Comprehensive Addiction And Recovery Act Of 2015

Floor Speech

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Mr. MARKEY. Madam President, as we consider the CARA bill on the floor at this time--the bill that deals with the opioid epidemic in our country--I thought it might be useful to bring a few statistics forward so we can consider the nature of the epidemic we are dealing with.

In 2014, 29,267 people died from prescription opioid and heroin overdoses in our country, with 10,574 of those people dying from heroin. That is a 28-percent increase from 2013. Can I say that again? There was a 28-percent increase in heroin deaths in our country in 1 year. That is the trendline we are talking about with this epidemic.

Deaths from synthetic opioids like fentanyl increased 79 percent from 2013 to 2014. Can I say that again? A synthetic opioid, fentanyl, had an increase of 79 percent in deaths from 2013 to 2014.

Here is another statistic: Today's young White adults age 25 to 34 are experiencing the highest death rates since the Vietnam war. Can I say that again? White adults between the ages of 25 and 34 are experiencing the highest death rates since the Vietnam war.

In 2014, an estimated 1.9 million people had an opioid use disorder related to prescription pain relievers and an estimated 586,000 had an opioid use disorder related to heroin use.

This is the profile of the epidemic we have in our country right now.

In the 5-year period between 2008 and 2013, overdose deaths from prescription painkillers and heroin combined increased 37 percent.

In 2010, enough opioid painkillers were sold to medicate every American adult with a typical dose of hydrocodone every 4 hours for 1 month.

In 2012, health care providers wrote 259 million prescriptions for opioid painkillers--enough for every American adult in our country to have a bottle of opioid painkillers in 2012. Can I say that again? Enough of these opioid painkillers were prescribed so that every adult could have a bottle on their shelf in 2012.

Pick a number of how many 10-milligram opioid painkillers were approved by the Drug Enforcement Agency in the year 2014. Just pick a number in your brain of how many pills were authorized to be manufactured in our country in 2014. Just pick a number in your brain of 10-milligram pills, of opioids. Here is the answer. You were wrong. The number is 14 billion 10 milligram-equivalent pills that were authorized to be manufactured in our country by the Federal Government--by the Drug Enforcement Agency--in the year 2014.

Again, all this is part of the recipe. Stir well, ignore it for about 15 years, and let our country finally recognize that there is an epidemic in their house, on their street, with their relative, with their friend that should never have happened because we know what the cause of this issue is.

This unparalleled rise in overdose deaths in the United States parallels a fourfold increase from 1999 to 2010 in the sale of opioid painkillers. We know there has been a tripling in the number of overdose deaths from 1999 to 2012 in our country, but we also know this: America is only 5 percent of the world's population, and yet we now consume 80 percent of all of the opioid painkillers on the planet.

Again, this is not some big puzzle in terms of what has caused this problem. This is all very simple, easy-to-understand stuff that ordinary families have been grappling with, especially over the last 10 years, beginning with their understanding that OxyContin and Percocet and all these other drugs that are allegedly ``abuse-deterrent'' in fact, when they are swallowed pursuant to a prescription, if done on an extended basis, can cause an addiction that is worse than the underlying problem of the individual taking these painkillers.

Roughly 480,000 emergency room visits in 2011 were attributable to the misuse and abuse of opioid painkillers in our country--488,000 emergency room visits on that one issue.

The prescription painkiller epidemic is killing more women than ever before, and it is estimated that about 18 women die every day from a prescription painkiller overdose.

The numbers are staggering.

We should create a requirement that if the DEA is going to license physicians to prescribe opioids--and every physician in America must go to the DEA to get a license--if they are going to be allowed to prescribe, the physician must prove he or she has been educated to do so.

Two years ago, the FDA authorized their voluntary education program for physicians. Pick a number in your mind of what percentage of all physicians in America have taken advantage of a voluntary education program for opioids. You are wrong, whatever number you just picked. Only 12 percent of all physicians have actually taken the voluntary education program.

The FDA continues to authorize new opioids on the market without even having an expert advisory panel to deal with the issue, even as the DEA continues to authorize 14 billion 10-milligram pills per year.

This issue is one that we have to deal with. We should have physician education. We should have tighter standards for what the FDA does in allowing for new drugs to go out on the market. We have to ensure that they are safe, and we have to ensure there is a proper understanding of their abuse potential. We have to have a day of reckoning with the costs of all of this.

We have to make sure that the funding level is there for families who are already suffering. We have to provide the help for them. We just have to. This is an epidemic that was largely created at the Federal level, largely created by physicians and pharmaceutical companies. It is time for us to finally begin to provide the help these families so desperately need.

Here is what I know most: It will not even be those who have the problem right now, although those families will get the help they need; it is all the families who will never need the help because we did put the right recipe on the books. We did put the right prevention measures on the books. We did put the preventative measures on the books so that their families never even knew this day arrived in their history.

I hope as we go through this whole process that we can keep those thoughts in mind. That is what we can do from the Federal Government. We should strive to do this. We should try our best to stand up and provide the help that these families need at the local level.

Madam President, I yield the remainder of my time.
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