[Congressional Record Volume 165, Number 39 (Tuesday, March 5, 2019)]
[Senate]
[Pages S1663-S1666]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                            OPIOID EPIDEMIC

  Mr. PORTMAN. Madam President, I have come to the floor of the Senate 
today to talk about the opioid crisis, to talk about what is happening 
out there in our communities and how some of our Federal legislation is 
working, and to talk about some good news, which is that there is some 
improvement in terms of the overdose deaths we have seen in this 
country, but also a warning that although we are finally making 
progress on the opioid crisis, we are also seeing other drugs, such as 
pure crystal meth, coming from Mexico and other drugs beginning to take 
hold in our communities.
  So let me start, if I could, by talking a little about what the 
opioid crisis has been and what we are doing to address it.
  You recall that the last data we had, which is for 2017--over 70,000 
Americans lost their lives to overdoses. The No. 1 drug, the No. 1 
killer, has been fentanyl, which is a synthetic opioid that, about 4 or 
5 years ago, hit our communities hard. Year after year, for 7 or 8 
years now, we have seen increases every single year in the number of 
people who die from overdoses, which is one way to measure it. Another 
way to measure it is just the number of people addicted. That is a 
harder figure to find, but that has also increased year to year.
  It is devastating communities. The No. 1 cause of death in my home 
State of Ohio is opioid overdoses. Among Americans under 50, it is now 
the No. 1 cause of death in America.
  It also has had many impacts on our health system and on our criminal 
justice system. Go to the emergency rooms. Look at our jails that are 
filled with people whose crimes somehow relate to opioids. Often, these 
are property crimes--people doing something to get the money to pay for 
their drugs.
  Look at the impact it has had on our families. The foster care system 
is overwhelmed. I was with some juvenile court judges today from Ohio 
who were telling me that they can't find sponsors, that they can't find 
foster parents because the system is overrun with kids whose parents 
are addicted to opioids, and they cannot go home, but they need a 
loving family.
  It has impacted our economy because so many people are now out of 
work altogether, aren't even looking for work, and don't even show up 
in the unemployment numbers. If you look at the labor force 
participation rate being so low--in other words, the number of people 
working--the unemployment rate today would not be 4 percent; it would 
be more like 8 percent if you just went back to a normal level. And a 
lot of that, based on studies done by the Department of Labor and 
Brookings and others, shows that the opioid crisis is driving that.
  It has impacted us in so many ways.
  Here is the exciting news: After 7 or 8 years of increases every year 
in the number of people whose hopes are lost,

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whose lives are lost, we are seeing--at the end of 2017 and into 2018, 
the initial numbers we have--some improvement. It starts from an 
unacceptably high number, so this is not something we should start 
congratulating ourselves about, but it is much better, finally, to see 
this trend start to reverse.
  Preliminary data from the Centers for Disease Control and their 
National Center for Health Statistics points to a promising, although 
very modest, downturn. They measure drug overdose deaths in 12-month 
periods, ending in any given month. The last data we have regarding 
predicted deaths was between September 2017 and March 2018, and during 
that time period, we saw the number of deaths fall from about 73,000 
Americans to 71,000 Americans.
  So there is still a crisis that we face as a country, but it shows 
that in many States, including Ohio, we are beginning to see a little 
progress. Again, this follows a time period where we saw a big increase 
due to this fentanyl--the synthetic drug that is 50 times more powerful 
than heroin--causing so many of those overdoses.
  In fact, in my view, we were beginning to make progress through some 
Federal, State, and local policies and also the innovative work of the 
nonprofits that were working in our communities. We had begun to see 
progress on treatment and prevention and recovery and providing more 
Narcan, and then this influx of fentanyl hit us and overwhelmed the 
system. Now we are beginning to see--even with the fentanyl still out 
there--that we are beginning to make progress.
  In Ohio--fentanyl hit our State particularly hard. We had a record 
4,800 overdose deaths in 2017, which was a 20-percent jump over 2016's 
toll. So it has been tough for 8 years in a row.
  What I can report today is that now we are seeing a little progress. 
We saw a 21-percent drop in overdose deaths in the first half of 2018. 
Again, we have not yet gotten all the numbers for 2018. When we have 
all those, I will come back to the floor and talk about them. But for 
the first half of 2018, we are getting the numbers in now at about a 
20-percent drop.
  That was the biggest drop in the Nation, by the way, during the 
period from July 2017 through June 2018, according to the Centers for 
Disease Control. So that is good, because Ohio has been in the middle 
of this. Other than West Virginia, we probably have had the highest 
number of overdose deaths on average in the last several years.
  Separately, preliminary data from the Ohio Department of Health shows 
a 34-percent decrease in overdose deaths from January to June 2018. 
Again, those first 6 months, we saw a little decrease, finally--34 
percent. That is progress--again, from a high starting point, but I 
believe we are headed in the right direction.
  Some people have asked me ``Are we ever going to see the end of this 
crisis?'' and I have always said yes. There is a light at the end of 
the tunnel because we know what we need to do.
  We need to have better education and prevention programs to keep 
people from falling into addiction in the first place. We need to stop 
the overprescribing from our doctors so that people aren't 
inadvertently, because of an accident or an injury, taking prescription 
pain pills and then becoming addicted and then moving to heroin and 
fentanyl and so on and often to overdoses.
  We need to do much more in terms of treatment and getting people into 
longer term recovery because we know initial treatment is important. In 
fact, essential to getting people through the process of coming out of 
their addiction is that they have to go through a painful process and 
then go into a treatment program. We have also found that longer term 
recovery programs are key to people's success--getting back on their 
feet, getting back to their families, and getting back to work.
  One of the reasons we have made progress is because, as I said 
earlier, at every level of government, there has been movement, and 
there has been progress made. Here in Washington, in the Congress, we 
have done things that are historic. As an example, never before have we 
funded recovery--until just a few years ago. We have never had this 
much focus on providing the funds for Narcan to be used to help our 
first responders and others use this miracle drug to reverse the 
effects of an overdose. We have never spent so much money on prevention 
and education. And, of course, we have never spent so much money on 
treatment.
  Several years ago, some of us came together, knowing this crisis was 
building, and said: How do we create legislation here in Washington 
that can make a difference? Some said it is not really a Federal role. 
My view was that the Federal Government has a big role here because it 
is a national emergency, a national crisis, but we ought to take the 
best information from around the country, find out what the best 
practices are, and then help the States by providing funding to 
leverage additional funding at the local level, the State level. That 
was called the Comprehensive Addiction and Recovery Act. We spent 3 or 
4 years putting it together. We had five conferences here in 
Washington. Senator Whitehouse on the other side of the aisle and I are 
the coauthors of that legislation.
  The first year, we got some money from Congress--$181 million--to 
support these treatment programs, education programs, treatment and 
recovery programs together, Narcan for our first responders--181 
million bucks. The next fiscal year, we got $267 million to fund these 
same programs. The next year, 2018, we got $608 million. In 2019, this 
year, we got $647 million. So we have increased the funding and 
increased the commitment. Why? Because it is working. Because we can 
all go home now and look at our States and see where some of this 
funding is going and show that through innovation, through doing things 
differently, we are beginning to make a difference.
  Let me give the best example, perhaps, that I see around the country; 
that is, instead of saving someone's life with Narcan and having that 
person overdose sometimes again and again--first responders will tell 
you that they find it frustrating to save the same people again and 
again and not find any route to success. You want to get these people 
into treatment. So what we have funded through CARA--the Comprehensive 
Addiction and Recovery Act--are these rapid-response teams. So when 
somebody overdoses from fentanyl, they don't just go back home or go 
back to the old community or the old gang. Instead, somebody visits--a 
law enforcement officer, a social worker, a treatment provider. They 
knock on the door and say: We want to get you into treatment. We want 
to help you. We are here to help. We are not here to arrest you; we are 
here to help you.
  The success rate is phenomenal--maybe greater than you would think--
because a lot of these people, particularly right after overdosing and 
having Narcan applied, saw their lives flash before their eyes, and 
they are looking for some help. Probably 8 out of 10 people are not 
getting into treatment, so they are looking for an avenue to treatment.
  In some places in Ohio, there has been as much as an 80-percent 
success rate in getting those people who were virtually a zero-percent 
success rate before into treatment programs. Again, they have to be the 
right programs, and there has to be that longer term recovery in order 
to ensure success, but programs like those are beginning to turn the 
tide.
  Over the past several months, I have been around the State of Ohio--
as I have done the last several years--and I met with local leaders to 
find out what is really going on and how the money is being spent.
  A couple of weeks ago, I met local leaders and participants in the 
Pathways Achieving Recovery by Choice program. That is a voluntary 
recovery program for incarcerated women with substance abuse disorders 
and many with co-occurring mental health issues as well. These are 
women behind bars who volunteer to go into this program. All of them 
are numerous repeat offenders. In other words, these are women whose 
chances of being back in the system after they get out is extremely 
high. The program director said it is virtually 100 percent because 
they have been arrested numerous times, and they keep coming back again 
and again into the system.

  This program that I got to see received a grant from the 
Comprehensive Addiction and Recovery Act of $881,000 so that this 
program could last not just

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1 year but several years. They put it in place. They are providing 
treatment and recovery services for these women and teaching them not 
just about how to avoid going back to the old neighborhood and getting 
back in trouble again but also how to establish their lives in a 
productive way--going back to work, getting back with their families.
  It was great to hear from Dr. Patrice Palmer, who runs the program, 
and also Franklin County Commissioner Marilyn Brown, Sheriff Dallas 
Baldwin, and others about how this is helping residents get what they 
need--the treatment and recovery services they need, the housing they 
need--but most importantly, get them to rebuild their lives and not 
come back into the system. I mentioned earlier that the recidivism rate 
is virtually 100 percent for this group. In other words, 100 percent of 
them are going to come back into prison based on the record. This 
program has got that down to 20 percent. In other words, 80 percent of 
these women have gotten out, gotten into the programs they need, gotten 
back on their feet, gotten a job, and found an apartment. Eighty 
percent of them are back in our communities as productive citizens. 
That, to me, is what this is all about.
  I spoke to a number of the participants in the program, and they were 
optimistic because it is a very upbeat program. I was asked to give a 
quote, and I gave a Winston Churchill quote about how when you fall 
down, the most important thing is getting back up. That is more 
important than success without having failures. I talked about the fact 
that I have been to a lot of these programs around the State, and I 
have seen where people find--for the first time in their lives, in many 
cases--the kind of meaning in their lives and the kind of hope for the 
future that let them get back on track.
  I talked to Nina Davidson. She is a repeat offender. Nina said what 
all the women said. She said: I don't want to go back to jail. She 
doesn't want to keep living that life. She has been in and out of jail 
many times. Pathways has helped her change her thinking, and that is 
what it is all about--changing the thinking and therefore changing 
lives and saving lives.
  Earlier this year, I met with law enforcement, local officials, and 
members of the Hamilton County Heroin Coalition to find out how they 
are using these Federal funds.
  Again, I am here talking to my colleagues, Republican and Democrat 
alike, saying that we need more money, and they want to know where it 
is going. Is it working?
  Well, I just talked about one that is working in Columbus. It is also 
working in Hamilton County, which is the Cincinnati Federal area. They 
have received Federal funding through the CARA legislation and also the 
21st Century Cures law--again, something this Congress passed on a 
bipartisan basis.
  The county has received a $500,000 CARA grant for an innovative 
program to help those with substance abuse and mental health disorders 
get help instead of going through the criminal justice system. They 
also got $50,000 for a prevention grant for a group called 
PreventionFirst!, which is a group I founded more than 20 years ago, 
about 25 years ago in Cincinnati. It is still there helping to prevent 
drug abuse. They are doing a good job. They have also received money 
through the 21st Century Cures Act. In fact, in the last 2 years, Ohio 
has received 26 million bucks a year from the Cures legislation that 
goes straight to the State, and the State decides how it is given out 
to good groups and organizations around the State.
  The Cures funding and the CARA funding, as I see it, is working. It 
is expanding Medicaid-assisted treatment. It is helping first 
responders--these are our EMS, our firefighters--who are out there 
trying to save lives. They need the training on Narcan. They need the 
funding.
  It has also helped with regard to closing the gap for those who are 
seeking treatment. I mentioned earlier the gap between Narcan being 
applied and somebody getting into treatment. There is also a gap, 
unfortunately, between people in treatment and getting into longer term 
recovery. Often, there is a waiting period there, and people fall back 
into their addiction. These gaps can be closed, and when they are and 
when it is a comprehensive, seamless program, the results are amazing.
  During our meeting in Hamilton County, Newtown, OH, Police Chief Tom 
Synan told me that fentanyl continues to be the deadliest drug in 
greater Cincinnati. He wants us to implement quickly two pieces of 
legislation. One is called the STOP Act, which this Congress passed to 
keep fentanyl from flowing freely into our communities.

  In August 2016, we had 174 overdoses in 6 days--174 in 6 days. It was 
what they called a bad batch. It was fentanyl being mixed with heroin. 
That drew national attention to the crisis. That is when we started 
working on this STOP Act, which is to say, let's stop this stuff from 
coming in through the U.S. mail system, which is where most of it 
comes, and from China, which is where most of it comes. We passed that 
legislation, and it is helping because it requires the U.S. Postal 
Service to actually screen through these packages to get the 
information to know what is a suspect package to help Customs and 
Border Protection pull these packages off and begin to pull some of 
these drugs out of our communities, which, at a minimum, increases the 
cost of this drug on the street, which is important.
  We also have the other legislation. I see that my colleague Sherrod 
Brown is on the floor today. The INTERDICT Act helps because it gives 
those same people more funding for the screening they need once they 
have identified a package that is suspect. That combination is making a 
difference right now. President Trump signed that law in October of 
last year after about 2 years of hard work and investigation by the 
Permanent Subcommittee on Investigations. It is making a difference, 
but, as Police Chief Tom Synan said, we have to implement it and 
implement it quickly.
  I spoke today to the Secretary of Homeland Security. She talked about 
the INTERDICT Act. She wants to push those quickly, and we need to, 
because those will continue to make a difference. But they are starting 
to work, and that is part of the reason we are seeing some progress.
  I recently toured the jail in Butler County, OH, to see firsthand how 
they are using their Federal funding. They got about $800,000 in a CARA 
grant. I met with Scott Rasmus, the executive director of the Butler 
County Mental Health and Addiction Recovery Services Board, Sheriff 
Jones, and other community leaders about how they are using this 
funding to close the gaps that often occur with treatment. Again, they 
are doing what I talked about earlier, with these rapid response teams 
that ensure, that, yes, they are saving people's lives with Narcan, but 
then getting them into a treatment program that works for them.
  In January I was in Portsmouth, OH, one of the hardest hit areas of 
our State. Portsmouth, OH, has been the subject of a lot of attention 
by the media--a lot of attention because they were hit so hard by the 
heroin crisis that followed the prescription drug crisis.
  I met there with law enforcement and local officials from Adams 
County, Lawrence County, and Scioto County. They have received $525,000 
in grants from the Cures Act, and they are using it to help to address 
every aspect of addiction, including the gaps in treatment I talked 
about. They funded a reentry project, the Hughes Re-Entry Center, which 
provides longer term assistance through outpatient services, assisted 
housing, and working with the Community Justice Center to close the 
gaps occurring when people get out of prison and getting them into 
programs that will help them to avoid getting right back into prison 
again.
  Lastly, I want to highlight a recent visit I made to the Oasis House. 
Oasis is a safe house in Dayton, OH. It provides a supportive 
environment and recovery services to women who were trafficked or 
abused, and it helps them get back on their feet through counseling, 
drug treatment, or other social services. I was there last month and 
had the opportunity to visit with the women. It is a Christian, 
nonprofit organization--a faith-based group--that runs these safe 
houses. Most of these women are victims of human trafficking. These 
women are often homeless. Every single one of them I talked to was also 
an addict or a recovering

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addict. They have been through a lot--a lot of trauma--and they need 
the help, but the good news is they are getting the help, and there is 
hope.
  At my visit to the safe house, I met these incredibly courageous 
women who have taken these steps voluntarily to get their lives back 
together, using faith and using, in some cases, treatment programs. The 
funding they are getting is coming through the Montgomery County ADAMHS 
Board, the alcohol and drug board, and that funding comes from the CARA 
legislation and the Cures legislation. Again, seeing in action what is 
actually happening on the ground gives me hope that we are beginning to 
make progress.
  I met with the safe house ``Mom.'' She is the resident mother, as she 
calls herself, of this house. She is there to take care of concerns 
that women have. She is a recovering addict herself. She is a domestic 
violence survivor. Oasis House saved her life, and now she is giving 
back by helping current Oasis clients to be able to help save their 
lives. I want to congratulate Cheryl Oliver, their executive director, 
for all of the great work they are doing. The bravery of these young 
women was inspiring and, again, it is great to see firsthand how this 
is making a difference in their lives.
  We have recently seen this issue of trafficking arise in connection 
with a sex trafficking ring in Florida. We are told that illicit spas--
like those in Florida that you have probably heard about in the media 
in the last week or so--can sometimes be hubs of human trafficking, 
where women, often imported from foreign countries, are brought in to 
America. They are often induced through fraud, fear, or some other type 
of coercion to perform sex acts for money, and that is what 
investigators believe happened here. They believe that the women in 
these spas were from foreign countries, and that they were induced into 
this through coercion. There is more information coming out. They don't 
have all of the details yet. The investigation continues, but they 
suspect the managers at these day spas were trafficking these women, 
and, therefore, they arrested the owners at several of these day spas. 
It is another disturbing reminder that human trafficking continues to 
exist right here in this country in this century, and we must stay 
vigilant in our efforts to combat this horrific crime.
  In my last 8 years here in the Senate, it has been one of our top 
priorities to pass legislation to combat human trafficking. We have 
passed bills into law to get better data on sex trafficking here in the 
United States, to ensure that victims are treated as victims and not as 
criminals, to increase Federal penalties on johns, and to enact a zero-
tolerance policy on human trafficking and government contracts.
  I am proud to say that, with Senator Blumenthal, we cofounded and 
cochaired the human trafficking caucus here. We started off with a 
couple Members, and now we have a couple dozen Members of this body who 
work day in and day out to say: How can we do more to help?
  One thing we found through our research was that online sex 
trafficking is growing dramatically and is one reason you see 
the increase in sex trafficking here in this country and around the 
world.

  After 18 months of investigation--particularly into backpage, which 
was the commercial site that had probably three-quarters of the 
trafficking on it--we passed a law called the SESTA legislation, which 
ensures that these websites that knowingly engage, facilitate, or 
promote trafficking are held accountable for what happens on their 
platforms. It is about time. We should have done it a long time ago.
  Having passed that legislation, backpage is now shut down, and the 
National Center for Missing and Exploited Children reported to us that 
probably about two-thirds of these online websites that sell women and 
children online have now been discontinued. Again, we haven't solved 
the problem. It is still very much out there. Other websites will crop 
up on the dark web as well, but we have made progress by focusing on 
the issue in a bipartisan way. Numerous websites have been shut down, 
as we have been told by the experts. I will quote the National Center 
for Missing and Exploited Children: ``Since the enactment of SESTA and 
the government's seizure of Backpage, there has been a major disruption 
in the online marketplace.''
  As we talked earlier--whether it is the SESTA legislation that is now 
working, whether it is the CARA legislation and the Cures legislation 
on the opioid crisis--that we are making a difference. The funding that 
has been provided by this body and by the House--after careful research 
to figure out what works and what doesn't work and sending it to 
evidence-based programs--is working. We cannot take our eye off the 
ball. We cannot stop now. If we do, we will just see this problem crop 
up in different ways.
  I mentioned that as we are making progress on opioids, law 
enforcement and those who are in the trenches--treatment providers--are 
talking about the fact that other drugs are beginning to rise, 
particularly crystal meth. So we can't stop. We have to continue.
  These programs are making a difference, helping people to get their 
lives back on track and helping to save their lives. The Federal 
Government continues to have a role here to be better partners in this 
effort with States, local governments, and nonprofits that are out 
there doing their best and, ultimately, with our families. That is what 
this is all about, giving people hope and saving lives.
  I yield back my time.
  The PRESIDING OFFICER. The Senator from Ohio.
  Mr. BROWN. Madam President, I thank my friend from Cincinnati for his 
work on both the issues he spoke about--both, on sex trafficking, which 
is a terrible affliction in our country and especially in Ohio, and on 
the issue of opioid deaths. We lose almost 100 people a week in Ohio to 
overdoses, and more than 11 a day on opioid overdoses. So I thank my 
colleague from Cincinnati for that.

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