Commerce, Justice, Science, Agriculture, Rural Development, Food and Drug Administration, Interior, Environment, Military Construction, Veterans Affairs, Transportation, and Housing and Urban Development Appropriations Act, 2020

Floor Speech

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Mr. BLUNT. Mr. President, I want to thank Senator Portman for his comments about what we have tried to do to provide the money, but let me tell you, having been involved in that part of it, really, before we began to pass legislation, nobody was more vigorously active than Senator Portman to try to continue to point out the size of this problem and that something had to be done. He was out there talking about how big a problem this was for the country before other people were.

Thanks to Senator Ernst for bringing this group together today to talk about this critical issue as we figure out better ways to deal with this terrible scourge of addiction and activity that preys on people who have become addicted.

More than 47,000 lives were lost due to opioids in the United States in 2017--47,000 people. More people died of opioid overdoses than died in car accidents. The No. 1 cause of accidental deaths changed dramatically in the last handful of years. For everybody who died, there were hundreds of others who were risking their lives by misusing prescription drugs or illegal drugs or, even worse, illegal drugs that they had no idea what was in them.

The fentanyl challenge is so big and so dangerous. It seems to me it would be a pretty poor business model to try to have a drug so powerful, a product so powerful, that there is a good chance the person you are selling it to will never be a customer again because they are going to die from taking this drug, often knowing it is an incredibly dangerous moment to try to get on a drug-induced high that defies anything that has happened to them before. Of course, once you cross that line, there is no other line to cross because you are no longer a customer. Your life is gone. Your dependency on these drugs, no matter how it began, whether it was a high school cheerleading accident or a car accident or a running accident or a dental appointment--all kinds of ways--and in past decades, people believed prescribing these opioids had no danger of addiction and, boy, did we find out that was wrong.

Now, 3.4 percent of our entire gross domestic product--almost $700 billion--was impacted and lost by the ongoing opioid crisis in 2018. Every State has a problem. Our State, Missouri, has a problem. We have seen a steady increase in synthetic opioid use over the last several years. This seemed to be moving from east to west, and I was hoping that by the time it got to us we would have more information, more thinking about it. I think that actually may have happened, but it is still bad. We had a 40-percent increase in fentanyl-related overdoses from 2016 to 2017.

Health and Human Services Secretary Azar and I were in Kansas City together at the Truman Medical Center to talk about this epidemic-- Truman Medical, the No. 1 provider of uncompensated care in our State. We went to the neonatal area and saw babies who had neonatal abstinence syndrome, which is affecting a number newborns now, and looked at how they were dealing with newborns who were born addicted.

Truman doctors and leaders there, as well as leaders in other area health centers in Kansas City, talked to us about how they were dealing with this. We have learned, even in the context of one urban area, that there is not necessarily a one-size-fits-all way to deal with this, which is why we have tried to focus our money at the Federal level on giving States the maximum flexibility they could have, within their State and in their State, to come up with what worked in the communities they were trying to work with.

We have provided the money. We haven't found every solution yet, but we are on the way, I think, to doing that. We have included flexibility for the States to use in funding for treatment, funding for prevention, funding for recovery from opioids, and other stimulants.

In Missouri, Federal funding in the last year has treated 4,000 people who wouldn't have been treated otherwise. Narcan is more and more available at workplaces and other places.

There is simply more work to do. We need to continue our focus on targeting resources toward opioid addiction but also toward behavioral health issues. I have said a number of times as we have dealt with this that if you don't have a behavioral health problem before you are addicted, you absolutely will have one after you are addicted.

One of the things we have found to be a big advantage in our State is that we had the good fortune to be part of this eight-State pilot program in which, in a number of locations in our State, regarding excellence in mental health, we are treating behavioral health, mental health, as we would treat any other health problem. That means you would treat it as long as it needs to be treated. There is no 14-day limit or 28-day limit. You can be treated just as you would for a kidney problem or another cancer problem or any other problem, as long as you need it. We are finding great success in combining not only the medicated assisted therapy with getting off opioids but also the ability to have that mental health component as long as it needs to be there.

We are hoping to continue to work on the facts we have put together to determine what happens when you treat behavioral health issues like all other health issues, to determine other healthcare costs that people have. We are hoping to extend that pilot another 2 years, not to make it a permanent Federal responsibility but to be sure that States and communities in the future will have the level of evidence they need to look at, that there will be enough evidence compiled to show what really happens because everybody understands that treating mental health like all other health is the right thing to do.

I think these pilot projects are compiling the evidence to show you that not only is it the right thing to do, but actually it is the financially responsible thing to do as well.

Attacking this problem from all levels is critical. We are way beyond where we were 5 years ago. We are not where we need to be yet. States are trying things, sharing things that work and sharing things that don't work and why they didn't work in the communities that tried them. So we are going to continue to move forward with this.

I know Senator Capito is going to speak after me. She is also one of the early advocates for doing something about what she saw were significant problems that had developed in her State. I was grateful to have her advice and her driving this discussion in the way she did.

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