Comprehensive Addiction and Recovery Act of 2015

Floor Speech

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Mr. DURBIN. Mr. President, having followed my friend and colleague from Tennessee, Senator Alexander has spelled out an exciting possibility, and I know it won't be easy. It is a heavy political lift. But what he is talking about is coming up with a dramatic commitment of funds for medical research for the next 8, 9, or 10 years, over and above the ordinary budget of the National Institutes of Health.

We have sat down and talked about this several times, and I wholeheartedly endorse not only his concept but also when he gets down to specifics. Some of the things he wants to focus on, including the Moonshot for Cancer, for example, is one, of course, the President and the Vice President and the vast majority of Americans would endorse because there isn't a single one of us who hasn't been touched by the threat or the actual disease of cancer among our families and friends.

I won't go through the entire list, but whether we are dealing with the issues involving the brain, including Alzheimer's, Parkinson's, neurological issues--there are so many needs there, and I wholeheartedly endorse what he is setting out to do. On a bipartisan basis, I will work with him and Senator Murray and Senator Blunt and Senator Lindsey Graham. We all share these feelings, that this is something that will be a legacy item for this Senate.

I thank the Senator from Tennessee for his leadership and his cooperation in building up the budget for the National Institutes of Health research this year. The $2 billion will make a difference. I thank the Senator for being on the floor. Lead Contamination

Mr. President, I would like to address a couple of issues.

The contaminated water crisis in Flint, MI, is a wake-up call across America. We have to have protections in place when it comes to lead contamination. My heart goes out to people in Flint, MI, dealing with the consequences of this preventable, manmade crisis. The Senate needs to do something to help the people of Flint. We must also recognize that children across America are poisoned every day by lead, and we need to do something about it to protect these families.

A Chicago Tribune reporter, Michael Hawthorne, recently authored some articles on this issue, revealing hundreds of cases of childhood lead poisoning stemming from different sources in Flint, such as lead-based paint in federally subsidized housing. That's right--housing we own as taxpayers, housing we manage as the Federal Government, and housing which is dangerous to the children who are living there. Exposure to high levels of lead poisoning can be devastating to a child, causing irreparable damage. Because the children who live in this housing are from low-income families--many minority families--lead poisoning can further trap these kids in the cycles of poverty, violence, and inequality. Families are often stuck in the homes even after the lead is discovered with no place to go.

That is why Senator Menendez from New Jersey and I joined together to offer the Lead-Safe Housing for Kids Act, to ensure safe and affordable housing by reducing the threat of lead exposure and lead poisoning. Congressional Representatives Keith Ellison, Mike Quigley from my State of Illinois, Brenda Lawrence, and Dan Kildee have introduced companion legislation in the House.

Since the enactment of Federal lead policies in the early 1990s, lead poisoning rates have fallen. This is a big success story. However, the risk of lead poisoning from lead-based paint hazards found in homes continues to threaten kids who are living in homes built before 1978. This is especially true in Illinois. It is a problem in Cleveland, Baltimore, Buffalo, Pittsburgh, and many other cities.

HUD regulations are outdated, ineffective, and based on old scientific discoveries that haven't been updated. Under current HUD regulations, a landlord is not required to remediate a home to make it safe where lead-based paint hazards have been found until a child's blood lead level is 20 micrograms of lead per deciliter. That standard from HUD is four times the standard of the Centers for Disease Control. When I asked Secretary Castro of Housing and Urban Development why would we have such a disparity--why would you allow lead contamination in a child four times the level of what the Centers for Disease Control says is acceptable? He said: I have no answer, and we are going to change it. It is just wrong. I salute him for acknowledging that, and I hope to help him in any way I can to change this regulation.

We also need better inspections. Inspections to qualify to be a part of a Federal housing program are cursory visual inspections. There is no way to discover lead paint that can be dangerous to household members or kids unless you have a thorough inspection. In addition to that, once we discover there is lead in the residence, we have to find another place for the family to live unless that lead can be remediated quickly.

No one knows this better than Lanice Walker. She moved out of public housing in 2012 and into a home with a housing choice voucher. What an opportunity for her family--a new home. Less than 5 months after she and her family moved in, her 4-year-old daughter was diagnosed with lead poisoning. Lanice was aware of the dangers of lead in kids. She asked the Chicago Housing Authority for permission to move. They said no. Why? Because her daughter's blood level hadn't met the HUD standard. It met the CDC standard, which was one-fourth, but hadn't met the HUD standards. So despite her daughter having a blood lead level twice that of what the CDC considers to be dangerous, they wouldn't move her out of her house. So she stayed. Within the next year, another child in the house was diagnosed with lead poisoning, too, and then another one. Before she moved out, all nine of Lanice's children had elevated blood lead levels. Even so, she received permission to move only after legal advocates intervened. This could have been avoided if the home had been properly inspected.

Sadly, this isn't an isolated incident. Since 2012, in Chicago alone at least 180 kids in section 8 housing have fallen victim to this mismatch in the blood level standards. After hearing Lanice's story, the Chicago Housing Authority said it would voluntarily recognize the CDC guidelines, even though HUD didn't require them to. That is a good step. However, families all across America need the same relief that will come when HUD standards are changed. That is what this bill is all about. I commend it to my colleagues and hope they would look at it carefully in an effort to ensure that public housing is safe.

What did we learn in Flint, MI? We think 9,000 children were exposed to the lead in the water that has had an impact on them--for some, brain damage that cannot be reversed. Who will answer for the poisoning of 9,000 children? How can we answer to the next generation that faces this hazard if we don't take this important step?

We need to ensure that Federal lead standards are updated in accordance with the best available science, and adopt primary prevention measures to protect children from lead exposure in low- income housing. That means aligning HUD standards with the CDC's standards and requiring a risk assessment before a family moves into a home, and allowing mothers like Lanice Walker to move her family without the fear of losing assistance when a lead hazard is identified.

We all know how destructive lead poisoning is on children and our society. Yet, our federal policies are actually allowing young children to stay in unsafe homes for months after they have been diagnosed with lead poisoning. By updating HUD's regulations, we can protect the most vulnerable children from the harmful, irreversible effects of lead poisoning.

I hope my colleagues will join me in this important effort. American children are depending on it, and they cannot afford to wait.

Mr. President, we have a bill before us to deal with opioids and the heroin crisis. It is a crisis that hit Illinois and hit it hard. Across Illinois we suffered from over 1,700 drug overdose deaths in 2014--a 30-percent increase over 2010; 40 percent were associated with heroin.

Last October in Chicago, in a weekend, we had 74 people die from fentanyl-laced heroin overdoses in 72 hours. The Chicago metro area ranked first in the country, sadly, for total number of emergency department heroin visits. This is higher than New York, which has three times the population. This epidemic demands our attention. We need a comprehensive solution.

First, look at Pharma flooding America with opioids such as OxyContin, hydrocodone, and similar opioid products. In the last year, there was a calculation that there were some 14 billion opioid pills manufactured by pharmaceutical companies in America. That is enough to give every adult person in America a 1-month prescription of opioids. Naturally, everyone doesn't need it, but they keep generating these volumes because the demand is there--not for medicinal purposes, sadly, but for narcotic purposes. The pharmaceutical industry has a responsibility, and doctors have a responsibility. Those pills don't move from the pharmaceutical companies to the end user except with a doctor and a pharmacy in most instances.

Many doctors are too loose in their prescriptions when it comes to painkillers. They prescribe too many pills. I guess somebody makes more money that way, or maybe doctors are not bothered on weekends that way, but, sadly, it puts into circulation a lot of medications that are not needed for pain. Some pharmacies know exactly what is going on as people walk in with scrip after scrip for opioids. They fill them without question. Many States don't have laws to monitor these sales.

Then comes the devastation of opioid addiction followed by heroin addiction. I have seen it across my State. There isn't a city too small or a suburb too wealthy or any corner of my State that hasn't been touched by this crisis. It is everywhere. Many of the kids that I have seen at these roundtables who have survived it and tell their heroic stories of coming back from heroin addiction--you look in their eyes and say: I would never have picked that kid out of a high school class to be a heroin addict. Some of them have been addicts for years before they finally get the treatment they need.

We need a comprehensive solution to address this crisis. We must prevent drug companies from flooding the market with excessive amounts of addictive pills. We must encourage the Drug Enforcement Administration to use their existing authority to keep unnecessary drugs off the market. We must crack down on doctors who over-prescribe and pharmacies that over-dispense. We must remove barriers to substance use disorder treatments, which is why Senator King and I introduced legislation ensuring that lower-income patients suffering from substance abuse disorders are able to get the care they so desperately need. And we must put our money where our mouth is. We cannot expect real change to come about through good intentions. We can authorize all the programs we want, issue all the directives we want, cite all the statistics we want, but nothing will change unless we give our Federal agencies and local governments the resources necessary to tackle this complex problem head on.

This bill before us is a step in the right direction. It requires the establishment of a Federal interagency task force to develop best practices for pain management and pain medication prescribing, creates a national drug awareness campaign on the risks of opioid abuse, and authorizes grants to States, locals, and nonprofits to address opioid abuse and fund treatment alternatives.

This bill could have a positive impact on communities in need if we are able to provide the necessary funding. That is why in addition to supporting the underlying bill I also strongly supported the amendment that Senator Shaheen offered last week. That amendment would have provided $600 million in emergency supplemental appropriations to address the heroin and opioid abuse epidemic. These funds would have helped ramp up law enforcement efforts, drug treatment and enforcement programs, and prevention programs through the Justice Department. They would have enhanced prescription drug monitoring programs. They would have improved access to medication assisted treatment services to high- risk areas as well as support school and community partnerships to create safe and drug-free environments and provide additional assistance to States to help pay for prevention and treatment care.

Unfortunately, Senator Shaheen's amendment was defeated when a majority of Republicans decided to vote against it. If we fail to provide the needed resources to help communities and families in need, we may be back here a year from now saying we should have done more. Families in Illinois and across the country can't wait that long.

I support both the Comprehensive Addiction and Recovery Act and the Shaheen amendment. But the bill should also address some of the many issues I have learned about at roundtable discussions in Illinois while talking to families, doctors, law enforcement, and those who have overcome substance abuse addiction.

That is why I introduced several amendments that would have helped improve the underlying bill, from requiring greater consideration at FDA before new opioids can come onto the market, to creating incentives for States to improve their prescription drug monitoring programs, to removing existing barriers to substance abuse treatment for lower- income patients, to requiring greater transparency on how many opioids are being manufactured in the United States annually. I am disappointed that many of these amendments will not receive a vote this week, but I will continue working with my colleagues in the Senate to advance these important proposals.

Let me say that one of the things that has helped is the fact that years ago here in the U.S. Senate, two of my colleagues who no longer serve really did something historic. One was Paul Wellstone of Minnesota, who passed away in an airplane crash, and the other, Pete Domenici, a retired Senator from New Mexico. They required that every health insurance policy in America cover two things that weren't covered by many: one, mental health counseling and the other, substance abuse treatment.

We built that into ObamaCare, so when you buy a health insurance policy in America today, it covers substance abuse treatment as well as mental health counseling. Luckily for many families, when their kids end up being addicted, they can turn to their health insurance, and their health insurance can help pay for substance abuse treatment. We need other sources, as well, when it comes to treatment for Medicaid, but for those who want to repeal ObamaCare and get rid of it, that is another provision to ask them about. Do they really want to get rid of a requirement that health insurance policies cover mental health counseling and substance abuse treatment? I think it is important that we have it. I am not sure what we would do without it.

The opioid abuse and heroin epidemic is a national public health emergency that requires a comprehensive response coupled with the necessary funding to actually make a difference. The amendments I have filed, as well as the Shaheen amendment, would make important improvements and provide emergency funding to help families in Illinois and across the country. Our communities need us to come together as partners to help solve this problem. I hope we do not let them down. Filling the Supreme Court Vacancy

Mr. President, I see my colleague from Oklahoma is here. This is the last statement I want to make, and it relates to the Supreme Court vacancy.

A group of historians and scholars sent a letter to President Obama about the Supreme Court vacancy occasioned by the death of Justice Antonin Scalia. The signers of the letter include Robert Dallek, Doris Kearns Goodwin, David M. Kennedy, Thomas E. Mann, Norman Ornstein, Geoff Stone, and numerous others.

The letter provides a helpful historical perspective on the decision by the Senate Republican majority to refuse any nominee to fill this vacancy a hearing before the U.S. Senate--something that has never happened in the history of the U.S. Senate.

The Senate Republicans have said to keep that Scalia vacancy right where it is--a 4-to-4 Supreme Court for at least a year longer. We haven't had a vacancy in the Supreme Court for over a year since the Civil War tore this Nation apart over 150 years ago.

This letter that has been sent to the President will be shared here. It makes clear that the actions that are being called for by the Republican majority are unprecedented--unprecedented. They have never happened--the fact that they would refuse to have a hearing for a nominee to fill the Scalia vacancy or a vote on that nominee.

One only has to go back to 1988, not that long ago, when President Ronald Reagan, a Republican outgoing President in the last year of his Presidency sent a name to the U.S. Senate, then in control by a Democratic majority, to fill a vacancy on the Supreme Court. Did the Democrats in the Senate in 1988 say to President Reagan: Oh, you are a lameduck. You are going to be gone in a year. We will wait until after the election. No. They said the Constitution requires President Reagan to send the Senate a name, and it requires the Senate to advise and consent, and they did. They had a hearing and they had a vote and Anthony Kennedy, a Ronald Reagan appointee to the Supreme Court, was sent to the Supreme Court by President Ronald Reagan with the support of the Democratic Senate majority. That is consistent with the Constitution.

I hope we can return to that, and I hope that future generations will judge that this Senate under the control of the Senate majority party is going to live by the words of our Constitution.

As I mentioned, a number of prominent historians and scholars from across the political spectrum sent a letter to President Obama about the current vacancy on the Supreme Court.

This letter provides a helpful historical perspective on the decision by Senate Republicans not to give any consideration to the forthcoming Supreme Court nominee.

The letter begins by saying:

We express our dismay at the unprecedented breach of norms by the Senate majority in refusing to consider a nomination for the Supreme Court made by a president with 11 months to serve in the position. . . .

It is standard practice when a vacancy occurs on the Supreme Court to have a president, whatever the stage in his term, nominate a successor and have the Senate consider it. And standard practice (with limited exception) has been for the Senate, after hearings and deliberation, to confirm the president's choice, regardless of party control, when that choice is deemed acceptable to a Senate majority.

The letter notes that history is, ``replete with instances where a vacancy on the Supreme Court was filled during a presidential election year.''

This includes 1988 under President Reagan; 1940 under President Roosevelt; 1932 under President Hoover; 1916 for two nominees named by President Wilson; and 1912 under President Taft.

The letter also discusses how President Eisenhower used his recess appointment power in the presidential election year of 1956 to appoint Justice William Brennan. Eisenhower, a Republican, made that recess appointment on October 16 while the Senate was under Democratic control.

Here's what it says:

If we accept the logic that decisions made by ``lame duck'' presidents are illegitimate or are to be disregarded until voters make their choice in the upcoming election, that begs both the questions of when lame duck status begins (after all, a president is technically a `lame duck' from the day of inauguration), and why senators up for reelection at the same time should not recuse themselves from decisions until the voters have decided whether to keep them or their partisans in office.

The letter ultimately concludes that, ``the refusal to hold hearings and deliberate on a nominee at this level is truly unprecedented and, in our view, dangerous.''

I hope my Republican colleagues heed the words of these preeminent historians.

There will be real consequences if the Senate fails to do its job and leaves a Supreme Court vacancy open for an extended time.

As President Ronald Reagan said in 1987, quote, ``Every day that passes with a Supreme Court below full strength impairs the people's business in that crucially important body.''

Major legal and constitutional questions are constantly brought before the Supreme Court for national resolution. When a case ends up with a tie vote among the Justices, the Supreme Court's ruling has no precedential impact and important questions go unresolved.

As Gregory Garre, former Solicitor General under President George W. Bush, recently said, ``the prospect of numerous 4-4 ties or dismissals would be undesirable to the Court.''

Millions of Americans are awaiting resolution of the questions that are before the Court. It is not fair to leave them twisting in the wind.

Consider the impact on the efforts of law enforcement to protect our communities.

On February 23, four former United States Attorneys wrote an op-ed in the Cincinnati Enquirer.

They said:

For federal prosecutors, agents and criminal investigations, a year is a lifetime. We have seen real threats, whether it is the heroin epidemic or the threat of ISIS recruitment, facing the people in our communities each day. While law enforcement stands ready to protect the public from those threats, they need to know the rules of the road.

The op-ed continues:

The Supreme Court is the ultimate arbiter of the hardest and most important questions facing law enforcement and our nation. Even as we write today, unsettled legal questions regarding search and seizure, digital privacy and federal sentencing are either pending before the Supreme Court or headed there. It is unfair and unsafe to expect good federal agents, police and prosecutors to spend more than a year guessing whether their actions will hold up in court. And it is just as unfair to expect citizens whose rights and liberties are at stake to wait for answers while their homes, emails, cell phones, records and activities are investigated.

We expect our law enforcement agents and prosecutors to do their job every day, even in election years. We should expect Senators to do their jobs as well and fill this Supreme Court vacancy.

Earlier this week, 356 constitutional law scholars wrote a letter to the Senate, explaining that ``a long term vacancy jeopardizes the Supreme Court's ability to resolve disputed questions of federal law, causing uncertainty and hampering the administration of justice across the country.''

Justice Scalia, in a 2004 memorandum discussing the Supreme Court's recusal policy, noted the problems the Court faces when only eight Justices hear a case. He said that when the Court proceeds to hear a case with eight Justices, it ``rais[es] the possibility that, by reason of a tie vote, it will find itself unable to resolve the significant legal issue presented by the case.'' He then went on to note that under the Supreme Court's Statement of Recusal Policy, ``even one unnecessary recusal impairs the functioning of the Court.''

Why would the Senate purposefully try to impair the functioning of the Supreme Court by leaving it with only eight Justices?

The Senate should do its job and consider a Supreme Court nominee so the Court can function like it's supposed to. I urge my Republican colleagues to do their job. Give the President's nominee a hearing and a vote.

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