Providing for Consideration of S. Comprehensive Addiction and Recovery Act of 2016
Floor Speech
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Mr. COLLINS of Georgia. Mr. Speaker, by direction of the Committee on Rules, I call up House Resolution 725 and ask for its immediate consideration.
The Clerk read the resolution, as follows: H. Res. 725
Resolved, That upon adoption of this resolution it shall be in order to consider in the House the bill (S. 524) to authorize the Attorney General to award grants to address the national epidemics of prescription opioid abuse and heroin use. All points of order against consideration of the bill are waived. An amendment in the nature of a substitute consisting of the respective texts of the bills specified in section 2(a) of this resolution shall be considered as adopted. The bill, as amended, shall be considered as read. All points of order against provisions in the bill, as amended, are waived. The previous question shall be considered as ordered on the bill, as amended, to final passage without intervening motion except: (1) one hour of debate equally divided among and controlled by the chair and ranking minority member of the Committee on Energy and Commerce and the chair and ranking minority member of the Committee on the Judiciary; and (2) one motion to commit with or without instructions.
Sec. 2. (a) The bills referred to in the first section of this resolution are as follows: H.R. 4641, H.R. 5046, H.R. 4063, H.R. 4985, H.R. 5048, H.R. 5052, H.R. 4843, H.R. 4978, H.R. 3680, H.R. 3691, H.R. 1818, H.R. 4969, H.R. 4586, H.R. 4599, H.R. 4976, H.R. 4982, H.R. 4981, and H.R. 1725, in each case as passed by the House.
(b) In forming the amendment in the nature of a substitute referred to in the first section of this resolution, the Clerk--
(1) shall assign appropriate designations to provisions within the amendment in the nature of a substitute;
(2) shall conform cross-references and provisions for short titles within the amendment in the nature of a substitute; and
(3) is authorized to make technical corrections within the amendment in the nature of a substitute, to include corrections in spelling, punctuation, page and line numbering, section numbering, and insertion of appropriate headings.
Sec. 3. Upon passage of S. 524 the title of such bill is amended to read as follows: ``To authorize the Attorney General and Secretary of Health and Human Services to award grants to address the national epidemics of prescription opioid abuse and heroin use, and to provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication, and for other purposes.''.
Sec. 4. If S. 524, as amended, is passed, then it shall be in order for the chair of the Committee on Energy and Commerce or his designee to move that the House insist on its amendments to S. 524 and request a conference with the Senate thereon.
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Mr. COLLINS of Georgia. Mr. Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentleman from Colorado (Mr. Polis), pending which I yield myself such time as I may consume. During consideration of this resolution, all time yielded is for the purpose of debate only. General Leave
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Mr. COLLINS of Georgia. Mr. Speaker, I am pleased to bring this rule forward on behalf of the Rules Committee. The rule provides for consideration of S. 524, the Comprehensive Addiction and Recovery Act.
The rule provides for 1 hour of debate equally divided among and controlled by the chairs and ranking minority members of the Energy and Commerce Committee and the Judiciary Committee.
The rule also provides for an amendment in the nature of a substitute that consists of the 18 bills passed by the House this week to combat the opioid epidemic. Under the rule, if S. 524 is passed, it will be in order for the chairman of the Energy and Commerce Committee to request a conference with the Senate on the House-passed package of bills.
Let me just emphasize this again for Members so they will understand the process. What we will do under the rule, if S. 524 is passed, it will then be made in order for the chairman of the Energy and Commerce Committee to request a conference with the Senate on the House-passed package of bills.
Each of these 18 bills included in the House package passed the House with strong bipartisan support. The level of support for these bills is a sign of the recognition that something must be done about the opioid epidemic.
You have seen Members who represent urban areas, Members who represent suburban areas, and Members like me who represent more rural areas support these bills. This problem does not discriminate. It is a nationwide issue, and it is taking a toll on communities all over our country. We need to act. With the passage of these bills, we are taking decisive action.
The Senate bill, the Comprehensive Addiction and Recovery Act, received unanimous support in that Chamber. I want to thank Senators Portman and Whitehouse for their leadership on that bill.
The House bills include elements of the Senate bill as well as additional measures. It is my hope that the conference provided for by these bills will yield the strongest possible measure. We need strong, swift, and decisive action to address the growing crisis of the opioid epidemic.
In the United States, more people die every year from drug overdoses than car accidents. As the debate has taken place here on the floor this week, I think the numbers have just been amazingly stark.
When you realize that a statistic like that, when the deaths from drug overdoses surpass car accidents, then we are dealing with something that begins to put it in perspective.
My home State of Georgia has 159 counties. In 2012, prescription drug overdoses led to deaths in 152 of those 159 counties, totaling 592 deaths. The opioid bills in the House package before us today help implement measures to prevent these tragedies.
Addiction is happening far too often with devastating consequences. Further, it is shown that prescription opioid abuse often leads to heroin abuse, compounding the problem. In fact, according to the Centers for Disease Control, 45 percent of people who used heroin were addicted to prescription opioid painkillers.
I mentioned this earlier in the week, but it is worth mentioning again now. I have had many conversations with sheriffs in my area in the Ninth District, which really runs on the I-85 corridor out of Atlanta and up into the northeast, and I keep in contact with them regularly.
My background with my father being in State Patrol, I know the law enforcement community very well. One of the first questions I always ask them--and in my 10 years, I was in the State House for over 6 years, and I have been up here now into my second term--I always ask: What is the biggest thing that you are seeing? What is the epidemic or what is the issue you most see?
Early on, it was methamphetamine. Especially in my rural area, my mountain area, methamphetamine still is very prevalent. But due to many of the restraints that were put in in Georgia--and I notice my friend here from Georgia as well--we worked in the State legislature to control the methamphetamine problem, and then the prescription opioid problem has developed.
Now what my sheriffs will tell me and my law enforcement community and my city police and others will tell me is that heroin is by far their fastest growing issue that they are seeing. It is hitting not just urban areas, it is hitting suburban areas, it is hitting very rural areas, and it is hitting across the income gap. Those who have been addicted to prescription opioids now find that heroin is cheaper to purchase and is cheaper to access.
The problem is, unlike many of the prescription opioid painkillers, the heroin issue is one in which they can take the first dose and it would be their last. This is something we cannot continue to look away from.
In Georgia, heroin deaths have increased 300 percent. That statistic alone should be a call to action. Nationwide, the number of people it affects is staggering. CDC statistics on opioid abuse show 18,893 overdose deaths related to prescription painkillers, and 10,574 overdose deaths related to heroin in 2014.
The opioid epidemic affects everyone. I believe that most people could tell you of a family member or friend who has suffered in some way because of this problem. And these problems aren't only affecting adults. They are affecting college-age students, high schoolers, children, and even the littlest among us, babies.
Every 25 minutes in our country babies are born with a dependency. This is tragic. Babies born addicted to opioids often struggle to survive, have dangerous health complications, and suffer from serious withdrawals.
These innocent children don't deserve this. They deserve a life full of promise. Instead, they face life-threatening challenges from the moment they are born. We can do better, and should do better. In fact, they suffer not only from the moment they are born, they are also suffering in the womb as well. This is an epidemic we have got to address.
Importantly, several of these bills in the House-passed package will help address this problem. For example, Congressman Lou Barletta introduced H.R. 4843, the Infant Plan of Safe Care Improvement Act.
This bill requires the Department of Health and Human Services to distribute information to States on best practices to develop safe care plans for infants affected by substance abuse and withdrawal symptoms.
H.R. 4978, the NAS Healthy Babies Act, introduced by Congressman Evan Jenkins, requires a report on neonatal abstinence syndrome.
Another bill in this package deals with the problems that youth athletes may face if they are prescribed opiates for a sports-related injury. H.R. 4969, the John Thomas Decker Act of 2016, introduced by Congressman Pat Meehan from Pennsylvania, requires the CDC to study information and resources available to youth and families regarding the dangers of opioid use and abuse.
Still other bills relate to veterans and how we can help them. For example, the Comprehensive Opioid Abuse Reduction Act, introduced by Mr. Sensenbrenner from Wisconsin, authorizes investments in veterans courts.
I believe there is another conversation that is going on in Congress right now concerning our criminal justice and criminal justice reform and things that we need to do to make sure that not only are we not using our jails as mental health facilities, but we are getting people the help that they need.
Some of the ways that you do that is found in treatment courts. Many of those are found in newer treatment courts, not just simply the substance abuse, but in veterans courts as well. We are going to continue to look at that.
In doing so, H.R. 4063, the Jason Simcakoski PROMISE Act, introduced by Congressman Gus Bilirakis, directs the Department of Defense and the Department of Veterans Affairs to jointly update the VA/DOD Clinical Practice Guideline, Management of Opioid Therapy for Chronic Pain. The bill also requires the VA to expand opioid safety initiatives.
I am a chaplain still in the Air Force Reserve. I served in Iraq. I saw firsthand the scars that the battlefield can leave, both physical and mental. We need support systems for our veterans like the ones provided for in H.R. 5046 and H.R. 4063.
We need to address their pain, and we need to ensure they have an avenue to get the help they need. I believe the bills this rule provides for will take steps to make that happen. Our veterans deserve our very best.
We cannot discuss this package without mentioning the resources that this bill provides for law enforcement. As the son of a Georgia State Trooper, this component is critically important to me.
The bill provides for law enforcement training. These measures also provide for the expanded use of naloxone by law enforcement. Naloxone can effectively reverse opioid overdoses, so it is a valuable tool to have on hand.
Through the establishment of a comprehensive grant program that will provide resources to law enforcement, communities, and States, and combined with other bills, we have a real chance to make a difference here today.
Mr. Speaker, addiction issues are often related to other co-occurring disorders, including mental health issues. Addiction claims victims, and addiction is a disease. We must not turn a blind eye to those in need.
We must work to halt the opioid epidemic. We must act to prevent more deaths and to stop the growth and spread of this problem. The Senate bill, the House-passed bill, and the motion to go to conference are steps towards doing that.
These bills were brought forward due to the hard work of many Members. Over the course of this week, we have seen Members from every walk of life, representing people from every walk of life, come to the floor to speak on the opioid epidemic.
Each and every one of these Members have made statements to show the depth and breadth of this problem to the real people that we are sent here to represent. Through the 18 House-passed bills and the conference with the Senate, we have a chance to ease that problem, to actually combat it.
These bills call for further studies to examine the response of the opioid crisis, provide support for doctors' treatment of abusers, and also to help law enforcement efforts to combat drug trafficking.
Neighborhoods and families are being torn apart by heroin addiction and opioid abuse. Communities like my home in northeast Georgia need help to address this problem.
Through these bills, we are helping to provide that. Importantly, we are also providing enough flexibility so that States can determine what will work best for their specific populations and communities.
Many communities, many Members, and many staffers have worked hard to bring together these important reforms. I want to thank them for their dedication and hard work. These reforms are a step in the right direction.
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Mr. COLLINS of Georgia. Mr. Speaker, some of the things also we have talked about today are education and prevention. It is also looking at things that we can be a part of and do.
As I have said earlier today, the things that have stuck out to me are some of the statistics that have jumped out. I mentioned the one earlier that more are dying from prescription overdoses than in car wrecks.
Also, there are other practical ways that we can be a part. If you are suffering out there--and, Mr. Speaker, if there is someone who is going through this with either prescription opioid abuse or through heroin abuse and addiction--there are toolkits available.
In fact, we have posted on our social media a place where people can go. It is from the Bipartisan Task Force to Combat the Heroin Epidemic. There are places where they can go to find a parent toolkit, where they can help their young children, also the young adults in their house, from middle school up through their 20s, on how we can best address some of these real issues.
It was very disturbing to me recently in a magazine article that I read that someone who was addicted, not only to heroin but was going through it, made the statement--and this just shows you the concern that is here--made the general statement that they were--there was this adrenaline rush when they were getting ready to shoot the heroin--is that this may be the last time I shoot up. That was almost driving them to do that.
To think about how that plays out, think about a young person who is so addicted and who is so wrapped to a drug that they really, when they go to put it in their body, knowing full well it could be the very last time they do anything, and yet that was part of the reason that they were doing it, that is just disturbing as we look at this.
There are also many other things that have come out. I think, as we go through this--we had a constituent who, knowing what we are doing here today, had looked to the pharmaceutical industry and who found ideas that are out there, such as this one from a pharmaceutical company that is looking at abuse-resistant opioids that don't have the same problems as we see in some of the others, such as OxyContin and some of the others that we have out there.
I think this is about proper management. I appreciate what Mr. Carter from Georgia said on dealing with this and finding that balance. I think when we have the study, especially on how doctors prescribe how pain medication is used, these are all the kinds of things that get us to a point in which we limit the good uses that they may have, but also of preventing the addiction and the preventative steps that are putting us in the situation that we currently have.
So there are a lot of issues out here, and I think this is why this rule is effective. This rule is a good first step. It is something we move forward on. In doing so, I think we make a statement to the American people that we are looking to the problems that they are experiencing. We are addressing those needs, and we are going to continue to do so.
If there is any indication that this was the last step, I think that is a misperception that is out there. This is a first step toward continuing this process. It will continue into the appropriations, I am sure, process as well. But these are the tools that we need to get into the toolbox right now and to be a part of that.
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Mr. COLLINS of Georgia. I yield myself such time as I may consume.
Mr. Speaker, as I went through in my opening statement, I mentioned a good many of the bills that were part of the House package this week. I want to go back through just a few more that we went through just to let people know the breadth and scope of what we have been doing.
H.R. 4982, Examining Opioid Treatment Infrastructure Act, is a bill that requires the Comptroller General to report to Congress on the inpatient and outpatient treatment capacity, availability, and needs in the United States. And that was by Mr. Foster of Illinois.
We also have H.R. 4599, Reducing Unused Medications Act of 2016, from Representative Clark of Massachusetts.
We also have H.R. 4586, Lali's Law, sponsored by Representative Dold of Illinois.
H.R. 3691, Improving Treatment for Pregnant and Postpartum Women Act of 2016, sponsored by Representative Ben Ray Lujan of New Mexico.
H.R. 3680, Co-Prescribing to Reduce Overdoses Act of 2016, sponsored by Representative Sarbanes of Maryland.
We also have H.R. 1818, Veteran Emergency Medical Technician Support Act of 2016, sponsored by Mr. Kinzinger of Illinois.
Again, as you see the breadth of what we are doing here and why I believe moving forward on this rule is important and going through, many times what we have said is: look, these issues all address specific needs. They all are encompassing of our body, as a whole, all 435 of us, because, as I read here, these were a mix of both Republican and Democrat bills that have been passed on this floor this week.
So, as we look ahead, we look to the serious nature of what we are doing, it also really looks at the breadth and the scope of what we are dealing with here. This is why this needs to move forward today, why this package needs to be approved and also go to conference so we can continue to move forward with these ideals and with the things that have been put before us this week.
We can do that by making a positive step and acknowledging the good work that has gone on here. I appreciate all of the speakers today on both sides of the aisle who have come forward to talk about this issue and talk about the real problems that we see that are occurring, really unfortunately, in kitchens and living rooms all across our country every day. So this is something that so many people can relate to.
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Mr. COLLINS of Georgia. Mr. Speaker, I inquire of the Chair how much time remains.
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Mr. COLLINS of Georgia. Mr. Speaker, if the gentleman from Colorado is prepared to close, I am prepared to close as well.
Mr. Speaker, just the other day I had an opportunity to speak to a longtime friend, and there was a general discussion about what was going on up here and the steps that were being taken.
During this time, my friend began to list and talk about folks close to him that either had addiction to prescription pain medications or were dealing with the aftereffects of that problem. This came, frankly, out of nowhere and even to my friend, who basically said, ``I had no idea.'' And yet, within just the matter of a few weeks, he had found out within just his own sphere of influence that there were a number of people in his family and in his friendship connection who were dealing with this abuse.
That tells you that this is something that a lot of times is hidden just below the surface, unfortunately dealt with in very private, very concerning ways, because so many times they are trapped in a cycle of addiction in which the addiction is found and then treated and it comes back again and it reexpresses itself in many different ways.
As a pastor and as a chaplain, I have dealt with these issues before, and there is nothing more heartbreaking than to see someone who wants to break free from an addiction and break free from the abuse that they are perpetrating basically on their own body and to see progress made and then get a call or not see them for a week or two and then find out that they fell back into their old pattern or they unfortunately found a new addiction that has taken over.
But when we come to the floor of the House--and we have spoken this week on 18 bills and the promise of the Senate bill and the promise of a conference committee going forward--it is saying that we have heard these sometimes silent screams, these sometimes silent tears of those who may not know how to deal with it but yet they are looking for ways.
We have heard the anguish of law enforcement officers and first responders who come to scenes, and if they have the proper medication, if they have the proper treatments, then they can reverse some of these disastrous effects. Now we are making sure that we can get that to them, we can look for better ways of helping them do their job that they so heroically do every day.
We are looking at ways of looking at a task force so that we can look at how we prescribe and how we treat pain and those things in people's lives that are chronic and ongoing, how do we treat them better so that we don't have to deal maybe with this addiction side and we don't have to deal with possible aftereffects of that.
We have to also look at our ways on how we deal with folks who are addicted and how we deal with them in treatment, not only from the veterans' perspective, from the son or daughter perspective, from the mom or dad perspective, the aunt or uncle, even the grandparent perspective. How do we do that? How do we do it effectively?
How do we make sure that when we get to our spending and we get to our appropriations and we make sure that these appropriations are going out that they are done so in appropriate ways? That is the function, I believe, of the Republican majority.
That is why we are bringing this forward today as we are, is to make a difference in the lives of people but do so in a way that is constructive and ongoing. As we have heard today and over the course of the week, the opioid epidemic is out of control, but we have an opportunity to start addressing the problem.
Again, the rule provides for consideration of legislation that will enact measures to address this problem through multiple avenues to ensure that we are taking a comprehensive approach to stopping this scourge. It takes important steps to address the serious and growing threat of opioid abuse. It keeps a promise that we won't sit idly by while people continue to battle addiction and die.
For that reason, I would urge my colleagues to support this rule, the Comprehensive Addiction and Recovery Act, and the motion to go to conference on the House-passed amendment in the nature of a substitute.
This is something we can do. This is a very positive step in a week in which, for the most part, we have come to the floor to hear bipartisan unity in saying, ``We will act.''
Do not let this day go by because we may not have gotten everything that everybody wanted. It is the time to vote ``yes'' on the previous question, it is the time to vote ``yes'' on the rule, and it is the time to vote ``yes'' to move forward so that we can conference with the Senate and put together a product that can make not only this body proud but make the American people know that we have heard their voice.
We agonize with them, many of us who have felt it firsthand. And in doing so, we are doing the people's business.
The material previously referred to by Mr. Polis is as follows: An Amendment to H. Res. 725 Offered by Mr. Polis
On page 2, line 2, strike ``the respective text of the bills specified in section 2(a) of this resolution'' and insert ``the text of H.R. 5189, as introduced,''.
Strike section 2 and redesignate subsequent sections accordingly. ____ The Vote on the Previous Question: What It Really Means
This vote, the vote on whether to order the previous question on a special rule, is not merely a procedural vote. A vote against ordering the previous question is a vote against the Republican majority agenda and a vote to allow the Democratic minority to offer an alternative plan. It is a vote about what the House should be debating.
Mr. Clarence Cannon's Precedents of the House of Representatives (VI, 308-311), describes the vote on the previous question on the rule as ``a motion to direct or control the consideration of the subject before the House being made by the Member in charge.'' To defeat the previous question is to give the opposition a chance to decide the subject before the House. Cannon cites the Speaker's ruling of January 13, 1920, to the effect that ``the refusal of the House to sustain the demand for the previous question passes the control of the resolution to the opposition'' in order to offer an amendment. On March 15, 1909, a member of the majority party offered a rule resolution. The House defeated the previous question and a member of the opposition rose to a parliamentary inquiry, asking who was entitled to recognition. Speaker Joseph G. Cannon (R-Illinois) said: ``The previous question having been refused, the gentleman from New York, Mr. Fitzgerald, who had asked the gentleman to yield to him for an amendment, is entitled to the first recognition.''
The Republican majority may say ``the vote on the previous question is simply a vote on whether to proceed to an immediate vote on adopting the resolution . . . [and] has no substantive legislative or policy implications whatsoever.'' But that is not what they have always said. Listen to the Republican Leadership Manual on the Legislative Process in the United States House of Representatives, (6th edition, page 135). Here's how the Republicans describe the previous question vote in their own manual: ``Although it is generally not possible to amend the rule because the majority Member controlling the time will not yield for the purpose of offering an amendment, the same result may be achieved by voting down the previous question on the rule. . . . When the motion for the previous question is defeated, control of the time passes to the Member who led the opposition to ordering the previous question. That Member, because he then controls the time, may offer an amendment to the rule, or yield for the purpose of amendment.''
In Deschler's Procedure in the U.S. It is one of the only available tools for those who oppose the Republican majority's agenda and allows those with alternative views the opportunity to offer an alternative plan.
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