Comprehensive Addiction and Recovery Bill

Floor Speech

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Mr. BLUMENTHAL. Mr. President, I am pleased to be on the floor to speak again in support of the Comprehensive Addiction and Recovery Act, which the Senate will consider and I hope approve this week. It is a long overdue measure to address the public health hurricane, a crisis we face in this country. It is every bit as real and threatening as threats from abroad. In fact, I have just now come from a hearing of the Armed Services Committee, where I had the opportunity to question some of our Nation's leading military experts, including the head of our Special Operations Command, General Votel, about the threat posed by illicit substances, such as heroin, to this country. The testimony was that those substances, when they come to this country, follow the same route as terrorists, illicit arms, and other military threats to this Nation.

The bipartisan support for the measure before us is a sign of the meaningful strides that this Nation has taken, but more is necessary to be done toward ending the epidemic of heroin addiction and prescription drug abuse. It is a danger to every community across the country, big cities and towns in Connecticut, suburban and urban. Every race and religion, ethnic group, and demographic is potentially a victim.

I have heard from our colleagues across the country that this crisis truly has proportions on a par with any of the tornadoes, floods or hurricanes we have seen as natural disasters. Abuse and addiction are crippling communities around the country, shattering families, and imposing enormous financial and human costs.

In my home State of Connecticut, overdose deaths have steadily increased, as they have throughout the Nation, and they now surpass automobile crashes as the leading cause of injury-related death for Americans between the ages of 25 and 64. Connecticut saw more than 700 overdose deaths in 2015. Without a doubt, we must act.

Many communities across Connecticut and our country already have taken steps and have dedicated resources to stopping the epidemic of heroin addiction and prescription drug overuse. I am very privileged to welcome a number of those communities to the Senate today. They are represented by mayors from major cities in Connecticut: Mayor Joe Ganim of Bridgeport, Mayor O'Leary of Waterbury, Mayor Moran of Manchester, along with local officials from Bridgeport, Groton, Manchester, New Haven, South Windsor, and the Connecticut Conference of Municipalities.

Groton

Bonnie Nault, Harry Watson. Manchester Town Council

Jay Moran (mayor), Margaret Hackett, Patrick Greene. New Haven City Council

Delphine Clyburn, Frank Douglass, Alberta Gibbs, Rosa Ferraro Santana, Brian Wingate. South Windsor Town Manager

Matt Galligan. Connecticut Conference of Municipalities

Ron Thomas, Kevin Maloney. Waterbury

Neil O'Leary (mayor).

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Mr. BLUMENTHAL. They have shown by their actions they are willing to not only talk the talk but actually walk the walk. I participated with Mayor Ganim over the weekend in a public press conference, noting the truly extraordinary and excellent work by their drug task force to stop, apprehend, arrest, and prosecute a major drug ring in the city of Bridgeport.

I have talked to Mayor O'Leary about efforts in Waterbury and throughout his region--a very responsible and effective action he took as police chief of Waterbury--but we know we are not going to arrest our way out of this crisis. Law enforcement needs more effective support and resources. There is no way around the need for supporting and enhancing the operations of our local, State, and Federal law enforcement officials--in fact, increasing the partnership and cooperation among them, as was so dramatically shown by the successful law enforcement in the city of Bridgeport against this drug ring last week. All have a role and all of their cooperation is necessary.

All of us have a responsibility to support their work, but the bill before us also recognizes that we are not going to arrest or jail our way out of this crisis. In fact, it provides resources for treatment and services and a more effective means of delivering Narcan, which can literally be a lifesaver, bringing overdose victims back from the brink of death.

What I have heard in roundtables I have conducted around the State of Connecticut is the need for those additional steps, not focusing on any one of them but a multifaceted effort, as this bill reflects. In the roundtables I have conducted, I have heard from law enforcement professionals, first responders, doctors, addiction specialists, elected officials, and many others, including recovering addicts and their families. Their stories are riveting and heartbreaking about the effects of addiction, beginning with powerful prescription painkillers for routine surgery, broken ankles or wrists, and wisdom teeth that have been removed. There was overprescription of 20 pills, 30 pills, when 2 pills or 3 pills would have been sufficient, and those pills are the gateway to more serious addiction or they find their way onto the street where they fuel the addiction of others and lead to addiction to heroin, which often is cheaper than the prescription pills.

Those stories I have heard from around our State, stories from people struggling with addiction or who have lost a loved one to this disease, add to the public record that exists. That record includes a story that appeared within the past week or so in the New London Day. It talks about two childhood friends, Nat and Joe. Both of them struggled with heroin addiction, but they are now in recovery. Between them, they have lost several friends, a former girlfriend, and a stepbrother to overdoses, and each has a sibling who has also become an addict. Nat is now 27 and the father of two. He said:

I started taking pills when I was 19 or 20 and was stressed out when I was going through a custody battle over my son. Somebody said to try one, and then I was taking them a couple of times a week and then every day I was buying off the street. It was out of control. It got so that I couldn't work without drugs.

The same happened to Nat's friend Joe with Percocet. He described how he took a few pills, liked the feeling, and rapidly began to take drugs with other friends, including OxyContin and heroin.

Another article in the Waterbury Republican American told the story of Thomas Obst, who was prescribed OxyContin for an eye injury. When he later suffered from withdrawal symptoms, he turned to heroin to keep himself from suffering. He explained:

You never know what a street drug is mixed with, but it's less expensive . . . someone mentioned heroin. I thought I could control it.

Thomas eventually overdosed, but his life was saved by a brave State Trooper named Josh Sawyer, who was able to administer naloxone. This drug can be a lifesaver if it is available to police--as it was in this instance--and first responders and firefighters. Unfortunately, its price has skyrocketed, and it is increasingly in short supply.

These stories from Connecticut are hardly unique. Our colleagues know they are happening in their communities. They know overdose deaths are skyrocketing, that addiction is increasing, and that the toll taken on their States and our communities is absolutely horrendous.

During our roundtable in Bridgeport last Friday, a manager of the Bridgeport Recovery Community Center explained the obstacles that people afflicted with addiction face in trying to obtain treatment this way:

Insurers will dictate what they will and will not pay for. You have to continually prove that this person is allowed to stay. You must make daily phone calls to plead your case.

When treatment is made available, there should be no wrong door; there should be no harassing need to demonstrate the problem and the need for treatment. We need more availability of insurance and increasing recognition that addiction is not a stigma, it is an affliction, a disease, every bit as much so as any other disease. And supplies of the drugs that can help treat that addiction--SUBOXONE, for example--have to be made available.

The legislation before us would provide more treatment, more beds, but it is only a down payment, only a beginning. There is truly a need for recognition that we face a public health hurricane and that this crisis, a spreading epidemic, will only become worse if we fail to provide more assistance.

This bill strengthens State programs like Connecticut's that are already in place, including State prescription drug monitoring programs as well as training for law enforcement and emergency responders in the use of Narcan. It provides important recovery support services for those struggling with addiction, and it would strengthen existing Federal programs, such as the DEA's drug take-back program.

The bill also provides more support for substance abuse treatment services for incarcerated individuals. We know a lot of people in prison today are there because of their addiction. If they are to emerge successfully from incarceration, they need that support and assistance to break the grip of addiction.

As important as this bill is, I agree with many of my colleagues--and they have spoken on the floor--that it is far less effective than it could be without the $600 million supplemental appropriations that I have advocated and fought to pass. I am disappointed the amendment of Senator Shaheen, which I spearheaded and cosponsored, was not included in this measure, and I look forward to continuing to fight for the resources necessary to make this fight real.

I want to thank all of my colleagues, including Senator Whitehouse and others, for incorporating a bipartisan provision I wrote with Senator Coats called the Expanding Access to Prescription Drug Monitoring Programs Act. This provision will 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 thereby determine if a patient has a history of addiction or receiving multiple prescriptions from multiple sources.

I know from my decade and a half of work in this area how doctor shopping and other abuses can in fact exacerbate this problem of addiction and prescription drug abuse. Although nurse practitioners and physician assistants wrote over 7 million opioid prescriptions in 2013, few States permit them to consult and submit prescribing data to these important State databases. Allowing these providers to access more information about patient history enables them to address potential addiction before--and I stress ``before''--it becomes a serious problem.

I hope this body will adopt a number of other amendments that I have proposed, including the one Senator Markey and I have spearheaded, amendment No. 3382, prescriber education. Prescriber education is crucial.

In a roundtable I held at the Yale medical school, a number of the docs told me that now--only recently--are there sufficient education and training and specific courses devoted to pain management and prescription discipline.

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Mr. BLUMENTHAL. It would provide as a condition that this training be conducted before any doctor receives a renewal of his or her license by the Drug Enforcement Administration.

To help our veterans, an amendment that I have offered, No. 3438, would eliminate naloxone copays for our veterans. As ranking member of the Veterans' Affairs Committee, I have seen how the opioid epidemic has affected our veterans. It is truly devastating. Safe prescribing of opioids is vital because many veterans, especially those returning from combat, have serious pain issues that must be addressed, but they must be addressed safely, with care and caution about the dangers of addiction.

I appreciate our dedication to addressing this problem. I hope that it will be bipartisan and that our approval this week will match the urgency of this problem in communities around the State of Connecticut and around this country. The solution to this problem is long overdue for action, and I look forward to this next step--only one of many that have to be taken--in aiding our law enforcers, our health care providers, our public officials, such as our representatives today on the Hill, in moving forward and addressing this problem.

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