[Congressional Record (Bound Edition), Volume 162 (2016), Part 2]
[Senate]
[Pages 2441-2451]
[From the U.S. Government Publishing Office, www.gpo.gov]




  COMPREHENSIVE ADDICTION AND RECOVERY ACT OF 2015--MOTION TO PROCEED

  The ACTING PRESIDENT pro tempore. Under the previous order, the 
Senate will resume consideration of the motion to proceed to S. 524, 
which the clerk will report.
  The senior assistant legislative clerk read as follows:

       Motion to proceed to Calendar No. 369, S. 524, a bill to 
     authorize the Attorney General to award grants to address the 
     national epidemics of prescription opioid abuse and heroin 
     use.

  The ACTING PRESIDENT pro tempore. The Senator from Maine.
  Ms. COLLINS. Mr. President, I rise to speak in support of the 
Comprehensive Addiction and Recovery Act, known as CARA, of which I am 
proud to be a cosponsor. I want to begin by commending Senators 
Whitehouse and Portman for crafting this vitally important bill and 
also to thank Chairman Grassley and Ranking Member Leahy for their 
leadership in the Judiciary Committee.
  The heroin and opioid crisis in this country is devastating to far 
too many families, including those in my State of Maine. This epidemic 
can be seen in emergency rooms, local jails, on Main Streets, and in 
homes throughout our country.
  In 2014, there were a record 208 overdose deaths in the State of 
Maine, including 57 caused by heroin, and the problem is only getting 
worse. Last year, in the city of Portland, ME, 14 people overdosed in 
just 1 day. Two of them died as a result of those overdoses.
  This last weekend, the Bangor Daily News had a special segment of the 
paper that chronicled the vivid and tragic story of a young man, 
Garrett Brown, whose spiral into addiction ultimately resulted in his 
death from a heroin overdose.
  This epidemic is also having tragic effects on the most vulnerable in 
our society--the children and babies born to addicts. Last year in 
Maine nearly 1,000 babies were born drug-affected. That is about 8 
percent of all births in our State. I have seen the videos of these 
babies in the neonatal intensive care unit. They are inconsolable. It 
is so tragic to watch them. Fortunately, the physicians and other 
health care providers in Maine have become very good at treating these 
babies, but I wonder what happens to them when they go back to their 
addicted mothers or fathers.
  The Comprehensive Addiction and Recovery Act takes the kind of 
multifaceted approach needed to address this epidemic. I have said we 
need a three-pronged approach.
  First, we need to focus on education and prevention. That is 
education of the public at large, particularly our school children, but 
it is also education of health care providers and of law enforcement as 
well. I remember vividly when I was a young student sitting through a 
presentation by a recovered heroin addict. I don't know if that is done 
anymore in our schools, but I can tell you it had a marked impact on 
all of us who listened to him. None of us

[[Page 2442]]

ever would have wanted to be in the position in which he found himself 
as he struggled to recover from his addiction. I don't understand how 
heroin has lost its stigma, but it clearly has, and it is creating 
tragic results for our country. So education and prevention are 
critical.
  Second is law enforcement. We need to do a better job of helping law 
enforcement. I have had so many sheriffs tell me we cannot arrest our 
way out of this epidemic. We need to connect people who voluntarily 
come into our jails, and we need to connect them to treatment. 
Unfortunately, there aren't enough treatment facilities or guidance 
counselors or substance abuse experts or physicians and nurses and 
others with this expertise in many rural areas of our country, 
particularly in States like Maine, and I suspect in urban areas like 
Chicago where the service providers are overwhelmed with the number of 
people who need help. There has been a tripling of people in Maine who 
need help.
  Law enforcement has another critical role; that is, to work to 
interdict the heroin that is coming into the State of Maine--whether it 
originates in other States, or through ties to cities in Connecticut 
and Massachusetts, where inner-city gangs are bringing heroin into 
Maine and swapping it for guns. There is this trafficking that is going 
on where addicts with no records are being used as straw buyers, buying 
guns for the gang members who then exchange the heroin for these 
weapons. We need to have a greater effort to keep heroin out of our 
country when it is coming from those international cartels in Mexico as 
documented by the Portland Press Herald's excellent investigation into 
this matter.
  Of course, the third prong is treatment. We need more treatment 
facilities. We need the ability of not just paramedics but law 
enforcement to administer the drug Narcan, which can reverse the 
effects of overdoses if it is administered in time.
  The bill before us takes that kind of multifaceted approach. It 
includes strengthening treatment programs, supporting law enforcement, 
and increasing education and prevention efforts. It would encourage 
States and communities to expand these efforts and to increase 
evidence-based treatments for substance abuse disorders. It would 
authorize heroin and methamphetamine task forces to support safe law 
enforcement agencies, and it provides grants for communities facing 
drug crises. This crisis is by no means confined to the cities in our 
States. It is in the most rural areas imaginable in my State. It 
affects suburbia, and it affects neighborhoods throughout our country.
  Part of the solution to this crisis includes examining pain 
management and prescribing practices. I have heard from Maine families, 
from physicians, and from law enforcement about a disturbing pattern of 
a significant percentage of individuals using heroin after abusing 
legal opioid medications. According to a recent report from the 
Substance Abuse and Mental Health Services Administration, prescription 
opioid abuse does indeed put individuals at a much higher risk of 
heroin use. In fact, nearly 80 percent of individuals using heroin 
reported that they began on their road to addiction by abusing 
prescription pain medications.
  CARA would create a task force to review, modify, and update best 
practices for pain management and prescribing pain medication. It would 
also expand the disposal sites for unwanted prescriptions through drug 
take-back programs, which is an important way for individuals to safely 
and securely dispose of their unused prescription drugs. I have long 
been a supporter of drug take-back programs, which have prevented tons 
of unused, unneeded or expired drugs from falling into the hands of 
children or drug dealers. At Maine's most recent drug take-back day, 
authorities safely disposed of nearly 10 tons of unused drugs. Think 
about that. In a State of just 1.3 million people, in just one of these 
drug take-back days, 10 tons of unused drugs were collected and safely 
disposed of. The bill would also authorize grants for strengthening 
State prescription drug monitoring programs to help prevent doctor 
shopping.
  I have great sympathy for our county sheriffs who have talked to me 
about this problem. They tell me their jails are overwhelmed by those 
who are struggling with addiction. Jails are not designed to take the 
place of treatment centers. Yet sheriffs and police chiefs must train 
their officers to look for signs of withdrawal and to monitor mental 
health status. CARA would establish a demonstration program to help 
identify addicted individuals who may benefit more from treatment than 
incarceration.
  Funding would also be authorized to purchase and train first 
responders in the use of Narcan, a drug that as I mentioned can reverse 
the effects of an overdose if administered in time, and a portion of 
this funding is designated to support rural areas in our country.
  There have been many discussions in this Chamber, in our committees, 
and in our caucuses about the heroin crisis. Last December, the Health, 
Education, Labor, and Pensions Committee on which I serve held a 
hearing to examine prescribing practices, expanding access to addiction 
treatment, reducing overdoses, and partnering with law enforcement.
  Just last week, the Special Committee on Aging--which I have the 
privilege to chair--examined opiate use among seniors and other 
Medicare participants, the potential for diversion of powerful pain 
killers and Medicare reimbursement policies that may penalize 
physicians who, in their best medical judgment, decide not to prescribe 
powerful opiate pain killers and instead provide other kinds of pain 
relief for their patients. Yet because of the way the surveys are 
worded, under the Medicare patient satisfaction program, their 
hospitals can actually lose reimbursement if it is found that a patient 
was not satisfied enough with control of their pain. Clearly, pain does 
need to be managed, but these questions are so biased in the way they 
are asked that they invite overprescription and the prescription of 
powerful pain killers when they may not be needed. I am not talking 
about individuals with cancer or end-of-life conditions for whom opiate 
pain killers may be exactly what is needed to relieve their pain, but 
we know there are better alternatives for many people who do not need 
that kind of pain relief. I am working with Senator Lankford, Senator 
Donnelly, Senator Casey, and others to see if we can come up with an 
amendment to this bill on this issue.
  It is clear we need to take a comprehensive approach to this 
epidemic, and the bill before us is a vital step forward. It recognizes 
opioid and heroin abuse for the public health crisis that it has 
become, and it offers meaningful and effective ways to support 
communities seeking to expand treatment prevention, law enforcement, 
and recovery efforts.
  Again, I salute the sponsors of this legislation. I am pleased to be 
a cosponsor, and I urge all of our colleagues to come together to 
support this much needed bill.
  My thanks to my colleague from Illinois for deferring to me.
  The ACTING PRESIDENT pro tempore. The assistant Democratic leader.
  Mr. DURBIN. Mr. President, before I speak on a separate issue, I 
would like to address the issue raised by the Senator from Maine.
  Her experience in Maine is exactly the same as my experience in 
Illinois. There is no town too small, no suburb too wealthy not to have 
been touched by heroin overdoses and deaths. It is interesting--the 
Senator may be encouraged to know that in one small town in downstate 
Illinois, when they were desperate when two or three teenagers died in 
1 week in a small town, they heard about a program in Gloucester, MA, 
where the chief of police, reacting to what the Senator said earlier, 
realized that we just can't keep arresting addicts. It is not working.
  He announced that if someone who was addicted came into the sheriff's 
office or the police department and reported their addiction, they 
wouldn't arrest them; they would take them to a treatment center 
immediately. The next day, 27 teenagers showed up in this small town in 
downstate Illinois.

[[Page 2443]]

Then, of course, the challenge was where to take them. In rural areas, 
it is a long drive. Some of them were not in good shape for a drive. 
But they went into treatment.
  What they told me after I visited the town was that something 
happened immediately: The jail was empty because the jail had been 
filled with petty criminals who had been stealing, burglarizing, trying 
to feed their habits. Now they were in rehab. So it made it a safer 
community and at least gave them a chance to straighten out their 
lives.
  One of the amendments I am offering with your colleague from Maine is 
about treatment. We decided a number of years ago, for fear that we 
would be warehousing patients, to limit substance abuse treatment 
facilities under Medicaid to no more than 16 beds. Sixteen beds may 
work in a rural area; it certainly doesn't work in the city of Chicago. 
We are not expanding it dramatically, but we allow treatment facilities 
to have up to 40 beds for residential treatment for substance abuse. We 
don't want to go back into the bad old days of warehousing, but we 
certainly want to expand treatment because the problem you have seen 
and I have seen is growing.
  As you noted, if we don't move quickly on treatment, we can't expect 
to turn it around. I thank the Senator for bringing this to our 
attention. The bill before us truly is a bipartisan bill, and it should 
be.
  Mr. President, I ask unanimous consent to speak as in morning 
business.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.


                   Filling the Supreme Court Vacancy

  Mr. DURBIN. Mr. President, 1 week ago the Republican majority leader 
made an announcement that stunned a lot of observers on Capitol Hill. 
Senator McConnell said that the Senate Republicans would basically turn 
their backs on what I consider to be a constitutional responsibility 
and that they would refuse to consider the nomination to fill the 
vacancy of Justice Scalia, who recently passed away.
  In article II, section 2 of the Constitution, the Founding Fathers 
established a very clear process for appointing Supreme Court Justices. 
Under the Constitution, the President ``shall nominate, and by and with 
the Advice and Consent of the Senate, shall appoint . . . Judges of the 
supreme Court.'' That is the language of the Constitution. It is 
explicit.
  The President has a constitutional obligation to send a Supreme Court 
nominee to the Senate, and the Senate has a constitutional obligation 
to consider the nominee. But the majority leader for the Republicans 
said last week that he would not give any consideration to a nominee 
sent by President Obama--not a hearing, not a vote--and then he went so 
far as to say he will not even meet with that nominee. This is a 
stunning abdication of the Senate's constitutional responsibility. All 
of us, as Senators, walk down this aisle, stand over to the side, raise 
our right hands, and swear to support and defend the Constitution of 
the United States and to bear true faith and allegiance to it. It is an 
oath each of us takes very seriously.
  The majority leader has tried to justify his decision by noting that 
this is an election year. Well, it turns out it doesn't take much 
constitutional study to realize that the Constitution applies to 
election years as well as every other year. There is nothing in the 
Constitution that directs the President or the Senate to ignore their 
responsibility when there is a political Presidential campaign 
underway. I have searched the Constitution. There is no reference 
whatsoever to a Presidential campaign year absolving either the 
President or the Senate from their constitutional obligations.
  One of the great ironies of the decision by the Senate Republican 
leadership was the way they reached it. Shortly after Justice Scalia 
passed away, Majority Leader McConnell issued a statement saying: ``The 
American people should have a voice in the selection of their next 
Supreme Court Justice.'' Then last Tuesday he summoned the Republican 
members of the Senate Judiciary Committee to his office, and there he 
decided with them that they would deprive the American people of a 
chance to view a hearing on President Obama's nominee to fill the 
Scalia vacancy. This is an unprecedented obstruction of a Supreme Court 
nominee, and this decision to obstruct certainly wasn't made by the 
American people. It was a unilateral, partisan decision made by a 
handful of Senators behind closed doors. The Republican Senators didn't 
bring their decision out into the open, not to a hearing of the 
Judiciary Committee, which they chair; they did it quietly behind 
closed doors.
  But the American people heard what happened. Last Friday a letter was 
sent to the Republican members of the Judiciary Committee by the 
Leadership Conference on Civil Rights and Human Rights and 81 other 
national organizations.
  I ask unanimous consent to have the letter printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                                February 26, 2016.
     Hon. Charles Grassley, Chairman,
     Hon. Orrin Hatch,
     Hon. Jeff Sessions,
     Hon. Lindsey Graham,
     Hon. John Cornyn,
     Hon. Michael Lee,
     Hon. Ted Cruz,
     Hon. Jeff Flake,
     Hon. David Vitter,
     Hon. David Perdue,
     Hon. Thom Tillis,
     Committee on the Judiciary, U.S. Senate, Washington, DC.
       Dear Senators: We, the undersigned organizations, urge you 
     to reconsider your unprecedented and destructive refusal to 
     give fair consideration to any Supreme Court nomination until 
     after the next President is sworn into office on January 20, 
     2017, as announced in your February 23rd letter to Senate 
     Majority Leader Mitch McConnell.
       Your letter claims that your refusal to hold a hearing on--
     or to even meet with--any potential nominee is part and 
     parcel to executing your ``constitutional authority to 
     withhold consent on any nominee.'' This is a clear perversion 
     of your constitutional duties as understood by almost every 
     scholarly authority on the topic and by most Americans.
       It is a dereliction of your constitutional duty to handcuff 
     the Supreme Court for two terms. Your proposed course of 
     action would cause a constitutional crisis that would shake 
     the very foundation of our democracy.
       We condemn this unprecedented overreach, and call on you to 
     uphold the Constitution by giving fair consideration, 
     including timely hearings and votes, to the next nominee to 
     the Supreme Court.
       Under Article II, Section 2 of the U.S. Constitution, the 
     President shall nominate a Justice to the Supreme Court ``by 
     and with the Advice and Consent of the Senate.'' This does 
     not give a select few senators veto power over the 
     President's role in selecting and nominating a candidate. The 
     Senate's duty is to evaluate a nominee's fitness and 
     qualifications, not to pick the President making the 
     nomination.
       Our legal system is based on the rule of law and requires 
     stability and certainty. The course you have charted would 
     mean that a new justice would not be confirmed until well 
     into 2017 at the earliest. Shackling the court for two terms 
     would undermine the rule of law, leave legal questions 
     unresolved, and hamper the administration of justice across 
     our nation.
       Refusing to consider any nominee, without due evaluation of 
     his or her merits, credentials, and experiences, is a direct 
     repudiation of your constitutional duties.
       We believe in upholding the Constitution. So should you.
           Sincerely,
       The Leadership Conference on Civil and Human Rights; Philip 
     Randolph Institute; AFL-CIO; African American Ministers In 
     Action; Alliance for Justice; American Association for 
     Access, Equity and Diversity; American Association For 
     Justice; American Family Voices; American Federation of 
     State, County, and Municipal Employees; American Federation 
     of Teachers; American-Arab Anti-Discrimination Committee; 
     Americans for Democratic Action (ADA); Americans United for 
     Change; Andrew Goodman Foundation; Asian & Pacific Islander 
     American Health Forum; Asian American Legal Defense and 
     Education Fund (AALDEF); Asian Americans Advancing Justice/
     AAJC; Asian Pacific American Labor Alliance,

[[Page 2444]]

     AFL-CIO (APALA); Association of Asian Pacific Community 
     Health Organizations (AAPCHO); Bazelon Center for Mental 
     Health Law.
       Bend the Arc Jewish Action; Center for American Progress; 
     Center for Community Change; Center for Pan Asian Community 
     Services, Inc. (CPACS); Coalition on Human Needs; Common 
     Cause; Communications Workers of America; Constitutional 
     Accountability Center; Defenders of Wildlife; Disability 
     Rights Education & Defense Fund; Earthjustice; Equal Justice 
     Society; Feminist Majority Foundation; Human Rights Campaign; 
     International Association of Official Human Rights Agencies 
     (IAOHRA); Iota Phi Lamda Sorority, Inc.; Japanese American 
     Citizen League; Jewish Labor Committee; Korean American 
     Resource & Cultural Center; Korean Resource Center.
       Lambda Legal; Lawyers' Committee for Civil Rights Under 
     Law; League of Conservation Voters; League of United Latin 
     American Citizens; MALDEF; Moveon.org Civic Action; NAACP; 
     NAACP Legal Defense and Educational Fund, Inc.; NAACP-
     National Voter Fund; NARAL Pro-Choice America; National Asian 
     Pacific American Families Against Substance Abuse; National 
     Association of Social Workers (NASW); National Black Justice 
     Coalition; National Coalition for Asian Pacific American 
     Community Development; National Congress of American Indians; 
     National Council of Asian Pacific Americans (NCAPA); National 
     Council of Jewish Women; National Education Association; 
     National Employment Law Project; National Employment Lawyers 
     Association.
       National Fair Housing Alliance; National Korean American 
     Service & Education Consortium; National LGBTQ Task Force 
     Action Fund; National Partnership for Women & Families; 
     National Queer Asian Pacific Islander Alliance; National 
     Tongan American Society; National Urban League; National 
     Women's Law Center; People For the American Way; Planned 
     Parenthood Federation of America; PolicyLink; Project Vote; 
     Reconstructionist Rabbinical Association; Service Employees 
     International Union; Sierra Club; South Asian Bar Association 
     of North America; Southeast Asia Resource Action Center 
     (SEARAC); Southern Poverty Law Center; TASH; Union for Reform 
     Judaism; United Auto Workers (UAW); Workmen's Circle.

  Mr. DURBIN. The letter described the Republicans' obstruction as ``a 
clear perversion of your constitutional duties as understood by almost 
every scholarly authority on the topic and by most Americans.'' The 
letter said that the Constitution ``does not give a select few Senators 
veto power over the President's role in selecting and nominating a 
candidate. The Senate's duty is to evaluate a nominee's fitness and 
qualifications, not to pick the President making the nomination.''
  I agree with that statement. By unilaterally refusing to give any 
consideration to any nominee made by this President, Senate Republicans 
are trying to stop this President from fulfilling his constitutional 
responsibility to nominate and appoint Supreme Court Justices under 
article II, section 2. They did it in secret in a back room, behind 
closed doors. Why are they so afraid to give President Obama's nominee 
a fair hearing? Are they concerned that if the nominee is well 
qualified and they turn that person down, it will reflect poorly on the 
Senate Republicans?
  The Senate Republican process of secrecy and obstruction is 
inconsistent with the Constitution. It does a disservice to the Supreme 
Court, to the President, and to the American people.
  I raised a point last week which is worth returning to. The argument 
is made that the next President should pick the nominee to fill this 
vacancy. The argument is made that the American people, when they 
select the next President in November of this year--that we will be 
saying to the American people: You make the choice. You select the 
President. And then you will know the Supreme Court nominee.
  Well, there may be some logic to that but for one thing: We have a 
President. He was elected in 2012 with a 5 million-vote majority. This 
is the fourth year of his Presidency.
  When you listen to the Republicans argue, you would think, wait a 
minute, Barack Obama was not elected for 4 years, only for 3 years and 
2 months. They argue at this point in time that this President does not 
have the constitutional authority or responsibility to fill the vacancy 
of Justice Scalia. The American people spoke. It wasn't all that close. 
By a margin of 5 million votes, they chose this President for 4 years, 
not for 3 years or 3 years and 2 months. He is the President, he has 
the authority of the Presidency, and he has that authority not given to 
him by God but by the American people. It is authority which should not 
be taken away by the Republican majority of the Senate.
  Their argument, ``Wait for the next election''--do you know what that 
means? It means that if they have their way, if they fail to do their 
job, if they don't even have a hearing for President Obama's nominee, 
don't even bring it to a vote, and the vacancy continues on the Supreme 
Court, it will be historic. The last time we will have left a vacancy 
of this duration on the Supreme Court dates back to the Civil War. A 
nation at war with itself left a vacancy for more than a year on the 
Supreme Court. Now the Senate Republicans of 2016 want to leave a 
vacancy on the Supreme Court for over a year. There is no need for it, 
and the Constitution certainly makes it clear how this vacancy should 
be filled.
  There is no secret that there is a political motive. The Senate 
Republicans hope Justice Scalia's seat will be filled by a person they 
choose. This is a political calculation they are willing to make, to 
take the heat for not following their constitutional responsibility in 
the hopes that a President Trump will pick someone to fill this vacancy 
or some other Republican President in the future. That is what they are 
counting on. That is political.
  Politics shouldn't trump the Constitution. Nothing should trump the 
Constitution when it comes to governing the United States. Because it 
is an election year doesn't mean Senators can take a yearlong break and 
ignore their own oath of office.
  It is time for the Senate Republicans to do their job. The President 
and the Senate must fulfill their constitutional responsibility in 
times of war, in economic depression, and even in an election year.
  Last week Majority Leader McConnell reportedly told a group of House 
Republicans that there isn't ``a snowball's chance in hell'' that he 
would back down from his plan of obstruction. Nevertheless, today 
President Obama has invited Majority Leader McConnell to meet with him 
in the White House to discuss the Supreme Court vacancy. They have also 
invited the chairman of the Senate Judiciary Committee, Senator 
Grassley; the ranking Democrat, Senator Leahy; and the minority leader 
of the Senate, Senator Reid.
  Why did the President offer this meeting? Because that is what always 
happens. When a President is about to consider filling such a historic 
vacancy, he brings together the leaders of the Senate to discuss his 
thought process and perhaps to solicit names from them of potential 
nominees. Even when we have disagreed in the past and have Presidents 
and Senators from different political parties, they still extended that 
courtesy to one another. President Obama is extending the majority 
leader that courtesy even if the majority leader has made it clear and 
publicly stated repeatedly that he will not even meet with, let alone 
consider, the President's nominee.
  The President is setting a good example of what should be done in 
this circumstance where the President follows tradition and the 
Constitution. I am glad the President is taking this seriously. I know 
he is in the midst of a careful, deliberative process to choose a 
nominee. The President should select an outstanding person who has the 
qualifications, a commitment to justice, a deep respect for the role of 
the judiciary, and life experience that points toward integrity and 
good judgment.
  The President is doing his job as the Constitution requires. My 
Republican colleagues in the Senate should do their job as well. They 
should honor the process established in the Constitution and give the 
President's nominee fair consideration, a hearing, and a vote.
  Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Flake). The clerk will call the roll.
  The legislative clerk proceeded to call the roll.

[[Page 2445]]


  Mr. CORNYN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. CORNYN. Mr. President, yesterday the Senate unanimously voted to 
advance consideration of the Comprehensive Addiction and Recovery Act, 
commonly known as CARA, and that is because this legislation gets at a 
big problem. The abuse of heroin and prescription painkillers is 
devastating families and communities across the country, including 
Texas. The truth is, the problem is getting worse, not better. Deaths 
due to heroin and prescription drug overdoses have even surpassed car 
accidents as the No. 1 cause of injury-related deaths nationwide.
  It is time for Congress to do something significant to address this 
disturbing trend. This bill is a good example of how Republicans and 
Democrats, working on a bipartisan basis, can zero in on a problem that 
is harming our Nation and work together to address it.
  I am proud to cosponsor this legislation, and I look forward to 
continuing to work on this bill and to voting on amendments that will 
actually improve it. Speaking of amendments, while this bill touches on 
how to battle drug addiction in this country, we need to do more to cut 
these drugs off at the source and keep them from getting into our 
country in the first place.
  The Senate Armed Services Committee recently heard about the supply 
side of this equation--this primarily goes to the heroin coming from 
Mexico--when they heard testimony from the Director of National 
Intelligence, James Clapper. In his testimony, Director Clapper talked 
about how Mexico has ramped up the production of heroin in response to 
this growing demand in the United States.
  I know the Presiding Officer is also from a border State and has had 
frequent conversations with our Mexican counterparts. When we complain 
about the supply, they usually turn it on me and say: Well, what about 
the demand in the United States? The truth is, we have to get at both 
components--both the supply and demand.
  In 2014, drug cartels smuggled more than a quarter of a million 
pounds of heroin across our borders. This was done by the same 
transnational criminal organizations that traffic human beings for sex 
or forced labor and who man the illegal immigration pipelines into our 
country. This is no longer a mom-and-pop operation. These are major 
criminal networks and organizations that will do anything for money 
and, of course, are happy to make money from the heroin that comes 
across our border.
  If we are going to make significant strides in the fight against 
addiction and drug abuse, we need to take a critical look at where the 
drugs are coming from and consider the strategies we can employ to keep 
them from even coming onto our soil. Unfortunately, even while the 
production and demand of these illegal drugs have been growing, we have 
not done enough to combat it.
  Earlier I mentioned that the U.S. Southern Command--that is the 
combatant command for the U.S. military that is south of Mexico and 
goes into Central and South America--has been given zero Navy ships to 
conduct counter-trafficking missions, and that is because our Navy 
fleet is simply too small and these resources have been diverted 
elsewhere to counter the growing threats around the world. It is 
irresponsible to ignore the transnational criminal threats in our own 
backyard. We need a strategy to interdict drug shipments and cut them 
off before they reach our shores, so I have submitted several 
amendments that would help focus our resources to interdict these 
shipments and to help stem the growing tide of illicit drugs entering 
the U.S. market.
  One amendment would simply require the Defense Department, when it 
allocates funding to the States for the National Guard Counterdrug 
Program, to prioritize drug interdiction. More effectively using the 
National Guard's military capabilities to help interdict drug flows 
would provide a needed boost to law enforcement and counternarcotics 
efforts, especially on our southern border. Too often, law enforcement 
agencies have been left with scant resources to handle this growing 
problem, so this amendment would allow the National Guard to play a 
bigger role in drug interdiction.
  Another amendment I have submitted would require the President to 
create a plan--a strategy, really--to increase interdiction of illegal 
drugs that enter across the southwest border. It would require the 
interdiction goal of 90 percent of those drugs, which would be a great 
leap forward from the current levels.
  Last year, General Kelly, then the commander of Southern Command, 
estimated that only 15 to 20 percent of drugs bound for the United 
States were interdicted, just 15 percent to 20 percent. General Kelly 
said that, due to a lack of resources in the Southern Command, 
basically many times they were relegated to being observers as illegal 
drugs would transit across their area of operation.
  Given our shortfall here, it is pretty amazing that a comprehensive 
plan across all relevant agencies doesn't already exist. It is shocking 
really. This amendment would make sure that one is created to boost the 
amount of drugs that we successfully interdict. It would also require 
the President to submit this plan to Congress so we can have a 
conversation between the executive branch and the legislative branch 
and so the American people could review it, could hold us accountable, 
and to make sure we are making progress on this front.
  Finally, I have submitted an amendment to strengthen the High 
Intensity Drug Trafficking Area Program. This would help Federal, 
State, and local law enforcement officials use task force funding to 
implement a multidisciplinary heroin response strategy. This has been 
tested in several high-intensity drug trafficking areas with great 
success. This amendment would help implement this strategy nationwide, 
giving law enforcement additional tools to combat the growing threat of 
heroin from both the supply and demand side.
  Mr. President, I am glad we are making some progress on this 
legislation. I am optimistic that we will be able to complete it this 
week in a bipartisan fashion, which is the only way you get these done 
around here. We desperately need to target the opioid epidemic 
happening across the Nation, and we also need to cut off as much of the 
supply of the cheap heroin as we can. When people can't get access to 
prescription drugs, too often they turn to cheap heroin, and that is 
why the supply issue is so important. But we need both pieces in order 
to make real progress and restore our communities currently plagued by 
addiction and drug abuse.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Ms. AYOTTE. Mr. President, I rise today to urge my colleagues to join 
me in supporting the Comprehensive Addiction and Recovery Act. This is 
a bill that we have been working on for 2 years--Senator Portman, 
Senator Whitehouse, and Senator Klobuchar. I thank them for their 
partnership and leadership on this bill. This is something the four of 
us got together on because we saw in our own States the public health 
epidemic that was happening with our constituents: individuals 
struggling with addiction, people who were addicted to prescription 
drugs and overusing and misusing prescription drugs, and then with the 
price of heroin on our streets so low that people are turning to heroin 
and also a combination of heroin and a deadly drug called fentanyl.
  I thank Senators Portman, Whitehouse, and Klobuchar for the work we 
have been doing together over the last several years on this bill to 
see this bill come to this Senate floor. This is a very important piece 
of legislation and will help us address the public health epidemic 
facing my home State of New Hampshire and this country. This is 
something I have come to the floor about on several occasions before.
  Traveling around my State, I can't tell you the number of stories I 
have heard from people in New Hampshire about what we are facing and 
the number of lives that are lost, the number of

[[Page 2446]]

lives that are devastated by heroin and fentanyl and misuse of 
prescription drugs.
  This is a life-or-death issue in my State. The number of drug 
overdose deaths has been staggering. Before I came to the Senate, I 
served as attorney general of our State, and so I worked with law 
enforcement on these issues, whether it was methamphetamine, cocaine, 
or other illegal drugs, but I have never seen anything like this. As of 
last week, the chief medical examiner's office had recorded that there 
were 420 drug deaths in 2015, and that was a dramatic increase in New 
Hampshire from the year before. The year before, we had about 320 drug 
deaths. So this is more than one person dying a day in my State. Many 
more than die in traffic accidents are dying from drug overdoses, and 
it is a combination, again, the driver of this--heroin and Fentanyl. 
Fentanyl is 40 to 50 percent times more powerful than heroin, and when 
the drug dealers mix it up with the heroin, it is a killer.
  As Eric Spofford told me--he is an incredible guy who is in recovery 
and has opened treatment facilities in our State. He got it right when 
he said fentanyl is a serial killer because that is what it is.
  In the month of February alone, there were 14 suspected opioid 
overdose deaths just in the city of Manchester--14 in just one city in 
my State. That is a record high in Manchester, NH. These are not just 
numbers that we are talking about. Behind every statistic is a life, a 
life that is taken from us far too soon and has been tragically lost--a 
mother, a daughter, a son, a brother, a neighbor, a friend, a coworker. 
This hits all of us, and these are people who are being lost from this 
horrible epidemic.
  Behind the statistics and behind the headlines we see every day in 
the news, there are family members, friends, and communities that have 
been deeply impacted by this public health crisis, such as the mother 
from Greenville, NH, who wrote to me. She spends her days actually 
doing incredibly important work, helping people who are struggling with 
addiction. She helps them, and yet she has been coming home to see her 
own son struggling with heroin. She told me, ``As I tried to comfort 
those who have been affected by this tragedy, I think that my son will 
be next.''
  In Laconia, a man helps those struggling to get treatment, but he 
feels helpless when they are faced with a 5-month waiting period for a 
rehabilitation facility. He wrote, ``In 5 months, these individuals may 
be dead.''
  A parent from Salem, NH, contacted me and told me her son is 
struggling with heroin addiction, and she needs help finding a 
treatment program for him since she could not afford to pay for 
treatment herself. Parents don't know where to go.
  I have met many parents who want to get help for their kids, and they 
are having a hard time finding a place and knowing where to go. Another 
mother of three children had to revive her son from an overdose before 
the paramedics could arrive.
  The Griffin family from Newton, whom I have gotten to know well, lost 
their beautiful 20-year-old daughter Courtney to an overdose. Now, 
Courtney's father Doug and Courtney's mother Pam have made it their 
mission to bring awareness to this issue and to make sure that others 
don't suffer from the same tragedy they have suffered in the lost life 
of a beautiful young woman named Courtney, who had so much of life 
before her and so much potential. Doug and Pam and so many other 
dedicated people in New Hampshire are working tirelessly to turn the 
tide against this epidemic.
  Over the past 2 years, I made it a priority to travel the State and 
hear from our public safety community, treatment providers, addiction 
experts, families, and individuals in recovery about finding effective 
strategies to address this problem. On ride-alongs with the police and 
fire, I have been to overdoses. I have seen them bring people back to 
life, administering Narcan only to say that they face this every single 
day. If we don't focus on prevention and we don't focus on treatment, 
and the important work that our first responders are doing, then we are 
not going to get at this problem and make sure people who are 
struggling get out of this cycle of addiction.
  Treatment facilities in New Hampshire are certainly working 
tirelessly, and individuals are stepping up to expand our capacity in 
New Hampshire to support individuals who need help, and they need more 
support. I want to take a moment to recognize some of their hard work. 
Among so many others, I am grateful that there are so many working hard 
together in New Hampshire: Hope for New Hampshire Recovery, Families in 
Transition Willows Program, the Farnum Center, Westbridge Community 
Services in Manchester, GateHouse Sober Community in Nashua, Hope on 
Haven Hill, Bonfire Recovery Services in Dover, The Granite House in 
Derry, and the New Freedom Academy in Canterbury. I have met many 
incredible people who are dedicating their lives to this.
  I have had the opportunity to visit these facilities and hear 
directly from the dedicated professionals who work there. They do 
critically important work. You have average people coming together, 
whether to organize a 5K race or to gain resources and support for 
people who are on the frontlines. This is what those who are on the 
frontlines are saying: Tackling this epidemic and reversing the tide of 
addiction will take a comprehensive, thoughtful approach, and include 
strategies for treatment, prevention, education, support for 
individuals in recovery, and interdiction. That is why we have to pass 
CARA.
  CARA is important because it embodies the comprehensive approach that 
so many in my State have told me they need. Here is what it looks like. 
It gives more support to first responders and law enforcement, 
expanding the availability of lifesaving drugs like Narcan, which our 
first responders are using every day. And because CARA will help make 
this happen, it has been endorsed by the National Fraternal Order of 
Police, National District Attorneys Association, and National 
Association of Attorneys General, including New Hampshire's own 
attorney general, Joe Foster.
  It strengthens prescription drug monitoring programs to help prevent 
``doctor shopping.'' This is something I have been advocating for since 
I was attorney general of our State so that our public health officials 
can have the tools--because we know from SAMHSA research that four out 
of five people started by misusing or overusing prescription drugs and 
transferred to heroin. So this is critical.
  It increases access to treatment, including evidence-based medication 
assisted treatment, which can help people have more access. We need to 
turn the tide. Over 130 stakeholder groups have gotten behind this 
legislation, groups that are on the frontline of this issue. Just to 
name some of them, it has been endorsed by the National Council for 
Behavioral Health, American Psychological Association, American Society 
of Addiction Medicine, Community Anti-Drug Coalitions of America, Harm 
Reduction Coalition, Faces and Voices of Recovery, Mental Health 
America, Young People in Recovery, National Association of State 
Alcohol and Substance Abuse Directors, among many others. I thank these 
groups for their feedback.
  It would support additional resources to identify and treat 
incarcerated individuals suffering from substance abuse disorders and 
expand prevention. It is so important we address prevention.
  It would establish a campaign to bring greater awareness to the 
association between the overuse and misuse of prescription drugs and 
what happens as people misuse prescription drugs and then go to heroin 
and deadly drugs like fentanyl.
  This bill has overwhelming bipartisan support. It has 42 bipartisan 
co-sponsors.
  I see my colleague from New Hampshire on the floor. I want to thank 
her for her sponsorship of this legislation. This crisis does not 
discriminate. It doesn't care. Heroin, fentanyl--the devastating impact 
of this drug does not care whether you're a Republican, a Democrat, an 
Independent, whatever your background.

[[Page 2447]]

  This is something that affects all of us. A high school student from 
Manchester who wrote to me, sharing how concerned he is about the 
negative impact this epidemic is having on his city. When he walks home 
from school, he sometimes sees discarded needles on the sidewalk, and 
tragically he lost his best friend to a fentanyl overdose.
  Abi, who lives in the Seacoast Region, struggled with an opioid use 
disorder through her pregnancy until she was finally able to receive 
help and treatment and enter recovery. I met Abi, and I am so inspired 
by her because she shows us we can make a difference and we can turn 
this around.
  A woman in Londonderry, who spoke to me at a community forum, was 
terrified her brother would suffer a reoccurrence as soon as he was 
released from prison because he wasn't getting treatment. She was 
worried about his path to a successful life because he was still 
suffering from a substance abuse disorder.
  Then there is Angela from Nashua, who has turned her story into a 
rallying cry for others. Angela lost her mother to a heroin overdose 17 
years ago and has adopted the children of several of her aunts and 
cousins who have lost their battles with addiction. After all of this, 
Angela's son and his girlfriend have become addicted to opioids and his 
girlfriend overdosed in Angela's home. Her son is still battling with 
heroin addiction.
  There are so many groups that are working to support these 
individuals and we need to give them our support. They cannot and 
should not have to do this alone.
  I see my colleague, Senator Shaheen from New Hampshire on the floor. 
I really appreciate her leadership on this issue. I am a cosponsor of 
Senator Shaheen's standalone legislation which would provide emergency 
appropriations in order to combat the heroin and prescription opioid 
crisis facing our State. In fact, she and I have both written to Health 
and Human Services and asked them to designate this as a public health 
emergency. We have seen the impact on our State and we have seen the 
lives that are being lost and impacted by this. So I am going to be 
cosponsoring Senator Shaheen's amendment to CARA and supporting it on 
the floor. I very much support her getting a vote on this amendment, 
and I hope that happens.
  In addition, I appreciate that the President has put in additional 
resources in his budget to address this issue. This is an issue that we 
all have to work together on.
  At the end of the year, there was also important funding that was 
passed that CARA would provide a very important framework for. Last 
year during the appropriations process, Congress worked to increase by 
284 percent funding for programs at CDC and SAMHSA related to combating 
opioid abuse. While this is a positive step forward, these dollars 
actually haven't been distributed yet. It is important we pass CARA to 
make sure that as we go forward with the dollars that have already been 
appropriated and as we go forward in the appropriations process this 
year, that we have the framework to properly redirect this funding for 
prevention, treatment, and first responders, to make sure we have the 
feedback of 130 stakeholder groups and law enforcement throughout the 
country and to ensure that these dollars are appropriately spent to 
address the epidemic we are facing.
  I have been honored to work over the last several years, again, with 
Senators Portman, Whitehouse, and Klobuchar in introducing this bill. 
In fact, I also thank the head of drug policy in the administration, 
Director Botticelli. He summed it up well when we asked him what he 
thought about CARA. He said in a hearing before the Judiciary Committee 
in January:

       There is clear evidence that a comprehensive response 
     looking at multidimensional aspects of this that are embedded 
     in the CARA Act are tremendously important. We know we need 
     to do more, and I think that all of those components put 
     forward in this bill are critically important to making 
     headway in terms of this epidemic.

  The Comprehensive Addiction and Recovery Act would be a significant 
step forward in a Federal response to this public health epidemic that 
is facing New Hampshire and so many other States in the country. I urge 
my colleagues to support this critical legislation, to listen to the 
people of New Hampshire and to the people of this country who are 
asking us to act.
  This is what they are saying in New Hampshire.
  In Center Barnstead: ``Please pass legislation to save my son's 
life.''
  In Manchester: ``I wake up every morning with a fear that I will find 
my son dead. I am crying out for help.''
  In Spofford: ``I want my voice to be heard so that no one else falls 
through the cracks.''
  In Londonderry: ``Addiction can happen to anyone.''
  In Tilton: ``We need action, and we need it right now.''
  We have an opportunity on this floor right now, in this debate, with 
very thoughtful legislation, very bipartisan legislation--the 
Comprehensive Addiction and Recovery Act--to take action now. We owe it 
to all those who have lost their lives, their families who have been 
impacted, and those who are struggling with addiction. We owe it to the 
first responders in our community and to the people who are working 
hard to turn this around in New Hampshire and across this country. To 
all, I thank them for the incredible work they are doing.
  We need to pass this legislation. I urge my colleagues to join me in 
supporting passage of the Comprehensive Addiction and Recovery Act. 
This bill will make a difference, and I believe it will help save lives 
in New Hampshire and across the country.
  There is no doubt that passing this bill will make a difference. We 
will all need to continue to do more. We will all need to continue to 
fight for more and more support through the appropriations process and 
any way we can. I intend to keep up this fight because I know lives are 
on the line. I know this issue is impacting my State. I know that as I 
talk to the mothers, the daughters, the fathers, the sons, the friends 
who are telling me the stories of the people they have lost, that we 
can turn this around. It is so important that we pass this legislation.
  Again, I wish to thank my colleague from the State of New Hampshire 
for her work on this.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Mrs. SHAHEEN. Mr. President, I ask unanimous consent to speak for up 
to 30 minutes, and I wonder if the Chair will advise me when I have 
about 3 minutes remaining.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Chair will so notify the Senator.
  Mrs. SHAHEEN. I thank the Presiding Officer.
  I am pleased to join my colleague from New Hampshire on the floor and 
the others who have spoken this morning so eloquently about the heroin 
and opioid epidemic that is ravaging families and communities in every 
one of our States.
  As Senator Ayotte said so well, we have seen in New Hampshire that we 
are at ground zero for this epidemic. In terms of the percentage of 
people affected in New Hampshire, we are losing a higher percentage 
than almost every State in the Nation. This is an issue we need to work 
together to address. I think we have to respond much more robustly than 
we have done at the Federal level because this epidemic is becoming a 
pandemic. It is affecting young and old, urban and rural, rich and 
poor, Whites and minorities.
  As others have said, the Senate is now considering the Comprehensive 
Addiction and Recovery Act or CARA. I want to congratulate the sponsors 
of the legislation because this is a good bipartisan bill. It is 
important as we look at what we need to do to address the epidemic we 
face.
  In addition to the authorizations and the good work that is in the 
CARA legislation, we also need to provide the resources that law 
enforcement and health professionals who are on the frontlines of 
dealing with this crisis are going to need. Despite heroic efforts, law 
enforcement and treatment professionals are increasingly overwhelmed by 
the sheer scope and scale

[[Page 2448]]

of the opioid and heroin crisis. Everywhere I go in New Hampshire, the 
lack of resources is abundantly clear. Our communities need additional 
funding--and they need it urgently.
  So this is why I have submitted an amendment cosponsored by the 
author of CARA, Senator Whitehouse, and I am pleased my colleague from 
New Hampshire has also joined in cosponsoring this amendment. This 
amendment would provide $600 million in emergency funding for critical 
programs that we know will help address this crisis.
  I am on the floor to urge the majority leader and the leadership of 
the Senate to allow a vote on this legislation because this is a 
nationwide emergency of the first order, and it is time for us in 
Congress to treat it like a nationwide emergency.
  In 2014, more than 47,000 Americans died from lethal drug overdoses--
more fatalities than from car accidents. Each day 120 Americans die of 
drug overdoses--2 deaths every hour. In our State of New Hampshire, 
where we have 1.3 million people, we are losing more than a person a 
day to drug overdose deaths.
  Here we have a map of America that shows the increases in deaths from 
drug overdoses. We can see in 2003 the majority of the map is lighter 
colored, so it means it doesn't have the same number of deaths. In 2008 
we can see this dark red color which shows the deaths from drug 
overdoses increasing. Here, in 2014, we see the impact of those 47,000 
people lost.
  The State of the Presiding Officer, like in New Hampshire, is at 
ground zero in the State of Arizona. In West Virginia, in Tennessee, 
and in Kentucky, they are seeing the same dramatic increase in the 
number of deaths from drug overdoses. This chart represents overdose 
deaths per 100,000 people. Again, it demonstrates how truly national in 
scope the crisis has become. No State is immune from the scourge.
  Across the country, our communities are asking why this is happening. 
They are asking why so many of our family members and neighbors are 
overdosing on these drugs. Sadly, as we have heard from people who have 
spoken on the floor, one of the primary reasons is because so many 
people are becoming addicted to prescription opioid drugs, better known 
as painkillers. In 2012, 259 million prescriptions were written for 
these drugs--almost 1 for every American. That is more than enough to 
give every American adult their own bottle of pills. During a 3-month 
stretch in 2015 in New Hampshire, 13 million doses of schedule II 
painkillers were dispensed at New Hampshire pharmacies in just one 3-
month period--13 million pills in 3 months for a State with a 
population of 1.3 million, and nearly 80 percent of these prescriptions 
were for heavy painkillers like oxycodone, morphine, and fentanyl.
  If we look, we can see how this graph dramatically tracks the 
increase in drug prescribing and the number of deaths that resulted. 
The number of drug overdose deaths has risen as opioid prescriptions 
have increased. This orange line is the number of deaths. The green 
line is the number of prescriptions that are being written. We are 
missing the data for the year 2012, but there is no doubt that those 
deaths track the number of prescriptions for painkillers that are being 
written.
  The National Institutes of Health have found that people who are 
addicted to opioid painkillers are 40 times more likely to be addicted 
to heroin. So when someone gets addicted to pain pills and can no 
longer get prescriptions, they turn to drugs like heroin and fentanyl.
  What I heard from law enforcement in New Hampshire and from the 
medical community is that people turn to heroin because it is cheaper 
and easier to get than prescription drugs after they become addicted. 
Of course, we have seen that drug traffickers are taking advantage. 
They are flooding our streets with these drugs. In many of our 
communities, that bag of heroin is cheaper than a six-pack of beer. Of 
course the end result is a staggering increase in overdose deaths, 
which we can see on this chart.
  Again, in 2014, nearly 21,000 people died from opioid abuse. There 
were more than 10,000 deaths from heroin. That is a 222-percent 
increase from 2009 levels.
  So we can see that these are opioid deaths, these are deaths from 
cocaine, and these are deaths from heroin. We can see the red line and 
the green line have gone up dramatically.
  A professor at Johns Hopkins School of Public Health, Brendan 
Saloner, describes opioid addiction as ``a chronic relapsing illness, 
just like diabetes.''
  We know treatment is the only effective answer. Again, what I have 
heard from law enforcement in New Hampshire is that they know they 
can't put drug users in jail. That is not the answer to deal with this 
challenge. We need to put the bad guys in jail, but we need to provide 
treatment to the people who need it because that is the only effective 
answer. Unfortunately, it is a tragic reality that nationwide nearly 9 
out of 10 people with substance use disorders don't receive treatment. 
They are being turned away and denied treatment due to a chronic lack 
of resources.
  My colleague from New Hampshire spoke very eloquently about some of 
the people she heard from. We have heard from people in the same way in 
New Hampshire. Of the 1.3 million people in our State, it is estimated 
that 100,000 people--almost 10 percent--are currently seeking treatment 
for substance use disorders. We are able to offer services to only a 
small fraction of that total.
  Over the last decade the number of people admitted to State treatment 
programs increased 90 percent for heroin use and 500 percent--500 
percent--for prescription drug use, with the largest increases 
occurring in the past several years.
  As we can see from this chart, lack of treatment is a national 
problem: the darker the green, the more people in that State who are 
not receiving treatment for addiction. Sadly, New Hampshire is a very 
dark green, as is Arizona, the Presiding Officer's State. You can see 
this dark green line coming down the east coast and going up the west 
coast.
  In 2014, in Kentucky, 82,000 people needed addiction treatment but 
failed to get it--in Tennessee, 116,000 people; in Arizona, 157,000; in 
Nevada, 55,000; in North Carolina, 200,000 people. These are all people 
who needed treatment who didn't get it. When people don't get 
treatment, they are overdosing in overwhelming numbers.
  Sadly, this map of the United States shows where the overdose death 
rates are the highest. Where the darkest colors are shown the death 
rates are greater than 19 per 100,000 of population. We can see many of 
the same States, such as New Hampshire, that have the most difficulty 
in people finding treatment. Those are the States where we are finding 
the highest death rates. In 2014 in Kentucky, 1,100 people died from a 
drug overdose; in Tennessee, 1,200 people; in Arizona, 1,200 overdose 
deaths; in Nevada, 500; and in North Carolina, 1,300.
  In recent days I have had a chance to visit three treatment centers 
in my home State, Headrest in Lebanon, Serenity Place in Manchester, 
and Seacoast Youth Services in Seabrook. These treatment centers are 
staffed by skilled, dedicated professionals. They are saving lives 
every day, but they tell me that for every life they save, many more 
are being lost for lack of treatment capacity, lack of facilities, and 
lack of funding.
  I had a chance on some of those visits to meet with some of the 
people in recovery. I can remember one young man up in Lebanon at 
Headrest who had been in and out of prison because of crimes committed 
when he was using. He said to me that it costs thousands of dollars to 
keep someone in prison. The figure he used was $35,000. He said: Don't 
you all know that it is cheaper to give somebody treatment? It is 
absolutely more cost effective for us to provide treatment for people 
who are in recovery, people who need help.
  I heard from a young woman in Manchester who said that she had been 
arrested for drug use. She said: I am not a criminal. My problem is I 
need treatment to deal with these drugs.
  Another young woman who was in her early twenties who had been in and

[[Page 2449]]

out of the Manchester jail--the Valley Street jail--said: You know, 
they don't provide treatment in the Valley Street jail. I learned when 
I got picked up that I don't tell them that I have a drug problem or 
that I have mental health issues because if I do, they put me in the 
bubble where I get observed 24 hours a day, regardless of what I am 
doing. What I need is treatment. I don't need to be in the bubble.
  Well, that is why this supplemental amendment would increase 
resources for treatment and recovery--because the answer is treatment. 
Our amendment includes $300 million for the Substance Abuse Prevention 
and Treatment Block Grant Program. This program is the premier Federal 
initiative to boost State and local resources for prevention, 
treatment, and recovery support. In 21 States this block grant program 
represents at least 75 percent of the State agency's substance abuse 
prevention budget. In some States, sadly, it is the only funding for 
substance abuse prevention. If we are going to get a handle on this 
problem, we are going to have to provide some additional resources for 
the treatment that these programs need. This funding will result in an 
immediate increase in the number of addicted individuals who will 
receive lifesaving treatment. It will also save taxpayer dollars in the 
future, just as I heard from that young man at Headrest, who said it is 
cheaper to provide treatment than to build prisons. He is absolutely 
right.
  The National Institute on Drug Abuse estimates that for every dollar 
spent on substance use disorder treatment programs there is a $4 to $7 
reduction in the cost of drug-related crime. An outpatient treatment 
program can result in savings that exceed costs by a factor of 12 to 1.
  I live in Stratford County in New Hampshire. It has used the modest 
funding from this block grant program, the Substance Abuse Prevention 
and Treatment Block Grant Program, to accomplish important things, 
including expanding the peer-based addiction recovery efforts and 
working at schools to engage at-risk students in the middle school 
years. If we can prevent addiction, that is obviously the best thing we 
can do.
  Unfortunately, many prevention and treatment efforts in Stratford 
County remain chronically underfunded. I recently learned about one 
local woman, a mother and waitress, who overdosed in front of her 2-
year-old child. Fortunately, she received inpatient treatment, and now 
she is doing well. Others have not been so lucky. Like cities and 
counties all across America, Stratford has a months-long waiting list 
for those needing treatment. When people with substance use disorders 
are turned away, they remain on the streets--desperate, often 
committing crimes to support their addiction, always at constant risk 
of a lethal overdose.
  Vice News in New Hampshire recently profiled the opioid epidemic. The 
reporter interviewed one desperate user who said this:

       I tried to get help and stop, but at the treatment center 
     they said I would have to wait 3 months. I had to go to the 
     hospital and tell them I was going to kill myself just to get 
     admitted.

  That should not happen in America.
  Another critical tool in the effort to stem the tide of this crisis 
is prescription drug monitoring programs. These State-run programs 
collect, monitor, and analyze electronically transmitted prescribing 
and dispensing data submitted by pharmacies and dispensing 
practitioners. We know that monitoring works. We have the data to show 
that it works, but only half of the 50 States are receiving Federal 
support.
  The emergency supplemental amendment would include $50 million for 
the CDC to expand and bolster State drug monitoring programs. Our 
amendment also allocates $10 million to improve access in high-risk 
communities to medication-assisted treatment services for heroin and 
prescription opioids because numerous studies have shown the 
effectiveness in including medication in the treatment of some 
individuals with substance use disorders. Medications like methadone, 
buprenorphine, and naltrexone have been shown to reduce opioid use.
  Our supplemental spending amendment would also speed emergency 
resources to law enforcement agencies. This Senator has heard from 
police in New Hampshire. They can't solve this problem by putting 
people in jail. They can help to solve it by putting traffickers in 
jail and by breaking up those networks that are supplying drugs.
  In recent years, the opioid epidemic has spread to small towns and 
rural areas in every part of the country. If we went back to that first 
map of the United States, we could see just how much the spread has 
been to rural parts of this country. Heroin traffickers in New York 
expressly target New Hampshire, Vermont, and Maine--all States with a 
large rural population. We don't have any real urban areas in our 
States, but we can see the spread of those drugs in northern New 
England.
  This amendment will provide $230 million in emergency funding for 
Edward Byrne Memorial Justice Assistance Grants, and $10 million for 
COPS Anti-Heroin Task Force Grants. The Byrne JAG Grant Program is the 
Nation's cornerstone crimefighting program. It has proved its 
effectiveness in each of our States, which is why it enjoys such strong 
bipartisan support. But the program has suffered cuts. In New 
Hampshire, we received $1.7 million in Byrne funding in 2007. Last year 
we received less than $1 million--almost a 50-percent reduction.
  I had the chance to travel with Senator Hoeven down to our southern 
border of Texas last spring because we both are on the Appropriations 
Subcommittee on Homeland Security. We talked with some of our Customs 
and Border Patrol employees who were down on the border in Laredo and 
were interdicting drugs down on our southern border. One of the things 
they talked about is that drugs are coming across our southern border 
and they are going up the Interstate Highway System. They are going up 
Interstate 95 to northern New Hampshire. They are going up Interstate 
35 through the middle of the country. We have to provide law 
enforcement with the funds they need to interdict those traffickers. We 
need an infusion of new funding to mobilize so that the programs are 
more aggressive for stopping opioid traffickers and dealers.
  Our amendment requires that Byrne JAG funds be used directly to 
combat the opioid crisis for this emergency funding. That will allow 
for programs that emphasize treatment over incarceration, such as drug 
courts.
  In New Hampshire we have seen what a difference it can make to have 
well-resourced, ambitious law enforcement initiatives. From May to 
December of last year, the High Intensity Drug Trafficking Areas Task 
Force, or the HIDTA Task Force, based in Bedford, NH, carried out 
Operation Trident. They draw on Federal, State, and local law 
enforcement resources in New Hampshire and Massachusetts. It makes 
sense because the more we cooperate, the more we can respond.
  Operation Trident resulted in 240 arrests. They took down four major 
heroin fentanyl trafficking organizations. They dismantled three 
processing mills, and they seized more than $1.2 million in assets. 
What we have to do is continue to recreate these successes all across 
the country by moving aggressively to take down the gangs and other 
trafficking organizations that are feeding the opioid epidemic. To do 
that we have to provide the resources.
  This emergency funding amendment doesn't create any new programs. 
Instead, we fund proven and effective initiatives like Byrne JAG and 
the substance abuse preventive and treatment block grants. These 
initiatives have earned bipartisan support because Senators have seen 
the good work it has done in each of our States. By allocating these 
emergency resources to these proven programs, this amendment will 
provide law enforcement and treatment professionals with the resources 
they need to go on the offensive to mobilize a real war on opioid 
trafficking and addiction.
  Perhaps most importantly, our emergency supplemental funding 
amendment funds the programs that are included in the CARA bill. I want 
to thank Senator Whitehouse and other

[[Page 2450]]

drafters of CARA, who have made important statutory steps and 
programmatic changes to improve programs that help treat addiction.
  But CARA, as important as it is, is an authorization bill that 
doesn't provide any funding. If we support making the changes in the 
law that are included in the CARA bill, then we should also support the 
funding needed to make these programs work.
  This chart shows a quote from the National Governors Association. 
Recently, they came together and they endorsed emergency appropriations 
to address this crisis. They wrote:
       Governors applaud the introduction of legislation that 
     would provide emergency assistance to states working on the 
     front lines of the opioid crisis. . . . [I]nvestment is 
     needed to help states mount an effective response to opioid 
     addiction, from increasing prevention and education regarding 
     the dangers of illicit drugs to strengthening state 
     prescription drug monitoring programs, expanding access to 
     addiction treatment and enhancing support for law 
     enforcement.

  The Fraternal Order of Police has endorsed this amendment, saying:

       This bill will help our State and local law enforcement 
     officers by giving them the necessary funding and tools to 
     battle their communities' heroin and opioid problems. 
     Something needs to be done.

  Mr. President, I ask unanimous consent to have printed in the Record 
the support letter from the Fraternal Order of Police.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                          National Fraternal Order


                                                    of Police,

                                Washington, DC, February 29, 2016.
     Hon. Jeanne Shaheen,
     U.S. Senate,
     Washington, DC.
       Dear Senator Shaheen: I am writing on behalf of the members 
     of the Fraternal Order of Police to advise you of our support 
     for your bill S. 2423, the ``Opioid and Heroin Epidemic 
     Emergency Supplemental Appropriations Act.'' This legislation 
     will make available $210 million to help law enforcement 
     fight the heroin and opioid epidemic that is destroying our 
     communities.
       This bill will help our State and local law enforcement 
     officers by giving them the necessary funding and tools to 
     battle their communities' heroin and opioid problems. This 
     funding will be used for expenses relating to drug treatment 
     and enforcement programs, law enforcement programing, and 
     drug addiction prevention and education programs. Something 
     needs to be done and Congress is correct to provide law 
     enforcement with the resources we need to combat this 
     epidemic.
       On behalf of more than 330,000 members of the Fraternal 
     Order of Police, I thank you for your continued leadership 
     and support of law enforcement. I look forward to working 
     with you and your staff to get this bill through Congress to 
     put an end to the heroin and opioid epidemic. If I can be of 
     any additional assistance, please do not hesitate to contact 
     me or my Executive Director Jim Pasco at my Washington 
     office.
           Sincerely,
                                                 Chuck Canterbury,
                                               National President.

  Mrs. SHAHEEN. We have also received support from groups such as the 
American Academy of Pain Management; the American Public Health 
Association; the American Society of Addiction Medicine; the 
Association of Women's Health, Obstetric and Neonatal Nurses; the 
Partnership for Drug-Free Kids; the American College of Physicians; and 
the National Association of State Alcohol and Drug Abuse Directors.
  Mr. President, I ask unanimous consent to have printed in the Record 
the list of groups.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

     Emergency Supplemental for Heroin and Opioid Abuse Supporting 
                             Organizations

       Fraternal Order of Police, American Academy of Pain 
     Management, American College of Physicians, American College 
     of Sports Medicine, American Osteopathic Association, 
     American Public Health Association, American Society of 
     Addiction Medicine, Association of Women's Health, Obstetric 
     and Neonatal Nurses, College on Problems of Drug Dependence, 
     Community Anti-Drug Coalitions of America.
       Connecticut Certification Board, Friends of NIDA, IC & RC, 
     Illinois Alcoholism and Drug Dependence Association, 
     California Consortium of Addiction Programs and 
     Professionals, National Association of State Alcohol and Drug 
     Abuse Directors, Partnership for Drug-Free Kids, Physician 
     Assistant Education Association, SAI, Trust for America's 
     Health.


               National Governor's Association Statement

       Provide emergency supplemental funding to help states and 
     communities turn the tide on the opioid epidemic. Governors 
     applaud the introduction of legislation that would provide 
     emergency assistance to states working on the front lines of 
     the opioid crisis. Congress has provided billions in 
     emergency aid to address natural disasters, security threats 
     and other crises, including more than $5 billion last year to 
     combat Ebola at home and abroad. A similar investment is 
     needed to help states mount an effective response to opioid 
     addiction, from increasing prevention and education regarding 
     the dangers of illicit drugs to strengthening state 
     prescription drug monitoring programs (PDMPs), expanding 
     access to addiction treatment and enhancing support for law 
     enforcement.

  Mrs. SHAHEEN. The question is, Why do we need emergency funding? Some 
of my colleagues have argued that additional funds are not needed 
because there was enough money for the opioid crisis in last year's 
omnibus. Yes, it is true there is additional funding for these programs 
in the omnibus. I sit on the Appropriations Committee; I was one of 
many on that committee who worked very hard to fight for those dollars. 
But with spending caps in place, these increases are modest at best.
  The majority of my supplemental amendment appropriates resources to 
two programs: The Substance Abuse Prevention and Treatment Block Grant 
and The Byrne JAG Program. These programs have been critically 
underfunded in recent years. For example, the substance abuse 
prevention and treatment block grant received a small increase in the 
omnibus. That was good, but the reality is that over the last 10 years, 
funding for this program has not kept up with health care inflation. So 
we have a 26-percent decrease in the real value of funding despite the 
small increase we got in the appropriations process. In order to 
restore the block grant to its purchasing power from 10 years ago--10 
years ago, before we had the explosion of the opioid and heroin 
crisis--just to get back to that level, Congress would need to allocate 
an additional $483 million for fiscal year 2017. My amendment provides 
$300 million for this program. It is a downpayment--only a 
downpayment--on where we need to be. The Byrne JAG Program has been 
flat-funded for the last 3 years.
  Fifteen years ago--again, before the explosion of the heroin and 
opioid crisis--Congress provided more than $1 billion in support to 
State and local law enforcement through Byrne JAG and block grant 
funding. By 2015 that number had been reduced to $376 million. Right 
now, despite the explosion in this heroin and opioid crisis, we are 
providing only about one-third of the support we provided 15 years ago.
  The reality is that criminal justice and prevention and treatment 
have been chronically underfunded and, as a result, deaths have 
continued to rise.
  The PRESIDING OFFICER. The Senator has consumed 27 minutes.
  Mrs. SHAHEEN. Thank you, Mr. President. I should be finished shortly.
  We have talked to the Department of Justice and to Health and Human 
Services, and they are ready to get this funding out the door 
immediately because there is no time to wait. Law enforcement and 
health care providers on the frontlines need this money, and they need 
this money now.
  In the past, Congress has risen to the challenge of epidemics. In 
2009, Congress appropriated nearly $2 billion in emergency funding to 
fight swine flu, which claimed the lives of about 12,000 Americans. 
That emergency appropriations bill passed the Senate 86 to 3. Mr. 
President, 51 Senators who voted for that bill are still serving in 
this Chamber, including 23 Republican Senators and every Member of the 
Republican leadership. Last year, Congress approved $5.4 billion in 
funding to combat the Ebola outbreak in West Africa, an outbreak that 
killed only one American. Surely we can come together now, this year, 
in this session, to fight a raging epidemic here at home. We cannot 
avert our eyes from 47,000 Americans who are being killed by lethal 
overdoses each year. We cannot accept that 9 out of 10 Americans with 
substance abuse disorders go without treatment. We cannot avoid the 
fact

[[Page 2451]]

that law enforcement officers in communities across this country are 
overwhelmed by aggressive drug traffickers and a rising tide of opioid-
related crimes.
  CARA will help fight the heroin and opioid epidemic in the longer 
term, but I urge my colleagues to also support this emergency 
supplemental funding amendment because it will provide urgent emergency 
funding to ramp up this fight in the months immediately ahead. This is 
a nationwide crisis, and it is time we mobilize a nationwide response 
that is equal to the challenge.
  I urge my colleagues, I urge the majority leader to allow a vote on 
my amendment and to pass this out so we can give our local communities 
and States the resources they need.
  I yield the floor.
  Mr. President, I suggest the absence of a quorum.
  The bill clerk proceeded to call the roll.
  Mr. LANKFORD. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. LANKFORD. Mr. President, I ask unanimous consent that the Senate 
recess as under the previous order.

                          ____________________