Comprehensive Addiction and Recovery Act of 2016--Conference Report--

Floor Speech

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Mr. MARKEY. Mr. President, I would like to start my remarks on the Comprehensive Addiction and Recovery Act with a story I received from one of my constituents, David. He is a patient at Hope House in Boston. Hope House is the oldest and one of the largest residential treatment programs for adults in Massachusetts. This is what he said:

Senator Markey: Addiction has totally ruined my life. It quickly took everything from me and my family. It has stripped me of my dignity and self worth along with my self respect. I also lost the trust of my entire family.

Addiction started late for me. I was 44 years old. I had everything I could possibly dream of. A beautiful wife, a son, two step-daughters that I raised and put through college. We also built a new home in 2000. I had a great career and was a few years away from 20 to retire.

Then my family and I went on vacation for two weeks and I came home with a parasite in my stomach for which I was prescribed pain medication. That was at the end of April that year. In May, I had my appendix taken out. In June, I had to have my gallbladder out. All the while being prescribed pain meds.

Before I knew it, I was addicted. It wasn't long after that there were no more scripts to be had. Then I was doing heroin. This was so scary for me because I had not used any drugs my entire life. Within two years, everything was gone. Wife, family, job, house. Everything.

It has been a real struggle to get out and stay clean between not being able to get a detox bed, or, if I did, after five days, only to be told that there were no beds available for further treatment. Which meant back on the street to start the whole process over again.

I finally did make it to the Hope House, which I am so grateful for. I know I am going to make it this time; I just feel it. Thank you for the chance.

I pray for David and all the patients at Hope House. They found the help they needed, and we hope they will have the strength and the support to achieve long-term recovery.

I am proud that this opioid legislation contains provisions of the TREAT Act--The Recovery Enhancement for Addiction Treatment Act--a bill I introduced with Senator Rand Paul of Kentucky and other colleagues here in the Senate. The TREAT Act addresses the demand side of the opioid epidemic.

I firmly believe that if we are going to reduce the supply of heroin, fentanyl, and illicit prescription drugs, we have to reduce the demand through treatment. But for far too long, outdated and scientifically unsound Federal restrictions have severely limited access to effective medication-assisted treatment like Suboxone for opioid addiction. The TREAT Act removes these restrictions. Importantly, the TREAT Act would allow appropriately trained nurse practitioners and physician assistants to treat patients with these lifesaving therapies.

These TREAT Act provisions, which are included in the CARA conference report, will increase access to treatment, especially in community health centers and rural communities across this country. I am grateful that these provisions are included in the bill we will vote on today. I am hopeful they will have an impact in the future.

It has been a long haul and hard work over the last few years, but we have achieved a measure of success that will impact lives as soon as this bill is signed into law. I sincerely thank Senator Murray and Senator Alexander for their support on the TREAT Act. I thank Senator Hatch and Representatives Pallone and Upton and all the CARA conferees who worked to get the TREAT Act provisions included in this final package we are voting on today. I would like to express my appreciation to Senators Whitehouse and Portman and all of the Senate and House cosponsors of the TREAT Act who supported efforts to get the law changed so that more people can get the treatment they need.

In Massachusetts, I am hearing enormous frustration from people who don't feel that adequate resources are being brought to bear on this enormous epidemic of prescription drug and heroin addiction. Just like David, countless people suffering from addiction cannot find a bed for detox, and then when they are at their most vulnerable moment in recovery, they cannot find a place or provider of long-term treatment.

For the months that we have been debating CARA in this Chamber, we have heard the statistics. Our Nation is experiencing more deaths from drug overdoses than from gun violence or auto deaths. Eighty percent of people suffering from heroin addiction started on opioid pain medications approved by the Food and Drug Administration and prescribed by doctors who aren't required to receive education on safe opioid prescribing.

Nearly 30,000 people in the United States died of an opioid overdose in 2014. Approximately 1,300 of those were in Massachusetts. Of those 1,300, 754 had fentanyl in their system. Massachusetts is 2 percent of America's population. If you multiply 754 times 50, you are up to 37,000 people dying from fentanyl in our country. That is like having a war in Korea every single year. We haven't even begun this battle on fentanyl. But it is coming, and it is coming with an urgency that is very difficult to even imagine. The total deaths from opioids in America would be equivalent to a Vietnam war every single year, and fentanyl is 50 times more powerful than morphine--unbelievable. That is how powerful it is--50 times more powerful.

This is just something that we are going to have to deal with, and approximately 2.5 million Americans abused or were dependent on opioids in 2012, but fewer than 1 million received treatment for their condition. Out of the 2.5 million people who needed help, only 1 million got it in our country. We are being overwhelmed by a tsunami of heroin, prescription drugs, and fentanyl addiction, and we must stop it before it drowns any more families in our country.

We had an opportunity here to make sure we put real funding into this bill for more treatment. We are not going to meet that challenge here today. We do need funding for those families--funding for treatment providers who help put people on the path to recovery and funding for our sheriffs, firefighters, and other first responders who carry the overdose prevention drugs that save lives. We need funding for the public education campaign so that we can prevent addiction before it takes hold. We will not save lives and stop this scourge of addiction unless we, in fact, ensure that there is full funding for treatment. We will save lives with more treatment options, more Narcan, more counselors, more education, more beds, and a better continuum of care, but we must fund it.

The bill we are voting on today is a good step, but we still have much further to go. Without that funding, this effort will not do the full job that our country wants us to do. Our cities are fighting a war, and we need to help them. We are hemorrhaging lives by the day. If we are to staunch the flow of suffering and death, we desperately need funding to implement all of the programs in this bill.

Ladies and gentlemen, we are at a defining moment in our national discussion to address the public health crisis of addiction. Our work doesn't stop here. It has only just begun. Let's be clear. Stopping the overprescription of opioid pain medication that is fueling addiction and overdoses starts with the prescribers. We need to require anyone who prescribes opioid pain medication and other controlled substances to undergo mandatory training on safe prescribing practices and the identification of possible substance use disorder.

We need to make sure that people who enter the judicial system don't arbitrarily have their Medicaid coverage terminated, making it more difficult to access treatment once they are released and fueling, once again, the vicious cycle of incarceration.

We need to make sure that all opioids approved by the Food and Drug Administration are first reviewed by independent experts to ensure that these drugs are not only safe and effective but also won't continue to fuel the epidemic of addiction in this country.

We need to make sure that prescription drug monitoring programs are fully utilized and nationally interoperable in order to prevent doctor shopping, and we must let Big Pharma know that their army of lobbyists on Capitol Hill will be matched by an army of advocates that work every day to raise awareness and save lives.

The Congress has an opportunity to let all those struggling with addiction know that help is on the way. We know that we have heard their stories, and we will not forget them.

We must let them know that no matter how dark life seems right now, there is hope, and sunlight will grace them once again, and this Chamber has not finished this job--this journey--that we must be on with every family in our country. Substance abuse is a crisis the likes of which we have never seen in America. A decade from now people will ask: What did you do to help end this epidemic? That is why I stand today congratulating all of those who worked on this bill, and we must also pledge to continue to stand up and fight for the funding and other investments we need to make.

We must stand united to end this crisis of addiction in our communities now and for generations to come so that children will not have to look to the history books to find that there ever was a year like 2016 with an epidemic that is raging across the country.

I yield back the remainder of my time.

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