[Congressional Record (Bound Edition), Volume 162 (2016), Part 2]
[Senate]
[Pages 2777-2787]
[From the U.S. Government Publishing Office, www.gpo.gov]




            COMPREHENSIVE ADDICTION AND RECOVERY ACT OF 2015

  The ACTING PRESIDENT pro tempore. Under the previous order, the 
Senate will resume consideration of S. 524, which the clerk will 
report.
  The bill clerk read as follows:

       A bill (S. 524) to authorize the Attorney General to award 
     grants to address the national epidemics of prescription 
     opioid abuse and heroin use.

  Pending:

       Grassley amendment No. 3378, in the nature of a substitute.
       Grassley (for Donnelly/Capito) modified amendment No. 3374 
     (to amendment No. 3378), to provide follow-up services to 
     individuals who have received opioid overdose reversal drugs.

  Mr. CORNYN. I suggest the absence of a quorum.
  The ACTING PRESIDENT pro tempore. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. MARKEY. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. MARKEY. Madam President, before I begin, as we discuss the 
Comprehensive Addiction and Recovery Act, I would like to take a moment 
to thank Senator Whitehouse for his role in developing the bill and 
bringing it this far. I also convey my gratitude to Minority Leader 
Reid and the ranking member of the Judiciary Committee, Senator Leahy, 
for their excellent staffs and for urging that my amendments--which I 
will address momentarily--be a part of the discussion and for managing 
the negotiations on this bill. I also thank Senator Murray, the ranking 
member of the HELP Committee, for help and counsel on amendments.
  Let us pause for a moment and consider the causes of the prescription 
opioid and heroin epidemic gripping our country. Understanding the 
causes will help us focus on the right solutions. Three distinct 
parties bear much of the blame for this public health crisis.
  First, there is Big Pharma. In the mid-1990s, the seeds of this 
epidemic were planted with the aggressive, misleading, and ultimately 
criminal marketing of the powerful opioid painkiller, OxyContin by 
Purdue Pharma. Perdue claimed OxyContin was not addictive and couldn't 
be abused. Neither of those claims turned out to be true. Purdue Pharma 
built a massive marketing and sales program for OxyContin. From 1996 to 
2000, Purdue

[[Page 2778]]

Pharma's sales force more than doubled from more than 300 sales 
representatives to almost 700 sales representatives. In 2001 alone, 
Purdue gave out $40 million in bonuses to its burgeoning sales force. 
As a result of these sales and marketing efforts, from 1997 to 2002, 
OxyContin prescriptions increased almost tenfold, from 670,000 in 1997 
to 6.2 million in 2002.
  Purdue's marketing of OxyContin broke the law. In 2007, Purdue Pharma 
paid $600 million in fines and other payments after pleading guilty in 
Federal court to misleading regulators, doctors, and patients about the 
risks of addiction to OxyContin and its potential for abuse.
  Second, Purdue Pharma's criminal wrongdoing did not occur in a 
vacuum. The Federal Government helped to enable this epidemic. The 
Federal Drug Enforcement Administration is responsible for approving 
the annual production quotas for pharmaceutical companies to 
manufacture oxycodone, the principal ingredient in OxyContin. From 1996 
to 2016, the Drug Enforcement Administration obliged Big Pharma and 
increased by almost 150 percent the amount of oxycodone authorized for 
manufacture. In 1996, the DEA authorized U.S. pharmaceutical companies 
to make the equivalent of 6 billion 10-milligram OxyContin pills. By 
2016, that figure had increased to almost 14 billion 10-milligram 
pills. That is right. Today the Drug Enforcement Administration is 
telling Big Pharma it is OK to make 14 billion OxyContin pills to sell 
in the United States in 1 year.
  The Federal Food and Drug Administration was also complicit, 
approving new opioid after new opioid. In the process, the FDA, charged 
with ensuring the safety of all prescription drugs on the U.S. market, 
began turning a blind eye to outside experts who were warning of the 
dangers these drugs posed.
  In 2013, an expert panel established to review the powerful new 
opioid painkiller Zohydro, voted 11 to 2 against recommending its 
approval, but the FDA approved the drug anyway, overruling the concerns 
voiced by experienced physicians on the panel.
  In 2014, in the wake of the Zohydro decision, the FDA twice skipped 
the advisory committee process altogether when it approved two new 
prescription opioids.
  Then, in August of 2015, the FDA did it again. This time it bypassed 
an advisory committee of outside experts on the question of a new use 
for OxyContin for children aged 11 to 16. The FDA even ignored its own 
rules that specifically call for advisory committee advice when a 
committee of pediatric dosing is involved. It was clear that the FDA 
was intentionally choosing to forgo advisory committees in order to 
avoid another overwhelming Zohydro-like vote, recommending against 
approval of a prescription opioid and in order to avoid any impediments 
to new opioids being sold in the United States.
  Finally, the medical profession must bear its fair share of 
responsibility for this crisis. Doctors are prescribing opioids at an 
alarming rate. In 2012, America's doctors wrote 259 million 
prescriptions for opioid pain relievers, enough pills for every single 
American adult to have a bottle of opioid pills given to them in the 
year 2012.
  And America's doctors are dangerously uninformed about the drugs they 
are prescribing. A recent survey of 1,000 physicians nationwide found 
that ``only two-thirds correctly reported that the most common route of 
abuse was swallowing pills whole.'' It is unconscionable that our 
doctors are so ill-informed. Nearly half of the doctors surveyed also 
erroneously reported that so-called abuse-deterrent formulations of 
opioids were less addictive than their counterparts. Abuse-deterrent 
opioids are supposed to be harder to crush, so they are harder to snort 
or to mix with liquid and inject, but abuse-deterrent formulations of 
opioids are just as addictive as non-abuse-deterrent opioids. Whether 
an opioid is abuse-deterrent or not hasn't prevented tens of thousands 
of people who have had their wisdom teeth removed or experienced lower 
back pain from getting addicted to these painkillers simply by 
swallowing them.
  So what is the result of the combination of Big Pharma's marketing of 
prescription opioids, the Federal Government's repeatedly approving 
them in ever-increasing numbers, and our doctors writing millions of 
prescriptions for them? Today, the United States is less than 5 percent 
of the world's population but we consume 80 percent of the world's 
opioid painkillers. We have become the United States of Oxy.
  When prescriptions run out or the price of Oxy pills on the street 
become too high for those who have become addicted, they turn to 
cheaper heroin, which shares the same molecular structure as OxyContin. 
Eighty percent of the people suffering from heroin addiction started 
with opioid pain medications approved by the FDA and prescribed by 
doctors.
  In 2014, nearly 33,000 people died of an opioid overdose in this 
country. Almost 1,300 of those deaths were in my home State of 
Massachusetts.
  I had hoped to offer amendments to CARA to address both the causes of 
this epidemic and to provide treatment for those suffering from the 
results. One of my amendments would have required the FDA to convene 
advisory committees for all prescription opioid approval questions.
  After I placed a hold on the nomination of Dr. Robert Califf to serve 
as FDA Commissioner, the agency announced it would only commit to 
convene advisory committees for non-abuse-deterrent opioids. The FDA 
refused to agree to convene advisory committees to inform all of its 
opioid-approval decisions.
  We need legislation requiring the FDA to seek expert advice about the 
risk of addiction before it approves any and all opioids, and I will 
continue to fight to require advisory committees at the FDA.
  We also need legislation requiring doctors to get and stay educated 
about the dangers of the pills they are prescribing in record numbers. 
Stopping the overprescription of opioid painkillers is a critical step.
  We need to ensure that all prescribers of these opioid painkillers 
are educated in the dangers of these drugs, how easily individuals can 
become addicted, and when and how to appropriately prescribe. The 
doctors say that they do not want education to be mandated, that it 
should be voluntary. Well, the FDA has had voluntary education for 
opioid prescribers in place since 2013 and has been actively 
encouraging doctors to take these voluntary education programs, but in 
more than 2 years, only 12 percent of prescribers have actually 
completed FDA's voluntary education program.
  It is imperative that any provider who is applying for a Federal DEA 
license to prescribe opioids have completed mandatory education on the 
basics of opioid prescribing and the inherent risk of addiction. My 
amendment would have done just that. It would have required basic 
education as a condition of a DEA license to prescribe these 
painkillers, and I will continue to fight to require prescriber 
education.
  Finally, we need to remove the barriers to effective treatment, 
including outdated Federal restrictions on medication-assisted 
therapies such as Suboxone. Medication-assisted therapy for opioid 
addiction is cost effective, decreases overdose deaths, and reduces 
transmission of HIV and hepatitis C. Unlike other treatment regimens 
for any other disease, physicians are severely limited in the number of 
patients they can treat with medication-assisted therapies such as 
Suboxone, contributing to long wait-lists and an inability of patients 
to get treatment for their addiction when they need it. Of 
approximately 2.5 million Americans who abused or were dependent on 
opioids, fewer than 1 million received treatment for their condition, 
partly because of the already existing Federal instructions.
  Senator Rand Paul of Kentucky and I have a bipartisan bill, the 
Recovery Enhancement for Addiction Treatment Act, or TREAT Act, which 
has broad stakeholder support, including the American Medical 
Association and nurse practitioners. It emphasizes quality of care and 
closes this gaping

[[Page 2779]]

hole in our addiction treatment system. We had hoped to offer TREAT as 
an amendment to CARA. We will continue to fight for it and are hopeful 
the HELP Committee will include it in the substance abuse legislation 
the committee will soon consider.
  My collaboration with Senator Paul shows that whether it is the 
Commonwealth of Massachusetts or the Commonwealth of Kentucky, this 
crisis is the same. It doesn't discriminate by geography, by age, by 
race, by socioeconomic status, or by employment. It requires a 
bipartisan effort.
  Thirty years ago, Nancy Reagan told us to just say no to drugs. Today 
we have to go further. We have to say enough is enough. We have to 
recognize what has worked and what hasn't worked. In the past, we 
believed we could incarcerate our way out of the problem. That did not 
work. So instead of ignoring and incarcerating, let's avow and act. 
Let's destigmatize, not criminalize. Let's treat, not retreat. Let's 
have a comprehensive plan which we put in place that deals with the 
pharmaceutical companies, the physicians, and the kinds of treatment 
patients need across our country so that they get the help they need. 
That is our job.
  I continue to believe we can do this in a bipartisan fashion as long 
as we understand the magnitude of the problem and what the causes of it 
were and continue to be and will be into the future unless and until we 
put these safeguards in place. So I am looking forward to continuing to 
work with my colleagues on the other side of the aisle. I compliment 
them for the work they have done so far in bringing this bill to the 
floor of the Senate this week, but I do believe there is more to be 
done.
  As long as this many Americans are addicted, as long as this much 
OxyContin and opioids are put into our system, then we are going to 
find that this heroin epidemic we have in our country, which is 
directly related, will continue to spiral out of control.
  I want to work with all my colleagues. I thank my colleagues for all 
the work they have done so far, but there is much work to be done in 
the future.
  Madam President, I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Alabama.
  Mr. SESSIONS. Madam President, I would like to talk for a few minutes 
about the crime problem we have in America today, the dramatically 
increasing problem of heroin abuse. Over the last week, we have had a 
lot of discussion about this crisis, which I am afraid we are just on 
the cusp of. I think it is going to get worse, based on my experience 
and my best judgment, but the effort to understand and address it has 
been going on for a while.
  In January, we had a good hearing on this issue in the Senate 
Judiciary Committee, and I want to mention a few things I think we 
ought to keep in mind as we address this very important problem.
  Just as background, I served 15 years as a prosecutor, 12 as a U.S. 
attorney, a Federal prosecutor, and 2\1/2\ as an assistant U.S. 
attorney. So that was my background when I came here. I was very active 
and studied the drug and crime problem in America, and I learned some 
things.
  There are cycles in this, and people wrote about it over the years. I 
think we are, unfortunately, moving into another cycle, and we have to 
be very careful. It is so painful to have a large prison population. We 
don't want to have that. Year after year, everybody wants to look for 
alternatives to prison, and we have tried, but if you go too far, you 
end up not having sufficient consequences for crime, not detaining 
dangerous offenders, and you end up increasing crime, increasing deaths 
of Americans from murders and other things, increasing heroin and 
serious drug problems that destroy families, destroy lives, destroy 
communities, and result in violence and death. It is a very real 
problem.
  A lot of people think, well, if you want to use heroin, so be it. 
Well, these people can't function. How are they going to survive? They 
either steal or they get on welfare or they have to go to treatment. 
And who pays for it, since they do not have any money?
  We have proven and seen for decades that drug use can be brought 
down, fewer people can become addicted. In the early 1980s, Nancy 
Reagan, as President Reagan's wonderful wife, formed the ``Just Say 
No'' program, and hundreds of thousands of volunteers nationwide in 
every community in America got together in their communities--they got 
the treatment community, the law enforcement community, the prevention 
community, the education community, and the schools--and they worked 
and worked and crafted policies that would create a climate of 
hostility for the use of dangerous drugs. The idea was to bring down 
the use. As a result, the use of illegal drugs dropped by half. It took 
us 15 or more years, but it dropped by half steadily. What a tremendous 
victory.
  In 1980, half of our high school seniors admitted they had used an 
illegal drug sometime in that year. What an unbelievable number. It had 
been going up steadily, it peaked, and then it began to go down under 
this sustained effort.
  What I have been worried about for some time, and have warned about 
it, is that if you don't maintain that but start going in the other 
direction, you can expect drug use to increase. It is that simple. And 
it is happening. Lives--and young people's lives--will be destroyed by 
this, families will break up, and children will be scarred.
  Drug use is no fun, innocent thing. It is destructive. If this Nation 
is using half as much illegal drugs as before, it is a better nation. 
It just is. And if we double the amount of drug use in America, it will 
be a more dangerous Nation and not as good a nation.
  According to the Centers for Disease Control and Prevention, over 
47,000 people died from drug overdoses in the United States in 2014. In 
2014, 47,000 died. That is one drug overdose death for every 12 
minutes. And 61 percent of those overdoses involved opioids. The rate 
of all opioid overdoses in the United States has tripled since 2000. 
Overdoses have tripled since 2000.
  Heroin overdose deaths specifically have increased sixfold since 
2001--600 percent--and have more than tripled in just the past 4 years 
alone. According to the National Survey on Drug Use and Health, there 
were approximately 169,000 new heroin users in 2013.
  According to the Substance Abuse and Mental Health Services 
Administration, in 2004, approximately 589,000 people in the United 
States had an opioid use disorder. We used to call that addiction--a 
problem. It is affecting their lives.
  The Drug Enforcement Administration's 2015 National Drug Threat 
Assessment noted that ``drug overdose deaths have become the leading 
cause of injury death in the United States, ahead of motor vehicle 
deaths and firearms.''
  This is a significant matter. As DEA Acting Administrator Chuck 
Rosenberg, a bright, young mind appointed by President Obama, noted 
last July that ``[a]pproximately 120 people die each day in the United 
States of a drug overdose.''
  Some argue that the increase in heroin abuse is due to over-
prescription of opioids from prescription drugs--you get addicted from 
a prescription drug, and then you move to heroin. I am sure that has 
some validity, but according to a January 14, 2016, study published in 
the New England Journal of Medicine, one of the premier authoritative 
medical journals in the world:

       In the majority of studies, the increase in the rates of 
     heroin use preceded the change in prescription-opioid 
     policies, and there is no consistent evidence of an 
     association between the implementation of policies related to 
     prescription opioids and increases in the rates of heroin use 
     or deaths, although the data are relatively sparse. 
     Alternatively, heroin market forces--

  Please hear this, colleagues--

       Alternatively, heroin market forces, including increased 
     accessibility, reduced price, and high purity of heroin 
     appear to be major drivers of the recent increases in rates 
     of heroin use.

  So it is purity, price, and accessibility. While treatment and 
accountability are critical to breaking the cycle of addiction, it is 
not the whole solution. We must also reduce the availability of 
heroin--we simply have to do that--and other illicit opioids.

[[Page 2780]]

  In December of last year, the Centers for Disease Control and 
Prevention Director Tom Frieden said it is important ``that law 
enforcement''--a lot of people don't want to talk about this. We have 
police officers, sheriffs' deputies, Federal agents, drug enforcement 
agents, and Border Patrol agents. He said it is important ``that law 
enforcement intensify efforts to reduce the availability of heroin, 
illegal fentanyl, and other illegal opioids.'' Similarly, Drug 
Enforcement Administration Acting Administrator Rosenberg said in the 
DEA's National Drug Threat Assessment that, in addition to providing 
treatment to addicted opioid abusers, ``law enforcement must continue 
to have the tools it needs to attack criminal groups who facilitate 
drug addiction.''
  I have been there. I was part of law enforcement's efforts. I 
invested a tremendous amount of my time in the Coalition for a Drug 
Free Mobile, the Partnership for Youth, Bay Area Drug Council--groups 
like that--working on a volunteer basis to change the use of drugs in 
the community. Law enforcement was always a critical part of it, and 
law enforcement does have the capability in ways that others don't to 
reduce the availability, make purity levels less, and otherwise 
restrict, raising the price of an illegal drug. The DEA's 2015 National 
Drug Threat Assessment confirms this. They studied the price of the 
drugs. One thing that tells us whether or not law enforcement and 
interdiction are effective is to discover if the price is going up or 
down.
  Mexican drug cartels are flooding the United States with cheap heroin 
and methamphetamine. When I was a young prosecutor, it was coming from 
Turkey, the Middle East, and that was pretty much shut off. President 
Carter did some good things. I was an Assistant U.S. Attorney and came 
back a few years later as a U.S. Attorney, but during that time they 
somehow reduced the supply of heroin from the Middle East. As a result, 
heroin addiction dropped all over the country, and very little heroin 
was in the heartland of America--mainly just in the big cities.
  We are also getting cheap methamphetamine from across the Mexican 
border, which is wide open. The statistics from the DEA Drug Threat 
Assessment confirm that, from 2010 to 2014, the amount of heroin seized 
every year at the southwest border has more than doubled. Well, are we 
catching that much more? No, we are not catching, I am sure, any 
substantially larger percentage. We are just having a larger amount 
moving across the border. The price has fallen, so we know we have 
more. If prices stay low, more people will try it more often, and as 
the purity level is higher, more people will get addicted sooner and 
often die quicker.
  These drug cartels are partnering with criminal gangs and fueling 
violence in our cities and communities. According to DEA's 2015 Threat 
Assessment, Mexican drug cartels ``control drug trafficking across the 
Southwest Border and are moving to expand their presence in the United 
States, particularly in heroin markets.'' They import, transport, and 
are now actually selling it in our cities instead of just bringing it 
in across the border.
  In 2013, the heads of the Chicago Crime Commission and the Chicago 
Office of the Drug Enforcement Administration both named El Chapo 
Guzman, the infamous leader of the Sinaloa Cartel, as Chicago's 
``Public Enemy #1.'' So a man in Mexico, moving heroin and 
methamphetamine into the United States and hammering Chicago with it--
Chicago named him as their No. 1 public enemy. It cannot be a 
coincidence, as the FBI's uniform crime statistics show, that the 
murder rate in Chicago increased by approximately 18 percent during the 
first 6 months of 2015. At that rate, it is a 36 percent increase in 
murders in Chicago in 1 year. This is an unbelievably dramatic surge in 
murders.
  Another example is Atlanta. DEA's Atlanta office reported an increase 
of heroin availability from a rating of ``stable'' in the first half of 
2013 to ``high'' just a year later. According to the FBI's uniform 
crime statistics, the murder rate in Atlanta increased by approximately 
15 percent in the first 6 months of 2015. This is an unsustainable 
thing. The old rule is a 7-percent increase and your money doubles in 
10 years. When you get 15- and 18-percent increases in 6 months--that's 
30 percent in 1 year--you are doubling the crime rate, the murder rate, 
in 3 years.
  At a November hearing of the Senate Caucus on International Narcotics 
Control, I asked DEA Deputy Administrator Jack Riley about these drug 
distribution networks and the people in local communities pushing the 
drugs, selling the drugs, and collecting the money. This money 
eventually ends up back in Mexico, Colombia, and South and Central 
America, funding the evil, violent drug cartels that are destabilizing 
whole nations. He responded that it is ``almost as big a problem as the 
cartels themselves.''
  When I asked him whether these drug traffickers are the ones causing 
the violence and death on our streets, he responded that ``they are the 
ones that regulate themselves by the barrel of a gun.'' If you want to 
collect a drug debt, you can't file a lawsuit in Federal court. You 
collect it by the barrel of a gun.
  By its very nature, drug distribution networks are violent criminals. 
It has always been so, and it will always be so. Conducting an illegal 
enterprise, they have to maintain discipline, and they use threats and 
violence to maintain it and collect their debts. We must not forget 
what became obvious in the early 1980s, when I was a U.S. Attorney: 
Drug dealers and their organizations are not nonviolent criminals. 
These are violent crimes.
  Rather than enforcing the law and making it tougher on drug cartels 
by keeping our border secure, the Obama administration has done exactly 
the opposite. Our unsecured borders make it easy for the cartels to 
flood our country with cheap heroin, and the administration has made it 
clear that officers are not to deviate from the President's lawless 
immigration policy. They are blocked from doing their job and following 
their oath.
  Just last week--and as someone who has worked closely with Federal 
Drug Enforcement officers and immigration officers as a Federal 
prosecutor--Customs and Border Protection Commissioner Gil Kerlikowske 
testified before the House Committee on Appropriations that ``if you 
don't want to follow the directions of your superiors, including the 
president of the United States and the commissioner of Customs and 
Border Protection, then you really do need to look for another job.''
  Do you hear what he is saying there, colleagues? What he is saying is 
that if you want to do your job and enforce the laws as the laws are 
written, which we have ordered you not to do, and you go on and do it 
anyway, then look for another job. It is one of the most amazing things 
I have seen in my entire law enforcement career. ICE officers--
Immigration and Customs Enforcement officers--who enforce drug laws, 
along with immigration laws, these officers sued their supervisors. 
They sued their supervisors, alleging that they were being ordered to 
violate their oath to enforce the immigration laws of the United States 
by these restrictive policies.
  It is hard to overestimate the destruction the Obama administration's 
policies--their Executive amnesty, their refusal to sufficiently fund 
and man the border--are causing to law enforcement. A big part of this 
now is the openness to heroin, methamphetamine, marijuana, and other 
drugs that are being imported. I take that statement by the 
Commissioner of Customs and Border Protection as a direct threat to 
those officers who want to follow their oath and do their duty.
  In August 2013, a dramatic event occurred that was too little 
appreciated. Attorney General Holder, the Attorney General of the 
United States, ordered Federal prosecutors not to charge certain drug 
offenders with offenses that carry mandatory minimum sentences that are 
in law. If you have so much drugs, you have a minimum penalty. You can 
get more than that, but you at least have to serve this minimum 
penalty. He ordered them not to charge

[[Page 2781]]

those crimes. This is directing prosecutors not to follow the law. It 
has contributed to a decrease in the number of traffickers being 
prosecuted and convicted. According to data from the Executive Office 
for United States Attorneys, at the end of 2015--in December--the 6-
month average of drug prosecutions was down 21 percent compared to 5 
years ago. And what are we seeing? A surge in crime, particularly 
drugs. Excluding prosecutions in magistrate courts, the 6-month average 
was nearly 32 percent lower at the end of 2015 than 5 years ago. We 
haven't cut the number of drug prosecutors. We haven't cut the number 
of DEA agents. This is policy that softens the enforcement of drug 
crimes against what we have been doing for 25 years, and it is having 
an impact. I am afraid it is going to continue.
  Meanwhile, State and local law enforcement agencies are not given the 
tools they need to continue taking these dangerous drug traffickers off 
of the streets.
  On December 21, 2015, the Department of Justice chose to stop all 
equitable sharing payments to State, local, and tribal partners under 
the Asset Forfeiture Program. These are seized proceeds, moneys that 
are seized from drug dealers, big fancy cars and boats that they seize. 
For the last 20 years, Federal and State officers worked together. The 
Federal Government has a good system for forfeiting the money. Then, 
when the forfeiture is over, it is divided among the agencies. As a 
result, State and local people are willing to commit law officers to 
participate in these local task forces because they are helping clean 
up drugs in their community, helping identify and prosecute nationally 
significant drug dealers, and they get some compensation back from it 
when they find a truck full of money.
  I personally have seen cases where $1 million, $500,000, $800,000 in 
cash was seized from these people. Some people think, oh, this is 
wrong; you shouldn't take their cash. This is the ill-gotten gain of an 
illegal enterprise and they should be able to keep it? They have no 
proof of any lawful source of this money. Virtually every time, in 
addition, there is evidence to prove it is connected to drugs. Half the 
time, they don't even show up to contest the seizure because they know 
they have no defense to it. This stops this sharing, and it is 
undermining the unity of effort that we really need to be successful.
  A joint letter signed by the International Association of Chiefs of 
Police, the National Association of Police Organizations, the Major 
County Sheriffs' Association, the National Sheriffs' Association, the 
National District Attorneys Association, and the Major Cities Chiefs 
Association, pointed out that ``the suspension of equitable sharing 
payments may cause some agencies across the country to reconsider their 
ability to participate in joint task forces with the Federal 
Government.''
  In other words, they are going to stop participating.
  ``The effects of this decision are far reaching and not only a 
disservice to law enforcement, but also to the public they are sworn to 
protect.''
  Mr. President, if there is a limit on my time or others are waiting 
to speak, I will wrap up. Otherwise, I have about 5 minutes to wrap up. 
I see my colleague Senator Leahy, the ranking member of the Judiciary 
Committee. I don't want to block him. If my time is up, I will yield 
the floor.
  The PRESIDING OFFICER (Mr. Coats). There is no time limit in place.
  Mr. SESSIONS. While law enforcement resources are being cut off, law 
enforcement officers are being blocked from doing their jobs, and drug 
prosecutions are being reduced, the administration and some in Congress 
want to push and advance a criminal justice ``reform'' bill. But these 
proposals will have a tendency, I am afraid, to worsen the current 
problem by allowing for more reductions in sentences than are already 
occurring and early release of thousands of dangerous drug traffickers, 
and the weakening of penalties for those prosecuted under our drug 
trafficking laws, which have already been weakened--sending the wrong 
message at exactly the wrong time.
  I am very concerned about this. I love my colleagues, and I know 
their hearts are in the right place, but I am convinced we should not 
be heading in this direction at this time.
  Make no mistake, Federal prisons are not filled with low-level, 
nonviolent drug possessors. According to the Bureau of Justice 
Statistics, 99.7 percent of drug offenders in Federal prison at the end 
of fiscal year 2012 were convicted of drug trafficking offenses, not 
drug possession. Drug trafficking is inherently violent activity, and 
it only serves to fund the drug cartels while fueling violence in our 
cities.
  According to the FBI, violent crime overall increased across the 
United States during the first half of 2015, by 6.2 percent for murders 
and 17 percent in the larger cities for murder--the largest single-year 
increase since at least 1960. Already this year, homicides in Chicago 
are double what they were all of last year.
  This is a complex subject. It is too soon to know the total reason 
for this increase, but it cannot go unnoticed that over the last decade 
the Sentencing Commission, which sets standards for sentencing in the 
United States--outside of the minimum mandatories that are set by our 
law passed by Congress--has unilaterally imposed reductions in the 
sentences for drug inmates currently in prison. So we reduced the 
sentences for those in prison and they are getting out earlier. The 
most recent reduction in sentences resulted in the release of more than 
46,000 drug traffickers--not drug possessors, drug traffickers--which 
has been wholeheartedly supported by the Obama administration.
  According to Bureau of Justice Statistics, 77 percent of drug 
offenders released were rearrested within 5 years. Hear this now: 77 
percent of these drug offenders were rearrested within 5 years, with 25 
percent of those rearrested being rearrested for a violent crime--
somebody hurt, maybe dead. Maybe that is part of the murder rate 
increase.
  Take Wendell Callahan, a Federal drug felon who was convicted of 
trafficking in crack cocaine and released early pursuant to the 
Sentencing Commission's directives. Upon his early release, he 
proceeded to brutally murder his ex-girlfriend and her two little 
girls, 7 and 10. He would have been deep into a 12\1/2\-year Federal 
sentence if it had been maintained, but the Sentencing Commission 
reduced it. The judge granted his petition for early release because of 
his ``good behavior'' in prison, and that led the judge to conclude he 
did not pose a danger to the safety of the public, even though in his 
background--when he was convicted and got the 12 years, he had 
previously been convicted in connection with a shooting offense and 
another drug offense. This is why you have to have some controls on 
judges. I have been there, and I saw it before the sentencing 
guidelines were passed.
  The Federal prison population is at its lowest level since 2008. We 
are already on a downward course of the drug Federal prison population 
being reduced. There are only 160,000 inmates in Bureau of Prisons 
custody today, well below its peak. The Bureau of Prisons has stated 
that this ``downward population trend is expected to continue into 
Fiscal Year 2017,'' bringing the Federal prisons population to the 
lowest level since 2005.
  The population is up. Crime is going up. The prison population is 
falling rather rapidly. Admissions to Federal prison have declined 
every year since 2011.
  You hear: We are filling our prisons. We are doing more and more.
  Actually, there are other things that are already happening. It is 
happening in State prisons, too, where larger numbers are incarcerated 
than in the Federal prisons. One of the reasons we are having this 
large decline in State prisons is not public safety but tight budgets. 
They are cutting back on the prison population to save money.
  We can be smarter. Some people can be released early. I worked with 
my Democratic colleague, Senator Durbin, 6 years ago, I believe, and we 
reduced the crack penalties more significantly than a lot of people 
know. I thought

[[Page 2782]]

that was justified. But we are now proceeding well beyond that, and it 
is causing me great concern.
  The Attorney General has ordered the prosecutors to not charge 
certain criminal offenses. Reducing sentences and releasing felons is 
equivalent to reducing the cost to the criminal enterprise of their 
criminal activity. It reduces the cost, the risk. Thus, crime--it is 
already rising--would further increase as a result of the criminal 
justice ``reform'' bill that would further reduce penalties.
  Can we take a breath, and let's think about this? I don't say there 
aren't some things we can do that will allow for some reduction in the 
Federal prison population. Some people probably serve more time than is 
absolutely necessary. But in truth, we have seen dramatic improvements 
over nearly 30 years, 25 years, in the reduction of crime. Until this 
surge, murder rates were less than half what they were in 1980 when I 
became a Federal prosecutor. Drug use dropped dramatically when Nancy 
Reagan started the ``Just Say No'' program, and drug use began to 
steadily decrease. It is now beginning to steadily increase.
  You have to have leadership from Washington. You can't have the 
President of the United States of America talking about marijuana like 
it is no different than taking a drink, saying I used marijuana when I 
was in high school and it is no different than smoking.
  It is different. And you are sending a message to young people that 
there is no danger in this process. It is false that marijuana use 
doesn't lead people to more drug use. It is already causing a 
disturbance in the States that have made it legal. I think we need to 
be careful about this.
  What if this is the beginning of another surge in drug use like we 
saw in the sixties and seventies that led to massive problems in our 
communities? The solution? Well, we have to control the border. All the 
heroin and a big chunk of the methamphetamine is coming across the 
Mexican border. We need barriers. We need more agents. People need to 
be arrested. They need to be deported. They don't get to be taken to 
some city in the United States they would like to go to and get 
released and asked to show up on bail, which they never do. That is an 
open invitation to illegality and illegal entry.
  We need to enforce our laws, and we have to make the consequences of 
drug trafficking a deterrent. We can do this. We have done it before, 
and it is all part and parcel with prevention programs, education 
programs, and treatment programs. All that has to be done, but it 
cannot be denied, in my opinion, that law enforcement plays a critical 
role in it. This means supporting, not blocking the efforts of law 
enforcement to do their jobs and giving them the tools to arrest drug 
traffickers and be effective at the border, putting them in jail, not 
giving them early release so they can commit more crimes.
  In January, a woman from Ohio named Tonda DaRe testified before the 
Senate Judiciary Committee at a hearing on the heroin and prescription 
opioid epidemic. She shared the powerful story of her daughter, who 
died from a heroin overdose. She said this:

       One of the things that I see happening in our little town 
     that frustrates me is . . . our officers have worked so 
     diligently to arrest people that they know are bringing this 
     [heroin] in. Just [to] have them go in front of our judges 
     and our judges just slapped these people on the wrist and 
     sent them right back out the door. . . . The boy that sold my 
     daughter the heroin that killed her just recently went back 
     in front of a judge for his fourth offense for trafficking 
     heroin. [It was the] fourth time he's been arrested for this 
     and he was given five months. How [is] that possible?

  We can talk about making sure we have treatment and recovery for 
people who have been addicted, although many people never ever recover 
from addiction--except by the grave. That is the sad truth. We should 
make that a priority. But we cannot hope to solve these problems by 
only treating people on the back end of addiction without reducing the 
availability of those drugs and keeping the purity down and the cost 
up, not continuing to fall. We have to stop people from becoming 
addicts in the first place, and we can't let the fact that we have a 
heroin abuse epidemic cause us to forget that we have a drug 
trafficking epidemic too.
  Law enforcement is prevention. Experts tell us that the price, 
purity, and availability of drugs, especially heroin, fuels more 
consumption, more addiction, more crime, more death, and more human and 
family destruction. I wish it were not true. I wish there were more 
options, but law enforcement is a central part of this effort, and 
history proves it.
  I thank the Chair and yield the floor.
  The PRESIDING OFFICER. The Senator from Vermont.


                   51st Anniversary of Bloody Sunday

  Mr. LEAHY. Mr. President, today is the 51st anniversary of Bloody 
Sunday--a horrible abuse of American citizens that occurred in Selma, 
AL. Each year we commemorate the events of that fateful day, because it 
helped transform our Nation and proved to be a catalyst for the passage 
of the Voting Rights Act. For the last two years, this commemoration 
has been a sad reminder of what five justices did to that cornerstone 
civil rights law. In Shelby County v. Holder a narrow majority of the 
Court drove a stake through the heart of the Voting Rights Act when it 
struck down the coverage formula for its preclearance provision in 
Section 5.
  I mentioned that because under section 5 of the Voting Rights Act, 
the Federal Government has the authority to examine and prevent 
racially discriminatory voting changes from going into effect before 
those changes disenfranchise voters in covered jurisdictions. By 
striking down the coverage formula that determined which States and 
jurisdictions were subject to Federal review, the Court rendered 
Section 5 unenforceable.
  Unfortunately, even though almost every single Republican and 
Democrat in the House and Senate voted for the Voting Rights Act, the 
Supreme Court, by a 1-vote margin--notwithstanding that 535 of us had 
voted--drove a stake through the heart of the Voting Rights Act by 
striking down the coverage formula for its preclearance provisions in 
Section 5.
  Since then Republican Governors and State legislatures have exploited 
Shelby County by enacting sweeping voter suppression laws that 
disproportionately prevent or discourage black Americans from voting. 
This includes the State of Alabama, which not only enacted a burdensome 
photo identification law after the decision, but then they made it even 
harder for many of its black citizens to obtain identification when the 
State closed more than 30 DMV offices in mostly poor, minority 
neighborhoods last October.
  It is hard to fathom that in 2016, well over 100 years after the 
Civil War and passage of the 13th, 14th, and 15th Amendments to the 
Constitution, and after transformative moments, such as Bloody Sunday, 
that States would continue to pass laws and take actions that would 
undermine black Americans' rights to vote.
  This past weekend, Congresswoman Terri Sewell, who represents the 7th 
District of Alabama--which includes Shelby County, Birmingham, and 
Selma--held a public forum in Birmingham to examine the harm caused by 
the Supreme Court's Shelby County decision. Several witnesses at that 
forum testified that the State had made it harder for their citizens to 
vote, and that a disproportionate number of those citizens were 
minorities. They also spoke about the urgent need to restore the 
protections of the Voting Rights Act. Congressman John Lewis, our great 
civil rights hero, was in attendance, and it is heartbreaking to 
realize that so many of the gains that he was able to help secure 
through his civil rights activism are being undone today.
  Despite the compelling testimony about the urgent need for Congress 
to address voting rights, most Republicans in Congress continue to 
disregard the urgency of this issue. More than two and a half years 
since the Shelby County decision, and despite the introduction of two 
separate bipartisan bills that would restore the protections of the 
Voting Rights Act, the Republican chairs of the Judiciary

[[Page 2783]]

Committee from both houses of Congress refuse to even hold a hearing on 
this issue. Instead, Republican leaders have only paid lip service to 
the issue, supporting the award of congressional medals for brave civil 
rights leaders. That is not enough.
  Recently, the Speaker of the House stated that he was supportive of 
one of the bipartisan voting rights restoration bills. In the same 
statement he explained that nothing could be done because the 
Republican chair of the House Judiciary Committee refuses to take up 
the bill or to have a hearing. This is not leadership. The American 
people expect more than talk.
  This pattern of Republican obstruction reached unprecedented heights 
recently when a few Senate Republicans declared that they would not 
even hold a hearing for the next Supreme Court nominee even before the 
President has even announced a nominee.
  Republicans have apparently decided that rather than be transparent 
and hold public hearings and votes on the most significant issues of 
the day--including voting rights, comprehensive immigration reform, and 
the next Supreme Court nominee--they would simply shut down the 
process. Instead they are making important and timely decisions 
affecting hundreds of millions of Americans behind closed doors. It is 
not good for our democracy and it is not good for the American people.
  We need hearings and a vote on the voting rights bills. And we need a 
hearing and a vote on the next Supreme Court nominee. We remember what 
came to be known as Bloody Sunday because the blood that was shed led 
to greater democratic participation and a more inclusive union. What 
Republicans are doing now undermines the hard-fought legacy of Bloody 
Sunday and the Civil Rights Movement. For the good of the Nation, I 
urge that Republican leaders in the Senate and the House change that 
shameful course.
  Mr. President, the Senate will soon vote to bring us one step closer 
to passage of the Comprehensive Addiction and Recovery Act or CARA. 
Last week I suggested that we stay in session and do our job on 
Thursday, Friday, and Saturday so we could finish the bill, but I 
understand the Republican leadership wanted to take a long weekend, so 
we did not finish it, but now we can.
  I am a cosponsor of this bill because it addresses the growing 
problem of prescription opioid and heroin addiction that has had 
devastating impacts on communities all over the country, including my 
home State of Vermont.
  This bill represents an important shift in the way we approach the 
issue of substance abuse and addiction. It sets a comprehensive 
framework to reduce opioid deaths, prevent addiction, and improve 
treatment. It will also help those who suffer from opioid use disorders 
achieve recovery, and perhaps most importantly this bill reflects the 
consensus of this body that the Nation cannot arrest or jail its way 
out of this addiction problem.
  Since my first field hearing in Rutland, VT, on this topic in 2008, I 
have been inspired by how my fellow Vermonters across the political 
spectrum have shaped the discussion about this public health crisis and 
how they have served as a model for communities across the Nation.
  I certainly feel this bill represents important progress, but we 
cannot be satisfied with just passing this one bill. We also need a 
significant commitment of targeted funding so we can carry out and 
implement the programs authorized by this bill.
  It is one thing to say we are going to authorize these great programs 
even though we are not going to pay for them, but don't you feel good 
that we authorized them. Now we can all go home and tell our 
constituents we care. We authorized it, but we will not pay for it.
  At least Senator Shaheen stood and proposed an amendment that would 
have provided emergency funding to do just that. Her vital amendment 
had the support of a majority in this body, but Republican Senators 
blocked it from being considered and adopted. It is unfortunate because 
Senator Shaheen's amendment would have provided the resources to 
strengthen both the law enforcement and public health components that 
would have delivered the necessary resources to health care 
professionals all over the country who are overwhelmed by a need they 
cannot meet.
  I believe there is bipartisan agreement that we have to stop the loss 
of life caused by opioid abuse. There should be a bipartisan agreement 
to provide the money necessary to do so.
  There is an opportunity to make the bill better. Many Members have 
filed amendments to improve CARA. A number of amendments were filed by 
both Republicans and Democrats. Unfortunately, the Republican leader 
has not allowed us to have an open amendment process, and contrary to 
what he said earlier, a number of Senators have been blocked from 
offering their amendments. I tried to work--and did in a bipartisan way 
with Senators Grassley, Whitehouse, and Klobuchar--to consider this 
bill and report it to the Senate floor. We have continued our 
bipartisan effort to reach agreement on a number of amendments that 
could improve the bill. I hope those important bipartisan efforts will 
continue this week so we can consider these amendments and have final 
passage this week.
  Let us have an open process. These amendments can be voted on up or 
down or adopted by consent. It is one thing for us to talk about what 
we want to do, it is another thing to have the courage to vote for it. 
If we do not vote for it, we are just voting maybe. Let us vote yes or 
no.
  As we work toward Senate passage of CARA, our goal should be to make 
this the best bill possible. Addiction is nothing less than an epidemic 
and CARA treats it like one. This bill demonstrates that Congress now 
sees addiction for what it is--a public health crisis all over our 
country. We need to equip our communities with both the programs and 
resources they need to get ahead of addiction.
  CARA will save lives. It is worth putting the money in there to make 
sure it works.
  Mr. President, I see the distinguished senior Senator from West 
Virginia on the floor, and I yield the floor.
  The PRESIDING OFFICER. The Senator from West Virginia.
  Mr. MANCHIN. Mr. President, I ask unanimous consent to speak for up 
to 10 minutes.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Mr. MANCHIN. Mr. President, I wish to thank the senior Senator from 
Vermont, who is a dear friend of mine. As he knows, this is a problem. 
It is an epidemic all over this country. No State is immune from it. It 
doesn't matter whether you are a Democrat or Republican. It has no 
home. It attacks and literally eradicates all of us, and it causes 
extreme hardships for all the families.
  I know the Presiding Officer, who is from Indiana, is aware of this 
problem. Every week I have come to the floor to read letters from 
people who have been affected by addiction in West Virginia and other 
States. I have a letter from the Presiding Officer's home State of 
Indiana, and I have a letter from my State too.
  This is something we have been fighting. The CARA Act is a bipartisan 
piece of legislation. It is not going to be a cure-all, but it starts 
in the right direction for us to start looking at opioid addiction and 
prescription drug abuse, not as much as we have in the past as a crime 
but as an illness, and an illness needs to have treatment. I think we 
are moving in that direction. Politically we are accepting this, and we 
are going to basically meet that need of treatment which is so few and 
far between.
  We have 51 people dying every day. In my little, beautiful State of 
West Virginia, just last year we lost over 600 lives to prescription 
drug abuse, and I have a State with less than 2 million people. From 
1999 to 2013 there has been an increase of over 700 percent.
  This is a product which has come on the market that is greater than 
anything we have ever seen. We hope the FDA gets serious about this. 
They are hearing us loud and clear. Dr. Califf was not someone whom I 
supported. I

[[Page 2784]]

am very hopeful he will do a great job, and I will support him. He 
needs to step up to the plate and change the culture of the FDA. The 
reason I say that is because the FDA has to take their role seriously 
and not just approve drugs because it meets a certain criteria but also 
needs to realize the impact it has on the well-being of the families 
who have been addicted and affected. They need to consider the 
devastating public health impacts of its repeated decisions to approve 
all of these drugs that don't need to be on the market. We are very 
hopeful for that.
  The thing that brings that to mind is that it took us forever to get 
Vicodin and Lortab from a schedule III to a schedule II. It took us 
over 3 years. Once we did, it took about 1 billion pills off the 
market, which resulted in a 22-percent decrease in Vicodin and Lortab, 
which were being passed out like M&Ms. We know it can save lives. Yet 
they came right back with Zohydro, which was against the wishes of 
their advisory committee.
  We believe it is imperative that they have an advisory committee for 
every opioid they want to bring to the market. They must listen to the 
advisory committee. If the FDA--the Commissioner and his staff--wishes 
to go ahead and put a product on the market that is recommended not to 
be on the market from their advisory committee, they should come before 
us in Congress and tell us why they believe this potent drug such as 
Zohydro is needed when it is against the recommendations of these 
experts and specialists.
  We have been flooded with these stories. I will read a story from the 
Presiding Officer's State of Indiana first.
  The girl's name is Danielle. She says: I live in Southern Indiana and 
work as a server. About 2\1/2\ years ago a customer by the name of Josh 
Harvey left me his number. At the time, he told me he was living in 
Chicago for school. Little did I know he was in rehab there. Granted, I 
didn't know about his addiction for over a year because we hadn't 
stayed in constant contact. About a year or so ago I found out about 
his heroin addiction. He still told me little about it. I do know it 
started out with prescription pills and later went into heroin when the 
pills became harder to get. He served a month in jail in Michigan, for 
the entire month of this past July, over a heroin-related charge. He 
came home immediately after and overdosed that same weekend. Luckily, 
his dad saved him that time. Now he got enrolled in college and was 
going to an outpatient program doing better--or so we all thought. 
School let out for break and I guess it all went downhill. He came to 
me on November 4 telling me he had used a couple of times and wanted my 
advice. I suggested an inpatient program. He went to Wellstone after he 
left my house, sat for several hours and finally was given a room. I 
went and checked on him two different times while he waited to make 
sure he was there. Thursday I didn't receive any calls. Friday nothing 
either. Then, Saturday morning, the 7th of November, his mother called 
me to break my heart. He had passed away that Friday the 6th over in 
Louisville and they didn't know who to contact until that Saturday 
morning, I guess. He had checked himself out of Wellstone, broke into 
his house, and took his Xbox, which he later either pawned or traded 
for heroin. Never in a million years did I think I would become close 
to anybody addicted to heroin. It doesn't discriminate. It can get a 
hold of anyone and everybody. Never in my life have I been so depressed 
or heartbroken. All I want is his story shared. He was my happy ending 
gone way too soon.
  That was from our friend in Indiana who wanted to share her story 
with us.
  Let me tell you about Amanda, who lives in West Virginia.
  Amanda said: I walked into our new apartment. Although we had only 
spent 2 nights there, it already felt like home. I was so excited to 
move in with Nate. We had been on the fence between being best friends 
and a couple, and making the decision to move in together had finally 
settled years of uncertainty. As I turned the corner, I was surprised 
to see that he was in the exact same position as when I had left for my 
morning classes. I knew it had been a rough night of ``partying,'' but 
I thought he would be up to start our busy day of painting and moving. 
I touched his chest to feel the rise and fall, something that, as a 
mother, I had been doing to sleeping children for years. There was 
movement. He was breathing. I breathed a quick sigh of relief. I walked 
to the back of the apartment to set down my things, and that is when I 
realized I needed to go and get some things from my old apartment, and 
I started to leave. My hand was on the doorknob, but something stopped 
me in my tracks. To this day, I don't know why I turned around. I laid 
down beside Nate, and I put my arm on his chest. He was not breathing, 
and when I looked up at his face, his eyes were wide open, but it was 
obvious that he was not there. The paramedics revived him to the point 
that he survived in a coma for 1 week. At one point while in the 
hospital, his eyes opened, and I thought that our nightmare was over, 
but it was just a muscle reflex and false hope. On January 30, 2007, 
prescription drugs took the life of Nathan Keith Dunn, age 24.
  Tall, dark, and handsome is what the world saw. Intelligent, funny, 
witty, loving, and kind were the qualities seen by those who knew Nate 
best. He was my best friend, my musical soulmate, and my sounding 
board. We were inseparable, and I began to experience an ache in my 
heart that, 9 years later, still occasionally brings me to my knees. 
But that is just who Nate was to me. He was also the older son of a 
mother who had left years of abuse at the hands of her husband in order 
to find a better life for her sons. He was the brother to--and the only 
soft spot of--a boy who had been hardened growing up on the streets of 
a town outside of Houston, TX. It seemed as if the only thing that ever 
kept him grounded was Nate's love. They had one another's back in the 
best and worst of times. Nate was also the instant crush of any girl 
who ever laid her eyes upon him. He was the best friend of anyone who 
knew him. I often wonder who and where he would be today. But I guess I 
will just have to wonder forever.
  I wish this was the end of my story about how prescription drugs have 
affected my life, but it is not even close to the end. For longer than 
I care to admit, drugs have been part of my everyday life. Shortly 
after Nate's death, I became addicted to prescription opiates. At 
first, they were prescribed by my doctor. Eventually, I couldn't get 
through a day without them. I was what is sometimes referred to as a 
``functioning addict,'' although it is fair to say that such a thing 
does not exist. To the outside world, I appeared to be fine, normal 
even. I held a job. I cared for my young sons. I kept a tidy home. 
Meanwhile, my tolerance was building, and I began to require more and 
more of the drugs just to feel normal, just to get through each day. 
Can you imagine living this life in which you wake up each day 
wondering if you have enough of the drug you need just to be OK for 
that day?
  So many people are facing this every single day. It could be the 
person sitting next to you. It could be your child's teacher. Even 
worse, it could be your own child.
  The first thing to suffer was my financial situation. Every dime I 
had was spent on the drugs that would allow me to function today, 
tomorrow, and if I am lucky, the next. Then, my relationships with 
friends and family began to fail. It was painfully obvious that I was 
stealing from them. Next, I couldn't keep a job--a record that will 
haunt me for the rest of my life. How could I go to work? How could I 
continue on?
  Then, a catalyst walked into my life. I met a very good man. As we 
became closer, I realized that I couldn't bring myself to tell him that 
I was a drug addict.
  This is a silent killer. Nobody speaks; they all keep it very quiet.
  Mr. President, if I may have about 1 minute to finish up, I would 
appreciate it.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.

[[Page 2785]]


  Mr. MANCHIN. Thank you, Mr. President.
  Very few people know what is actually happening in your life. In 
order to get help, you have to be willing to openly talk about your 
issues, and most of us fear being harshly judged--and rightfully so.
  Trying to treat a person with addiction issues by using medication 
only or therapy only is like trying to extinguish a raging house fire 
with a garden hose.
  She said: I was fortunate enough to have found a medication-based 
treatment program in my area, which is paid for by my insurance.
  She is going to move forward, and she wanted this story to be told. 
She said she wanted people to know how difficult it is.
  What we need to know as policymakers is how hard it is for people in 
our States who realize they need help and can't find it.
  So what I ask all of us to do--this CARA bill is a step in the right 
direction. It is a piece of legislation that is much needed. As we move 
forward today on this piece of legislation, I hope we will find 
basically the support that people are needing to fight this opiate 
addiction.
  Thank you, Mr. President.
  I yield the floor.


                             Cloture Motion

  The PRESIDING OFFICER. Pursuant to rule XXII, the Chair lays before 
the Senate the pending cloture motion, which the clerk will state.
  The legislative clerk read as follows:

                             Cloture Motion

       We, the undersigned Senators, in accordance with the 
     provisions of rule XXII of the Standing Rules of the Senate, 
     do hereby move to bring to a close debate on Senate amendment 
     No. 3378, the substitute amendment to S. 524, a bill to 
     authorize the Attorney General to award grants to address the 
     national epidemics of prescription opioid abuse and heroin 
     use.
         Mitch McConnell, Chuck Grassley, Deb Fischer, John 
           Barrasso, Shelley Moore Capito, Roy Blunt, Johnny 
           Isakson, John Boozman, Mike Crapo, David Vitter, Mike 
           Rounds, Bill Cassidy, James E. Risch, Lindsey Graham, 
           John McCain, Thom Tillis, Orrin G. Hatch.

  The PRESIDING OFFICER. By unanimous consent, the mandatory quorum 
call has been waived.
  The question is, Is it the sense of the Senate that debate on 
amendment No. 3378, as amended, offered by the Senator from Iowa, Mr. 
Grassley, to S. 524, shall be brought to a close?
  The yeas and nays are mandatory under the rule.
  The clerk will call the roll.
  The legislative clerk called the roll.
  Mr. CORNYN. The following Senators are necessarily absent: the 
Senator from Texas (Mr. Cruz), the Senator from Alaska (Ms. Murkowski), 
the Senator from Florida (Mr. Rubio), the Senator from Pennsylvania 
(Mr. Toomey), and the Senator from Louisiana (Mr. Vitter).
  Further, if present and voting, the Senator from Pennsylvania (Mr. 
Toomey) would have voted ``yea.''
  Mr. DURBIN. I announce that the Senator from California (Mrs. Boxer), 
the Senator from Delaware (Mr. Carper), the Senator from Missouri (Mrs. 
McCaskill), the Senator from Maryland (Ms. Mikulski), the Senator from 
Florida (Mr. Nelson), and the Senator from Vermont (Mr. Sanders) are 
necessarily absent.
  The PRESIDING OFFICER (Mr. Lankford). Are there any other Senators in 
the Chamber desiring to vote?
  The yeas and nays resulted--yeas 86, nays 3, as follows:

                      [Rollcall Vote No. 32 Leg.]

                                YEAS--86

     Alexander
     Ayotte
     Baldwin
     Barrasso
     Bennet
     Blumenthal
     Blunt
     Booker
     Boozman
     Brown
     Burr
     Cantwell
     Capito
     Cardin
     Casey
     Cassidy
     Coats
     Cochran
     Collins
     Coons
     Corker
     Cornyn
     Cotton
     Crapo
     Daines
     Donnelly
     Durbin
     Enzi
     Ernst
     Feinstein
     Fischer
     Flake
     Franken
     Gardner
     Gillibrand
     Graham
     Grassley
     Hatch
     Heinrich
     Heitkamp
     Heller
     Hirono
     Hoeven
     Inhofe
     Isakson
     Johnson
     Kaine
     King
     Kirk
     Klobuchar
     Lankford
     Leahy
     Manchin
     McCain
     McConnell
     Menendez
     Merkley
     Moran
     Murphy
     Murray
     Paul
     Perdue
     Peters
     Portman
     Reed
     Reid
     Risch
     Roberts
     Rounds
     Schatz
     Schumer
     Scott
     Sessions
     Shaheen
     Shelby
     Stabenow
     Sullivan
     Tester
     Thune
     Tillis
     Udall
     Warner
     Warren
     Whitehouse
     Wicker
     Wyden

                                NAYS--3

     Lee
     Markey
     Sasse

                             NOT VOTING--11

     Boxer
     Carper
     Cruz
     McCaskill
     Mikulski
     Murkowski
     Nelson
     Rubio
     Sanders
     Toomey
     Vitter
  The PRESIDING OFFICER. On this vote, the yeas are 86, the nays are 3.
  Three-fifths of the Senators duly chosen and sworn having voted in 
the affirmative, the motion is agreed to.
  The Senator from Ohio.
  Mr. PORTMAN. Mr. President, that is good news. The Presiding Officer 
just announced the results of the vote, and that is good news because 
it means the Senate has just taken another step toward the passage of 
CARA, the Comprehensive Addiction and Recovery Act.
  I see my colleague Senator Whitehouse is on the floor. I thank him 
and thank my colleagues on both sides of the aisle for moving forward 
on this legislation that will help us to save friends, family members, 
our neighbors, and communities that are struggling with addiction.
  This is a very important opportunity for us to be able to move 
forward on legislation that is comprehensive, that is bipartisan, and 
that has a companion bill on the House side, so there is a very good 
chance we could get this to the President's desk. It is the only 
bipartisan legislation that is comprehensive and evidence based, and it 
is critical we move forward with it.
  In addition to Senator Whitehouse, I also thank Senator Ayotte, 
Senator Klobuchar, and 42 bipartisan cosponsors for their support.
  Frankly, more important to me is the support around the country this 
legislation has. I think Senator Whitehouse and I now have over 130 
groups around the country that are supporting this legislation. This 
includes doctors, nurses, health care professionals, also law 
enforcement, people who are in the trenches dealing every day with 
treatment and recovery, and those who are focused on prevention and how 
to ensure people cannot just be treated for addiction but try to keep 
people out of the funnel of addiction.
  We started working on this legislation about 3 years ago. We started 
by hearing from experts around the country. We had five conferences in 
Washington where we looked at all the issues, including criminal 
justice, women and addiction, the science of addiction, youth 
prevention, recovery issues, substance abuse impacting our veterans--a 
number of issues that enabled us to write legislation that actually 
makes sense, that will make a difference in our communities. These 130 
groups around the country are focused on getting this bill passed 
because they know it is going to make a difference in our communities.
  If enacted, this will help States and communities develop and 
implement these evidence-based practices that we have looked at from 
around the country. It expands prevention and educational efforts to 
prevent prescription opioid abuse and the use of heroin and increases 
drug disposal sites to keep medications out of the hands of youth.
  It also authorizes law enforcement task forces to combat heroin and 
methamphetamine and expands the availability of the overdose reversal 
drugs such as naloxone, which are miracle drugs. It provides not just 
naloxone but also more training to our law enforcement officials, to 
firefighters, and to other emergency responders.
  In the criminal justice system, CARA will help promptly identify and 
treat individuals suffering from substance abuse and expand diversion 
and education efforts to give individuals a second chance. Frankly, it 
is going to help to get people into treatment rather than going into 
the criminal justice system. Locking up people hasn't worked. If people 
are being arrested for possession alone, for using, this legislation 
will help to divert those people into the treatment to get them back on 
their feet.

[[Page 2786]]

  CARA also authorizes resources to expand treatment in general, 
including medication-assisted treatment--again based on the research 
that has been done around the country.
  It allows veterans who were discharged for a substance abuse disorder 
to use drug courts as they recover. So it provides actual grants to 
these veterans treatment courts. They are doing a terrific job. I have 
toured these in Ohio and talked to some of these veterans who have been 
through these programs. Again, it helps get our veterans back on the 
right track. Rather than ending in jail, they end up in a treatment 
program with other veterans helping them and supporting them, where 
they can begin to deal with their addiction and mental health issues.
  CARA supports recovery programs, including those focused on youth and 
building communities of recovery. This happens now at our colleges and 
universities increasingly. We want to support that. It also creates a 
task force on recovery to improve ways to address the collateral 
consequences imposed by addiction.
  One of the most important aspects of this legislation expands drug 
treatment for pregnant women who struggle with addiction and provides 
support for babies born with neonatal abstinence syndrome, babies who 
are born with addiction.
  Recently, my wife Jane and I visited Rainbow Babies and Children's 
Hospital in Cleveland, OH. We toured the neonatal unit. If you haven't 
done this, it will break your heart because you will find there an 
increasing number of babies who are born, again, with this addiction, 
the neonatal abstinence syndrome. Unfortunately, when you look at what 
has happened in Ohio, we have had a 750-percent increase in the number 
of babies who are diagnosed with this neonatal abstinence syndrome just 
since 2004--a 750-percent increase. I am told in some of our States now 
10 percent of the babies are being born addicted.
  I have also been at other hospitals around our State, including 
Cincinnati Children's Hospital Medical Center and St. Rita's Special 
Care Nursery in Lima, OH. Last week my wife went to Nationwide 
Children's Hospital in Columbus. Every single one of these children's 
hospitals is experiencing the same thing. What I have learned from 
these incredibly compassionate nurses and doctors who take these 
newborns through a withdrawal process is that the numbers of babies who 
have been exposed to heroin or prescription drugs continue to grow. The 
problem is getting worse, not better. These hospitals serve as yet 
another reminder that addiction is a disease. It is a disease that has 
to be treated like other diseases, and it is a disease that can impact 
anyone.
  It is wonderful that these caring nurses, doctors, and others are 
working to try to ensure that these babies become healthy. We don't 
know what the long-term consequences are, but we need to do more to 
avoid the addiction in the first place and better treat it when it 
occurs, and that is what this legislation does. Specifically, the 
measure takes steps to help women and babies by expanding treatment for 
expectant and postpartum women and authorizing the Department of Health 
and Human Services to award grants to ensure that these women have 
access to evidence-based treatment services. That is in this 
legislation. It also reauthorizes residential treatment programs for 
pregnant and postpartum women struggling with addiction.
  There is a great center in Columbus, OH, called Amethyst. I had the 
opportunity to visit it. It is a treatment center, and the average 
length of stay there is almost 2 years. Their results are unbelievable. 
They allow women to come with their babies, with their children, to go 
through treatment together. So there is hope. There are treatment 
centers doing a great job. We want to hold those up and encourage more 
of that around the country.
  Finally, the legislation also creates a pilot program for State 
substance abuse agencies that allows funds to be used to target women 
who are addicted to opioids and provide family-based services to those 
women in nonresidential settings. So it helps on the residential side 
but also with the nonresidential outpatient side.
  Helping these women and helping these babies is just one aspect of 
this bill, but it is a very critical one. As we work to turn the tide 
in the struggle against addiction, it is one on which we should all be 
focused.
  The good news is that the bipartisan momentum we have seen here 
tonight is building. I think the Senate is ready to move on this 
legislation this week. There are other amendments that have been filed. 
The deadline was today. I hope we will have the opportunity to go 
through some more amendments, as we did last week, but meanwhile, we 
have strong support and strong momentum, as we saw tonight, on both 
sides of the aisle. Both Republican and Democratic leaders have lined 
up to support this legislation. We need to pass this bill and get it 
signed into law so it can begin to make a real difference in the lives 
of people we represent.
  As the heroin epidemic in Ohio and around the country has reached 
crisis level, I look forward to working with my colleagues to get this 
bill over the finish line here in the Senate and then get it passed in 
the House, where there is companion legislation, and then on to the 
President's desk and enable this Congress to play a role as a better 
partner with State and local governments and with our nonprofits around 
this country to address this growing heroin epidemic around our entire 
country.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Ohio.


                         Miners Protection Act

  Mr. BROWN. Mr. President, last week I met with Rita Lewis of 
Westchester, OH, in southwest Ohio. She was here to testify in front of 
the Senate Committee on Finance in honor of her late husband Butch.
  Butch worked as a trucker for 40 years with the promise that the 
pension he earned would be there to care for his family after he 
retired.
  I would also add that Butch had been drafted by the Pittsburgh 
Pirates to play baseball some 45 years ago. Instead, he enlisted to go 
into the U.S. Army and on to Vietnam. He was injured and could never 
play baseball again competitively. He came back and became a trucker 
and joined the Teamsters.
  As I said, he worked as a trucker for 40 years with the promise that 
the pension he earned would be there to care for his family after he 
retired. But for Butch and Rita and thousands more Ohio retirees, that 
promise is under threat. Truckers and mine workers in Ohio and across 
the country are facing crippling cuts to the benefits they have earned.
  The Multiemployer Pension Reform Act that Congress passed 2 years ago 
allows pension trustees to propose massive cuts to the earned benefits 
of retirees when a plan is running low on funds. This is disgraceful. 
If a pension fund is in bad shape, it is our job to fix it, not break 
promises to American workers who have worked their whole lives to earn 
that pension. I believed that 2 years ago when I voted against that law 
which allowed these proposed cuts, and I believe it more strongly now. 
That is why I am calling on the Treasury Department to reject and to 
reject immediately the proposed cuts to the Central States Teamsters' 
pension. I am calling for us to immediately mark up and pass the Miners 
Protection Act, which will protect the benefits Ohio workers earned 
over a lifetime of work.
  Under MEPRA, the bill I talked about a moment ago, multiemployer 
pension trustees such as Central States are now able to propose massive 
cuts to the earned benefits of participants and retirees if the plans 
are in ``critical and declining status.'' Pension trustees for plans in 
``critical and declining status'' may submit an application for 
proposed benefit cuts to the U.S. Treasury Department.
  The Central States pension plan trustees used the authority of MEPRA 
to propose cuts of as much as 70 percent, but in their own application, 
they admit that even with these drastic cuts, their plan--get this--
still only has a 50.4-percent chance of remaining

[[Page 2787]]

solvent. In other words, they are asking Treasury to approve massive, 
life-shattering cuts to hundreds of thousands of workers for what 
amounts to a coin flip. Treasury should immediately reject this 
application.
  Put yourself--this is something we don't do well around here--put 
yourself in the place of a worker who has planned for her retirement 
with her family. She expected a $2,000-a-month pension on top of $1,200 
a month in Social Security, and she all of a sudden finds out her 
pension is cut 30, 40, 50, 60, 70 percent. That was the money she 
planned to live on. She has some savings, but all that was calculated 
because it was a promise from this pension plan to honor that 
commitment of decades earlier.
  As I said, Treasury should immediately reject this application.
  The mine workers' pension plan and the others are too far gone to use 
MEPRA. The United Mine Workers of America's 1974 pension plan covers 
100,000 mine workers, including thousands of miners in eastern and 
southern Ohio. It was almost completely funded before the financial 
collapse of 7 years ago brought on by Wall Street overreach and greed, 
but the plan was devastated by the recession. It has too few assets, 
too few employers, and too few union workers paying in. If Congress 
fails to act, thousands of retired miners could lose their health care 
this year and the entire plan could fail as early as next year.
  There is a bipartisan solution that is proposed by Senator Manchin, 
Senator Casey, me, and others and supported by leaders of both parties. 
If it were brought to the floor today, it would pass with an 
overwhelming majority. It is time for the Senate to act. The Committee 
on Finance should mark up this legislation this week. The Senate should 
bring it to the floor immediately.
  Miners worked in dangerous jobs--dangers from a mining accident, an 
explosion, or a collapse every day when they went to work, and 
dangerous in the sense that so many mine workers die early because of 
premature bronchial illnesses and heart ailments brought on by working 
in the mines. They have worked underground their whole lives to put 
food on the table, to send their kids to school, and to help power this 
country. Truckers criss-cross the State and country to pay their bills 
and support their families and drive our economy forward. They all 
deserve the full pension and health benefits they were promised and 
they worked a lifetime to earn.
  Butch Lewis led the Southwest Retirees Pension Committee's fight 
against cuts to their earned benefits. He passed away on New Year's Eve 
due to a stroke, which doctors have attributed at least in part to the 
stress he faced over the proposed pension cuts not just to him and his 
family but to the workers he was fighting for as a union activist. The 
benefits to his widow, his wife Rita, have already been cut. She faces 
an additional 40-percent reduction because of the proposed cuts put 
forth by Central States. Butch said the cuts being forced on retirees--
his words--``amount to a war against the middle class and the American 
dream.'' He is right. Ohio's retired workers have earned their pensions 
and their retirement savings over a lifetime of hard work. It was 
promised to them, whether they worked behind a desk, on the factory 
floor, down in the coal mines, or behind a wheel.
  We should honor Butch's memory by continuing his work. That means 
coming together to support a bipartisan solution to protect Rita's 
benefits and the pensions of tens of thousands of retired Teamsters and 
retired mine workers.
  Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. McCONNELL. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________