[Congressional Record Volume 167, Number 205 (Monday, November 29, 2021)]
[Senate]
[Pages S8799-S8804]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                            OPIOID EPIDEMIC

  Mr. PORTMAN. Mr. President, I thank my colleague from Ohio, and I am 
on the floor today to talk about a major public health crisis facing 
our country, one that is resulting in thousands of people losing their 
lives, causing the death of over 100,000 Americans a year, and has 
negatively impacted so many millions more in my home State of Ohio and 
all around the country.
  And, no, I am not talking about COVID-19. I am talking about an 
epidemic within the pandemic. I am talking about the surging epidemic 
of drug use and addiction that has fueled a record number of overdose 
deaths and threatens to get even worse.
  In the past 19 months or so, our attention has, understandably, been 
directed toward the COVID-19 crisis. And, once again, we see with 
Omicron the possibility of another variant coming, and those public 
health challenges are real.
  But I have to tell you that it has led us to ignore another crisis. 
The Centers for Disease Control, the CDC, recently issued a report 
which was shocking and should serve as a wake-up call to all of us.
  It said that between April of 2020 and April of 2021, the most recent 
year for which we have data, we had over 100,000 individuals lose their 
lives to drug overdose deaths in this country. That is the highest 
ever. It is a record.
  By the way, 100,000 deaths per year is more than the deaths from 
gunshot wounds and the deaths from car accidents combined. It is truly 
the epidemic within the pandemic.
  Away from the headlines, we have this other tragic healthcare crisis 
that has left no part of the country unaffected. Forty-six States and 
the District of Columbia have seen their overdose rates go up in the 
last year, with a 26-percent increase in my home State of Ohio. In some 
States, there are now as many drug overdose deaths as there are COVID 
deaths.
  Like many of you, I have seen firsthand the damage drugs like crystal 
meth or cocaine or heroin or now the synthetic opioids are causing to 
the families we represent, to people who have gotten caught in that 
spiral of drug abuse and addiction.
  I have also seen the heroic efforts of first responders who have 
saved people's lives by administering naloxone, which some call Narcan, 
its brand name. It is a miracle drug that literally saves lives by 
being able to reverse the effects of an overdose.
  And I have ridden with law enforcement and treatment providers on 
rapid response teams in various places in Ohio that follow up with 
those who have overdosed. Literally, somebody overdoses, and then this 
rapid response team--usually made up of law enforcement but also 
treatment providers, social workers--goes to people's homes, and it is 
amazing what you will find out.
  I was, frankly, a little surprised during my first visit--then, I got 
more used to it--which is that people respond very favorably. Most 
people who are approached by these rapid response teams agree to get 
into treatment. And isn't that the key? Using Narcan again and again 
and again to save someone's life is not the answer. The answer is to 
get that person into treatment so that that person can get back to his 
or her family, his or her work, and to a normal life and to be more 
productive in life.
  I have also met with families and loved ones affected, hearing their 
stories about how losing a family member to addiction has had such a 
negative impact, often tearing those families apart.
  And, of course, I have talked to a lot of people in recovery who have 
told me about the grip of addiction on their lives and how they got 
help and what worked and what didn't work.
  Unfortunately, a lot of people get help, get into treatment, and it 
doesn't work for them. They have to do it again and again. But, 
ultimately, for those who can stay in recovery and are able to stay 
sober and clean, they have the most amazing stories. And so many of 
them are coming back and contributing in big ways to our communities--
many helping others. Their recovery, basically, is reaching out to 
others and helping them along the way. Some are called recovery 
coaches, which is a more formal title, but so many of them are, in 
effect, recovery coaches helping others who are struggling.
  There are so many lives that have been touched by this crisis--
100,000-plus deaths, but so many others affected. And I have made it a 
goal of mine to make sure Congress is playing its role in addressing 
this effort that must be at the community level, at the State level, 
but also at the national level to respond to what is a true national 
crisis.
  What makes it especially heartbreaking to me is that, only a few 
years ago, we had finally begun to make progress on this. We were 
beginning to turn the corner. We were seeing lower addiction rates. We 
were seeing lower overdose deaths for the first time in decades.
  How did we do it? Well, we redoubled our efforts on prevention, on 
getting people into treatment, on getting people into longer term 
recovery, making more naloxone available.
  Thanks to the bipartisan leadership here in Congress, the 
Comprehensive Addiction and Recovery Act, or CARA, which I coauthored 
with my colleague Sheldon Whitehouse, and the 21st Century CURES Act 
were both signed into law in 2016, helping to pave the way for several 
billion dollars in new Federal funding to strengthen State, local, and 
nonprofit efforts to combat addiction.
  Our CARA legislation and the follow-up CARA.2 legislation that we 
passed a few years ago took a comprehensive approach based on best 
practices. We actually had seminars here in Washington. We brought 
people from all over the country here. We had four different 
conferences where we got information as to what was working and not 
working in our communities, and things that were working we funded.
  We directed resources toward more treatment and recovery services for 
individuals and more focus on prevention.
  I can't overstate how critical these kinds of proven services are for 
people on the path to recovery. Congress had never, before this 
legislation, ever funded recovery services.
  I have visited a number of inpatient and outpatient centers for 
addiction in Ohio to talk with those working to overcome their 
addiction. They have told me time and again how these recovery services 
gave them the structure, the support, and, most importantly, the hope 
they needed to be able to overcome this disease.
  And we actually started to see that hope translate into real success 
on the ground, real numbers and real people's lives.
  In 2017, Ohio's overdose death rate had increased for 30-plus 
straight years, and Ohio's death per capita that year, 2017, was almost 
three times that of the national average.
  But that next year, in 2018, as these two signature laws, CARA and 
CURES, were fully implemented, Ohio began to turn the tide with a 22-
percent reduction in overdose deaths in 1 year.
  Again, after more than 30 years of increases in overdose deaths every 
single year, a 22-percent decrease. Nationally, overdose deaths 
declined that year about 4 percent, again, after a year after year of 
increases. In 2019, we had a slight decrease also. These were promising 
developments.
  But since then, there has been a lethal convergence on both the 
supply side of this issue and the demand side of this issue. Sam 
Quinones, the author of ``Dreamland,'' which I think is the seminal 
book on the rise of opioids in this country, recently put it well. He 
said in an interview that before COVID hit, Mexican cartels had 
achieved their goal, finally, of covering our country with ``the most . 
. . mind-mangling drugs we've ever seen. . . . It just so happened that 
we went into isolation at the very moment when these drugs hit their 
apex.''

[[Page S8800]]

  A terrible coincidence that as the supply increased because of the 
greed of traffickers, the demand increased because of COVID. These two 
things came together, and that has caused this huge increase in 
overdoses, addiction, and overdose deaths.
  Let's look at the supply side of this crisis first. The record number 
of deadly narcotics and other drugs that are taking the lives of moms, 
dads, children, and loved ones all across the country are coming into 
our country in record numbers. As many are aware, for much of the past 
few decades, the most common cause of overdose deaths were prescription 
opioids like OxyContin or Percocet. Often people who suffered a serious 
injury or accident needed pain relief, and often, unfortunately, 
doctors and dentists overprescribed opioids. People developed an 
addiction that led to accidental overdoses, often from cheaper and more 
available heroin when the prescription drugs ran out.
  Now we are dealing with a class of drugs that are tens if not 
hundreds of times deadlier than those prescription drugs, the so-called 
synthetic opioids. The most well known of these is fentanyl, which, as 
you can see by this chart of drug overdoses, has become the drug most 
responsible for overdose deaths.
  The red here is overdose deaths overall, and the blue is overdose 
deaths that are attributed to fentanyl. You can see what has happened. 
Fentanyl was about half of overdose deaths in 2018. Half of all 
overdose deaths was one drug, fentanyl. In 2019, it was more than half 
and, in 2020, way more than half of all the overdose deaths caused by 
one drug, a synthetic opioid called fentanyl. It is the deadliest one.
  Incredibly, 80 percent of drug overdoses in Ohio and overdose deaths 
in Ohio can now be attributed to this deadly substance, based on what 
the experts tell me--80 percent. It is not surprising that the amount 
of fentanyl seized on the streets of Ohio cities like Dayton, OH, 
recently has nearly doubled compared to last year. And it is not only 
the amount of fentanyl that is flooding our country.
  Evil traffickers have increasingly disguised it by mixing it with 
other drugs or pressing it into fake pills to look like common 
pharmaceuticals. This concerted effort to expand the reach of fentanyl 
addiction started before the pandemic, but it is only accelerating.
  It is a profitable business for drug dealers. Compared to heroin, 
fentanyl is less expensive to manufacture and, pound-for-pound, far 
more potent. A few flakes can kill you. Traffickers make a bigger 
profit, and people are trapped into addiction more easily.
  Traffickers increasingly lace fentanyl with other drugs--cocaine, 
crystal meth, heroin, and even marijuana in some cases. They do it as a 
way to boost its effects and cut down on its costs. In Mexico, they use 
cheap pill presses to mold fentanyl doses into the shape of 
prescription drugs--everyday pills that people take for a variety of 
reasons. What that means is that many of the individuals who now lose 
their lives to a fentanyl overdose don't even know they are taking 
fentanyl until it is too late.
  Recently, I participated in a roundtable discussion on the border 
crisis and how it has impacted the addiction crisis. We heard from an 
Ohio mother, Virginia Krieger, who lost her daughter Tiffany to an 
accidental fentanyl death. Virginia told us about how Tiffany had been 
unable to get the care she wanted from her physician. That led her to 
buying pills on the street--pills she was told were Percocet, and it 
looked like Percocet. That is what was stamped on it. But in reality, 
it was laced with lethal doses of heroin and fentanyl. When Tiffany 
took these pills for her pain, she was poisoned by the fentanyl, and 
the life of a young 26-year-old woman was snuffed out far too soon.
  We are hearing this across the State. Recently, in Cleveland, OH, 
Xanax pills, an antianxiety medication--fake pills pressed by Mexican 
traffickers contained fentanyl and caused overdoses and overdose 
deaths.
  My heart goes out to these families. My heart goes out to Virginia, 
who, by the way, has channeled her grief into something positive, and 
that is going to schools and explaining to young people how dangerous 
this is. Her view is that no one should ever take a pill unless they 
know it comes from a pharmacy.
  She is right. People across the country need to know that pills of 
all shapes and sizes can contain fentanyl even though they might say 
something else. No street drug is safe right now from the threat of 
fentanyl poisoning, and too many kids and adults who weren't addicted 
to opioids are unknowingly ingesting these substances and putting 
themselves at risk. We need to be on high alert. Parents and kids need 
to know that right now no drug you get on the street can be safe.
  Our communities are saturated with fentanyl and other synthetic 
opioids right now. Among other things, of course, this drives the price 
of the drugs down. So, yes, the most important thing is to reduce the 
demand for drugs, but with its overwhelming supply, the price of the 
drug goes down and there is higher use and higher demand.

  A conversation about how we can cut down on the supply side of course 
has to start with our strategy on our southern border. For years, 
fentanyl and other synthetic opioids were overwhelmingly illegally 
manufactured in China. As then-chairman of the Permanent Subcommittee 
on Investigations, I led a bipartisan investigation back in 2017 which 
showed that fentanyl was coming into our country from China primarily 
through our own lax Postal Service. Our own Postal Service was the 
conduit. That is why I worked in a bipartisan manner to write and pass 
what is called the STOP Act, which required the Postal Service, for the 
first time, to crack down on fentanyl through the mail.
  We required the Postal Service to get advanced tracking data on 
international shipments coming to the United States, showing the 
package's origin, contents, and destination. This allowed law 
enforcement to spot potentially dangerous packages ahead of time and 
make it much more difficult to move fentanyl into the United States in 
this manner. Other carriers were already doing it--FedEx, private 
carriers, DHL, but the post office was not.
  The good news is that the STOP Act has been effective, and also, 
after persistent engagement and pressure from the United States, China 
scheduled fentanyl, meaning made it illegal, and its analogues as a 
class of illegal drugs. We believe these changes have helped to 
dramatically reduce the flow of fentanyl directly from China into the 
United States.
  But, obviously, it hasn't solved the problem because Mexican 
transnational criminal organizations know a great business opportunity 
when they see one, and they moved in to take over the fentanyl market 
in the United States. Now Mexican transnational criminal organizations 
work with criminal gangs in China to import into Mexico the ingredients 
used to make fentanyl, where the final product is made in so-called 
superlabs.
  We have a record amount of the substance pouring in, both at our 
ports of entry and through other gaps in our southern border security 
by car, by truck, by courier. This is a problem that continues to get 
worse as this shocking chart shows us.
  Look at the dramatic increases in fentanyl that was seized along the 
U.S. border. This past fiscal year, Customs and Border Protection 
seized 11,201 pounds of fentanyl, enough to kill every man, woman, and 
child in America--more than double the amount from the previous year 
and four times the amount from fiscal year 2019. Just a few weeks ago 
in Southern California, border officials discovered 8\1/2\ tons of meth 
in a single truck along with 400 pounds of fentanyl. Remember, it only 
takes a few flakes of fentanyl to kill you. This 400 pounds could kill 
millions.
  Their smuggling operations are complex and sophisticated, and Customs 
and Border Protection have their hands full. According to the most 
recent statistics, last month, seizures of fentanyl increased 42 
percent. That is 42 percent in 1 month. This is only how much we know 
was discovered, was apprehended. We don't know how much more made it 
over the border undetected.
  When I have asked Customs and Border Protection and DHS, our homeland 
security officials, in public hearings, as I did the week before last, 
they don't

[[Page S8801]]

answer the question because they don't know. But in private 
conversations with Border Patrol agents, they tell me that they believe 
the vast majority of drugs are coming in undetected. So this is just 
the seizures, not the amount of drugs that are streaming across the 
border.
  I take no pleasure in saying this, but the failure of the Biden 
administration to control the southern border has resulted in record 
levels of deadly fentanyl coming in to our country and contributes to 
the growing strength of the Mexican transnational criminal 
organizations. Part of the problem is that the Biden administration's 
own policies have encouraged an unprecedented surge of unlawful 
migrants at the border, diverting our Customs and Border Protection 
officers and Border Patrol agents away from interdicting drugs. I have 
seen that on the southern border as has anyone else who has visited.
  These law enforcement officers who should be on the line stopping the 
criminals carrying drugs are instead processing a record number of 
migrants. This massive influx of unlawful migrants began when President 
Biden was inaugurated and made specific policy changes, and it has only 
continued to worsen ever since. We had all hoped that during the summer 
months, when normally unlawful migration slows down because of the 
heat, that we would have a lessening of this issue, but it didn't 
happen. In fact, last month was a record month for October for Border 
Patrol apprehensions.
  As the border crisis created by the Biden administration policy 
changes continues, the administration has failed to give Customs and 
Border Protection the resources they need: additional personnel, better 
technology, infrastructure, and more, to enable them to better protect 
our Nation along the nearly 2,000-mile border with Mexico. On an 
average day in 2020, Customs and Border Protection processed 650,000-
plus passengers and pedestrians, 187,000 incoming privately owned 
vehicles, and 77,900 truck, rail, and sea containers. The amount of 
traffic at the border is going up now that there is less concern about 
the pandemic.
  However, only 2 percent of those privately owned vehicles are 
physically searched at the border, and less than 20 percent of all 
those commercial vehicles are scanned for drugs before they cross into 
the United States.
  Let me repeat that: 2 percent. So if you are a smuggler driving a 
sedan with multiple pounds of fentanyl concealed in hidden 
compartments, right now you have a very good chance of getting across 
the border without a search. That is not a gap in our security, that is 
a gaping hole.
  We have known this is a problem. Congress, last January, almost a 
year ago, passed and President Trump signed into law a requirement that 
the Department of Homeland Security give Congress a plan and a strategy 
on using technology and making policy and resources changes to be able 
to scan all vehicles.
  Unfortunately, the Biden administration is late delivering this 
report. It was due over 4 months ago, and we still don't have it. In 
conversations with administration officials the week before last, I got 
assurances that it is coming soon. I hope so. We need it. It would be 
extremely helpful to have this information as we finalize the spending 
bills over the next month or so.
  I am proud that the recently enacted Infrastructure Investment and 
Jobs Act invested billions of dollars in upgrading and modernizing our 
ports of entry, including ports of entry on the southern border. Our 
ports are aging, some of them badly. This funding would allow Customs 
and Border Protection officers to have adequate space to do more 
screening of vehicles.
  However, we cannot and should not build a brandnew port of entry and 
then just install the old legacy technology for scanning and detection 
of deadly narcotics. We have a once-in-a-generation opportunity to 
dramatically upgrade seaports of entry with modern, state-of-the-art 
detection technology that can help our officers catch more of these 
drugs before they enter our communities.
  In May, I introduced bipartisan legislation with Senator Mark Kelly 
of Arizona to establish a $1 billion irregular migration border 
response fund so that the Department of Homeland Security is not forced 
to transfer resources away from drug interdiction priorities to fund 
processing of individuals, food, clothing, blankets, and transportation 
when there is an influx of migrants, as has happened periodically. 
These contingency resources would be available immediately when there 
is a surge to quickly respond to increased migration at the border.
  Considering the crisis at our border and the record amounts of 
fentanyl coming in, it was not surprising to me in September when the 
Drug Enforcement Agency, DEA, issued its first public safety alert in 
more than 6 years after it seized more than 9.5 million fake pills this 
year, more than the last 2 years combined. As I said, we all need to be 
on high alert.

  We hear a lot these days about problems with the supply chain, with 
delayed shipments and cancelled orders. I will tell you the Mexican 
transnational criminal organizations don't have that problem. They are 
moving more fentanyl than ever into our communities, and once that 
fentanyl is here, what a waste. Sadly, more people are caught in the 
grip of addiction.
  This brings us to the demand side of the equation. Again, most 
important to me is reducing the demand for these drugs, but both the 
demand and the supply side are related.
  As we discussed, the supply of deadly fentanyl was already increasing 
when COVID-19 hit us almost 2 years ago. Clearly, this pandemic has led 
to more isolation, anxiety for some, depression for others. Millions of 
Americans lost their jobs through no fault of their own. Millions have 
lost loved ones to COVID-19. Some in recovery have not been able to be 
with their treatment providers or with their recovery coaches, as we 
talked about earlier. Millions have had their lives turned upside down, 
and some have turned to drugs as a coping mechanism. Others, who were 
on the path to recovery, have suffered setbacks--relapsing into drug 
use again.
  Last month, I visited with Erin Helms, who runs recovery homes for 
women in northeast Ohio that I have had the chance to visit. Erin told 
me about the challenges during COVID to connect people with treatment 
and recovery support services when they overdose or when they are being 
released out of the criminal justice system. When we were in the most 
restrictive time of the pandemic, those people fell through the cracks, 
and we are seeing the results of that today. These overdose deaths are 
happening away from the national headlines, but they are taking a toll 
all the same.
  As I said, this is truly a nationwide crisis. It will take all of us 
here in Congress coming together to work on a bipartisan basis to find 
solutions to turn the tide again, reduce overdose deaths, and put more 
affected individuals on the path to recovery.
  So what can we do here in Congress in moving forward? What are the 
answers?
  First, we have got to be able to address both the supply side and the 
demand side. This chart lays out some of the ways we can help with 
both, all of which I have talked about tonight. This means we need to 
complete the installation of enhanced border security technology, which 
has already been appropriated by Congress, so that the Border Patrol 
has the tools it needs to complete its national security mission--so 
enhanced border security.
  In March, I visited El Paso and saw fully funded construction 
materials laying on the ground, at the border, at the place where there 
was a gap in the wall. I heard directly from Border Patrol officers 
about the importance of enhancing border security to give them the 
opportunity to complete their national security mission and help them 
to stop the drugs.
  That is why, at his nomination hearing in October, I pressed Tucson 
Police Chief Chris Magnus, the nominee to be Commissioner of the U.S. 
Customs and Border Protection, on the need to install the enhanced 
border technology and complete the funded sections of the wall.
  Not only are there physical gaps in the wall right now that we have 
already paid for, but there is technology, which, to me, is the most 
important part of the wall. So you need the barrier, but, also, you 
need the technology to be able to monitor it, and it is only about 10 
percent completed in that El Paso sector. That is outrageous.

[[Page S8802]]

  Everybody--Republicans and Democrats alike--likes to say they are for 
technology. We should complete the technology along the border and help 
the Border Patrol be able to do their important job, including keeping 
these deadly narcotics out of our communities.
  We also must pass the bipartisan Border Response Resilience Act, 
which I talked about, that I introduced with Senator Kelly. It would 
provide an additional billion dollars to the Border Patrol and U.S. 
Customs and Border Protection folks during a surge in unlawful 
migration, like the one we are in right now.
  Due to limited resources, Border Patrol agents are pulled off the 
border to care for migrants, and drug cartels are taking advantage of 
these open gaps in our Nation's security. Even some of the checkpoints 
had to be closed down when there was a recent surge on the border near 
Del Rio, TX. Drug interdiction checkpoints here in the United States 
are left unmanned so offices can process more migrant families.
  But the supply chain doesn't start and end on the U.S. border. 
Criminals understand the opportunities of the globalized world, and 
they pose a dynamic threat to the United States. They are smart and 
adaptable and can take advantage of the complexity and volume of 
international trade and travel patterns, and they do that. They also 
understand how to exploit openings in law enforcement and regulatory 
approaches.
  Many of the ingredients used to make fentanyl continue to come from 
China, and Chinese money laundering networks have emerged as key 
enablers in the business model of Mexican transnational criminal 
organizations. This must stop. While we have a complex and difficult 
agenda with China, this issue needs to remain at the top of our list. I 
urge the Biden administration to push the Chinese Government to be our 
partner in cracking down on these international crime rings rather than 
a tacit enabler. It is in both of our countries' interests.
  Likewise, the issue should be front and center in our relationship 
with Mexico. Both of our countries lose when the traffickers are 
successful. Our country is inundated with lethal substances, and the 
cartels gain money and sometimes American-made firearms that allow them 
to better wage war on the government in Mexico City. For both of our 
countries' sakes, we need to partner more effectively with Mexico--
international cooperation.
  We should also recognize that these adaptable drug traffickers will 
have other options as we go after this current supply chain. We saw 
this after the STOP Act started to be implemented and traffickers from 
China shifted to Mexico. There is a risk that it becomes a game of 
whack-a-mole--when you stop it in one place and it crops up somewhere 
else. As an example, as we work to stop the flow of fentanyl 
ingredients from China, other countries, like India, could prove to be 
good alternative sources. We need to be prepared to partner with India 
and other potential new sources in this lethal supply chain to ensure 
we continue to improve our security.

  We also need to continue to enforce the provisions in the STOP Act to 
ensure that our postal service does not, once again, become the viable 
option for traffickers moving fentanyl into the United States. After 
missing the initial October 2019 deadline for full implementation of 
the STOP Act regulations, in March, Customs and Border Patrol finally 
began demanding 100 percent of advanced tracking data on shipments 
entering the country. That is good. I am glad we got there. That means 
that, for every package coming into the United States that originates 
from a country like India or China, we have a sense of what the package 
contains, where it is from, and where it is going, or else it doesn't 
come in.
  However, a number of waivers remain in place for these regulations 
for low-risk, low-volume, and less-developed countries. These waivers 
allow some countries to continue to skirt these reporting requirements, 
including, if you can believe it, Russia. It should not be in that 
category. This means criminals in Russia can continue to send 
potentially illegal packages into the United States without our knowing 
in advance what they may contain, posing a significant security risk, 
and undercutting the goals of the STOP Act.
  Frankly, I think it is an unacceptable oversight in enforcement, and 
I believe there is bipartisan agreement that that is the case. That is 
why I am urging DHS Secretary Mayorkas and the Biden administration to 
narrow down the STOP Act waivers and ensure that high-risk countries, 
like Russia, have to comply with these critical advanced tracking data 
requirements.
  In addition to this added security at the border, closer cooperation 
with the international community, and better STOP Act enforcement, we 
need to take the unexpected but important step to make sure that these 
deadly synthetic opioids actually remain illegal so that our law 
enforcement can take the proper steps to crack down on them. In order 
to avoid prosecution, prior to 2018, evil scientists in China and drug 
traffickers started making slight modifications to fentanyl, sometimes 
adjusting a single molecule and creating what are essentially fentanyl 
copycats to get around the law.
  While these fentanyl-related substances have the same narcotic 
properties as fentanyl, their tiny variations allow them to evade 
prosecution. Oftentimes, actually, these simpler substances than 
fentanyl were even more deadly. Carfentanil is actually more deadly 
than fentanyl, and that was one of the substances that was being made. 
Just this past week, we have learned that a fentanyl-related substance 
called para-fluorofentanyl has been discovered laced into drugs in my 
home State of Ohio, as an example.
  To address all of this, the Drug Enforcement Administration, in 2018, 
used its authority to temporarily classify all fentanyl-related drugs 
as schedule I substances, which allows law enforcement to aggressively 
intercept and destroy them. Unfortunately, this designation was only 
temporary. We have successfully extended the designation a few times, 
but it will expire in about 2 months, at the end of January.
  Until we make these fentanyl-related drugs--these are fentanyl 
copycat drugs, some more dangerous than fentanyl--law enforcement will 
not have the certainty they need to go after criminals moving these 
deadly substances, and lives will be lost.
  Fortunately, we have legislation, already, to address this. Our 
bipartisan FIGHT Fentanyl Act, which I introduced with Senator Joe 
Manchin, would fix this problem by permanently classifying fentanyl-
related drugs as schedule I. It is about time. That would give our law 
enforcement the certainty to go after synthetic opioids in all of its 
forms and show we are committed to addressing the threat posed by this 
dangerous class of drugs. The FIGHT Fentanyl Act would increase the 
costs of fentanyl on the street and would be an important step toward 
rededicating our efforts to stopping these drugs from stealing 
thousands of lives and causing so much pain.
  I urge my colleagues on both sides of the aisle to come together and 
support this legislation to help us reduce the supply of dangerous 
synthetic opioids on our streets.
  So, again, on the supply side, let's pass legislation to be sure we 
are making fentanyl permanently illegal.
  Let's look at what we can do on the demand side to reduce this 
demand--insatiable sometimes in our country--for these illegal drugs: 
more effective prevention and education and ensuring individuals 
struggling with addiction get the support they need to overcome the 
disease and no longer feel the need to turn to these dangerous 
substances. That is all part of it.
  The first step, to me, is to continue to build on what we know has 
worked. Remember, back in 2018, we actually had the first year-over-
year decrease in overdose deaths in the country in about three 
decades--a 22-percent decrease in my home State of Ohio in 1 year. 
Building on that success starts with building on our CARA legislation 
we talked about earlier.
  Before CARA, the Federal Government provided no funding of any kind 
for recovery support services, which are so essential to so many in 
overcoming their addictions. There was also no Federal funding for 
naloxone, also known as Narcan, which is so effective because it is a 
miracle drug that allows first responders to reverse the effects of an 
overdose and save lives and get people into treatment.
  CARA also lifted the cap on the number of patients a doctor could 
treat

[[Page S8803]]

with a medication assisted treatment called Suboxone, while also 
allowing nurse practitioners and physician assistants to prescribe this 
medication. All of these provisions expanded access to treatment, and 
that was incredibly important.
  I remember a father who came to me from Ohio and talked about his 
daughter. His daughter had an accident, an injury. She took pain 
medication. She became addicted to opioids. She then shifted to heroin 
because it was more available and less expensive. She was in and out of 
treatment and never took it seriously. One day, she went to her father 
and said, ``I am ready. I am ready to go into treatment. I am ready to 
turn my life around.'' He was convinced it was true until he went out 
to find a treatment provider for her, and as continues to be the case 
in some communities--and at that time, before 2018, it was the case in 
many communities--there were no beds available. There was no treatment 
option. She had to go on a waiting list. While she was on the waiting 
list, she overdosed on heroin and died in her own bedroom, and her 
father found her there.
  So all of these provisions we put in place expanded access to 
treatment to be able to ensure that those stories are not repeated.
  In the 5 years since our CARA legislation has become law, I have 
visited with hundreds of recovering addicts at treatment centers; I 
have visited with experts on local addiction and mental health boards; 
and I have been to recovery homes and other nonprofits across Ohio. We 
have talked about what we can do now to build on the successes we were 
having back in the 2018-2019 period, as well as what we did with regard 
to CARA 2.0, which is the bill that passed in 2018.
  The result of those discussions is CARA 3.0--the third CARA 
legislation. I introduced that with Senator Whitehouse earlier this 
year, and it builds on the existing CARA framework and expands its 
scope to ensure all Americans who are fighting addiction have the 
chance to overcome this disease. It does so by addressing three 
important areas: one, research, education, prevention; two, treatment 
and recovery; and, three, criminal justice reform.
  CARA 3.0 will bolster our work to prevent drug abuse--before it even 
happens--through better research and better education and prevention.
  I believe effective prevention is done when it is at the community 
level, which is where it is most effective, and engages a wide variety 
of stakeholders--youth, parents, faith leaders, educators--all with a 
focus on showing the risks of drug abuse and addiction.
  There are now about 2,000 community coalitions around the country 
that do this, and God bless them for the work they do. They benefit 
from our legislation called the Drug-Free Communities Act, which is 
also something that is important with regard to CARA 3.0.
  Over 25 years ago, I found in my own community an antidrug coalition. 
It is now called PreventionFIRST! It is still in existence, doing a 
great job. In fact, I had a Zoom call with the leaders of 
PreventionFIRST! last week to learn about some of the new innovations 
they are coming up with to reach more people. They do a drug survey 
every 2 years--they are in the middle of fielding that right now--where 
they get the best information. It is almost like a census, not a 
survey, from high schoolers all over the greater Cincinnati area to 
find out what drugs are being used, what people's attitudes are about 
drugs. They take that and use that to try to promote the prevention 
message in a way that is effective.
  I appreciate what they do, again, and that is part of what we need to 
do in this new legislation, is to redouble our efforts on prevention, 
to keep people out of the funnel of addiction in the first place. It is 
obviously the most effective way to address this issue.
  In our legislation we call for a massive new national drug awareness 
campaign as part of this. I believe that ought to be done with help 
from the private sector, by the way. There are plenty of people in the 
private sector who have concerns about this issue and should. It 
affects their workforce.
  Certainly, with regard to companies that are in the pharmaceutical 
business, they should have a strong interest in this. We could leverage 
funding--taxpayer funding--in ways that could create, for the first 
time in a couple of decades, a very effective national media campaign 
to get the word out there.
  We know that a number of Federal Agencies have smaller efforts on 
this front, but we need more coordination and a united message coming 
from the Federal Government and from the private sector.
  Our bill also includes more for research and development of 
alternative pain treatment methods that don't lead to addiction. To me, 
it is unbelievable that we are still relying on these opioid pain 
medications that were developed a couple of decades ago. And although 
some have worked on this issue--and I appreciate those researchers--we 
need to put more money and focus on this to find ways to treat pain 
without the addictive properties of the opioids.
  And CARA 3.0 will also take the important step of addressing the 
disproportionate effect the addiction crisis has had on certain 
vulnerable communities.
  Second, our bill will build on what has worked with regard to 
treatment and recovery. So the first step is more research, education 
and prevention. The second one is with regard to treatment and 
recovery. It will double down on proven evidence-based addiction 
treatment methods while expanding treatment options for groups 
particularly vulnerable to addiction, including young people, new and 
expecting mothers, rural communities, and communities of color.
  Third, our bill will build on what works and how we treat addiction. 
It will double down on these treatment methods. It will, importantly, 
make permanent the current expanded telehealth options for addiction 
treatment that were temporarily created in response to the social 
distancing required by the COVID-19 pandemic.
  This is important. Telehealth was something that was a necessity 
during COVID. People couldn't come to the doctor for visits. They 
couldn't be at their treatment providers in person. And we wondered 
whether telehealth would be effective. I believe that for mental health 
treatment and for addiction services, behavioral health, that it has 
been incredibly important. And although addictions have gone up during 
this period, obviously, and the overdose rates are at record highs, my 
belief--and from talking to experts I have come to this belief--it 
would be even worse if we had not had the telehealth options.
  So in the dark cloud of the pandemic, the silver lining may be that 
we learned how to use telehealth better. And our legislation allows 
that to continue to be used with reimbursement; as an example, Medicaid 
reimbursement or Medicare reimbursement.
  CARA 3.0 will also bolster the recovery options for individuals 
working to put addiction behind them through funding to support the 
recovery support services and networks. It eliminates the waiver 
required of physicians who want to provide medication-assisted 
treatments to their patients and changes the law to allow those drugs 
to be prescribed via telehealth for greater ease of access.
  The bill will also help to destigmatize addiction recovery in the 
workplace by ensuring that one of these medications to treat addiction 
does not count as a drug-free workplace violation.
  Finally, CARA 3.0 reforms our criminal justice system to ensure that 
those struggling with addiction, including our veterans, are treated 
with fairness and common sense, putting them on a path to recovery 
rather than a downward spiral of abuse.

  Importantly, CARA 3.0 funds a Department of Justice grant program to 
help incarcerated individuals struggling with addiction to receive 
medication-assisted treatment while they are still in the criminal 
justice system. This means that when they are released, they have a 
much higher chance of success.
  If someone is addicted, and you don't treat it, and you let them out 
of the system, they are very likely to go back to a life of addiction. 
But if we allow medication-assisted treatment in the criminal justice 
system, we will reduce recidivism or repeated offenses. I think that 
makes sense for the person addicted, for the community, and certainly 
for the taxpayer.
  CARA and CARA 2.0 have given States and local communities new 
resources and authorities to make a real

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difference. CARA 3.0 renews and strengthens these programs. And given 
the recent spike in addiction, it provides a boost in funding as well. 
When added with the existing CARA programs that are authorized through 
2023, we would be investing over $1 billion per year to address this 
longstanding epidemic, putting us on the path toward a brighter future 
free from addiction.
  The addiction epidemic has proven to be resilient. It is a disease 
that knows no ZIP Code, and one that is always ready to come roaring 
back should we not stay vigilant.
  Columnist Peggy Noonan was exactly right when she wrote a couple of 
weeks ago in the Wall Street Journal that:

       We have a deep and profound addiction crisis in our country 
     and we've had it so long we forget to see it . . . and 
     nobody's talking about it because nobody has a plan.

  She is exactly right. We need a plan right now to tackle this crisis 
that continues to devastate our country. I have laid out one tonight 
that can give us some understanding of the magnitude of the problem, 
the nature of the challenge, but also have the Federal Government take 
concrete steps to turn the tide once again. Again, we have done it 
before. Let's do it again.
  Washington can and should be a partner to the State and local groups 
on the ground every day working to combat this crisis. We should be a 
better partner. We have got to all work together to find constructive 
solutions to the addiction epidemic and ensure more Americans don't 
suffer in silence, that we don't lose more lives to these deadly drugs 
but instead ensure that more Americans can achieve their God-given 
potential in life.
  I yield back my time.

                          ____________________