Comprehensive Addiction and Recovery Act of 2015

Floor Speech

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Mr. MARKEY. Mr. President, I would like to start my remarks on the Comprehensive Addiction and Recovery Act today by complimenting all of the Members--Senator Whitehouse, Senator Grassley, Senator Portman, Senator Ayotte, Senator Shaheen, and all the Members who have been working so hard on this legislation to produce something which is very much needed by our country.

I will start my remarks by telling a little story of a constituent who wants to remain anonymous. This is her story:

On July 20, 2009, I was the passenger in a vehicle with my close friend at the time behind the wheel. The light turned green and as expected he hit the gas. While he was hitting the gas, the oncoming car never hit their brakes to stop at the red light they were approaching.

I was painfully pinned in the passenger's seat. All I could hear was my friend asking me if I was OK. Upon arriving in the ER I was quickly poked, prodded, and injected with high- level painkillers. This is where it all began.

Walking out of the hospital, I wasn't only walking out with crutches, but a prescription that changed the next 5 years of my life. I was prescribed OxyContin to help manage the pain I was experiencing. With continuing follow-up appointments and check-ins, also came more prescriptions for ``pain management prescriptions.''

Two months after getting into a car accident, I was a heroin addict. How quickly all things I knew changed. In September of 2009 I not only began shooting heroin but I also began my first semester of college. I was a freshman at UMass Boston, worked full time, but, secretly, I was also a heroin addict. I kept my addiction a secret from everyone I knew including my close friends and family.

On August 31, 2014 I woke up and said to myself ``enough is enough.'' It took three overdoses in order to open my eyes. Since leaving treatment in November of 2014, my recovery has not stopped; I continue to learn and to grow daily. I have also learned of the medical issues and complications that my heroin use has led to. I now suffer from seizures because the excessive drug use over 5 years has led to minor brain damage. Along with the seizures, I have tested positive for Hepatitis C and HIV, which is common with injection drug users.

At the end of the day, all I want to do is to help others who are struggling because I know what they are going through.

Mr. President, she is one of the fortunate ones. She found the help she needed and had the strength and support to get clean. But I am hearing enormous frustration from people who don't feel that sufficient resources are being brought to bear on this enormous epidemic of prescription drug and heroin addiction.

All week we have heard the statistics here in this Chamber. Our Nation is experiencing more deaths from drug overdoses than from gun violence or auto accidents. Eighty percent of the people suffering from heroin addiction started with opioid pain medications approved by the FDA and prescribed by doctors, with 27,000 people dying from an opioid overdose in 2014 and 1,300 of those coming from the State of Massachusetts.

This issue is one that doesn't just affect the Bay State. America is drowning in a tsunami of heroin and prescription drug addiction that we must stop before it drowns any more families and communities.

Let us compare what we are did as a nation when confronted with other deadly epidemics. A bipartisan majority in Congress funded more than $5 billion to respond to Ebola. We dispatched the medical community and public health experts. Today the Obama administration is asking Congress for $1.8 billion in emergency funding to fight the Zika virus.

Imagine if we applied the same commitment, the same urgency, and the same level of resources to the prescription drug and heroin epidemic. We need an immediate and comprehensive strategy that requires commitment from all levels of government--State, local, and Federal. That means Congress must step up to respond with leadership and with resources. We need to stop the overprescription of opioid pain medication, we must prevent addiction before it takes hold, and we must provide the funding necessary to ensure that we stem this tide of deadly addiction.

The Food and Drug Administration must change its decision not to seek expert advice about the risks of addiction before it approves abuse- deterring opioids. Abuse-deterring opioids is a contradiction in terms. Whether an opioid is used as a deterrent or not, it has not prevented tens of thousands of people who have had their wisdom teeth removed or experienced lower back pain from getting addicted to these painkillers. By refusing to convene the advisory committee to inform all of its opioid approval decisions, the FDA continues to ignore outside experts who could help stem the tide of tragic deaths and overdoses plaguing this country.

That is why I have filed an amendment to require the FDA to convene advisory committees of outside experts for all opioid approval decisions--period. Now is the time to implement effective and commonsense solutions, but we need funding to do that; funding for families, funding for treatment providers, funding for our sheriffs and firefighters who carry overdose prevention drugs that save lives. We need to provide the real resources necessary to address a crisis that is only growing in numbers and severity, and that comes in the form of emergency funding. We are hemorrhaging lives by the day, and supplemental funding is the first step needed to staunch the flow of suffering and death.

Ladies and gentlemen, we are at a watershed moment in this national debate to address the public health crisis of addiction. So let us be clear. Stopping the overprescription of pain medication that is fueling opioid addiction and overdoses starts with the prescribers. We need to require anyone who prescribes opioid pain medication and other controlled substances to undergo mandatory training on safe prescribing practices and the identification of possible substance abuse disorders. That is why I have filed an amendment that requires prescribers to get the education needed to help staunch this wall of suffering and death.

The doctors will say they don't 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 modules, but in more than 2 years, less than 12 percent of prescribers have actually completed the FDA's voluntary education program. A survey of 1,000 physicians nationwide found that nearly one-half of doctors erroneously reported that abuse-deterrent formulations were less addictive than their counterparts. It is unconscionable that our doctors know so little about these potentially deadly painkillers.

I intend to call up amendment No. 3382 later so we can make consideration of the bill. The amendment would ensure that as a condition of receiving a license to prescribe opioids, the recipient of the license is educated in the best practices for using opioids and the connection with addiction and with diversion. I intend to call up that amendment later, asking for consideration.

From my perspective, if we are going to have a real strategy, then we have to make sure there is a requirement that there is continuing education. We also need to remove the barriers to effective treatment, including outdated Federal restrictions on medication-assisted therapies like SUBOXONE.

Medication-assisted therapy for opioid addition is cost-effective, it decreases overdose deaths, and it reduces transmission of HIV and hepatitis C. That is why I have filed an amendment that would lift the caps that are limiting the number of patients doctors can treat with medication-assisted therapy. If we are going to reduce the supply of heroin and illicit prescription drugs, we have to reduce the demand through effective treatment. I have been working with Senator Paul from Kentucky on that amendment.

Also, fear of a lawsuit should not deter anyone from trying to save the life of someone suffering from an overdose. That is why I have filed an amendment that creates a Federal Good Samaritan provision that shields from civil liability family members, friends, and other bystanders who administer opioid prevention treatments like Narcan.

The debate we are having on this legislation this week is just the beginning. We must let prescribers know that unless they get basic education in opioids, they will have to turn off the spigot of painkillers that are flooding this country and leading to deadly overdoses. We must let law enforcement and the judicial system know we cannot incarcerate our way out of this problem. We must let Big Pharma know we are going to work to ensure that we have a lifting of awareness of this issue every single day. Enough is enough in this country. Enough is enough. We have just seen an explosion in terms of this problem.

We must now let all of those struggling with addiction know that help is on the way and that no matter how dark life seems right now, there is hope and the Sun will rise for them once again.

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