Madam President, I appreciate the thoughtful comments from my colleague from Oklahoma of the need for us to have an independent judiciary. I am on the floor to talk about a different issue, and it is the latest, very troubling information…
Madam President, I appreciate the thoughtful comments from my colleague from Oklahoma of the need for us to have an independent judiciary.
I am on the floor to talk about a different issue, and it is the latest, very troubling information that we are receiving regarding the addiction epidemic and specifically drug overdose deaths in the United States. I am also going to talk about some of the steps we can take right now to address that reality.
One of the top priorities I have had in this body and in the House has been this drug addiction issue. Frankly, this is a moment of frustration because we were making progress, and then COVID-19 hit. Unfortunately, the drug epidemic has hit my State of Ohio particularly hard. The latest data from the Centers for Disease Control and Prevention, the CDC, show that it is a pretty grim picture right now, and it should be a wake-up call to all of us. Overdose deaths rose nearly 30 percent nationwide from September 2019 to September 2020. During this time period, you can see the overdose deaths numbers going up dramatically.
This is heartbreaking for me because we were making progress. After literally decades of increases in drug overdose deaths every single year--decades--going back to the 1990s, we finally here in the 2017, 2018, 2019 periods began to make progress in reducing overdose deaths. In fact, in Ohio, we had a 24-percent decrease in overdose deaths during 1 year, 2018, but, right now, the numbers are getting higher and higher, and it is everywhere.
As you can see from this chart, if something is in any of these colors, this means that there is an increase in overdose deaths. If it is in blue, it means there is a decrease, and this was just during this period of September
2019 to September 2020, the latest data for which we have good information. It doesn't even include all of 2020, and as we know, the pandemic, unfortunately, went all the way through 2020 and into 2021. All of the data show that, as you got further into the pandemic, we had higher rates, so we expect, when the final data come out for 2020, it will be even higher.
Here is where we are now. Look at this. Other than the State of South Dakota, every single State has seen an increase--and a substantial increase in many cases--in overdose deaths. This is in 49 of 50 States. In my own State of Ohio, there has been about a 25-percent increase in overdose deaths during this period.
Only a few years ago, again, we were making progress. One reason that we had begun to turn the tide was because of work that had been done here in the U.S. Congress. Right around this time period, we passed legislation called the Comprehensive Addiction and Recovery Act. We also passed legislation called the 21st Century Cures Act. Both were signed into law in 2016. So it would have been in this period. It became effective in this period and actually helped to reduce overdose deaths for the first time in decades.
I commend my colleagues for that legislation. It was the first time we had ever funded recovery, as an example. We also funded prevention and treatment and provided our law enforcement with more naloxone, this miracle drug that reverses the effects of an overdose. Many of my colleagues have had the opportunity to speak with their local addiction boards or have been with law enforcement or other first responders-- firefighters--who have used this naloxone effectively to save lives.
So things were getting better until we saw this big increase in connection with the coronavirus pandemic. The stresses of this unprecedented time, clearly, have contributed to the spike in drug abuse. People have felt lonelier. People have felt more isolated. Specifically, people have not been able to get access to recovery programs. Being in person with a recovery coach is a whole lot different than being on a Zoom call. That is what I hear from recovering addicts, and it makes sense.
I will say that people have turned to drugs to cope during this tough period, but also, many of those who are in recovery have been stalled in their progress because of their inability to be with other recovering addicts. So part of the best practices and best scientific evidence we have is that an effective way to help people overcome their addictions is to be with other people who also have those addictions. We have known this for years in terms of alcohol treatment programs--AA and so on--but this has been one of the problems.
Another issue I am going to raise, which apparently is somewhat controversial, but I hear it from the experts--and those are the people on the ground, in the field, who are dealing with this issue--is that, when we here in Congress provided lump sums to all Americans under a certain income--and you will remember the individual payments--they didn't go out right away because our State offices couldn't process them quickly enough, particularly with regard to unemployment insurance, wherein our workers' comp and our unemployment offices could not get the money out the door on a weekly basis but could retroactively provide those funds.
We had individuals getting--instead of $300 a week or $600 a week-- $10,000 a week because it was an accumulation of many weeks. People were owed that, but getting these big lump sums was not helpful in the context of many people who were in recovery because it led to their purchasing drugs and it led to what we are finding out--again, back home--in talking to the experts, were some of the reasons you had this spike. So there are a lot of reasons here.
I guess what we need to focus on now is, How do we get beyond this?
These deaths are happening away from the national headlines because the coronavirus is taking the national headlines, understandably. A story just last week, from a news station in Dayton, OH, summed it up perfectly with a quote from Lori Erion, who is the founding president of Families of Addicts.
She said:
During the pandemic, addiction and families struggling with
it haven't gone anywhere. We have been here the whole time.
But they have not gotten much notice. There were 87,000 people who died from overdoses in the September 2019 to the September 2020 period we talked about. There were 87,000 Americans who died. If not for the COVID-19 pandemic, I don't think we would have seen this increase--from everything we are hearing if the correlation is almost precise--but also we would be hearing a lot more about the addiction crisis and doing more about it here.
We did put some funding into the CARES Act and into the two most recent COVID-19 packages to help with behavioral health, people's mental health, and also with addiction. That has been helpful, but we need to go much broader and do something much more comprehensive to take this moment to recommit ourselves to fighting addiction and ensuring that more Americans don't continue to lose their lives to overdoses. We have bipartisan legislation that has been introduced that we have been working on with a lot of people on the outside to try to come up with some new ideas, some ways to address this problem.
In the 5 years since this Comprehensive Addiction and Recovery legislation has become law, which was in part the reason we saw this reduction--also, a lot of great work was done at the local level and the State level--the substantial, several billion-dollar commitment we made here in this Chamber for more prevention, treatment, and longer term recovery with naloxone and so on, made a difference, but it has been 5 years.
During that time, I have visited with literally hundreds of different organizations in my home State. I have also just talked to a lot of experts about this. I have been to a lot of nonprofits, from Cleveland to Cincinnati and from Portsmouth to Toledo. I have talked to literally hundreds of recovering addicts about what works and what doesn't work for them.
There is legislation that we are introducing now, which we call CARA 3.0. We had the first Comprehensive Addiction and Recovery Act, and we had a second one back in 2018, a smaller one. Now we have this new, bipartisan CARA 3.0 legislation. Senator Sheldon Whitehouse is my coauthor, but we have a number of Members who have joined up to help, and it addresses three major areas.
One is research and education. We still need to find out more, and we still need to get better research and better alternatives to opioids to deal with pain because much of this is being driven, as you know, from opioids--both heroin and prescription drugs but also these new synthetic opioids, which are the deadliest of all.
Second, we focus on education. Getting the prevention message out there is incredibly important to keep people from coming into the funnel of addiction in the first place, which is incredibly powerful and effective.
Third, of course, are treatment programs.
The fourth is recovery. Again, Congress had never funded recovery before; yet all of the best science shows that these recovery programs, when done properly, can be incredibly helpful, and longer term recovery, unfortunately, is needed, which is costly, but the alternative is worse.
Finally, there is criminal justice reform, which I will talk about in a moment.
It will bolster our work to prevent drug abuse before it happens through funding for research and education. A new national drug awareness campaign is part of this legislation, and the research and development of alternative pain treatment methods that don't lead to addiction is part of it.
CARA 3.0 will also take the important step of addressing the disproportionate effect the addiction crisis has had on people in poverty and communities of color. Unfortunately, during this increase, we have seen a higher percentage of overdoses in communities of color. A national commission has been formed to look at this issue to better develop treatments and best practices to avoid overdoses.
Second, our bill will build on what works and how we treat addiction. It will double down on proven, evidence-based addiction treatment methods
while expanding treatment options for groups that are particularly vulnerable to addiction, including young people, new and expecting mothers, rural community residents, and communities of color-- individuals who live in those communities. One of the things that we have learned through, again, evidence-based research into what works and what doesn't work is that medication-assisted treatment, when done properly, can be very effective.
It will also make permanent the current expanded telehealth options for addiction treatment that were created temporarily in response to the social distancing required by the COVID-19 pandemic. This is really important. Telehealth is one of the few silver linings in an otherwise very dark cloud of the coronavirus pandemic. Yet, for many individuals, telehealth was effective, particularly with regard to behavioral health and addiction services. So we want to be sure that the temporary ability to pay for those telehealth visits, as an example, through Medicaid as an example or Medicare, can continue past the pandemic.
CARA 3.0 will also bolster the recovery options for individuals who are working to put addiction behind them through funding to support recovery support services and networks. It will enable physicians to provide medication-assisted addiction treatments, like methadone, to a greater number of patients and change the law to allow these drugs to be prescribed via telehealth for a greater ease of access. This will require a change in legislation to allow people to provide these kinds of treatments.
Our bill will also destigmatize addiction recovery in the workplace by ensuring that taking one of these medications--again, medications to get people over their addictions--will not count as a drug-free workplace violation. This may seem like an obvious change, but, unfortunately, it will take a change of law to be able to make that happen.
Finally, CARA 3.0 reforms our criminal justice system to ensure that those who are struggling with addiction, including our veterans, are treated with fairness and compassion by the law, putting them on a path to recovery instead of into a downward spiral of drug abuse.
Importantly, CARA 3.0 funds a Department of Justice grant program to help incarcerated individuals who are struggling with addiction to receive medication-assisted treatment while they are still in the criminal justice system. Again, that may seem like a pretty obvious solution, but there are people who go into the system addicted, and they come out addicted. They are not given the treatment options when they are incarcerated, and they simply go back to lives of addiction. Those people have high rates of recidivism, clearly. Most are rearrested and are back in the system within a relatively short period of time.
So this will reduce recidivism, repeat offenses. It makes sense for the person addicted, and it certainly makes sense for the community, with fewer crimes being committed. It also makes a lot of sense for the taxpayer because that treatment, although there is an additional expense while in the criminal justice system, will have a much better chance of getting those people back to lives wherein they can go back to work, back to their families, be in recovery, and not be back in the expensive criminal justice system. So it is a win-win-win.
CARA and CARA 2.0 gave States and local communities new resources and authorities to make a real difference in my State and others. CARA 3.0 renews and strengthens those programs, and given the recent spike in addiction we see here, it provides a significant boost in funding as well. When added with the existing CARA programs that were authorized through 2023, we will be investing well over $1 billion per year to address this longstanding epidemic, putting us on the path toward a brighter future free from addiction.
Another important part of CARA 3.0 is our bipartisan legislation to build on this expanded telehealth option for addiction services.
It was necessary during the pandemic to have it because of social distancing. We found out that, although there is no substitute for face-to-face interaction, telehealth has kept patients in touch with their doctors and allowed physicians to prescribe medication-assisted treatment remotely.
It doesn't make sense to get rid of these options once the pandemic goes away, so again, CARA 3.0 included legislation we had previously introduced separately called the Telehealth Response for E-Prescribing Addiction Therapy, or the TREATS Act, to make permanent a number of temporary waivers for telehealth services and bolster telehealth options for addiction treatment services.
Specifically, it does a couple things. First, it allows for a patient to be prescribed these lower scheduled drugs, like SUBOXONE, through telehealth on their first visit. You can't do that now. Current law requires you to go in person for a visit when needing an initial prescription for controlled substances, but this has been a deterrent to patients in crisis and in urgent need of treatments from schedule III or schedule IV drugs, like SUBOXONE or certain other drugs for a co-occurring mental health condition.
It also limits abusive practices by both audio and visual capabilities to be able to interact with the treatment providers to reduce fraud and abuse when it is your first visit, and it would also keep the existing requirements for in-person visits when prescribing schedule II drugs--these are the harder drugs, like opioids and stimulants--which are much more prone to being abused through these telehealth visits.
So we have a provision in there to avoid abuse, but it is also important to continue this telehealth when other options aren't there. I think it is a balanced approach that makes sense.
Second, our bill will allow for Medicare to bill for audio only or telephone telehealth visits for mental health and substance abuse if it is not the patient's first visit. Due to access to the broadband or distance, in-person or even video appointments aren't always possible, particularly for our seniors.
We need to focus on safety and robust treatment options, but in order to balance the needs of patients, we have proposed to allow our Nation's seniors under Medicare to use phones for subsequent mental health or behavioral health visits when they don't have access to the internet and where fact-to-face interaction isn't possible and isn't as necessary.
I believe the TREATS Act will make a difference in the addiction treatment space and will help us prevent more untimely overdoses.
So the legislation I have laid out so far--CARA 3.0 and the TREATS Act--cover an important aspect of the addiction crisis: the addiction treatment efforts that help lessen the demand for drugs, which is the single most important thing, reducing that demand.
But there is also more we have to do on the supply side because as drugs are pouring into our country, they are at a lower price on the streets of Cincinnati or Columbus or Cleveland or Dayton or Toledo. So we do need to do more to curb the supply of these dangerous substances. This is especially true right now because there is such a critical crisis ongoing, and there is a looming deadline to keep one class of very dangerous drugs illegal and off the streets.
I am talking about the kinds of opioids that are--like fentanyl, that are synthetic opioids but have a slight molecular change. So unless we act here in Congress, they will no longer be scheduled, no longer be illegal.
Data from the CDC, again, shows that the biggest driver to this surge in overdose deaths that we see here comes from fentanyl, comes from these synthetic opioids. They are often far more deadly than traditional opioids, like heroin. In fact, fentanyl is 50 times more powerful than heroin. A pound of fentanyl is lethal enough to kill a half a million people. And fentanyl, as you will find out talking to your law enforcement folks and others in the treatment space, it is often now being laced with other drugs, like cocaine, like crystal meth or heroin.
Most of this synthetic opioid is being illegally manufactured in China and then smuggled across our borders, either coming in through the mail system or going to Mexico and then being smuggled across.
There is also evidence now that it is also being produced in Mexico, which is a change and a major concern.
In order to avoid prosecution, prior to 2018, scientists in China-- evil scientists in China--and drug traffickers started making slight modifications to fentanyl, sometimes adjusting a single
molecule and creating what are essentially fentanyl copycats.
While these fentanyl-related substances have the same narcotic properties as fentanyl, their tiny variations allowed them to evade prosecution. But oftentimes, these similar substances, like carfentanil, which some of you are aware of, are even deadlier than fentanyl itself.
To address this, the Drug Enforcement Agency in 2018 used its authority to temporarily classify all fentanyl-related drugs as schedule I substances, which allows law enforcement to aggressively intercept and destroy these substances. Unfortunately, this designation was only temporary. That is all DEA could do.
So, in 2019, Congress extended that designation until May 6, 2021, so a 2-year extension until 14 days from now.
If that deadline lapses 14 days from now, criminals who run labs in China and Mexico will be able to avoid law enforcement as they flood the United States with unlimited slight variants of fentanyl that are just as deadly. We can't let that happen.
Let me say that again. At a time when we are experiencing an alarming rise in overdose deaths that we see here, and fentanyl is the major culprit, the No. 1 killer, we may face a situation where law enforcement will lose the ability to aggressively stop these fentanyl copycats in the United States unless Congress acts in the next 14 days.
Fortunately, we have legislation to do that. Our bipartisan FIGHT Fentanyl Act, which I introduced with Senator Joe Manchin, will fix this problem by permanently classifying fentanyl-related drugs as schedule I drugs. It would give our law enforcement certainty to go after synthetic opioids in all their forms and show we are committed to addressing the threat posed by this dangerous class of drugs.
Our proposal is the one bipartisan approach to this in the Senate. We structured it to address concerns from the criminal justice community and made sure it does not impose mandatory minimum sentencing under criminal charges brought under our bill. That has been one of the concerns expressed, particularly by some on the other side of the aisle. So we took that out.
I urge my colleagues on both sides of the aisle to come to the table and support this urgent legislation.
The House just passed a 5-month extension this week. That is, to me, very sad. Let's make this permanent. There is no reason to do a short- term extension and to create the uncertainty with law enforcement, and, frankly, to tell these evil scientists in places like China, in 5 months, you are going to be able, potentially--to be able to sell this substance again without worrying about the law. This makes no sense. Let's make it permanent. Let's give the DEA the authority to do what they need to do. And by doing so, let's reduce the amount coming in, which increases the cost on the street, which is an important step toward rededicating our efforts to stop these drugs from stealing thousands of lives and causing so much pain.
In conclusion, I urge my colleagues--our Nation faces a crisis. It is the coronavirus pandemic that is finally winding down, but it is also the addiction crisis. It has been happening underneath the coronavirus. As was said by my constituent--this woman who unfortunately has faced addiction in her own family--we have been here the whole time, and it hasn't gotten better; it has gotten worse.
Many of its victims are suffering in silence. We know a lot about what is going on with COVID. We don't know a lot about what is going on with this pandemic, this epidemic of drugs.
So let's act now, without delay. We have 14 days until DEA loses the authority to go after dangerous fentanyl copycats, but we can do something about it. We can pass legislation right now that will help people at their point of pain, as well as provide law enforcement the tools to cut off the source of their suffering--both the CARA 3.0 legislation to deal with the demand side and the legislation to be sure this poison can't come into our communities freely.
As the CDC data shows, this is an issue that affects every single one of us. Forty-nine States have seen a big increase. We know we need to do it. Let's not wait any longer to get to work once again turning the tide on our addiction crisis.
I yield the floor.