[Congressional Record Volume 165, Number 126 (Thursday, July 25, 2019)]
[Senate]
[Pages S5089-S5091]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                            Opioid Epidemic

  Mr. PORTMAN. Mr. President, I am on the floor this afternoon to talk 
about an issue that I have come to this floor other times to speak 
about, and that is the drug crisis we face in this country. In fact, I 
am told that over the last 3 years, I have now come to the floor 58 
times to address this topic--to talk about the opioid crisis, talk 
about the new resurgence of crystal meth, and talk about what we can do 
about it.
  I will tell you, during those 3 years, we made a lot of progress, not 
just in talking about this issue but doing something about it. We put 
new policies in place at the Federal level for better prevention, 
better treatment, better longer term recovery, and to also help our 
first responders--specifically, to give them access to this miracle 
drug naloxone, which reverses the effect of overdose.
  Congress passed legislation, like the Comprehensive Addiction and 
Recovery Act, the Cures legislation, and the STOP Act. We have provided 
actually more than $4 billion of additional funding for these 
programs--particularly for treatment--over just the last few years. In 
Ohio alone, we have received $140 million through CARA and Cures since 
they were signed into law. That money has gone toward innovative, 
evidence-based programs that are actually making a difference. We had 
to do this because this crisis has gripped our country in the worst 
drug epidemic ever. More people are now dying every year from overdoses 
from these drugs than died in the entire Vietnam conflict, as an 
example. We have never seen anything quite this bad, so we responded, 
as we should have, at the national level to a national crisis.

  Working with States, localities, nonprofits, people out there in the 
trenches doing the hard work, we are beginning to make a difference. 
Last week, the Centers for Disease Control--CDC--issued a report with 
their latest statistics on overdose deaths. While drug overdose deaths 
are still way too high, they show we are actually seeing a reduction.
  By the way, this is the first time we have seen a reduction in opioid 
overdose deaths in more than 8 years. Think about that. Every year for 
8 years, we have seen increases in deaths, to the point that we had 
over 70,000 people a year dying of overdoses in 2017. In 2018--we now 
have the numbers in from CDC--it went from roughly 71,000 to roughly 
68,000. Again, that is way too high. No one should be satisfied with 
that. But after increases every year, to have a 4-percent decrease 
nationally shows that we are beginning to turn the tide. Let's keep 
doing what we are doing. We cannot pull back now. If we do, it will 
just go back up again. Actually, it is the first time since 1990, I am 
told, that nationwide overdoses from any kind of drugs--opioids and 
other things--have decreased in a calendar year. That is the first time 
since 1990.
  In Ohio, we did even better from 2017 to 2018. We had more than a 4-
percent drop; we actually had a 22-percent drop in Ohio. That is partly 
because my home State has been ground zero for this. Like West 
Virginia, Kentucky, and other States, we have been hit really hard. To 
go 22 percent below where we were the previous year is progress, and we 
should be proud of that. Still, we are seeing overdose rates that are 
way too high. Overall, around the country, 33 States had reductions.
  As I said earlier, the area where we made the most progress is in 
combating opioids, partly because of legislation we passed here. 
Particularly, we tried to address this issue of prescription drugs, 
heroin, and fentanyl.
  The Washington Post recently published a stunning analysis showing 
why it is so important that we continue to push back and how we got 
here. They showed that for the 6 years between 2006 and 2012, there was 
an absolutely unbelievably high number of shipments of prescription 
pain medications. Oxycodone and hydrocodone were the ones they focused 
on, which account for three-quarters of the total opioid pill shipments 
to pharmacies.
  In a single CVS pharmacy right outside of Cleveland, OH, more than 
6.4 million pills were delivered during that 6-year period. Think about 
that. In one small pharmacy, there were over 6 million pills. Overall, 
the Post found that over that period, more than 3.6 billion 
prescription pain pills were supplied to Ohio. That is ``billion'' with 
a ``b.'' That is an astounding number. That means that during those 6 
years, there were approximately 313 opioid prescription pain pills 
prescribed for every single man, woman, and child in Ohio. That is what 
we are talking about here.
  Obviously, this was used as a way for people to take these pills and 
spread them, not just in Ohio but in other places, causing immense harm 
because people got addicted to these pills and turned to heroin and 
fentanyl. Many of these people are people who not just have an 
addiction but end up having overdoses, and many of them died.
  This week, the largest civil trial in U.S. history will begin in my 
home State of Ohio. I think it is appropriate that it is in Ohio. This 
will consolidate cases from around the country. More than 2,000 cities, 
counties, Native American Tribes, and others will sue some of the 
biggest pharmaceutical companies and major distributors for their role 
in this drug crisis. The pharmaceutical companies and the distributors 
are going to be sued in court in Ohio through a consolidated case. This 
is the biggest civil trial, they say, in the history of our country.
  Two of the Ohio plaintiff counties--Cuyahoga and Summit--have been 
among the areas in my State that were hardest hit by opioids. No wonder 
they are part of this lawsuit. In 2016, the death rate from 
pharmaceuticals--opioids, painkillers--in Cuyahoga County was 3.26 
times the national average. In Summit County, so many people died from 
overdoses that a mobile morgue had to be created in order to help 
process the bodies. I was there in Summit County during that time 
period. They actually had to bring in a mobile unit to be able to deal 
with all the overdose deaths.
  The more we find out about the sheer number of pills these drug 
companies pumped into the United States--more than 76 billion overall 
during that period--the more it is clear that lawsuits like this are 
going to be necessary to get to the bottom of what happened and require 
these entities to help those who were affected by these pain pills. A 
lot of these people turned to other substances that were more 
accessible and less expensive, like heroin, but had

[[Page S5090]]

started with an addiction to pain medication. We are pushing back 
against the opioid pill industry that flourished for too long within 
our borders. That is a positive sign.
  While the CDC showed an overall decrease in overdose deaths, as I 
talked about earlier, there are some troubling trends that have 
continued.
  First, while the number of opioid overdose deaths fell, the number of 
overdose deaths fell related to synthetic opioids--specifically, cheap 
and dangerous fentanyl--actually rose. Heroin and prescription drugs 
went down, but actually, for the synthetic opioid--which is 50 times 
more powerful than heroin and unfortunately produced overseas and 
shipped into our country--those numbers actually rose. Fentanyl deaths 
actually rose. In fact, last year, more deaths were attributed to 
fentanyl than to heroin and prescription drugs combined.
  Fentanyl is the big new danger. There is overall progress, but 
fentanyl is getting worse. We had a report last week of a single kilo 
of fentanyl being seized in Middletown, OH, which is enough of the drug 
to kill more than half a million people. This was in our community, 
Middletown, OH. That is enough of the drug to kill more than half a 
million people.
  We are beginning to push back on fentanyl, as some of you know, 
through legislation, including the STOP Act, which got passed in this 
Chamber and in the House. This is doing a better job with keeping this 
poison from coming through our U.S. mail system, which is where most of 
it has been coming from. Our own postal system has been the conduit for 
this poison. Most of it is coming from one country--China. It is 
produced in chemical labs there by unscrupulous scientists and chemists 
and then sent through the mail.
  The 2019 audit by the inspector general of the Postal Service found 
that the Postal Service identified and pulled a package requested by 
Customs and Border Protection 88 percent of the time. This was an 
improvement from only 79 percent of the time the year before, in 2017, 
and only 67 percent of the time in 2016, but it is still not complying 
with the STOP Act. The STOP Act says 100 percent, not 88 percent.

  Again, why is that important?
  This stuff is getting in through the mail. If the U.S. Customs and 
Border Protection can identify these packages and screen them and pull 
them offline, less of that poison will come into our neighborhoods. It 
also raises the price of this product, which is part of the problem 
right now--that it is not just powerful and deadly but also 
inexpensive.
  Overall, it was said that the Postal Service missed a number of 
packages--12 percent--due to operational errors. We can't afford these 
operational errors. It is too important.
  We need to ensure that all packages that enter the United States have 
the kind of information we need to be able to track potentially harmful 
packages once they get inside our border. This is advance electronic 
data. It is not required everywhere, but it needs to be.
  The STOP Act requires the Postal Service to do that, including with 
100 percent of the packages coming in from China. It required it, by 
the way, by December 31 of last year. Yet the Postal Service just 
informed us on the Permanent Subcommittee on Investigations, on which 
we did this work--where we investigated this over many, many months--
that it has only received data on 52.8 percent of all of our 
international packages and only 70.7 percent on those from China for 
2018. In March of this year, 2019, it was up to 57 percent and 78 
percent. Let's get to 100 percent from China. This legislation requires 
70 percent from other countries. There is no excuse for not meeting 
this. Again, it is the law of the land. So, while it is improving, the 
process is taking too long, and it has failed to meet the requirements 
in the STOP Act.
  The next big milestone, by the way, in the implementation of the law 
requires the Postal Service to begin refusing foreign shipments without 
there being the required advance electronic data that reads where it is 
from, what is in it, and where it is going. This is to apply to any 
package to be received after December 31, 2020. At the end of next 
year, if it is not providing the data, we will refuse the package.
  A lot of people have expressed concern about that to me. ``My gosh. 
This is going to stop international freight back and forth.'' No. It is 
going to require the Postal Service to do what it should be doing 
already, which is to require these shippers to do what they should be 
doing, and that is to provide the data. It is not hard, and it is not 
expensive. Again, most people are doing it. By the way, FedEx, DHL, and 
UPS--the private carriers--have done it for years. They have done it 
based on the law that passed after the 9/11 attacks. It is our post 
office that has not. Sometimes it has viewed this, apparently, as its 
having a competitive advantage in its not having to require that. Do 
you know what? It is too important to us and to the deaths that are 
occurring from fentanyl not to require that.
  We have to improve the screening in the mail, and we are, and we will 
continue to make progress on that. Of course, that is not all we have 
to do. More fentanyl is now coming from other places, particularly from 
across our southern border. This is very concerning because we have 
gaps on our southern border right now. They say that between 40 and 60 
percent of the Border Patrol agents are being pulled off the border to 
deal with the very real humanitarian crisis on the border.
  I was there a week ago last Friday, and I had an opportunity to speak 
to a number of Border Patrol agents who were processing individuals and 
dealing with the humanitarian needs of a surge of families and 
children, including those who were claiming asylum. We need to have 
these people attending to the humanitarian needs and processing these 
individuals. Yet I will tell you, when I talked to the Border Patrol 
agents about it, that was not where they wanted to be. They want to be 
doing their jobs because they know these drugs are coming in when they 
are not out there with a watchful eye on our border.
  Unfortunately, we are in a situation right now where we need more 
humanitarian aid, which we have finally provided, thank goodness. We 
also need more help on the border itself to be able to close some of 
these gaps. I want to be sure that we are, indeed, dealing with both 
issues. We can and should.
  The drug smugglers who are affiliated with Mexican cartels are pretty 
smart. They know where there are gaps. They take advantage of them and 
bring in more fentanyl. Last year, Customs and Border Protection seized 
about 1,800 pounds of fentanyl at the border. In the first half of this 
year alone, it seized more than 2,000 pounds of fentanyl. This year, we 
are headed toward apprehending double the fentanyl at the border. I 
will tell you we don't know how much is coming in. Nobody does.
  Because of these gaps and because of the Border Patrol's having been 
pulled off the border to deal with the very real crisis down there with 
regard to the humanitarian issue and the flux of people coming in, 
there are more gaps. The numbers of those shipments that have been 
apprehended have been bad enough--more than double this year. It has 
been enough fentanyl to kill millions of people, and it is probably 
worse than that.
  This fentanyl is increasingly being laced into other drugs by the 
cartels. The fentanyl makes you so likely to become addicted that they 
put it in other things, including crystal meth, including cocaine, 
including heroin. Individuals who consume anything right now that is a 
street drug might be unknowingly ingesting this incredibly toxic drug 
fentanyl also and risking their lives because of the overdose deaths 
that are associated with it.
  In Ohio, the number of overdose deaths attributed to fentanyl-laced 
cocaine and methamphetamines has increased dramatically. As an example, 
Columbus Public Health actually released a public alert just this week 
that urged anyone who uses drugs or knows someone who uses drugs to 
have naloxone, a miracle drug--some people call it Narcan--that 
reverses the effects of the overdose from opioids. They say you have to 
have this miracle drug on hand because of the fentanyl poisoning that 
is going on in Columbus. Already in 2019, 740 doses of Narcan have been 
issued in response to overdoses in one town alone, Toledo, OH.

[[Page S5091]]

  This issue of fentanyl is very real. It is affecting our communities 
in new ways, and we have to be able to respond flexibly to what is 
happening. It remains a dangerous threat.
  Also complicating the recovery process is the continued resurgence of 
psychostimulants, particularly crystal meth. Again, crystal meth is 
coming from--where?--across the border, from Mexico. You will probably 
remember that at one time in your communities, there was talk about 
meth labs. You may have seen some coverage of that, and you may have 
had some meth labs in your neighborhood. There are horrible 
environmental issues, obviously, in the producing of methamphetamines, 
which are so dangerous. Guess what. There are no more meth labs in your 
neighborhood. That is the good news. The bad news is, there are no meth 
labs because this stuff that comes in from Mexico is cheaper and more 
powerful, more devastating, and more damaging to our communities. So it 
is a concern.
  The latest CDC data on overdose deaths--particularly with regard to 
opioids--is very hopeful, but the overdose deaths by psychostimulants 
and cocaine continue to increase. That is because, again, fentanyl is 
being mixed into these psychostimulants. Methamphetamine deaths 
increased by nearly 30 percent, and 42 percent of all overdose deaths 
last year were directly attributable to cocaine, psychostimulants like 
meth, or both mixed together. That is the new problem, and we have to 
address it.
  As we have continued to fight opioid abuse, I recently introduced a 
bill, entitled ``Combating Meth and Cocaine Act,'' in order to address 
this resurgence and to be sure that here in Congress we are being 
flexible in responding to it and not waiting until we have another huge 
drug crisis here of a new way to mix drugs or a new resurgence of 
crystal meth. To date, grants provided by the 21st Century Cures Act, 
which is now called the State opioid response grants, have been used to 
increase access to naloxone--again, a very important drug--as well as 
to long-term addiction treatment and support services. Yet, for all the 
good these grants have done, they can't be used to address the crisis 
beyond opioids, which ignores the underground reality, at least in my 
State and in so many other States.
  Earlier this year, for example, I participated in a roundtable 
discussion with leaders in Knox County, and I do this around the State 
on a regular basis. In Knox County, the prosecutor's office estimated 
that 80 to 90 percent of all drug incidents now involve crystal meth--
methamphetamines. They told me they have been able to use the State 
opioid response grants to help with the treatment and recovery services 
but that they are not effective with regard to meth because there is 
not an effective way to treat meth with drugs, as there is with 
opioids. There is not an effective way to use the Narcan with meth, as 
there is with opioids. So we need to be more flexible in providing 
these communities with the help they need to combat this new 
resurgence. Our legislation will allow the State opioid response grants 
to be used for programs that focus on methamphetamines and on cocaine 
usage. More flexibility is important.
  We know these funds are making a difference, so the bill will also 
reauthorize the State opioid response grants for 5 years, which will 
give some certainty by providing the $500 million annually that will be 
needed to ensure there will be a stable funding stream to go to these 
innovative programs in the States. This is a simple, commonsense 
change. It will allow State and local organizations the flexibility 
they need to fight what is quickly becoming a two-front war on 
addiction--opioids but also psychostimulants that are coming back with 
a vengeance.
  The latest data from the CDC is a promising sign that we can and will 
recover from the drug crisis if we continue to work to give those in 
need the help they need to get back on their feet. We also need to 
ensure that we don't rest on our laurels as cartels continue to 
innovate themselves and try different angles.
  There is so much money in this that these deadly drugs will continue 
to come unless we show the same kind of flexibility when responding. If 
they can, they are going to continue to send drugs through the postal 
system. They are going to continue to send them across the southern 
border. Fentanyl, cocaine, and meth have shown themselves to be 
continuing public health threats, and we have to keep working--all of 
us here on a bipartisan basis--to ensure that State and local 
governments get the resources they need to help stem the tide.
  The Federal Government has been a better partner over the past few 
years with our States, with our localities, and with our nonprofits 
that are there in the trenches, doing the hard work. We can't give up 
now. The numbers from the CDC are hopeful with regard to opioids, but 
that just means we need to redouble our efforts to ensure that we do 
not now back off. We cannot take our eye off the ball. We have to 
continue to focus on what we are doing and then add to that more 
flexible responses to the new resurgence of fentanyl being mixed with 
meth and crystal meth coming in directly from Mexico. This new drug 
reality is one that must be met with the same kind of innovative 
response we have responded with here in the last few years.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Colorado.