Comprehensive Addiction and Recovery Bill

Floor Speech

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Mr. CASEY. Mr. President, I rise to address an issue we are confronting in the Senate, and it is an issue folks in Pennsylvania and across the country are dealing with every day; that is, the opioid crisis. There are a lot of ways to describe this crisis. I am pleased to be able to talk about this issue with two of my colleagues who will be following me in succession after my remarks have concluded.

This Senator wants to thank, in a particular way, Senator Whitehouse, Senator Shaheen, and our leadership for bringing this issue to the forefront within our caucus and here in the Senate. I know the effort to pass the Comprehensive Addiction and Recovery Act--known by the acronym CARA--is a bipartisan effort. I certainly appreciate that.

In the case of Senator Whitehouse, he brings a deep reservoir of experience as a Federal prosecutor, U.S. attorney, as well as the attorney general of Rhode Island. He brings a law enforcement set of experience as well as his caring and concern about those who have addiction issues. We appreciate his leadership. Senator Brown has worked on this for many years in the Senate and as a Member of the House of Representatives. This is an issue that confronts all of us in our States. Our efforts have to be commensurate to match the severity of the problem.

This week the Senate missed an important opportunity to invest substantial resources in our Nation's heroin crisis. The amendment offered by Senators Shaheen and Whitehouse would have provided $600 million in emergency funding to aid public health professionals and law enforcement, the two main segments of our society that deal with the challenge of addiction on a daily basis. That amendment was defeated, and I think that was the wrong conclusion for the Senate and wrong for the country.

While the Senate failed to act on this amendment, there is no reason we shouldn't find other opportunities to invest in anti-heroin strategies or, expressed another way, strategies that will lessen or reduce the likelihood that more people will be addicted to some opioid which often leads to other kinds of challenges such as heroin. It too often leads not just to the darkness of addiction but literally to the darkness of death itself. We have some work to do.

We know we can pass the Comprehensive Addiction and Recovery Act, the CARA Act, as I mentioned before. That is good, but it is not nearly enough. We have to do more than simply pass good legislation that will authorize policies to better confront the challenge. That will not be enough. If we have in place new programs, new approaches, and new strategies, that is a measure of progress, but we can't ask medical professionals to do more to treat addiction if they don't have the resources. We cannot ask law enforcement to do more if they don't have the resources.

Heroin overdose deaths have increased 244 percent from 2007 to 2013. In roughly a 6-year timeframe, heroin overdose deaths are up 244 percent. It is hard to even comprehend that kind of increase of a death statistic--not just a number but a number that indicates the increase in the number of deaths. That alone should motivate us to do everything possible to do whatever it takes. Whatever authority, whatever policy, whatever dollars we need to invest in this, we have to do that. There are lots of other numbers, and sometimes you can get lost in reciting the numbers. I will mention a few that are relevant to Pennsylvania before I conclude.

In addition to just passing the CARA bill, we ought to focus on taking measurable steps to solve the crisis. We don't want to just address the issue, confront the challenge, we want to solve the crisis. It will not happen in 1 year, and it will not happen because of one bill or one policy, but we have to put every possible resource or tool on the table to actually solve the crisis.

There are lots of ways to illustrate the degree of the problem. I will talk about a couple of communities in Pennsylvania, just by way of example.

The Washington Post--a great newspaper here--went to Washington, PA. We have a county and city just below the city of Pittsburgh, just south of Pittsburgh, Washington County and the city of Washington. The Post went there last summer and began to interview people at the local level.

In one of the more stunning statistics they found in their reporting, in 70 minutes there were eight overdoses related to heroin--in this case not yet deaths but overdoses. A newspaper could track in 1 hour 10 minutes, eight overdoses in one community in one State. Then they tracked it over a 2-day timeframe. In 48 hours there were 25 overdoses in Washington County, PA, and 3 deaths, in a 48-hour period. I cite that not just for the compelling nature of those numbers but because of where it happened. This is not happening in communities we used to think of as having a major heroin or drug addiction problem. We tended to think of it, at least in my lifetime, as being an urban issue that big cities have this problem and less so in small towns, suburbs, and rural communities. In this case, this horror, this evil knows no geographic or class boundaries. It is happening in big cities and very small towns in Pennsylvania. It is happening in suburban communities, high- and low-income communities and in middle-income communities. It is happening everywhere. There is no escaping it.

If it is happening in places like Washington County--the city of Washington, PA, is not a big city but a moderate-sized city. Other parts of that county tend to be more rural, small towns to rural. If it is happening there in those kinds of numbers, in 70 minutes or 48 hours, overdoses and overdose deaths, that gives you an indication of the gravity of the problem.

The Coroners Association in Pennsylvania, which has to track the number of deaths in their counties, reported that in just over a few years in Pennsylvania, the number of deaths from overdoses went from less than 50 to hundreds of deaths in just a couple of years. The gravity of this problem is self-evident.

It is not good enough to diagnose the problem and recite statistics. We have to solve the crisis. There is no doubt this is a huge issue for the country.

By not passing the funding that we tried to pass, we are missing a chance to support, for example, the substance abuse prevention and treatment block grant, the so-called SABG, or the SA block grant. That is an existing program--an existing block grant program--that works. The only good news here, in this debate about what policy to put in place, is that local officials know what they are doing. Addiction and medical professionals know exactly what to do. They know exactly what works. They know exactly what they need. What they are asking us for is a little bit of policy or a significant amount of policy, maybe. But they are also asking for research and resources, and we have to give those resources to them.

I conclude with the following. We know that good treatment works. All the professionals tells us it works. We know so much more today than we did 25 years ago about what works. We know that good treatment works. It takes a long time. There is no 90-day program here because it takes a lot longer than that. So we know that for sure. There is no dispute about that. We also know that good treatment costs money. You cannot just have good intentions here.

Lifesaving overdose reversal drugs such as naloxone cost money. The good news is we have a drug to reverse the adverse impact of an overdose, and yet a lot of communities cannot afford to get this very important drug called naloxone, the so-called reversal drug as some call it.

Intercepting drugs before they reach our streets costs money. The worse this epidemic gets, the more these services are in demand.

So Congress--the Senate and the House of Representatives--must provide additional funding to make sure local communities can meet the demand. We know that investing in programs that treat addiction and save lives is an abiding obligation.
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Mr. CASEY. It is an abiding obligation that we must fulfill. We have to tackle this problem. We can't do it without resources.

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