this. We do feel in our committee 
and in Congress that it is unlikely that the best way to deal with this 
in one place is necessarily the best way to deal with it in other 
places.
  My State of Missouri received $10 million last year. We will receive 
$28 million this year if this grant funding is approved, and other 
States will go up proportionately, exactly as we did.
  What did we do with that money in our State of Missouri to see how we 
could deal with this epidemic? More than 1,700 people have received 
evidence-based medical treatment for opioid-use disorder; 1,700 people 
in the last 12 months or so have received that. More than 4,300 kits of 
naloxone, which is what you take when you overdose, have been 
distributed. That is less effective sometimes than it used to be 
because of fentanyl, and people don't have any idea, when they are 
trying to help you with what you put into your system--and you don't 
either--so, occasionally, you will get that shot to relieve you from 
the overdose and think that has helped, and then suddenly what you have 
put into your system overwhelms even that normal cure if you get it on 
time. ``Cure'' might be the wrong word because all it does is save you 
that one time.
  Around 4,000 people have received training on what to do in the event 
of an overdose. About 10,000 people have received training in our State 
on topics from treatment to prevention to recovery.
  For a State like ours, the rate of opioid deaths has increased; 
opioid overdose deaths have more than quadrupled in the past 15 years. 
That would not be an unusual number for States to see.
  Senator Capito from West Virginia and I were here on the floor 
talking about this earlier this year. This is not necessarily an urban 
problem. In fact, in most cases, it is more of a rural problem per 
capita than an urban problem per capita. We have set aside money 
targeted for those rural communities. There is $135 million set aside 
for rural communities based on different things that appear to be 
needed more in rural communities than in any other communities.
  A couple of hundred million dollars goes into community health 
centers to support people who have behavioral health concerns and 
mental health concerns. If you don't have a mental health problem 
before you get addicted to opioids, you have one once you have gotten 
addicted to opioids. So those funds go there to try to deal with that.
  Senator Stabenow and I introduced a bill a few years ago, the 
Excellence in Mental Health Act, and eight of our States now have a 
situation where they are treating, in that eight-State pilot, 
behavioral health problems like all other health problems. That 
particularly steps up if someone with an opioid addiction problem has a 
behavioral health problem they wouldn't have had otherwise. And there 
is no limit. Just as there would be no limit if you had kidney 
dialysis, there is also no limit in those eight States for your 
behavioral health problems. There is no limit where, if you haven't 
whipped this in 28 days, you are going to have to deal with this as a 
unique problem. Dealing with mental health and behavioral health in the 
same way matters in all cases, but it particularly seems to apply as 
people try to beat addiction.
  The Department of Labor and Health and Human Services bill includes 
$60 million for child abuse prevention and treatment programs to 
support what happens in families when someone in that family gets into 
a situation of abuse.
  The number of people who become addicted needs to change, but also 
how we deal with pain needs to change. So there is some unique money 
available to the National Institutes of Health to try to develop a pain 
medicine that is nonaddictive; $500 million went toward that effort.
  In all of these cases, we feel as though we have produced a good bill 
out of our committee. It has about one-third of the money in it after 
defense is taken off the table. It is a big bill that covers a large 
jurisdiction.
  Everyone in the Senate deserves a chance to be part of this debate. 
Everyone in the Senate deserves to look at how the appropriators--I 
think it was 33 to 1 that they voted for this bill--have decided to 
spend the money. It may be the way everyone decides to spend the money, 
but everyone ought to have a chance on this floor to say ``No, I think 
this money would be better spent here and here, better spent this way 
and that way.'' Every single Senator ought to be able to be part of 
that discussion.
  If we continue this process that we have been in for a few years--one 
big bill that nobody ever gets to vote on--that means the Senators who 
aren't on the Appropriations Committee will not have a say in 
establishing our national priorities. It is time to do that.
  These bills are all out of committee and have been for almost a month 
now. We have had three of them on the floor already. I think we plan to 
have four of them on the floor next week, and maybe Defense, Labor, and 
HHS not too long after that.
  These are big issues that every Senator should have a say in, and the 
only way that will happen is if these issues are decided right here on 
the floor. Hopefully we will set some records, at least, of having 
these bills on the floor and debated.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. TOOMEY. Mr. President, I want to reflect on some of the data that 
has been coming in on our economy in response to our tax reform and 
deregulatory push.
  Before I do, I want to commend my colleague from Missouri and thank 
him for his leadership and work on the incredible crisis of opioids we 
are dealing with. It is not a uniformly national crisis; it is more 
concentrated regionally, and my State of Pennsylvania is affected as 
badly as any place in the country.
  I am pleased we have been able to take a number of constructive 
measures, but we have a lot of work yet to do as we try to deal with 
this scourge. I want to thank him for that.