Comprehensive Addiction and Recovery Act of 2016--Conference Report--
Floor Speech
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Ms. MURKOWSKI. Mr. President, there is a great deal of discussion this week on very difficult and hard issues.
The comments of the Senator from California, which were preceded by the comments of our colleague from South Carolina, remind us that as lawmakers, as policymakers, our jobs are indeed difficult, as we do try to make good on that pledge for a more perfect union because we are clearly not there today.
I am on the floor to speak to another type of killer that we face in this country, and that is the killer that comes with drugs, substance abuse, illegal drugs, opioids, heroin--this insidious scourge that has afflicted us as a nation. We are fortunate in that we have an opportunity--hopefully soon--to be voting for the Comprehensive Addiction and Recovery Act, CARA.
I thank all of my colleagues who have been involved in this effort, very aggressively pushing this bill. Senator Portman from Ohio, Senator Ayotte from New Hampshire are among the many who have stepped forward to really shine a light on an area where we know that we need to work to develop a comprehensive solution, a community-focused solution to so much of what we are dealing with.
The CARA act touches on all areas of this issue, from education to awareness, from access to treatment to preventing and treating overdose, from families to veterans to infants with neonatal abstinence syndrome, and even teens who may suffer a sports injury. Opioid and heroin addiction is a serious threat to our Nation's prosperity, and the legislative initiative that we have in front of us is one way to fight back.
The rates of opioid abuse have skyrocketed. Drug overdose-related deaths have more than quadrupled since 1999. When an addict can no longer afford to get access to opioids, we find, unfortunately, that they oftentimes turn to heroin, a cheaper alternative with similar effects.
The rates of heroin overdose have tripled between 2010 and 2014. In my State of Alaska, we like to think that sometimes we are far enough away geographically that we are isolated or insulated from some of what happens in the lower 48. But in fact we have seen instances of heroin use, opioid abuse, that have resulted in statistics that are shattering. Efforts to prevent those deaths by overdose have resulted in many States, like the State of Alaska, passing legislation which has removed the liability for a family member to administer the lifesaving drug naloxone. CARA does this, as well, through grants that improve access to medically assisted treatment, opening access treatment to overdose treatment, and it provides for first responder training.
Over the course of these many months, there have been so many personal horror stories about the impact of opioid and heroin addiction in our respective States. We have witnessed the sense of urgency and desperation as we hear those stories from families who are truly desperately seeking help. Too often those families face a multitude of different challenges from treatment centers that are at capacity, very expensive private options--if you can find them--that put families in a financial bind. In so many cases, there is just no option. In Alaska our options are extraordinarily limited, so what happens is that you have to send your loved one outside of the State to find treatment if you can find it. There are so many of our families that simply lack the tools or the resources to help those they love who are suffering from substance abuse. They don't have the resources, and they really don't know where to turn. They don't even know whom to talk to.
Addiction to opioids and heroin does not just harm the individual; it breaks the community. It leaves these communities with a sense of hopelessness amongst the loss.
But despite the anguish that we know that addiction brings, I actually have been very inspired by several of the communities in my State that have really come together to fight back and to deal with the levels of addiction that they see in their communities and say: No, we are going to be engaged; we are going to come together to make a difference.
In 2014, the community of Juneau lost seven young people--all in their early twenties--to drug overdoses. After they lost their loved ones, what happened was that these families just kind of closed up. It was very difficult, extraordinarily hard, to be able to talk about what had happened because, quite honestly, of the stigma that is attached to drug abuse.
By 2015, a year later, that community came together and said: Enough. Our silence is not going to help anyone.
So they came together to help support families. They formed a group that provides support, educational tools, and community outreach.
This group, which is called Stop Heroin, Start Talking, works proactively with Alaska's young people, goes into the classrooms to talk with the kids early on about drug abuse, and focuses on making kids active participants in the discussion, instead of just kind of preaching the talk to them.
In the Matanuska Valley, another group called Fiend 2 Clean runs a Facebook page and reaches out to at-risk teens in the community. They also run a peer-run support system that really empowers these young people by reminding them: Look, you are not alone in this. We are here as a resource, we are here to talk to, and we are here with you.
Fiend 2 Clean works with another organization called MyHouse to empower young people and really support them as they are developing job skills, building self-worth, and understanding their role in the community. These peer-focused programs make the difference. They really help make the difference in the day-to-day lives of these young people, their families, and their communities. More importantly, these efforts highlight the importance of making sure that all members of the community are involved in addressing addiction.
CARA acknowledges that any successful efforts at combating opioid and heroin addiction must focus on building community-centered and culturally inclusive methods that engage everyone who may be impacted by drug abuse.
The grants within CARA will give States and local communities the funding, as well as the tools they need, to build these sorts of relationships and work toward not just treating but really preventing that abuse up front.
We have seen rapid rates of prescribing opioids for pain, largely due to a lack of consensus on uniformity or prescribing opioids. While many State legislative bodies in the Department of Health and Human Services have already begun to do their part in addressing prescribing guidelines and establishing prescription drug-monitoring programs, CARA takes this one step further. The task force on pain management will provide more information about pain management practices by supporting evidence-based practices as they examine the trends of opioid prescription nationwide.
CARA also offers support for our Nation's veterans by improving opioid prescribing safety measures within the VA system through education and training on pain management for our providers. I think we have all heard far too many stories of concerns from our veterans or from their families where, in an effort to get a vet through the system and with not enough providers or with a backlog, the easiest thing to do is just to provide a prescription for pain medication rather than really trying to work to rebuild that body.
In addition, there are provisions to improve patient advocacy, support the integration of care, and enable multiple treatment options--depending on that particular veteran's needs--really moving away from this rush to prescribe opioid medications.
CARA provides the support and treatment needed for postpartum mothers and infants with neonatal abstinence syndrome and establishes a pilot program meant to enhance funding flexibility so that States can support the services that will properly benefit women and their children. CARA will also improve the reporting and understanding of addiction related to youth sports injuries. I think we recognize that kids are out playing soccer or basketball, doing things, and they get hurt. Those providers who are treating them need to be included in the discussion of how to treat sports-related youth injuries. Kids shouldn't just be given highly addictive medications, opening them up to possibly future addiction. Again, let's look at comprehensive pain management care that is focused on different treatment options.
The families, friends, and communities that are working together to address opioid addiction need to know that they are not alone and that the situations they face are not hopeless.
We can provide that hope. We can provide the tools needed to build up these communities so they can really come together to fight back against the addiction that we see. I think that by moving forward and passing CARA, we take the steps to do this.
This legislation takes into consideration the diversity and the magnitude of the opioid epidemic and works to address this issue head- on through improved research, pain management practices, community- focused programs, and opening up the dialogue about drug addiction because we know that the more we allow ourselves to talk openly and honestly about this issue, the more that stigma fades.
CARA is an encouraging first step. We all know there is much more work to be done, and I certainly remain dedicated to the fight against substance abuse now and well into the future.
(At the request of Mr. Lankford, the following statement was ordered to be printed in the Record).
In 2015, Oklahoma sought to address this problem by introducing House bill 1948 that requires doctors to check an online database before prescribing opioids. This law went into effect in November and was designed to help spot patients who are receiving prescriptions from several physicians at the same time, a practice known as doctor- shopping. Oklahoma is taking an important step in addressing the opioid epidemic, but as we know, this does not just affect my State, but the entire Nation.
The Comprehensive Addiction and Recovery Act, CARA, will provide grants to States to fight the abuse of prescription pain relievers and heroin, as well as grants that address criminal justice activities, treatment of pregnant and postpartum women with substance abuse problems, first responder education and training and treatment and recovery programs.
In addition, CARA addresses the opioid issue as it affects the veterans' community specifically. Our veterans have put their lives on the line to protect our Nation, and it is our job to make sure that they are getting the treatment and prevention services they deserve. Many of our veterans come home with painful injuries that will alter their daily lives going forward. It is important that, through the Department of Veteran's Affairs, we develop best practices for pain management that do not lead to addiction. CARA addresses this by requiring that all VA employees who prescribe opioids receive education and training on pain management and safe opioid prescribing practices.
This truly is a comprehensive response to the opioid epidemic, and I hope my colleagues will join me in support of this bill as we take an important step in combating this addiction crisis.
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