Comprehensive Addiction and Recovery Act of 2015

Floor Speech

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Mr. BROWN. Mr. President, I thank the Senator from Pennsylvania for his leadership.

Various doctors may not realize they are prescribing duplicative opioid painkillers. We have done the lock-in with Medicaid. In many States, it has worked. This is a commonsense solution to help a relatively small number of people but a growing number of seniors whom a Medicare lock-in could assist.

I urge support for the Toomey-Brown amendment.

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Mr. BROWN. Mr. President, I appreciate the comments from my friend from West Virginia and his work on this issue that has hit West Virginia and, particularly, southeast Ohio kind of first and hardest. But it has spread to so many other places and caused so much heartache and so much family disruption--not just for the young men or women, in the case of young people who are addicted, but the whole family. As one mother of a teenager said to me in Youngstown, OH, or in Warren, OH, one day, this is really a family affair.

I am pleased to see bipartisan support for finally tackling the opioid addiction epidemic. It has touched every State and almost every community in our country. In 2014, more people died from drug overdoses than any year on record, with 2,482 in Ohio. That is a record number of prescription drug overdoses and a record 1,177 overdoses related to heroin. People often start with pain medication, sometimes overprescribed prescription medicine that will, in far too many cases, lead to heroin addiction. Heroin is cheaper to buy on the street than for people to get OxyContin or oxycodone or Percocet or any number of legal morphine pain medications.

These numbers mean that in 1 year alone, 2,500 Ohioan families lost a loved one to addiction. What those numbers don't account for are the thousands of other families and hundreds of other communities that continue to struggle with opioid abuse. It should not be easier for Americans to get their hands on opioids than it is for them to get help to treat their addiction. It should not be easier for Americans to get their hands on opioids than it is to get help to treat their addiction.

Addiction is not an individual problem. It surely is not a character flaw, as many people half a generation ago liked to say when it was people who didn't look like them. But the fact is it was not a character flaw then and it is not a character flaw now. It is a chronic disease.

When left untreated, it places a massive burden on our health care system and a terrible, terrible cost on families who have an addicted family member. When we think about this epidemic, we have in our minds a young worker who turned to painkillers after a back injury or a car accident, someone who started with oxycodone--maybe as a party drug-- and then turned to heroin. This problem is bigger than that.

Our national conversation forgets the hundreds of thousands of seniors who often are given unsafe and duplicative prescriptions for opioids. It is not uncommon for seniors to be treated by multiple specialists and physicians. Doctors may not know they are prescribing duplicative painkillers, meaning this doctor prescribed a painkiller-- maybe oxycodone or OxyContin or Vicodin or another--and this other doctor may have done the same thing. They weren't communicating, and didn't know. Seniors find it difficult to manage all of their different prescriptions far too often.

Take, for example, Ohioan Dennis Michelson. I met him at the Benjamin Rose Institute on Aging in Cleveland last August. He is one of the estimated 170,000 Medicare beneficiaries who recently battled an addiction to pain medication.

He was prescribed pain medication by his doctor to manage chronic migraines. When his primary care doctor sought to wean him off the medication, he went to other doctors and pharmacists to obtain those opioids. He was eventually arrested and charged with felonies for tampering with prescriptions. He has since recovered. He is now an advocate for reform to address the prescription drug epidemic.

After hearing his story, it strikes me that if a patient with legitimate and sometimes complex medical needs winds up getting pain medication from several different doctors--you could see how that would happen; none of those doctors know about one another--the system has failed the patient.

It is why I worked with Senator Toomey from Pennsylvania to introduce the Stopping Medication Abuse and Protecting Seniors Act. I was proud to see this body support it as an amendment today. We already have a proven tool to address the problem of patients getting duplicative opioids from multiple doctors and pharmacists. It is called Patient Review & Restriction Programs. But despite their success in State Medicaid programs and commercial plans, these programs aren't available in Medicare prescriptions under current law. That is the purpose of the Toomey-Brown amendment and what we are trying to fix.

The amendment will ensure that a small number of seniors who receive high doses of addictive opioids from multiple doctors get those painkillers from one doctor and one pharmacist. It is what we did on so-called Medicaid lock-in--for people who were abusing the system on purpose or more likely those who sort of fell into this trap and went from doctor to doctor, pharmacist to pharmacist, in some sense doctor shopping or pharmacy shopping--so that practice would end. We have done the same sort of thing now with so-called Medicare lock-in. It would save taxpayers $100 million over the next decade. It will reduce overprescribing, and it will crack down on fraud.

I am pleased we have bipartisan support for this commonsense measure, but this amendment and this bill are a step. We need a comprehensive approach that addresses the entire spectrum of addiction from crisis to recovery. I have introduced the Heroin and Prescription Drug Abuse Prevention and Reduction Act. It will boost prevention efforts, it will improve tools for crisis response, it will expand access to treatment, and it will provide support for lifelong recovery.

Addiction is chronic. It doesn't mean that when somebody overcomes their addiction and seems to defeat it, it won't come back later in life. If we are serious about fighting this epidemic, we have to make sure we provide a serious investment that will deliver results long term.

My colleagues, Senator Shaheen of New Hampshire and Senator Whitehouse of Rhode Island, introduced an amendment that would have provided $600 million to fight this epidemic. It would have gone directly to public health workers, directly to law enforcement officials who are working on the frontlines of this battle every day. It would have shown constituents we are serious about addressing this crisis.

I was disappointed this body was unwilling and unable to find the money necessary to address these problems. This legislation is a good bill. Without the money, it is a good bill, but it is really only half a good bill because my colleagues are simply unwilling--maybe it is the tea party influence, maybe they are afraid of a Republican rightwing primary, whatever it is--to ante up the dollars that would fully help us deal with this epidemic. We can't do this without an investment.

I met with a number of tuberculosis experts in my office today. We have been successful in this country with eliminating smallpox, eliminating polio, and keeping Ebola from being contracted in the United States and killing any Americans. We have done all of that because we invested in a public health system. We can't address this opioid epidemic without dollars. Yet my colleagues will simply always back off and say: Well, we can't afford to do this. They can afford tax cuts for wealthy people, and they can afford continuing to pump money into expensive weapons systems, but they will not spend money to address probably the most serious public health crisis we have seen in this country in years.

Once again, I say that it should not be easier for Americans to get their hands on opioids than it is to get help to treat their addiction. This Senate should get serious about this. We should pass this bill, to be sure, but there is so much else. I am distressed my colleagues chose not to step up to the plate and do what deep down they know we should do. vote explanation
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