[Congressional Record Volume 165, Number 70 (Tuesday, April 30, 2019)]
[Senate]
[Page S2510]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
THE OPIOID CRISIS
Mr. ALEXANDER. Madam President, I ask unanimous consent that a copy
of my opening statement at the Senate Health Education, Labor, and
Pensions Committee be printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
Managing Pain During the Opioid Crisis
Mr. ALEXANDER. The Senate Committee on Health, Education,
Labor and Pensions will please come to order. Senator Murray
and I will each have an opening statement, and then we will
introduce the witnesses. After the witnesses' testimony,
senators will each have 5 minutes of questions.
Dan, a constituent of mine who lives in Maryville,
Tennessee, recently wrote me about his wife, who has a rare
disease that causes her chronic pain. Dan is concerned
because it has become more difficult for her to access
painkillers. Dan wrote, ``She is not an abuser, and is doing
everything right. Now it's harder for her to get the medicine
she needs.''
Dan's wife is one out of 100 million Americans who,
according to a 2011 report by what was then the Institute of
Medicine, now the National Academy of Medicine, are living
with some pain--that is about 30 percent of Americans. 25
million of those have moderate or severe pain.
A new report released in 2018, from the Centers for Disease
Control and Prevention, says that about 50 million Americans
have chronic pain, and nearly 20 million of those Americans
have high-impact chronic pain.
Here is the reality: we are engaged in a massive effort to
make dramatic reductions in the supply and use of opioids--
the most effective painkiller we have. But on the theory that
every action has an unintended consequence, we want to make
sure that as we deal with the opioid crisis, we keep in mind
those people that are hurting.
We are holding this hearing to better understand the causes
of pain, how we can improve care for patients with pain, and
where we are on developing new medicines and ways to treat
pain.
We know that pain is one of the most frequent reasons
people see a doctor, and, according to the Mayo Clinic, the
number of adults in the United States with pain is higher
than the number of people with diabetes, heart disease, and
cancer combined. These Americans need more effective ways
than opioids or other addictive painkillers to manage pain.
Opioids, which are commonly used to treat pain, can lead to
addiction and overdose. More than 70,000 Americans died from
drug overdoses last year, including prescription opioids,
making it the biggest public health crisis in our country.
Last year, Congress passed comprehensive opioid legislation
to combat this crisis, which President Trump called ``the
single largest bill to combat a drug crisis in the history of
our country.''
Our legislation included more than 70 ideas from 72
Senators, and eight committees in the House and five
Committees in the Senate that included: Reauthorizing
training programs for doctors and nurses who prescribe
treatments for pain; increasing access to behavioral and
mental health providers; and encouraging the use of blister
packs for opioids, such as a 3 or 7-day supply, and safe ways
of disposing unused drugs.
We also took steps to ensure our new law wouldn't make life
harder for patients with pain, but now we need to take the
next step to try to find new ways to help them: first--we
gave the National Institutes of Health more flexibility and
authority to spur research and development of new non-
addictive painkillers. We also asked the Food and Drug
Administration to provide guidance for those developing new
non-addictive painkillers to help get them to patients more
quickly. I'm pleased to see Commissioner Gottlieb's
announcement this morning that the agency is developing new
guidances on how FDA evaluates the risks and the benefits of
new opioid treatments for patients with pain and to help the
development of non-opioid treatments for pain.
Sam Quinones, a witness at one of our hearings, called new
non-addictive painkillers the ``holy grail'' to solving the
opioid crisis. We have backed up those new authorities with
substantial funding--most recently $500 million to help the
National Institutes of Health find a new nonaddictive
painkiller.
Second, we included provisions to encourage new pain
management strategies, such as physical therapy. Third, the
new law requires experts to study chronic pain and report to
the Director of the NIH how patients can better manage their
pain. And fourth, the new law requires the Secretary of
Health and Human Services to report the impact on pain
patients that Federal and State laws and regulations that
limit the length, quantity, or dosage of opioid
prescriptions.
Now that we have started to turn the train around and head
in a different direction on the use of opioids, everyone--
doctors, nurses, insurers, and patients--will need to think
about the different ways we should treat and manage pain.
There are other things the federal government is doing to
better understand what causes pain and how we treat and
manage it.
For example, the National Pain Strategy, developed by the
Interagency Pain Research Coordinating Committee, which
develops recommendations to prevent, treat, manage, and
research pain. Through the National Institute on Drug Abuse
and the National Institutes of Health's HEAL Initiative,
researchers are working to better understand pain and why
some people experience it differently than others. This will
help us find more ways to more effectively treat pain and
help get people the treatment they need.
For example--physical therapy or exercise may be the best
course of treatment for some kinds of back pain. It may also
help us understand why some people can take opioids to manage
their pain for years without becoming addicted, while others
more easily become addicted.
Today, I hope to hear about how close are we to having a
non-addictive painkiller, and how doctors and nurses can
better treat people with pain.
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