Comprehensive Addiction and Recovery Act of 2016--Conference Report

Floor Speech

BREAK IN TRANSCRIPT

Mr. DURBIN. Mr. President, pending before the Senate is an important bill. It is a bill that relates to the opioid epidemic in America--an epidemic which is linked directly to the heroin epidemic in America and the sad reality of the deaths that are occasioned by heroin overdoses.

The prescription opioid and heroin epidemic claimed 28,647 American lives in 2014--1,652 in my State of Illinois. That is a 30-percent increase in just 4 years.

I have seen this devastation firsthand. I have sat with parents who have lost their kids. I have met with young teenagers who were addicted. Thank goodness that some of them have been able--with treatment, counseling, and strength--to fight off that addiction.

The reality is obvious. This narcotics epidemic is not an inner city problem. It is an American problem. It is a problem that not only touches the inner cities of America, but it also touches every other community. There is no town too small, no suburb too wealthy to escape the opioid and heroin epidemic.

I have been across my State, from one end to the other, at roundtables with law enforcement, with medical professionals, with those who do addiction treatment and with those who have lived through these addictions. I have seen firsthand what it has done to communities and families and lives. We need a forceful response, and we are going to vote on one in about an hour. It is called the CARA bill. It is a bill that moves us in the right direction when it comes to dealing with this addiction.

The conference report has many important elements to it, and that is why I am going to support it. It includes my proposal to require reforms at the FDA, or the Food and Drug Administration, to ensure better oversight of dangerous and addictive opioid drugs before they are approved for sale in our country. My provisions will ensure the FDA convenes scientific advisory committees before approving new opioid drugs and that the Pediatric Advisory Committee has a voice in the decision.

We require the FDA to consider the public health impacts before allowing more addictive products to come onto the market. We direct Federal health agencies to develop plans for continuing medical education with doctors and other providers who prescribe opioids. We require the FDA to encourage drug companies to make abuse-deterrent formulations of these dangerous drugs.

The CARA conference report also includes a proposal I have worked on to improve State prescription drug monitoring programs. This legislation will make it easier for States to share information about overprescribing and overusing opioids, it gives doctors more information to better perform their prescribing practices.

I am pleased the CARA conference report includes new grant programs to expand access to naloxone--the lifesaving anecdote--to promote treatment alternatives instead of arrests for those suffering from addiction and to create flexibility and treatment options for those who need medication-assisted therapy or pregnant women who need specialized care.

Having said all of these positive things about what we are to vote on, let me state the obvious. When only 12 percent of the people in Illinois are able to receive care for their addiction, and there is a 12-week wait at facilities for vulnerable patients to get into drug treatment, authorizing new programs, which this bill does, is good but not good enough. We need to make an investment. We need to put taxpayers' dollars behind this commitment to end this epidemic, and it is needed now.

That is why Senator Jeanne Shaheen of New Hampshire offered an amendment during the Senate floor consideration of this bill. Her amendment would have put $600 million into actually making the bill work, enforcing it, investing in it. It failed.

During the CARA conference meetings, Senator Murray and Congressman Pallone offered amendments to ensure that Congress would put some money into the promise of this bill. They couldn't get it passed in a conference dominated by the Republican majority. Why? Why would these efforts be blocked when the Republicans are joining us and saying this is a national problem that deserves our immediate attention? Because Republicans have said they have already proposed to increase funding in appropriation bills to take care of this. Yet many Republicans are supporting a continuing resolution that freezes funding at this year's level and provides for no increase in opioid epidemic treatment. When they say they are going to put more money in and then call for a continuing resolution, they know and we know that it is a sham.

The Republicans are opposing an increase in funding for this bill by saying they already proposed increased funding in another bill, but at the same time they are advocating a freeze, or flat-funding a continuing resolution. They can't have it both ways.

It is confusing, but those of us who live in this world know what they are up to. They want to take the credit for passing this bill and the promise of funding it in the future into the election in November but not provide the money that is needed to make it work. That is playing games with people's lives. America deserves better.

Failing to provide the dollars today is not going to help those who are currently suffering. It is not going to help that mother who was awake all last night worrying about a son or a daughter who is facing an addiction, praying they can get that child they love into treatment in time to break that addiction and save their lives.

You know what else is missing from this CARA conference report? Many of these measures in the bill deal with addiction after it has taken hold. We have to do things to prevent addiction on the front end. The best way is to ensure people don't get addicted in the first place. I have introduced the Addiction Prevention and Responsible Opioid Practices Act, or the A-PROP Act. It is going to help shut off the spigot for fueling this crisis.

Here is something most people don't understand or realize. The Drug Enforcement Administration sounds like the kind of law enforcement agency that polices America to reduce the likelihood that narcotics are going to be found in our homes, in our neighborhoods, in our communities, and in our States. It also has another responsibility. Each year pharma, the major pharmaceutical companies, comes to this agency and asks for the approval to make even more narcotics. These are prescription narcotics like opioids. The DEA has to sign off on this increase in production each year.

If we are going to take a look at the seriousness of this opioid problem and its growth in America, take a look at the growth of production in America that has been approved by this Federal agency. Between 1993 and 2015, the Drug Enforcement Administration-approved quotas for oxycodone increased almost 40 times. In 1993, they were producing about 3\1/2\ tons of these opioid pills. Now they are producing 150 tons of these opioid pills.

The DEA has approved pharma to produce enough opioid narcotic pills to provide--listen closely--every adult in America a 1-month prescription each year to opioid narcotics--every adult in America. That goes way beyond any medical need. It is pharma's effort to make more money and to feed the beast of this opioid epidemic, and DEA each year gives the seal of approval. That is wrong.

Once these pills are produced, it takes a doctor or a dentist or some other authorized medical professional to prescribe them. How they are making it through that process onto the streets and into the homes of America is the next question beyond this DEA approval of pharma's overproduction.

We need continuing medical education to be mandated. Incidentally, DEA approves doctors to give them the authority and power to prescribe narcotics. They can monitor this, as well, and see where the abuse is taking place. We need an all-hands-on-deck approach to this epidemic. Each stakeholder needs to play a role.

I am going to vote for this CARA conference report. On its face, it is hard to vote against, but I want to do it with the knowledge of having said in this statement on the floor that it isn't enough. Unless we pass Senator Jeanne Shaheen's amendment, unless we follow up on Senator Patty Murray's amendment in conference and fund this effort to stop this epidemic, we are basically sending a very nice greeting to America that we recognize the problem but we are not paying to solve it. People across America understand this epidemic. It is time for us to take it seriously, not for political posturing.

BREAK IN TRANSCRIPT

Source