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Statements on Introduced Bills and Joint Resolutions

Location: Washington, DC




S. 538. A bill to educate health professionals concerning substance use disorders and addiction; to the Committee on Health, Education, Labor, and Pensions.

Mr. BIDEN. Mr. President, I rise today to introduce legislation to address the problem of substance abuse in our country.

The Robert Wood Johnson Foundation has called substance abuse America's No. 1 health problem. I don't think that overstates it.

Most of us knows someone--a family member, maybe a neighbor, a colleague, or a friend--who is addicted to drugs or alcohol. In fact, nearly 15 million people in this country abuse alcohol or are alcoholics. More than 19 million use drugs, and an estimated 4 million are in need of treatment but not receiving it.

Drug and alcohol abuse has far-reaching consequences. It exacerbates social ills. It is a public safety problem. It is a public health problem. It is a public expenditure problem. There is an undeniable correlation between substance abuse and crime. Eighty percent of the 2 million men and women behind bars today have a history of drug and alcohol abuse or addiction or were arrested for a drug-related crime. Illegal drugs are responsible for thousands of deaths each year. They fuel the spread of AIDS and hepatitis C. They contribute to child abuse, domestic violence, and sexual assault. And we all pay the price.

It costs this Nation almost $275 billion in law enforcement, criminal justice expenses, medical bills, and lost earnings each year. That means that preventing and treating substance abuse makes sense. It makes good criminal justice sense. It makes public health sense. It makes budgetary sense. Not to mention the fact that it is the right thing to do.

Yet there remains a reluctance to recognize substance abuse as a health issue. There is a reluctance to accept addiction as a disease. It is a reluctance that has kept public policy from asserting that addicts should be in treatment. Whether addicts are in prison or out, it seems to me, treatment is the only legitimate choice.

But it is not only about increasing access to treatment. It is also about moving treatment into the medical mainstream. Unless family doctors, nurses, physician assistants, and social workers can identify addiction when they see it, unless they know how to intervene, we will never make any real progress.

That aspect of the challenge came into sharp focus for me when I read a report a few years ago by the National Center on Addiction and Substance Abuse at Columbia University, CASA.

That report said that fewer than 1 percent of doctors presented with the classic profile of an alcoholic older woman could diagnose it properly. Eighty-two percent misdiagnosed it as depression, some treatments for which are dangerous when taken with alcohol. A follow-up study showed that 94 percent of primary care physicians fail to diagnose substance abuse when presented with the classic symptoms, and 41 percent of pediatricians fail to diagnose illegal drug use in teenage patients.

No one recognizes this problem better than the doctors themselves. Fewer than one in five--only 19 percent--feel confident about diagnosing alcoholism. And only 17 percent feel qualified to identify illegal drug use. Having said that, even if they diagnose it, most doctors don't believe that treatment works.

Among practitioners, as well as policymakers, we need to get the message out loud and clear: Addiction is a chronic relapsing disease, and as with other such diseases, while there may not be a cure, medical treatment can help control it.

The medical professionals have to be educated to recognize the signs of substance abuse and to pursue the effective therapies that are available. That is why I am introducing legislation to help train medical professionals to prevent and recognize addiction and refer patients to treatment if they need it. Representative PATRICK KENNEDY will introduce companion legislation in the House of Representatives.

Like treatment, training works. According to a study published in the Brown University Digest of Addiction Theory and Application, 91 percent of health professionals who took part in training on addiction at Boston University were using the techniques they learned 1 to 5 years later.

Every family doctor does not need to be an addiction specialist, but they do need to be able to recognize the signs. And they need to know what help is available.

My legislation does the following three things: authorizes $9 million in grants to train medical generalists to recognize substance abuse in their patients and their families and know how to properly refer them for treatment; authorizes $6 million to fund substance abuse faculty fellows at educational institutions to teach courses on substance abuse, incorporate substance abuse issues into to required courses at the institution, and educate health professionals about issues related to non-therapeutic uses of prescription medications; and establishes centers of excellence at medical centers or universities across the United States to (1) initiate, promote and implement training, research and clinical activities related to special areas of substance abuse and (2) provide opportunities for interdisciplinary collaboration in curriculum development, clinical practice, research and policy analysis. The bill authorizes $6 million for this purpose.

These are additional steps--and, in my view, crucial ones to help bridge the divide between research and practice. They will help chip away at the incredible substance abuse-related costs we face each year in human as well as monetary terms.

I hope my colleagues will join me to support this important legislation.

I ask unanimous consent that the text of the bill be printed in the RECORD.

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