Comprehensive Addiction and Recovery Act of 2015
Floor Speech
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Mr. BLUMENTHAL. I am always honored to be in this Chamber, and I feel immensely privileged to participate in any debate. But I must say, Mr. President, that the average American listening to the colloquy that has been conducted just within the past few minutes would regard it somewhat in disbelief, maybe dismay, because the Presiding Officer is absolutely right that the people of our States are literally dying as a result of the heroin and opioid epidemic that has created a public health hurricane, a crisis of untold proportion.
This body should and hopefully will pass a bill that will help to address that public health crisis. It is only a downpayment, only a first step, and only effective if accompanied by funding, an emergency supplemental necessary to provide the real resources to address this problem. But this body is capable of passing that bill and still debating whether there should be a hearing and vote on the President's Supreme Court nominee.
The voting on the Comprehensive Addiction and Recovery Act, also known as CARA, is within the control of the majority. That is a simple fact. As Ronald Reagan said, facts are stubborn things. The fact is that control of the votes on that measure are within the prerogative of the majority.
In the meantime, the majority also has the power and authority to say we will have a hearing and a vote on the President's Supreme Court nominee; we will do our job. That is what Senators are elected to do. That is why we have come to the floor of the Senate to say that the Senate must do its job. It has a constitutional duty. It has no discretion whether it should wait for a politically opportune time to do its job or whether it should hear from its base politically. It should do its job when the President submits his nominee.
What may be most regrettable about this debate and about the majority leadership's refusal to have a hearing and a vote on the President's nominee is that it demonstrates political machination--game playing-- that threatens the Supreme Court as an institution. It endangers its credibility and trust. The Supreme Court has no armies or police force. It depends, for the enforceability of its decisions, on its credibility and trust. And when it is demeaned in the eyes of the public, when its stature is diminished, when it is dragged into the political morass of a partisan debate and partisan paralysis, its credibility and trust and its stature are vastly diminished, and its powers and institution are in danger.
I am dismayed that these machinations tend to diminish and demean this institution where I worked for a year as a law clerk for Supreme Court Justice Harry Blackmun, where I argued cases when I was attorney general, and where I was yesterday on those steps with the same awe and admiration and, indeed, reverence that the American people should feel for an institution above politics, higher than the ordinary give-and- take and contention that occurs on this floor and throughout the political institution. The refusal to even consider having a hearing, having a vote, having a meeting with the President's nominee endangers this institution.
Elections have consequences. We all say so. Obstruction has consequences too. The failure to consider these nominees means that critical decisions will be left undecided.
I urge my colleagues to enable us to have a vote.
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Mr. BLUMENTHAL. May I have just 1 more minute?
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Mr. BLUMENTHAL. Thank you.
Madam President, I want to close with the words of Justice Scalia, who said, when he was asked to recuse himself, that leaving the Court potentially equally divided 4 to 4--that a 4-to-4 vote was to be avoided if possible. He said:
With eight justices [it] rais[es] the possibility that, by reason of a tie vote, [the Court] will find itself unable to resolve the significant legal issue presented by the case. . . . Even one unnecessary recusal impairs the functioning of the Court.
Even one unnecessary 4-to-4 vote impairs the stature and credibility and the effectiveness of the Court.
I urge all of us to move forward with the President's nominee when it is made.
Thank you, Madam President.
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Mr. BLUMENTHAL. Mr. President, I begin by calling attention to a private Iranian airline, designated by the U.S. Department of Treasury for its support for terrorism and funneling of weapons to Hezbollah and to the Assad regime in Syria. This airline continues to operate and even expand its international business network, despite tough words from the administration. But this kind of tough language is insufficient.
The time to impose sanctions on Mahan Air is now. The time to impose sanctions on Mahan Air is clearly now. I have called on the administration in a letter, which I helped to lead and on which I am joined by a number of my colleagues, in late February--February 29--to the Secretary of the Treasury. Sanctions might be forthcoming against this airline if this body were to approve Adam Szubin to be Under Secretary for Terrorism and Financial Intelligence, but so far we have failed to do so. His confirmation has been blocked. I regret it. Whether or not he is confirmed, sanctions should be imposed on this airline. Mahan Air relies on a host of local partners who provide financial and other services for it to maintain this robust international flight network.
So taking this action against Mahan Air will not only send a signal, it will end actions by Mahan Air that are against international law and support terrorism and the funneling of weapons to some terrorist groups that can do harm to the United States as well as to our allies and partners abroad.
Mr. President, I also want to talk about the Comprehensive Addiction and Recovery Act. Hopefully, we will vote today in support of it. It is a great bipartisan bill. I am privileged to have worked on it as a member of the Judiciary Committee. I thank all of the members of that committee and others, most especially Senator Whitehouse and Senator Leahy, for incorporating provisions that I have helped to offer in this bill.
We heard from our colleagues around the country about the public health crisis that we face today. It is more than a crisis. It is a hurricane--almost like a public health hurricane--a natural disaster that requires us to act now. Abuse and addiction are crippling our communities, shattering our families, carrying enormous financial and human costs. The overdose deaths have steadily increased. They now surpass automobile accidents as the leading cause of injury-related deaths for Americans between the age of 25 and 64.
The United States consumes over 80 percent of prescription opioids, even though we make up only 4.6 percent of the world's population. In Connecticut, I have held roundtables across our State, and I hear again and again the tragic stories of young people who begin taking powerful painkillers when they break a leg or a wrist in a sports injury or when they have wisdom teeth removed and they receive a prescription for 30 days. They only need 3 days' worth of painkillers, if they need them at all. But the overprescription and the abuse that results from it often leads to addiction.
The gateway to addiction is these powerful painkillers that provide the beginnings of the problem. One university counselor wrote to me recently:
When I first began this position 14 years ago, it was extremely uncommon to be working with a student who abused a substance besides alcohol. Today, I have a recovery house and a program full of students battling addiction from [prescription opioids].
I have heard from mothers and families, from teachers and counselors who have struggled to find quality substance abuse treatment programs and behavioral health services for their loved ones. One mother wrote to me about her two sons. Some 8 years ago, her oldest son died from a heroin overdose after a prescription program released him early. Her younger son continues to struggle with addiction but was recently told by his insurance company that he lacked a long enough history of substance abuse to qualify for inpatient treatment.
We must address these problems, and the solution is multifaceted. Supporting law enforcement is part of the solution, with resources and with other measures that will enable interdiction of the supplies of heroin and cracking down on the illicit supplies of painkillers. But law enforcement has told me, as a former colleague, that we are not going to arrest our way out of this problem. The jails and prisons alone do not provide a solution.
There is a need for more treatment and services. I hear that point again and again and again, but that source of solution alone will not be the panacea. There is no one solution. Education for our doctors and providers and prescribers is part of what is needed. Again, alone, no single solution is sufficient.
I want to thank the bill sponsors for incorporating the provision that I wrote with Senator Coats, the Expanding Access to Prescription Drug Monitoring Programs Act. This provision would allow nurse practitioners and physician assistants to access the information they need. Specifically, they would be able to access State prescription drug monitoring programs to consult a patient's prescription opioid history and determine if that patient has a history of addiction or is receiving multiple prescriptions from multiple sources. It is critical that we recognize the key role that nurse practitioners and physician assistants play in curbing prescription drug abuse and diversion.
I propose a number of amendments that attack other elements of this problem. I am going to continue to advocate for them, whether they are in the final package or not--and some of them may well be. I will continue the effort to make them real and adopt them as law, whether or not they are included in this measure.
Over and again, we have heard that many struggling with addiction start by abusing those prescription drugs after receiving a legitimate prescription. That is why Senator Markey and I have submitted amendment No. 3382, which would cut down on overprescribing opioids by requiring providers, when they apply for a license from the DEA to prescribe these controlled substances, to first complete education programs so they are encouraged to adopt responsible prescribing practices. Those practices can be as simple as keeping track and scrutinizing the use of these painkillers. Every licensee, every provider, every nurse practitioner, everyone writing out a slip of paper that enables somebody to purchase these powerful prescription painkillers would have to take a course and complete this training.
In Blumenthal amendment No. 3327, a separate measure that I am proposing as ranking member of the Veterans' Affairs Committee, there would be better access to naloxone, known as Narcan, by veterans. We have seen how naloxone or Narcan is a lifesaver. It can bring people back from the brink of death. There should be more of it. It should be more available to our police, firefighters, and first responders on the streets of Connecticut and in neighborhoods and communities across the country. It is insufficiently available. It has skyrocketed in price, and there have been shortages. But I have seen how the opioid epidemic has affected, particularly, our veterans, and often, again, with overprescriptions in certain parts of the country.
We have moved to address that problem. In Wisconsin, for example, and with the great help of Senator Baldwin, my colleague on the Veterans' Affairs Committee, we have worked to craft legislation that will help contain and cut that abusive prescription of opioids. I believe that this measure will give information to veterans and the tools they need also to prevent deaths in case of an overdose.
Much of the work of the Veterans' Affairs Committee is focused on the opioid epidemic and the Jason Simcakoski Memorial Opioid Safety Act we are working to pass into law. But safe prescribing of opioids is vital because many veterans, even when legitimately prescribed, have serious pain issues that can lead to abuse once those issues are addressed.
So I have filed this amendment that would eliminate the requirement that veterans pay a copay for naloxone kits and for education for providers as to how to use them. In other words, the providers will provide education, along with providing the prescriptions, as to how to use the Narcan kits that veterans could receive without any copay. Naloxone is necessary for those first responders, and the underlying bill includes provisions that would help to provide it, but this measure would focus particularly on veterans, where the need is great and growing greater.
I wish to point out that the cost of this measure would be less than $100,000 per year. The savings in dollars long term would vastly exceed that amount, and the savings in lives more than justifies this, even without the savings in dollars. We are talking here about the ability to save veterans' lives. We have an obligation to leave no veteran behind, to keep faith with our veterans, and to make sure that a minimum amount of spending will enable the saving of lives.
I appreciate again the work of my colleagues in crafting this bill. I hope we will move forward in passing it and that the amendments I have suggested will be adopted to strengthen it even further.
Thank you, Mr. President.
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