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On Senate Floor, Portman Outlines Progress, Ongoing Challenges on the Frontlines of Addiction Crisis in America


February 12, 2020

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WASHINGTON, DC Today, U.S. Senator Rob Portman (R-OH) delivered remarks on the Senate floor on the ongoing efforts at the federal, state, and local levels to address the addiction crisis. Progress is being made in Ohio and nationwide in reducing overdose death rates due in part to some of his legislative priorities like his Comprehensive Addiction & Recovery Act (CARA), the 21st Century CURES Act, and the STOP Act, but overdose death rates for certain drugs like fentanyl, psychostimulants like methamphetamine, and cocaine have all continued to rise. That’s why Portman is pushing this year to pass his FIGHT Fentanyl Act to permanently schedule fentanyl-related substances like carfentanil so that law enforcement can continue to take this deadly class of drugs off our streets. He is also working to garner support for his CARA 2.0 legislation, which will increase funding for proven and effective grant programs and implement new regulations on opioids that would address some of the root causes of the opioid addiction crisis.

Transcript of his remarks can be found below and a video can be found here.

 

“I’m here on the Senate floor to once again talk about the addiction crisis in our country. Over the past four years, I’m told that I have given over 60 floor speeches on this topic and that’s because it is a crisis and a national one. We’ve done a lot here in this United States Senate and also in the House of Representatives to deal with the issue. We’ve passed some important legislation. We’re making some progress, but, gosh, prescription opioids, heroin, fentanyl, methamphetamines, cocaine continue to harm so many people in our communities, so many of the families we represent. We’ve put new policies in place to help deal with it, better prevention, better treatment, better recovery efforts. Among other things we’ve passed legislation like the SUPPORT Act, the Comprehensive and Addiction Recovery Act, the 21st Century CURES Act, the STOP Act. Through these new laws we have also provided over $4 billion in additional federal resources just over the last three years to be able to combat this epidemic, particularly the opioid epidemic. In Ohio alone our state’s received nearly $140 million through the CARA and CURES legislation. It’s gone toward innovative evidence-based programs to try to figure out how do we intervene at the appropriate time to keep people who are addicted from overdosing and instead to get them into treatment, into longer term recovery in a successful way.

“I’ve gone to visit many of these programs across our state and I can tell you many of them are working and they’re working because local volunteers, local communities, the state is also involved. So that’s the positive thing. I was very pleased that the year-end spending bill passed with a record $658 million as an example in funding for these CARA grants that again go to these innovative ideas back home. Let me give you an example of one. We have in many of our communities now the ability after somebody has overdosed not to simply have them go back home, go to the same neighborhood, and continue to be addicted and overdose again and again and again but rather to intervene and to go there with law enforcement, with treatment providers, with first responders and get them into treatment, and it’s working. A program I was recently at in Columbus, Ohio, the RREACT team, 80 percent of the people who they go to visit end up getting into treatment, and the evidence is that not only are they getting into treatment, but because there is the ability to monitor that, they’re also going into longer-term recovery programs. And it’s helping to save lives, but it’s also for the first responders, it’s a great relief because no one is more frustrated than them. Think about it, you help somebody through an overdose by applying Narcan, that miracle drug that reverses the effects of an overdose. The next day they’re right back again. So this is the right thing to do and again we’ve made progress in that.

“The good news is it looks like it’s starting to pay off. After many, many years of increases in overdose deaths every single year, finally we are making progress. In states like mine, overdose deaths had climbed to the number-one cause of death in our state. In other words, surpassing car accidents or anything else. More people dying of drug overdose deaths than anything else. Nationwide, we had some great success between 2017 and 2018. We now have those numbers in. 2017, we had about 70,700 people who died of overdoses. In 2018, it went down to about 67,700. That’s a decrease of four percent. Now, that’s nothing to write home about, four percent. On the other hand, this is after three decades of increased overdose deaths every year, and in some years, substantial increases. So just to have that 4 percent decrease — and we’re waiting for the 2019 figures to become available — was a big deal. In Ohio, we’re one of the states that’s been hardest it and our number out of 2018 was a 22.4 percent reduction. We are one of the states that led the country in this. I’m proud of that. That means a lot of lives saved. Still, though, overdose rate way too high, way too high.

“We’re also, I think you on the positive side seeing more accountability for the opioid crisis in particular, as courts around the country hear cases of those affected by prescription opioids like OxyContin, these drug companies are being held accountable by individual states, by some local governments, by the federal government. Every day we learn more about what they did and how wrong it was. The sheer number of pain pills that drug companies pumped into the United States is astounding, with more than 100 billion pain pills between 2006 and 2014. So during that one period of time, eight years, 100 billion pain pills. We have one county in southern Ohio, Scioto County, where we had 48 million opioid pain pills distributed by manufacturers during those eight years. By the way, that’s 617 pills for every man, woman, and child in that one county in southern Ohio. We were flooded with pain pills that were addictive, and we got to be sure that that kind of a crisis doesn’t start again.

“As I travel around the state of Ohio, I hear stories all the time from people who had an accident, an injury, they took pain medication prescribed by a doctor. That led to a physical addiction. Something in their brain changed. They became addicted. They couldn’t get the prescription drugs because they’re too expensive, not accessible enough. So they turned to heroin. And in many cases, the tragedy that occurred was not just an overdose but sometimes an overdose and a life lost. And I hear this all the time. Just this morning at my weekly Buckeye Coffee — we have constituents come in once a week, meet with Ohioans — I met a young man, an impressive young man from Northeast Ohio. He told me about his brother, Dylan. He reminded me that I met his mom, I already knew about Dylan because his mom had told me but Dylan struggled with pain pill addiction before tragically dying of an opioid overdose. It is a pattern we’ve seen too often in our communities and it needs to stop. So we’re making some progress there, partly because of the lawsuits I think, and partly because of increased awareness, and partly because of the federal legislation we’ve discussed that’s helped on this. Partly because doctors and others are beginning to get the message. We’ve cracked down on pill mills as well, I mentioned Portsmouth, Ohio and Scioto County, Ohio where there were hundreds of pain pills per person. They had pill mills.

“Because of all that, the number of prescription pain pills prescribed between 2013 and 2018 fell by more than 80 million, about a 33 percent decrease nationwide. So pushing back against this opioid flow that flourished for way too long here in the United States is helping, and that’s a positive sign as well. But, again, while the CDC, Centers for Disease Control, has shown an overall decrease in drug overdose deaths for the past 18 months or so, I want to talk tonight about some new, troubling trends. And for the need for us here in Congress not to take our eye off the ball, because sometimes around here you get a little progress, you think, ‘Okay, let’s go on to the next thing.’ Unfortunately, that’s not the way addiction works. And we’ve seen this over time. Back in the 1990’s, we thought would had solved the cocaine crisis. We didn’t. Now some think we have solved the opioid crisis. We haven’t. In addition, there are new troubling trends that I want to talk about tonight.

“The most worrying is that while the overall number of opioid overdose deaths has fallen, the number of overdose deaths related to the very deadliest of opioids — and that would be synthetic opioids like fentanyl or carfentanil — has actually increased. In fact in 2018 more deaths were attributed to fentanyl than to heroin and prescription drugs combined. So, it’s shifted. Think about this, from the prescription drugs to the heroin, now to fentanyl. Fentanyl is 50 times more powerful than heroin. A few flakes of this stuff can kill you. And, unfortunately, it’s being mixed into other drugs partly because it is so powerful and a few flakes can kill you. According to the Centers for Disease Control, 40 percent of drug overdoses in 2017 were at least partly because of fentanyl use, 40 percent, by far the largest problem. That data also showed that overdose deaths due to fentanyl had increased by 88 percent per year since 2013. So it’s been going up really since the 2013-2014 time period.

“We’re seeing this mixing occur in a lot of overdose reports from Ohio communities where declining prescription opioid and heroin use has opened the door now for this other form of addiction. In particular, psychostimulants, as they’re called, like crystal meth and cocaine are being laced with fentanyl. This is a deadly combination. According to our state’s Deputy Attorney General for Law Enforcement, Carol O’Brien, Ohio law enforcement officials in 2018 tested double the amount of methamphetamine samples as they had in 2017, triple the amount from 2016. So crystal meth is unfortunately making a resurgence in our communities. By the way, you may remember in your community in the past couple of decades you heard about these meth houses, where people would be cooking meth literally, you know, in a home or in a trailer, in the basement and causing environmental concerns and so on. You don’t hear about that anymore. And you know why? Because the crystal meth coming straight from Mexico is so powerful and so cheap that people don’t have to make it at home anymore. So that’s a bad thing because this has expanded the people that have become addicted to methamphetamines because of this powerful crystal meth.

“Anyway, today I met with law enforcement officers from around the state of Ohio. The FOP was in town, Fraternal Order of Police. Many of you met with them, my colleagues, and they confirmed this troubling trend. And they told me that the crystal meth and the cocaine, because they are psychostimulants, are much more difficult for them to deal with and puts their lives more at risk and their safety more at risk. As well as the citizens that they’re there to protect. Why? Because it causes a more violent reaction. So think about it. With heroin, with other opioids, prescription drugs, fentanyl, people talk about the nodding effect. It calms people more, whereas with cocaine and with the other psychostimulants like crystal meth, it makes people more agitated, more violent. And we have seen not just more assaults on individuals, but more violent crime overall coming out of this. So it’s a shift that is having impacts on our police officers and on our citizens as well in terms of increased violent crime.

“I’m really pleased to say that the legislation we passed in December, just about a month and a half ago, responded to this issue of the increase in meth and cocaine. And it’s because it included our legislation called the Combating Meth and Cocaine Act — it’s a really important bill. Basically what it says is let’s give local communities the flexibility to use the opioid grant money that I talked about earlier that’s increased over the last three or four years for also to be used for psychostimulants. And I felt very strongly about this because I was hearing it back home. ‘Thank you very much for your help on the opioid crisis. By the way, we’ve shifted now in our community. Opioids are not as big a deal, but we need the funding to also help us deal with the consequences of crystal meth or cocaine.’ So I thank my colleagues for passing that legislation. It’s going to make a big difference and we’ll begin, I think, to see the ability now to address this new threat.

“The U.S. Attorneys for the Northern and Southern district of Ohio have recently weighed in and told me what’s going on in terms of this mixing of cocaine and crystal meth with fentanyl. They say that it is a crisis. Preliminary data from the Cuyahoga County, which is Cleveland, Ohio, suggests that about 45 percent of the fatal overdoses in the county last year were associated with cocaine, much of that mixed with fentanyl. And that’s twice the amount, by the way, of heroin overdoses over that same time period from the previous year, which shows how again the front lines of addiction have shifted. Partly in response to our successes on the opioid front. We’re hearing similar things in the Southern district of Ohio where more than a third of overdose deaths are from cocaine and fentanyl where they just had 10 overdose deaths from the combination of fentanyl and cocaine in the last several days.

“So I met with the Columbus, Ohio, Police Chief Tom Quinlan on Friday in the middle of a spike there, a spike in overdose deaths that they’ve seen from this mixture. In the first 10 days of February, this month, Columbus, Ohio, Franklin County, had 28 overdose deaths involving some combination of fentanyl and cocaine. 28 in 10 days. I was actually in Columbus on Saturday, a day on which five people died from overdoses of this mixture of fentanyl and cocaine. So just yesterday the Columbus police informed me that they seized in one drug bust over 200 grams of cocaine and nearly two kilograms of fentanyl. That’s enough to kill about one million people. So again we’ve made some progress on the opioid front, no question about it, we’ve made progress in terms of the prescription drug overprescribing. But unfortunately, my colleagues, this issue is not going away. And the more flexible funding we got in at the end of the year is important. We’ll begin to see that take effect here over the next several months, it’s just being implemented now. But we’ve got to deal with it.

“The other thing we’ve got to deal with in terms of fentanyl is being sure that some evil scientist doesn’t slightly change the molecular compound of fentanyl making it an analog to fentanyl and it’s not illegal. You have to schedule a drug to make it illegal. And as we’ve seen an uptick in these fentanyl copycats, we have seen the reality that it’s not just about fentanyl. It’s also about carfentanil, it’s also about other analogs. We had an 819 percent increase from a just year ago in Cleveland, as an example, with carfentanil deaths in 2019. So 2018 to 2019, an 819 percent increase. That’s why DEA, the Drug Enforcement Agency, has made the right call in 2018 in temporarily making these fentanyl-related substances, like carfentanil, illegal to possess, transport or manufacture. And thanks to that designation, our law enforcement officials have been better able to protect our communities by seizing and destroying this fentanyl-related substance because it is illegal. We had a real problem here in the last couple months in Congress because as of early this month, just last week, that scheduling of those analogs expired and we almost had a situation where these drugs were going to become legal. Thank goodness, at the last minute we stepped in and we provided a temporary extension. Otherwise again, last week we would have had a real crisis. Unfortunately, the temporary extension, like so much stuff around here, was kind of kicking the can down the road. So in May of next year, just a year and a few months from now, again it is going to expire.

“So I strongly urge my colleagues to join me, Senator Manchin, and others on both sides of the aisle in passing legislation that puts these analogues on the schedule making them illegal permanently. It should be permanent. The legislation is called the FIGHT Fentanyl Act, and again it just codifies what the DEA has done, but also gives them the flexibility to be able to schedule new things as again these scientists come up with ways to slightly alter the molecular compounds for these incredibly dangerous and deadly drugs. Our legislation, by the way, has strong bipartisan support but also has the support of every single attorney general in every state in America and six territories. So 56 of our attorneys general have come forward and endorsed our bill and I thank them for that. And let’s do that. Let’s push back against these deadly copycats of fentanyl and be sure that our communities are just a little bit safer.

“Again, we’ve made a lot of progress in the fight, but as we’ve seen, addiction, not a particular drug but addiction is really the crisis that we face. And as we’ve made progress against opioids, including an unprecedented federal response here, and I appreciate that very much, we now see the playing field changing. We see these psychostimulants like cocaine and crystal meth making a comeback. We see this mixing with fentanyl. Again, the funding bill passed last year will help as we begin to implement these changes. We need to be sure that FIGHT Fentanyl legislation is passed. We need to be sure that we continue the funding. Again, it’s easy to say, well, this crisis is better, let’s move on. We have to keep our eye on the ball. So I thank my colleagues as we go through the funding process again that we got to keep the funding for the CARA legislation and others.

“We also have a new bill called CARA 2.0. So Comprehensive Addiction and Recovery Act 2.0.  It expands the reach of these evidence based programs we’re talking about, particularly longer-term recovery programs because we’ve learned that so critical to actually get somebody into recovery and keep them in recovery for a long enough time so they don’t relapse. We also have in that legislation, important legislation with regard to opioid prescriptions because that still is a problem. We say that there should be a limit of three days for acute pain. Not for chronic pain, but for acute pain. Limited to three days. That comes from a recommendation by the Center for Disease Control and Prevention but also from the FDA. Again, I’ve heard from too many families like the young man I heard from this morning about someone whose child has become addicted because the doctor gave them too many opioids. And by the way, I now know several families whose son or daughter was given opioids when he or she had a wisdom tooth removed, which apparently is one of the top two or three most common procedures in America. Doctors are still, dentists are still giving these kids opioids. I think that’s wrong. And I think that should be stopped altogether. But in the meantime, three days is a sensible limit. A doctor can always prescribe more if you have an issue, but — and I think there are proper exceptions for chronic pain — but our legislation would, I think, make a big difference. It also has a prescription drug monitoring program which would require states to make their monitoring programs and their data available at other states because people go from state to state to get these prescription pain pills. This will help against overprescribing, making sure people are treated as soon as possible, identified.

“So I urge my colleagues who are not yet cosponsors of any of these bills, the FIGHT Fentanyl bill, the CARA 2.0 bill, to help us, to join us in responding to this ever-evolving challenge we have, which again is not just an opioid problem, it’s an addiction problem. Every state represented in this chamber is affected by this epidemic and these two bills at least provide us an opportunity to continue to give law enforcement the tools they need and give our communities the help they need to be able to overcome this crisis.”

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