Comprehensive Addiction and Recovery Act of 2015--Motion to Proceed

Floor Speech

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Mr. PORTMAN. Mr. President, first I thank my colleague and chairman of the Judiciary Committee, Chuck Grassley.

Many years ago I went to Iowa with Senator Grassley to set up an anti-drug coalition. We had done one in Ohio. I was the chair of that, and Chuck Grassley asked if I would come. This was probably 20 years ago that Senator Grassley--and I was in the House.

We had a great visit. We had a couple of townhall meetings. Chuck Grassley is a guy who understands the issue, cares about it, and has devoted a lot of time and resources to it in Iowa. The people of Iowa know he is sincere about it because he has been on the ground setting up these coalitions and dealing with this issue.

Frankly, it is a little disappointing--probably to him and to me--to see that some 20 years later we are still facing this issue now and even different issues. He mentioned methamphetamines. He mentioned, of course, the heroin and opiate addiction problems with prescription drugs.

Twenty years ago it was more marijuana and cocaine, but I think the lesson we have all learned is these drugs will come and go in terms of their severity and their impact on our communities and our families, but it is always going to be there, and we need to keep up the fight.

Right now we have an urgent problem. That urgent problem was outlined by Senator Grassley, but it is this growing use of opiates that leads to a horrible addiction. It has a grip on so many of our constituents, so many of our loved ones.

Over the weekend I had a townhall meeting. I asked--after we had talked about taxes, trade, energy, and other issues--if people would just raise their hands if they had been affected by the heroin and prescription drug addiction problem. I said: Has anybody in your family and friends been affected? Half of the hands in the room went up.

Unfortunately, that is the reality of this situation. In Ohio last year we lost almost 2,400 just to overdose deaths. That doesn't account for the fact that so many people are being saved now by naloxone--which is something that is encouraged by our legislation and we will talk about it in a second. Narcan is being used, but even those who survive the overdoses, of course, are seeing their families broken apart, their communities devastated.

I talked to a prosecutor over the weekend in one of our more rural counties, and he said: Rob, over 80 percent of our crime is directly related to this issue now, heroin and prescription drugs. Often it is people committing crimes to pay for their habit.

The people who are the purveyors of these drugs have a business plan; that is, to get you hooked with a relatively low cost at first and then you need more and more to be able to feel the same high. It gets more expensive to the point that it might go from $50 to $100 the first time to $1,000 or $1,500 a day by the end of your addiction. This is how horrible it is and it leads to so many collateral consequences.

I am very pleased the Senate voted tonight to proceed to this legislation called CARA, the Comprehensive Addiction and Recovery Act. CARA is a Federal response to this issue. It is attempting to make the Federal Government a better partner with State and local governments, with nonprofits, to be able to help to reverse this tide to deal with this urgent problem in our communities. I would call it an epidemic. It certainly is at epidemic levels in my State of Ohio. Sadly, we are the top five in the country in terms of overdose deaths, but again it goes well beyond just those deaths. There are so many people who are affected by it negatively and so many who have not been able to fulfill their God-given purpose because of this horrible addiction.

This legislation called CARA is bipartisan. It is comprehensive. As Senator Grassley said, he got it through the Judiciary Committee. I appreciate that. He got it through with something very extraordinary around here, which is a unanimous vote--meaning nobody objected. That never happens around here. It just means that every Senator is addressing this issue back home, understands it, and wants to do something about it. This legislation is built on common sense, research, and experts from around the country who have come in.

I thank Senator Sheldon Whitehouse, who is the lead Democrat on this legislation and my lead cosponsor. He and I are the coauthors of this legislation. I also thank Senators Kelly Ayotte and Amy Klobuchar, who have been terrific partners. Then there are 34 other bipartisan cosponsors. I thank them all for their support.

I am excited that if this bill can pass, it will pass in the House as well because there is companion legislation. In fact, the House bill has 88 cosponsors right now--also bipartisan. So the idea is to get this bill passed, get it through the House, and have it signed into law by the President of the United States. It is urgent we do it.

This is a bill that not only has a lot of support on both sides of the aisle, but--much more importantly to me--it has the support of people all over the country who are experts in this field: doctors; those in recovery; experts in prevention, treatment, and recovery; and law enforcement.

The legislation actually comes--I hope you can see on this chart, the words are kind of small--but it comes from the last few years, putting together these experts from all around the country. We had five different summit meetings in Washington, DC.

One was with the criminal justice system. We brought in experts from all around the country to talk about treatment and alternatives to incarceration. As you will see in this legislation, we have ways to divert people from incarceration into treatment programs, which we think is part of the way to solve this problem.

We then had one that focused on women, the special interests and needs of women who are facing addiction and how to ensure they get into treatment. As we will talk about later, this has a lot to do with one of the problems that is out there right now, which is more and more babies who are born with addiction and having to take those babies through withdrawal. The care and compassion involved in that is truly impressive, but that was a good forum for us. We had one on the science of addiction and addressing the consequences of addiction. There are a lot of good people around the country who understand the science of this and what medication might work and what future medication might be better to deal with it.

We talked about youth drug prevention and developing communities of recovery. This is a very important aspect of our legislation. We don't just talk about treatment, as important as that is, we talked about how you divert people from getting into it in the first place through better prevention and education.

Finally, we had a forum on veterans focusing on substance abuse and PTSD and other issues. I recently visited one of our veterans courts in Columbus, OH, and saw the good work they are doing. Most people going through that court have mental health issues. Most also now have, sadly, opioid addiction issues, usually starting with prescription drugs and moving to heroin.

As I said, there is strong bipartisan support for this legislation in the House and the Senate. It is endorsed by more than 130 groups nationwide. By the way, those groups include some groups you might not expect normally to be together on something such as this--the Fraternal Order of Police, the American Society of Addiction Medicine, the Faces and Voices of Recovery, the Coalition for a Drug Free America, the Children's Hospital Association, the National Association of Addiction Treatment Providers, the Partnership for Drug Free Kids, the American Society of Addiction Medicine, the National Association of State Alcohol and Drug Abuse Directors, groups who are in all of our States, the National Council for Behavioral Health, and, of course, the Major County Sheriffs' Association. So law enforcement, treatment, recovery, education--everybody is coming together on this because we realize this is going to take that kind of comprehensive approach with all sectors of our community being involved and engaged.

CARA now has support not only of a lot of these groups from around the country, but because of these groups--they helped us write a better bill.

What does the bill do? Here are the basic elements of CARA:

First, with regard to prevention and education, it does establish new task forces to develop better practices for prescribers simply because there has been overprescribing, particularly of prescription drugs. These narcotics have been overprescribed to the point that many people end up on heroin as a less expensive alternative to the prescription drugs to which they have become addicted. The task force is an interagency task force that is reporting back to the Congress on how to develop these best practices for the medical community.

The bill also establishes a national awareness campaign with regard to prevention and education. That is critical for us to get the word out. It has grants to local coalitions. This is in the Drug-Free Communities Act area. The Drug-Free Communities Act goes back to the 1990s. Since 1998 there has been $1.3 billion spent under the Drug-Free Communities Act. I was the author of that in the House. It is good legislation that helped create over 2,000 community coalitions around America. I chaired ours in Cincinnati, OH, for 9 years and am still very involved with it, and they do great work. But, again, we now have this new issue, this new threat we must address. This helps with regard to specific grants where there is a high degree of opioid addiction and the negative consequences of it, to be able to blend with the drug-free community program.

Law enforcement. The bill provides for training for Narcan--what is known as naloxone--for first responders to prevent overdoses. I think everybody in this Chamber has run into this back home. I went to a firehouse recently because we had lost a brave firefighter in a house fire, and I went to talk to his shift about him and to thank them for their service. After talking to them about their fallen comrade, they wanted to talk about this issue. They told me: Rob, we are spending more time administering Narcan than we are fighting fires these days. In other words, they are going out and helping people who are having overdoses and are saving their lives.

A friend of mine who is a firefighter in Cincinnati told me just a couple of weeks ago that he was responding to an overdose, saving someone in front of a house, when, in an entirely different group in the back of the house, an overdose occurred.

In Toledo last week, there was a response by emergency medical services to somebody who had hit a telephone pole. They found him with a syringe in his arm. He had overdosed. While they were responding to him, there were two other overdose calls in Toledo--one city in Ohio. There were three at the same time. Two of the three were saved by Narcan. The third died.

Our folks in law enforcement and our first responders, our firefighters, are doing a terrific job. They need help. They need more Narcan and more training to be sure they can continue to do what they are doing to prevent these overdoses. It is not the answer. Of course, the answer is prevention, education, and better treatment. But in the meantime, we have to provide them the help they need.

The law enforcement side also expands these drug prescription take- back programs. They work very well, as Senator Grassley said, in some of our States. We need to do more to expand those, and that is usually done through our law enforcement communities.

It also authorizes a task force to combat heroin and methamphetamines. These are the law enforcement task forces we talked about earlier, which will help to coordinate Federal, State, and local law enforcement to deal with this issue.

On the treatment and recovery side, it expands medication assisted treatment for opioid and heroin addiction. It creates diversion, education, and treatment programs in the criminal justice system. We talked about that earlier. That is so important.

I have been at roundtable discussions all around my State and at a number of treatment centers talking to recovering addicts about how they got into the situation they are in and what advice they have. A young man told me a classic story. He had an injury. He started using prescription drugs. He got addicted. He needed money to buy these expensive pain pills. He actually stole from a family member, and he ended up in the law enforcement system and in jail. It was in jail that he was told for the first time that it was actually cheaper to buy heroin. He got out and bought heroin and became a heroin addict. He is now in treatment. He hit rock bottom, as he said, and I think it was because he had an overdose.

This is something where we need to figure out a better way to get people diverted and use the criminal justice system to provide the incentive to get them into the right treatment program.

It also supports recovery for youth and building communities of recovery, again focusing on our youth to get them to make the right decisions but also steering our youth who are addicted into the recovery they need. Sadly, this is now necessary in many of our high schools and in our colleges and universities.

It also establishes a task force to review some of the recovery and collateral consequences. This is an interagency task force that is going to report back to us on what is truly working and what is not working in order to do a deeper dive to ensure we are using this money most effectively in order to make a difference.

It has treatment services for women and veterans included. This is a special interest of ours in this legislation--expanding treatment for pregnant women who are struggling with addiction, again to avoid this horrible situation where babies are born with an addiction.

It also supports care for our veterans. Our veterans right now can enter treatment, of course, following discharge with this legislation. This is important. Our veterans have some special needs and special circumstances--often trauma, PTSD, and other things related to their addiction. We find these veterans courts are incredibly helpful, to be able to have them surrounded by fellow veterans in order to make more progress. That is in here as well.

Finally, the legislation incentivizes the States themselves to enact comprehensive initiatives to address the opioid and heroin abuse problem--the prescription drug monitoring program, for instance. This is very important. The Federal Government has a big role to play here. Think about it. If you are in one State and you are monitoring someone's prescription drug medications, knowing where they are going and how much they are getting to avoid overprescribing, if that person crosses State lines, it is very difficult. So our legislation expands on what can be done there to ensure that, for instance, my State of Ohio knows whether someone has gone to Kentucky, West Virginia, Pennsylvania, Indiana, or Michigan to get prescription drugs. So the prescription drug monitoring program will work better for every State.

Prevention and education on heroin abuses--this is to incentivize States to do a better job on the prevention and education side and, of course, to prevent overdose and to improve drug treatment.

These are all aspects of this legislation. It is comprehensive because the problem is complex and requires a comprehensive approach.

Here are some statistics--we have already talked about some this evening--that are shocking. We know that 28,647 Americans died in the last year for which we had data, which is 2014, from a drug overdose. The 2015 numbers will be higher than that. That is roughly 120 Americans dying every day.

There were 27,000 diagnosed cases of neonatal abstinence syndrome in 2013, the last numbers we have. It is even worse this year. This means babies were born with an addiction. A baby is born dependent on opioids every 19 minutes in America. So while I am speaking today, there will be another baby born who is addicted.

I have gone to hospitals in Cincinnati; in Lima, OH, to St. Rita's; to Rainbow Babies Children's Hospital in Cleveland, OH. They are incredible caregivers. My wife Jane was at Nationwide Children's Hospital today, actually, on this very issue. These are babies who are so tiny, you can almost hold them in the palm of your hand. They need caregivers to take them through a process where they go through withdrawal. And we are not sure what the long-term consequences are because we don't have the data yet because this is such a new issue. There has been a substantial increase over the last several years. In Ohio, the same thing I said earlier--750 percent increase in the number of babies diagnosed with neonatal abstinence syndrome since 2004. There has been a 750-percent increase in babies born addicted.

These are the issues this legislation gets at. Again, it does so in a way that is not just bipartisan, which is important, and not just House and Senate, which is important--the House has its own companion bill, one the President will be able to sign into law--but most importantly, it is because of the input of people from all over this country, the experts, people who are recovering themselves, and those who are most affected by this, that this legislation makes sense, and not just for my State but for our country.

The Judiciary Committee had a number of good witnesses. One was a woman named Tonda DaRe. Tonda DaRe is from Ohio. She had a daughter named Holly. On her 21st birthday, Holly, who had a bright future ahead of her--she was engaged to be married, and she had been very involved in her high school and active in sports--tried heroin for the first time. She became addicted. She went into recovery, and unfortunately, as in many cases, she had a relapse. At age 23 her young life ended in an overdose.

Her mom, Tonda DaRe, set up an organization called Holly's Song of Hope. She testified before the Judiciary Committee about the importance of her work--talking to other mothers and fathers and sons and daughters about the devastating consequences of this heroin and prescription drug addiction. This legislation needs to be passed so that we can help Tonda. She testified on behalf of this legislation because she has looked at it and knows it will make a difference in her life and her community.

This is an urgent problem, as I said earlier. It is also one we have a lot of bipartisan consensus around. There will be opportunities during this debate to hear from a lot of different people on a lot of different ideas on amendments to the legislation. That is good. It is good to have a debate. But I hope my colleagues on both sides of the aisle will keep focused on the importance of getting this done. It is important to get it done in terms of providing immediate help to our communities and also providing a structure to more effectively spend funds this year--and yes, we have funds to spend this year that have been appropriated consistent with CARA--but also next year and the year after and the year after. Some will support more resources, and that is fine. We need to have that debate. I myself think it is a priority, and we should be providing the resources to be able to deal with this issue.

I would also urge my colleagues to ensure that we get this over the finish line. It is too important. We can't play politics with it. This is one of those issues, again, like so few around here, that got out of the committee without a single dissenting vote. We have done the right thing on a bipartisan basis to bring in the experts. We have a good solution to an urgent problem we all face.

I am pleased with the vote tonight, and I urge my colleagues to have a good debate on the floor. Let's get this done for the sake of Tonda DaRe and so many other mothers, fathers, and others out there who deserve to have a little help in their fight against opioid addiction.

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