Statements on Introduced Bills and Joint Resolutions - S. 2288

STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

By Ms. COLLINS:

S. 2288. A bill to amend the Public Health Service Act to assist States in establishing, maintaining, and improving systems to reduce the diversion and abuse of prescription drugs; to the Committee on Health, Education, Labor, and Pensions.

Ms. COLLINS. Mr. President, the abuse of prescription drugs has reached epidemic proportions in this country. In many States, including my home State of Maine, deaths from prescription drug overdoses now exceed deaths from illicit drugs. Nationwide, emergency room visits for prescription drug problems more than doubled in the last decade.

The number of Americans who divert prescription drugs from their intended purposes and abuse them was estimated at 4 million in 1998. Today, the estimate is 11 million Americans. At a time when, according to the National Institute on Drug Abuse, our young people are turning away from marijuana, cocaine, ecstasy, and even alcohol, they unfortunately are turning to the medicine cabinet.

Nearly one in five of our Nation's high school juniors and seniors say they abuse prescription drugs.

The cost of drug abuse to our society in treatment, health care, lost productivity, crime, and incarceration exceeds $150 billion a year. The cost to its victims is incalculable. That is why today I am introducing the Prescription Drug Stewardship Act. I use the word "stewardship" to emphasize our responsibility as individuals and as a society to see that these beneficial medications are used for their intended purposes, not to cause addiction, disability, and even death.

This legislation attacks the spiraling cycle of diversion and abuse with three key stewardship activities:

First, computerized prescription drug systems to better track the flow of medications.

Second, ongoing practitioner training to help our busy medical professionals keep current with the trends in diversion treatment and abuse.

Third, and perhaps most important, public education to help our citizens better understand the dangers posed by the misuse of these drugs.

I have found in talking with experts in this field that many individuals who would never think of trying heroin, for example, will take leftover prescription drugs that may, in the long run, be equally addictive and just as harmful.

Combined with improved and more accessible substance abuse treatment programs, the legislation I am introducing would help to stem the rising tide of abuse and addiction that has swamped families and weakened communities in my State and across the country.

My bill would authorize per year for each of the next 3 years to fund prescription drug monitoring and education programs at the State level. It would create competitive grant programs which would be administered by the Substance Abuse and Mental Health Services Administration. They would require States to demonstrate their commitment to stewardship with matching funds and also to meet the privacy requirements under current law as they carry out these important activities.

What we have found is that the most abused medications are those that relieve pain and anxiety. For millions of legitimate patients suffering from illness or injury, these medicines are vital and their availability is proper and humane. They can make the difference between suffering and the ability to carry on with a normal life for people who are in serious pain or suffering from serious disease or injury. It is tragically clear, however, that these medications, many of them as powerful or as addictive as illegal drugs, increasingly are being diverted from their legitimate use to trafficking and abuse.

I want to emphasize that the problems is not with these medications when they are prescribed, dispensed, and consumed responsibly. In fact, we know that pain is still undertreated in this country, and that most physicians are extremely responsible in trying to relieve pain felt by their patients. The problem is what happens when the chain of responsibility breaks.

Oversight of the licensing and practices for prescribing and dispensing of these medications has long been a matter of State jurisdiction. As a former State regulator who was in charge of licensing boards for physicians and pharmacists, for example, I certainly have no desire to change that system. The States have not shirked their stewardship responsibility. They simply have been overwhelmed by this epidemic of diversion and abuse, and they need some Federal assistance, not to take over their programs, but to help them in a partnership to make them more effective.

This national calamity has hit rural States particularly hard. The Presiding Officer's home State of North Carolina is one of those States that has felt the devastating impact of this epidemic. Kentucky, Virginia, West Virginia all report prescription drug abuse at epidemic levels. But no State, unfortunately, has been hit harder than my State of Maine.

From 1997 to 2002, the number of accidental deaths in Maine from all drugs soared from 19 to 126, an increase of more than 500 percent, and prescription drugs were present in 60 percent of these deaths.

The 2002 Main Youth Drug and Alcohol Survey found that a disturbing 25 percent of my State's high school juniors and seniors abuse prescription drugs. That is an astonishing number and a very disturbing statistic. In the last 5 years, enrollment in Main clinics that treat opiate addiction has increased tenfold.

These shocking numbers from Main demonstrate that drug abuse and addiction is not longer a big-city problem. It is a problem that afflicts our citizens no matter where they live, whether it is Los Angeles, CA, or Calais, ME. In fact, a hearing I helped put together last year demonstrated that there is a terrible problem in Washington County in Downeast, ME. Some estimates are that as many as 1,000 of the citizens of this county of only 35,000 citizens are struggling with drug addiction and abuse. This was a hearing before the HELP Committee. It actually was 2 years ago. But last August, I chaired a committee meeting of the Governmental Affairs Committee in Bangor, ME, where we heard from law enforcement officers, from drug treatment counselors, and from many others who are expert in drug addiction and abuse. The picture they painted was a startling one. It showed that drug abuse, and abuse of prescription drugs in particular, is a problem throughout the entire State of Maine.

My legislation would provide States, such as Maine, with the resources to carry out three critical stewardship activities. The first would help States to monitor the flow of prescription drugs from practitioner to pharmacy to patient. We know that prescription drugs often find their way to the street when unscrupulous individuals obtain multiple prescriptions from multiple doctors. These so-called doctor shoppers operate in every State. Sometimes they act alone and sometimes they act in concert with organized gangs of criminals. Each can divert hundreds, even thousands, of pills per day. Many of these drugs have a street value 10 times the cost at the pharmacy.

Twenty States now have prescription tracking systems. Maine began operating such a system or putting it together just this summer. About half of these systems use the latest computer technology and have proven that illegal diversion can be curtailed without reducing access to these medications by legitimate patients and without breaching that essential doctor-patient confidentiality.

We want to make sure any system we put in place does not chill a doctor's ability to prescribe legitimate medication for patients who are suffering and need help with their pain.

These systems have also demonstrated an effective prescription drug system more than pays for itself by reducing the tremendous costs associated with drug abuse and addiction. Thirty States, however, have no system whatsoever for monitoring or tracking prescription drugs in a way that would help us identify and put a stop to doctor shopping. My legislation would provide the States with the resources to start up such a system to help improve its quality or to maintain it.

The testimony I heard last August in Bangor, ME, before the Governmental Affairs Committee, along with my colleague Senator SUNUNU, provided the basis not only for that provision of our bill but also for two others. The testimony we heard that day from those who are on the front lines, law enforcement, hospital emergency room physicians, and treatment clinic personnel, was alarming. They told us medical practitioners need our help. Our doctors, our physician assistants, our nurses are busy professionals, often far too busy. Many simply do not have the time to travel to seminars where they would receive information about the latest trends in drug abuse, learn how to recognize drug-seeking behavior, dependence, or addiction among their patients. The most effective and efficient way to provide that kind of training to medical personnel is to take the education to them through one-on-one small group mentoring in their offices or in their hospitals.

The second part of my legislation would provide grants for such mentoring projects so practitioners with special training in drug abuse issues can pass along this vital knowledge to their colleagues who are practicing in communities all over America. Experts also tell us a major reason so many Americans with no history of abusing illegal drugs now are abusing prescriptions drugs is many people have a terrible misconception that these prescription drugs are somehow safe to abuse, that it is safe to take someone else's prescription. After all, they think they are researched in high-tech laboratories, manufactured in modern factories, prescribed and dispensed by highly trained medical experts; therefore, they must be safe. When they are used properly, they are, but as the overdose and addiction statistics prove, when used improperly they can be fatal.

We need an aggressive public education campaign to warn our citizens about the dangers of abusing prescription drugs. The reduction in smoking rates, in illicit drug use, even in drunk-driving deaths is testament to the progress we can make with seemingly intractable problems when we commit the resources for public education campaigns in partnership with the States. I believe the same approach can help our citizens become better stewards of prescription medications.

I urge my colleagues to join me in support of the legislation I am introducing today to address the increasingly devastating problem of prescription drug abuse.