U.S. GOVERNMENT PUBLISHING OFFICE

27–598 PDF WASHINGTON : 2018

MEMBER DAY: TESTIMONY AND PROPOSALS ON 

THE OPIOID CRISIS 

HEARING 

BEFORE THE

SUBCOMMITTEE ON HEALTH 

OF THE

COMMITTEE ON ENERGY AND 

COMMERCE 

HOUSE OF REPRESENTATIVES 

ONE HUNDRED FIFTEENTH CONGRESS 

FIRST SESSION 

OCTOBER 11, 2017 

Serial No. 115–64 

( 

Printed for the use of the Committee on Energy and Commerce 

energycommerce.house.gov 

COMMITTEE ON ENERGY AND COMMERCE 

GREG WALDEN, Oregon 

Chairman 

JOE BARTON, Texas 

Vice Chairman 

FRED UPTON, Michigan 

JOHN SHIMKUS, Illinois 

TIM MURPHY, Pennsylvania 

MICHAEL C. BURGESS, Texas 

MARSHA BLACKBURN, Tennessee 

STEVE SCALISE, Louisiana 

ROBERT E. LATTA, Ohio 

CATHY MCMORRIS RODGERS, Washington 

GREGG HARPER, Mississippi 

LEONARD LANCE, New Jersey 

BRETT GUTHRIE, Kentucky 

PETE OLSON, Texas 

DAVID B. MCKINLEY, West Virginia 

ADAM KINZINGER, Illinois 

H. MORGAN GRIFFITH, Virginia 

GUS M. BILIRAKIS, Florida 

BILL JOHNSON, Ohio 

BILLY LONG, Missouri 

LARRY BUCSHON, Indiana 

BILL FLORES, Texas 

SUSAN W. BROOKS, Indiana 

MARKWAYNE MULLIN, Oklahoma 

RICHARD HUDSON, North Carolina 

CHRIS COLLINS, New York 

KEVIN CRAMER, North Dakota 

TIM WALBERG, Michigan 

MIMI WALTERS, California 

RYAN A. COSTELLO, Pennsylvania 

EARL L. ‘‘BUDDY’’ CARTER, Georgia 

FRANK PALLONE, JR., New Jersey 

Ranking Member 

BOBBY L. RUSH, Illinois 

ANNA G. ESHOO, California 

ELIOT L. ENGEL, New York 

GENE GREEN, Texas 

DIANA DEGETTE, Colorado 

MICHAEL F. DOYLE, Pennsylvania 

JANICE D. SCHAKOWSKY, Illinois 

G.K. BUTTERFIELD, North Carolina 

DORIS O. MATSUI, California 

KATHY CASTOR, Florida 

JOHN P. SARBANES, Maryland 

JERRY MCNERNEY, California 

PETER WELCH, Vermont 

BEN RAY LUJA ́ N, New Mexico 

PAUL TONKO, New York 

YVETTE D. CLARKE, New York 

DAVID LOEBSACK, Iowa 

KURT SCHRADER, Oregon 

JOSEPH P. KENNEDY, III, Massachusetts 

TONY CA ́ RDENAS, California 

RAUL RUIZ, California 

SCOTT H. PETERS, California 

DEBBIE DINGELL, Michigan 

SUBCOMMITTEE ON HEALTH

MICHAEL C. BURGESS, Texas 

Chairman 

BRETT GUTHRIE, Kentucky 

Vice Chairman 

JOE BARTON, Texas 

FRED UPTON, Michigan 

JOHN SHIMKUS, Illinois 

TIM MURPHY, Pennsylvania 

MARSHA BLACKBURN, Tennessee 

CATHY MCMORRIS RODGERS, Washington 

LEONARD LANCE, New Jersey 

H. MORGAN GRIFFITH, Virginia 

GUS M. BILIRAKIS, Florida 

BILLY LONG, Missouri 

LARRY BUCSHON, Indiana 

SUSAN W. BROOKS, Indiana 

MARKWAYNE MULLIN, Oklahoma 

RICHARD HUDSON, North Carolina 

CHRIS COLLINS, New York 

EARL L. ‘‘BUDDY’’ CARTER, Georgia 

GREG WALDEN, Oregon (ex officio) 

GENE GREEN, Texas 

Ranking Member 

ELIOT L. ENGEL, New York 

JANICE D. SCHAKOWSKY, Illinois 

G.K. BUTTERFIELD, North Carolina 

DORIS O. MATSUI, California 

KATHY CASTOR, Florida 

JOHN P. SARBANES, Maryland 

BEN RAY LUJA ́ N, New Mexico 

KURT SCHRADER, Oregon 

JOSEPH P. KENNEDY, III, Massachusetts 

TONY CA ́ RDENAS, California 

ANNA G. ESHOO, California 

DIANA DEGETTE, Colorado 

FRANK PALLONE, JR., New Jersey (ex 

officio) 

(II) 

(III) 

C O N T E N T S 

Page 

Hon. Michael C. Burgess, a Representative in Congress from the State of 

Texas, opening statement .................................................................................... 1 

Hon. Gene Green, a Representative in Congress from the State of Texas, 

opening statement ................................................................................................ 3 

WITNESSES

Hon. Greg Walden, a Representative in Congress from the State of Oregon ..... 4 

Prepared statement .......................................................................................... 6 

Hon. Frank Pallone, Jr., a Representative in Congress from the State of 

New Jersey ........................................................................................................... 7 

Prepared statement .......................................................................................... 8 

Hon. Fred Upton, a Representative in Congress from the State of Michigan .... 9 

Prepared statement .......................................................................................... 10 

Hon. Leonard Lance, a Representative in Congress from the State of New 

Jersey .................................................................................................................... 11 

Prepared statement .......................................................................................... 12 

Hon. Doris O. Matsui, a Representative in Congress from the State of California ..................................................................................................................... 13 

Prepared statement .......................................................................................... 14 

Hon. Gus M. Bilirakis, a Representative in Congress from the State of Florida .......................................................................................................................... 15 

Prepared statement .......................................................................................... 16 

Hon. G.K. Butterfield, a Representative in Congress from the State of North 

Carolina ................................................................................................................ 17 

Prepared statement .......................................................................................... 18 

Hon. Larry Bucshon, a Representative in Congress from the State of Indiana . 19 

Prepared statement .......................................................................................... 20 

Hon. Robert E. Latta, a Representative in Congress from the State of Ohio ..... 20 

Prepared statement .......................................................................................... 22 

Hon. Bill Johnson, a Representative in Congress from the State of Ohio .......... 23 

Prepared statement .......................................................................................... 24 

Hon. Peter Welch, a Representative in Congress from the State of Vermont .... 24 

Prepared statement .......................................................................................... 25 

Hon. Susan W. Brooks, a Representative in Congress from the State of 

Indiana .................................................................................................................. 26 

Prepared statement .......................................................................................... 27 

Hon. Ben Ray Luja ́n, a Representative in Congress from the State of New 

Mexico ................................................................................................................... 28 

Prepared statement .......................................................................................... 30 

Hon. Nancy Pelosi, a Representative in Congress from the State of California 31 

Prepared statement .......................................................................................... 32 

Hon. Markwayne Mullin, a Representative in Congress from the State of 

Oklahoma .............................................................................................................. 33 

Prepared statement .......................................................................................... 34 

Hon. Paul Tonko, a Representative in Congress from the State of New York ... 35 

Prepared statement .......................................................................................... 37 

Hon. Richard Hudson, a Representative in Congress from the State of North 

Carolina ................................................................................................................ 38 

Prepared statement .......................................................................................... 39 

Hon. Joseph P. Kennedy, III, a Representative in Congress from the Commonwealth of Massachusetts ...................................................................................... 40 

Hon. Bob Goodlatte, a Representative in Congress from the Commonwealth 

of Virginia ............................................................................................................. 41 

Prepared statement .......................................................................................... 42 

Page

IV 

Hon. Tim Walberg, a Representative in Congress from the State of Michigan . 43 

Prepared statement .......................................................................................... 44 

Hon. Harold Rogers, a Representative in Congress from the Commonwealth 

of Kentucky ........................................................................................................... 45 

Prepared statement .......................................................................................... 46 

Hon. Earl L. ‘‘Buddy’’ Carter, a Representative in Congress from the State 

of Georgia .............................................................................................................. 47 

Prepared statement .......................................................................................... 48 

Hon. Cheri Bustos, a Representative in Congress from the State of Illinois ..... 49 

Prepared statement .......................................................................................... 50 

Hon. Michael R. Turner, a Representative in Congress from the State of 

Ohio ....................................................................................................................... 51 

Prepared statement .......................................................................................... 52 

Hon. Roger W. Marshall, a Representative in Congress from the State of 

Kansas ................................................................................................................... 53 

Prepared statement .......................................................................................... 54 

Hon. Steve Stivers, a Representative in Congress from the State of Ohio ......... 55 

Prepared statement .......................................................................................... 56 

Hon. Bradley Scott Schneider, a Representative in Congress from the State 

of Illinois ............................................................................................................... 58 

Prepared statement .......................................................................................... 59 

Hon. Hakeem S. Jeffries, a Representative in Congress from the State of 

New York .............................................................................................................. 60 

Prepared statement .......................................................................................... 61 

Hon. Evan H. Jenkins, a Representative in Congress from the State of West 

Virginia ................................................................................................................. 62 

Prepared statement .......................................................................................... 63 

Hon. Brad R. Wenstrup, a Representative in Congress from the State of 

Ohio ....................................................................................................................... 64 

Prepared statement .......................................................................................... 65 

Hon. Katherine M. Clark, a Representative in Congress from the Commonwealth of Massachusetts ...................................................................................... 66 

Prepared statement .......................................................................................... 67 

Hon. Elizabeth H. Esty, a Representative in Congress from the State of 

Connecticut ........................................................................................................... 67 

Prepared statement .......................................................................................... 68 

Hon. Mia B. Love, a Representative in Congress from the State of Utah .......... 70 

Prepared statement .......................................................................................... 71 

Hon. Bill Pascrell, Jr., a Representative in Congress from the State of New 

Jersey .................................................................................................................... 71 

Prepared statement .......................................................................................... 72 

Hon. Thomas MacArthur, a Representative in Congress from the State of 

New Jersey ........................................................................................................... 73 

Prepared statement .......................................................................................... 74 

Hon. Tom O’Halleran, a Representative in Congress from the State of Arizona ....................................................................................................................... 75 

Prepared statement .......................................................................................... 76 

Hon. Bruce Poliquin, a Representative in Congress from the State of Maine ... 77 

Prepared statement .......................................................................................... 78 

Hon. David Rouzer, a Representative in Congress from the State of North 

Carolina ................................................................................................................ 79 

Prepared statement .......................................................................................... 80 

Hon. David Young, a Representative in Congress from the State of Iowa ......... 81 

Prepared statement .......................................................................................... 82 

Hon. Earl Blumenauer, a Representative in Congress from the State of Oregon ....................................................................................................................... 83 

Prepared statement .......................................................................................... 84 

Hon. Karen C. Handel, a Representative in Congress from the State of Georgia .......................................................................................................................... 84 

Prepared statement .......................................................................................... 85 

Hon. Charlie Crist, a Representative in Congress from the State of Florida ..... 86 

Prepared statement .......................................................................................... 87 

Hon. John J. Faso, a Representative in Congress from the State of New 

York ....................................................................................................................... 88 

Prepared statement .......................................................................................... 89 

Hon. John Katko, a Representative in Congress from the State of New York ... 90 

Prepared statement .......................................................................................... 91 

Page

V 

Hon. William R. Keating, a Representative in Congress from the Commonwealth of Massachusetts ...................................................................................... 92 

Prepared statement .......................................................................................... 94 

Hon. Erik Paulsen, a Representative in Congress from the State of Minnesota .................................................................................................................... 95 

Prepared statement .......................................................................................... 96 

Hon. Lisa Blunt Rochester, a Representative in Congress from the State 

of Delaware ........................................................................................................... 97 

Prepared statement .......................................................................................... 98 

Hon. Judy Chu, a Representative in Congress from the State of California ...... 98 

Prepared statement .......................................................................................... 99 

Hon. Jackie Walorski, a Representative in Congress from the State of Indiana ......................................................................................................................... 100 

Prepared statement .......................................................................................... 101 

Hon. Daniel M. Donovan, Jr., a Representative in Congress from the State 

of New York .......................................................................................................... 102 

Prepared statement .......................................................................................... 102 

Hon. Vicky Hartzler, a Representative in Congress from the State of Missouri ....................................................................................................................... 103 

Prepared statement .......................................................................................... 104 

Hon. Brian K. Fitzpatrick, a Representative in Congress from the Commonwealth of Pennsylvania ........................................................................................ 104 

Prepared statement .......................................................................................... 104 

Hon. Ryan A. Costello, a Representative in Congress from the Commonwealth 

of Pennsylvania .................................................................................................... 106 

Prepared statement .......................................................................................... 107 

Hon. Keith J. Rothfus, a Representative in Congress from the Commonwealth 

of Pennsylvania .................................................................................................... 108 

Prepared statement .......................................................................................... 109 

SUBMITTED MATERIAL

Statement of Hon. Wm. Lacy Clay, a Representative in Congress from the 

State of Missouri, submitted by Mr. Burgess .................................................... 110 

Statement of Hon. Anna G. Eshoo, a Representative in Congress from the 

State of California, submitted by Mr. Burgess .................................................. 111 

Statement of Hon. Alcee L. Hastings, a Representative in Congress from 

the State of Florida, submitted by Mr. Burgess ................................................ 111 

Statement of Hon. David P. Joyce, a Representative in Congress from the 

State of Ohio, submitted by Mr. Burgess ........................................................... 112 

Statement of Hon. Ann M. Kuster, a Representative in Congress from the 

State of New Hampshire, submitted by Mr. Burgess ....................................... 114 

Statement of Hon. Stephen F. Lynch, a Representative in Congress from 

the Commonwealth of Massachusetts, submitted by Mr. Burgess .................. 125 

Statement of Hon. David B. McKinley, a Representative in Congress from 

the State of West Virginia, submitted by Mr. Burgess ..................................... 126 

Statement of Hon. Richard M. Nolan, a Representative in Congress from 

the State of Minnesota, submitted by Mr. Burgess ........................................... 131 

Statement of Hon. Niki Tsongas, a Representative in Congress from the 

Commonwealth of Massachusetts, submitted by Mr. Burgess ......................... 131 

Article of August 17, 2017, ‘‘Wilson sees 2 recent heroin, opioid overdose 

deaths,’’ by Olivia Neeley, The Wilson Times, submitted by Mr. Butterfield . 133 

Article of August 23, 2017, ‘‘As overdoses surge, agencies joining forces to 

help heroin, opioid addicts,’’ by Olivia Neeley, The Wilson Times, submitted 

by Mr. Butterfield ................................................................................................ 134 

Article of May 30, 2015, ‘‘A Choice for Recovering Addicts: Relapse or Homelessness,’’ by Kim Barker, The New York Times, submitted by Mr. Green .... 136 

News release of the Department of Justice, U.S. Attorney’s Office, Southern 

District of Florida, ‘‘Owner Sentenced to More than 27 Years in Prison 

for Multi-Million Dollar Health Care Fraud and Money Laundering Scheme 

Involving Sober Homes and Alcohol and Drug Addiction Treatment Centers,’’ May 17, 2017, submitted by Mr. Green ................................................... 158 

(1) 

MEMBER DAY: TESTIMONY AND PROPOSALS 

ON THE OPIOID CRISIS 

WEDNESDAY, OCTOBER 11, 2017 

HOUSE OF REPRESENTATIVES

SUBCOMMITTEE ON HEALTH, COMMITTEE ON ENERGY AND COMMERCE, Washington, DC. 

The subcommittee met, pursuant to call, at 10:17 a.m., in room 

2322, Rayburn House Office Building, Hon. Michael C. Burgess 

(chairman of the subcommittee) presiding. 

Members present: Representatives Burgess, Guthrie, Barton, 

Upton, Shimkus, Lance, Bilirakis, Bucshon, Brooks, Mullin, Hudson, Collins, Carter, Walden (ex officio), Green, Butterfield, Matsui, 

Luja ́n, Kennedy, Eshoo, and Pallone (ex officio). 

Staff present: Adam Buckalew, Professional Staff Member, 

Health; Kelly Collins, Staff Assistant; Zack Dareshori, Staff Assistant; Jordan Davis, Director of Policy and External Affairs; Paul 

Eddatel, Chief Counsel, Health; Adam Fromm, Director of Outreach and Coalitions; Caleb Graff, Professional Staff Member, 

Health; Jay Gulshen, Legislative Clerk, Health; Zach Hunter, Communications Director; Katie McKeogh, Press Assistant; Alex Miller, 

Video Production Aide and Press Assistant; Christopher Santini, 

Counsel, Oversight and Investigations; Kristen Shatynski, Professional Staff Member, Health; Jennifer Sherman, Press Secretary; 

Jeff Carroll, Minority Staff Director; Waverly Gordon, Minority 

Counsel, Health; Tiffany Guarascio, Minority Deputy Staff Director 

and Chief Health Advisor; Jourdan Lewis, Minority Staff Assistant; 

Jessica Martinez, Minority Outreach and Member Services Coordinator; Samantha Satchell, Minority Policy Analyst; Andrew 

Souvall, Minority Director of Communications, Member Services, 

and Outreach; Kimberlee Trzeciak, Minority Senior Health Policy 

Advisor; and C.J. Young, Minority Press Secretary. 

Mr. BURGESS. Subcommittee will come to order, and I will recognize myself for an opening statement. 

OPENING STATEMENT OF HON. MICHAEL C. BURGESS, A 

REPRESENTATIVE IN CONGRESS FROM THE STATE OF TEXAS 

United States of America is in the midst of a fierce battle against 

an epidemic brought to us by opioids. It does not matter where you 

live. This crisis has touched every corner of American society. 

While New England and the Ohio Valley regions represent 

States hardest hit by the epidemic, health officials from the South 

and reaching across the West all report a growing number of overdose deaths in those counties. 

2 

The latest figures from the Center for Disease Control and Prevention are astounding. Ninety-one Americans die every day from 

an overdose. 

Now, more than ever, we must come together and strengthen our 

commitment to fight this malady. I expect today’s Members Day 

will bring to the forefront key insights and potential solutions on 

this critical issue. 

In the previous Congress, the Energy and Commerce Committee 

led several bipartisan initiatives to help address the opioid epidemic. 

The Comprehensive Addiction Recovery Act and the 21st Century 

Cures Act are now law and providing resources at the State and 

local levels. 

Much-needed policy changes are being implemented the passage 

of both CARA—with the passage of both CARA and Cures. 

In fact, as a result of CARA, patients suffering from substance 

abuse now have greater access to evidence-based treatment, addiction treatment services, and overdose reversal therapies. Cures, on the other hand, provided $1 billion in grants for States 

to support an array of prevention treatment and recovery services. 

I believe these initiatives are making a significant difference. 

At the same time, other issues have emerged in this fight. Earlier this year, our committee responded to reports of people overdosing on heroin laced with synthetic opioids—fentanyl, 

carfentanyl—which are 100 to 10,000 times more potent than morphine. 

The ready availability of these synthetic opioids have become a 

public health threat and illegal online pharmacies, primary operating in foreign countries, are exacerbating this epidemic every day 

for our State and Federal officials. 

Today’s hearing will allow us to gain Member perspective on potential ways to complement existing policies and Federal regulations to combat the opioid epidemic. 

Representatives both on and off the Energy and Commerce Committee will testify about the opioid epidemic, share their stories, 

and propose legislative solutions for our consideration. 

In advance, I want to thank House Members for participating in 

this important discussion, and we look forward to hearing from everyone who’s going to be before us today. 

Let me yield what little time I have left to the vice chairman of 

the Health Subcommittee, Mr. Guthrie. 

Mr. GUTHRIE. Thank you very much. Obviously, I am going to be 

brief. 

So many families have been devastated by this, and in ‘‘Dreamland,’’ which is a book that I read about the opioid crisis—an important book that I read about the opioid crisis—had all these different scenarios. 

But when you see it in reality, I was in Owensboro one evening 

and met a mom. The mom was the mother of an athletic student— 

an athlete and an honor student—who had her ACL torn playing 

soccer, was prescribed painkillers. 

After her recovery she was addicted to pain killers. Since she 

couldn’t have access to them, turned to heroin, and passed away 

due to an overdose. 

3 

This is a sad story that is repeated through all groups and all 

areas and it’s something that I am looking forward to hearing all 

the testimony today to look for ideas to further do what Congress 

has done through CARA and moving forward as well. 

So I thank you, Mr. Chairman, for yielding and I yield back the 

balance of my time. 

Mr. BURGESS. The Chair now recognizes the ranking member of 

the subcommittee, Mr. Green, 3 minutes for an opening statement, 

please. 

OPENING STATEMENT OF HON. GENE GREEN, A 

REPRESENTATIVE IN CONGRESS FROM THE STATE OF TEXAS 

Mr. GREEN. Thank you, Mr. Chairman. 

The Centers for Disease Control and Prevention has called for 

prescription drug overdose abuse in the United States an epidemic, 

has found drug overdose to be the leading cause of injury death in 

the United States. 

Between 1999 and 2010, the death rate from prescription painkillers more than quadrupled and only continues to rise. In 2015, 

more than 52,000 people died of drug overdoses in America and 

about two-thirds of those were linked to opioids. 

The toll is only rising. The New York Times’ analysis of preliminary data found that 59,000 to 65,000 likely died from overdoses 

in 2016. 

Today, it’s estimated that more than 2 million have use disorder 

and too few of these people are in treatment. The rate of heroin 

overdoses had increased dramatically in recent years. 

Its rise is directly linked to the opioid epidemic. In 2010, approximately 3,000 drug-poisoning deaths were connected to heroin. In 

2013, the number jumped to a total of 8,000 overdose deaths and 

only continues to rise. 

There is no community that has not been touched by this crisis 

and some have been ravaged by it. This committee has taken steps 

to address the crisis but so much is needed to combat it when families and communities across the country are being torn apart. 

Included in the 21st Century Cares, or the State-targeted response to the opioid crisis grant program, it provided a billion dollars over 2017 to 2018 to States to address the opioid epidemic. 

Extending this money is a crucial part of any continued Federal 

efforts to respond to the epidemic. We need an approach that employs proven health—public health strategies and spans the entire 

spectrum from prevention to treatment and recovery. 

These include robust funding to support prevention, crisis response and expanded access to treatment and long—lifelong recovery tools. 

The Affordable Care Act is a vital part of our efforts to fight 

against the opioid epidemic. More than 1.5 million Americans with 

substance abuse use disorders have access to treatment through 

Medicaid that doesn’t—that didn’t before the ACA, thanks to the 

Medicaid expansion. 

Unfortunately, Americans fighting addiction that live in States 

that refuse to expand their Medicaid programs like Texas were left 

out in the cold. 

4 

For those in the individual market, all plans must include services for substance abuse disorders and mental health, and consumers cannot be denied coverage because of a history of substance 

abuse, all thanks to the ACA. 

This is not a small feat. Prior to the ACA, roughly a third of all 

individual market policies didn’t cover substance abuse treatment. 

Repealing the mental substance abuse disorder coverage provision of the ACA will remove at least $5.5 billion annually from the 

treatment of low-income people with mental and substance abuse 

disorders. 

Going even further is to gut the traditional Medicaid or scrap the 

Medicaid expansion in States that took the money would be absolutely devastating to our fight against prescription drug and heroin 

addiction crisis. 

We are in the midst of the largest public health crisis that our 

country has known and this is not time to cut health care safety 

nets that serve those in recovery. 

I am pleased that we have the opportunity to hear from our colleagues about their proposals and to combat the prescription drug 

epidemic. 

We need a comprehensive solution to the crisis that includes real 

dollars and targets the entire spectrum of addiction, prevention, 

crisis response for those who fall through the cracks, and expanding access to treatment and proving support for recovery. 

We must be guided by science and avoid stigmas and not fall into 

traps, misconceptions about proven treatment strategies. 

I thank the chairman for having this conversation and look forward to advancing new strategies and funding to turn the side of 

this growing crisis and really help families and communities that 

desperately need it. 

And I yield back my time. 

Mr. BURGESS. Gentleman yields back. The Chair thanks the gentleman. I will just make an organizational note before we move to 

our first panel. 

We are going to be hearing from Energy and Commerce members 

at the outset. Energy and Commerce members are welcome to give 

their testimony from the witness table or from the dais, whichever 

they prefer. 

We are going to move to our first panel, which will consist of 

Chairman Walden, Ranking Member Pallone, Chairman Upton, 

Ms. Eshoo, and Chairman Latta, and again, you are welcome to 

testify either from the table or from the dais. 

So, with that, the Chair recognizes the chairman of the full committee, Mr. Walden. 

STATEMENT OF HON. GREG WALDEN, A REPRESENTATIVE IN 

CONGRESS FROM THE STATE OF OREGON 

Mr. WALDEN. I thank the chairman. 

I come here today on behalf of my constituents like I do every 

day, but I think especially today, with our opportunity for all Members to make their case to the Energy and Commerce Committee, 

first we want to welcome them. 

5 

And I think as our colleagues on both sides of the aisle have already said, all of us in all of our communities face these challenges 

related to drug overdoses. 

I held a round table the day before yesterday in Bend, Oregon, 

where I learned a lot about the problems they’re facing and some 

of the successes they are having, and the importance of the work 

that we are doing here. 

It is a heartbreaking epidemic that has been featured on the 

front pages of our local newspapers, on national television, as part 

of the stories from our friends and family members, and with good 

reason. 

Conservative estimates forecast that more than 90 Americans die 

from opioid abuses overdoses each day—90 a day, Mr. Chairman, 

while more than a thousand are treated each day for abusing 

opioids. 

In 2016 alone, more than 64,000 Americans died from drug 

overdoses and in Oregon alone, more people died last year from 

drug overdoses than from car accidents. 

I recently held round tables in southern and central Oregon to 

discuss how we can better combat this crisis. Meeting with the people on the front lines of this fight in our communities to find out 

what is working, what more can be done, is crucial to our efforts 

to end this scourge. 

The Energy and Commerce Committee has led a number of bipartisan initiatives to help address the opioid epidemic, from 

groundbreaking initiatives that are now law like the Comprehensive Addiction and Recovery Act—CARA—and the 21st Century 

Cures Act. 

Resources are become available and important policy changes are 

being implemented to stem the tide of opioids. 

CARA established a comprehensive strategy for improving evidence-based treatment for patients with substance abuse disorders 

and it made significant changes to expand access to addiction treatment and services and overdose reversal medications. 

The new law also included criminal justice and law enforcementrelated provisions. The 21st Century Cures Act provided a billion 

dollars in grants for States, the first half of which was made available in April of 2017 to be administered by the Substance Abuse 

and Mental Health Services Administration, or SAMHSA. 

My State of Oregon received $6.5 million in grants to help combat the epidemic that has plagued our great State. However, so 

much more work needs to be done. 

Since the passage of CARA and the 21st Century Cures Act, 

other issues have emerged in the fight against opioids such as the 

proliferation of fentanyl and its analogs, and then there are allegations of pill dumping and the practice of patient brokering. 

In my own district, I’ve heard the all-too-familiar tale of the 

mother whose oldest son was first prescribed opioids after injuring 

his ankle playing basketball. It didn’t take long for him to become 

addicted. 

Another parent shared with me the story of his sister and nurse 

who died of an overdose after years of suffering from addiction and 

bounding between pharmacies, passing off forged prescriptions. 

6 

He spoke about how better tracking and treatment could have 

helped catch his sister’s problem earlier and perhaps made counseling more effective. 

As it was, she was the—she was only caught because two pharmacies in the small town happen to check with each other. You see, 

by then it was too late, though. 

These two stories may have come from Oregon, but they’re not 

exclusive to the Beaver State. They’re why we are here today. 

Addressing the opioid epidemic requires an all hands on deck effort. Today we’ll be hearing testimony and stories from our colleagues both on and off the Energy and Commerce Committee 

about what more can be done and I am looking forward to hearing 

feedback and input from both sides of the aisle to hear about what 

is working and what is not and find ways to complement our existing law and to address emerging issues. 

So with that, Mr. Chairman, I appreciate everyone here today 

with us, taking time to participate. I look forward to hearing from 

all my colleagues, and together we must continue to fight this 

opioid crisis in America, and I yield back. 

[The prepared statement of Mr. Walden follows]: 

PREPARED STATEMENT OF HON. GREG WALDEN

It’s great to see so much activity in our hearing room today. While there are a 

lot of familiar faces, there are plenty that we don’t see in here on a regular basis. 

For those folks, I’d like to say welcome to Energy and Commerce. I’m glad you could 

join us for this important opportunity to highlight the opioid crisis. 

The heartbreaking epidemic has been featured on the front pages of our local 

newspapers, on national television, and as part of stories from our friends and family members. And with good reason—conservative estimates forecast more than 90 

Americans die from opioid overdoses each day, while more than 1,000 are treated 

each day for abusing opioids. In 2016 alone, more than 64,000 Americans died from 

drug overdoses, and in Oregon alone, more people died last year from drug 

overdoses than from car accidents. 

I recently held roundtables in southern and central Oregon to discuss how we can 

better combat the crisis. Meeting with the people on the front lines of this fight in 

our communities to find out what is working, and what more can be done, is crucial 

to our efforts to end this scourge. 

The Energy and Commerce Committee has led a number of bipartisan initiatives 

to help address the opioid epidemic. From groundbreaking initiatives that are now 

law, like the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act, resources are becoming available and important policy changes are 

being implemented to stem the tide of opioids. 

CARA established a comprehensive strategy for improving evidencebased treatment for patients with substance-use disorders and made significant changes to expand access to addiction treatment services and overdose reversal medications. The 

new law also included criminal justice and law enforcement-related provisions. 

The 21st Century Cures Act provided $1 billion in grants for States, the first half 

of which was made available in April 2017, to be administered by the Substance 

Abuse and Mental Health Services Administration (SAMHSA). Oregon received $6.5 

million in grants to help combat the epidemic that has plagued our great State. 

However, more work needs to be done. 

Since the passage of CARA and the 21st Century Cures Act, other issues have 

emerged in the fight against opioids, such as the proliferation of fentanyl and its 

analogues, allegations of pill dumping, and the practice of patient brokering. 

In my own district, I’ve heard the all too familiar tale of the mother whose oldest 

son was first prescribed opioids after injuring his ankle playing basketball. It didn’t 

take long for him to become addicted. Another parent shared with me the story of 

his sister, a nurse, who died of an overdose after years of suffering from addiction 

and bouncing between pharmacies passing off forged prescriptions. He spoke about 

how better tracking and treatment could have helped catch his sister’s problem earlier and perhaps made counseling more effective. As it was, she was only caught 

7 

because two pharmacies in a small town happened to check with each other. You 

see, by then it was too late. 

Those two stories may have come from Oregon, but they’re not exclusive to my 

home State. And they’re why we’re here today. 

Addressing the opioid epidemic requires an all-hands-on-deck effort. Today we will 

be hearing testimony and stories from our colleagues both on and off the Energy 

and Commerce Committee about what more can be done. I’m looking forward to 

hearing feedback and input from both sides of the aisle—to hear about what’s working and what’s not, find ways to complement existing law, and to address emerging 

issues. 

I appreciate everyone here with us today taking the time to participate, and I look 

forward to hearing from my colleagues on both side of the aisle. Together, we must 

continue to fight to combat the opioid crisis. 

Mr. BURGESS. Gentleman yields back. The Chair thanks the gentleman. 

And again, just to reiterate the format for today, members on the 

Energy and Commerce Committee are invited to either give testimony from the witness table or from the dais, whichever they prefer. 

So at this time I will recognize the ranking member of the full 

committee, Frank Pallone from New Jersey, for 5 minutes, please. 

STATEMENT OF HON. FRANK PALLONE, JR., A REPRESENTATIVE IN CONGRESS FROM THE STATE OF NEW JERSEY 

Mr. PALLONE. Thank you, Chairman Burgess. 

Today’s Member Day provides us the opportunity to hear from 

our colleagues about how the epidemic is uniquely affecting their 

districts as well as to hear their ideas of additional efforts and 

funding that is needed to help individuals, families, and communities affected by this crisis. 

Like all communities across the country, the opioid epidemic is 

having devastating consequences in my home State. Drug 

overdoses are the leading causes of accidental death in New Jersey. 

According to the Centers for Disease Control and Prevention, 

there were—there was a 16 percent increase in drug overdose 

deaths in New Jersey between 2014 and 2015, and last year drug 

overdose deaths topped more than 2,000. 

And unfortunately, we are continuing to see increased deaths 

from this tragic epidemic. I am proud of the steps this committee 

has taken to respond to this tragic epidemic that is taking the lives 

of 91 Americans every day. 

I am pleased that we worked together in a bipartisan fashion to 

pass the Comprehensive Addiction and Recovery Act, or CARA. We 

also worked together to create the State-targeted response to the 

opioid crisis grant program as part of the 21st Century Cures Act 

and this grant program provides a billion to States to address the 

opioid epidemic. 

There were positive and—well, these were positive and bipartisan laws that we produced in 2016 during the last year of the 

Obama administration. That was 2016. Two thousand seventeen 

has been much different. 

Congressional Republicans have spent much of this year trying 

to repeal the Affordable Care Act, which would have prevented millions of Americans from getting the help that they need to treat 

opioid use disorders and the repeal legislation passed here in the 

House would have allowed insurers to once again discriminate 

8 

against people with preexisting conditions such as opioid use disorders. 

The Republican-passed bill would also have allowed States to 

waive essential health benefits including mental health and substance use treatment. 

But, thankfully, those repeal efforts have failed to date. So as we 

move forward, what is clear is that individuals with substance use 

disorder, their families, and their communities need us to work together to do more. 

Despite some progress here in Washington, the epidemic has 

shown no signs of relenting and that is why we must continue to 

support and increase funding for proven health—public health approaches spanning the entire spectrum from crisis to recovery, including expanding access to medication-assisted treatment. 

Those efforts should include more funding and we should extend 

the State-targeting response to the opioid crisis grant program so 

that we can expand even further people’s access to opioid abuse 

treatment, prevention, and recovery support services. 

So I look forward to hearing from my House colleagues and continuing to work together in a bipartisan fashion to help our country 

respond to this crisis. 

I yield back, Mr. Chairman. 

[The prepared statement of Mr. Pallone follows:] 

PREPARED STATEMENT OF HON. FRANK PALLONE, JR. 

Thank you Chairman Burgess. Today’s Member Day provides us the opportunity 

to hear from our colleagues about how the epidemic is uniquely affecting their districts as well as to hear their ideas of additional efforts and funding that is needed 

to help individuals, families, and communities affected by this crisis. 

Like all communities across the country, the opioid epidemic is having devastating consequences in my home State. Drug overdoses are the leading cause of 

accidental death in New Jersey. According to the Centers for Disease Control and 

Prevention, there was a 16 percent increase in drug overdose deaths in New Jersey 

between 2014 and 2015. Last year, drug overdose deaths topped more than 2,000. 

And unfortunately, we are continuing to see increased deaths from this tragic epidemic. 

I am proud of steps this committee has taken to respond to this tragic epidemic 

that is taking the lives of 91 Americans every day. I am pleased that we worked 

together in a bipartisan fashion to pass the Comprehensive Addiction and Recovery 

Act (CARA). We also worked together to create the State Targeted Response to the 

Opioid Crisis grant program as part of the 21st Century CURES Act. This grant 

program provides $1 billion to States to address the opioid epidemic. 

These were positive and bipartisan laws that we produced in 2016 during the last 

year of the Obama administration. That was 2016—2017 has been much different. 

Congressional Republicans have spent much of this year trying to repeal the Affordable Care Act, which would have prevented millions of Americans from getting the 

help that they need to treat opioid use disorders. 

The repeal legislation passed here in the House would have allowed insurers to 

once again discriminate against people with preexisting conditions, such as opioid 

use disorders. The Republican passed bill would also have allowed States to waive 

essential health benefits, including mental health and substance use treatment. 

Thankfully, repeal efforts have failed to date. 

As we move forward, what’s clear is that individuals with substance use disorder, 

their families, and their communities need us to work together to do more. Despite 

some progress here in Washington, the epidemic has shown no signs of relenting. 

That is why we must continue to support and increase funding for proven public 

health approaches spanning the entire spectrum from crisis to recovery, including 

expanding access to medication-assisted treatment. Those efforts should include 

more funding. We should extend the State Targeting Response to the Opioid Crisis 

grant program so that we expand even further people’s access to opioid abuse treatment, prevention, and recovery support services. 

9 

I look forward to hearing from my House colleagues and continuing to work together in a bipartisan fashion to help our 

I yield back. 

Mr. BURGESS. Gentleman yields back. The Chair thanks the gentleman. 

Chair recognizes the chairman of the Energy Subcommittee, Mr. 

Upton, for 3 minutes. 

STATEMENT OF HON. FRED UPTON, A REPRESENTATIVE IN 

CONGRESS FROM THE STATE OF MICHIGAN 

Mr. UPTON. Well, thank you, Mr. Chairman. 

This is very important, this Member Day, as we are able to all 

share our personal experiences on a crisis that has been plaguing 

our Nation over the last couple of years—opioid addiction and 

abuse. 

This silent epidemic has for sure torn through families, 

neighbourhoods, and communities, both certainly in my home State 

of Michigan. But we know across the country as well. 

In fact, in 2015, there were nearly 2,000 opioid abuse-related 

deaths in Michigan alone. Even more tragically, more than 22,000 

babies are born every year across the country with neonatal opioid 

withdrawal syndrome. 

This terrible epidemic has hit home both in my community and, 

yes, even in my extended family. So this is very personal to me as 

it is with so many throughout our communities. 

In the last couple of years, I have been meeting with first responders, crisis center employees, advocacy groups, and yes, individuals suffering. 

All of these folks have said that, tragically, the death toll continues to rise. That is why we have been taking concrete steps here 

in this committee to combat the widespread epidemic. 

Just last year, the President signed into his sweeping package 

aimed at attacking the opioid epidemic from all sides. 

As part of 21st Century Cures, a bill that every one of our committee members supported, an additional $1 billion was allocated 

to the States like Michigan to address opioid addiction, treatment 

and prevention. 

This year the first round of funding was delivered. We received 

$16 million and that grant funding will make a real difference. It 

will. 

To those suffering I just say help is on the way, and as a result 

of this legislation as well as administrative action, NIH Director 

Francis Collins is helping to lead the charge. 

This summer, the NIH started meeting with experts in academia 

and the biopharmaceutical industry to talk about innovative ways 

in which Government and industry can work together to address 

the crisis. 

I strongly support that work and look forward to seeing the results of the research that NIH is doing with its industry partners. 

There are also things that we in Congress can help NIH with in 

these endeavors. First, we need the NIH to develop more options 

for overdose reversals. 

10 

Second, we need the evidence that the NIH can develop an effective therapy for addiction, and finally, we must accelerate the development of nonaddictive pain medicines. 

The sooner that we in Congress supply the resources necessary 

to conduct that work, the sooner that we can supply powerful new 

tools for every community. 

These efforts can’t happen fast enough and these are some of the 

many reasons that I continue to support robust NIH funding. 

There is more work to be done, and here in Congress we will continue to take steps to address that epidemic and in this committee 

we are on the front lines to advance meaningful bipartisan legislation that indeed will make a difference. Together, we will bring it 

out of the shadows. 

I yield back. 

[The prepared statement of Mr. Upton follows:] 

PREPARED STATEMENT OF HON. FRED UPTON

Mr. Chairman, thank you for holding this very important Member Day hearing 

on a crisis that has been plaguing our Nation over the last several years—opioid 

addiction and abuse, This silent epidemic has torn through families, neighborhoods, 

and communities both in my home State of Michigan and indeed across the entire 

country. In fact, in 2015, there were nearly 2,000 opioid abuse related deaths in 

Michigan alone. 

In the last few years I have been meeting with first responders, crisis center employees, advocacy groups, and yes—individuals suffering. All of these folks have said 

that, tragically, the death toll continues to rise. 

This is why we have been taking concrete action here in the Energy and Commerce Committee to combat this widespread epidemic. Just last year, the president 

signed into law a sweeping package aimed at attacking the opioid epidemic from all 

sides. 

As part of my landmark, bipartisan 21st Century Cures Act, an additional $1 billion was allocated to States, like Michigan, to address opioid addiction treatment 

and prevention. Just this year, the first round of that funding was delivered. 

Michigan received more than $16 million. This grant funding will make a real difference. To those suffering, I just say this: Help is on the way. 

As a result of my legislation as well as administrative action, my good friend Dr. 

Francis Collins is helping to lead the charge in his position as director of the National Institutes of Health. This summer, the NIH started meeting with experts in 

academia and the biopharmaceutical industry to talk about innovative ways in 

which Government and industry can work together to address this crisis. I strongly 

support this work and look forward to seeing the results of the research NIH is 

doing with its industry partners. 

There are also things we in Congress can help NIH with in these endeavors. First, 

we need NIH to develop more options for overdose reversal. Second, we need the 

evidence NIH can develop on effective therapies for addiction. And finally, we must 

accelerate the development of nonaddictive pain medicines. The sooner we in Congress supply the resources necessary to conduct this work, the sooner we can supply 

powerful new tools for our communities. These efforts can’t happen fast enough, and 

these are some of the many reasons that I continue to support robust NIH funding. 

There is more work to be done. Clearly. And here in Congress we will continue 

to take steps to address this epidemic. Here in this committee, we’re on the front 

lines in advancing meaningful, bipartisan legislation that will make a difference. Together, we can take this ‘‘silent epidemic’’ and bring it out of the shadows. 

Mr. BURGESS. Gentleman yields back. Chair thanks the gentleman. 

Chair recognizes the gentleman from New Jersey, Mr. Lance, 3 

minutes, please. 

11 

STATEMENT OF HON. LEONARD LANCE, A REPRESENTATIVE 

IN CONGRESS FROM THE STATE OF NEW JERSEY 

Mr. LANCE. Thank you, Mr. Chairman, and I must say this is the 

first time I’ve been on this side of the dais and what a fine looking 

group. 

Mr. GREEN. It is more fun being over here, as you know. 

Mr. BURGESS. If it makes the gentleman more comfortable, we 

can swear you in. 

[Laughter.] 

Mr. LANCE. That means I would be under oath. 

Mr. BURGESS. Yes. 

Mr. LANCE. Thank you, Chairman Burgess, for organizing this 

conversation today. The opiate crisis is devastating families and 

communities across New Jersey, the State I represent. 

In 2015, the Garden State’s death rate was two and a half times 

the skyrocketing U.S. rate. We are making progress with the implementation of the Comprehensive Addiction Recovery Act of 

2016, but more work needs to be done. 

I acknowledge the efforts of one of my constituents, Basking 

Ridge resident Clodette Sabatelle. Clodette has done critical work 

and has made a positive difference in the lives of those suffering 

from drug addiction. 

Her advocacy group, Community in Crisis, helps equip the loved 

ones of those in pain. None of the progress we have made so far 

in this fight against drug addiction and opiate abuse would have 

been possible without the work of people like Clodette and organizations like Community in Crisis. Their efforts are efforts that we 

should make sure Congress understands and applauds. 

I worked closely with Clodette on the issue of over prescription. 

In 2012, health care providers wrote 259 million prescriptions for 

opiates. 

The CARA provisions I authored addressed that issue by reforming and improving the medical drug approval and label process at 

the Food and Drug Administration. 

For the first time, Congress has required the agency to work 

closely with expert advisory committees before making critical 

product approval and labeling decisions and to make recommendations regarding educational programs for prescribers of extended 

release and long-acting opiates. 

CARA also encourages the development and approval of opiates 

with abuse-deterrent properties. We also have to make sure resources such as the State-targeted response to the opiate crisis 

grants administered by the Substance Abuse and Mental Health 

Services Administration continue to give States the tools they need 

to experiment and test best practices. 

New Jersey recently secured a $13 million Federal grant from 

the Substance Abuse and Mental Health Services Administration 

to focus on this crisis. 

The Drug-Free Community Support program in the White House 

Office of National Drug Control Policy also recently awarded Community in Crisis and two other able organizations Hunterdon Prevention Resource and EmPoWER Somerset, each with a $125,000 

grant to assist addressing the problem of opiate and heroin abuse, 

provide education, and implement prevention measures. 

12 

Community in Crisis Hunterdon Prevention Resource and EmPoWER Somerset are great partners in connecting people with the 

resources and support they need. 

These investments are not only the right thing to do but help 

lessen the significant strain on law enforcement resources. I commend each group on its important work. 

Mr. Chairman, I stand ready to work with you and colleagues on 

both sides of the aisle to continue this work. Thank you for calling 

this hearing today. 

[The prepared statement of Mr. Lance follows:] 

PREPARED STATEMENT OF HON. LEONARD LANCE

Thank you, Chairman Burgess, for organizing this conversation today. 

The Energy and Commerce Committee has done a lot right in the fight against 

drug addiction. Last year’s landmark legislation set up lanes for success but it is 

going to be up to this committee to make sure the administration, the respective 

agencies and all stakeholders continue this effort to implement the Comprehensive 

Addiction and Recovery Act of 2016 and do all we can for those in need. I think 

today’s Member Day demonstrates we are committed to doing that. 

The opioid crisis is devastating families and communities across the Garden 

State. In 2015, New Jersey’s heroin death rate was two-and-one-half times the skyrocketing U.S. rate. We are making progress with CARA’s implementation but there 

is much more work to be done. Too often we are hearing about another life cut short 

from the scourge of drug addiction. This is not just a New Jersey problem, but an 

epidemic facing the entire country. We need to be working together and empowering 

the groups and organizations that are succeeding in turning the tide against drug 

abuse. 

I would like to acknowledge the efforts of one of my constituents, Basking Ridge 

resident Clodette Sabatelle. Clodette has done critical work and has made a difference in the lives of those suffering from drug addiction. Her advocacy group, 

Community in Crisis, helps empower and equip the loved ones of those in pain. 

None of the progress we have made so far in this fight against drug addiction and 

opioid abuse would have been possible without the work of people like Clodette and 

organizations like Community in Crisis. Their efforts equipped Congress to act and 

helped craft and champion the CARA legislation. 

I worked closely with Clodette on the issue of over prescription. In 2012, health 

care providers wrote 259 million prescriptions to people for opioids. The CARA provisions I authored address that issue by reforming and improving the medical drug 

approval and label process within the Federal Food and Drug Administration. For 

the first time, Congress has required the agency to work closely with expert advisory committees before making critical product approval and labeling decisions and 

to make recommendations regarding education programs for prescribers of extended-release and long-acting opioids. CARA also encourages the development and 

approval of opioids with abuse-deterrent properties. 

We also have to make sure resources such as the State Targeted Response to the 

Opioid Crisis Grants administered by the Substance Abuse and Mental Health Services Administration continue to give States the tools they need to experiment and 

test best practices. New Jersey recently secured a $13 million Federal grant from 

the Substance Abuse and Mental Health Services Administration to prioritize five 

specific strategies: strengthening public health surveillance, advancing the practice 

of pain management, improving access to treatment and recovery services, targeting 

availability and distribution of overdose-reversing drugs and supporting cuttingedge research. 

The Drug-Free Communities Support Program the White House Office of National 

Drug Control Policy also recently awarded Community in Crisis and two other very 

able organizations, Hunterdon Prevention Resource and Empower Somerset, each 

with a $125,000 grant to assist addressing the problem of opioid and heroin abuse, 

provide education and implement prevention measures. Community in Crisis, 

Hunterdon Prevention Resource and Empower Somerset are great partners in connecting people with the resources and support they need. These investments are not 

only the right thing to do, but help lessen the significant strain on law enforcement 

resources. I commend each group on its important work. 

Mr. Chairman, I stand ready to work with you and colleagues on both sides of 

the aisle to continue this work. Thank you for calling this hearing today. 

13 

Mr. BURGESS. Chair thanks the gentleman. Gentleman yields 

back. And the Chair wants to thank this panel. 

We will move to our second panel. Members identified wishing to 

speak in the second panel: Mr. Butterfield of North Carolina, Ms. 

Matsui in California, and Mr. Bilirakis of Florida. 

Again, Members are advised they may either speak from the witness table or from the dais, whichever is their preference. 

So the Chair recognizes Ms. Matsui of California for 3 minutes. 

STATEMENT OF HON. DORIS O. MATSUI, A REPRESENTATIVE 

IN CONGRESS FROM THE STATE OF CALIFORNIA 

Ms. MATSUI. Thank you, Mr. Chairman, for inviting us today to 

testify about proposals to address our Nation’s opioid epidemic. 

We all have heartbreaking stories of constituents whose lives 

were lost too soon to an opioid overdose. In my home district of 

Sacramento, they have experienced a particularly deadly overdose 

crisis last year due to pills contaminated with fentanyl, which is as 

much as 50 times stronger than heroin. 

Addiction is a devastating disease that knows no bounds and we 

must come together to provide solutions in a comprehensive manner. In this committee, we took a step forward by passing the Comprehensive Addition and Recovery Act into law last year. 

We need to build on these efforts. Understanding addiction and 

its consequences are multipronged and we need a multipronged solution. 

I look at this problem as I do any other health care problem, 

which means I examine it holistically across the spectrum from 

prevention to early intervention to treatment. 

In the case of the opioid epidemic there is a lot we can do at each 

of these stages, all of which rest on truly building up our Nation’s 

mental health system and integrating behavior health care with 

physical health care. 

Historically, mental health and addiction have bee treated as 

character flaws and therefore not addressed with evidence-based 

medical treatment. We can reverse that course by making treatment more available, bolstering our mental health work force, and 

reducing stigma. 

In 2012, Representative Lance and Senators Stabenow, Blunt, 

and I passed the Excellence in Mental Health Demonstration 

Project into law. This project is allowing States to demonstrate that 

building up Community-Based Behavioral Health Clinics improves 

access to care. 

Last week, we introduced legislation to extend the years of the 

program and expand it to more States. We should strongly consider 

this as one way to help address the opioid crisis. 

We also need to enforce mental health parity laws to make sure 

health insurers are offering mental health benefits equal to physical health benefits. 

However, this work on parity is irrelevant if mental health benefits are not offered in the first place. There have been proposals 

which included provisions that allow States to waive essential 

health benefits, meaning insurance once again not be required to 

cover mental health and addiction treatments. That’s not good. 

14 

Cutting billions from the Medicaid program would also mean loss 

of coverage from millions suffering from substance use disorder. We 

cannot take these steps backward. 

I am encouraged by steps being taken across the health care sector to address the crisis including the limiting of opioid prescriptions for prescribes and insurers. 

We need to build on these efforts. That includes considering proposals in Congress to provide resources and training for State and 

local enforcement and bolstering a mental health workforce, educating the public, addressing availability of a range of treatment 

options from outpatient to inpatient to residential care and more. 

And I do look forward to continuing to work with the committee 

on these policy proposals to address this pressing issue. 

Thank you, and I yield back. 

[The prepared statement of Ms. Matsui follows:] 

PREPARED STATEMENT OF HON. DORIS O. MATSUI

Thank you, Mr. Chairman, for inviting us to testify today about proposals to address our Nation’s opioid epidemic. We all have heartbreaking stories of constituents 

whose lives were lost too soon to an opioid overdose. In my home district of Sacramento, we experienced a particularly deadly overdose crisis last year due to the 

introduction of pills contaminated with fentanyl, which is as much as 50 times 

stronger than heroin. 

Addiction is a devastating disease that knows no bounds and impacts us all, and 

we must come together to provide solutions in a comprehensive manner. 

In this committee, we took a first step by passing the Comprehensive Addiction 

and Recovery Act, or CARA, into law last year. We need to build on those efforts; 

understanding addiction and its consequences are multipronged, we need a 

multipronged solution. 

I look at this problem as I do any other health care problem or disease, which 

means I examine it holistically across the spectrum from prevention to early intervention to treatment. 

In the case of the opioid epidemic, there is a lot we can do at each of these stages, 

all of which rest on truly building up our Nation’s mental health system and integrating behavioral health care with physical health care. 

If people are able to get behavioral health treatment when they need it in their 

communities, we can start to address the root causes of addiction and prevent and 

catch issues earlier. Historically, mental health and addiction have been treated as 

character flaws and therefore not addressed with evidence-based medical treatment. 

We can reverse that course by making treatment more available, bolstering our 

mental health workforce, and reducing stigma. 

In 2012, Rep. Lance and Senators Stabenow, Blunt, and I passed the Excellence 

in Mental Health Demonstration project into law. This project is allowing States 

and local communities to demonstrate that building up Community-Based Behavioral Health Clinics, in coordination with physical health clinics and community resources, will improve access to care. This project is currently in eight States, and 

last week we introduced the Excellence in Mental Health and Addiction Treatment 

Expansion Act to extend the years of the demo and expand it to more States. We 

should strongly consider this project and legislation as a way to build up community 

care to address the opioid crisis. 

We also need to ensure that mental health parity is truly achieved. When an insurance company offers mental health benefits, they should be equal to physical 

health benefits offered. We need to ensure that this rule is being followed across 

the country. However, the rule is irrelevant if mental health benefits are not offered 

in the first place. Trumpcare proposals have included provisions that allow States 

to waive essential health benefits, meaning insurers would once again not be required to cover mental health and addiction treatment. Cutting billions of dollars 

from the Medicaid program would also mean loss of coverage for millions of Americans suffering from substance use disorder. We cannot take these steps backward. 

I am encouraged by steps that are being taken across the health care sector to 

address the crisis. Prescribers and insurers are limiting opioid prescriptions , such 

as for pain following a surgery, to seven days. This prevents bottles of extra unused 

15 

pills from sitting in people’s medicine cabinets, as do prescription drug ‘‘take back’’ 

days where people can turn in unused pills to the DEA. 

We need to build on these efforts and work together across the system. That includes considering proposals in Congress that provide resources and training for 

State and local law enforcement, bolstering our mental health workforce, educating 

the public on what they can do to prevent or react to a crisis, addressing the availability of a range of treatment options from outpatient to inpatient to residential 

care, and more. I look forward to continuing to work with the committee on policy 

proposals to address this pressing issue. 

Mr. BURGESS. Chair thanks the gentlelady. Gentlelady yields 

back. 

Chair recognizes the gentleman from Florida, Mr. Bilirakis, for 

3 minutes, please. 

STATEMENT OF HON. GUS M. BILIRAKIS, A REPRESENTATIVE 

IN CONGRESS FROM THE STATE OF FLORIDA 

Mr. BILIRAKIS. Thank you, Mr. Chairman. 

The United States is in the midst of an opioid overdose epidemic. 

Sadly, 91 Americans die every day due to opioid overdoses. Nearly 

half of all opioid overdose deaths involve a prescription opioid. 

In 2010, in response to the opioid crisis in Florida’s pill mill problem, Florida’s legislature enacted statewide tracking of painkiller 

prescriptions coupled with law enforcement using drug trafficking 

laws to prosecute providers caught over prescribing. Within 3 

years, Florida saw a decrease of more than 20 percent in overdose 

deaths. 

Despite this positive trend, opioid abuse continues to plague my 

district. In fact, my district had the second-highest prescription 

drug death rate in Florida in 2014. 

In response, I worked last Congress to ensure that Pasco County 

was included as a high-intensity drug trafficking area, enabling 

law enforcement to receive additional resources to combat the 

spread of drug-related crime. 

I want to applaud the committee for including my bills, the Medicare Patient Safety and Drug Abuse Prevention Act and the Promise Act in CARA, which passed last Congress. 

The Medicare Patient Safety and Drug Abuse Prevention Act created a pharmacy and physician block-in program within the Medicare Advantage and Medicare Part D, giving CMS the tools to 

crack down on this abuse in the Medicare program and it’s important for us to maintain oversight, of course, as you know, on this 

program as CMS is developing the rules. 

The Promise Act will increase safety for opioid therapy and pain 

management by requiring the VA and DoD to update their clinical 

practice guidelines for managing of opioid therapy for chronic pain, 

requiring the VA opioid prescribes to have the enhanced pain management and safe opioid prescribing education and training and encourage the VA to increase information sharing with State licensing boards. I think that is critical. 

As part of the 21st Century Cures Act, Florida has received over 

$27 million in grants to help fight the opioid epidemic by increasing access to treatment and recovery services, strengthening public 

health surveillance, and improving pain management practices. 

These critical funds are supporting Florida’s all-hands-on-deck 

approach across the State to curb opioid abuse and save lives. 

16 

I am pleased the administration and this committee are leading 

the charge on this critical issue and I look forward to working together to help save lives and prevent addiction. 

I yield back, Mr. Chairman. Thank you. 

[The prepared statement of Mr. Bilirakis follows:] 

PREPARED STATEMENT OF HON. GUS M. BILIRAKIS

Thank you Mr. Chairman for hosting today’s Member Day to discuss the impact 

of opioid abuse in our communities. 

The United States is in the midst of an opioid overdose epidemic. According to 

the Centers for Disease Control and Prevention, more citizens died from drug 

overdoses in 2015 than any other year on record. Of those deaths, six out of ten 

involve opioids. Last year, an estimated 60,000 Americans died due to drug 

overdoses, more than all the Americans who died in the Vietnam War. Sadly, 91 

Americans die every day due to opioid overdoses. Nearly half of all opioid overdose 

deaths involve a prescription opioid. 

Florida has been in the crosshairs of this epidemic. In 2010, in response to the 

opioid crisis and Florida’s ‘pill mill’ problem, Florida’s legislature enacted statewide 

tracking of painkiller prescriptions coupled with law enforcement using drug trafficking laws to prosecute providers caught overprescribing. Within 3 years, Florida 

saw a decrease of more than 20 percent in overdose deaths. 

Despite this positive trend, opioid abuse continues to plague my district—Florida’s 

12th District. Pasco and Pinellas counties had some of the highest oxycodone-caused 

deaths-almost 200 in 2014. In fact, my district had the second-highest prescription 

drug death rate in Florida in 2014. In response, I worked last Congress to ensure 

that Pasco County was included as a High Intensity Drug Trafficking Area 

(HIDTA), which has enabled law enforcement to receive additional resources to combat the spread of drug-related crime. 

Additionally, I invited the head of the Office of National Drug Control Policy to 

visit my district last year. We toured local facilities and met with law enforcement, 

key health care providers, patients, and experts to determine the next steps in addressing this problem. I want to applaud the committee for including my bills, the 

Medicare Patient Safety and Drug Abuse Prevention Act and PROMISE Act in the 

Comprehensive Addiction and Recovery Act which passed last Congress. The Medicare Patient Safety and Drug Abuse Prevention Act created a pharmacy and physician lock-in program within Medicare Advantage and Medicare Part D. Private insurance was already using this strategy against doctor and pharmacy shopping, and 

States had adopted it as part of the Medicaid program. This gives CMS the tools 

to crackdown on this abuse in the Medicare program, and it’s important for us to 

maintain oversight on this program as CMS is developing the rules. Furthermore, 

the PROMISE Act will increase safety for opioid therapy and pain management by 

requiring the VA and DOD to update their Clinical Practice Guidelines for Management of Opioid Therapy for Chronic Pain, requiring VA opioid prescribers to have 

enhanced pain management and safe opioid prescribing education and training, and 

encourages the VA to increase information sharing with State licensing boards. 

As part of the 21st Century Cures Act this Congress, Florida has received over 

$27 million in grants to help fight the opioid epidemic by increasing access to treatment and recovery services, strengthening public health surveillance, and improving 

pain management practices. These critical funds are supporting Florida’s all-handson-deck approach across the State to curb opioid abuse and save lives. 

Now the rise in fentanyl and its various derivatives have presented new challenges to my State. However, we remain optimistic with Florida’s recent legislative 

initiatives including: 

• Requiring doctors to log prescriptions in a statewide painkiller database by the 

end of the next business day to curb ‘doctor shopping’; 

• And setting aside State funds for medications that can help reduce opioid dependency, most of which will be spent in the State prison system. 

We need to continue to work closely with local law enforcement, medical professionals, addiction treatment specialists, and those impacted by addiction. I am 

pleased the administration and this committee are leading the charge on this critical issue, and I look forward to working together to help save lives and prevent 

addiction. Thank you and I yield back the remaining balance of my time, Mr. Chairman. 

17 

Mr. BURGESS. Gentleman yields back. The Chair thanks the gentleman. 

Chair recognizes the gentleman from North Carolina, Mr. 

Butterfield, for 3 minutes, please. 

STATEMENT OF HON. G.K. BUTTERFIELD, A REPRESENTATIVE 

IN CONGRESS FROM THE STATE OF NORTH CAROLINA 

Mr. BUTTERFIELD. Thank you very much, Mr. Burgess, and to my 

fellow colleagues. Thank you for opportunity to address the committee today about the state of the opioid epidemic in my home 

State of North Carolina. 

And let me just begin, Mr. Chairman, by crediting my friend and 

our former colleague, Mary Bono, who was also up from Florida— 

Mr. Bilirakis, who talked so incessantly about this issue because it 

was very dear to her and she knew the impact that it was having 

on her State. 

Ms. Mack brought this important topic to the forefront of our 

subcommittee some years ago. She was the chairman of the subcommittee, and I was the ranking member. 

At first, Mr. Chairman, I thought Mary was a little bit overreacting to the opioid crisis in Florida because it had touched her 

family personally. 

But after we had hearings and after I looked into it, I came to 

the conclusion that she was not overreacting—that it was indeed 

an epidemic not just in Florida but all across the country. 

Just last year, I worked with many of my colleagues in this room 

on the Comprehensive Addiction and Recovery Act that was passed 

into law. That bill included, roughly, 20 different legislative proposals to help slow the epidemic. As part of the 21st Century Cures 

Act, this committee approved $500 million. 

The American people need to know that, Mr. Chairman. We approved $500 million in supplemental funding to address opioid 

abuse. 

Despite the investments and attention from Congress, we are 

still feeling the opioid crisis very close to home. During the August 

work period I saw the effects of the epidemic on my small community in Wilson, North Carolina. Just in August alone, there were 

two deaths because of the opioid abuse in the community. 

According to reports in the Wilson Times—and I have a copy of 

that with me today—medics in Wilson County administered the appropriate drug in response to opioid crisis 28 times by mid-August, 

when they usually administered the treatment 30 times per quarter. 

According to Chris Parker with the Wilson County Emergency 

Medical Services, there is a definite increase in opioid use and 

abuse in our county. 

North Carolina has a real problem on its hands. America has a 

real problem on its hands. By July of this year, there were more 

than 500 diagnoses for emergency department visits, up from 410 

at the same point last year. 

Regrettably, Mr. Chairman, in my humble opinion, the administration is not taking this situation seriously. The budget offered by 

the current administration cuts HHS funding by 16 percent, the 

18 

CDC by 17 percent, the National Institutes of Health by 19 percent. 

I am also very concerned about the proposals to get the Medicaid 

program that we have considered in this committee. The Center for 

Budget and Policy Priorities estimates that nearly 100,000 people 

with an opioid use disorder have gained coverage through Medicaid 

expansion under ACA. 

Congress must do all that it can to help stop this epidemic from 

devastating more lives, more families, and communities. 

Congress should provide certainty—certainty and funding to 

combat this epidemic, which is why I am the original cosponsor of 

H.R. 3495, the Opiate and Heroin Abuse Crisis Investment Act of 

2017 that was introduced by Mr. Luja ́n. 

We must also protect existing fundings for research in opioid use 

disorder coverage, provide tools to communities to address this epidemic, and reduce the stigma for those needing treatment. 

So I want to thank you for convening this hearing. I want to 

thank Mr. Latta, Mr. Bucshon, Mr. Bilirakis, and all of you for 

your time, your attention, and your energy to this issue because it 

is an emergency in our country. 

Thank you. I yield back. 

[The prepared statement of Mr. Butterfield follows:] 

PREPARED STATEMENT OF HON. G.K. BUTTERFIELD

Chairman Burgess, thank you for the opportunity to address the committee today 

about the state of the opioid epidemic in North Carolina. 

I credit my friend and colleague Mary Bono Mack with bringing this important 

topic to the forefront of this committee’s work to protect public health. As ranking 

member of the subcommittee previously known as Subcommittee on Commerce, 

Manufacturing and Trade, I worked closely with Representative Bono Mack to ensure the supply chain for potentially dangerous narcotics is airtight. 

Just last year, I worked with many of my colleagues in this room on the Comprehensive Addiction and Recovery Act that was passed into law. That bill included 

roughly twenty different legislative proposals to help slow the opioid epidemic. As 

part of the 21st Century Cures Act, this committee approved $500 million in supplemental funding to address opioid abuse. 

Despite the investments and attention from Congress, we are still feeling the 

opioid crisis close to home in North Carolina. During the August work period, I saw 

the effects of the epidemic on my community in Wilson, North Carolina. 

Just in August alone, there were two deaths because of opioid abuse in Wilson. 

According to reports in The Wilson Times, medics in Wilson County administered 

Naloxone in response to opioid crises 28 times by mid-August, when they usually 

administer the treatment 30 times per quarter. According to Chris Parker with Wilson County Emergency Medical Services, ‘‘there is a definite increase in opiate use 

in Wilson County.’’ 

North Carolina has a real problem on its hands. By July of this year, there were 

more than 500 opioid diagnoses for emergency department visits, up from 410 at 

the same point in 2016. 

Clearly, the administration is not taking this situation seriously. The budget offered by the Trump administration cuts HHS by 16 percent, the CDC by 17 percent, 

and that National Institutes of Health by 19 percent. I am also very concerned 

about the proposals to gut the Medicaid program that we have considered in this 

very committee. The Center for Budget and Policy Priorities estimates that nearly 

100,000 people with an opioid use disorder have gained coverage through Medicaid 

Expansion under the ACA. 

Congress must do all it can to help stop this epidemic from devastating more 

lives, families, and communities. Congress should provide certainty in funding to 

combat this epidemic, which is why I am original cosponsor of H.R. 3495, the Opioid 

and Heroin Abuse Crisis Investment Act of 2017, that was introduced by my friend 

Ben Ray Luja ́n. We must also protect existing funding for research and opioid use 

19 

disorder coverage, provide tools to communities to address this epidemic, and reduce 

stigma for those needing treatment. 

I ask unanimous consent to submit two articles from The Wilson Times for the 

record. I yield back. 

Mr. BURGESS. Chair thanks the gentleman. Gentleman yields 

back. 

Chair recognizes the gentleman from Indiana, Mr. Bucshon, for 

3 minutes, please. 

STATEMENT OF HON. LARRY BUCSHON, A REPRESENTATIVE 

IN CONGRESS FROM THE STATE OF INDIANA 

Mr. BUCSHON. Chairman Burgess, Ranking Member Green, 

thank you for holding this important hearing today. 

Opioid abuse disorder has ravaged our communities, and while 

it is important to look forward and address what else needs to be 

done to combat this terrible disease, we need to ensure the legislation we have already passed is being properly implemented and is 

working as Congress intended. 

In July 2016, the Comprehensive Addiction and Recovery Act— 

CARA—landmark legislation addressing the opioid abuse crisis was 

passed into law. I spent months convening stakeholder round tables and working on bipartisan language which became Section 303 

of CARA. 

Section 303 updates the Controlled Substances Act and officebased opioid addiction treatment laws by ensuring that patients 

are offered and physicians are trained on all FDA-approved treatments. 

Under previous law, prior to CARA millions of opioid-addicted 

patients had their treatment determined based on their setting of 

care. 

With the passage of CARA, patients in these settings must now 

be offered a full range of treatment options based on their individual clinical needs and individualized treatment plan. 

Unfortunately, 15 months after the legislation was signed into 

law, Section 303 still has not been implemented. I urge the committee to conduct strong oversight to ensure SAMHSA will be properly implementing the law. 

Every day that this law goes unimplemented is one more day 

that our family members, friends, and colleagues are battling a disease with fragmented and incomplete treatment options. 

Specifically, SAMHSA should send a dear colleague letter to notify physicians that they must offer all anti-addiction medicines 

based on a patient’s clinical needs. 

Additionally, curriculum for doctors, PAs, and nurse practitioners 

should be updated to include training on all FDA-approved opioid 

addiction medications. 

Moreover, all of SAMHSA’s public-facing material, including 

their Web site, should be modernized to reflect this patient-centered approach. 

According to the Evansville Courier and Press, 55 people in 

Vanderbergh County, Indiana, have died of a drug overdose in the 

first nine months of this year, which is more than all of 2016. 

20 

The availability of all medication-assisted treatments regardless 

of where a patient chooses to seek them will help to stem the tide 

of these unnecessary deaths. 

It is vital that as the committee moves forward in the fight 

against opiate abuse disorder that we ensure CARA is properly implemented and helping people combat this terrible disease. 

Mr. Chairman, again, thank you for this hearing, and I yield 

back my time. 

[The prepared statement of Mr. Bucshon follows:] 

PREPARED STATEMENT OF HON. LARRY BUCSHON

Chairman Burgess and Ranking Member Green, thank you for holding this important hearing today, Opioid abuse disorder has ravaged our communities. and while 

I it is important to look forward and address what else needs to be done to combat 

this terrible disease. we also need to ensure that the legislation we have already 

passed is being properly implemented. and is working as intended by Congress, 

In July, 2016, the Comprehensive Addiction and Recovery Act, landmark legislation addressing the opioid abuse crisis, was passed into law, 

I spent months convening stakeholder roundtables and tweaking language on a 

bipartisan agreement, which became section 303 of CARA, 

In particular, Section 303 updates the Controlled Substances Act and Office-Based 

Opioid Addiction Treatment laws by ensuring that patients are offered, and physicians are trained, on all FDA-approved treatments, Under previous law, prior to 

CARA, millions of opioidaddicted patients had their treatment determined based on 

their setting of care, With the passage of CARA, patients in these settings must now 

be offered the full range of treatment options based on their individualized clinical 

needs, 

Unfortunately, 15 months after the legislation was signed into law, Section 303 

still has not been implemented. I urge the committee to conduct strong oversight 

to ensure SAMHSA will be properly implementing the law, Every day that this law 

goes unimplemented, is one more day that our family members, friends, and colleagues are battling a disease with fragmented and incomplete treatment options, 

Specifically, SAMHSA should send a Dear Colleague letter to notify physicians 

that they must offer all anti-addiction medicines based on a patient’s clinical needs, 

Additionally, curriculum for doctors, PAs, and nurse practitioners should be updated 

to include training on all FDA-approved opioid addiction medications, Moreover, all 

of SAMHSA’s public facing material should be modernized to reflect this patientcentered approach, 

According to the Evansville Courier and Press, 55 people in Vanderburgh County, 

IN have died of a drug overdose in the first nine months of this year, which is more 

than all of 2016. The availability of all medication-assisted treatments, regardless 

of where a patient chooses to seek them, will help to stem the tide of these unnecessary deaths. 

It’s vital that as the committee moves forward in the fight against opioid abuse 

disorder that we ensure the hard work that the committee has already accomplished 

is implemented and working. 

Mr. BURGESS. Gentleman yields back. Chair thanks the gentleman and recognizes the gentleman from Ohio, Mr. Latta, for 3 

minutes, please. 

STATEMENT OF HON. ROBERT E. LATTA, A REPRESENTATIVE 

IN CONGRESS FROM THE STATE OF OHIO 

Mr. LATTA. Well, thank you, Mr. Chairman, and again, thank 

you for holding this hearing today. 

Opioid abuse and addiction has caused devastation in every community across our Nation and Ohio has been especially hard hit. 

In Ohio, in 2015, 3,050 people lost their lives from unintentional 

drug overdose. 

21 

In 2016, that number increased to 4,050. That’s a 32 percent increase from the previous year and that means 11 deaths a day. For 

comparison, in 2016, there were 1,133 traffic fatalities in Ohio. 

That means that drug overdoses cause nearly four times as many 

deaths compared to traffic accidents. These figures are heartbreaking and sad to know that this problem isn’t getting any better. 

Many county coroners in Ohio say that 2017’s overdose fatalities 

are outpacing 2016’s. This problem knows no limits and has affected husbands, wives, children, brothers, sisters, fathers, and 

mothers. It has destroyed marriages, ruined careers, and cut too 

many lives short. 

When I read through the obituaries in my local newspapers over 

the past year or two I have noticed more younger individuals without a cause of death being listed. 

Unfortunately, in too many of instances it is because of drug 

overdoses. Across my district in northwest and west central Ohio, 

I have heard how opioid addiction impacts our communities. 

I have toured businesses and met with community leaders and 

spoke with families to hear how substance use disorders have directly affected their lives. 

It is because of these stories that I plan to introduce legislation 

that would direct the Department of Health and Human Services 

to create a public electronic database of information relating to nationwide efforts to combat the opioid crisis. 

The database would serve as a central location of information for 

the public and others to track Federal funding allocations made 

available for research and treatment of opioid abuse, find research 

relating to opioid abuse from all Federal agencies, State, local, and 

Tribal governments as well as nonprofits, law enforcement, medical 

experts, public health educators, and research institutes. 

Furthermore, the legislation would charge HHS to evaluate a 

myriad of issues relating to pain management, addiction, prescription guidelines, treatments, trends and patterns, and effective solutions to problems used across the country. 

These findings would be available on the database as well and 

HHS would be instructed to offer recommendations for targeted 

areas of improvement. 

I believe that with the help of HHS and other relevant agencies 

this database will allow for easier access of information, funding 

streams, and relevant data that can help to combat the opioid 

abuse epidemic across our Nation. 

With 11 people dying every day in Ohio and over 91 Americans 

dying nationwide every day, we have run out of time to find a solution to this crisis. We need action now. 

I appreciate the committee for holding this forum to express creative ideas and solutions and hope it leads to more lives being 

saved. 

Mr. Chairman, I appreciate the opportunity to be here, and I 

yield back the balance of my time. 

[The prepared statement of Mr. Latta follows:] 

22 

PREPARED STATEMENT OF HON. ROBERT E. LATTA

Opioid abuse and addiction has caused devastation in every community, and Ohio 

has been hit especially hard. 

In 2016, Ohio lost at least 4,050 people from unintentional drug overdose. That’s 

a 32 percent increase from the previous year and 11 deaths a day. 

For comparison, in 2016, there were 1,133 traffic fatalities in my State. That 

means drug overdoses caused nearly 4 times as many deaths compared to traffic accidents. 

These figures are heartbreaking and it’s sad to know that this problem isn’t getting any better. Many coroners say that 2017’s overdose fatalities are outpacing 

2016’s. 

This problem knows no limits and has affected husbands, wives, children, brothers, sisters, fathers, and mothers. It has destroyed marriages, ruined careers, and 

cut lives far too short. 

I frequently read obituaries in my local newspaper, and over the past year or two 

I started to notice a pattern of younger individuals without a cause of death. I soon 

realized that no cause was listed because they had died from a drug overdose. This 

happens far too often. 

All across my district in Northwest and West Central Ohio, I’ve heard how opioid 

addiction impacts our communities. I’ve toured businesses, met with community 

leaders, and spoke with families to hear how substance use disorders have directly 

affected their lives. 

It’s because of these stories that I plan to introduce a bill that will direct the Department of Health and Human Services to create a public electronic database of 

information relating to nationwide efforts to combat the opioid crisis. 

The database would serve as a central location of information for the public and 

others to: 

• Track Federal funding allocations made available for research and treatment of 

opioid abuse; and, 

• Find research relating to opioid abuse from all Federal agencies, State, local, 

and Tribal governments, as well as nonprofits, law enforcement, medical experts, 

public health educators, and research institutes. 

Furthermore, my bill would charge HHS to evaluate a myriad of issues relating 

to pain management, addiction, prescription guidelines, treatments, trends and patterns, and effective solutions and programs used across the country. 

These findings would be available on the database as well and HHS would be instructed to offer recommendations for targeted areas of improvements. 

I hope that with the experts at HHS, and other relevant agencies, this database 

will allow for easier access of information, funding streams, and relevant data that 

can help to combat the opioid abuse epidemic across our country. 

With 11 people dying every day in my home State of Ohio, and over 91 Americans 

dying every day nationwide, we have run out of time to find a solution to this crisis. 

We need action now. 

I appreciate the committee for holding this forum to express creative ideas and 

solutions, and hope it leads to lives being saved. 

Mr. BURGESS. Chair thanks the gentleman. The gentleman yields 

back. 

The Chair wants to thank all the Members on this panel for your 

testimony. You are now excused, and we will seek the next panel, 

and I—— 

Mr. BUTTERFIELD. Mr. Chairman, a parliamentary inquiry. 

Did—— 

Mr. BURGESS. The gentleman will state his parliamentary inquiry. 

Mr. BUTTERFIELD. I am not sure that is the right terminology. 

But I wanted to include into the record two newspaper articles that 

I referenced. 

Have I lost my right to do that? 

Mr. BURGESS. Is the gentleman asking unanimous consent? 

Mr. BUTTERFIELD. I am. Yes, sir. 

Mr. BURGESS. Without objection, so ordered. 

23 

[The information appears at the conclusion of the hearing.] 

Mr. BUTTERFIELD. Thank you. 

Mr. BURGESS. And the Chair now would ask that the next panel, 

which is Mr. Johnson, Mr. Welch, Leader Pelosi, and Mrs. Brooks. 

And, again, members of the committee are welcome to provide 

their testimony from their seated position on the dais or from the 

witness table, whichever is your preference. 

And, Mr. Johnson, I will recognize you for 3 minutes. 

STATEMENT OF HON. BILL JOHNSON, A REPRESENTATIVE IN 

CONGRESS FROM THE STATE OF OHIO 

Mr. JOHNSON. Thank you, Mr. Chairman. I appreciate this discussion about an issue that is so vitally important. 

It is no secret that America is in the midst of an opioid crisis. 

Last year, in my home State of Ohio alone, about 86 percent of 

overdose deaths involved an opioid. 

This epidemic can be felt in virtually every community across the 

country and today I want to share a story that will shed some light 

on some of the good work being done by people in my district to 

help combat the opioid epidemic and to perhaps let everyone know 

about some of the positive things that are taking place. 

Recently, I had the honor of visiting Field of Hope, a faith-based 

nonprofit treatment facility in southeastern Ohio that assist area 

families ravaged by poverty and drug abuse. 

Field of Hope Recovery House was founded by a man named 

Kevin Dennis after he witnessed his own daughter become addicted 

to opioids after she had knee surgery from a high school athletic 

injury. 

Her prescriptions ran out before her pain was managed. But, unfortunately, by that point, she was addicted. She ended up in prison several times for theft and checked into numerous rehab facilities before she fully recovered from addiction. 

She is now a recovery counselor at Field of Hope and is happily 

married with a child. I heard some incredibly powerful and touching stories during my visit to the Field of Hope Campus and I witnessed the good work they are doing firsthand. 

We, in Congress, and especially in this committee have an important role to play in supplementing and enabling the work being 

done by organizations like Field of Hope. 

On the front end, we need to develop prevention policies that 

steer people like Kevin’s daughter away from opioids in the first 

place. Innovative nonopioid nonaddictive treatments exist today 

and more are on the way. But this—these innovative treatments 

are not always covered by Federal programs like Medicare and 

Medicaid. 

We should closely examine the reimbursement policies in place 

to ensure that patients have access to effective alternatives for pain 

management without the risk of addiction. 

I’ve also been encouraged by recent efforts by private payers, providers, pharmacists, and patient groups to address the addiction 

crisis through increased awareness, prescribing guidelines, and 

new treatment options. I believe Congress can play a role in ensuring that all prescribers are equipped with education in pain manVerDate Mar 15 2010 09:50 Oct 11, 2018 Jkt 037690 PO 00000 Frm 00029 Fmt 6633 Sfmt 6633 C:\USERS\WLAUFERT\DESKTOP\115X64MEMBERSOPIOIDSPDFMADE WAYNE
24 

agement so they can provide effective pain treatments for patients 

and timely intervention for those who are addicted. 

I look forward to continuing to work with my colleagues on the 

committee and in the House to find effective solutions to this 

scourge. 

Mr. Chairman, it is a national crisis. We need to act, and, with 

that, I yield back the balance of my time. 

[The prepared statement of Mr. Johnson follows:] 

PREPARED STATEMENT OF HON. BILL JOHNSON

It is no secret that the United States is in the midst of an opioid epidemic. Last 

year, in my home State of Ohio alone, about 86 percent of overdose deaths involved 

an opioid. This epidemic can be felt in virtually every community across the country; 

and today, I want to share a story that will shed some light on some of the good 

work being done in my district to help combat the opioid epidemic, and to let people 

know about some of the positives taking place. 

I had the honor of visiting Field of Hope, a faith-based, nonprofit, treatment facility in Southeastern Ohio that assists area families ravaged by poverty and drug 

abuse. Field of Hope recovery house was founded by a man named Kevin Dennis, 

after he witnessed his own daughter become addicted to opioids after she had knee 

surgery from a high school athletic injury. Her prescriptions ran out, but she was 

addicted. She ended up in prison several times for theft, and checked into numerous 

rehab facilities before she fully recovered from addiction. She is now a recovery 

counselor at Field of Hope, and is happily married with a child. I heard some incredibly powerful and touching stories during my visit to the Field of Hope campus, and 

I witnessed the good work they are doing firsthand. 

We in Congress, and especially in this committee, have an important role to play 

in supplementing and enabling the work being done by organizations like Field of 

Hope. On the front end, we need to develop prevention policies that steer people, 

like Kevin’s daughter, away from opioids in the first place. Innovative nonopioid 

treatments exist today, and more are on the way, but are not always covered by 

Federal programs like Medicare and Medicaid. We should closely examine the reimbursement policies in place to ensure that patients have access to effective alternatives for pain management without the risk of addiction. 

I’ve also been encouraged by recent efforts by private payers, providers, pharmacists, and patient groups to address the addiction crisis through increased awareness, prescribing guidelines, and new treatment options. I believe Congress can play 

a role in ensuring that all prescribers are equipped with an education in pain management so they can provide effective pain treatments for patients and timely intervention for those who are addicted. 

I look forward to continuing to work with my colleagues on the committee and 

in the House to find effective solutions to this scourge. 

Mr. BURGESS. Gentleman yields back. Chair thanks the gentleman. 

The Chair is then pleased to recognize the entire Vermont delegation. Mr. Welch, you are recognized for 3 minutes. 

STATEMENT OF HON. PETER WELCH, A REPRESENTATIVE IN 

CONGRESS FROM THE STATE OF VERMONT 

Mr. WELCH. We don’t have the numbers of Texas, but I appreciate the recognition. 

First of all, Dr. Burgess, thank you, and Mr. Green, thank you— 

your taking time to focus attention and demonstrate the urgency 

of this challenge. 

Second, this so affects us all. I mean, it’s heartbreaking and it 

doesn’t matter whether it’s a red district or a blue district. It 

doesn’t matter what your view is on the size and scope of Government. This is hurting people in your district, Dr. Burgess and Mr. 

Green, and in my district and my colleagues’ here. 

25 

In Vermont, our Governor dedicated his entire State of the State 

Address to this epidemic in 2014, and I remember at that time 

many of my colleagues asked the question, ‘‘Peter, isn’t this going 

to do bad things for the reputation of Vermont,’’ but then acknowledged that what he was saying was true in their own State—in 

their own districts. 

So you focussing attention on it, Mr. Chairman, thank you. That 

is step number one. I can give you some statistics in Vermont but 

they would be very similar to Mr. Johnson. 

I mean, our prescription drug problems with individuals increased from 2,477 in 2012 by 80 percent. Heroin went from 913 

in 2012 and increased to 3,488—a 380 percent increase. Every one 

of those stories is a story of family heartache. 

I mean, I got a letter from a mom whose 27-year-old son became 

addicted to heroin and just the story about him being homeless, 

him going from being a full time working person to being out on 

the street, him—her having to call her daughters, saying that their 

brother may soon be dead—all of that is real and all to vivid. 

So this is an enormous challenge. Our job in Congress is to come 

up with some policies that are going to help people help themselves 

and I would like to make a few suggestions of things that we need 

to do. 

Number one, we do have to have funding. We have to have full 

funding for the Comprehensive Addiction and Recovery Act, and 

we’ve got to find the money in order to allow our communities to 

do that work. 

Two, we have to have more research into alternative treatment. 

I am working with Mr. McKinley to try to get the Comprehensive 

Addiction and Recovery Act to find better alternatives to treat pain. 

Three, let us allow for partial filling of opioid subscriptions. 

Many of us have signed letters that would allow that to happen. 

Four, let’s support the recent action by Commissioner Gottlieb. 

He has done some good things. Immediate release—he is trying to 

get immediate release opioid manufacturers to follow a more stringent set of REMS requirements which includes training doctors to 

safely prescribe these drugs. 

So this hearing is tremendous—focusing attention. The next step 

is to put this into legislative action. 

Thank you, Mr. Chairman. 

[The prepared statement of Mr. Welch follows:] 

PREPARED STATEMENT OF HON. PETER WELCH

First of all, Dr. Burgess, thank you, and Mr. Green, thank you, you’re taking time 

to focus attention and demonstrate the urgency of this challenge. Second, this so affects us all, I mean it’s heartbreaking, and it doesn’t matter if it is a red district 

or a blue district, it doesn’t matter what your view is on the size and scope of Government. This is hurting people is your district Dr. Burgess and Mr. Green, and in 

my district and my colleagues’ here. 

In Vermont, our Governor dedicated his entire State of the State address to this 

epidemic in 2014, and I remember at that time many of my colleagues asked the 

question ‘Peter, isn’t this going to do bad things for the reputation of Vermont?’ but 

then acknowledged that what he was saying was true in their own State, in their 

own districts. So you focusing attention on it Mr. Chairman, thank you, that is step 

number one. 

I can give you some statistics in Vermont, they would be very similar to Mr. Johnson. I mean our prescription drug problems with individuals increased from 2,477 

26 

in 2012 by 80 percent, heroin went from 913 in 2012 and increased to 3,488, a 380 

percent increase. Every one of those stories is a story of family heartache. I mean, 

I got a letter from a mom whose 27-year-old son became addicted to heroin, and just 

the story about him being homeless, him going from being a full time working person to being out on the street, her having to call her daughters saying that their 

brother may soon be dead. All of that is real and all too vivid. So this is an enormous challenge. 

Our job in Congress is to come up with some policies that will help people help 

themselves. And I’d like to make a few suggestions of things that we need to do. 

Number one, we do have to have funding. We have to have full funding for the Comprehensive Addiction and Recovery Act. And we have got to find the money to in 

order allow our communities to do that work. Two, we have to have more research 

into alternative treatment. I’m working with Mr. McKinley to try to get the Comprehensive Addiction and Recovery Act to find better alternatives to treat pain. 

Three, let’s allow for partial filling of opioid prescriptions. Many of us have signed 

letters that would allow that to happen. Four, let’s support the recent action by commissioner Gottlieb. He’s done some good things. He is trying to get immediate release opioid manufacturers to follow a more stringent set of REMS requirements, 

which includes training doctors to safely prescribe these drugs. So, this hearing is 

tremendous, focusing attention. The next step is to put this into legislative action. 

Mr. BURGESS. Chair thanks the gentleman. Gentleman yields 

back. 

The Chair recognizes the gentlelady from Indiana, Mrs. Brooks, 

for 3 minutes, please. 

STATEMENT OF HON. SUSAN W. BROOKS, A REPRESENTATIVE 

IN CONGRESS FROM THE STATE OF INDIANA 

Mrs. BROOKS. Thank you, Mr. Chairman, and thank you, Ranking Member Green, for hosting this incredibly important hearing. 

Too many Americans are struggling with the crippling effects of 

drug abuse and addiction and the statistics, as we know, are devastating. 

According to the Indiana State Department of Health, every 2 

1A1⁄2 hours, a Hoosier is sent to the hospital for an opioid overdose. 

Across our State there are enough bottles of painkillers in circulation for nearly every Hoosier to have their own and the number 

of infants born addicted to opioids is increasing at an alarming rate 

with health care costs for these babies costing Indiana more than 

$64 million in 2014 alone. 

And as we know, like so many other States, Hoosiers are now 

more likely to die from a drug overdose than a car accident. 

When I came to Congress in 2013, I had been very focussed on 

our communities and families that this epidemic has swept up. And 

like so many of my colleagues, we have held round tables. We have 

held meetings. We have met with addicted individuals’ families. We 

have been on the front line with prescribers, health care workers. 

We all agree this is a Federal problem and a local problem. 

Last year, we passed CARA, which included my bill to establish 

an interagency task force to review, modify, and update the best 

practices for pain management and prescribed pain medicine. 

HHS has already taken steps informing this task force, but more 

needs to be done. In my view, it is critical to ensure that the medical professionals have continuing medical education for the prescribing of DEA-controlled substances that have such a high risk 

of abuse. 

I am exploring options to ensure that physicians and other medical professionals who prescribe these schedule drugs have more 

27 

and better education linked to the application and renewal of their 

DEA licenses. 

Professionals who prescribe and dispense opioid medications 

must have better training so that they fully understand those patients who, sadly, have gotten the onset of addiction due to what 

they’ve been prescribed and now they need even better education 

to help prevent that onset and then to help them with the addiction. 

Indiana is tackling our problems head on and in fact just yesterday Indiana University announced a new initiative called Responding to the Addictions Crisis. It is being led by IU’s Dean of Nursing, Robin Newhouse. IU is committing $50 million over the next 

5 years to collaborate with State and community partners to tackle 

this crisis. 

It is going to be one of the most comprehensive State-based responses and every IU campus in the State is going to be involved. 

It is going to focus on training and education, data collection and 

analysis, policy analysis and development, addiction sciences, community and workforce development. 

So major steps are being taken across our State because everyone has a role to play, from our prescribers to our medical, to our 

higher ed institutions. 

And I want to remind folks that DEA has a national prescription 

drug take-back day. It is approaching on October 28th. 

It provides that safe, convenient, responsible way to dispose of 

excess prescriptions drugs so that people can get those drugs out 

of their medicine cabinets and out of our kids’ reach. And not just 

kids—to adults. So there are going to be locations all across the 

country and I really encourage everyone because everyone has a 

role to play. And so October 28th is National Take-Back Day and 

I hope that we get that word out. 

Thank you, Mr. Chairman. I yield back. 

[The prepared statement of Mrs. Brooks follows:] 

PREPARED STATEMENT OF HON. SUSAN W. BROOKS

Thank you, Mr. Chairman. 

Too many Americans are struggling with the crippling effects of drug addiction 

and abuse and too many families are grieving the loss of a loved one to an overdose. 

Since I joined Congress in 2013, I have been committed to helping people overcome 

this sweeping epidemic. According to the Indiana State Department of Health, every 

2 1A1⁄2 hours, a Hoosier is sent to the hospital for an opioid overdose. Across the 

State there are enough bottles of painkillers in circulation for nearly every Hoosier 

to have their own. The number of infants born addicted to opioids is increasing at 

an alarming rate, costing Indiana more than $64 million in 2014 alone. Hoosiers are 

now more likely to die from a drug overdose than a car accident; Indiana is one of 

four States where the fatal drug overdose rate has quadrupled since 1999, ranking 

us 15th in the country in overdose fatalities. 

At home in the district, I have pursued answers to this epidemic through 

roundtables and meetings with individuals and families on the front lines of this 

crisis, prescribers and health workers and first responders, and community leaders. 

I have visited the neonatal intensive care unit (NICU) at Saint Vincent’s Hospital 

in Indianapolis to see firsthand the devastating effects of infants born addicted to 

opioids and who must already fight for survival through withdrawal in their very 

first days on this earth. I meet with juvenile court judges and social workers whose 

caseloads have doubled as more and more children are being removed from their 

parents’ care because their parents are more concerned about where to find their 

next high than the welfare of their child and it is no longer safe for them in their 

28 

home. Indiana first responders tell me they are overwhelmed with the unprecedented increase in drug overdoses. 

Last year Congress passed the Comprehensive Addiction and Recovery Act which 

included significant resources and reforms to combat this crisis; the measure included my bill to establish an inter-agency task force to review, modify, and update 

best practices for pain management and prescribe pain medicine. Although we’ve 

made great strides to turn the tide of the epidemic, we need to do more to bring 

prescribers in as part of the solution and help educate people struggling with substance abuse and their families. 

Just a few months ago, I met with the Grant County Substance Abuse Task Force 

at Marion General Hospital and heard from community leaders how important it 

is to fight this crisis at a Federal AND local level. In order to do this, it is critical 

that our first responders have the equipment they need to safely respond to situations where toxic substances are present. We must also educate the youngest members of our communities of the dangers of substance abuse, and ensure our kids do 

not have access to harmful prescription drugs. As part of my ongoing effort to combat this crisis, I will be participating in the DEA’s National Prescription Drug Take 

Back Day on October 28. This provides a safe, convenient, and responsible way to 

dispose of excess prescription drugs, while also providing an opportunity to raise 

awareness of the opioid crisis and to educate our friends, family members, and 

neighbors about the potential for abuse of medications. 

Indiana is tackling the problem head-on. I trust our State and local partners to 

do what’s necessary to address this crisis and it is a priority for Governor Holcomb. 

He recently established a Commission to Combat Opioid Abuse and, just yesterday, 

Indiana University announced it committing an investment of $50 million to collaborate with State and community partners to tackle this crisis, making it one of the 

Nation’s largest and most comprehensive State-based responses. Major steps are 

being taken across the State, proving that it will take everyone—from the Federal 

Government to individuals in our communities—do their part to combat this crisis. 

Thank you, Mr. Chairman, and I yield back. 

Mr. BURGESS. Very well, and of course, I thank the gentlelady for 

providing the date. This hearing is being streamed on Facebook 

Live, so your information now has been distributed to everyone 

who’s been tuning in this morning. So that is a good thing, and 

perhaps we can each individually try to make that date part of our 

discussions as we go through the rest of the month. 

I want to thank this panel for being here. You all are excused. 

I have a panel identified of Mr. Luja ́n, Markwayne Mullin of Oklahoma, Mr. Tonko, Mr. Hudson, and Mr. Kennedy. 

Again, Energy and Commerce members are advised that they 

may present from the dais or from the witness table, whichever is 

your preference. 

If you are seated at the table, we will provide a name tag for you. 

So, whenever you are ready, Mr. Luja ́n, you are recognized for 3 

minutes, please. 

STATEMENT OF HON. BEN RAY LUJA ́ N, A REPRESENTATIVE IN 

CONGRESS FROM THE STATE OF NEW MEXICO 

Mr. LUJA ́ N. Thank you, Mr. Chairman. I thank the chairs and 

ranking members for the opportunity to discuss how New Mexico 

has been impacted by the opioid crisis. 

Five hundred and one New Mexicans died of drug overdose 

deaths in 2015. Across this country, there were 52,404 deaths in 

2015 and more than 560,000 deaths between 1999 and 2015—a 

half a million people who missed Thanksgiving dinner or their 

daughter’s softball game, who weren’t able to help their son with 

math homework or kiss their spouse good night. 

29 

That’s brothers and sisters, parents and friends and children 

that we have lost too soon because in part Congress has not responded forcefully enough to the crisis. 

Last Congress, we did important work by passing the Comprehensive Addiction and Recovery Act—CARA—and 21st Century 

Cures Act. These were steps in the right direction but these efforts 

alone are not enough. 

I have heard from my community that the funding passed in 

Cures is helpful but hard to use. In part, this is because of the 

short funding period which impacts communities’ ability to plan for 

the long-term and expand capacity. 

We know that in two many areas like New Mexico there are simply not enough people and resources. Many want help and can’t get 

it. 

I am reminded of a story relayed to me by one of my constituents, Jay, who have stopped using heroin on his own—who felt as 

if he was going into relapse and sought help at a local treatment 

facility. 

Jay was told, come back when you are using. He was turned 

away and told to come back only if he started using again because 

they lacked the capacity to treat patients who were not active drug 

users. That’s simply not right. 

To really expand the treatment prevention and wraparound services that our constituents need, we must increase funding and create stability. We need to give local governments and organizations 

the ability to plan and not fear losing vital support from Congress. 

Most of all, we need to give constituents like Jay a place to go 

after he’s fought a tough fight on his own. That’s why I introduced 

the Opioid and Heroin Abuse Crisis Investment Act to continue the 

funding to combat the opioid epidemic we passed in 21st Century 

Cures for an additional 5 years. 

I would welcome my colleagues’ support because we absolutely 

must extend this funding for an additional 5 years and beyond. 

However, this still isn’t enough, which is why we must look at 

new efforts to drive vital investments to help those in need and address the barriers to appropriate quality and accessible treatment. 

These barriers include a decaying rural mental health and substance abuse treatment infrastructure, lack of regional coordination 

of treatment resources, lack of support for rural physicians providing substance abuse treatment, administrative barriers against 

the most effective form of opioid abuse treatment, and a shortage 

of rural physicians who provide medication-assisted treatment. 

We as a committee must recognize that hoping for the best is not 

valid public policy—there is a quick fix to solve the opioid crisis. 

That is simply not true. 

We need to advance serious legislation that takes into account 

long-term planning for the Federal Government and for States and 

communities. We need to bring it to the floor of the House, send 

it to the Senate, get it passed, and to the president’s desk. 

I fear that until we recognize this fact we will continue to lose 

brother’s and sisters, parents and friends, and children. 

Mr. Chairman, I thank you for holding this important hearing 

and finding a way for us to work in a bipartisan fashion to address 

this important issue. 

30 

Thank you, Mr. Chairman. I yield back. 

[The prepared statement of Mr. Luja ́n follows:] 

PREPARED STATEMENT OF HON. BEN RAY LUJA ́ N

I thank the chairs and ranking members for the opportunity to discuss how New 

Mexico has been impacted by the opioid crisis. 

Five hundred and one New Mexican died of drug overdoses deaths in 2015. 

Across this county, there were 52,404 deaths in 2015 and more than 560,000 

deaths between 1999 and 2015. 

A half million people who missed Thanksgiving dinner, or their daughter’s softball 

game. Half-a-million who weren’t able to help their son with their math homework 

or kiss their spouse goodnight. 

That’s brothers, sisters, parents, friends, and children that we lost too soon because, in part, Congress has not responded forcefully enough to this crisis. 

Last Congress, we did important work by passing the Comprehensive Addiction 

and Recovery Act (CARA), and 21st Century Cures Act. 

These were steps in the right direction, but these efforts alone are not enough. 

I’ve heard from my community that the funding passed in 21st Century Cures is 

helpful, but hard to use. In part, this is because of the short funding period, which 

impacts communities’ ability to plan for the long-term and expand capacity. 

We know that in too many areas like New Mexico, there are simply not enough 

people and resources. Many want help and can’t get it. 

I am reminded of a story relayed to me by one of my constituents, Jay, who had 

stopped using heroin on his own, but felt as if he was going to relapse and sought 

help at a local treatment facility. 

Jay was turned away and told to come back only when he started using again, 

because they lacked the capacity to treat patients who were not active drug users. 

That’s simply not right. 

To really expand the treatment, prevention, and wrap around services that our 

constituents need, we must increase funding and create stability. 

We need to give local governments and organizations the ability to plan—and not 

fear losing vital support from Congress. Most of all we need to give Jay a place to 

go after he’s fought a tough fight on his own. 

That is why I introduced the Opioid and Heroin Abuse Crisis Investment Act to 

continue the funding to combat the opioid epidemic we passed in 21st Century 

Cures for an additional 5 years. I would welcome my colleagues support because we 

absolutely must extend this funding for an additional 5 years and beyond. 

However, this still isn’t enough, which is why we must look at new efforts to drive 

vital investments to help those in need and address the barriers to appropriate, 

quality, and accessible treatment. 

These barriers include a decaying rural mental health and substance abuse treatment infrastructure, lack of regional coordination of treatment resources, lack of 

support for rural physicians providing substance abuse treatment, administrative 

barriers against the most effective form of opioid abuse treatment, and a shortage 

of rural physicians who provide Medication Assisted Treatment. 

We as a committee must recognize that ‘hoping for the best’ is not valid public 

policy. There is no quick-fix to solve this opioid epidemic. 

We need to advance serious legislation that takes into account long-term planning 

for the Federal Government, and for States and communities. We need to bring it 

to the floor of the House, and we need to send it to the President’s desk. 

I fear that until we recognize this fact, we will continue to lose brothers, sisters, 

parents, friends, and children. 

Mr. BURGESS. Gentleman yields back. Chair thanks the gentleman. 

Mr. Mullin, you are going to be recognized for 3 minutes. After 

that, we will allow the Minority Leader to be seated at the table 

and hear her testimony. 

But Mr. Mullin, go ahead for 3 minutes, please. 

Mr. MULLIN. OK. Mr. Chairman, I have no problem with letting 

Ms. Pelosi go next, if she would like to. 

Mr. BURGESS. If the Minority Leader is ready, then, yes, we will 

recognize you for—you are recognized. 

31 

STATEMENT OF HON. NANCY PELOSI, A REPRESENTATIVE IN 

CONGRESS FROM THE STATE OF CALIFORNIA 

Ms. PELOSI. Thank you, Mr. Chairman. Thank you, Rep. Mullin, 

for your courtesy. I really came to listen as well as to convey some 

thoughts. 

This is only the second time I’ve ever testified as Leader or as— 

in that capacity because this issue rises to the level, as you know, 

of life and death. And so, with gratitude to you and to the ranking 

member, Mr. Green, for bringing us together in a bipartisan way 

on this issue that is a matter of life and death. 

Thank you, Mr. Burgess. 

The opioid epidemic, again, is taking a savage daily toll on the 

American people. We know that, and regardless of who they are or 

where they live, they are in every district in the country, as we 

know. 

The scourge is tearing families apart, have an impact on the 

well-being of our children, hollowing out communities. It has 

claimed the lives of tens of thousands of Americans every year, on 

average robbing 91 people of their lives each day. 

Again, just to testify to that—I know it’s a matter of your record 

here. Opioid addiction is a public health catastrophe and is growing 

more dire and deadly every day. 

And I believe that it is really important for us to respond to this 

national emergency with the seriousness and urgency it requires. 

Fortunately, we have had bipartisanship in passing legislation— 

the Comprehensive Addiction and Recovery Act. 

We all came together during the bipartisan legislation that was 

passed—the 21st Century Cures Act that people were so happy 

that the addiction language was in there. That day we heard the 

stories of families so affected—break your heart—families who had 

lost a child, a young teenager or 21-year-old or whatever within a 

matter of days or weeks before that particular signing. 

President Obama signed that legislation. But it had the language. It just hasn’t had the money to the adequate extent and 

that, Mr. Chairman, is my appeal to you for our Democrats and Republicans to work together to have the funding to fund the key initiatives authorized in the bill. 

I do want to make a pitch for Medicaid be built on the progress. 

The ACA’s Medicaid expansion has provided a vital lifeline for tens 

of thousands of Americans struggling with addiction. 

As Governor of Ohio, our former colleague, John Kasich, noted, 

thank God we expanded Medicaid, because that Medicaid money is 

helping to rehab people. 

Yet 19 States have not taken that step. We stand ready to work 

with you, Mr. Chairman, in good faith with Republicans to update 

and improve the ACA but we remain vigilant against efforts to gut 

Medicaid because it will create even more of a problem in terms 

of opioids, just to name one thing. 

The opiate epidemic is a challenge to the conscience of the entire 

country. We must, again, act urgently and boldly to get America’s 

families the prevention treatment and recovery resources they 

need, and in that regard I said we must work with providers in the 

pharmaceutical industry to push effective prevention measures so 

32 

we can reduce unnecessary prescriptions and stop this epidemic at 

the source. 

Knowing of your busy schedule, I will submit my entire statement for the record. Again, thank you for the courtesy of being able 

to testify before your committee and thank you for your leadership 

on this important issue, and thank you, Mr. Green, as well. 

[The prepared statement of Ms. Pelosi follows:] 

PREPARED STATEMENT OF HON. NANCY PELOSI

Thank you all for being here to shine a light on the devastating epidemic of opioid 

addiction. 

Opioid addiction is inflicting a savage daily toll on Americans—regardless of who 

they are, where they live or how much money they make. 

This scourge is tearing apart families and hollowing out communities. It is claiming the lives of tens of thousands of Americans every year—robbing an average of 

91 people of their lives each day and driving down the national life expectancy. 

Opioid addiction is a public health catastrophe. And it is growing more dire and 

deadly each day. 

SERIOUS, URGENT ACTION

We must respond to this national emergency with the seriousness and urgency 

it requires. 

We must increase funding and improve capacity, so that health systems and providers can offer high-quality, evidence-based opioid addiction treatment, including 

medication-assisted treatment and recovery support services. 

It is unacceptable that our Nation lacks the capacity to treat nearly half of the 

men and women who suffer from opioid use disorders; 

We must also improve access to treatment—combatting the stigmas, cost and 

misperceptions that prevent people from accessing care. 

And we must work with providers on effective prevention measures—so we can 

limit opioid supply, and stop this epidemic at the source. 

CARA FUNDING

Fortunately, Congress has already created the tools to improve prevention and expand access to care. 

Last year, Democrats and Republicans worked together to pass the Comprehensive Addiction and Recovery Act—a landmark bill to provide the full continuum of 

care to those suffering from opioid addiction. 

But, unfortunately, the Republican Congress has so far failed to adequately fund 

the key initiatives authorized by this bill. 

There is no room for politics in the life-or-death fight against opioid addiction. We 

cannot shortchange the resources needed to fight the tragedy of opioid addiction in 

our country. 

Congress is appropriating billions to rebuild communities after natural disasters—we must show a similar commitment to rebuilding communities ravaged by 

opioids. 

ACA MEDICAID EXPANSION

We must also build on the progress of the ACA’s Medicaid expansion, which has 

provided a vital lifeline for tens of thousands of Americans struggling with opioid 

addiction. 

As Ohio Governor John Kasich noted, ‘‘Thank God we expanded Medicaid, because 

that Medicaid money is helping to rehab people.’’ 

Yet, 19 States still have not taken the step of extending the life-saving benefits 

of Medicaid coverage. We must work with States to expand Medicaid, so we can 

bring urgently needed care to men and women fighting for their lives. 

Democrats stand ready to work in good faith with Republicans to update and improve the ACA. But we will remain vigilant against any effort to gut Medicaid or 

create higher costs for less care for families. 

CLOSE

The opioid epidemic is a challenge to the conscience of the entire country. 

33 

We must act urgently and boldly to get America’s families the prevention, treatment and recovery resources they need. Thank you, all, for your leadership in this 

fight. 

Mr. BURGESS. The Chair thanks the Minority Leader for being 

here today. You are welcome to stay and listen to the testimony of 

the other Members, but we also respect your schedule, and if you 

need to leave, that is certainly understandable as well. 

But in the meantime, I will recognize Mr. Mullin for 3 minutes. 

Ms. PELOSI. Thank you for your hospitality. I will listen. I will 

listen. 

Mr. BURGESS. Well, yes, I will recognize the gentleman from 

Texas. 

Mr. GREEN. Thank you, Leader, for being here. But before Mr. 

Mullin testifies, Mr. Chairman, I would like to thank him for his 

work. 

Literally, when the water was going down in Houston, you called 

me and said, ‘‘I have some churches in Tulsa who want to partner 

with your churches.’’ 

So we did that, and instead of having one week’s worth of your 

folks from your Cherokee Nation, I think they stayed a month, 

helping my seniors and disabled clean out their 3 or 4 feet of water 

in their house, and I didn’t realize they had that drywall skills. So 

thank you. 

Ms. PELOSI. As one with a daughter in Houston, and grandchildren, I thank you as well. 

Mr. MULLIN. Thank you. 

STATEMENT OF HON. MARKWAYNE MULLIN, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF OKLAHOMA 

Mr. MULLIN. Mr. Green, thank you. Cherokee Nation called us 

right off the bat and said, ‘‘How can we help?,’’ and we had churches reach out to us, and we have been very fortunate to work together on multiple issues here in Congress. It has been a friendship that carried past that and it was a—it was an honor to be able 

to help your constituents. 

Thank you, Mr. Chairman and Mr. Green, for allowing us to talk 

about such an important epidemic that is going across our Nation. 

We talk often about the opioid epidemic. But what are we talking 

about as far as how did we get here and then how do we go back. 

We never want to talk about taking medicine backwards. But I 

stand—I sit in front of you, from a gentleman who’s had surgeries 

since I was a little boy. I was born with my hips out and my feet 

in club—in the club feet position and I started having surgeries 

very young. I also built up a very large pain tolerance. And I have 

never been one to use pain medicine. 

Now, my wife says that I am different than most. I think most 

people in this room would probably agree with that. But I do understand pain, and I understand the need for medicine. 

But in ’96 when pain became a sense and, in my opinion, we let 

the genie out of the bottle. We started treating it like it was something that can be treated like a cold or the flu, and all we do is 

mask it. 

And we’ve seen stronger and stronger drugs coming out. We’ve 

seen them become controlled substance—narcotics—that we send 

34 

home simply in a bottle with a prescription and say that is—that 

is controlled. 

Now we’ve seen an epidemic spread from the middle class to the 

low class to the wealthy and to our mothers and our fathers, to our 

brothers and our sisters and our coworkers. 

When do we put the genie back in the bottle? How do we continue to allow drugs—addictive drugs—continue to be sent home 

with our loved ones? The highest percentage of death—of accidental opioid deaths—are mothers—middle-age women. Most of 

them got addicted to them after birth or an elective surgery. 

How is that possible? How do we let it continue to move down 

that path and not say that we have to do something bold about 

this? When it’s a controlled substance, why do we allow it to go 

home? Wouldn’t that be better treated in the hospital? 

We talk about a lot of remedies but we have got to go back to 

where it started, and it started when we started treating it like a 

sense. 

I am very proud to be on this subcommittee. I am very proud 

that, Chairman Burgess, you are taking a very heavy interest in 

this and I am proud that Chairman Murphy had took an interest 

in this, too. 

And that is why we are proud to be able to pick up one of his 

bills. It is H.R. 3545 that will at least allow doctors after surgery 

to be able to access records to know if that person has an addictive 

behavior so we are not sending those type of drugs home with 

them. 

I look forward to continuing to work with the committee. I look 

forward to finally being able to put some type of remedy in bringing this to a closure and quit hurting our families back home, and 

I hope that we can approach this in a bipartisan approach, put politics aside, and put families first. 

Thank you. I look forward to working with you. I yield back. 

[The prepared statement of Mr. Mullin follows:] 

PREPARED STATEMENT OF HON. MARKWAYNE MULLIN

It’s so common to hear from the media about the dysfunction of Washington. It’s 

so uncommon to hear the success stories. As a member of the Energy and Commerce 

Committee, I’ve been working on legislation related to opioid abuse since March of 

2015, when our committee led a number of bipartisan initiatives to help address the 

opioid epidemic. That year, we were successful in passing numerous pieces of legislation through committee and through the House. 

In July of 2016, President Obama signed the Comprehensive Addiction and Recovery Act, or CARA, into law—which included over a dozen bills passed by the Energy 

and Commerce Committee. Our committee is a productive one and the legislation 

passed helps fight the opioid epidemic from the ground up. 

The Comprehensive Addiction and Recover Act (CARA) and the 21st Century 

Cures Act offered a truly comprehensive response to the opioid epidemic and touches on prevention, criminal justice reform, access to treatment, overdose reversal, and 

recovery. The final bill included an amendment that I offered, which ensures that 

the Attorney General considers the needs of Native Americans, rural communities, 

and communities heavily impacted by opioid overdose deaths when awarding grants. 

Overprescribing painkillers has been a significant driver in the opioid and heroin 

epidemic, which is why CARA and CURES created a task force to review best practices for chronic and acute pain management and prescribing pain medication. It improved access to the overdose treatment and the opioid reversal drug naloxone and 

it expanded NIH opioid research. 

Just last week in my district, the Claremore Police Department used the opioid 

reversal drug, Narcan, for the first time in the field. The victim, who was found unVerDate Mar 15 2010 09:50 Oct 11, 2018 Jkt 037690 PO 00000 Frm 00040 Fmt 6633 Sfmt 6633 C:\USERS\WLAUFERT\DESKTOP\115X64MEMBERSOPIOIDSPDFMADE WAYNE
35 

conscious and admitted to using opioids, was taken to the hospital for further treatment after police were able to administer the Narcan drug. These success stories 

are taking place nationwide, thanks to CARA and CURES. I am very proud to have 

worked on CARA and CURES, but there is still more work that needs to be done. 

Oklahoma has been hit hard by the epidemic. Our Attorney General has filed a 

suit against opioid manufacturers, Cherokee Nation has filed a suit against drug 

distributors and pharmacies, and our Governor has assembled an Oklahoma Commission on Opioid Abuse. In 2014, Oklahoma had the 10th-highest drug overdose 

death rate in the Nation. More people died from overdoses than in car crashes. My 

district also has two of the five counties in the entire State that have the highest 

rates of unintentional painkiller overdoses—Coal and Muskogee. 

We can all agree that more needs to be done to address this crisis, which is why 

I have worked with my colleague Rep. Katherine Clark to introduced H.R. 3528, the 

Every Prescription Conveyed Securely (EPCS) Act. The EPCS Act would direct all 

States to employ electronic prescribing for controlled substances (EPCS) technology 

for Medicare Part D transactions by 2020. This is a step that seven States have already taken in an effort to combat the crisis and better secure the prescription distribution chain. So far all of our policy has been reactive, and this policy is 

proactive. 

This policy prevents large amounts of opiates from ever reaching the addicts 

hands and dramatically decreases doctor shopping. The EPCS Act will provide realtime reporting and ensure that the information gathered by electronic medical 

records can be used in a meaningful way. Electronic prescribing solutions, currently 

provided by more than 20 companies, are used like an app on the Electronic Health 

Records and give prescribers feedback on when prescriptions are filled and with 

what drug. 

According to the Department of Justice, most illegally obtained prescription 

opioids are obtained either through doctor shopping, forged prescriptions, and theft, 

which can be addressed by an EPCS regime. Another piece of legislation I am supportive of is H.R. 3545, the Overdose Prevention and Patient Safety Act, also known 

in the Senate as Jessie’s Law. This legislation would help put the laws governing 

the medical records of those struggling with addiction into the 21st Century. 

Currently, a law that was passed in 1972 still governs how doctors and health 

care professionals share alcohol or substance use disorder treatment records. Under 

this law, when a patient goes to receive treatment at an addiction treatment facility, 

their medical records will remain segregated from the patient’s overall medical 

record. This puts the patient at tremendous risk because doctors can no longer know 

their patient’s substance use or history of care. In the case of Jessie Grubb, this outdated law was fatal. 

Jessie, who was in substance use recovery, went in for routine surgery, and providers were informed by her parents that she should not be given opioids except 

under strict supervision. However, upon discharge Jessie was prescribed 50 

oxycodone pills, and the hospital pharmacy filled the prescription because her substance use disorder treatment history was not in her medical record. That night, she 

died as the result of an overdose. Doctors cannot safely treat their patients if they 

don’t know the whole story. H.R. 3545 would prevent tragedies like Jessie’s and 

bring the Part 2 law into the 21st century. 

Our committee has done good work to combat the opioid epidemic, but our work 

isn’t done. We can do more. We can inspire more success stories, but our work starts 

here. I urge my colleagues today to support these two bills and continue our dedication on this committee to combating the deadly opioid epidemic. I yield back the remainder of my time. 

Mr. BURGESS. Chair thanks the gentleman. Gentleman yields 

back. 

Chair recognizes the gentleman from New York, Mr. Tonko, for 

3 minutes. 

STATEMENT OF HON. PAUL TONKO, A REPRESENTATIVE IN 

CONGRESS FROM THE STATE OF NEW YORK 

Mr. TONKO. Thank you, Chair Burgess and Ranking Member 

Green, and members of the subcommittee. 

We are a nation in crisis. The opioid epidemic is wreaking havoc 

in our communities at an unprecedented scale with CDC estiVerDate Mar 15 2010 09:50 Oct 11, 2018 Jkt 037690 PO 00000 Frm 00041 Fmt 6633 Sfmt 6633 C:\USERS\WLAUFERT\DESKTOP\115X64MEMBERSOPIOIDSPDFMADE WAYNE
36 

mating 64,000 dead from drug overdoses in 2016—an astonishing 

21 percent increase from the previous year. 

This public health disaster is costing us more lives annually than 

at the peak of the AIDS epidemic—as many lives as gun violence 

and traffic accidents combined. 

If this Congress doesn’t find additional solutions to turn the tide 

on the opioid epidemic, we will be complicity in this American tragedy. 

I am here today to offer two such legislative solutions. First, I 

introduced the Addiction Treatment Access Improvement Act—H.R. 

3692—with my good friend, Congressman Ben Ray Luja ́n. 

This legislation would expand access to medication-assisted 

treatment by allowing certified nurse midwives and other advanced 

practice registered nurses to prescribe buprenorphine and, in addition, this legislation would codify the 2016 rule that allowed physicians to treat up to 275 patients with buprenorphine and eliminate 

the sunset of a provision that allows nonphysician providers to prescribe MAT. 

The Addiction Treatment Access Improvement Act would particularly benefit pregnant and post-partum women who are struggling 

with addiction and improve outcomes for the over 13,000 infants 

that are born each year with neonatal abstinence syndrome. 

Despite the expansion of medication-assisted treatment in the 

Comprehensive Addiction and Recovery Act, there is still a significant shortage in treatment capacity, resulting in individuals waiting months, if not years, to receive effective addiction treatment. 

Only 20 percent of patients who need treatment for opioid use disorder are currently receiving it. 

Let me repeat that. Only 20 percent of patients who need treatment for opioid use disorder are currently receiving it. The Addiction Treatment Access Improvement Act would address this treatment gap and save lives. 

This committee should act on this bipartisan legislation without 

delay. 

The second bill I’d like to discuss is the Medicaid Reentry Act— 

H.R. 4005. This legislation is a targeted attempt to address the 

problem of overdose deaths that occur post-incarceration. 

Studies have shown that individuals who are released back into 

the community post-incarceration are, roughly, eight times more 

likely to die of an overdose in the first two weeks post-release compared to other times. 

The risk of overdose is elevated during this period due to reduced 

physiological tolerance for opioids amongst the incarcerated population, a lack of effective addiction treatment options while incarcerated, and poor care transitions back into the community. 

The Medicaid Reentry Act would grant States flexibility to restart Medicaid coverage for Medicaid-eligible individuals 30 days 

pre-release. 

By allowing the Medicaid benefit to restart prior to release, 

States would be able to more readily provide effective addiction 

treatment pre-release and would allow for smoother transitions to 

community care, reducing the risk of overdose deaths post-release, 

striking an overall wiser use of scarce Medicaid dollars. 

37 

Let me be clear: This legislation that I’ve introduced would not 

expand Medicaid eligibility in any way. It would simply grant 

States new flexibility to restart an individual’s Medicaid benefits 

30 days earlier than allowed under current law. 

This increased flexibility would dovetail with innovative reentry 

programs already being championed by Republicans and Democrats 

in States across our country and would give individuals reentering 

society a fighting chance to live a healthier drug-free life. 

Let me just end with an urgent plea for action and bipartisanship. I know that many of the ideas that this committee will hear 

today would, in normal times, be met with the typical partisan objections and end up stuck in a procedural morass. 

These are not normal times. When your house is on fire you don’t 

look to see whether the firefighter is wearing red or blue uniforms 

before they turn their hoses on. 

If we are truly going to make a difference in this crisis and save 

lives, we have to have a big heart and an open mind. 

I thank my colleagues for their time and for their consideration 

of this legislation that I have presented and, again, to the chair, 

ranking member, and members of the subcommittee, thank you for 

offering such, you know, attention to a crisis that has gripped this 

country in severe measure. 

Thank you. I yield back. 

[The prepared statement of Mr. Tonko follows:] 

PREPARED STATEMENT OF HON. PAUL TONKO

Thank you, Mr. Chairman. 

We are a nation in crisis. The opioid epidemic is wreaking havoc in our communities at an unprecedented scale, with the CDC estimating 64,000 dead from drug 

overdoses in 2016, an astonishing 21 percent increase from the previous year. 

This public health disaster is costing us more lives annually than at the peak of 

the AIDS epidemic—as many lives as gun violence and traffic accidents combined. 

If this Congress doesn’t find additional solutions to turn the tide on the opioid epidemic, we will be complicit in this American tragedy. 

I’m here today to offer two such legislative solutions. 

First, I introduced the Addiction Treatment Access Improvement Act, H.R. 3692, 

with my good friend Congressman Ben Ray Luja ́n. This legislation would expand 

access to medication-assisted treatment by allowing certified nurse midwives and 

other advanced practice registered nurses to prescribe buprenorphine. In addition, 

this legislation would codify the 2016 rule that allowed physicians to treat up to 275 

patients with buprenorphine and eliminate the sunset of a provision that allows 

nonphysician providers to prescribe MAT. 

The Addiction Treatment Access Improvement Act would particularly benefit 

pregnant and postpartum women who are struggling with addiction and improve 

outcomes for the over 13,000 infants that are born each year with neonatal abstinence syndrome. 

Despite the expansion of medication-assisted treatment in Comprehensive Addiction and Recovery Act, there is still a significant shortage in treatment capacity, resulting in individuals waiting months or years to receive effective addiction treatment. Only 20 percent of patients who need treatment for opioid use disorder are 

currently receive it. 

The Addiction Treatment Access Improvement Act would address this treatment 

gap and save lives. This committee should act on this bipartisan legislation without 

delay. 

The second bill I’d like to discuss is the Medicaid Reentry Act, which is a targeted 

attempt to address the problem of overdose deaths that occur post-incarceration. 

Studies have shown that individuals who are released back into the community 

post-incarceration are roughly 8 times more likely to die of an overdose in the first 

two weeks post-release compared to other times. The risk of overdose is elevated 

during this period due to reduced physiological tolerance for opioids among the inVerDate Mar 15 2010 09:50 Oct 11, 2018 Jkt 037690 PO 00000 Frm 00043 Fmt 6633 Sfmt 6633 C:\USERS\WLAUFERT\DESKTOP\115X64MEMBERSOPIOIDSPDFMADE WAYNE
38 

carcerated population, a lack of effective addiction treatment options while incarcerated and poor care transitions back into the community. 

The Medicaid Reentry Act would grant States flexibility to restart Medicaid coverage for Medicaid-eligible individuals 30-days pre-release. By allowing Medicaid 

benefits to restart prior to release, States would be able to more readily provide effective addiction treatment pre-release and would allow for smoother transitions to 

community care, reducing the risk of overdose deaths post-release. 

This legislation would not expand Medicaid eligibility in any way, it would simply 

grant States new flexibility to restart an individual’s Medicaid benefits 30-days earlier than allowed under current law. This increased flexibility would dovetail with 

innovative reentry programs already being championed by Republicans and Democrats in States across the country and would give individuals reentering society a 

fighting chance to live a healthier, drug-free life. 

Let me just end with an urgent plea for action and bipartisanship. I know that 

many of the ideas that this committee will hear today would, in normal times, be 

met with the typical partisan objections and end up stuck in a procedural morass. 

These are not normal times. When your house is on fire, you don’t look to see 

whether the firemen are wearing red or blue uniforms before they turn the hoses 

on. If we are truly going to make a difference in this crisis and save lives we have 

to have a big heart and an open mind. 

I thank my colleagues for their time and for their consideration of the legislation 

I have presented. 

Mr. BURGESS. Gentleman yields back. Chair thanks the gentleman. 

Chair recognizes the gentleman from North Carolina, Mr. Hudson, for 3 minutes, please. 

STATEMENT OF HON. RICHARD HUDSON, A REPRESENTATIVE 

IN CONGRESS FROM THE STATE OF NORTH CAROLINA 

Mr. HUDSON. Thank you, Chairman Burgess and Ranking Member Green, for giving me the opportunity to speak on behalf of my 

constituents. 

As has been noted, the opioid epidemic is not an isolated issue. 

It is a nationwide issue and it deserves our attention. The New 

York Times noted last month that the opioid epidemic is killing 

more people per year right now than the HIV epidemic did at its 

peak in the ’90s. 

These drugs do not discriminate based on gender, race, social 

class, or age, and they destroy lives, families, marriages, and careers. 

In my home State of North Carolina, the opioid epidemic has 

really hit hard. North Carolina is home to four cities in the top 25 

of worst cities affected by the crisis, one of which is in my district, 

Fayetteville, North Carolina. 

One particularly devastating story that stuck with me from a 

constituent I met while touring a treatment facility last year in my 

district, he was a police captain, the son of the police chief in the 

same town, and he injured his back on the job and was prescribed 

an opioid following his surgery. 

He told me he vividly remembers the moment he became addicted the first time he took one of these medications. Within a 

year, he was a full-blown heroin addict. He’s since recovered and 

now mentors addicts through treatment. 

Unlike many stories, this is a story with a happy ending. Fayetteville has become home to soldiers and veterans—or is the home 

of soldiers and veterans who have become addicted after being prescribed opioids for injuries sustained in combat or training. 

39 

The tragedy is that the VA does not have enough inpatient beds 

to treat every veteran and so oftentimes veterans go without help 

and are forced to self-medicate by using opioids found on the black 

market. 

This is outrageous and it is unacceptable. We need to find real 

solutions so we can put an end to this heartbreak. 

I am proud to have worked last Congress with this committee’s 

investigation into opioid addiction which resulted in the passage of 

both the Comprehensive Addiction and Recovery Act and the 21st 

Century Cures Act. 

These laws have made huge steps forward in the treatment and 

prevention of opioid addiction but it is clear we have work left to 

do. 

One idea I am working on is expanding access to safe ways to 

dispose of prescription drugs, particularly opioids. DisposeRX is a 

company in my district that manufacturers a powder that mixes 

with water inside the pill bottle and renders any unused opioids 

not only inaccessible and inextricable but also biodegradable. 

It is innovation ideas like this that we need to explore and I look 

forward to working with my colleagues on the committee to help 

treat and prevent this opioid addiction. 

Thank you, Mr. Chairman. I yield back. 

[The prepared statement of Mr. Hudson follows:] 

PREPARED STATEMENT OF HON. RICHARD HUDSON

Thank you, Chairman Walden and Chairman Burgess, for giving me the opportunity to speak on behalf of my constituents. As has been noted, the opioid epidemic 

is not an isolated issue. It is a nationwide issue and it deserves our attention. The 

New York Times noted last month that the opioid epidemic is killing more people 

per year right now than the HIV epidemic did at its peak in the nineties. These 

drugs do not discriminate based on gender, race, social class, or age and they destroy lives, families, marriages, and careers. 

In my home State of North Carolina, the opioid epidemic has really hit hard. 

North Carolina is home to four cities in the top 25 of worst cities affected by this 

crisis, one of which is in my district, Fayetteville. One particularly devastating story 

that has stuck with me was from a constituent I met while touring a treatment facility in my district. He was a police captain—the son of a police chief in the same 

town—and injured his back on the job and was prescribed an opioid following surgery. He told me he vividly remembers becoming addicted the first time he took one 

of these medications. Within a year, he was a full blown heroin addict. He’s since 

recovered and now mentors addicts going through treatment, but his story has an 

unusually happy ending. 

Fayetteville is also home to soldiers and veterans who have become addicted after 

being prescribed opioids for injuries sustained in combat or training. One problem 

with this epidemic is the VA does not have enough inpatient beds to treat every 

veteran so oftentimes veterans go without help and are forced to self-medicate by 

using opioids acquired on the black market. We need to find real solutions so we 

can put an end to this heartbreak. 

I am proud to have worked last Congress on this committee’s investigation into 

the opioid addiction which resulted in the passage of both the Comprehensive Addiction and Recovery Act and the 21st Century Cures act. These laws have made huge 

steps forward in the treatment and prevention of opioid addiction, but it is clear we 

have work left to do. One idea I am working on is expanding access to safe ways 

to dispose of prescription drugs, particularly opioids. DisposeRx, a company in my 

district, manufactures a powder that mixes with water inside the pill bottle and renders any unused opioids not only inaccessible and inextricable, but also bio-degradable. It is innovative ideas like this that we need to explore and I look forward to 

working with colleagues on committee to help treat and prevent opioid addiction. 

40 

Mr. BURGESS. Gentleman yields back. Chair thanks the gentleman. 

Chair recognizes the gentleman from Massachusetts, Mr. Kennedy, for 3 minutes, please. 

STATEMENT OF HON. JOSEPH P. KENNEDY, III, A REPRESENTATIVE IN CONGRESS FROM THE COMMONWEALTH OF MASSACHUSETTS 

Mr. KENNEDY. Thank you, Mr. Chairman, and many thanks to 

the ranking member, Mr. Green, as well for convening this hearing 

and for bringing all of us together—our colleagues from across the 

country. 

I also want to thank my colleagues that have testified already. 

Their comments, I think, are right on. I think they show the depth 

of this epidemic across the country and how it’s affected so many 

in our districts from around our Nation and the myriad ways in 

which our Federal Government can help respond to it. 

There is no silver bullet to this but there are ideas out there that 

are, I think, genuine that have widespread support and that I hope 

will deserve this committee’s attention, going forward. 

Addiction, as many know, is not a disease that knows congressional districts or State borders or electoral college results. It is not 

one that cares about how much money is in your bank account or 

asks how many children you have. 

For patients and families on the front lines of this epidemic 

today it is personal, it is painful, and it is petrifying. 

The question, I think, before all of us isn’t is there an epidemic. 

I think you’ve heard from everybody today saying that there is. 

The question is how do we go forward. My colleagues have outlined some of their solutions. I wanted to touch on a couple of 

broad themes as well. 

First and foremost is Medicaid. Medicaid, as of now, covers about 

30 percent of all nonelderly adults with an opioid addiction in this 

country—30 percent—and the 20 percent of opioid addicts that do 

not have health insurance largely stems from individuals in States 

that did not take a Medicaid expansion. 

This is not enough. We need to strengthen our Medicaid programs to ensure that everybody gets the care that they need when 

they need it. 

That means not just ensuring access to Medicaid and eligibility 

but it means fleshing out the networks that Medicaid provides so 

that you don’t have the stories that so many of us have heard from 

folks around the country of even if they are enrolled in Medicaid 

that there are not providers that will take it, and if providers do 

take it that they would have wait months in order to get a slot to 

get into treatment. 

There is complex reasons for that but, in my own opinion, a big 

portion of that comes through low Medicaid reimbursement rates 

that ends up putting the burden of treatment on the backs of providers rather than making sure that patients get the care that they 

need. 

Second is law enforcement. Folks, we lock people up in this country that are sick and we need to be doing an awful lot more not 

only to make sure that that safety net for our mental health sysVerDate Mar 15 2010 09:50 Oct 11, 2018 Jkt 037690 PO 00000 Frm 00046 Fmt 6633 Sfmt 6633 C:\USERS\WLAUFERT\DESKTOP\115X64MEMBERSOPIOIDSPDFMADE WAYNE
41 

tem is not a criminal justice system but supporting our first responders and police officers who end up being on the front lines of 

this epidemic and addiction epidemic across the country and put in 

an impossible place of forcing to have to arrest people, forcing to 

put themselves in danger because our mental health system is not 

robust enough. 

I was a State prosecutor. We threw people in jail that were sick. 

They would break into homes and cars to try to satiate an opioid 

epidemic—an opioid addiction because they didn’t have anywhere 

else to go. 

Finally—and I will be brief, Mr. Chairman—the medical community. You heard Mrs. Brooks talk about education. We have heard 

folks talk about prediction of drug monitoring programs. We have 

heard folks talk about prescription guidelines. All of those need to 

be on the table. 

I, like Mr. Mullin, have had surgery before. I got in an argument 

with a surgery technician on my hospital bed who was trying to 

prescribe me pain killers that I wouldn’t take because I am so 

deathly afraid of these things. That part needs to change. 

I look forward to working with my colleagues in the weeks and 

months ahead to try to make sure that our Government does take 

the step forward we need. 

I yield back. 

Mr. BURGESS. Chair thanks the gentleman. 

Chair thanks everyone on this panel. We will allow you to depart, and we have a panel that will be Mr. Costello of Pennsylvania, Mr. Walberg of Michigan, Mr. Carter of Georgia, and Chairman Goodlatte of Virginia. 

And Mr. Walberg, we are doing Energy and Commerce members 

first. But with your permission, I will go to the Chairman of the 

Judiciary Committee since he has made time to be with us this 

morning. 

And Chairman Goodlatte, you are recognized for 3 minutes. 

STATEMENT OF HON. BOB GOODLATTE, A REPRESENTATIVE 

IN CONGRESS FROM THE COMMONWEALTH OF VIRGINIA 

Mr. GOODLATTE. Mr. Chairman, Ranking Member Green, members of the committee, thank you very much for the opportunity to 

testify about the opioid crisis in America. 

This crisis affects Americans across all socioeconomic levels in all 

regions of the country, including in my home district in Virginia, 

and has rightfully gained the attention of Congress. 

According to the Northern Shenandoah Valley Substance Abuse 

Coalition, they have seen 11 opioid overdoses resulting in four 

deaths since September 20th, making 33 deaths in that portion of 

my district so far this year. 

Just recently, I met with a mother in Roanoke whose daughter 

is an opioid addict living on the streets. Her concern for her daughter was heartbreaking to hear. 

Sadly, I know that every Member of Congress in this room has 

heard these stories of bright futures wasted away and lives taken 

too early. 

42 

That is why we must act to provide more tools to help addicts 

reclaim and rebuild their lives, stop drug traffickers, and make our 

communities safer. 

We at the Judiciary Committee have been pleased to work with 

the committee on Energy and Commerce in this fight to combat 

this epidemic. 

Since last year, the Judiciary Committee has passed seven legislative measures that address the multifaceted nature of the opioid 

epidemic. 

Notably, the Judiciary and Energy and Commerce Committees 

worked collaboratively to see the Comprehensive Opioid Abuse Reduction Act—CARA—signed into law last year. 

This bipartisan legislation combats the opioid epidemic by establishing a streamlined comprehensive opioid abuse grant program 

including vital training and resources for first responders and law 

enforcement, criminal investigations for the unlawful distribution 

of opioids, drug and other alternative treatment courts, and residential substance abuse treatment. 

We have also targeted those who traffic in opioids. The 

Transnational Drug Trafficking Act, which is now law, improves 

law enforcement’s ability to pursue international drug manufacturers, brokers, and distributors in source nations. 

Federal prosecutors can now use the important tools in that bill 

to pursue foreign drug traffickers who are poisoning American citizens. 

Additionally, in July of this year, the Judiciary Committee reported favorably the Stop the Importation and Trafficking of Synthetic Analogs Act. It is an unfortunate reality that synthetic drug 

use and the opioid epidemic are inextricably linked. Heroin is regularly laced with synthetic drugs such as fentanyl. 

This bill ensures that our laws keep pace with the creation of 

new chemically altered drugs and provides law enforcement with 

the tools needed to keep these drugs off of our streets. 

That legislation, I believe, is currently before the Energy and 

Commerce Committee. I hope you will take a very close look at it 

and if we can pass it out of the committee I am sure it will pass 

the House with a very strong vote. 

Mr. Chairman and members of the committee, I appreciate the 

opportunity to testify. My dedication to curtailing the opioid crisis 

is unwavering and I look forward to our continued work together 

to that end. 

Thank you. 

[The prepared statement of Mr. Goodlatte follows:] 

PREPARED STATEMENT OF HON. BOB GOODLATTE

Chairman Walden and Ranking Member Pallone, thank you for the opportunity 

to testify about the opioid crisis in America. This crisis affects Americans across all 

socioeconomic levels in all regions of the country—including in my home district in 

Virginia—and has rightfully gained the attention of Congress. 

According to the Northern Shenandoah Valley Substance Abuse Coalition, they 

have seen 11 opioid overdoses resulting in four deaths since September 20th—making 33 deaths in that region so far this year. Just recently, I met with a mother 

in Roanoke whose daughter is an opioid addict living on the streets. Her concern 

for her daughter was heartbreaking to hear. 

Sadly, I know that every Member of Congress in this room has heard these stories 

of bright futures wasted away and lives taken too early. That is why we must act 

43 

to provide more tools to help addicts reclaim and rebuild their lives, stop drug traffickers, and make our communities safer. 

The Committee on Energy and Commerce, as well as the House Judiciary Committee, of which I currently serve as chair, has been active in the fight to combat 

this epidemic. Since last year, the Judiciary Committee has passed seven legislative 

measures that address the multifaceted nature of the opioid epidemic. 

Notably, the Judiciary and Energy and Commerce Committees worked collaboratively to see the Comprehensive Opioid Abuse Reduction Act signed into law last 

year. This bipartisan legislation combats the opioid epidemic by establishing a 

streamlined, comprehensive opioid abuse grant program, including vital training 

and resources for first responders and law enforcement, criminal investigations for 

the unlawful distribution of opioids, drug and other alternative treatment courts, 

and residential substance abuse treatment. 

We have also targeted those who traffic in opioids. The Transnational Drug Trafficking Act, which is now law, improves law enforcement’s ability to pursue international drug manufacturers, brokers, and distributors in ‘‘source nations.’’ Federal 

prosecutors can now use the important tools in that bill to pursue foreign drug traffickers who are poisoning American citizens. 

Additionally, in July the Judiciary Committee reported favorably the Stop the Importation and Trafficking of Synthetic Analogues Act. It is an unfortunate reality 

that synthetic drug use and the opioid epidemic are inextricably linked. Heroin is 

regularly laced with synthetic drugs, such as fentanyl. This bill ensures that our 

laws keep pace with the creation of new, chemically altered drugs and provides law 

enforcement with the tools needed to keep these drugs off of our streets. 

Mr. Chairman and members of the committee, I appreciate the opportunity to testify. My dedication to curtailing the opioid crisis is unwavering. I look forward to 

our continued work together to that end. 

Mr. BURGESS. The Chair thanks the gentleman. Thanks for making time to be with us on our panel today. We sincerely appreciate 

you being here. We know we have got work to do, and we will work 

together on this. 

Mr. GOODLATTE. Thanks for the opportunity. 

Mr. BURGESS. Mr. Walberg, you are recognized for 3 minutes, 

please. 

STATEMENT OF HON. TIM WALBERG, A REPRESENTATIVE IN 

CONGRESS FROM THE STATE OF MICHIGAN 

Mr. WALBERG. Thank you, Mr. Chairman, and I am always delighted to go behind the chairman of the Judiciary Committee, especially since there are some of my bills in this committee. 

But let me say, Chairman Burgess and Ranking Member Green, 

I want to thank you for holding today’s hearing to receive input 

from members who represent different corners of our country and 

yet the very same problem. 

Since the heroin and opioid crisis came to the forefront, I have 

heard so many devastating stories about families losing loved ones. 

I have toured recovery centers, talked with survivors who continue 

to battle addiction and ridden along with law enforcement to understand the challenges that they face in keeping our 

neighbourhoods safe. 

I have also met a number of amazing compassionate individuals—fellow citizens who have stepped up and are leading the fight 

in their communities. 

A few weeks ago, I had the opportunity to meet with a constituent named George Barath from Monroe County. He established Ryan’s Hope Foundation, a nonprofit organization named in 

honor of his son who died from a heroin overdose in 2012. 

44 

He was only 25. Ryan’s Hope funds structured long-term residential treatment for addicts and so far they have helped nearly— 

helped nearly 40 addicts by sending them to rehab. 

To help cover these costs, Mr. Barath has also teamed up with 

local first responders to organize a charity hockey game called 

Hockey Against Heroin. 

In Lenawee County, my own home county, the Pathways Recovery Engagement Center just opened its doors last week. I got a 

chance to see the center in August when it was in the final stages 

of construction. 

This recovery-based program in downtown Adrian is the result of 

a community partnership between local police and the county sheriff’s office, Rotary Clubs, and the local hospital system and mental 

health authority. 

Ryan’s Hope and the Pathways Resource Center are just two 

shining examples of constituents in my district making a difference. We need more community-based initiatives like these to 

get resources to those in need. 

But Congress also has more to do. One example is Jessie’s Law, 

a bipartisan bill I have introduced with Congresswoman Debbie 

Dingell. It seeks to ensure that medical professionals are equipped 

to safely treat their patients and prevent overdose tragedies. 

It is named after Jessie Grubb, who died last year of an opioid 

overdose. Jessie had battled a heroin addiction for nearly 7 years 

but had been clean for six months. She had made a new life for 

herself in Michigan and was training for a marathon when an infection related to a running injury required her to have surgery. 

Jessie’s parents told doctors that she was a recovering addict and 

shouldn’t be prescribed opioids. Unfortunately, Jessie’s discharging 

physician didn’t know her addiction history and sent Jessie home 

with a prescription for 50 oxycodone pills. Jessie became a sad 

death by overdose statistic. 

Jessie’s law will ensure that physicians and nurses have access 

to a consenting patient’s complete health information when making 

treatment decisions. 

Such information is crucial to provide a patient-centered care, 

prevent relapses, and ultimately save lives. As we work together to 

address this crisis, it is my hope the stories and ideas shared today 

will inform our efforts and ensure we pursue meaningful solutions 

to remove obstacles to care and empower local communities to tackle the opioid crisis head on, and I thank you for listening to my 

story. 

[The prepared statement of Mr. Walberg follows:] 

PREPARED STATEMENT OF HON. TIM WALBERG

Chairman Burgess, Ranking Member Green, I want to thank you for holding today’s hearing to receive input from Members who represent different corners of our 

country. 

Since the heroin and opioid crisis came to the forefront, I have heard so many 

devastating stories about families losing loved ones. I’ve toured recovery centers, 

talked with survivors who continue to battle addiction, and ridden along with law 

enforcement to understand the challenges they face in keeping our neighborhoods 

safe. I’ve also met a number of individuals who have stepped up and are leading 

the fight in their communities. 

A few weeks ago, I had the opportunity to meet with a constituent named George 

Barath from Monroe County. He established Ryan’s Hope Foundation, a nonprofit 

45 

organization named in honor of his son who died from a heroin overdose in 2012. 

He was only 25. Ryan’s Hope funds a structured, long-term residential treatment 

for addicts, and so far they have helped send nearly 40 addicts to rehab. To help 

cover these costs, Mr. Barath has also teamed up with local first responders to organize a charity hockey game called ‘‘Hockey Against Heroin.’’ 

In Lenawee County, the Pathways Recovery Engagement Center just opened its 

doors last week. I got a chance to see the center in August when it was in the final 

stages of construction. This recovery-based program in downtown Adrian is the result of a community partnership between local police and the county sheriff’s office, 

rotary, and the local hospital system and mental health authority. 

Ryan’s Hope and the Pathways Recover Center are just two shining examples of 

constituents in my district making a difference. We need more community-based initiatives like these to get resources to those in need, but Congress also has more to 

do. 

One example is a Jessie’s Law, a bipartisan bill I introduced with Congresswoman 

Debbie Dingell. It seeks to ensure that medical professionals are equipped to safely 

treat their patients and prevent overdose tragedies. 

It’s named after Jessie Grubb, who died last year of an opioid overdose. Jessie had 

battled a heroin addiction for nearly 7 years but had been clean for six months. She 

had made a new life for herself in Michigan and was training for a marathon when 

an infection related to a running injury required her to have surgery. 

Jessie’s parents told doctors that she was a recovering addict and shouldn’t be 

prescribed opioids. Unfortunately, Jessie’s discharging physician didn’t know her addiction history and sent Jessie home with a prescription for 50 oxycodone pills. 

Jessie’s Law will ensure that physicians and nurses have access to a consenting 

patient’s complete health information when making treatment decisions. Such information is crucial to provide patient-centered care, prevent relapses and ultimately, 

save lives. 

As we work together to address this crisis, it is my hope the stories and ideas 

shared today will inform our efforts and ensure we pursue meaningful solutions that 

remove obstacles to care and empower local communities to tackle the opioid crisis 

head on. 

Mr. BURGESS. Gentleman yields back. The Chair thanks the gentleman, and I believe this concludes all the Energy and Commerce 

members seeking to give testimony. If any arrive, we will allow 

them to testify as they come in. 

But I think our panel now will be Chairman Rogers, Mr. Marshall of Kansas, Mr. Turner, mayor of Dayton, Ohio. 

Mrs. Bustos, if you wish to join us now, that would be good as 

well. And Chairman Rogers, thank you for being here and being 

part of this discussion this morning. You are recognized, sir. 

STATEMENT OF HON. HAROLD ROGERS, A REPRESENTATIVE 

IN CONGRESS FROM THE COMMONWEALTH OF KENTUCKY 

Mr. ROGERS. Well, thank you, Mr. Chairman, and colleagues. 

Thank you for hosting us on this very, very important topic. 

Over the past 15 years, many of you have heard me advocate for 

a holistic approach to the calamity that we face, including enforcement, prevention, and treatment measures like those successfully 

implemented by Operation Unite in Kentucky. 

We need to further encourage regional collaboration on this issue 

that ignores lines on a map, and I hope to work with the committee 

on this issue in the future. 

Today, however, Mr. Chairman, I would like to focus on treatment. Despite the light we’ve shown on addiction, only 10 percent 

of those needing treatment for alcohol or drug-related addiction actually receive it—10 percent. 

Underlying challenges in the treatment workforce further compound this lack of access. There are simply not enough incentives 

46 

for health professionals in training to specialize in addiction medicine. 

Treatment professionals work in stressful environments, receive 

relatively low pay, and turn over at rates much higher than other 

health professionals. 

NIH continually pioneers research on addiction science and new 

ways to treat this chronic disease. Yet, America has only half the 

number of practising addiction specialists needed to put their findings in practice. 

This is a patient safety and public health calamity. Patients in 

need of addiction treatment often have access to specialized care in 

every corner of the country. 

That is why I will soon be introducing legislation with my colleague, Katherine Clark, to create a student loan repayment program for qualified substance use disorder treatment professionals. 

This program will not only encourage health professionals to pursue careers in addiction medicine but steer them towards areas 

most in need of their services. 

Though it is not a silver bullet, this bill would be another substantial step in the right direction and I hope to work with each 

of you, Mr. Chairman and members, to this end and I thank you 

for allowing us here today. 

I yield. 

[The prepared statement of Mr. Rogers follows:] 

PREPARED STATEMENT OF HON. HAROLD ROGERS

Thank you, Mr. Chairman. I appreciate you holding this hearing to discuss Congress’ continued work on opioid misuse and abuse. Over the past 15 years, many 

of you have heard me advocate for a holistic approach to addiction, including enforcement, prevention, and treatment measures like those successfully implemented 

by Operation UNITE in Kentucky. We need to further encourage regional collaboration on this issue that ignores lines on a map. I hope to work with the committee 

on this issue in the future. 

Today, however, I’d like to focus on treatment. Despite the light we’ve shone on 

addiction, only 10 percent of those needing treatment for alcohol- or drug-related addiction actually receive it. Underlying challenges in the treatment workforce further 

compound this lack of access. 

There are simply not enough incentives for health professionals in training to specialize in addiction medicine. Treatment professionals work in stressful environments, receive relatively low pay, and turnover at rates much higher than other 

health professionals. NIH continually pioneers research on addiction science and 

new ways to treat this chronic disease, yet America has only half the number of 

practicing addiction specialists needed to put their findings in practice. 

This is a patient safety and public health calamity. Patients in need of addiction 

treatment ought to have access to specialized care in every corner of this country. 

That is why I will soon be introducing legislation with my colleague Katherine 

Clark to create a student loan repayment program for qualified substance use disorder treatment professionals. This program will not only encourage health professionals to pursue careers in addiction medicine, but steer them towards areas most 

in need of their services. 

Though it’s not a silver bullet, this bill would be another substantial step in the 

right direction. I hope to work with each of you to this end and I thank the chairman for having me today. 

Mr. BURGESS. Chair thanks the gentleman. Gentleman yields 

back. 

Will the gentleman from Georgia, an Energy and Commerce 

member, wish to join us at the table and, Mr. Carter, if you are 

ready I will recognize you for 3 minutes. 

47 

STATEMENT OF HON. EARL L. ‘‘BUDDY’’ CARTER, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF GEORGIA 

Mr. CARTER. Thank you, Mr. Chairman and Ranking Member 

Green. 

I want to start my testimony by thanking you for holding today’s 

hearing for soliciting input from Members on how to continue to 

combat this growing epidemic. 

As a pharmacist, I have always made it a priority to advise and 

assist my patients with the medications they are prescribed. As a 

community pharmacist, I develop close bonds with people who are 

often my friends and neighbors. That bond pushes pharmacists to 

always act proactively in helping their patients. 

One of the largest concerns I have seen is the increased prescribing of opioids for pain relief. We need to look at other options 

and other outlets for the treatment of pain and find a good medium. I believe we can work with the FDA to prioritize nonopioid 

treatments for patients and create a channel for the approval of 

those therapies. 

In addition, as it currently stands, prescribers are able to write 

up to three 30-day prescriptions or Schedule II drugs for patients. 

I believe it would be pertinent to reexamine that prescribing structure and look at the effectiveness of allowing fewer initial prescriptions and a limited number of refills rather than three months of 

prescriptions. 

Similar to that notion, allowing pharmacists to have a greater 

say in limiting the number of pills filled in a prescription could 

help to address the transition to addiction. 

For instance, limiting the fill for acute pain needs such as a dental procedure could help prevent an individual from getting hooked 

on opioids. 

Under CARA, a pharmacist is only able to partially fill a prescription with the consent of the patient or prescriber or in the instance it doesn’t have enough stock to fully fill a prescription. 

A simple seven-day fill could cover their pain needs and keep 

more pills out of potential use or circulation. Prescription drug 

monitoring programs—PDMPs—are a great resource in combatting 

prescription drug abuse. But they can be strengthened to better 

curb this epidemic. 

One way to do so is to better align the data including in those 

PDMPs so that States can collaborate to create a more comprehensive picture of people’s drug use. Further linking State PDMPs and 

including data in work flows could allow for more accuracy in how 

States monitor and respond to potential abuses. 

Drug take-back programs continue to expand across the country. 

Currently, at least 19 States have some form of drug take-back programs and 23 States have programs allowing pharmacists to accept 

unused and unwanted drugs. 

One of the most common ways in which adolescents access prescription drugs is through the drug cabinets of their parents and 

grandparents. 

Too often these unused pills can act as a gateway to further 

abuse by young adults. Expanding these programs through law enforcement pharmacies or paid-for mail programs can take some of 

these prescription drugs off the street. 

48 

The creation of middle grounds of therapies will provide for alternatives that are missing in today’s market. By facilitating research 

and development, we can help drive the expensive and time-consuming efforts needed to make those treatments a reality. 

Currently, there are few options left between Tylenol, Tramadol, 

and opioids, and that void is driving prescription decisions across 

the country. 

So thank you, Mr. Chairman and committee, for the opportunity 

to provide testimony here today and I look forward to working with 

everyone to tackle this issue. 

[The prepared statement of Mr. Carter follows:] 

PREPARED STATEMENT OF HON. EARL L. ‘‘BUDDY’’ CARTER

Chairman Burgess and Ranking Member Green, I want to start my testimony by 

thanking you for holding today’s hearing and for soliciting input from Members on 

how to continue to combat this growing epidemic. 

As a pharmacist, I have always made it a priority to advise and assist my patients with the medications they are prescribed. As a community pharmacist, I developed close bonds with people who were often my friends and neighbors. That 

bond pushes pharmacists to always act proactively in helping their patients. 

One of the largest concerns I have seen is the increased prescribing of opioids for 

pain relief. We need to look at other options and other outlets for the treatment of 

pain and find a good medium. I believe we can work with the FDA to prioritize 

nonopioid treatments for patients and create a channel for the approval of those 

therapies. 

In addition, as it currently stands, prescribers are able to write up to three 30- 

day prescriptions for schedule two drugs for patients. I believe it would be pertinent 

to reexamine that prescribing structure and look at the effectiveness of allowing 

fewer initial prescriptions and a limited number of refills rather than 3 months of 

prescriptions. 

Similar to that notion, allowing pharmacists to have a greater say in limiting the 

number of pills filled in a prescription could help to address the transition to addiction. For instance, limiting the fill for acute pain needs, such as a dental procedure, 

could help prevent an individual from getting hooked on opioids. 

Under CARA, a pharmacist is only able to partially fill a prescription with the 

consent of the patient or prescriber or in the instance it doesn’t have enough stock 

to fully fill a prescription. A simple, seven-day fill could cover their pain needs and 

keep more pills out of potential use or circulation. 

Prescription drug monitoring programs (PDMPs) are a great resource in combating the prescription drug abuse, but they can be strengthened to better curb this 

epidemic. One way to do so is to better align the data included in those PDMPs so 

that States can collaborate to create a more comprehensive picture of people’s drug 

use. Further linking State PDMPs and including data and work flows could allow 

for more accuracy in how States monitor and respond to potential abuses. 

Drug take-back programs continue to expand across the country. Currently, at 

least 19 States have some form of drug take back programs and 23 States have programs allowing pharmacies to accept unused and unwanted drugs. One of the most 

common ways in which adolescents access prescription drugs is through the drug 

cabinets of their parents and grandparents. Too often, these unused pills can act 

as a gateway to further abuse by young adults. Expanding these programs through 

law enforcement, pharmacies, or a paid-for mail programs can take some of these 

prescriptions drugs off the street. 

The creation of a middle ground of therapies will provide the alternatives that are 

missing in today’s market. By facilitating research and development, we can help 

drive the expensive and time-consuming efforts needed to make those treatments a 

reality. Currently, there are few options left between Tylenol, Tramadol and opioids 

and that void is driving prescribing decisions across the country. We have an opportunity to support the efforts of NIH through public-private partnerships to address 

this and other issues. 

Finally, as a lifelong pharmacist, I am never short of amazed at how my colleagues in our profession continue to evolve and excel in their roles advising patients. We now have an opportunity to capitalize on existing progress and to work 

with the administration, the FDA, and outside groups to right the ship on opioid 

49 

abuses. I thank the committee for the opportunity to provide testimony and I look 

forward to working with everyone to tackle this issue. 

Mr. BURGESS. The Chair thanks the gentleman. The gentleman 

yields back. 

The Chair recognizes the gentlelady from Illinois, Mrs. Bustos, 

for 3 minutes, please. 

STATEMENT OF HON. CHERI BUSTOS, A REPRESENTATIVE IN 

CONGRESS FROM THE STATE OF ILLINOIS 

Mrs. BUSTOS. All right. Thank you, Mr. Chairman, and also 

Ranking Member Green. 

I would like to start out by telling you a story about a young man 

from my congressional district in Rockford, Illinois. His name is 

Chris Boseman. I had the good fortune of meeting his mother, who 

told me this story. 

Chris passed away in the summer of 2014 when he was only 32 

years old. He had injured his back and as a result of that his physician prescribed an opioid to relieve his pain. Soon after that, he became dependent upon those—that prescription opioid and found out 

that he could go to the street and find something very cheap called 

heroin—$10. 

So he continued the cycle of overdose, rehab, relapse, and he was 

on the right path. He enrolled in a college called Rock Valley College, where he was studying construction management. 

But a year after being clean, he relapsed again and ended up 

passing away. And we know stories very similar to this are happening all over our country. 

And I was so proud when we came together, Democrats and Republicans, and actually passed some meaningful legislation on—to 

help address this opioid crisis. 

One of those bills that was included in that was to care for infants born with an opioid dependency due to their parents’ addiction. In fact, we received the Government Accountability report 

that my bill called for very recently, and it reviews and makes recommendations to care for these infants. 

But what it really ended up showing is that we have a very long 

way to go. The Department of Health and Human Services has a 

strategy for improving infant care, but they haven’t yet put this 

into practice. 

There is not even a protocol to screen and treat these newborn 

babies who are born addicted because of their parents’ addiction. 

So it further reinforces that this is not the time to cut Medicaid. 

Medicaid pays for four out of every five babies that are suffering 

from opioid withdrawal upon their birth. It has helped 1.6 million 

people with substance abuse disorders and access to treatment. 

And I just really more than anything want to make the point 

that Medicaid has to be protected and not cut. 

I want to stress one other point because of the congressional district that I represent and that is that the opioid crisis is actually 

worse in rural communities where the drug-related deaths are actually 45 percent higher. 

Rural States have higher rates of overdose, especially prescription opioids like the kind that Chris had been prescribed for his 

back injury. 

50 

So, you know, we don’t have the resources to fight back at the 

level that we need to. We don’t have enough physicians in rural 

America. 

We don’t have enough hospitals that are—with up-to-date technology to help with this crisis. We don’t even have the needed 

transportation to reach these treatment centers. 

So that is why earlier this year I introduced bipartisan piece of 

legislation to help rural communities better leverage the U.S. Department of Agriculture programs to combat heroin and opioid use. 

So we need to continue to look at solutions that work in rural 

areas like telemedicine, which will help us overcome the transportation and access issues that I mentioned earlier. 

With that, Mr. Chairman, I yield back the rest of my time. 

Thank you. 

[The prepared statement of Mrs. Bustos follows:] 

PREPARED STATEMENT OF HON. CHERI BUSTOS

Thank you Chairman Walden and Ranking Member Pallone. 

Let me tell you about a young man from Rockford, Illinois named Chris Boseman. 

Chris passed away in the summer of 2014. He was 32 years old. 

He was a kind, tender-hearted son and brother. A back injury led to a painkiller 

prescription that he soon became dependent on. 

And when he could no longer fill that prescription, he began buying pain medication on the street. 

But as the costs added up, his dealer told him that heroin would give him the 

same effects . for only $10. 

After a continuing cycle of overdose, rehab, and relapse, Chris was enrolled in 

Rock Valley College and studying construction management when, after a year of 

being clean, he relapsed and died. 

This is happening every day, all across the country. 

I was proud that Congress came together last summer to pass legislation that 

helps communities address the opioid crisis. 

Which included my bill to improve care for infants born with an opioid dependency due to their parents’ addiction. 

In fact, we just received the GAO’s report that my bill called for. 

It reviews and makes recommendations to care for these infants. But really what 

it shows is that we have a long way to go. 

HHS has a strategy for improving infant care. 

But they haven’t put it into practice yet. 

There is not even a protocol to screen and treat these newborn babies who, 

through no fault of their own, are addicted. 

Which further reinforces that this is not the time to cut Medicaid, which pays to 

treat over 80 percent—that’s four out of every five—of our newborns suffering from 

opioid withdrawal. 

And helped 1.6 million people with substance abuse disorders to access treatment. 

It has dropped the uninsured rate for the mentally ill down to 5 percent in expansion States. 

Medicaid must be protected, not cut. 

And I want to stress another point: the opioid crisis is worse in rural communities, where drug-related deaths are 45 percent higher. 

Rural States have higher rates of overdose, especially from prescription opioids 

like the kind Chris was given by his doctor. 

And we just don’t have the resources to fight back. 

We don’t have enough doctors. 

We don’t have hospitals with up-to-date technology and services. 

And we don’t have public transportation to reach the right treatment centers. 

That is why earlier this year I introduced bipartisan legislation to help rural communities better leverage USDA programs to combat opioid and heroin use. 

We need to continue to look at solutions that work in rural areas, like telemedicine, which will overcome transportation and access issues. 

Thank you. I am happy to yield back. 

51 

Mr. BURGESS. Chair thanks the gentlelady. Gentlelady yields 

back. 

Chair recognizes the gentleman from Dayton, Ohio, Mr. Turner, 

for 3 minutes, please. 

STATEMENT OF HON. MICHAEL R. TURNER, A 

REPRESENTATIVE IN CONGRESS FROM THE STATE OF OHIO 

Mr. TURNER. Thank you, Chairman Burgess, Ranking Member 

Green, and members of the subcommittee. I want to thank you for 

the opportunity to appear before you today on this important issue. 

As the chairman said, I come from Dayton, Ohio. My counties in 

Ohio are Montgomery, Greene, and Layette, and despite our communities’ efforts to battle the opioid epidemic for years, the epidemic continues to destroy my community and my constituents on 

a daily basis. 

This year, current estimates suggest that 800 people could die in 

my primary county—Montgomery County—due to opioid overdose. 

Sadly, that would more than double the 371 drug overdose deaths 

from 2016, the highest number recorded to date. Imagine 800 families receiving notice that someone in their family has died as a result of opioid overdose. 

Heartbreaking numbers like this have made Montgomery County, Ohio, ground zero in the fight against opioid abuse and addiction. 

Recently, in working in conjunction with the county sheriff I 

have called for the appointment of a Dayton area drug czar to help 

us streamline and coordinate our region’s response to this epidemic. 

While I have worked on a local basis to help stem this tide, today 

I would like to highlight my bill, H.R. 982, the Reforming and Expanding Access to Treatment Act—the TREAT Act. 

As the title suggests, the TREAT Act would increase access to 

substance abuse treatment by lifting two restrictions that hamstring full deployment of Federal resources. 

Medicaid’s Institutions for Mental Disease Exclusion States that 

facilities with more than 16 beds, like jails, are not eligible for reimbursement for substance abuse treatment services furnished to 

individuals who are incarcerated. 

Composing the problem, a Substance Abuse and Mental Health 

Administration Policy dating to 1995 limits the use of grants from 

its Center for Substance Abuse Treatment—CSAT—to only community-based treatment facilities excluding those who are incarcerated. 

My Treatment Act offers a common sense solution that would 

eliminate these barriers to treatment for individuals who are incarcerated by allowing Medicaid to reimburse for substance abuse 

treatment services furnished to individuals who are incarcerated. 

There is not reason why someone who is Medicaid eligible should 

lose their benefits the moment they become incarcerated. 

Limiting the SAMHSA policy that prohibits the use of grant 

funding for providing substance abuse treatment to individuals 

who are incarcerated would also assist. 

Since I first introduced the TREAT Act in November of 2015 and 

then reintroduced it in this Congress it has garnered a broad specVerDate Mar 15 2010 09:50 Oct 11, 2018 Jkt 037690 PO 00000 Frm 00057 Fmt 6633 Sfmt 6633 C:\USERS\WLAUFERT\DESKTOP\115X64MEMBERSOPIOIDSPDFMADE WAYNE
52 

trum of support from law enforcement to medical providers to local 

jurisdictions. 

The President’s Commission on Combatting Drug Addiction and 

the Opioid Crisis Interim Report, which was just issued July 31st, 

2017, strongly endorsed this concept that is in the TREAT Act. 

The White House Commission called lifting Medicaid’s IMD exclusions, quote, ‘‘the single fastest way to increase treatment availability across the Nation, noting that every Governor, numerous 

treatment providers, parents, and nonprofit advocacy group organizations have urged this course of action.’’ 

Chairman Burgess, Ranking Member Green, and members of the 

subcommittee, lives are at stake. This would be an important step 

to bring treatment to those individuals who are at a time we have 

an ability to intervene in their lives. 

Thank you. 

[The prepared statement of Mr. Turner follows:] 

PREPARED STATEMENT OF HON. MICHAEL R. TURNER

Chairman Burgess, Ranking Member Green, and members of the subcommittee, 

thank you for the opportunity to appear before you today. 

I am Congressman Michael R. Turner, and I proudly represent Ohio’s 10th Congressional District, which centers around the city of Dayton and includes Montgomery, Greene, and Fayette counties. 

This morning, I will briefly explain how the opioid epidemic is ravaging the district I serve and propose possible solutions to what has become a national crisis of 

frightening proportions. 

Despite battling against it for years, the heroin and opiate epidemic continues to 

destroy my community and my constituents on daily basis. 

This year, current estimates suggest that 800 people could die in Montgomery 

County alone due to an opiate overdose. Sadly, that would more than double the 

371 drug overdose deaths from 2016, the highest number recorded to date. 

The Montgomery County morgue regularly surpasses capacity and has even been 

forced to use refrigerated trailers to house victims’ bodies. The coroner has described 

what is occurring as a ‘‘mass-casualty event.’’ 

To make matters worse, deadly synthetic opioids like fentanyl, which can be 50 

times stronger than heroin, and carfentanil, which can be 5,000 times stronger, 

have flooded the Miami Valley. 

It is heartbreaking numbers and stories like these that have made Montgomery 

County, Ohio ‘‘the overdose capital of America’’—meaning that, per capita, more of 

my Montgomery County constituents are dying as a result of drug overdoses than 

anywhere else in the United States. 

Our struggle in southwestern Ohio mirrors that of countless other areas across 

the country—91 Americans die every day as the result of an opioid overdose. 

These sobering statistics paint a picture of a country facing an exponentially 

growing epidemic of opioid abuse that is resulting in drastic increases in addiction 

rates, overdose deaths, and incarceration. The opiate crisis is tearing apart families, 

neighborhoods, cities, and indeed our society as a whole. 

While I have spearheaded several initiatives—in conjunction with State and local 

partners—to stem the tide of the opioid epidemic, today I would like to highlight 

my bill H.R. 982, The Reforming and Expanding Access to Treatment (TREAT) Act. 

As the title suggests, my TREAT Act would increase access to substance abuse 

treatment by lifting archaic restrictions that hamstring full deployment of Federal 

resources. The concept behind my TREAT Act originated from a tour of my district’s Greene 

County Jail and Green Leaf Alcohol & Drug Treatment Program in August 2015. 

During the visit, I discovered that individuals who are incarcerated cannot receive 

substance abuse treatment through Medicaid, even if they are otherwise eligible. 

This is due to Medicaid’s Institutes for Mental Disease (IMD) exclusion, which 

states that facilities with more than 16 beds—like jails—are not eligible for reimbursement for substance abuse treatment services furnished to individuals who are 

incarcerated. 

Compounding the problem, the Substance Abuse and Mental Health Administration (SAMHSA) currently prohibits the use of grants from its Center for Substance 

53 

Abuse Treatment (CSAT) for substance abuse treatment services provided to individuals who are incarcerated. Instead, this over 20-year-old policy limits use of such 

grants to only community-based treatment facilities. 

These unnecessary restrictions act as obstacles, limiting our flexibility in how we 

employ the Federal resources that are so desperately needed to combat this growing 

epidemic and supply medical treatment to individuals suffering from substance 

abuse disorders and addiction. 

My TREAT Act offers a common-sense solution that would eliminate these barriers to treatment for individuals who are incarcerated by: • Allowing Medicaid to reimburse for substance abuse treatment services furnished to individuals who are incarcerated; and • Lifting the SAMHSA policy that prohibits the use of grant funding for providing 

substance abuse treatment to individuals who are incarcerated. 

Since I first introduced the TREAT Act in November 2015 and reintroduced it this 

Congress, it has garnered a broad spectrum of support from law enforcement to 

medical providers to local-level jurisdictions. 

The President’s Commission on Combating Drug Addiction and the Opioid Crisis’ 

Interim Report, issued July 31, 2017, strongly endorsed the TREAT Act’s core concept. 

The White House Commission called lifting Medicaid’s IMD exclusion the ‘‘single 

fastest way to increase treatment availability across the Nation,’’ noting that ‘‘every 

Governor, numerous treatment providers, parents, and nonprofit advocacy organizations’’ have urged this course of action in an effort to combat the opioid epidemic. 

Chairman Burgess, Ranking Member Green, and members of the subcommittee, 

my constituents’ lives and indeed the well-being of my entire community are at 

stake here, as are many of yours. They are under assault from an opioid epidemic, 

the likes of which have never been seen. 

My TREAT Act can help put an end to the opiate crisis-but it cannot wait any 

longer. I urge you to work with me to report the TREAT Act out of committee, and 

support its passage in the House of Representatives. 

Thank you for the opportunity to speak with you today, and I look forward to addressing any questions or concerns you may have. 

Mr. BURGESS. Chair thanks the gentleman. The gentleman yields 

back. 

Chair recognizes the gentleman from Kansas, Dr. Marshall, for 

3 minutes. 

STATEMENT OF HON. ROGER W. MARSHALL, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF KANSAS 

Mr. MARSHALL. Thank you, Chairman, very, very much. Appreciate—thank you, Chairman, for the opportunity to come and talk 

and share some of my 30 years of experience as an OB/Gyn in rural 

Kansas. 

As most of the members of the committee know, 92 people die in 

this country every day. Ninety-two people die in this country every 

day from opioid addiction. 

What I wanted to do was describe a couple sentinel events. Why? 

Why did we end up in this situation? And as I—as I look back in 

these last 10 years, the number of pills that I would send home for 

a post-op patient doubled. 

For the average C-section, the average hysterectomy, all of a sudden each week, to get the people to that post-op visit the number 

of pills they would need literally doubled. 

So I went back to try to figure out why and how come, and the 

first thing I think of, the Patient Bill of Rights came about 1993 

or so, and over the next 10 years, though it was a great document, 

patients suddenly began to expect that they should have no pain— 

no pain after surgery. They would come into the ER with a 

sprained ankle and expect to have no pain and the demand for narcotics went up and up. 

54 

Somewhere in the early 2000s, something was introduced called 

a pain scale and they called it the fifth vital sign. It is probably 

the worst thing I’ve ever seen introduced in my medical career 

where they suddenly described the amount of pain, which is very 

subjective, and beyond that it eventually became part of a measure 

of how good a medicine you were practising, even tied to your reimbursement. 

So suddenly patients in the post-op PACU area were getting double and triple the medications, and then on the post-operative floor, 

rather than getting Percocets every 6 hours, they were getting 

them every 4 hours and the PCA pumps increased doses. 

So what I am trying to say is we almost doubled the amount of 

narcotics people were getting in the hospital and then they wanted 

twice the amount to go home with as well. 

So physicians were faced with this struggle of saying well, I don’t 

think you need this much, but patients becoming more and more 

in control of how many—of their own health care. 

So I think those are a couple of reasons why we ended up here 

and I think there needs to be some reeducation done. I would like 

to point towards Valley Hope at Norton, Kansas. They have treated 

over 300,000 patients over the past 50 years. They have kept incredible statistics. They have incredible treatment plans. 

And what they taught me is about a month after release—a 

month after they started their Path to Recovery that they had a 

second physiological reaction and that is when they—these people 

OD and die. People need to recognize that for a month that they 

need to have very close treatment and probably for two months, 

then even a year. 

So it’s during that second episode when they—when before they 

had treatment they were taking a certain amount of heroin and a 

handful of pills and a pint of whiskey. When they retreated from 

that for a month and they went back to that same dose, they 

overdosed and stopped dying. 

We need to understand what kills people is that—that if I gave 

anybody enough morphine you would stop breathing. So they are 

unable to metabolize it. We need to recognize that that is a very 

critical moment. Treatment plans cannot last a week. 

They’re going to last months and years probably. We need to 

make sure we are adequately funding outpatient treatment and 

that we are making sure that there is good follow-up at home and 

we need to reward facilities like Valley Hope who have great outcomes—great long-term outcomes. 

Mr. Chairman, thank you so much for taking on this task and 

look forward to working with you, as always. 

[The prepared statement of Mr. Marshall follows:] 

PREPARED STATEMENT OF HON. ROGER W. MARSHALL

As a practicing physician for nearly 3 decades, and now a freshman Congressman, 

I have had a unique perspective from which to understand the causes, and to identify solutions for the opioid crisis we face. 

Over the last decade, it has become clear that many actions taken by the medical 

community to better-address pain, such as pain-scales, and stronger pain treatments 

for chronic diseases or cancer, have helped fuel an opioid epidemic that is killing 

an unprecedented number of Americans. 

55 

While we began to improve the restrictions on prescribing these painkillers, tens 

of thousands of addicted people turned to street-level drugs as cheap, potent alternatives. 

Today, I don’t pretend to have all the answers or solutions to this complex situation, but there are some simple things already being done that have proven successful. 

One part of the solution is quality community addiction treatment. For 50 years, 

Valley Hope in Norton, KS, has treated over 300,000 patients. They address substance-abuse as a chronic health care problem, just like you would treat hypertension or diabetes. They don’t treat it as some sort of moral deficiency. 

Valley Hope also recognizes that opioid addiction has a second withdrawal about 

a month after stopping the use of narcotics. It is that secondary withdrawal that 

patients are most likely to overdose. Patients go back to taking the amount of drugs 

they usually took to get high. Their bodies cannot metabolize like they used to, and 

the patient overdoses and stops breathing. 

The key to avoiding these disasters is to maintain contact through weekly follow 

ups and outpatient checkups. The future treatment for opioid abuse will be found 

in rewarding good outpatient management, and institutions that pride themselves 

in low rates of readmission and relapse. 

Solving this crisis begins in the doctor’s office. Physicians, nurses and patients 

must all be willing to understand the potential for addiction when the prescribe, administer or take medications. 

When we pair this understanding with capable community treatment, along with 

respect, compassion and empathy toward those suffering, we will have taken the 

first steps to overcome this challenge. 

Mr. BURGESS. Chair thanks the gentleman. Gentleman yields 

back. 

The Chair recognizes the gentleman from Ohio, Chairman Stivers, for 3 minutes. 

STATEMENT OF HON. STEVE STIVERS, A REPRESENTATIVE IN 

CONGRESS FROM THE STATE OF OHIO 

Mr. STIVERS. Thank you very much, Mr. Chairman. I appreciate 

you holding this hearing. Appreciate Ranking Member Green and 

all of you looking at solutions that—for this opioid crisis that is 

plaguing all of the communities across this country. 

Congressman Turner already alluded to it, but in Ohio opioid 

overdoses now exceed car accidents as the leading cause of death 

for most Ohioans. 

And there have been a lot of great ideas presented here today 

and I really have appreciated learning from many of our colleagues. 

I, for the last 5 years, have held opioid round tables—drug round 

tables in my district to talk about solutions and we have come up 

with some ideas from the field of folks that know what is driving 

this crisis. 

And I will talk about some medical things in a second but the 

first thing I know we have to do is bring back hope and economic 

opportunity to people and I think what you are doing, Mr. Chairman, with regulatory reform and what we are doing with tax reform is going to help with that. 

But there are a lot of other things we can do. First, you know, 

the idea that came out of our round table this year was on evidence-based treatment. If you’ve been to one treatment facility you 

have been to one treatment facility, because they all do things differently. 

Too many of them do things that when you walk out that door, 

there is nothing tying you to the treatment anymore and that is 

56 

a problem, and they need to—I think we should have evidencebased treatment. 

It should be based on the science of the day and how recovery 

works, and I think we need to build that into our reimbursement 

standards. I think that is so important. 

Dr. Marshall already talked about the second issue I want to 

bring up, which is pain as a vital sign. Every other vital sign you 

can think of—you know, your temperature, your blood pressure, 

your pulse—can be measured by a machine. Pain can’t be measured by a machine. 

It is a subjective number and it should not be the fifth vital sign. 

It has led to our over prescribing culture in this country and we 

have to try to fix it. 

I appreciate what CMS has done to remove the reimbursement 

based on the surveys of pain management. But I think we need to 

remove pain as a vital sign. 

The third idea is encouraging alternatives. There is lots of ways 

to manage pain including acupuncture, chiropractic services, and 

other things that don’t involve a pill and I think we need to change 

the culture on that. 

The fourth idea is some prescription changes and I know that 

Buddy Carter, who is a pharmacist, talked about a couple of these. 

I sponsored the partial fill legislation that was rolled into CARA 

and became law. But I believe that pharmacists should be empowered to authorize partial fill of opioid prescriptions on their own. 

And Buddy already said it, but 70 percent of the folks who misuse prescriptions get it at some point—bridge that addiction 

through their friends’ and families’ medicine cabinets and we have 

got to fix that. 

The final issue that I don’t hear talked about enough is tapering 

doses. When somebody is on an opioid for about 30 days, they have 

a physical addiction to it and if you talk to most pharmacists they 

will talk about a tapering does instead of going off cold turkey, and 

I think that is something we need to bring a culture around of having folks understand that because a lot of primary care physicians, 

Mr. Chairman, feel very uncomfortable with doing—issuing more 

prescriptions but a tapering does actually will reduce the physical 

addiction and actually will result in less people wanting to feed 

that addiction in other ways. 

So those are just five ideas of some proposed solutions. Many of 

my colleagues also have great ideas. I really appreciate, Mr. Chairman and Ranking Member, you holding this hearing and we are 

committed to working with you to driving this scourge of drug addiction out of this country, and I really appreciate what you are 

doing. 

I yield back. 

[The prepared statement of Mr. Stivers follows:] 

PREPARED STATEMENT OF HON. STEVE STIVERS

Thank you Chairman Burgess and Ranking Member Green for having this hearing today to discuss solutions for addressing the opioid crisis plaguing communities 

across America. 

We have seen drug overdoses surpass traffic accidents as the leading cause of accidental death in the United States. 

57 

This issue affects everyone—no matter your race, income level, gender, or political 

party. We need to work together to curb this epidemic. 

MY DISTRICT

Ohio has been devastated by this crisis. In 2016, 4,050 Ohioans died from an unintentional drug overdose. This was a 32.8 Percent increase from 2015 (3,050). 

In my district alone, there were 112 overdose deaths in 2015, according to the 

Ohio High Intensity Drug Trafficking Area. 

Because of how much this has affected my district, I have held roundtables for 

the past 5 years to bring together people from all sides of the issue to discuss how 

we can better work together to address this issue in Ohio. 

EVIDENCE-BASED TREATMENT

In one of my recent roundtables, we discussed how we need to ensure that we 

support only the treatments that are proven to work and are evidence-based. 

Based on these discussions, we have learned of a serious need to raise the evidenced based standards that are used in approving treatment programs that are 

largely funded by the Federal Government and administered at the local level. 

The Ohio Department of Mental Health and Addiction Services estimates that almost 500,000 Ohioans receive publicly funded mental health services, which includes addiction treatment, every year. 

Whether it be a discrepancy between accreditation standards, or inadequate reporting requirements, Congress should be ensuring that Federal funds going to 

Ohio, and to my district, are going towards treatments that are based on a foundation of evidence as to its efficacy. 

Simultaneously, we need to promote data collection and research in order to better inform our evidence-based efforts over time, so that we do not discourage emergent therapies and can justify deploying innovative approaches that can meet this 

epidemic head on. 

PAIN AS A VITAL SIGN

Another issue we discussed is removing pain as the fifth vital sign and finding 

ways to change the culture surrounding pain management and the overprescription 

of opioids. 

Pain being considered a vital sign can, in some cases, lead to the overprescribing 

of opioids by focusing on pain management instead addressing and treating the underlying causes of pain. 

This culture of overprescribing has also been found in patient-reported satisfaction scores. On these surveys, ‘‘pain management’’ is a section doctors and hospitals 

have been scored on. 

Poor marks in satisfaction scores can lead to lower reimbursements for these doctors and hospitals, and this attempt to manage pain, while well intentioned, created 

a perverse incentive that led to some health care professionals to work towards a 

score, rather than the best overall health of the patient. 

Recently, CMS has announced that they will no longer be directly tying these 

‘‘pain management’’ questions to the Hospital Value-Based Purchasing Program, 

starting next year. 

I am encouraged by CMS’s recent actions. By building upon these actions and 

working to remove the use of pain as a vital sign, we can remove the incentive to 

overprescribe opioids to patients, and rather focus on prescribing them when they 

are absolutely necessary. I implore the committee to learn from this example to ensure further policies are always focused on the long term health of the patient over 

short term benchmarks and quotas. 

ENCOURAGING ALTERNATIVES

As we seek to change the culture of pain management, we also need to find ways 

to support and bolster alternative methods for treating and managing pain—outside 

of opioids. 

This can include treatment options such as chiropractic services and acupuncture. 

There is no doubt that we should ensure patients can receive the medicine they 

need, but overreliance as a quick and easy fix must be discouraged when there are 

other alternatives that could be used. 

58 

TAPERING OPIOID USE

Furthermore, as you know, last year, the passage of the Comprehensive Addiction 

and Recovery Act (CARA) was one of the highlights in the fight against opiate addiction. 

Language from my legislation, the Reducing Unused Medications Act was included in the final passage of CARA. This bill allows for the partial fill of prescriptions at the request of patients or doctors, reducing the number of unused painkillers that can be abused or diverted. 

With more than 70 percent of adults who misuse prescription opioids getting them 

from medicine cabinets of friends or relatives, we needed to reduce unused medications in homes. 

Now, we need build on that legislation. One way to do that is to focus on supporting better education and protocols for physicians to taper down the dosages of 

prescribed opioids over the course of treatment. 

This approach must be specific to each patient, and we should be finding ways 

to encourage better conversations about pain management between patients, their 

doctors, and their pharmacists. 

I look forward to working with this committee to find better ways to better inform 

patients of resources and tools at their disposal—like partial fill opportunities—and 

giving physicians more freedom to address pain management at an individual level. 

CLOSING

There is no single legislative fix for the opioid epidemic. We need to keep pushing 

to find ways to better prevent opioid abuse and treat those who are suffering from 

addiction. 

Those are just a few of the proposed solutions I am advocating, and I hope I can 

continue working with everyone on this committee to craft legislation that delivers 

relief to Ohio’s 15th District and all communities suffering from this epidemic. 

Again, I want to thank the chairman and ranking member for having this important hearing. I lookforward to working with everyone on solutions to stop the opioid 

epidemic in our country. 

Mr. BURGESS. Chair thanks the gentleman. Gentleman yields 

back, and I want to thank all of you for providing your testimony 

today. 

This panel is excused, and our next panel will be Dr. Wenstrup 

from Ohio, Mr. Schneider from Illinois, Ms. Clark from Massachusetts, Mr. Jeffries from New York, and Mr. Jenkins from West Virginia. 

And Representative Schneider, you are recognized for 3 minutes. 

STATEMENT OF HON. BRADLEY SCOTT SCHNEIDER, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF ILLINOIS 

Mr. SCHNEIDER. Thank you. Thank you, Chairman Burgess, 

Ranking Member Green, for inviting me here today to discuss the 

epidemic of opioid addiction abuse and overdose that is ravaging 

our communities. 

I represent the people of Illinois’ 10th District including parts of 

Cook and Lake Counties, and the opioid crisis has hit our 

neighbourhoods extremely hard. 

In Cook County, which includes the city of Chicago, opioid 

overdoses increased by 87.4 percent—I repeat that, 87.4 percent— 

between 2013 and 2016. 

Over the same period, we witnessed a troubling increase in 

fentanyl, a synthetic opioid which is even more deadly than heroin 

and whose overdoses are often fatal. 

In the face of these challenges, I would like to recognize the Lake 

County Opioid Initiative and Chicago area Opioid Task Force along 

59 

with other area organizations for their work to prevent opioid 

abuse, addiction, overdose, and health—and death, rather. 

In this epidemic, our adversary is constantly shifting. So must 

ensure our doctors are up to date with the most recent best practices and research for preventing and treating this disease. 

Earlier this year, I introduced a bill called the Preventing Opioid 

Abuse Through Continuing Education, or Opioid PACE Act. This 

bill would require providers who treat patients will prescription 

opioids for pain management to complete 12 hours of continuing 

education every 3 years. 

This would be linked to renewal of the providers’ Drug Enforcement Agency license. In an effort to cut down on over prescribing, 

the CME would focus on pain management treatment guidelines 

and best practices, early detection of opioid use disorder, and the 

treatment and management of patients with opioid use disorder. 

I am proud that a modified version of this bill requiring continuing education of medical professionals at the Department of 

Defense was included as an amendment to the NDA authorization. 

Our men and women in uniform are not immune from the damages of opioid addiction. In fact, the National Institute of Health 

reports rates of prescription opioid misuse are higher among service members than among civilians due to the use of these drugs to 

treat symptoms of PTSD and chronic pain. 

As we seek new legislative solutions, I urge my colleagues to support these programs we have in place to fight back. In particular, 

the Affordable Care Act greatly increased our ability to counter 

opioid epidemic by expanding Medicaid and requiring individual 

market policies that they would cover services related to treating 

substance use disorders. 

The States with the highest rates of drug overdose deaths are 

also the States that would suffer from a rollback of Medicaid expansion. 

Simply put, repealing the ACA would add fuel to the fire of the 

opioid epidemic. I urge my colleagues to consider new solutions to 

address this crisis including the Opioid PACE Act and preserve the 

programs we have in place to address this epidemic. 

And with that, I yield back. 

[The prepared statement of Mr. Schneider follows:] 

PREPARED STATEMENT OF HON. BRADLEY SCOTT SCHNEIDER

Thank you, Chairman Burgess and Ranking Member Green, for inviting me here 

today to discuss the epidemic of opioid addiction, abuse, and overdose that is ravaging our communities. 

I represent the people of Illinois’ 10th District including parts of Cook and Lake 

Counties, and the opioid crisis has hit our neighborhoods hard. In 2015, there were 

42 heroin-related deaths in Lake County, a seven-percent increase over the previous 

year. In Cook County, which includes the City of Chicago, opioid overdoses increased by 87.4 percent between 2013 and 2016. Over the same period, we’ve witnessed a troubling increase in fentanyl—a synthetic opioid which is even more deadly than heroin and whose overdoses are often fatal. 

In the face of these challenges, I’d like to recognize the Lake County Opioid Initiative and Chicago Area Opioid Task Force, along with other area organizations, for 

their work to prevent opioid abuse, addiction, overdose, and death. 

In this epidemic, our adversary is constantly shifting, so we must ensure our doctors are up-to-date with the most recent best practices and research for preventing 

and treating this disease. 

60 

Earlier this year I introduced a bill called the Preventing Opioid Abuse Through 

Continuing Education or Opioid PACE Act, that would require providers who treat 

patients with prescription opioids for pain management to complete 12 hours of continuing medical education (CME) every 3 years, linked to the renewal of the provider’s Drug Enforcement Agency (DEA) license. 

In an effort to cut down on overprescribing, the CME would focus on pain management treatment guidelines and best practices, early detection of opioid use disorder, and the treatment and management of patients with opioid use disorder. 

I’m proud that a modified version of this bill requiring continuing education medical professionals at the Department of Defense was included as an amendment in 

the National Defense Authorization Act. Our men and women in uniform are not 

immune from the damages of opioid addiction. In fact, the National Institute of 

Health reports rates of prescription opioid misuse are higher among service members than among civilians due to the use of these drugs to treat the symptoms of 

PTSD and chronic pain. 

As we seek new legislative solutions, I urge my colleague to also support the programs we have in place to fight back. 

In particular, the Affordable Care Act greatly increased our ability to counter the 

opioid epidemic by expanding Medicaid and requiring individual market policies 

cover services related to treating substance use disorders. 

The States with the highest rates of drug overdose deaths are also the States that 

would suffer from a rollback of the Medicaid expansion. Simply put, repealing the 

ACA would add fuel to the fire of the opioid epidemic. 

I urge my colleagues to consider new solutions to address this crisis—including 

the Opioid PACE Act—and preserve the programs we have in place to counter the 

epidemic. 

Mr. BURGESS. Chair thanks the gentleman. Gentleman yields 

back. 

Chair recognizes Representative Jeffries from New York for 3 

minutes, please. 

STATEMENT OF HON. HAKEEM S. JEFFRIES, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF NEW YORK 

Mr. JEFFRIES. Thank you, Chairman Burgess and Ranking Member Green, for holding this hearing as well as for your leadership 

on this very important issue. Appreciate the opportunity to testify 

today on the Synthetic Drug Awareness Act of 2017—H.R. 449. 

The opioid crisis has ravaged families across the country without 

regard to zip code, income, race, religion, or gender. Like a malignant tumor, the opioid crisis is eating away at young people in 

urban American, rural America, as well as suburban America. 

One reason the opioid abuse has become so prevalent and so 

deadly is the emergence of the synthetic drug called fentanyl, a 

substance that can be 50 to 100 times stronger than morphine. 

In order to address the multifaceted public health crisis we confront, it’s important to consider both the cause and effect. H.R. 449 

addresses a critical and sometimes overlooked threat—the use of 

synthetic drugs by teenagers. 

It requires the surgeon general to prepare a comprehensive report on the public health effects of synthetic drug abuse by 12-to18-year-olds in America. 

With the information the study will provide, Congress can work 

to prevent substance abuse by younger Americans through an enhanced and enlightened lens. Nationwide, the drug overdose death 

rate has more than doubled during the past decade among younger 

Americans. 

61 

Many experts believe this troubling phenomenon results from the 

rise and availability of potent and dangerous substances like illicit 

fentanyl and other synthetic drugs. 

Teenage fentanyl use is a vicious cycle. Adolescents have a still 

developing prefrontal cortex which can facilitate drug-seeking behavior. The drug then alters the development of this area of the 

young brain, making that behavior permanent. 

In fact, more than 90 percent of adults who develop a substance 

abuse disorder begin using prior to the age of 18. In New York 

City, overdoses now kill more people each year than murder, suicides, and car crashes combined. This phenomenon we have seen 

repeated over and over again all across America. 

This bill has significant support amongst Republicans and Democrats and has been incorporated into the legislative agenda for the 

bipartisan Heroin Task Force. It also has support from a number 

of health and patient advocacy groups including the American 

Academy of Pediatrics, American Association of Nurse Practitioners, as well as the National Association of Police Organizations. 

Thank you again for this opportunity to testify and I respectfully 

respect committee consideration at your earliest convenience. 

[The prepared statement of Mr. Jeffries follows:] 

PREPARED STATEMENT OF HON. HAKEEM S. JEFFRIES

Let me first thank the leadership of the Energy and Commerce Committee, Chairman Walden and Ranking Member Pallone, and of the Subcommittee on Health, 

Chairman Burgess and Ranking Member Green, as well as the distinguished Members of the Energy and Commerce Committee for holding this hearing. I appreciate 

the opportunity to testify today on the ‘‘Synthetic Drug Awareness Act of 2017’’-H.R. 

449. 

The opioid crisis has ravaged families across the country without regard to zip 

code, income, race religion or gender. Like a malignant tumor, the opioid crisis is 

eating away at young people in urban, rural and suburban America. One reason 

opioid abuse has become so prevalent, and so deadly, is the emergence of the synthetic drug called fentanyl-a substance that can be 50 to 100 times stronger than 

morphine. 

In order to address the multifaceted public health crisis, we must consider both 

the cause and effect. H.R. 449 addresses a critical and sometimes overlooked threat, 

the use of synthetic drugs by teenagers. It requires the Surgeon General to prepare 

a comprehensive report on the public health effects of synthetic drug use by 12-to18-year-olds in America. With the information this study will provide, Congress can 

work to prevent substance abuse by younger Americans through an enhanced and 

enlightened lens. 

Nationwide, the drug overdose death rate has more than doubled during the past 

decade among younger Americans.1 Many experts believe this troubling phenomenon results from the rise and availability of potent and dangerous substances 

like illicit fentanyl and other synthetic drugs. 

Teenage fentanyl use is a vicious cycle: adolescents have a still-developing 

prefrontal cortex, which can facilitate drug-seeking behavior. The drug then alters 

the development of this area of the brain, making that behavior permanent. In fact, 

more than 90 percent of adults who develop a substance abuse disorder begin using 

before they are 18 years old. 

In New York City, overdoses kill more people each year than murders, suicides 

and car crashes combined. Between 2015 and 2016, city officials saw a huge jump 

in overdose-related deaths, with more than eight in ten involving an opioid, a trend 

driven by fentanyl.3 

This bill has significant support among Republicans and Democrats and has been 

incorporated into the legislative agenda for the Bipartisan Heroin Task Force. Furthermore, a number of health and patient advocacy groups are supportive of this 

bill, including the American Academy of Pediatrics, American Association of Nurse 

Practitioners, American Academy of Child & Adolescent Psychiatry, American Psychological Association, College on Problems of Drug Dependence, Community AntiVerDate Mar 15 2010 09:50 Oct 11, 2018 Jkt 037690 PO 00000 Frm 00067 Fmt 6633 Sfmt 6633 C:\USERS\WLAUFERT\DESKTOP\115X64MEMBERSOPIOIDSPDFMADE WAYNE
62 

Drug Coalitions of America, Friends of the National Institute on Drug Abuse, 

Healthy Teen Network, Mental Health America, National Association of County and 

City Health Officials and National Association of Police Organizations. 

Thank you again for the opportunity to testify today, and I respectfully request 

committee consideration of the ‘‘Synthetic Drug Awareness Act’’ at the earliest possible time. 

Mr. BURGESS. Chair thanks the gentleman. Gentleman yields 

back. 

Chair recognizes the gentleman from West Virginia, Mr. Jenkins, 

for 3 minutes, please. 

STATEMENT OF HON. EVAN H. JENKINS, A REPRESENTATIVE 

IN CONGRESS FROM THE STATE OF WEST VIRGINIA 

Mr. JENKINS. Thank you so much, Chairman Burgess, Ranking 

Member Green, and members of the subcommittee for giving me 

the opportunity to discuss this most challenging public health and 

safety issue of our time. 

My home State of West Virginia is ground zero for the opioid epidemic. West Virginia has the Nation’s highest overdose rate and 

the highest rate of newborns exposed to opioids and other drugs 

known as neonatal abstinence syndrome, or NAS. 

From this tragic epidemic, however, has come an exceptional response from communities across my State coming together to find 

solutions. One shining example is Lilly’s Place, a unique facility 

that specializes in treating newborns suffering from NAS. 

I was proud to work with two NICU nurses and a passionate 

community leader to start Lilly’s Place after they saw, we saw, the 

dramatic rise in newborns with NAS. Lilly’s Place has been operating for 3 years and has cared for more than 190 precious 

newborns. 

Lilly’s Place has brought national attention to West Virginia solutions. Just yesterday, the First Lady, Melania Trump, visited 

Lilly’s Place in my hometown of Huntington to talk with the caregivers about helping the most vulnerable in our society. Lilly’s 

Place provides a great environment with are given by doctors and 

nurses in a nurturing setting conducive to recovery. 

Mothers and families are included in the healing process. Lilly’s 

Place and others advocating for this model of care had struggles 

dealing with CMS, making it harder to replicate this model. 

That led to my introduction of the Nurturing and Supporting 

Healthy Babies Act. Last year through this committee’s work my 

legislation was incorporated in CARA, which, of course, became law 

and was passed. Thank you for your work. 

My legislation requiring GAO to closely look at the different care 

models for NAS and Medicaid coverage and the GAO report was 

just released last week. 

It found that nonhospital settings like Lilly’s Place are a proven 

model of care to treat NAS newborns. It identified this model of 

care as a proven effective treatment approach and can actually reduce the cost of care. 

Here is my ask. I would encourage this committee to advance 

two measures critical to the care of these precious newborns. First, 

I have sponsored the CRIB Act pending before this committee with 

Congressman Mike Turner which makes sure these models of care 

63 

are included in nonhospital treatment facilities are recognized by 

Medicaid to remove the barriers. 

Second, based on the GAO report, I ask you, working with me— 

this committee—to memorialize in legislation the recommendations 

in this report and have these become law so these precious 

newborns can receive the very best possible care. 

Thank you, Mr. Chairman, for your interest in this issue, and I 

yield back. 

[The prepared statement of Mr. Jenkins follows:] 

PREPARED STATEMENT OF HON. EVAN H. JENKINS

Thank you, Chairman Burgess, Ranking Member Green, and members of the subcommittee, for giving me the opportunity to discuss the most challenging public 

health crisis of our time. States and communities across this country have been 

dealing with the ravages of opioid and drug addiction. This is not a rural or urban 

problem, it is a crisis that has hit cities and small towns alike. 

West Virginia has been ground zero for the opioid epidemic. The statistics speak 

for themselves. West Virginia has the highest overdose death rate, we have the 

highest rate of newborns exposed to opioids and other drugs known as Neonatal Abstinence Syndrome or NAS, and the lowest workforce participation rate. 

But from this tragic epidemic has come an exceptional response from communities 

across my home State. Communities have come together to find solutions and they 

are working to get their communities healthy again. 

One of the most shining examples is Lily’s Place, a unique stand-alone facility 

that specializes in treating newborns suffering from NAS in a clinically appropriate 

setting. I was proud to have worked with two NICU nurses to start Lily’s Place after 

they had seen a dramatic rise in newborns with NAS at the local hospital. 

Lily’s Place has brought national attention to West Virginia solutions, being featured in a number of news stories. Just yesterday, First Lady, Melania Trump, visited Lily’s Place in West Virginia to talk with caregivers helping the most vulnerable in our society, newborns suffering from NAS. 

Lily’s Place provides a perfect environment for newborns suffering from NAS, with 

a low lit, low stimulus environment with doctors and nurses providing care. Lily’s 

Place has become a model for its ability to treat newborns, and Lily’s Place includes 

the mothers and families in the healing process. 

Last year, with the tireless work of the Energy and Commerce Committee, Congress passed and the President signed the Comprehensive Addiction and Recovery 

Act or CARA. I was honored to have my legislation, the Nurturing and Supporting 

Healthy Babies Act included in the package of bills. This legislation required the 

GAO to take a close look at the different care models for NAS and how NAS is covered by Medicaid. I thank the members of this committee for working with me to 

further our understanding of how best to take care of newborns with NAS. 

The GAO report released last week, had important information and a number of 

key findings in it. Part of what we have learned from the GAO report is that nonhospital settings are sometimes a better alternative to the NICU for the care that 

NAS newborns need. The report identified and took a close look at different care 

models and how the best practices at nonhospital settings can actually reduce costs 

of care. 

I have sponsored legislation, the CRIB Act, with Congressman Mike Turner which 

makes sure that these nonhospital settings are recognized by Medicaid to remove 

this barrier to care for NAS newborns. This legislation would clear the confusion 

at CMS on how to certify these facilities and as to what a nonhospital NAS treatment center is. 

The GAO report also highlighted that the Department of Health and Human 

Services has a number of recommendations they developed but HHS does not have 

a clear strategy or timeline for implementing these recommendations. I am working 

on legislation to make sure HHS develops a clear timeline and begins implementing 

a number of these recommendations. This legislation will give the needed push to 

HHS so we can help the newborns that are most impacted by the opioid epidemic 

start their lives happy and healthy. 

We have a unique opportunity to continue the strong bipartisan work on addressing the opioid epidemic and these two pieces of legislation can continue this effort. 

I look forward to working with the committee to bring these two pieces of legislation 

to the House floor and send them to the President’s desk. 

64 

Caring for the most vulnerable impacted by the opioid crisis is a truly noble cause 

and one that we can all come together to support. 

Mr. BURGESS. Chair thanks the gentleman. Gentleman yields 

back. 

Dr. Wenstrup, you are recognized for 3 minutes, please. 

STATEMENT OF HON. BRAD R. WENSTRUP, A 

REPRESENTATIVE IN CONGRESS FROM THE STATE OF OHIO 

Mr. WENSTRUP. Well, thank you, Chairman Burgess and Ranking 

Member Green, for hosting this today, and I mean that sincerely. 

We are hearing a lot of good ideas and it gives us a lot of food for 

thought. 

But the opioid crisis is affecting each and every one of our districts across the country. That is very obvious, and I appreciate the 

chance to come and speak today and share with you some stories 

from Ohio’s 2nd District. 

My office recently sent a survey to the constituents of our district 

and we asked them to share their stories and experiences with the 

opioid epidemic, and the results are heartbreaking, as you might 

imagine. 

We received hundreds of responses—up to seven pages of responses, and I just want to share a couple of those with you. 

One said, ‘‘My brother, unfortunately, became addicted as a teenager. He is very lucky, because at 33 years old he’s still here but 

he is still fighting every day to stay sober. These drugs have no 

place in our country. They are ruining our youth, our future.’’ 

Another one—a woman said, ‘‘I have four boys and three of them 

are struggling with this addiction. The cost of going to a methadone 

clinic is very difficult. The cost of treatment facilities is too expensive. I am going broke trying to get my children sober.’’ 

Clearly, this epidemic is devastating for southern Ohio as it is 

across the country. In one county alone, the overdose death rate 

was 37.5 per 100,000 residents and in another county 318 residents 

died of an intentional drug overdose in just—in 2016. 

This spring, the Columbus Dispatch reported at least 4,149 Ohioans died from an unintentional drug overdose in 2016 and one local 

newspaper called the overdoses the new normal in that county. 

I appreciate what Dr. Marshall had to say earlier. As a doctor, 

I can agree with him on many of the factors that have driven so 

many people into addiction, and I would really like for us to talk 

sometime about prevention, which I think is the long-term vision 

for our country. 

I can tell you as a doctor I had someone come up to me just last 

year and say, ‘‘My friend wanted me to thank you if I met you,’’ 

and I said, ‘‘Why is that?‘‘ He said, ‘‘Because she was addicted to 

prescription pain meds, and when she came to you, you gave her 

alternatives, and you didn’t give her any.’’ 

We search for answers. We are all searching for answers. One of 

the sheriffs in my district, he’s working hard on the solution and 

he’s using prevention because he said, I can’t incarcerate our way 

out of this. 

But he did show me what one patient received on Medicaid in 

a year—what one patient in one year received from Medicaid as far 

65 

as narcotics, and I promise you it was more than I prescribed in 

my entire surgical practice in a year. 

And then he showed me what Medicaid paid for it. And so while 

I understand that Medicaid is providing help and care for a lot of 

people, it may be driving the problem as well, because as some are 

getting treatment, many are getting fed and the problem is being 

exacerbated and we need to look at that and there needs to be better oversight of how we are handling this. 

This sheriff directs an essay contest, asking local students to 

write an essay about the dangers of opioids and how they hope to 

become the generation to stop the epidemic. 

As I said before, he said he can’t incarcerate his way out of this. 

We can’t always treat our way out of this. But I hope that we take 

some time in this process for a long-term vision of how we can prevent people from ever getting in this situation to begin with. 

And with that, I yield back, and I thank you for your time and 

attention today. 

[The prepared statement of Mr. Wenstrup follows:] 

PREPARED STATEMENT OF HON. BRAD R. WENSTRUP

Thank you, Health Subcommittee Chairman Burgess and Health Subcommittee 

Ranking Member Green, for hosting this Member Day today. The opioid crisis is affecting each and every one of our districts across the country, so I appreciate the 

opportunity to come and speak to you today, along with my colleagues, and share 

with you some stories from Ohio’s 2nd District. 

My office recently sent a survey to the constituents of Ohio’s 2nd District, asking 

them to share their stories and experiences with the opioid epidemic. The results 

are heartbreaking. We received hundreds of responses—all telling the same stories. 

I wanted to just read aloud a few of them for you. 

One woman wrote, ‘‘My brother unfortunately became addicted as a teenager. He 

is a very lucky one at 33 years old he is still fighting every day to stay sober. These 

drugs have no place in our country. They are ruining our youth, our future.’’ 

Another said, ‘‘My daughter is currently in rehab for heroin addiction; she’s destroyed several relationships with various members of our family, I am raising her 

18-month-old son and she’s been in and out of jail for several years and she’s only 

27. She’s overdosed at least once that I know about and has been physically and 

emotionally abused by a boyfriend. I am terrified that she won’t live to see 30 and 

that her son will never know the sweet and caring person she was/is when not 

high.’’ 

Another constituent shared, ‘‘I have 4 boys and 3 of them are struggling with this 

addiction.the cost of going to a methadone clinic is very difficult.the cost of treatment facilities is too expensive.I am going broke trying to get my children sober.’’ 

Clearly, this epidemic is devastating for Southern Ohio, as it is across the country. In one county in Ohio alone, the overdose death rate was 37.5 per 100,000 residents. In another county, 318 residents died of an unintentional drug overdose in 

2016. This spring, the Columbus Dispatch reported that at least 4,149 Ohioans died 

from unintentional drug overdoses in 2016. One local newspaper called the 

overdoses the ‘‘new normal’’ in that county. 

As we search for solutions to this crisis, I hope you’ll keep this in mind: Adams 

County Sheriff Kimmy Rogers, in my district, is working hard on a key part of this 

solution: prevention. He runs an after-school program at a local church that teaches 

young kids about the dangers of drugs and opioids. He also runs an essay contest, 

asking local students to write an essay about the dangers of opioids and how they 

hope to become the generation to stop the epidemic. When I asked Sherriff Rogers 

about these programs, he said we can’t incarcerate our way out of this problem. We 

can’t always treat our way out of this. But I hope we take some time in this process 

for a long-term vision of how we can prevent people from every getting in this situation to begin with. 

With that, I yield back, and I thank you for your time and attention today. 

Mr. GREEN [presiding]. Thank you. 

66 

The Chair, in absence, is recognizing Congresswoman Clark. 

STATEMENT OF HON. KATHERINE M. CLARK, A REPRESENTATIVE IN CONGRESS FROM THE COMMONWEALTH OF MASSACHUSETTS 

Ms. CLARK. Thank you, Ranking Member Green, and thank you 

to you and to Chairman Burgess for holding this Member Day 

today. 

We are all here because we lose 91 Americans a day to the opioid 

epidemic and every one of those 91 deaths affects not only the victim but also their loved ones, their workplace, and their community. 

Now is the time for us to come together and find solutions to end 

this national health emergency. And with that in mind, I would 

like to speak in favor of four common sense proposals that I am 

leading, each with a great Republican partner, aimed at addressing 

a different aspect of the opioid epidemic. 

The first is the Youth Act, which I introduced with my colleague 

from Indiana, Dr. Bucshon. The opioid epidemic has had a tragic 

impact on our young people. From harmful changes in brain and 

social development to long gaps in education and job training, the 

effects can be profound. 

The Youth Act would expand access to evidence-based medication-assisted treatment for adolescents and young adults, giving 

them the best possible chance at recovery. 

The second proposal is the Prescriber Support Act, which I introduced with my colleague, Congressman Evan Jenkins. Tragically, 

opioid addiction often begins in the doctor’s office where patients 

are often prescribed more medication than they need or without 

being informed about the risks of addiction. 

The Prescriber Support Act would establish State-based resources for prescribers to consult when making decisions about prescribing opioids. 

Third, I recently the Every Prescription Conveyed Securely Act 

with my colleague from Oklahoma, Congressman Mullin. This proposal would ensure that all prescriptions for controlled substances 

filled through Medicare Part D would be transmitted electronically. 

Electronic transmission would help doctors and pharmacists spot 

patients attempting to doctor shop and it would make more—make 

it more difficult to forge a prescription, all the while saving taxpayer dollars. 

Finally, I will soon be introducing a bill with my colleague from 

Kentucky, Congressman Hal Rogers, that will create a student loan 

forgiveness program for professionals who enter and stay in the 

substance use treatment field. 

In my district, I have heard time and time again from families 

and providers that there simply aren’t enough treatment specialists 

available to help the growing number of Americans struggling with 

substance use disorder. 

Our bill will help build this critical work force. There is no single 

solution to the opioid crisis. However, these four bipartisan solutions can help put us on a path to beating this epidemic. 

67 

I thank the chairman and the ranking member for giving us this 

opportunity to have this conversation, and I look forward to working together. 

I yield back. 

[The prepared statement of Ms. Clark follows:] 

PREPARED STATEMENT OF HON. KATHERINE M. CLARK

Thank you, Mr. Chairman. 

I’d first like to thank you, Chairman Burgess and Ranking Member Green, for 

holding this Member Day today. 

The opioid epidemic claims the lives of 91 Americans a day. 

Every one of those 91 deaths affects not only the victim who has lost their life, 

but also their loved ones, their workplace, and their community. 

Now is the time for us to come together and find solutions to end this national 

health emergency. 

With that in mind, I would like to speak in favor of four common-sense proposals 

that I am leading, each with a great Republican partner and aimed at addressing 

a different aspect of the opioid epidemic. 

The first is the YOUTH Act, which I introduced with my colleague from Indiana, 

Dr. Buchson. 

The opioid epidemic has had a tragic impact on our young people. 

From harmful changes in brain and social development, to long gaps in education 

and job training-the effects can be profound. 

The YOUTH Act would expand access to evidence-based medication assisted treatment for adolescents and young adults, giving them the best possible chance at recovery. 

The second proposal is the Prescriber Support Act, which I introduced with my 

colleague, Congressman Jenkins. 

Tragically, opioid addiction often begins in a doctor’s office, where patients are 

often prescribed more medication than they need, or without being informed about 

the risks of addiction. 

The Prescriber Support Act would establish State-based resources for prescribers 

to consult when making decisions about prescribing opioids. 

Third, I recently introduced the Every Prescription Conveyed Securely Act with 

my colleague from Oklahoma, Congressman Mullin. 

This proposal would ensure that all prescriptions for controlled substances 

filledthrough Medicare part D would be transmitted electronically. 

Electronic transmission would help doctors and pharmacists spot patients attempting to doctor-shop, and it would make it more difficult to forge a prescriptionall while saving taxpayer dollars. 

Finally, I will soon be introducing a bill with my colleague from Kentucky, Congressman Hal Rogers, that will create a student loan forgiveness program for professionals who enter, and stay, in the substance use treatment field. 

In my district, I have heard time and time again from families and providers that 

there simply aren’t enough treatment specialists available to help the growing number of Americans struggling with substance use disorder. 

Our bill will help build this critical workforce. 

There is no single solution to the opioid crisis.However, these four bipartisan solutions can help put us on a path to beating this epidemic. 

I thank the chairman and the ranking member for giving us the opportunity to 

have this conversation, and I look forward to working together. 

Mr. BURGESS [presiding]. Chair thanks the gentlelady. 

Gentlelady yields back. 

The gentlelady from Connecticut, Ms. Esty, is recognized for 3 

minutes, please. 

STATEMENT OF HON. ELIZABETH H. ESTY, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF CONNECTICUT 

Ms. ESTY. Thank you, Mr. Chairman—Chairman Burgess and 

Ranking Member Green. Thank you so much for holding this important hearing on the growing opioid epidemic. 

68 

Everywhere I go in Connecticut, I meet people whose families 

have lost loved ones to drug addiction—moms and dads, sons and 

daughters, brothers and sisters. It is an epidemic that affects families and communities across the country regardless of age, race, 

gender, socioeconomic status. 

During one of my visits recently to Staywell Oasis—it’s an addiction treatment center in Waterbury—I met a young woman who 

has been struggling on the streets with addiction. 

She has a new child and she is so grateful to be in a program 

that is allowing her to stay clean and helping her keep her child. 

I met a 45-year-old man in the Farrell Treatment Center in New 

Britain who for 20 years has been battling his addiction and is finally coming to terms with it and able to hold a steady job. 

These are real people, real families, and real lives that are affected by this crisis, and the stakes are high. If these vital treatment centers are forced to close their doors or if we limit access to 

them, people will die. 

In my home town of Cheshire, a neighbor whose daughter was 

a classmate of one of my children contacted the office. They had 

lost track of their daughter. 

She had been on the streets, addicted to drugs. We were able to 

help them find her. She wouldn’t accept the treatment, and a week 

later she was dead. 

That’s what it’s like now in America. The situation is so dire in 

Connecticut that our chief medical examiner lost its accreditation. 

They cannot keep up with the autopsies. 

We are expecting more than a thousand deaths this year. That 

is the third-highest rate in the country. They literally cannot keep 

up with the autopsies. We need to do something and this Congress 

needs to act. 

I am pleased at our good bipartisan work last year. My bill of 

the Prevent Drug Addiction Act of 2016 was included as part of the 

conference committee in our good bipartisan work to ensure that 

we are addressing the issues of prevention with many of my colleagues have addressed here today—both provider education on 

how to prescribe as well as for parents, coaches, and others who 

need to be aware of the risks of prescription drugs. 

But there is important—there is important work at stake and I 

do want to say something about the Affordable Care Act. We need 

to protect the funding, which is providing vital access for people 

across America, and we are real risk now as we consider that funding and whether the Medicaid access will be cut off, which is funding so many of the important programs in my State. 

So again, I want to thank this committee for the good work and 

encourage all of our members to come together and help address 

this vital need—this growing epidemic that is affecting all Americans. 

Thank you, and I yield back. 

[The prepared statement of Ms. Esty follows:] 

PREPARED STATEMENT OF HON. ELIZABETH H. ESTY

Mr. Chair, thank you for holding this hearing on the growing opioid epidemic. 

This epidemic is literally filling the morgues across our country. 

69 

Everywhere I go in Connecticut, I meet people whose families have lost loved ones 

to drug addiction—moms and dads, sons and daughters, brothers and sisters. 

It’s an epidemic that affects families and communities across the country—regardless of age, sex, race, or socio-economic status. 

During one of my recent visits to Staywell Oasis, an addiction treatment center 

in Waterbury, I met a young woman who has a new baby and is so grateful for the 

help that the program is providing for her. 

She emphasized to me how important Staywell is for her—that the it is is keeping 

her clean and off the streets so that she can keep her baby. 

Or there’s the 45-year-old man that I met at Farrell Treatment Center in New 

Britain who is getting his 20-year battle with opioids under control for the first 

time. 

These are real people, real families, and real lives that are affected by the opioid 

crisis. 

And the stakes are high. 

If these vital treatment centers are forced to close their doors, or if we limit access 

to them, people will die. 

In my hometown of Cheshire, one of my neighbors came to my office pleading for 

help—they could not find their daughter. 

Their daughter had been battling substance addiction for years. 

The family did ultimately find their daughter, but it was too late. 

She died weeks later without the care and treatment she so desperately needed. 

This is how dire the situation is: In our State, the Office of the Chief Medical Examiner actually lost its accreditation because it simply could not keep up with the 

body count, due to the sharp rise of drug overdose deaths in Connecticut. 

Connecticut’s Chief Medical Examiner projected that Connecticut will hit a devastating benchmark this year: More than 1,000 people will die from opioid overdoses 

in our State alone before the end of the year. 

The medical examiner’s office simply cannot keep up with the demand for autopsies on the rising number of people who are dying from drug overdoses. 

Congress needs to act, and it needs to act now, to save lives. 

Instead of finding ways to hire more medical examiners to keep up with the rocketing death toll, Congress needs to work together to come up with commonsense solutions to end this devastating epidemic. 

Last year, I was proud to help write a landmark, bipartisan bill to improve resources for cities and towns to address this crisis and to create new consumer and 

provider education campaigns to encourage prevention. 

The funding in this bill was not everything our communities need—but it was an 

important step forward. 

The State Targeted Response to the Opioid Crisis Grant program, created by the 

21st Century Cures Act, provided $1 billion over the next 2 years to States to address the opioid epidemic. 

These grants help support programs for people struggling with addiction at places 

like the Farrell Treatment Center in New Britain, the Staywell Oasis Addiction 

Treatment Center in Waterbury, or the McCall Center for Behavioral Health in 

Torrington, provide life-lines to people struggling with addiction. 

At the same time, we must ensure that the millions of Americans with substance 

use disorders who currently get treatment through Medicaid expansion are able to 

continue to get the care they need. 

The recent, misguided efforts to repeal the Affordable Care Act and defund Medicaid expansion would have cut over $800 billion from the Medicaid program, removing access to treatment for low-income people with mental and substance use disorders. 

I am heartened that you have invited me here today to talk about how this devastating epidemic is affecting my district, and I am committed to continuing to partner with my colleagues in Congress to prevent more lives from being taken by the 

opioid epidemic and to help those suffering from addiction to recover and move forward. 

Thank you. 

Mr. BURGESS. Chair thanks the gentlelady. The gentlelady yields 

back. 

The Chair recognizes the gentlelady from Utah, Mrs. Love, for 3 

minutes, please. 

70 

STATEMENT OF HON. MIA B. LOVE, A REPRESENTATIVE IN 

CONGRESS FROM THE STATE OF UTAH 

Mrs. LOVE. Thank you, Mr. Chairman, for such—talking about 

such an issue, and I would like to thank the Ranking Member 

Green also for giving us the opportunity to speak about the opioid 

epidemic and crisis. 

Nationwide, the rate of deaths has exploded to over—over the 

last 10 years to now more than 60,000 deaths every year. In Utah, 

the Department of Health says that more people are dying from 

opioid and heroin overdose than ever before. 

Six people die from opioid overdose per year. Alarming increases 

from 2013 to 2015. Utah is seventh-highest for those deaths per 

capita in the United States. 

Here is what hits me the hardest is the innocent children that 

are being affected by the opioid epidemic. In too many cases, parents are no longer parents. Their children are parenting themselves and the parents are now slaves to their addiction. 

This is actually happening in Elk Ridge, Utah, a place where— 

which is just a few minutes away from my home. There is a boy 

who is in 3rd grade who talks about his life with his mom, who is 

addicted, and his stepfather, who is addicted. 

He talks about waking up by himself and getting himself ready 

for school and also getting his brother ready for school and his 

newborn sister. He makes breakfast for them and prepares a bottle 

for his newborn baby, who is his sister. 

He talks about the fact that many times he misses the bus when 

he’s going to school because he is taking care of his brother and sister and there is no one to take him to school. 

His brother cries, asking for his mom and dad, and he, as a 3- 

year-old has to try to explain to his brother why Mom and Dad 

aren’t around. 

That’s not the end of his story. His newborn sister is actually addicted to opioids because his mother took the drugs while she was 

pregnant, and while in the hospital, for fear of getting caught, she 

actually took opioids and would rub it on the gums of her baby so 

that the baby wouldn’t show signs of withdrawal. 

This is what is happening in America. This story is not unique 

to Utah. It is happening everywhere. The parents are now in jail. 

They were arrested for trying to return stolen merchandise at the 

local Wal-Mart and neglect of their children. 

But I have to say that the children’s lives aren’t better now without mom and dad. Their nightmare is just beginning. So I feel very 

strongly about this. At a time where there is so much partisan politics, this is an issue where so many of us are standing together. 

I believe that American democracy is at its best when two people 

are in a room and talk about what they are for, and here we are, 

in a room talking about what we are for. 

I am so proud that we are actually coming together, but coming 

together is not enough. We actually have to apply some of these solutions that we are talking about when it comes to the crisis, and 

I think the opportunity to—I am thankful for the opportunity to 

work on this. 

Thank you, and I yield back. 

[The prepared statement of Mrs. Love follows:] 

71 

PREPARED STATEMENT OF HON. MIA B. LOVE

I appreciate the opportunity to speak on this epidemic of the Opioid Crisis, and 

I appreciate the efforts of everyone here. To fight this public health crisis, we must 

work together. I pledge to do whatever I can to assist in that effort, because Utah 

is being hit especially hard by opioid abuse and death. 

I am humbled by the raw fact and statistics regarding this in my State: 

• The Utah Department of Health says that 24 individuals die from prescription 

opioid overdoses every month in Utah. A growing number of people are dying from 

heroin overdoses. 

• The rate of these deaths has exploded over the last 10 years. I would say it’s 

out of control. The National institute on Drug Abuse reports that there are more 

than 60,000 death per in year in our country from prescription and heroin use. Utah 

is in the top five for those types of death per capita. 

I don’t like to see anyone suffer and die from the miserable cycle of drug dependency and abuse. 

And here’s what hits me the hardest: Innocent children are being affected by this 

epidemic. 

In too many cases, parents are no longer parents, they’re drug addicts. Their children are doing the parenting themselves, and for their brothers and sisters. 

I recently learned of a case in Elk Ridge, Utah, which is just minutes from my 

home. 

There, a boy in the 3rd grade told the story of life with his mom and stepdad: 

Waking up by himself, making breakfast and dinner for his 2-year-old brother and 

newborn sister. About missing the bus, with no one to take him to school. Of his 

brother crying because his mom and dad weren’t there. 

Mom and Dad were on heroin: That’s why they weren’t there. 

And that’s not the end of the story. 

That boy’s sister—the newborn baby—was born addicted to opioids, because her 

mother was using while she was pregnant. After she was born, to hide the baby’s 

withdrawal symptoms from the hospital staff, the parents rubbed crushed opioids 

on the child’s gums. 

The parents are now in jail-arrested trying to return stolen merchandise for 

money at the local Wal-Mart. And for child abuse and neglect. 

Those kids are just an example of the toll this epidemic is taking. 

But there are those in my State that are taking steps to deal with it. Utah’s Intermountain Healthcare has set a goal to reduce opioid prescribing by 40 per cent in 

its 22 hospitals and 180 clinics by the end of next year. 

I applaud this effort, but it’s obviously just one piece of a larger puzzle. 

We need to put those pieces together for our children, for ourselves, and for the 

future of the United States of America. 

Mr. BURGESS. Chair thanks the gentlelady. Gentlelady yields 

back. 

Let me take the New Jersey delegation in seniority, and, Mr. 

Pascrell, I will go to you first for 3 minutes. 

STATEMENT OF HON. BILL PASCRELL, JR., A REPRESENTATIVE IN CONGRESS FROM THE STATE OF NEW JERSEY 

Mr. PASCRELL. Thank you, Chairman Burgess, Ranking Member 

Green. 

I don’t have to tell you or anyone here that opiate abuse and misuse is one of our country’s fastest growing problems. It is also one 

of the most vexing problems we face and there are no simple solutions. 

Prescription drugs serve a valid medical purpose. But many of 

them carry high risk of addiction and abuse. Many of my colleagues 

have good ideas about steps we can take to address opiate abuse 

and misuse. So I commend you for giving us the opportunity to 

share them. 

72 

Today, I would like to share some information about a program 

that was developed and is in use at my hometown hospital, St. Joseph’s Regional Medical Center in Paterson, New Jersey. 

As the busiest emergency department in the State of New Jersey, 

St. Joe’s commitment to reducing abuse can serve, I believe, as a 

model for emergency departments across the State an across the 

country. We need to recognize that emergency departments are in 

a unique position with respect to prescription drug abuse. 

On one hand, a component of many of their patients’ treatment 

involves acute pain that legitimately needs to be addressed. But 

emergency departments, because of the short-term nature of the 

care they provide, are also more susceptible to doctor shopping 

than many other health settings. 

To prevent addiction, where it often starts with a valid prescription in the emergency room, St. Jo’s initiated a first-of-its-kind Alternatives to Opioids, or ALTO—ALTO program, the Alternatives 

to Opiates. 

This new approach utilizes protocols primarily targeting five 

common conditions. The alternative therapies offered through St. 

Jo’s ALTO program include targeted nonopiate medications, trigger 

point injections, nitrous oxide, ultrasound-guided nerve blocks to 

tailor patient pain management needs, and avoid opiates whenever 

possible. 

In the first year of operations, this program decreased emergency 

department opiate prescriptions by more then 50 percent. The goal 

is not to eliminate opiates altogether because these drugs remain 

an important part of pain management. 

However, the ALTO program reserves their use for severe pain, 

end-of-life pain, surgical conditions. That’s it. As a result, only 

about 25 percent of the acute pain patients treated with nonopiate 

protocols since the program’s launch, eventually needed opiates. 

I believe that the initial successes of this program make it very 

important that we—to have a broader implementation and study. 

I leave this to your discretion. 

That is why Senator Booker and I plan to introduce legislation 

to establish a national demonstration program to test pain management protocols that limit the use of opiates in hospital-based emergency departments. 

It is my hope that strategies that provide alternatives to opiates 

can become a larger part of the discussion on how to combat this— 

the opiate epidemic and that this committee will review and consider my legislation upon its introduction. 

And with that, Mr. Chairman, Mr. Ranking Member, I yield back 

to you. 

[The prepared statement of Mr. Pascrell follows:] 

PREPARED STATEMENT OF HON. BILL PASCRELL, JR. 

Chairman Burgess, Ranking Member Green, thank you for holding this hearing 

today. I don’t have to tell you or anyone here that opioid abuse and misuse is one 

of our country’s fastest-growing problems. It is also one of the most vexing problems 

we face; and there are no simple answers. Prescription drugs serve a valid medical 

purpose, but many of them carry a high risk of addiction and abuse. Many of my 

colleagues have good ideas about steps we can take to address opioid abuse and misuse, so I commend you for giving us the opportunity to share them. 

73 

Today, I would like to share some information about a program that was developed and is in-use at my hometown hospital St. Joseph’s Regional Medical Center 

in Paterson, New Jersey. As the busiest emergency department in the State of New 

Jersey, St. Joe’s commitment to reducing abuse can serve as a model for emergency 

departments across the State and across the country. 

We need to recognize that emergency departments are in a unique position with 

respect to prescription drug abuse. On one hand, a component of many of their patients’ treatment involves acute pain that legitimately needs to be addressed. But 

emergency departments—because of the short-term nature of the care they provide—are also more susceptible to doctor shopping than many other health care settings. 

To prevent addiction where it often starts—with a valid prescription in the emergency room—St. Joe’s initiated a first-of-its kind Alternatives to Opioids (ALTO) 

program. This new approach utilizes protocols primarily targeting five common conditions. The alternative therapies offered through the St. Joe’s ALTO program include targeted nonopioid medications, trigger point injections, nitrous oxide, and 

ultrasound guided nerve blocks to tailor patient pain management needs and avoid 

opioids whenever possible. 

In the first year of operations, the ALTO program decreased Emergency Department opioid prescriptions by more than 50 percent. The goal is not to eliminate 

opioids altogether, because these drugs remain an important part of pain management. However, the ALTO program reserves their use for severe pain, end of life 

pain, and surgical conditions. As a result, only about 25 percent of the acute pain 

patients treated with nonopioid protocols since the program’s launch eventually 

needed opioids. 

I believe that the initial successes of this program make it worthy of broader implementation and study. That is why Senator Booker and I plan to introduce legislation to establish a national demonstration program to test pain management protocols that limit the use of opioids in hospital-based emergency departments. 

It is my hope that strategies that provide alternatives to opioids can become a 

larger part of the discussion on how to combat the opioid epidemic; and that this 

committee will review and consider my legislation upon its introduction. 

Thank you. 

Mr. BURGESS. Chair thanks the gentleman. The gentleman yields 

back. 

Mr. MacArthur, you are recognized for 3 minutes, please. 

STATEMENT OF HON. THOMAS MACARTHUR, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF NEW JERSEY 

Mr. MACARTHUR. Well, I thank the Chairman Burgess and Ranking Member Green for hosting this opportunity today for those of 

us not on this committee to share our thoughts. 

We have all seen the numbers. Last year, over 60,000 deaths 

from overdose, opioids involved in the vast majority of those. 

In Ocean County, New Jersey, my home county, we are losing 

somebody every 43 hours. A couple of weeks ago, my county was 

designated a high-intensity drug trafficking area—desperately 

needed, but also disturbing sign of where we are. 

It may be unusual for a member to sit here and promote other 

people’s bills, even bills written by the other party. But as the Republican cochairman of the bipartisan Heroin Task Force, representing over 90 members of both parties, that is exactly what I 

am here to do today. 

As your committee considers legislative next steps to pursue, I 

want to recommend the bipartisan Heroin Task Force’s legislative 

agenda for your consideration. 

We are committed to being rigorously bipartisan. We did not include any bills in our agenda unless it had bipartisan cosponsors 

and both the Republican and the Democratic cochairs agreed to it. 

74 

Five of the bills that were recommended fall within your jurisdiction. Representative Tim Walberg’s Jessie’s Law will ensure that 

doctors have access to a consenting patient’s prior history of addiction so they can make informed decisions. 

Representative David Joyce’s Stop OD Act will increase first responders’ access to Narcan and synthetic opioid testing. Representative Hakeem Jeffries’ Synthetic Drug Awareness Act requires that 

we investigate how the synthetic opioid crisis is affecting young 

people specifically. 

Representative Evan Jenkins’ CRIB Act will ensure treatment 

for babies with neonatal abstinence syndrome, and Representative 

Brian Fitzpatrick’s Road to Recovery Act addresses the IMD exclusion, which is one of the primary barriers preventing access to substance abuse treatment. 

We are proud of our members’ work. I would also note that many 

of our agenda ideas coincide with the White House’s Opioid Commission’s recommendations and I also note the good work being 

done by the Republican Main Street on this same issue. 

On behalf of my Democratic cochair, Representative Annie 

Kuster, our vice chairs, Donald Norcross and Brian Fitzpatrick, 

and our 90-plus members, I urge you to consider these bills. 

We will continue to expand and update our legislative agenda as 

we tackle this critical issue facing our country. 

Thank you, and I yield back. 

[The prepared statement of Mr. MacArthur follows:] 

PREPARED STATEMENT OF HON. THOMAS MACARTHUR

Mr. Chairman, Ranking Member: 

Thank you for the opportunity to testify. We have all seen the numbers—drug 

overdose deaths have increased from 52,000 in 2015 to an estimated 64,000 last 

year, with opioids involved in the majority of those deaths. In Ocean County, New 

Jersey—my home county—someone dies of an overdose, on average, once every 43 

hours. So thank you for the committee’s work on this incredibly important subject. 

It may be unusual for a Member to sit here and promote other people’s bills, even 

bills written by the other party, but as the Republican cochairman of the Bipartisan 

Heroin Task Force, representing over 90 members of both parties, that is exactly 

what I’m here to do. 

As the committee considers legislative next steps to pursue, I want to recommend 

the Bipartisan Heroin Task Force’s legislative agenda for your consideration. We are 

committed to being rigorously bipartisan—we did not include a bill on this agenda 

unless it had bipartisan cosponsors and unless the bipartisan chairs all agreed to 

it. Five of these bills fall under your jurisdiction: 

• Rep. Tim Walberg’s Jessie’s Law, which would help ensure doctors have access 

to a consenting patient’s prior history of addiction in order to make fully informed 

treatment decisions. 

• Rep. David Joyce’s STOP OD Act, which would expand efforts to prevent addiction, promote treatment and recovery, and increase first responders’ access to 

Naloxone and synthetic opioid testing. 

• Rep. Hakeem Jeffries’ Synthetic Drug Awareness Act, which requires that we 

investigate how the synthetic opioid crisis is affecting young people specifically. 

• Rep. Evan Jenkin’s CRIB Act, which would help increase access to treatment 

for babies with neonatal abstinence syndrome (NAS) due to exposure to opioids during pregnancy. 

• And Rep. Brian Fitzpatrick’s Road to Recovery Act, which would address the 

IMD exclusion, which we all recognize as one of primary barriers preventing access 

to substance abuse treatment. 

We’re proud of our members’ work, and I would also note that many our agenda’s 

ideas coincide with the White House Opioid’s Commission’s recommendations. I also 

note the good work being done by Republican Main Street on this issue—many of 

the bills they recommend are also on our agenda. 

75 

On behalf of my Democratic cochair, Rep. Annie Kuster, our Vice Chairs Donald 

Norcross and Brian Fitzpatrick, and our 90-plus members, I urge you to consider 

these bills. We’ll continue to expand and update our legislative agenda as we tackle 

additional critical topics like PDMPs and prescriber education, and we stand ready 

to work with committee staff however we can to promote good legislation that addresses all aspects of this devastating epidemic. 

Mr. BURGESS. Gentleman yields back. Chair thanks the gentleman. 

Chair recognizes the gentleman from Arizona, Mr. O’Halleran, 

for 3 minutes, please. 

STATEMENT OF HON. TOM O’HALLERAN, A REPRESENTATIVE 

IN CONGRESS FROM THE STATE OF ARIZONA 

Mr. O’HALLERAN. Chairman Burgess, Ranking Member Green, 

and members of the committee, thank you for allowing me to come 

before you today to testify on an issue that has had a devastating 

impact on my district. 

I want to, first of all, echo the sentiments of Representative MacArthur. I am also on the task force. 

At least two Arizonans die every day from opioid overdoses. Last 

year, deaths due to opioids rose 16 percent from the year before. 

As a former law enforcement officer, some of what I see today is 

familiar from my time serving communities—the harrowing stories 

of addiction, the pain family members face including child abuse, 

domestic abuse, and the loss of a loved one, and also the relationship to organized crime. 

But I must tell you that what we are seeing today, the devastation that opioids have wrought on our communities is far more 

impactful than the drugs I fought to keep off the streets when I 

was a cop. 

Over the summer, I held a round table in my district on opioids. 

I heard from families, first responders, local law enforcement, and 

health care providers. 

I am here today to bring their voices to you as we commit to 

tackling this issue in a bipartisan and comprehensive way. 

As you work to develop policies to combat this epidemic, I implore you to consider the impacts to rural communities and to tribal communities, which face unique obstacles and barriers to treatment, care, and recovery resources. 

According to the CDC, American Indian and Alaska natives have 

the highest death rates from opioids than any other community. 

American Indians and Alaska natives have long faced disparities 

when it comes to resources for mental health care and substance 

abuse. 

That’s why funding created by the 21st Century Cures Act, in addition to expanded Medicaid coverage in Arizona, have been crucial 

in helping families get the care they need. 

As many of your know, access to crucial healthcare services in 

rural communities and across Indian country can be scarce and 

often requires families to travel long distances. 

Providers in rural America have benefited from expanded Medicaid coverage and are now seeing lower rates of uninsured patients than before. 

76 

In fact, in States that expanded Medicaid, the share of uninsured 

substance use or mental health disorder hospitalizations fell from 

20 percent in 2013 to 5 percent in 2015. 

The increase in coverage has allowed rural providers to operate 

on the thinnest of margins, to help keep their lights on and their 

doors open. If Congress repeals that coverage, rural providers will 

close their doors and patients who need the help will face fewer 

choices. 

We need to give States, local law enforcement, and tribes more 

resources and more flexibility to test what works. But we must approach this problem comprehensively and with a robust commitment to those we represent. 

I urge your committee to thoughtfully consider these issues and 

how they affect communities across rural and tribal communities. 

Those voices must be heard when it comes to this crisis. 

And I thank you, and I yield. 

[The prepared statement of Mr. O’Halleran follows:] 

PREPARED STATEMENT OF HON. TOM O’HALLERAN

Chairman Walden, Ranking Member Pallone, and members of the committee: 

Thank you for allowing me to come before you today to testify on an issue that 

has had a devastating impact in my district. 

At least two Arizonans die every day from opioid overdoses. Last year, deaths due 

to opioids rose 16 percent from the year before. 

As a former law enforcement officer, some of what I see today is familiar from 

my time serving communities: the harrowing stories of addiction, the pain family 

members face, and the relationship to organized crime. 

But I must tell you that what we’re seeing today—the devastation that opioids 

have wrought on our communities—is far scarier than the drugs I fought to keep 

off the streets when I was a cop. 

Over the summer, I held a roundtable in my district on opioids. I heard from families, first responders, local law enforcement, and health care providers. I’m here 

today to bring their voices to you as we commit to tackling this issue in a bipartisan 

and comprehensive way. 

As you work to develop policies to combat this epidemic, I implore you to consider 

the impacts to rural communities and to tribal communities, which face unique obstacles and barriers to treatment, care, and recovery resources. 

According to the CDC, American Indian and Alaska Natives have the highest 

death rates from opioids than any other community. 

American Indian and Alaska Natives have long faced disparities when it comes 

to resources for mental health care and substance abuse. 

That’s why funding created by the 21st Century Cures Act, in addition to expanded Medicaid coverage in Arizona have been crucial in helping families get the 

care they need. 

As many of you know, access to critical health care services in rural communities 

and across Indian Country can be scarce, and often requires families to travel long 

distances. 

Providers in rural America have benefitted from expanded Medicaid coverage, and 

are now seeing lower rates of uninsured patients than before. In fact, in States that 

expanded Medicaid, the share of uninsured substance use or mental health disorder 

hospitalizations fell from 20 percent in 2013 to about 5 percent in 2015. 

The increase in coverage has allowed rural providers, who operate on the thinnest 

of margins, to help keep their lights on and their doors open. In communities across 

my district, these providers are the backbone of care. 

If Congress repeals that coverage, rural providers will close their doors and patients who need help now will face fewer choices. We need to work with each other 

to build on the progress we’ve made, not go backwards. 

We need to give States, local law enforcement, and tribes more resources and 

more flexibility to test what works. But we must approach this problem comprehensively, and with a robust commitment to those we represent. For too long, care and 

resources have been delivered in silos, and those looking for help have had to naviVerDate Mar 15 2010 09:50 Oct 11, 2018 Jkt 037690 PO 00000 Frm 00082 Fmt 6633 Sfmt 6633 C:\USERS\WLAUFERT\DESKTOP\115X64MEMBERSOPIOIDSPDFMADE WAYNE
77 

gate a patchwork of programs, many of which were never created to address the 

scope of the problems we’re seeing today. 

I urge your committee to thoughtfully consider these issues and how they affect 

communities across rural and tribal communities, whose voices must be heard when 

it comes to this crisis. 

Thank you. 

Mr. BURGESS. Gentleman yields back. The Chair thanks the gentleman. 

If you wish to be excused, you may do so. But we are all anxious 

to hear what the gentleman from Maine has to share with us. 

So, Mr. Poliquin, you are recognized for 3 minutes. 

STATEMENT OF HON. BRUCE POLIQUIN, A REPRESENTATIVE 

IN CONGRESS FROM THE STATE OF MAINE 

Mr. POLIQUIN. Thank you, Mr. Chairman, very much and thank 

you, Ranking Member, for the opportunity to be in front of you 

today. 

In our great State of Maine, Mr. Chairman, we have on average 

one person dies every day from a drug overdose. There was a recent study that said that six out of 10 families in our great State— 

six out of 10, Mr. Chairman—are impacted directly or indirectly by 

this epidemic, including, I might add, my own family. 

Rural Maine has been hard hit. Rural America has been hard hit 

with this epidemic and that is why I joined the bipartisan task 

force to combat the heroin epidemic and that led in part to a very 

comprehensive bill that we all passed in a bipartisan way last year, 

the Comprehensive Addiction Recovery Act, that sent about a billion dollars back to our States so they had better resources and 

more flexibility to address this scourge on our kids and our family 

members directly at the—on the ground in our—in our respective 

districts. 

Now, the motto, Mr. Chairman, of the great State of Maine is 

‘‘Dirigo.‘‘ It means, in Latin, ‘‘I lead.’’ And there are a bunch of 

things we have been doing in Maine to help fight this epidemic 

that I think the rest of the country can learn as we learn from others. 

We have put in place a prescription monitoring program that is 

very tough and very effective. In particular, it sets very strict limits 

on what opioid—opiates are prescribed. 

It mandates the use of this system by prescribers and if you are 

prescribing opioids in the State of Maine, you must check this program—this database—on a regular basis to make sure those that 

are being prescribed should be, in fact, those that are receiving the 

painkillers. 

If folks are coming from out of State or they’re paying with cash, 

it also triggers a review of the program to make sure that these 

drugs are falling in the hands of the right people. 

Now, I also serve, Mr. Chairman, I might add, on the House Veterans Affairs Committee, and along with Mr. Dunn, Ms. Tenney, 

Jodey Arrington from Texas, and Mr. Tonko, we have introduced 

a bill that asks the Veterans Administration facilities in the State 

of Maine, and hopefully around the country, to use their local State 

prescription monitoring programs or to interface with those beVerDate Mar 15 2010 09:50 Oct 11, 2018 Jkt 037690 PO 00000 Frm 00083 Fmt 6633 Sfmt 6633 C:\USERS\WLAUFERT\DESKTOP\115X64MEMBERSOPIOIDSPDFMADE WAYNE
78 

cause they’re more comprehensive. In many cases, they are tougher. 

I would also encourage you, Mr. Chairman and Mr. Ranking 

Member, as you are going down this path to make sure we do everything humanly possible to hold those that are manufacturing 

synthetic opioids like fentanyl, hold them accountable. These drugs 

are horrible, they are not expensive to manufacture, and they are 

anywhere from 50 to 100 times more potent than heroin and methadone. 

So with that, sir, I appreciate the opportunity to participate here. 

I know that my associates on either side of me have a lot to say. 

But we’ve done a lot in Maine, and we are very proud of it. But 

we’ve got a lot more work to do. 

Thank you, sir. 

[The prepared statement of Mr. Poliquin follows:] 

PREPARED STATEMENT OF HON. BRUCE POLIQUIN

Good afternoon, Chairman Burgess, Ranking Member Green and members of the 

subcommittee. I appreciate the opportunity to discuss an issue that touches so many 

Maine families, including my own. An increasing number of Mainers are severely 

affected by drug abuse and addiction. In 2015 alone, 269 Mainers died of an opioid 

overdose. It is clear that we must work to solve this serious problem impacting 

Maine and the rest of our Nation. 

I am a founding member of the Bipartisan Task Force to Combat the Heroin Epidemic. Since 2015, we have been a force for action, addressing the epidemic by 

learning from professionals in communities impacted by addiction. We have welcomed panelists, who have been able to provide valuable, real-life insight to help 

us work toward common-sense solutions. The Task Force helped bring awareness to 

the Nation’s need to address drug prevention and treatment, as well as to ensure 

that law enforcement officers have the tools necessary to fight this epidemic. I’m 

pleased that Congress responded to this crisis by passing the Comprehensive Addiction and Recovery Act. 

This legislation was a crucial step towards recovery for our families, friends, and 

communities, but was just one of many steps on the long road ahead. I am here 

today to discuss the importance of advancements in tools for prevention, enhanced 

reforms for bad actors, and our role in fostering interagency communication. 

In order to help ensure that patients are not abusing prescriptions, Maine has set 

strict limits on opioid prescriptions. In addition to mandating the use of the prescription monitoring program, Maine requires prescribers to check the program 

when first prescribing, and every 90 days thereafter, requires dispensers to check 

the respective State’s program when dispensing to an out-of-State resident and for 

a prescription written by an out-of-State provider. The dispenser also needs to check 

the program if an individual is paying with cash or if the person has not had a prescription for an opioid medication in the previous 12 months. 

These additional requirements create significant barriers to those attempting to 

abuse the system. Looking forward, it is crucial that we work toward the sharing 

of data between States to further deter system abuse and decrease the number of 

patients who will develop an addiction. As a member of the House Veterans Affairs 

Committee, I, along with Rep. Dunn, Rep. Tenney, Rep. Arrington and Rep. Tonko, 

have introduced the Veterans Opioid Abuse Prevention Act to ensure that providers 

from the Department of Veterans Affairs also use the program when prescribing 

controlled substances. 

There will always be bad actors, but it is our responsibility to remain steadfast 

in our work to close any loopholes for abuse. As the Energy and Commerce Committee continues to examine synthetic opioids, it is crucial that law enforcement receive the resources they need to hold accountable those who illegally manufacture 

fentanyl. The death rate for synthetic opioids other than methadone has significantly increased in Maine. The Task Force has discussed how local law enforcement 

can collaborate with the Federal and State governments as well as public health 

agencies to combat the use of synthetic opioids. Furthermore, we have discussed 

how the investigative arm of the Department of Homeland Security works with Federal, State, and local law enforcement to investigate criminal organizations that are 

79 

participating in the trafficking of synthetic drugs. I hope to continue these discussions as we review and modify best practices. 

As we continue to work towards addressing today’s crisis and future threats, I 

would like to thank you for your time and attention to these critical issues. 

Mr. BURGESS. Chair thanks the gentleman. 

Would the gentleman entertain one question on your prescription 

drug monitoring program? 

Mr. POLIQUIN. Yes, sir. 

Mr. BURGESS. Do you provide feedback to the prescribing doctor: 

This is the list of patients we have for you that you have prescribed? Is this a two-way street? 

Mr. POLIQUIN. It is, but the system is quite accurate, Mr. Chairman, such that the prescriber can see that data online. 

Mr. BURGESS. Very well. 

Representative Rouzer, you are recognized for 3 minutes, please. 

STATEMENT OF HON. DAVID ROUZER, A REPRESENTATIVE IN 

CONGRESS FROM THE STATE OF NORTH CAROLINA 

Mr. ROUZER. Thank you, Mr. Chairman, and the other members 

of this distinguished committee for your work to bring awareness 

to this opioid epidemic as well as your work to bring forward solutions to help address it. 

I am particularly grateful for your willingness to allow members 

who do not serve on this committee the opportunity to share how 

our districts have been impacted by this scourge. 

Opioid addiction has become a growing problem throughout 

North Carolina and particularly in the southeastern part of the 

State, home of the 7th Congressional District, which I have the 

privilege to represent. 

It is a growing and significant challenge for our communities, 

parents, law enforcement, local health departments, treatment facilities, and schools, to name just a few. 

This epidemic is so rampant, in fact, it would not be a stretch 

to say that if a family doesn’t have a relative suffering from this 

addiction, they know a friend or a family who does. 

Perhaps most alarming to me are the reports out of my district 

about Narcan parties. That’s right, Narcan parties. These are parties where teens and others go intending to get as high as possible 

with the expectation that they will be brought back to life by an 

injection of Narcan if needed. 

I also hear from members of the law enforcement community 

that they are administering Narcan to the very same individuals 

on a regular, even weekly, basis. 

Now, if this isn’t a sobering fact of how this addiction is destroying lives, I don’t know what is. 

In 2015, there were more than 1,100 opioid-related deaths across 

the State of North Carolina. The three counties most impacted by 

the opioid epidemic in the 7th Congressional District are Brunswick, New Hanover, and Pender counties. 

In 2015, there were 24 deaths in Brunswick County, 45 deaths 

in New Hanover, and 14 deaths in Pender County. Now, I’ve met 

with and heard from parents who have lost a child to an overdose, 

law enforcement officers who are struggling daily to prevent this 

epidemic from further penetrating into our communities, and indiVerDate Mar 15 2010 09:50 Oct 11, 2018 Jkt 037690 PO 00000 Frm 00085 Fmt 6633 Sfmt 6633 C:\USERS\WLAUFERT\DESKTOP\115X64MEMBERSOPIOIDSPDFMADE WAYNE
80 

viduals working at treatment facilities who do not have enough resources or beds to keep up with the demand. 

As with every complex problem, there is no silver bullet answer 

to this epidemic, unfortunately. However, it’s my belief that Congress can play a significant role by facilitating collaboration among 

the very best and brightest to bring solutions forward that will enable the country to turn the tables on this scourge. 

In the 7th Congressional District, we are fortunate to have many 

bright and committed individuals who have been working diligently 

on this issue for some time, many of whom serve on my Law Enforcement and Health Care Advisory Committees. 

And each of them, Mr. Chairman, stand ready to assist this committee and Congress as we work to address this problem in a comprehensive and effective way. 

Thank you again, Mr. Chairman, for the opportunity to testify 

today. I yield back. 

[The prepared statement of Mr. Rouzer follows:] 

PREPARED STATEMENT OF HON. DAVID ROUZER

Thank you, Mr. Chairman, and the other members of this distinguished committee for your work to bring awareness to the opioid epidemic as well as your work 

to bring forward solutions to help address it. I am particularly grateful for your willingness to allow members who do not serve on this committee the opportunity to 

share how our districts have been impacted by this scourge. 

Opioid addiction has become a growing problem throughout North Carolina, and 

particularly in the southeastern part of the State, home of the 7th Congressional 

District, which I have the privilege to represent. It is a growing and significant challenge for our communities, parents, law enforcement, local health departments, 

treatment facilities, and schools to name just a few. This epidemic is so rampant, 

in fact, it would not be a stretch to say that if a family doesn’t have a relative suffering from this addiction, they know a friend or family who does. 

Perhaps most alarming are the reports out of my district about Narcan parties. 

That’s right—Narcan parties. These are parties where teens and others go intending 

to get as high as possible with the expectation that they will be brought back to 

life by an injection of Narcan, if needed. I also hear from members of the law enforcement community about how they administer Narcan to the same individuals on 

a regular and repeated basis. If this isn’t a sobering fact of how this addiction is 

destroying lives, I don’t know what is. 

In 2015, there were more than 1,100 opioid related deaths across the State of 

North Carolina. 

The three counties most impacted by the opioid epidemic in the 7th District are 

Brunswick, New Hanover, and Pender counties. In 2015, there were 24 deaths in 

Brunswick County, 45 deaths in New Hanover County and 14 deaths in Pender 

County. 

I’ve met with and heard from parents who have lost a child to an overdose, law 

enforcement officers who are struggling daily to prevent this epidemic from further 

penetrating into our communities, and individuals working at treatment facilities 

who do not have enough resources and beds to keep up with the demand. 

There is no silver-bullet answer to this epidemic, unfortunately. However, Congress can play a significant role by facilitating collaboration among the very best 

and brightest to bring solutions forward that will enable the country to turn the tables on this growing epidemic. 

In the 7th Congressional District, we are fortunate to have many bright and committed individuals who have been working diligently on this issue—many of whom 

serve on my law enforcement and health care advisory committees. Each of them 

stands ready to assist this committee and Congress as we work to address this problem in a comprehensive and effective way. 

Thank you again, Mr. Chairman, for allowing us this opportunity to testify today. 

Mr. BURGESS. Chair thanks the gentleman. The gentleman yields 

back. 

81 

Chair recognizes the gentleman from Iowa, Mr. Young, for 3 minutes, please. 

STATEMENT OF HON. DAVID YOUNG, A REPRESENTATIVE IN 

CONGRESS FROM THE STATE OF IOWA 

Mr. YOUNG. Thank you, Mr. Chairman and Ranking Member. I 

would like to thank the committee for holding this hearing and I 

just really want to tell a story. 

I want to highlight the actions the community of Bridgewater, 

Iowa has undertaken in the last year to take back their town. 

Bridgewater, a small town of about 200 people in Adair County in 

southwest Iowa, is facing a problem with opioids and a range of 

other drugs. 

As drug use in the area slowly started to rise in the community, 

which relies on the county sheriff’s office to keep them safe, the 

residents were unable but not unwilling to stop the influx of drugs 

into their town. 

Residents of Bridgewater started to see cars coming into their 

town with out-of-State license plates and from counties across the 

State as the cars came, so did the crime. 

Residents and law enforcement noticed an uptick of crimes, theft, 

and vandalism, which traced back to drug users and dealers coming to town. Empty houses turned into drug houses powered by gas 

and generators, which led to more than four houses burning to the 

ground. 

Last spring, the residents were fed up as they saw the town they 

were raised up in slipping away. They decided to take action. Concerned residents met in the basement of a church to find a way to 

save their town. This is when they decided to take back Bridgewater. 

Residents formed a nonprofit group to fight the drug crisis together. As word spread, media outlets across the State came to the 

small town to shine a light on one of the many communities suffering in this 3rd District. 

I visited Bridgewater in April to meet with the residents in that 

same church basement as they began their mission to make sure 

that their town was safe again. I studied their faces, listened intently, and their mission is my mission. 

They started to hold forums with drug counsellors, law enforcement, State and local legislators and other individuals offering 

help. As residents started to clean up their town, they were met 

with hostility and retaliation from drug dealers and users. 

Leaders of the take back Bridgewater movement were run off the 

road, swerved at by those who wanted to protect the status quo. 

A number of other incidents occurred but the residents pressed on. 

The citizens of Bridgewater will not surrender. 

As neighboring communities saw what the residents of Bridgewater were doing, they wanted to do something in their communities. Leaders from towns across southwest Iowa often discussed 

strategies together to protect their neighbors. That is what Iowa is 

all about—neighbors helping neighbors, communities helping communities. 

Just last night, residents of Bridgewater gathered in the basement of that very same church to kick off a fundraiser for their 

82 

nonprofit. They will be going throughout southwest Iowa to sell 

Christmas trees to adorn the doors of homes throughout the region. 

Residents will use these funds to take back the community. 

Bridgewater will not turn a blind eye to opioids and drugs in their 

community. And, of course, we mustn’t forget the human tragedy 

of addiction and desperation. This epidemic is enslaving and killing 

our sons and daughters, our mothers and fathers. 

As the Federal Government addresses this issue, it is my hope 

we use Bridgewater as an example that local communities can have 

the largest impact if we partner with them and helping them to 

have those tools they need to be successful. 

A one-size-fits-all program will not save as many lives as a solution tailored to one community which has the buy-in of its residents. 

Take back Bridgewater is not just a slogan. It is an action plan, 

it is reality, and it is happening, and it is not just happening in 

Bridgewater. It is happening all around the country. 

Thank you for holding this hearing. 

[The prepared statement of Mr. Young follows:] 

PREPARED STATEMENT OF HON. DAVID YOUNG

Mr. Chairman, I would like to thank the committee for holding this hearing. 

I want to highlight the actions the community of Bridgewater, Iowa has undertaken in the last year to take back their town. 

Bridgewater, a small town of around 200 in the heart of Adair County in southwest Iowa, is facing a problem with opioids and a range of other drugs. 

As drug use in the area slowly started to rise in the community, which relies on 

the county sheriff’s office to keep them safe, the residents were unable, but not unwilling, to stop the influx of drugs into their town. 

Residents of Bridgewater started to see cars coming into town with out of State 

license plates, and from counties across the State. 

As the cars came, so did the crime. 

Residents and law enforcement noticed an uptick of crimes—theft and vandalism—which traced back to drug users and dealers coming to town. 

Empty houses turned into drug houses powered by gas and generators, which led 

to more than four houses burning to the ground. 

Last spring, residents were fed up as they saw the town they were raised in slipping away. They decided to take action. 

Concerned residents met in the basement of a church to find a way to save their 

town. This is when they decided to take back Bridgewater. 

Residents formed a nonprofit to fight the drug crisis together. As word spread, 

media outlets across the State came to this small town to shine a light on one of 

many communities suffering in the 3rd District. 

I visited Bridgewater in April to meet with residents in that church basement as 

they began their mission to make their town safe again. I studied their faces. I listened intently. And their mission is my mission. 

They started to hold forums with drug counselors, law enforcement, State and 

local legislators, and other individuals offering help. 

As residents started to clean up their town they were met with hostility and retaliation from drug dealers and users. 

Leaders of the Take Back Bridgewater movement were run off the road, swerved 

at by those who wanted to protect the status quo. A number of other incidents occurred, but the residents pressed on. The citizens of Bridgewater will not surrender. 

As neighboring communities saw what the residents of Bridgewater were doing, 

they wanted to do the something in their communities. Leaders from towns across 

southwest Iowa often discuss strategies together to protect their neighbors. 

That is what Iowa is all about: neighbors helping neighbors, communities helping 

communities. 

Just last night, residents of Bridgewater gathered in the basement of that very 

same church to kick off a fundraiser for their nonprofit. They will be going throughout southwest Iowa to sell Christmas wreaths to adorn the doors of homes throughout the region. 

83 

Residents will use the funds to take back their community. Bridgewater will not 

turn a blind eye to opioids and drugs in their community. And of course we must 

not forget this this human tragedy of addiction and desperation. This epidemic is 

enslaving and killing our sons and daughters; mothers and fathers. 

As the Federal Government addresses this issue, it is my hope we use Bridgewater as an example local communities can have the largest impact if we partner 

with them and helping with the tools they need to be successful. A one-size-fits-all 

program will not save as many lives as a solution tailored to each community which 

has the buy-in of its residents. 

Take Back Bridgewater is not just a slogan. It’s an action plan. It’s a reality. And 

it’s happening. And it’s not just happening in Bridgewater, it’s happening all around 

the country. 

Thank you again for the opportunity to join you today. 

Mr. BURGESS. Gentleman yields back. Chair thanks the gentleman. 

The gentleman from Oregon, Mr. Blumenauer, recognized for 3 

minutes. 

STATEMENT OF HON. EARL BLUMENAUER, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF OREGON 

Mr. BLUMENAUER. Thank you, Mr. Chairman. I appreciate the 

focus on the opioid crisis that grips every community to some degree and affects every State, especially critical for our veterans who 

are twice as likely to die from accidental overdoses. 

As we are slowly acknowledging the depths of the opioid crisis, 

which is good, we seldom acknowledge one of the simplest most effective solutions—medical marijuana. Cannabis. Now available in 

28 States, largely driven by the voters, not the politicians, most recently in Florida, where their voters approved it by over 70 percent. 

I have distributed some information here entitled, ‘‘The Physician Guide to Cannabis-Assisted Opioid Reduction’’ On the back 

are the citations for each of the points that are on this chart referencing cannabis reducing opioid overdose mortality, how cannabis reduces opioid consumption, how cannabis can prevent dose 

escalation and the development of opioid tolerance. Cannabis alone 

or in combination with opioids could be a viable first line analgesic. 

Mr. Chairman, we don’t talk much about this, although on the 

floor of the House repeatedly over the last 3 years Congress has 

been moving in this direction and voted last Congress to have the 

Veterans Administration be able to work with veterans in States 

where medical marijuana is legal. 

But I focus on just one simple item, not the facts, which I hope 

this committee would look at. But there is one piece of legislation 

that I have introduced with Dr. Andy Harris, somebody who 

doesn’t agree with me about the efficacy of medical marijuana but 

he strongly agrees with me that there is no longer any reason for 

the Federal Government to interfere with research to be able to 

prove it. 

The Federal Government as a stranglehold on this research. We 

have bipartisan legislation, 3391, which would break that stranglehold and be able to have robust research to resolve these questions 

so there would no longer be any doubt. 

This is the cheapest, most effective way to be able to stop the crisis. Where people have access to medical marijuana, there are 

fewer overdoses and people opt for it dealing with chronic pain. 

84 

I would appreciate the subcommittee looking at this issue as 

your time permits. Thank you, Mr. Chairman, Ranking Member. 

[The prepared statement of Mr. Blumenauer follows:] 

PREPARED STATEMENT OF HON. EARL BLUMENAUER

As this hearing today highlights, opioids have wreaked havoc on our country, killing people and devastating families. I am here today to offer an alternative treatment for pain, PTSD, and a number of other health problems-medical cannabis. 

Despite the fact that more than 95 percent of Americans live in States that have 

legalized some form of medical cannabis, Federal policy is blocking biomedical research of marijuana. 

This is outrageous! 

We owe it to patients and their families to allow for the research physicians need 

to understand marijuana’s benefits and risks and determine proper use and dosage. 

The Federal Government should get out of the way to allow for this long overdue 

research. 

Unfortunately, States cannot address this research gag on their own. Congress 

must act to allow for the research of marijuana-which I stipulate would be a safer, 

less addictive alternative than opioids for some health problems. 

And, it’s not just me who thinks this. I have veterans banging down my door seeking alternatives to opioids. Many veterans are in an untenable situation— Untreated chronic pain can increase the risk of suicide, but poorly managed opioid regimens can also be fatal. The fact that veterans are TWICE as likely to die from accidental opioid overdoses than their civilian counterparts to get Congress off the dime. 

Dr. Andy Harris—a well-known marijuana prohibitionist—and I—the Member of 

Congress from Portlandia—have teamed up to introduce the Medical Marijuana Research Act. This bill would create a pathway for qualified researchers to conduct research using marijuana. Senators Hatch and Schatz have a similar bill on the Senate side. 

I ask that this committee hold a hearing on the bill as patients desperately need 

a safer, less addictive alternative to opioids. 

Mr. BURGESS. The Chair thanks the gentleman. Gentleman 

yields back. 

Chair recognizes the gentlelady from Georgia, Mrs. Handel, for 

3 minutes, please. 

STATEMENT OF HON. KAREN C. HANDEL, A REPRESENTATIVE 

IN CONGRESS FROM THE STATE OF GEORGIA 

Mrs. HANDEL. Thank you, Mr. Chairman, and thank you as well 

for holding this hearing. 

The opioid crisis has hit the suburban Atlanta counties of Fulton, 

Cobb, and DeKalb as hard as, frankly, anywhere in the country, 

from prescription painkillers to synthetic drugs to heroin. 

In 2016, 72.3 percent of all drug-related fatalities in Cobb County 

were caused by opioids and that was an increase from 16.8 percent 

just the year before. 

In 2015, the Cobb County narcotics team seized more than— 

more heroin than in the previous 20 years combined. Meanwhile, 

in Fulton County, the medical examiner’s office recorded a total of 

77 heroin deaths in 2014. That is compared to just four such 

deaths in 2010. 

Behind these statistics, though, are hurting devastated families—families that are being torn apart by addiction, facing financial ruin in their desperate effort to try anything to make things 

right, or worse, losing a loved one to a drug overdose or suicide. 

The opioid crisis, as we’ve heard, is indeed a complex one. It is 

an incredibly sensitive issue, particularly for communities that 

have long felt immune to fatal substance abuse problems. 

85 

Still, communities, through churches, law enforcement, nonprofits, with the support of local, State, and Federal government 

are coming together to take action. 

This year in the city of Alpharetta, they created a new program 

designed to reduce painkiller abuse across the county. With the 

help of the Rotary Club in Alpharetta, the city purchased special 

boxes that were—are used to collect unused and unwanted prescription medication and locating those at police headquarters and 

fire stations throughout the county. 

While the boxes cost about a thousand dollars each, they are designed and constructed specifically to prevent anyone from stealing 

the drugs inside. This is—may seem a small measure, but it is 

making an impact by providing a safe secure disposal point. 

In the city of Johns Creek, the Hub Community Resource Center 

is acting as a lifeline for those seeking drug abuse and mental illness attention. 

Ultimately, the incarceration of addicts, though, should not be 

seen as some kind of victory or solution. Instead, we have to continue to look for the root causes. 

As the district attorney in Cobb County said, we are not going 

to be able to arrest our way out of this epidemic. The road to recovery must be lined with treatment options. 

So further, nonopioid and nonpharmacalogical treatments for 

therapies do exist. Atlanta’s Emory University recognized Pain 

Awareness Month in September by educating our community about 

these alternatives. 

We also need to do a better job of data sharing important information that exists at the local, State, and Federal level. I stand 

ready to help you in any way. 

Thank you, Mr. Chairman, for this opportunity. 

[The prepared statement of Mrs. Handel follows:] 

PREPARED STATEMENT OF HON. KAREN C. HANDEL

The opioid crisis has hit the suburban Atlanta counties of Fulton, Cobb & Dekalb 

as hard as anywhere in the country. 

In 2016, 72.3 percent of all drug-related fatalities in Cobb County were caused 

by opioids, up from 64.8 percent just 1 year before. And in 2015, the Cobb County 

Narcotics team seized more heroin than in the previous 20 years—combined. 

Meanwhile, in neighboring Fulton County, the Medical Examiner’s Office recorded 

a total of 77 heroin deaths in 2014, compared to just four in 2010. 

Behind these statistics are hurting families—families that are being torn apart by 

addiction, facing financial ruin in their effort to try anything to make things right, 

or worse, losing a loved one to overdose or suicide. 

Our community’s—our Nation’s—opioid crisis is a complex issue, and it’s not 

going to be solved with any single proposal. Admitting there is a problem is the first 

step, however. 

This is an uncomfortable, sensitive issue, particularly in communities that have 

long felt immune to fatal substance abuse problems. Still, communities—through 

churches, law enforcement, non profits—are coming together to take action. 

This year, the North Fulton city of Alpharetta created a new program designed 

to reduce painkiller abuse across the county. With the help of Alpharetta’s Rotary 

Club, the city purchased boxes that will collect unused and unwanted prescription 

medications at its police headquarters and fire stations. 

The boxes cost about $1,000 each and are designed and constructed to prevent 

anyone from stealing the drugs inside. 

It may seem a small measure, but it is making an impact by providing a safe, 

secure disposal point. 

In the city of Johns Creek, the Hub Community Resource Center acts as a lifeline 

for those seeking drug abuse and mental illness attention. Centers like these help 

86 

people suffering from addiction and prevent others from succumbing to the same 

fate in the future. 

Ultimately, the incarceration of addicts should not be seen as some kind of victory 

or solution. Instead, we must look at the root causes, most effective potential solutions, and—most importantly—we must work towards finding ways for those affected by opioid addiction to recover to lead healthy, productive lives. 

As Cobb County District Attorney Vic Reynolds said, ‘‘We cannot arrest our way 

out of this epidemic. The road to recovery must be lined with treatment options.’’ 

Further, nonopioid and nonpharmacological treatments or therapies for pain do 

exist. Studies show that these alternative therapies can be just as beneficial or better than prescription pain medications, but without the side effects of overuse and 

abuse. 

Atlanta’s Emory University recognized Pain Awareness Month in September by 

educating the community about pain relief alternatives to prescription medications. 

As the opioid epidemic spreads, we need data and alternatives to medications now 

more than ever. 

Finally, I want to specifically commend two legislators in my home State of Georgia—State Senator Renee Untermann and State Representative Sharon Cooper— 

each of whom have been leading the efforts on opioid addiction prevention from the 

State capitol. Senator Unterman is the chairman of the Committee on Health and 

Human Services and sponsor of SB81, legislation focused on Naloxone availability 

and electronic reporting of controlled substances in Georgia. 

We can do better than this crisis we’re facing across the country, and creative options like those we’re seeing throughout the 6th District of Georgia are all part of 

the national effort. Our local, State and Federal law enforcement, healthcare groups, 

drug enforcement agencies and elected leaders must continue to work together. The 

lives of tens of thousands of Americans are literally depending on it. 

Mr. BURGESS. The Chair thanks the gentlelady. Gentlelady yields 

back. 

Recognize Representative Crist from Florida, 3 minutes, please. 

STATEMENT OF HON. CHARLIE CRIST, A REPRESENTATIVE IN 

CONGRESS FROM THE STATE OF FLORIDA 

Mr. CRIST. I would like to thank Chairman Burgess and Ranking 

Member Green for providing us this opportunity for Members to 

share how the opioid crisis is affecting their constituents, including 

my neighbors in Pinellas County, Florida. 

The statistics for opioid deaths and disorders are shocking. Our 

society’s use of opioids has truly become an epidemic. Last year, 

11.8 million Americans age 12 or older misused opioids, including 

nearly 900,000 children age 12 to 17. 

Over 50 percent of the people with both substance abuse and a 

mental health disorder do not receive treatment for either issue. 

Tragically, my home State of Florida was the prescription drug 

abuse capital of the United States in the last decade. 

They were known as pills mills and prescribed massive amounts 

of otherwise legal narcotics which were then distributed into our 

neighbourhoods, schools, communities, and throughout the country. 

When I was Governor, we went after pill mills and put them out 

of business. While Florida may have won the battle against these 

pill mills, our country is losing the war on opioid abuse and its addiction. 

We are ignoring mental health, under funding addiction treatment, sidestepping what the science tells us is the best way to fight 

the addiction, and now the scope of the crisis has broadened beyond 

prescription drugs into heroin and even fentanyl. 

My home of Pinellas County was no exception. Last year, we saw 

a string of deaths from Xanax mixed with fentanyl. In 2015, herVerDate Mar 15 2010 09:50 Oct 11, 2018 Jkt 037690 PO 00000 Frm 00092 Fmt 6633 Sfmt 6633 C:\USERS\WLAUFERT\DESKTOP\115X64MEMBERSOPIOIDSPDFMADE WAYNE
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oin, fentanyl, and oxycodone were responsible for over 3,800 deaths 

in Florida alone. 

It is a tragedy, it is an epidemic, and the need for action is immediate. I saw the devastation firsthand recently when I visited 

the nonprofit Operation PAR in my district just a few months ago. 

I heard directly from those in recovery being helped by their innovative, more holistic approach. 

If we are going to combat this problem, we can’t concentrate on 

law enforcement alone. Florida should serve as an example to the 

rest of the country that only going after suppliers is insufficient. 

Let us be clear. The people who misuse opioids aren’t the worst 

of the worst. They are our neighbors, our friends, parents, and children who are desperately in need of help. 

They often suffer in silence and isolation because of the stigma 

and shame surrounding drug abuse. Unfortunately, America 

learned this lesson the hard way, treating the crack epidemic as 

simply a law enforcement exercise. 

We can’t combat our opioid crisis without investing in new treatment options, long-term mental health, and substance abuse recovery resources, and the men and women on the ground working in 

nonprofits and Government, collaborating with first responders and 

law enforcement to help those in need in all of our communities. 

This includes funding for the substance abuse mental health 

service and the National Institutes of Health, which provides the 

research and innovative treatments not often permitted using traditional funding. 

This funding provides grants including in Pinellas County for innovative local solutions for treating mental health and substance 

abuse disorders, like what is happening at Operation PAR and 

Bent Not Broken organization. 

This includes funding overdose reversal. We will lose this fight 

without Naloxone. Americans will die unnecessarily, and because 

Florida did not expand Medicaid, the funding for these organizations is even more vital and something I hope your committee continues to prioritize in this ongoing battle. 

Thank you again for this opportunity to share how my home in 

Pinellas County is combatting this epidemic. 

Thank you, Mr. Chairman, and committee. 

[The prepared statement of Mr. Crist follows:] 

PREPARED STATEMENT OF HON. CHARLIE CRIST

I’d like to thank Chairman Burgess and Ranking Member Green for providing us 

this opportunity for Members to share how the opioid crisis is affecting their constituents, including my neighbors in Pinellas County, Florida. 

The statistics for opioid deaths and disorders are shocking. Our society’s use of 

opioids has truly become an epidemic. Last year, 11.8 million Americans aged 12 

or older misused opioids, including nearly 900,000 children aged 12–17. Over 50 percent of the people with both substance abuse and a mental health disorder do not 

receive treatment for either issue. 

Tragically, my home State of Florida was the prescription drug abuse capital of 

the United States in the last decade. They were known as ‘‘pill mills’’ and prescribed 

massive amounts of otherwise legal narcotics, which were then distributed into our 

neighborhoods, schools, communities, and throughout the country. When I was Governor, we went after ‘‘pill mills’’ and put them out of business. 

While Florida may have won the battle against these ‘‘pill mills’’, our country is 

losing the war on opioid abuse and its addiction. We’re ignoring mental health, 

underfunding addiction treatment, side-stepping what the science tells us is the best 

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way to fight addiction. And now the scope of the crisis has broadened beyond prescription drugs—into heroin and even fentanyl. My home of Pinellas County was no 

exception. Last year, we saw a string of deaths from Xanax mixed with fentanyl. 

In 2015, heroin, fentanyl, and oxycodone were responsible for over 3,800 deaths in 

Florida alone. It is a tragedy. It is an epidemic. And the need for action is immediate. I saw the devastation firsthand recently when I visited the nonprofit ‘‘Operation PAR’’ in my district just a few months ago. I heard directly from those in recovery, being helped by their innovative, more holistic approach. 

If we are going to combat this problem, we can’t concentrate on law enforcement 

alone. Florida should serve as an example to the rest of the country that only going 

after suppliers is insufficient. Let’s be clear: the people who misuse opioids aren’t 

the worst of the worst; they are our neighbors, our friends, parents, and children 

who are desperately in need of help. They often suffer in silence and isolation because of the stigma and shame surrounding drug abuse. Unfortunately, America 

learned this lesson the hard way treating the crack epidemic as simply a law enforcement exercise. 

We can’t combat our opioid crisis without investing in new treatment options, 

long-term mental health and substance abuse recovery resources, and the men and 

women on the ground working in nonprofits and Government, collaborating with 

first responders and law enforcement, to help those in need in all of our communities. This includes funding for the Substance Abuse and Mental Health Service 

(SAMHSA) and the National Institutes of Health, which provides the research and 

innovative treatments not often permitted using traditional funding. This funding 

provides grants, including in Pinellas County, for innovative, local solutions for 

treating mental health and substance abuse disorders, like what’s happening at 

‘‘Operation PAR’’ and ‘‘Bent Not Broken’’ organization. This includes funding overdose reversal. We will lose this fight without naloxone. Americans will die unnecessarily. And because Florida did not expand Medicaid, funding for these organizations is even more vital, and something I hope your committee continues to 

prioritize in this ongoing battle. 

Thank you again for this opportunity to share how my home of Pinellas County 

is combating the opioid crisis. Thank you, Mr. Chairman and committee. 

Mr. BURGESS. The gentleman yields back. The Chair thanks the 

gentleman. 

The Chair recognizes Mr. Faso for 3 minutes, please. 

STATEMENT OF HON. JOHN J. FASO, A REPRESENTATIVE IN 

CONGRESS FROM THE STATE OF NEW YORK 

Mr. FASO. Thank you, Chairman Burgess, Ranking Member 

Green, and members of the committee for holding this important 

hearing and hosting all of us today. 

I appreciate and understand many of the testimonies we have 

heard from our colleagues. It is important to note that we represent districts that are often extremely different from each other— 

Democrat, Republican, rural, and urban. It is rare when an issue 

can unite not only a conference but an entire Congress. 

At the risk of speaking for my colleagues, I would like to express 

that we all stand together against the opioid epidemic. Now, in my 

district, in the 19th District in upstate New York, I can tell you 

a couple of stories. 

Greene County emergency responders recently reported to me 

they came upon a scene where they had two individuals who had 

overdosed. One individual required eight doses of Naloxone in order 

to be revived. Another required six. 

This is not an uncommon phenomena. County sheriffs had reported to me going back to the same household, the same apartments on the same evening to administer Narcan to revive people 

who have overdosed. 

Other county sheriffs have told me that every single drug dealer 

they arrest has public benefit and food stamp cards in their possesVerDate Mar 15 2010 09:50 Oct 11, 2018 Jkt 037690 PO 00000 Frm 00094 Fmt 6633 Sfmt 6633 C:\USERS\WLAUFERT\DESKTOP\115X64MEMBERSOPIOIDSPDFMADE WAYNE
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sion. It is ironic that we, the public, are often sustaining economically those that prey upon our citizens. 

In my district in the Board of Supervisors in Columbia County 

recently passed an opioid epidemic response plan. This plan is an 

enormous step forward to combatting the opioid crisis in our region. 

Ulster County has also substantially increased local funding to 

fight the crisis. Twin County Recovery Services in Columbia and 

Greene Counties is also serving those with addiction through clinical, residential, and educational programs. 

And I think the bottom line, Mr. Chairman, my colleagues, we 

have got to have educational programs that help us staunch the demand for these substances and not just try to staunch the supply. 

Congress must continue to help our local communities by ensuring they have the support and the 21st Century Cures and CARA, 

supporting SAMHSA legislation, and passing legislation such as 

the STOP Act to support our local law enforcement officers by making it more difficult for the U.S. Postal Service to ship fentanyl and 

carfentanyl through the mail. 

I recommend more research into how opioids affect the brain and 

learn more into how to defeat this chemical dependency. 

Our work is far from finished. We must stay engaged with each 

other, stay engaged with our communities and stay engaged with 

victims and families to truly effectuate and facilitate an authentic 

reversal of this dangerous and upward trend of opioid addiction in 

our communities. 

I thank the committee for their service and for allowing us to 

bring this testimony forth today. 

[The prepared statement of Mr. Faso follows:] 

PREPARED STATEMENT OF HON. JOHN J. FASO

Thank you, Chairman Burgess, Ranking Member Green, and members of the committee for holding this important hearing and hosting me today. 

I appreciate and understand many of the testimonies we have heard from our colleagues. It is important to note that we represent districts that are extremely different from each other; Democrat, Republican, rural, and urban. It is rare when an 

issue can unite not only a conference, but an entire Congress. At the risk of speaking for my colleagues, I would like to express that we stand together against the 

opioid epidemic. 

My particular district in upstate New York is fairly rural, Mr. Chairman. 

When we think of rural America, it evokes images of small towns, diners on the 

corners, two lane roads framed by family farms, and a community where neighbors 

look out for each other, and work hard for what they have. 

While all of these sentiments ring especially true in my district, so does the opioid 

crisis. 

Our local communities and counties across upstate are stepping up to the plate 

and finding ways to address this problem in a manner that meets their needs. With 

help from the State and Federal governments, our local governments and groups facilitate outreach programs, education programs, informational resources, trainings 

and working groups. 

In my district, the Board of Supervisors of Columbia County recently passed an 

Opioid Epidemic Response Plan. This plan is an enormous step forward in combating the opioid crisis in our region. Twin County Recovery Services is also another 

institution in my district serving those with addiction through clinical, residential, 

and educational programs. These initiatives enable local entities to most effectively 

help those with addiction, educate first responders, prevent future tragedies, and deploy Federal and State funding in our communities. 

90 

I come before the committee today to implore my colleagues to work with me to 

empower local governments, that are closest to the crisis, to improve education and 

prevention programs and fight addiction on the front lines. 

Congress must continue to help our local communities by ensuring they have our 

support through means such as adequately implementing and funding CARA and 

21st Century Cures, supporting SAMHSA (sam-sa) and passing legislation such as 

the STOP Act to support our local law enforcement officers by making it more difficult to ship fentanyl and carfentanil. 

I appreciate committee-led initiatives to work in a bipartisan-nature in passing 

ground-breaking addiction treatment legislation, holding numerous hearings to explore further Congressional action, and remaining open and inclusive during this 

process. 

Our work is far from finished. We must stay engaged with each other, stay engaged with our communities, and stay engaged with the victims to truly, and effectively facilitate an authentic reversal of this dangerous upward trend of opioid addiction. 

I stand ready to help the committee in this fight. Thank you. 

Mr. BURGESS. Chair thanks the gentleman. The gentleman yields 

back. 

Chair recognizes Mr. Katko for 3 minutes, please. 

STATEMENT OF HON. JOHN KATKO, A REPRESENTATIVE IN 

CONGRESS FROM THE STATE OF NEW YORK 

Mr. KATKO. Thank you, Mr. Chairman and Ranking Member 

Green. I appreciate you giving me the opportunity to testify today 

about this most important topic and giving me the opportunity to 

not only discuss what has been being discussed but a possible partial solution to the problem from a law enforcement standpoint. 

And that is a bill that I introduced, H.R. 2851, the Stop the Importation Trafficking of Synthetic Analogs Act of 2017, which I will 

refer to as SITSA. 

I am driven in my testimony today and my support for this bill 

by two things. One is my 20 years as a Federal organized-crime 

prosecutor, prosecuting every manner of drug known to man, and 

knowing that, based on that experience, I have never seen anything that remotely resembles the tragic consequences of the current synthetic drug problem and the heroin issue in this country, 

and they are intertwined. 

And I can talk chapter and verse about what is going on in my 

community but I just want to introduce you to a few people that 

we have lost since I have been in Congress. 

John and Tina Socci lost their daughter, who was murdered in 

front of her 18-month-old child by her boyfriend, who was addicted 

to opioids. Two years later, still grieving the loss of their daughter, 

they lost their son to a heroin overdose. Their son was a drug counselor. 

Joe Campanella lost his son—I am sorry—Joe Campanella lost a 

son and his son was a drug counselor at the time, and John Socci 

and Tina Socci lost their son as well. Kevin Jones lost his stepdaughter. 

Theresa Wilson lost her son after he ingested synthetic marijuana that was purchased over the counter at a local head shop 

and he had convulsions and drowned. 

Deanna Axe—all these stories are tragic but this one is perhaps 

the worst—Deanna was a high school athlete, a great individual. 

She got involved with heroin after abusing opiates and she became 

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pregnant. She went cold turkey and quit. She was five months 

pregnant and she had not had any relapses whatsoever. 

A drug dealer who I can only describe as one of the most reprehensible creatures on earth, cajoled her into trying one more time 

because a new mixture had come in. She tried it that one time and 

she died, and she lost her five-month-old child as well—unborn 

child. 

That is the face of this tragedy. That is the face of what is going 

on here and that is what I am trying to address with respect to 

the SITSA Act. 

Toxic synthetic drugs are designed to mimic street drugs like 

marijuana and what this drug is trying to do is recodify the problem. The problem I encountered when I was a prosecutor doing 

synthetic drugs prosecutions is that the statutes don’t keep up. 

The drug that killed Theresa Wilson’s son took 4 1A1⁄2 years 

after they identified the chemical compound before it was listed in 

a drug analog statute. 

This bill that I have that has already passed the Judiciary and 

is simply waiting to get out of E and C before it can be voted on 

on the floor and I think will pass overwhelmingly turbo charges 

that process to reduce it to about 30 days, and it also, in a nutshell, 

will give individuals in Congress who may disagree with the classification of one of these drugs 180 days after it is classified to have 

it removed through a congressional act. 

So I was going to talk much longer about it. I realize my time 

is up. But I can tell you from looking through the prism of a prosecutor there is three ways that you need to address this. 

Number one is law enforcement, number two is prevention, and 

number three is treatment. As my colleague, Mr. Faso, noted, we 

have done a lot with the CARA Act and other things to address 

prevention and treatment. 

This SITSA Act is something that law enforcement needs and, 

quite frankly, it is a game changer and I hope that E and C will 

consider it in a swift manner so it can get to floor for a vote and 

get into law and give another—put it in the arsenal for law enforcement to be able to attack this problem in a meaningful manner. 

And with that, I yield back, Mr. Chairman. 

[The prepared statement of Mr. Katko follows:] 

PREPARED STATEMENT OF HON. JOHN KATKO

Thank you, Chairman Burgess, Ranking Member Green, and members of the Subcommittee on Health, for allowing me to speak today about the synthetic drug epidemic and my bill, H.R. 2851, the Stop the Importation and Trafficking of Synthetic 

Analogues (SITSA) Act of 2017. 

Synthetic drug abuse has crippled communities across this Nation, leading to 

countless tragedies in places like my district. This year, Syracuse area hospitals saw 

a record number of overdoses due to synthetic drug abuse. In May, over 15 individuals had overdosed on synthetic drugs and were taken to the ER in the span of 24 

hours. Unfortunately, stories like this have become the new normal. First responders and emergency room physicians across the Nation have seen incredible increases 

in calls due to synthetic overdoses, which is why they wholeheartedly support my 

legislation. 

Toxic, synthetic drugs are designed to mimic street drugs like marijuana, LSD, 

cocaine, ecstasy and other hard drugs. They can be more potent than the real thing 

and oftentimes are more deadly. Unfortunately, when law enforcement encounters 

and begins to combat a specific synthetic drug compound, manufacturers of these 

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substances are able to slightly alter the chemical structure of the drug. This puts 

law enforcement at a serious disadvantage, leaving them constantly one step behind. As a former U.S. attorney, but more importantly, as a father, getting these 

drugs off the streets and out of the hands of our loved ones remains a top priority 

for me. 

Right before I introduced the bill, I met with a constituent in my district, Teresa 

Woolson, whose son was tragically killed by a synthetic drug identified as XLR–11. 

Unfortunately for Teresa, the drug that killed her son managed to remain legal and 

on the streets for 4 years after his death, until it was finally added to the controlled 

substances list. This is unacceptable and these families deserve to see justice. 

The potency and danger of synthetic drugs do not only threaten users, we are now 

seeing local law enforcement and first responders put in harm’s way simply by coming in contact with these often lethal substances. Numerous cases across the country 

have resulted in emergency personnel becoming gravely ill and even dying while responding synthetic overdoses. The threats synthetic drugs pose to our communities 

and law enforcement must be stopped. H.R. 2851 takes a big step towards eradicating these harmful substances and protecting our communities. 

The SITSA Act will give local, State, and Federal law enforcement the necessary 

tools to target synthetic substances and the criminals who traffic them. Specifically, 

this legislation will create a new schedule to the Controlled Substances Act and establish a mechanism by which synthetic analogues can be temporarily or permanently added to that schedule in as little as 30 days after the chemical composition 

is determined by the Attorney General. The new schedule, Schedule A, will also add 

13 synthetic fentanyls that have been identified by the DEA as an immediate threat 

to public health and safety. These synthetics have been confirmed as the cause of 

death in at least 162 cases in the United States. Finally, the bill maintains firm 

penalties for foreign manufacturing and importation and provides a multistep sentencing process which includes application of existing Federal guidelines. The goal 

of this legislation is to not only prevent drug abuse, but to facilitate proper research 

so that we may better understand these chemical compounds. 

The stories of synthetic drug abuse are in no way limited to my area of the country; this is a nationwide epidemic. I respectfully ask this subcommittee to consider 

the SITSA Act because every moment we fail to act; another person is effected by 

synthetic drugs. 

This summer, the Judiciary Committee unanimously passed this bipartisan legislation. We have worked with Members on both sides of the aisle as well as stakeholders across the law enforcement and health communities. I welcome your comments and amendments so that we can make this bill a powerful tool in eradicating 

these harmful substances. 

Again, I thank you for allowing me to testify this morning and urge this subcommittee to take action on H.R. 2851. 

Mr. BURGESS. Gentleman yields back. Chair thanks the gentleman. 

The Chair recognizes the gentleman from Massachusetts, Mr. 

Keating, for 3 minutes, please. 

STATEMENT OF HON. WILLIAM R. KEATING, A REPRESENTATIVE IN CONGRESS FROM THE COMMONWEALTH OF MASSACHUSETTS 

Mr. KEATING. Thank you, Mr. Chairman. 

Let me just go off my notes and try and speak from the heart. 

Before I was a Member of Congress, I was a DA for 12 years. Started a task force. Now, it’s over a decade and a half on—at the time, 

heroin task force, but it was the result of my work as a DA. 

We would go to unattended deaths. We would find out that the 

person there had no criminal record. They started their addiction 

with prescription drugs, went to heroin—it was just cheaper, more 

available, believe it or not—and then they died. 

I consoled parents who lost the child. I worked with grandparents who were raising their children. In my own family, I lost 

a cousin to an overdose right after he was coming out of detox, the 

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most dangerous time. On a brighter note, I have another family 

member a decade and a half in recovery. 

So I’ve seen this first hand. I’ve dealt with it in my district now. 

Since we are sharing that, one of my communities I share with 

Representative Kennedy. 

At Fall River, Mass., they are on pace for over a thousand—just 

this one city over a thousand overdoses this year and over a hundred deaths. It is the effect of fentanyl and carfentanyl in our area. 

In my district, I have four of the five leading counties in terms 

of opioid deaths. 

I want to thank this committee, though, for the work they have 

done with the CARA Act, with 21st Century Cures. You are working—I think that work is at risk if we backtrack on the availability 

of treatment through the ACA or another source because, as you 

know, 34 percent of the people before then did not have the guarantee of that treatment, which is important. 

Eighteen percent didn’t have the coverage for mental health 

treatment that is necessary as well. In the Medicaid expansion— 

those States that did it—there is now 11 million low-income Americans covered by this. 

I also want to thank you on efforts that we’ve worked on a bipartisan basis. I worked on efforts with the STOP Act, which was part 

of this committee. I hope that it moves forward. 

Some of that is being done administratively where we look at 

making our drugs that are there tamper resistant—abuse resistant. 

Cosponsoring a Saves Act also, which allows a coprescription of 

Naloxone that is there—it solves the problem for the medical community and work with the veterans in terms of making sure they 

are educated. 

I just heard my colleague talk about the fact that we deal with 

this in three ways. The interdiction is limited. I just had a private 

meeting, since I am on Homeland Security, in my office with the 

leaders in terms of Customs and Border Patrol and what is going 

on. 

It is limited because so much of it’s increased through the mail, 

through Fed Ex, through UPS. Very hard to deal with in that respect, although we should do what we can to do it. 

Prevention is important, obviously, in terms of medical-assisted 

treatment and dealing with the middle school population. 

Let me just conclude with this, because I was up last night 

thinking what I was going to say to you today. About 7 years ago 

when I got here, four Members of Congress, myself included, sat 

down with the FDA and people just to air out some real concerns. 

Only myself and Representative Hal Rogers are still here from that 

group. 

At the end of listening to us, all these experts came and they 

said, Congressman, you don’t understand—you don’t understand 

about medicine. You don’t understand about medical treatment. We 

are there to deal with some pain and, you know, that is part of our 

reason. 

And I said—and I slammed the table and I said, you don’t understand about pain—the pain of losing a son or a daughter, a grandchild. The pain of families—the pain of what it does to your income 

and work when this happens. That kind of pain doesn’t go away. 

94 

And we haven’t progressed enough from that, frankly. It is great 

for this committee. It is great, I think, for myself to take whatever 

expert advice we can. 

But on this issue, people are depending on us. We’ve got to create 

the urgency and deal with it ourselves. We can’t rely on other people to do it. In many cases, we are the court of last resort. 

We can do this. We can work together and we can make sure it 

can be done. But let’s do it ourselves and let us take that leadership, and I want to thank you for the leadership you’ve shown in 

this, and I plan to work with you any way I can. 

Thank you. 

[The prepared statement of Mr. Keating follows:] 

PREPARED STATEMENT OF HON. WILLIAM R. KEATING

Chairman Burgess, Ranking Member Green, and other distinguished members of 

the committee, thank you for the opportunity to testify about this critical issue. 

Dating back to my time as District Attorney, I have witnessed the devastation of 

the opioid crisis for nearly two decades. Countless families in my area have felt the 

effects, including my own. I have been called to sites of unattended deaths resulting 

from overdose. I have consoled parents who have lost a child to an overdose. I have 

worked with grandparents who are raising their grandchildren because of addiction. 

And all of this was before I got to Congress 7 years ago, when the number of opioidrelated deaths was 45 percent lower than it is today. Today, we even have entire 

facilities dedicated to babies born addicted to opioids. As the members of this committee know, we cannot continue only to talk about this at arm’s length. This goes 

beyond just numbers or statistics. People are feeling real pain. And we are losing 

an entire generation. 

The district I represent in Congress includes four of the top five counties in Massachusetts by opioid death rate. Further, Fall River, Massachusetts, a city I represent along with Congressman Kennedy, is projected to see at least 1,000 opioid 

overdoses and over 100 deaths in 2017 alone. This is a horrible scourge for my constituents, and as evinced by the need for this hearing, a tragic epidemic nationwide. 

To begin, I thank this committee for their work guiding the House through enactment of two important laws, laws which laid meaningful groundwork for progress 

in battling the opioid crisis. The strategy outlined in the Comprehensive Addiction 

and Recovery Act (CARA) and the $1 billion in funding included in the 21st Century 

Cures Act have been significant steps in the right direction. More people have access 

to treatment, more health professionals understand early signs of addiction, and the 

number of opioid prescriptions has declined. However, some of the health legislation 

we have seen this year places this progress at risk. 

Prior to the Affordable Care Act (ACA), an estimated 34 percent of insurance 

plans did not cover treatment for opioid use and other substance use disorders, and 

18 percent did not provide coverage for any mental health conditions. The ACA required insurance policies to include this coverage. Similarly, the law’s Medicaid expansion provided access to treatment for substance use disorders to 11 million lowincome Americans. In fact, at an estimated $60 billion in coverage for behavioral 

health services each year, Medicaid is the largest source of funding for mental 

healthcare in the country—including services related to substance use disorders. Efforts to repeal the Affordable Care Act and cut funding for Medicaid place this coverage at grave risk. Accordingly, I am committed to defending the Affordable Care 

Act and preserving access to addiction treatment for all Americans. 

Aside from these concerns, I am encouraged that we do find consensus elsewhere. 

For example, we agree the solution to this crisis requires a multipronged approach. 

Last Congress, I introduced three bipartisan pieces of legislation aimed at combatting the opioid crisis from three different fronts. The first, the Stop Tampering of 

Prescription Pills Act, calls on the Food and Drug Administration to facilitate the 

creation of tamper-resistant formulations for commonly misused pain medication. 

The second, the Coprescribing Saves Lives Act, encourages physicians to coprescribe 

naloxone alongside opioid prescriptions and make naloxone more widely available in 

Federal health settings. The legislation also authorizes a grants program to funds 

State-level efforts to encourage the establishment of coprescribing guidelines, assist 

in the purchase of naloxone, fund training for health professionals and patients, and 

support patient copays. Last, the Safe Prescribing for Veterans Act outlines a common-sense plan to decrease opioid overuse among veterans by establishing a pain 

95 

management continuing education requirement for opioid prescribers affiliated with 

the Department of Veterans Affairs. I look forward to working with my colleagues 

as I reintroduce these initiatives this Congress. 

We in this House are constantly learning about innovative approaches to pain 

management, improved methods of treating addiction, and novel ideas for opioid disorder prevention and education. There are even technologies that function as alternatives to pain medications, such as spinal cord stimulators implanted as long-term 

solutions to chronic pain. I appear before this committee ready to work on new approaches to caring for those who need help and ensuring our families, our neighbors, 

and all Americans have the resources they need as they seek a path down the road 

to recovery. 

Mr. BURGESS. Chair thanks the gentleman. Gentleman yields 

back. 

The Chair recognizes the gentleman from Minnesota, Mr. Paulsen, for 3 minutes, please. 

STATEMENT OF HON. ERIK PAULSEN, A REPRESENTATIVE IN 

CONGRESS FROM THE STATE OF MINNESOTA 

Mr. PAULSEN. Thank you, Mr. Chairman, and also for this opportunity to speak about the opioid addiction in Minnesota. 

Minnesota is like the rest of the country. It is struggling with the 

crisis. It is tearing families apart through addiction and death and 

the numbers are only getting worse. 

Minnesota saw a 12 percent rise in opioid deaths from in 2016 

over 2015. The crisis affects Minnesotans of all backgrounds in 

rural communities, big cities, and in our suburbs. 

Just a year and a half ago in my hometown of Chanhassen, we 

saw the passing of music legend Prince due to an opioid overdose. 

In Minnesota, there are 50 opioid prescriptions written for every 

100 patients that visit our doctors. 

Clearly, we need to change the culture and our delivery of care 

to stop the flow of opioids when there are proven alternative types 

of treatments that may not require those prescriptions. 

When someone requires surgery for back pain, they can choose 

between minimally invasive surgery or the standard surgery that 

requires a long post-surgery stay in the hospital and powerful painkillers. 

One way to reduce the dependency on opioids is to use procedures that are minimally invasive and do not require long hospital 

stays and opioids to dull the pain from other invasive procedures. 

An example is minimally invasive sacroiliac, or IS, infusion, 

which has been shown to reduce the need for dangerous pain killers. 

Unfortunately, some private insurers don’t cover this procedure, 

forcing people to choose the standard surgery that requires addictive opioids for pain management. 

Instead of simply prescribing a drug for the pain, providers 

should also look to other therapies and insurers so they can 

proactively cover these therapies so that people are given more 

choices to manage their pain. 

We must hold providers and patients accountable and encourage 

insurers to cover more types of procedures. The opioid crisis also 

affects businesses including our local pharmacies. 

96 

According to the DEA, in 2014 there were 16 armed robberies involving stolen opioids at Minnesota pharmacies. Last year, that 

number doubled. People get hurt and die during these crimes. 

Dangerous drugs are put on the street. Businesses have to close 

their doors because of safety concerns and communities lose vital 

resources and neighbors because of addiction and the crime that 

goes with it. 

Earlier this year, I spoke to a mom from Maple Grove, Minnesota, whose son bought carfentanyl online, consumed it, and 

died. 

We need to increase funding for safety resources, for addicts and 

trained law enforcement officers to spot and stop opioid-related 

crime. 

Our communities depend on access to health care and we need 

to do more to reduce the crime and death associated with opioid addiction if we are going to help get people—and get the care that 

they need. 

I want to thank you, Mr. Chairman. I look forward to working 

with you and the rest of the members on your committee for bipartisan solutions to the problems associated with opioid addiction. 

[The prepared statement of the Mr. Paulsen follows:] 

PREPARED STATEMENT OF HON. ERIK PAULSEN

Thank you, Chairman Walden and Ranking Member Pallone, for this opportunity 

to speak about the opioid addiction crisis in Minnesota. 

Minnesota is like the rest of the United States in and unfortunately, it is suffering 

with addiction to and death from opioids. 

It’s a crisis tearing families apart through addiction and death and the numbers 

are only getting worse. Minnesota saw a 12 percent rise in 2016 over 2015-with 376 

opioid related deaths. The crisis affects Minnesotans of all backgrounds in rural 

communities, big cities, and suburbs. In April 2016, in my hometown of 

Chanhassen, we saw the passing of music legend Prince due to an opioid overdose. 

In Minnesota, there are 50 opioid prescriptions written for every 100 patients that 

visit our doctors. Clearly we need to change the culture in our delivery of care to 

stop the flow of opioids when there are proven alternative types of treatments that 

may not require those prescriptions. 

When someone requires surgery for back pain, they can choose between minimally 

invasive surgery or the standard surgery that requires a long post-surgery stay in 

the hospital and powerful pain killers. One way to reduce the dependency on opioids 

is to use procedures that are minimally invasive and so do not require long hospital 

stays and opioids to dull the pain from other invasive procedures. An example is 

minimally invasive sak-roh-il-ee-ak joint, or SI fusion, which has been shown to reduce the need for dangerous pain killers. 

Unfortunately, some private insurers don’t cover this procedure, forcing people to 

choose the standard surgery that requires addictive opioids for pain management. 

Instead of simply prescribing a drug for the pain, providers should look to other 

therapies and insurers should proactively cover those therapies so that people are 

given more choices to manage their pain. We must hold providers and patients accountable, and encourage insurers to cover more types of procedures. 

The opioid crisis also affects businesses, many times our local pharmacies. According to the DEA, in 2014 there were 16 armed robberies involving stolen opioids at 

Minnesota pharmacies. Last year, that number doubled. People get hurt and die 

during these crimes, dangerous drugs are put on the street, businesses have to close 

their doors because of safety concerns and communities lose vital resources and 

neighbors because of addiction and the crime that goes with it. 

Earlier this year, I spoke to a mother Maple Grove, MN whose son bought 

carylfentanyl online, consumed it, and died. We must increase funding for safety resources for addicts and train law enforcement officers to spot, and stop opioid-related crime. Our communities depend on access to health care, but we must do 

something to reduce the crime and death associated with opioid addiction if we are 

going to help people get and keep the care they need. 

97 

I thank you again, Mr. Chairman and Ranking Member Pallone, for allowing me 

this opportunity, and I look forward to working with to come up with more bipartisan solutions to the problems associated with opioid addiction. 

Mr. BURGESS. Chair thanks the gentleman. Gentleman yields 

back. 

Chair recognizes the gentlelady from Delaware, Ms. Rochester, 

for 3 minutes, please. 

STATEMENT OF HON. LISA BLUNT ROCHESTER, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF DELAWARE 

Ms. BLUNT ROCHESTER. Thank you, Mr. Chairman. Thank you, 

Mr. Chairman. 

I want to start off by saying as a former Deputy Secretary of 

Health and Social Services in Delaware, former Secretary of Labor, 

and community member and family member, substance abuse has 

touched my life and so many others, everything from our economy 

to our prison system to our families, from crack to heroin to all 

forms of opioids. 

And in many ways, Delaware reflects our Nation. Geography— 

we are urban and rural. We mirror the country in terms of demographics and, unfortunately, like the rest of the Nation we are facing a growing opiate crisis. 

Just yesterday, our death toll from this horrible disease rose to 

171 Delawareans for the year. That might not seem like a lot to 

some, but to put that into perspective, that many deaths in a State 

the size of Delaware made us number 13 per capita in the country 

last year for opioid overdose deaths, according to the Kaiser Family 

Foundation. 

This public health crisis is prevalent in districts across the country, and Congress has the opportunity to impact it in a meaningful 

way and take action. 

This is why it’s so important to tackle this issue on a bipartisan 

basis. The opioid addiction has taken a strong hold across the Nation and we must work together to combat the flow of drugs 

throughout our country. 

This is a problem for all States but particularly on the East 

Coast, where compact States means that none of us can act alone. 

Drug trafficking doesn’t stop at Delaware’s borders with Maryland 

or Pennsylvania or New Jersey, and neither does this public health 

crisis. 

Delaware and our neighbors have made great progress through 

collaborative programs like HIDTA and prescription drug monitoring programs. But that should just be the beginning. We aren’t 

doing enough. 

But it is also important to remember that there are people in 

Delaware and in all of our communities making a difference. Every 

day on the ground for people, for families, and in neighbourhoods 

they are combatting this crisis on the ground. 

I want to thank all those people who are fighting, whether they 

are in public health, whether they are doctors, first responders, the 

faith community, community groups, families—all those who are 

doing their part to make sure that we tackle this issue. 

98 

We in Congress need to join them. I hope that we in Congress 

will also continue to work together and address this epidemic by 

providing resources for prevention, support for recovery, and access 

to care. 

Thank you so much. I yield back my time. 

[The prepared statement of Ms. Blunt Rochester follows:] 

PREPARED STATEMENT OF HON. LISA BLUNT ROCHESTER

In many ways, Delaware reflects our Nation. Geography—we’re urban and rural, 

demographics, and unfortunately we are facing a growing opioid crisis. 

Just yesterday, Delaware’s death toll from this horrible disease rose to 171 for the 

year. This public health crisis is prevalent in districts across the country and Congress has the opportunity to impact it in a meaningful way and take action. This 

is why it’s so important to tackle this on a bipartisan basis. 

The opioid epidemic has taken a strong hold across the Nation, and we must work 

together to combat the flow of drugs throughout our country. This is a problem for 

all States, but particularly on the East Coast, where compact States mean that none 

of us can act alone. Drug trafficking doesn’t stop at Delaware’s borders with Maryland, or Pennsylvania, or New Jersey—and neither does this public health crisis. 

Delaware and our neighbors have made great progress through collaborative programs like HIDTA and prescription drug monitoring programs, but that should be 

just the beginning. We aren’t doing enough. 

But there are people in Delaware, and in all of our communities, making a difference. Every day, on the ground, for people and families and neighborhoods they 

are combating this crisis on the ground. Thank you to the people who are fighting— 

the doctors, public safety officers, community groups, all of those doing what they 

can to help those around them. We need to join them. 

I hope that we, in Congress, will all continue to work together to address this epidemic by providing resources for prevention, support for recovery, and access to 

care. 

Mr. BURGESS. Chair thanks the gentlelady. Gentlelady yields 

back. 

We are going to have a series of votes, and it is my hope that 

we will adjourn when votes occur. I am going to ask the Members 

who are here, and I appreciate you staying with us for so long. 

Let us continue to yield 3 minutes, but let’s try to do it in 2 so 

everyone gets a chance to testify before the vote. So all the Members who remain, if you will join us at the table. 

And Ms. Chu, you are recognized for 3 minutes. 

STATEMENT OF HON. JUDY CHU, A REPRESENTATIVE IN 

CONGRESS FROM THE STATE OF CALIFORNIA 

Ms. CHU. Mr. Chair, I want to start by thanking you for allowing 

Members to testify on this issue. 

Today, I would like to draw the subcommittee’s attention to the 

significant needs of those who have sought help for addiction, completed treatment and are just beginning to live in recovery. 

These individuals often choose to live in sober living facilities 

after completing treatment in order to ease into the routines of 

daily life. 

However, there are far too many sober homes that are commonly 

unequipped to handle patients at risk of overdose or do not employ 

staff with specialty training for individuals in recovery. 

Worst of all, some of these facilities do not encourage recovery at 

all but exploit vulnerable people recently released from treatment 

in order to collect insurance payments. 

99 

This could mean life or death for people like Tyler from my district of Pasadena, California, who died from an overdose after his 

sober home didn’t recognize the symptoms of his overdose and 

didn’t have Naloxone, the medication that can reverse an overdose. 

Tyler was only 23 years old. 

Unfortunately, this is not an isolated issue. I have heard from 

advocates in Arizona, Pennsylvania, Missouri, Ohio, and countless 

others who are concerned for their friends and neighbors living in 

unregulated sober living facilities. 

I would like to submit for the record a New York Times article 

from 2015 and a May 2017 report from the Department of Justice 

outlining abuse and fraud at sober homes in New York and Florida. 

Mr. BURGESS. Without objection, so ordered. 

[The information appears at the conclusion of the hearing.] 

Ms. CHU. These reports describe sober living facilities that lacked 

access to Naloxone, ordered unnecessary tests on residents to exhaust their insurance benefits, and required residents to relapse 

and reenter treatment so resident directors could claim some of the 

Medicaid benefits. 

Licensing for recovery residences or sober living facilities vary 

substantially from State to State, and there are facilities in every 

State operating without licenses at all. 

Further, oversight of these facilities is minimal so patients and 

families with loved ones in recovery struggle to distinguish good actors from bad ones. 

For some individuals, they may not discover their facility is negligent until it is too late. That is why this week I plan to introduce 

the Ensuring Quality Sober Living Act. My legislation would require the Substance Abuse and Mental Health Services Administration to develop a set of best practices for residential recovery facilities so patients, families, and States can distinguish quality 

sober living facilities from sites that are fraudulent or unequipped 

to offer appropriate assistance. 

The bill would require SAMHSA to disseminate these best practices to each State and authorize the agency to provide technical 

assistance and support. 

My bill would require States to help SAMHSA set up criteria to 

distinguish quality sober living facilities. These best practices to 

allow the guidelines for common sense measures like requiring that 

all fees and charges be explained to residents before entering a 

binding agreement and that Naloxone is available and accessible 

and that staff and residents are trained to use it in emergencies. 

Thank you very much. 

[The prepared statement of Ms. Chu follows:] 

PREPARED STATEMENT OF HON. JUDY CHU

Chairman Burgess and Ranking Member Green, I want to start by thanking you 

for allowing Members to testify on this issue, which has impacted all of our districts. 

Today, I would like to draw the subcommittee’s attention to the significant needs 

of those who have sought help for addiction, completed treatment, and are just beginning to live in recovery. These individuals often choose to live in sober living facilities after completing treatment in order to ease into the routines of daily life. 

However, ‘‘sober homes’’ are commonly unequipped to handle patients at risk of 

overdose, or do not employ staff with specialty training for individuals in recovery. 

Worst of all, some of these facilities do not encourage recovery at all, but exploit 

100 

vulnerable recently released from treatment in order to collect insurance payments. 

This can mean life or death for people like Tyler, from my district of Pasadena, California, who died from an overdose after his sober home didn’t recognize the symptoms of his overdose, or have Naloxone, the medication that can reverse an overdose, on hand. Tyler was only 23 years old. 

Unfortunately, this is not an isolated issue. I have heard from advocates in Arizona, Pennsylvania, Missouri, Ohio, and countless others who are concerned for 

their friends and neighbors living in unregulated sober living facilities. I would like 

to submit for the record a New York Times article from 2015 and a May 2017 report 

from the Department of Justice outlining abuse and fraud at sober homes in New 

York and Florida. These reports describe sober living facilities that lacked access 

to Naloxone, ordered unnecessary tests on residents to exhaust their insurance benefits, and required residents to relapse and re-enter treatment so resident directors 

could claim some of the Medicaid benefits. 

Licensing for recovery residences, or sober living facilities, varies substantially 

from State to State, and there are facilities in every State operating without licenses 

at all. Further, oversight of these facilities is minimal, so patients and families with 

loved ones in recovery struggle to distinguish good actors from bad ones. For some 

of these individuals, they may not discover that their facility is negligent until it 

is too late. 

That is why this week, I plan to introduce the Ensuring Quality Sober Living Act. 

My legislation would authorize the Substance Abuse and Mental Health Services 

Administration (SAMHSA) to develop a set of best practices for residential recovery 

facilities so patients, families, and States can distinguish quality sober living facilities from sites that are fraudulent or unequipped to offer appropriate assistance to 

their residents. The bill would require SAMHSA to disseminate these best practices 

to each State, and authorize the agency to provide technical assistance and support 

to States that wish to adopt or implement these best practices. 

My bill would allow States, who are struggling to address the opioid crisis, to 

work with SAMHSA to help set up criteria to designate quality sober living facilities. These best practices will follow the guidelines that have been published by the 

National Association of Recovery Residences, which provide benchmarks for various 

levels of quality facilities. These benchmarks include common-sense measures like 

requiring that all fees and charges be explained to residents before entering a binding agreement, that paid work performed at the facility be completely voluntary and 

not impede the recovery process, and that Naloxone is available and accessible, and 

that staff and residents are trained to use it in emergencies. 

Thank you again for taking the time to hear from your colleagues on ways to address this growing crisis. I ask that as you continue to consider legislation on the 

opioid epidemic, you include ways to address the needs of those newly in recovery. 

Mr. BURGESS. Gentlelady’s time has expired. 

The Chair recognizes the gentlelady from Indiana, Mrs. 

Walorski, for 3 minutes, please. 

STATEMENT OF HON. JACKIE WALORSKI, A REPRESENTATIVE 

IN CONGRESS FROM THE STATE OF INDIANA 

Mrs. WALORSKI. Thank you, Mr. Chairman. 

Indiana is no different than any other State that we’ve heard 

from sitting here. Pain is the number-one reason why Americans 

seek health care, the number-one cause of disability that costs the 

U.S. economy more than $600 billion in direct health care costs and 

lost productivity. 

The veteran population is particularly impacted by the chronic 

pain crisis with more than 50 percent of the VA patient responding 

and reporting to chronic pain. 

We can reduce demand by more effectively treating chronic pain 

and providing better access to FDA-approved Nonopioid pharmaceuticals, advanced medical devices, and integrated alternative 

therapies. 

101 

As we develop policy, we should, number one, recognize the importance of a multi disciplinary approach. Chronic pain is pervasive 

and is largely unaddressed by the public health care system. 

Promote—and number two, promote cutting-edge pain research 

to encourage effective opioid alternatives. High quality evidence is 

urgently needed to help clinicians and patients make informed decisions about how to manage chronic pain safely and understand 

the causes and mechanisms of chronic pain. 

Advanced best practices and pain management within Medicare. 

In 2016, one in three Medicare Part D beneficiaries received a prescription opioid. The GAO should conduct a study of the coverage 

options offered within Medicare for evidence-based pain management as an alternative to opioid prescriptions. 

Also, there should be a review of the graduate medical education 

programs’ training and education of providers on pain management 

and opioid prescriptions. 

I hope these ideas will be helpful in future planning discussions 

to reduce the abuse of opioids in our communities. 

Thank you, Mr. Chairman. I yield back my time. 

[The prepared statement of Mrs. Walorski follows:] 

PREPARED STATEMENT OF HON. JACKIE WALORSKI

Thank you, Chairman Burgess and Ranking Member Green, for holding this hearing on the opioid crisis. 

America is facing two interrelated public health epidemics: chronic pain and 

opioid addiction, misuse, and abuse. A long-term solution to the opioid epidemic will 

not be achieved without addressing the challenge of appropriately treating chronic 

pain. According to the Institute of Medicine (IOM), 100 million Americans suffer 

from chronic pain. Pain is the number one reason why Americans seek health care, 

the number one cause of disability, and costs the US economy more than $600 billion in direct healthcare costs and lost productivity. The veteran population is particularly impacted by the chronic pain crisis with more than 50 percent of VA patients reporting chronic pain. 

Thousands of lives are lost to both opioid-related overdose and chronic pain-related suicide. Reducing the supply of or access to opioids will not, by itself, solve 

this crisis. Currently, 80 percent of heroin users started with prescription opioids. 

We must reduce demand for them by more effectively treating chronic pain, and providing better access to FDA-approved nonopioid pharmaceuticals, advanced medical 

devices, and integrated alternative therapies. 

As we look to develop policy, we should: 

1. Recognize the importance of a multidisciplinary approach to pain management 

as a key component of overcoming the opioid crisis. Chronic pain is pervasive and 

largely unaddressed public health crisis. Solving it is a crucial part of solving the 

larger opioid epidemic. 

2. Promote cutting edge pain research to encourage effective opioid alternatives. 

High-quality evidence is urgently needed to help clinicians and patients make informed decisions about how to manage chronic pain safely and understand the 

causes and mechanisms of chronic pain. 

3. Advance best practices in pain management in Medicare. Currently 1 in 3 

Medicare beneficiaries are prescribed an opioid. The GAO should conduct a study 

of the coverage options for evidence-based pain management. In addition, there 

should be a study conducted on the Graduate Medical Education program on the 

training and education that providers receive regarding pain management. 

I hope these ideas will be helpful in future policy discussions to reduce the abuse 

of opioids in our communities. Thank you for the time, and I yield back. 

Mr. BURGESS. The Chair thanks the gentlelady. 

Mr. Donovan, you are recognized for 3 minutes. 

102 

STATEMENT OF HON. DANIEL M. DONOVAN, JR., A REPRESENTATIVE IN CONGRESS FROM THE STATE OF NEW 

YORK 

Mr. DONOVAN. Thank you, Mr. Chairman. 

Chairman Burgess, Ranking Member Green, and members of the 

subcommittee, thank you for the opportunity to testify before you 

today to share my thoughts on the opioid crisis. 

This year alone, there have been more than 100 reported overdose deaths in my district. That number would be much higher if 

it weren’t for the 574 Naloxone saves reported by our local hospitals and the New York City Police Department. 

Before I came to Congress, I served as district attorney of Richmond County, which comprises of Staten Island, New York. Based 

on that experience, my time in Congress, and input from local experts like the Staten Island Partnership for Community Wellness, 

I support a three-tiered approach for this problem that addresses 

education, treatment, and enforcement. 

Targeted education campaigns can teach the next generation of 

potential users about the dangers of substance abuse including particularly sinister compounds like fentanyl. 

Treatment is, of course, crucial. We have learned that recovery 

is a cycle and relapses will happen. Our policies should reflect that 

reality. Our society now understands that addiction is a medical illness and not a criminal act. 

Let us help the addicted, not punish them. To that end, consistently appropriating grants for local treatment programs is the most 

effective way to help end the cycle of addiction from the Federal 

level. 

Lastly, we cannot ignore the importance of enforcement, particularly against traffickers. My Comprehensive Fentanyl Control Act 

would ban pill presses that traffickers use to create their deadly 

fentanyl-laced cocktails. It would also update sentencing guidelines 

to reflect the fact that a few grains of—few grains of rice worth of 

fentanyl can kill an individual. 

I firmly believe that the experts on the ground are best equipped 

to tailor their approaches to meet their communities’ needs. It is 

our job as legislators to provide them with the resources necessary 

to accomplish their mission. 

Legislation like the 21st Century Cures Act and the Comprehensive Addiction and Recovery Act, which I championed to constituents back in my district, are exactly the right approach. 

Thank you again for the opportunity to share my thoughts. I look 

forward to working with the subcommittee and to continuing to address this national crisis. 

Thank you, sir. 

[The prepared statement of Mr. Donovan follows:] 

PREPARED STATEMENT OF HON. DANIEL M. DONOVAN, JR. 

Chairman Burgess, Ranking Member Green, and members of the subcommittee, 

thank you for the opportunity to testify before you today to share my thoughts on 

the opioid crisis. 

This year alone, there have been more than 100 reported overdose deaths in my 

district. That number would be much higher if it weren’t for the 574 Naloxone saves 

reported by our local hospitals and the NYPD. 

103 

Before I came to Congress, I served as District of Attorney of Richmond County, 

which comprises Staten Island, NY. Based on that experience, my time in Congress, 

and input from local experts like the Staten Island Partnership for Community 

Wellness, I support a three-tiered approach that addresses education, treatment, 

and enforcement. 

Targeted education campaigns can teach the next generation of potential users 

about the dangers of substance abuse, including particularly sinister compounds like 

fentanyl. 

Treatment is of course crucial. We’ve learned that recovery is a cycle and relapses 

will happen. Our policies should reflect that reality. Our society now understands 

that addiction is a medical illness and not a criminal act. Let’s help the addicted, 

not punish them. To that end, consistently appropriating grants for local treatment 

programs is the most effective way to help end the cycle of addiction from the Federal level. 

Lastly, we can’t ignore the importance of enforcement, particularly against traffickers. My Comprehensive Fentanyl Control Act would ban pill presses that traffickers use to create their deadly, fentanyl-laced cocktails. It would also update sentencing guidelines to reflect the fact that a few grains of rice worth of fentanyl can 

kill. 

I firmly believe that experts on the ground are best equipped to tailor their approaches to meet their community’s needs. It’s our job as legislators to provide them 

with the resources necessary to accomplish their mission. Legislation like the 21st 

Century Cures Act and the Comprehensive Addiction and Recovery Act—which I 

championed to constituents back in my district—are exactly the right approach. 

Thank you again for the opportunity to share my thoughts. I look forward to 

working with the subcommittee to continue addressing this national crisis. 

Mr. BURGESS. Chair thanks the gentleman. 

Representative Hartzler, you are recognized for 3 minutes. 

STATEMENT OF HON. VICKY HARTZLER, A REPRESENTATIVE 

IN CONGRESS FROM THE STATE OF MISSOURI 

Mrs. HARTZLER. Thank you, Mr. Chairman. 

Mr. BURGESS. But only use two. 

Mrs. HARTZLER. And thank you for this opportunity. 

In Missouri, the scourge of drug abuse is a growing problem and 

it will take all of us to help solve it. I have heard of too many stories of families torn apart and livelihoods in tatters. 

To this end, I ask the committee to explore ways to make it easier for faith-based organizations to offer addiction treatment programs. I have seen firsthand the power of faith-based recovery programs in treating addiction. 

In my own district, I have visited multiple Christian organizations that have high rates of success in treating addiction. 

By centering on a community of faith, these organizations provide support structures that stay with recovering addicts their entire lives. In some cases, they also provide services that aren’t 

available in other addiction recovery programs in the area. 

For instance, one religious organization in my district provides 

housing for both mothers and their children while the mothers seek 

treatment for their addiction. No doubt their recovery is greatly facilitated by the additional support of their children. 

I firmly believe faith-based recovery programs are part of a holistic approach to treat both the body and spirit. They provide emotional and spiritual support for individuals and their families during the darkest times and I ask the committee to seriously consider 

making available and expanding any and all funding opportunities 

to faith-based organizations providing addiction, treatment, and 

programs. 

104 

In addition, on a second topic, the IMD exclusion caps the number of beds mental health facilities receiving Medicaid can have at 

16. Multiple health care groups have come into my office saying 

this blocks critical access to treatment for people who need inpatient treatment for addiction including some of society’s most vulnerable—veterans, pregnant addicted women, women with dependent children, and youth. 

I encourage the committee to explore ways to provide some relief 

to this outdated rule. Thank you very much. I yield back. 

[The prepared statement of Mrs. Hartzler follows:] 

PREPARED STATEMENT OF HON. VICKY HARTZLER

Chairman Burgess, Ranking Member Green, and members of the Subcommittee 

on Health, I thank you for the opportunity to talk today about the opioid crisis 

that’s facing our Nation, and I appreciate the committee continuing to look for solutions to this ongoing epidemic. 

In Missouri, the scourge of drug abuse is a growing problem, and it will take all 

of us to help solve it. I have heard too many stories of families torn apart and livelihoods in tatters. Over one-twelfth of U.S. and Missouri adults report substance use 

disorders, and this rate is even higher among young adults. As we continue to address this problem, we must consider all avenues available. To that end, I ask the 

committee to explore ways to make it easier for faith-based organizations to offer 

addiction treatment programs. 

I have seen first-hand the power of faith based recovery programs in treating addiction. In my own district, I have visited multiple Christian organizations that 

have high rates of success in treating addiction. By centering on a community of 

faith, these organizations provide support structures that stay with recovering addicts their entire lives. In some cases, they also provide services that aren’t available in other addiction recovery programs in the area. For instance, one religious 

organization in my district provides housing for both mothers and their children 

while the mothers seek treatment for their addiction. No doubt, their recovery is 

greatly facilitated by the additional support for their children. 

I firmly believe faith based recovery programs are part of a holistic approach that 

treat both the body and spirit. They provide emotional and spiritual support for individuals and their families during their darkest times. These religious organizations provide a foundation for recovery that medication assisted treatment alone 

cannot. It’s the love and power of God and the life purpose He gives that ultimately 

provides a sustainable path to recovery for many individuals. I ask the committee 

to seriously consider making available and expanding any and all funding opportunities to faith based organizations providing addiction treatment programs. 

REPEAL THE IMD EXCLUSION

The IMD exclusion caps the number of beds mental health facilities receiving 

Medicaid can have at 16. Multiple health care groups have come into my office saying this blocks critical access to treatment for people who need inpatient treatment 

for addiction, including some of society’s most vulnerable: veterans, pregnant addicted women, women with dependent children, and youths. I encourage the committee to explore ways to provide some relief to this outdated rule. 

Mr. BURGESS. Chair thanks the gentlelady. Gentleman from 

Pennsylvania is recognized for 3 minutes, but only use 2, please. 

STATEMENT OF HON. BRIAN K. FITZPATRICK, A REPRESENTATIVE IN CONGRESS FROM THE COMMONWEALTH OF PENNSYLVANIA 

Mr. FITZPATRICK. Thank you, Mr. Chairman. 

As this committee is aware, drug overdoses involving prescription opioids and heroin have nearly quadrupled since 1999 and are 

now the leading cause of accidental death in this Nation. 

105 

Substance abuses costs our country over $600 billion annually. In 

my home State of Pennsylvania, drug-related deaths and opioid addiction rates were amongst the highest in the Nation. 

Within one year, Pennsylvania’s opioid-related deaths rose 20 

percent while my district’s increased by 50 percent. 

Mr. Chairman, this epidemic is costing us both resources and 

precious lives, like my constituent, Carlos Castellanos. Carlos, in 

Falls Township, always loved sharing his talents and love of music 

by playing the guitar and drums at school for a local church group. 

However, like so many around the Nation, Carlos got involved 

with drugs during his time at school and even spent some time in 

jail. But with the strength and support of his family he began receiving treatment and his life improved. He helped others by volunteering at a recovery home and he brought people suffering in similar situations to treatment programs. 

Last December, Carlos walked his mother, Pamela, down the 

aisle for her wedding. He was getting ready to get back to school. 

He had a stead job and a girlfriend. 

It would seem that many of Carlos’ battles with addiction were 

heading in the right direction, a needed point of hope in the war 

that has caused so much devastation. 

Then, Mr. Chairman, on December 23rd, just days before Christmas, two police detectives showed up at Pamela’s door to tell her 

the devastating news that no mother can ever prepare for. 

Carlos overdosed on a drug laced with fentanyl and was unable 

to be saved. 

Mr. Chairman, Carlos’ life and his death cast a bright light on 

the fact that addiction is nothing short of a chronic disease and I 

would also like to bring to this attention what my colleague did— 

the so-called Institute for Mental Disease, or IMD, exclusion is a 

longstanding policy that prohibits the Federal Medicaid matching 

funds to States for services rendered to Medicaid enrollees who suffer from substance use disorder for mental health treatment. 

Some States, like my State of Pennsylvania, have used the in 

lieu of services provision allowing for inpatient treatment but with 

limitations on population size, facility size and length of stay. 

These limitations disproportionately affect those using Medicaid, 

blocking access to treatment for people who need inpatient treatment for addiction including some of society’s most vulnerable. 

I urge my colleagues to adopt the Road to Recovery Act, a bill 

I introduced which addresses real-world concerns expressed by 

local lawmakers, community leaders, and health care professionals. 

Mr. Chairman, I yield back. 

[The prepared statement of Mr. Fitzpatrick follows:] 

PREPARED STATEMENT OF HON. BRIAN K. FITZPATRICK

I would like to start off by thanking Chairman Burgess, Ranking Member Green, 

and members of the Subcommittee on Health for holding this hearing. 

Mr. Chairman, drug overdoses involving prescription opioids and heroin have 

nearly quadrupled since 1999 and are now the leading cause of accidental death. 

Substance abuse costs our country over $600 billion annually. In my home State of 

Pennsylvania, drug-related deaths and opioid addiction rates were among the highest in the country. Within 1 year, Pennsylvania’s opioid-related deaths rose 20 percent while my district’s increased by 50 percent. 

This epidemic is costing us both resources and precious lives. 

106 

Carlos Castellanos of Falls Township, Bucks County always loved sharing his talents and love of music by playing the guitar and drums at school and for local 

church groups. 

However, like so many around the Nation, Carlos got involved with drugs during 

his time in school and even spent some time in jail. But, with the strength and support of his family, he began receiving treatment and his life improved. He helped 

others by volunteering at a recovery house and he brought people suffering in similar situations to treatment programs. 

In early December, Carlos walked his mother, Pamela, down the aisle for her wedding. He was getting ready to go back to school, he had a steady job, and a 

girlfriend. It would seem to many that Carlos’ battle with addiction was heading in 

the right direction—a needed point of hope in a war that’s caused so much devastation. 

Then, on December 23rd, just days before Christmas, two police detectives showed 

up at Pamela’s door to tell her the devastating news that no mother can prepare 

for: Carlos had overdosed on a drug laced with fentanyl and was unable to be saved. 

Mr. Chairman, Carlos’ life—and his death—cast a bright light on the fact that addiction is nothing short of a chronic disease. 

I share this story with Members of this chamber because we must realize that 

we have treat the whole person, not just the addiction. We must focus on the underlying issues driving people to seek opioids, while increasing the accessibility and affordability for prevention, education, treatment, and recovery of this disease. The socalled Institutions for Mental Diseases—or IMD—exclusion is a long-standing policy 

that prohibits the Federal Medicaid matching funds to States for services rendered 

to Medicaid enrollees who suffer from substance use disorder and mental health 

treatment. 

Some States—including my home State of Pennsylvania—have used an ‘‘in lieu 

of services’’ provision allowing for inpatient treatment, but with limitations on patient population, facility size, and length of stay. These limitations disproportionately affect those under Medicaid—blocking access to treatment for people who need 

inpatient treatment for addiction including some of society’s most vulnerable. 

That is why I introduced bipartisan legislation that eliminates the IMD exclusion 

for substance use disorder and help States expand access to inpatient addiction 

services for Medicaid enrollees in a fiscally responsible manner while not intruding 

on their flexibility to implement care. 

The Road to Recovery Act addresses real-world concerns expressed by local lawmakers, community leaders and healthcare professionals in my district who endeavor to tackle this epidemic each day. 

I urge my colleagues to learn more about this issue and support this bipartisan 

bill, but also to recommit ourselves to addressing the addiction crisis and fighting 

for those who suffer. 

I yield back. 

Mr. BURGESS. Chair thanks the gentleman. 

Chair recognizes the gentleman from Pennsylvania for 3 minutes. 

STATEMENT OF HON. RYAN A. COSTELLO, A REPRESENTATIVE 

IN CONGRESS FROM THE COMMONWEALTH OF PENNSYLVANIA 

Mr. COSTELLO. Thank you, Mr. Chairman. 

In speaking with constituents about the opioid epidemic, I have 

learned firsthand the impact this epidemic is having on our communities in Pennsylvania. It is affecting families and individuals of 

all ages, races, and socioeconomic backgrounds. 

Throughout my congressional district and throughout this Nation 

there are parents, teachers, athletes, doctors, teenagers, and seniors struggling with addiction, a disease that has no boundaries 

when it comes to who it affects. 

These families and these individuals are why we must continue 

our work to pass legislation like the Comprehensive Addiction Recovery Act and the 21st Century Cures Act, two bills I supported 

that are both now law. 

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These bipartisan bills are helping our communities through increasing access to treatment and expanding prevention, education, 

and intervention efforts. 

In the communities I represent, a recurring sentiment I have 

heard was, you would not believe how much treatment costs. The 

cost of treatment and recovery is, indeed, crippling for so many 

families, even for individuals who have insurance—$35,000 for a 

30-day at a treatment center, $10,000 for a 10-day detox, hundreds 

of dollars spent on flights to recovery programs across the country. 

Families are being forced to refinance their homes, parents are 

taking on second jobs, and retirees are reentering the workforce to 

help pay for treatment for a family member struggling with addiction. 

Those seeking help should not be faced with insurmountable 

costs. To help individuals provide assistance—financial assistance 

to family members struggling with addiction, I have added my 

name as a cosponsor to H.R. 1575, the Addiction Recovery through 

Family Health Accounts Act. 

Under current law, individuals can only use funds in their health 

savings account, flexible spending account, or health reimbursement arrangement to pay for addiction treatment for their spouse 

or dependents. 

This bill will give individuals the option to use funds from these 

accounts to help family members receiving drug treatment, be it a 

niece, grandfather, cousin, in-law, et cetera. This legislation is a 

step in the right direction in alleviating the financial burden of 

substance abuse treatment. 

I am proud of the work the committee has done to help those facing this epidemic and I am committed to continuing this work. 

I yield back. Thank you, Mr. Chairman. 

[The prepared statement of Mr. Costello follows:] 

PREPARED STATEMENT OF HON. RYAN A. COSTELLO

In speaking with constituents about the opioid epidemic, I have learned firsthand 

the impact this epidemic is having on our communities in Pennsylvania—it is affecting families and individuals of all ages, races, and socioeconomic backgrounds. 

Throughout my Congressional district and throughout this Nation, there are parents, teachers, athletes, doctors, teenagers, and seniors struggling with addition— 

a disease that truly knows no boundaries when it comes to who it affects. 

These families, these individuals are why we must continue our work to pass legislation like the Comprehensive Addiction and Recovery Act, and the 21st Century 

Cures Act—two pieces of legislation I supported that are both now law. These bipartisan bills are helping our communities through increasing access to treatment, and 

expanding prevention, education, and intervention efforts. 

In the communities I represent, a recurring sentiment I’ve heard was, ‘‘you 

wouldn’t believe how much money we’ve spent.’’ 

The cost of treatment and recovery is crippling, even for individuals who have insurance $35,000 for a 30-day stay at a treatment center. $10,000 for a 10-day detox. 

Hundreds of dollars spent on flights to recovery programs across the country. 

Families are being forced to refinance their homes, parents are taking on second 

jobs, and retirees are re-entering the workforce to help pay for treatment for a family member struggling with addiction. 

Those seeking help should not be faced with these insurmountable costs. 

To help individuals provide financial assistance to family members struggling 

with addiction, I have added my name as a cosponsor of H.R. 1575, the Addiction 

Recovery through Family Health Accounts Act. 

Under current law, individuals can only use funds in their Health Savings Account, Flexible Spending Account, or Health Reimbursement Arrangement to pay for 

addiction treatment for their spouse or dependents. 

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This bill would give individuals the option to use funds from these accounts to 

help family members receive drug treatment—a niece, a grandfather, a cousin, a 

grandchild’s spouse, in-laws, etc. 

This legislation is a step in the right direction in alleviating the financial burden 

of substance abuse treatment. 

I am proud of the work we have done in this committee to help those facing this 

epidemic, and I am committed to continuing this critical work. 

Mr. BURGESS. Chair thanks the gentleman. Gentleman yields 

back. 

The Chair recognizes the final gentleman from Pennsylvania for 

3 minutes, but only use 2. 

STATEMENT OF HON. KEITH J. ROTHFUS, A REPRESENTATIVE 

IN CONGRESS FROM THE COMMONWEALTH OF PENNSYLVANIA 

Mr. ROTHFUS. Thank you, Mr. Chairman, for holding this important hearing today for Members across the country to come and 

testify about this epidemic. 

I think it is interesting that you have had three Pennsylvanians 

right in a row that represents the geography of Pennsylvania— 

eastern, middle, and western. Certain, communities in western 

Pennsylvania are among the hardest hit in our national opioid epidemic. 

There has been a staggering amount of overdose deaths specifically in my district. In 2016, Allegheny County had 648 individuals 

lose their lives from heroin or opioid-related overdoses. Last year, 

that number was 4,342 in Pennsylvania alone. 

According to a recent article in the Pittsburgh Post Gazette in 

2016, the number of overdose deaths in Pennsylvania was four 

times the number of deaths caused by car accidents. 

In other recent reports, three people in my district were revived 

by Narcan after each overdosed at a convenience store. Thankfully, 

the first responders were able to save their lives. 

While it is encouraging to see that both Congress and the administration have taken action to address this issue, we still have a 

long way to go. From my perspective, we should be taking a threepronged approach to combatting the epidemic. 

We must implement measures to prevent addiction. We must 

treat addiction once it has taken hold over someone. Finally, we 

must vigorously enforce the laws on the books to stop drug traffickers from spreading their poison into our communities. 

To help combat this, I led an effort to include language in the 

landmark Comprehensive Opioid Reduction Act that will help ensure our veterans who are at significant risk to have access to the 

specialized program they need—program that they need to prevent 

or overcome opioid addiction. This is one positive step in the right 

direction. 

Another area where Congress should focus, one of which is of 

specific interest to me, is to increase and strengthen our partnership with Mexico, especially through the State Department’s 

Merida Initiative. 

Our neighbor to the south has suffered a horrific level of murder 

at the hands of drug cartels. By increasing our cooperation with 

Mexico, we can help them defeat the cartels that caused so much 

pain both there and here in the U.S. 

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Often overlooked is the fact that many of the narcotics that 

Mexican cartels traffic end up in the hands of Americans. Furthermore, increasing security at ports of entry through increased use 

of technology, cameras, and manpower is absolutely necessary to 

interdicting drugs. 

Pending legislation like Chairman McCaul’s Border Security for 

America Act will do just that. Another bipartisan bill that I hope 

will end the crisis was introduced with Congress Collin Peterson, 

H.R. 3526. I look forward to that moving forward. 

Again, I sincerely thank you for the opportunity to testify before 

the committee this morning on an issue that greatly affects the 

constituents in my district. 

[The prepared statement of Mr. Rothfus follows:] 

PREPARED STATEMENT OF HON. KEITH J. ROTHFUS

Thank you Mr. Chairman for holding this important hearing today for members 

from across the country to testify about this epidemic. 

I think it is interesting that you’ve had three Pennsylvanians right in a row. It 

represent the geography of Pennsylvania; Eastern, Middle and Western. 

Certainly communities in Western Pennsylvania are among those hit hardest in 

the National opioid epidemic. There has been a staggering amount of overdose 

deaths, specifically in my district. In 2016, Allegheny County had 648 individuals 

lose their lives from heroin or opioid-related overdoses. Last year, that number was 

4,342 in Pennsylvania alone. 

According to a recent article in the Pittsburgh Post-Gazette, in 2016, the number 

of overdose deaths in Pennsylvania was four-times the number of deaths caused by 

car accidents. In other recent reports, three people in my district were revived by 

Narcan after each overdosed at a convenience store. Thankfully, the first responders 

were able to save their lives. 

While it is encouraging to see that both Congress and the administration have 

taken action to address this issue, we still have a long way to go. From my perspective, we should take a three-prong approach to combating the epidemic. 

We must implement measures to prevent addiction. We must treat addiction once 

it has taken hold over someone. Finally, we must vigorously enforce the laws on the 

books to stop drug traffickers from spreading their poison into our communities. 

To help combat this, I led an effort to include language in the landmark Comprehensive Opioid Reduction Act that will help ensure our veterans, who are at significant risk, have access to the specialized programming they need to prevent or 

overcome opioid addiction. This is one positive step in the right direction. 

Another area where Congress should focus, one of which is of specific interest to 

me, is to increase and strengthen our partnership with Mexico, especially through 

the State Department’s Merida Initiative. Our neighbor to the south has suffered 

a horrific level of murder at the hands of drug cartels. By increasing our cooperation 

with Mexico we can help them defeat the cartels that cause so much pain both there 

and here in the US. Often overlooked, is the fact that many of the narcotics that 

Mexican cartels traffic end up in the hands of Americans. 

Furthermore, increasing security at ports of entry through increased use of technology, cameras, and man-power is absolutely necessary to interdicting drugs. Pending legislation, like Chairman McCaul’s Border Security for America Act, will do 

just that. 

Another bipartisan bill that I hope can help end the crisis is one that I introduced 

with Congressman Collin Peterson, H.R. 3526 (the Border Protection Fund Act). I 

look forward to that moving forward. 

Again, I sincerely thank you for the opportunity to testify before the committee 

this morning on an issue that greatly affects my constituents and our country. 

Mr. BURGESS. Chair thanks the gentleman. The gentleman yields 

back. 

All Members having had a chance to speak, with votes on the 

floor, the committee stands adjourned. 

[Whereupon, at 1:33 p.m., the subcommittee was adjourned.] 

[Material submitted for inclusion in the record follows:] 

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PREPARED STATEMENT OF HON. WM. LACY CLAY

Good morning Mr. Chairman, Mr. Ranking Member, and honorable Members of 

this vital committee. 

I thank you for this special opportunity to come before you. 

I am here because, in 2016, 650 people in the St. Louis metropolitan area died 

from an opioid overdose. 

I am here because that number of needless, tragic deaths has quadrupled since 

2007. 

I am here because the number of annual opioid overdose deaths in the community 

that I represent is now more than three times the number of homicides. 

I am here because this Congress must summon our national courage to finally 

confront the menace of opioid addiction and opioid overdoses as an urgent public 

health emergency. 

First, incarcerating people does very little to get at the underlying causes of this 

epidemic. 

We absolutely should not condone criminals who are peddling heroin, fentanyl, 

carfentanil and other deadly drug combinations. 

But just putting someone behind bars who has an addiction doesn’t solve that person’s problem. In fact, it is a huge waste of scarce taxpayer dollars that would be 

much better spent on treatment. 

Indeed, people who go to jail and are then released—if they are not given treatment—are at high risk of re-using and are also at a very high risk of a life-threatening overdose. 

I strongly believe in the value of life-saving and life-renewing services offered by 

community-based nonprofits that provide treatment for substance abuse disorders. 

We know that evidence-based treatment is effective and that when people are in 

treatment, they use drugs less and they overdose less. 

Treatment comes in many forms, but in the United States, we rely heavily on 

nonprofit community-based treatment providers as the safety net for treatment for 

low-income people and others who are disenfranchised, such as people who are 

homeless; many of whom are veterans. 

Many of these providers rely on the Substance Abuse Prevention and Treatment 

Block Grant to survive, and I would wholeheartedly urge that we continue to 

robustly fund this essential program. 

I do want to highlight the antiquated policy, over 50 years old, known as the Medicaid Institution of Mental Diseases Exclusion, better known as the IMD Exclusion, 

which bars Medicaid from paying for residential treatment at a facility of more than 

16 beds. 

According to the New York Times in a July 10, 2014 article on the negative impact of the IMD Exclusion, in some States this policy means that 9 out of 10 treatment beds are in programs too large to receive Medicaid reimbursement. 

That is a huge barrier to recovery for our most needy, most vulnerable, poorest 

Americans—and it yields a two-tiered health care system, where only people on 

Medicaid lose access to a kind of treatment that may be clinically indicated and 

medically necessary. 

Fortunately, there is growing support for ending this outdated policy. 

For example, the National Governors Association has called for the elimination of 

the IMD Exclusion for SUD to help States expand access to addiction treatment. 

And in July 2017, the President’s Commission on Combating Drug Addiction and 

the Opioid Crisis Interim Report recommended that all 50 States be granted waiver 

approvals to eliminate barriers resulting from the IMD exclusion. 

Perhaps most importantly in terms of legislative action, two key bills have been 

introduced in the 115th Congress that deserve your favorable consideration. 

One is H.R. 2938, sponsored by Rep. Brian Fitzpatrick of Pennsylvania, the Road 

to Recovery Act, which would eliminate the IMD Exclusion for community-based 

residential treatment. 

This is not a full repeal of the IMD Exclusion which also affects treatment for 

mental health, but rather is finely targeted to repeal the ban for the SUD treatment 

that is so sorely needed today amid the opioid epidemic. 

Another bill is H.R. 2687, the Medicaid CARE Act, sponsored by Congressman Bill 

Foster of Illinois, which would turn the current exclusion into a cap on Medicaid 

reimbursement, under which programs could be reimbursed for residential SUD 

treatment for up to 40 beds in a program for up to 60 days. 

These are just two ways that Congress can end one of the most formidable barriers to treatment, and immediately help increase capacity and beds in every State. 

Opioid addiction and the thousands of American lives it takes each year does not 

respect political parties, regional differences, racial or ethnic backgrounds or even 

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age.it is an equal opportunity killer that we need to confront together as the People’s House. 

Thank you for allowing me to share this time with you today, and I look forward 

to working closely with you in a bipartisan way to save our fellow Americans. 

PREPARED STATEMENT OF HON. ANNA G. ESHOO

Thank you, Chairman Burgess and Ranking Member Green, for holding this listening session and giving Members of the House the opportunity to speak about the 

tragic impacts of the opioid crisis in their districts. This crisis claims 142 lives each 

day and has killed more people than our deadliest wars. Over 2 million people have 

a prescription opioid addiction, 591,000 have a heroin addiction, and we’ve seen 

overdose deaths triple in the last 13 years. Opioid abuse touches every American 

and doesn’t discriminate. It affects mothers, fathers, children and even newborn babies. 

I’ve heard from substance abuse treatment facilities in my congressional district 

and they report that the number of young people walking through their doors with 

addiction have strikingly increased in the past decade. This is a national crisis. 

These drugs are crippling a generation of America’s youth. 

President Trump appropriately announced that he would declare it a national 

emergency in August, yet it has been 62 days since he made that announcement 

and no emergency declaration has been filed. 

Instead, in the months since the President announced that he would declare the 

opioid crisis a national emergency, we’ve seen constant attacks on the very health 

care system that provides treatment and services to those suffering from opioid addiction. Medicaid and CHIP provide insurance coverage for 30 percent of people suffering from opioid addiction. Medicaid has repeatedly been targeted by attempts to 

repeal the Affordable Care Act and now, through the Majority’s tax reform plan. It’s 

hypocritical to claim that you are committed to fighting this catastrophic crisis and 

then, at every turn, undermine the systems in place to treat and support those who 

struggle with addiction. 

Last Congress, we took important steps through the Comprehensive Addiction 

and Recovery Act and 21st Century Cures Act to address and treat opioid abuse, 

but both of these pieces of legislation must secure funding from Congress. We have 

to make good on the promises we made to those Americans who suffer from opioid 

addiction and fund the programs that they rely on to receive the treatment and support they need. 

Any future approach this committee or the administration takes must address the 

entire spectrum of addiction, from prevention, to crisis response, to treatment and 

recovery. A law and order approach that only punishes prescription drug abusers 

does a disservice to our country and impedes progress toward addressing this epidemic. 

PREPARED STATEMENT OF HON. ALCEE L. HASTINGS

Mr. Chairman, thank you for holding this important hearing about how the opioid 

epidemic is affecting communities nationwide. Today, I would specifically like to discuss the importance of repealing or reforming the Medicaid Institutions for Mental 

Diseases exclusion, which is a barrier to residential treatment for low-income people. 

Unfortunately, Mr. Chairman, one of my counties, Palm Beach County, Florida, 

saw nearly 600 fatal overdoses last year, mostly related to opioids. The number of 

fatal opioid overdoses has gone up 230 percent in the past 2 years, overwhelming 

police, firefighters, hospitals, and morgues. In fact, the Opioid crisis has been declared a public health emergency by Florida Governor Rick Scott. 

Recovering drug users are flocking to South Florida from everywhere—drawn by 

a world-renowned drug treatment industry. Some find good centers and a path to 

recovery. Others fall victim to corrupt operators and wind up homeless, without 

money, and in the most tragic cases, dead. 

Substance use disorder (SUD) plagues the United States both socially and economically. The cost of substance abuse and drug addiction to our health care system 

totals $705 billion annually, where the emotional costs of drug addiction, on family, 

friends and those battling addiction, cannot be calculated. 

An estimated 23.1 million Americans ages 12 or older needed treatment for substance abuse in 2012; however, only 2.5 million of them actually received treatment. 

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This shortfall is due primarily to the limited availability of substance use disorder 

services, particularly for those in need of residential care to address chronic addiction. 

Last year, I introduced a bill to amend title XIX of the Social Security Act and 

remove the exclusion of coverage for services in institutions of mental diseases 

(IMD) under Medicaid. My legislation is designed to enable more Americans who 

suffer from SUD to gain equal access to the treatment necessary for their long-term 

recovery. 

Under current law, Medicaid beneficiaries are barred access to community-based 

residential treatment for severe conditions due to the IMD exclusion that prohibits 

reimbursement care of patients at facilities with more than 16 beds. This nonsensical exclusion has effectively deterred facilities from serving those in dire need of 

care. Eliminating the IMD exclusion will allow those who suffer from severe substance 

use disorders to have equal access to treatment, to achieve stable, long-term recovery, and to become productive members of society. The IMD elimination will also 

reduce the health, public safety, and economic consequences associated with addiction. 

Addiction must be treated like any other chronic disease in this country, with a 

full continuum of treatment options based on the person’s level of need. Current 

Medicaid policy hinders States’ efforts to make this continuum available to Medicaid 

patients. My legislation would remove this Federal payment prohibition for behavioral health services provided in residential settings. Such a removal would improve 

access to substance use treatment services for millions of Americans across the 

country. 

The President’s Commission on Combating Drug Addiction and the Opioid Crisis 

Interim Report recommended that all 50 States be granted waiver approvals to 

eliminate barriers resulting from the IMD exclusion. Providing health care services 

and treatment resources to those who suffer from substance abuse is critical. In the 

face of this opioid epidemic, our Nation cannot afford to continue to bear the unintended constraints of 50-year-old provision under Medicaid, which severely impedes 

availability and access to treatment. 

Once again, Mr. Chairman, I want to thank you for holding this critically important hearing today, and greatly appreciate the opportunity to testify for your subcommittee. 

PREPARED STATEMENT OF HON. DAVID P. JOYCE

I would like to thank Chairman Burgess, Ranking Member Green, and the other 

Members of the Energy and Commerce Subcommittee on Health for holding this important and timely hearing. As an Ohio Member of Congress, and a former prosecutor of 25 years, I have seen firsthand the devastation caused by this epidemic. 

This is why I introduced my legislation, the Stem the Tide of Overdose Prevalence 

from Opiate Drugs Act of 2017, or the STOP OD Act. I went straight to the source 

to craft this bill, gathering input from the healthcare experts that are treating overdose patients on a daily basis. Cleveland Clinic, MetroHealth, and University Hospitals were instrumental in the drafting of the STOP OD Act, and endorsed it in 

its final form. The bill also has the support of the Fraternal Order of Police (FOP), 

Community Anti-Drug Coalitions of America (CADCA), and the Association of the 

United States Navy (AUSN). We wanted to know what our local communities needed, so we took their invaluable feedback, developed a bill that would provide resources where necessary, and then identified a savings measure to pay for those resources. As a Congress, we have made progress in this arena, but there is more work to 

be done. As an original cosponsor of my colleague’s Comprehensive Addiction and 

Recovery Act of 2015, I was proud when that piece of critical legislation passed both 

Chambers and was signed into law. My legislation is intended to be complementary 

to that effort. Although CARA roll-out is still a work in progress, more and more 

victims are overdosing every day, and our communities in Ohio are still communicating the need for more resources. The longer we wait to provide these resources, 

the harder this epidemic will be to address in the future. This is a downhill snowball and we need more firepower. 

First and foremost, the STOP OD Act would make available grants for not more 

than $150 million annually for 2 years to provide access to life-saving Naloxone, 

training in the administration of the drug, and for coroners and medical examiners 

to test for fentanyl so we can get a better idea of just how deep this problem runs. 

Further, the bill would attach a fee of $80 to drug-related offenses to ensure crimiVerDate Mar 15 2010 09:50 Oct 11, 2018 Jkt 037690 PO 00000 Frm 00118 Fmt 6633 Sfmt 6633 C:\USERS\WLAUFERT\DESKTOP\115X64MEMBERSOPIOIDSPDFMADE WAYNE
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nals that are enabling the supply and demand of the drug trade pay into mitigating 

the consequences of their actions. The fee goes toward paying for the grant programs under this bill, and after 2 years toward paying down the Federal debt. 

The STOP OD Act also makes available grants for not more than $75 million annually for 2 years to expand educational efforts to prevent opiate abuse, promote 

treatment and recovery, and promote the understanding that addiction is a chronic 

disease. The educational grants, coupled with the Naloxone grants, total $450 million. That’s the maximum grant allocation. In addition to the fee for drug offenses, 

this bill contains a pay-for to completely cover the maximum grant allocation. I 

worked with GAO to identify savings of at least $500 million by extending the current data center consolidation initiative. That effort is set to sunset in 2018, but the 

STOP OD Act would authorize the extension of that program for 2 more years, and 

would put those savings toward these grants, which will save lives and prevent further addiction. This bill works on the front end and the back end to address this 

crisis. Naloxone can resuscitate a victim of overdose. Meanwhile, we can utilize the 

other grant pool to educate our communities about the dangers of these drugs. We 

need a multifaceted approach to tackling this problem. This legislation is an important step toward our shared goal: ending the opiate drug overdose epidemic that is 

ravaging our great Nation. Moreover, I want to note that, as of this week, my legislation has a total of 46 bipartisan cosponsors, exactly evenly split between Republicans and Democrats, and spanning 20 States. It’s clear that no matter which side 

of the aisle you are on, your community has probably been affected by this epidemic, 

and you want to take even more action to address it. That’s what I am seeing when 

talking to my colleagues, and the bottom line here is: this bill will do some good. 

Thank you again for holding this hearing, and for inviting members outside the 

committee to weigh in and contribute our legislative proposals for your deliberation 

moving forward. I am happy to answer any questions regarding my legislation. I appreciate your time and consideration. 

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PREPARED STATEMENT OF HON. STEPHEN F. LYNCH

Good morning. Chairman Burgess, Ranking Member Green, and members of the 

Energy and Commerce Subcommittee on Health, thank you for the opportunity to 

submit my testimony for the record, and thank you for holding this important hearing. 

Mr. Chairman, my State of Massachusetts was hit early on and has suffered 

greatly from this crisis. In the late 1990’s, South Boston saw a disturbing uptick 

in the number of teen deaths, many of which were related to Oxycontin and heroin 

abuse. At the time, I worked to help establish the Cushing House Recovery Home 

for Adolescents, a drug and alcohol rehabilitation clinic in South Boston for teenagers. This initiative was just one of the many that the Commonwealth, at the State 

and local levels, has undertaken as part of a multifaceted approach to tackling this 

problem. Other initiatives include instituting a Prescription Monitoring Program, 

making addiction treatment facilities and services more accessible, increasing 

awareness of the scope of the epidemic, working with doctors to reduce the length 

of time that they prescribe opioids, and supporting innovative intervention efforts 

to reduce the rate of overdose deaths. 

Recent State statistics are showing that we are making an impact, but that we 

cannot afford to pull back on these efforts. In 2016, 2,107 citizens of Massachusetts 

died from an overdose. That level was an increase of 17 percent compared to 2015, 

which saw an increase of 31 percent, and 2014 in which the death toll rose by 40 

percent. We cannot be satisfied with only slowing down the rates of death: we must 

instead double down on the effective and proven initiatives that are saving lives. 

This brings me to the concerns I have that the Majority is pushing legislation that 

will undercut the efforts being undertaken both in my State and across the country. 

Recent bills to repeal the Affordable Care Act have included provisions that undermine Medicaid, which, according to the Kaiser Family Foundation, covers 3 in 10 

nonelderly adults with opioid addiction. In addition, these bills would have allowed 

States to opt out of covering addiction treatment and the mental health services 

that are necessary to ensure that recovery is sustainable. Legislative actions such 

as these will only worsen the crisis and threaten the still-fragile progress that has 

been made so far. Separately, I am also concerned by the recent omnibus spending 

package that included a cut of $306 million to the Substance Abuse and Mental 

Health Services Agency (SAMHSA). These cuts in funding and in coverage will only 

worsen the epidemic. 

Mr. Chairman, our country lost nearly 60,000 of our fellow Americans to the 

opioid epidemic last year. We must ensure that we are doing everything in our 

power to provide those families and individuals who are battling addiction with the 

support and help they need to overcome this destructive disease. In particular, we 

must ensure that the programs and initiatives that can help them will be funded 

and available. 

Thank you very much for the opportunity to testify. 

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PREPARED STATEMENT OF HON. RICHARD M. NOLAN

Chairs Walden and Burgess and Ranking Members Pallone and Green, 

Thank you for inviting me to submit testimony for today’s House Energy and 

Commerce Subcommittee on Health’s Member Day. 

Make no mistake about it—the abuse of opioids and other prescription drugs has 

become an epidemic and a crisis of major proportion in this country. 

According to the latest figures from the Department of Health and Human Services, 33,000 people die every year from overdoses. 

And 12.5 million people misuse and abuse opioids and prescription drugs every 

year. 

The fact is—in just a very few generations, we’ve increased the life expectancy 

in this country from less than 50 years to nearly 80. And the Centers for Disease 

Control recently concluded that our life expectancy would be even higher but for this 

epidemic of prescription drug misuse. 

With all that in mind—there is probably no more innovative or successful intervention program in the country than the community-based model being undertaken 

in Minnesota by CHI–St. Gabriel’s & Morrison County Prescription Drug Abuse 

Project. 

Their model—which at my invitation has been presented to Congressional staff 

twice now—has produced tremendous results by bringing together doctors, nurses, 

pharmacists, social workers, law enforcement, home health and skilled nursing professionals and educators in the communitywide effort you will hear about today. 

The results speak for themselves. 

In the community of Little Falls, the four participating pharmacies have experienced a 23 percent decrease in controlled substance prescriptions. 

324 patients have tapered off controlled substances entirely, primarily through 

the use of suboxone. 

And what that means is—370,000 fewer controlled substances have entered the 

community since the program began. At about $7 per dose, that’s a savings of about 

$2.6 million every year for patients in Morrison County. 

And what’s more, in the first 8 months of the program alone, pain went from the 

number one reason people were being admitted to the Emergency Room—to not 

even in the top 20. 

The fact is, doctors are not only managing pain better, but they are doing it with 

many new and effective options that don’t include long term use of narcotics. 

This program has become a model for our entire Nation, and I wanted to share 

it with the committee today for their awareness and examination. 

In closing, thank you for convening this hearing today—and helping us all move 

forward to put an end to this crisis that is affecting so many lives and families and 

communities. 

PREPARED STATEMENT OF HON. NIKI TSONGAS

Mr. Chairman, Ranking Member, and members of the House Committee on Energy and Commerce Subcommittee on Health, thank you for the opportunity to submit testimony today on the opioid epidemic, a health crisis indiscriminately affecting 

communities across this country. 

In my home State of Massachusetts, there were an estimated 2,107 opioid-related 

deaths in 2016, an increase of over two-hundred percent in the last 10 years. To 

put that increase in perspective on a national level, according to news reports, in 

2016, more Americans died of drug overdoses than have ever died from car crashes, 

gun violence, or HIV/AIDS during any single year. 

Thanks to the work of this committee, Congress has taken several steps to begin 

to address this crisis, but the stunning rise in opioid misuse, addiction and deaths 

calls on us to do more. 

When people become addicted to painkillers, and then lose access to their prescription drug, many turn to illegally obtaining cheaper, more potent opioids such 

as heroin and synthetic drugs. 

According to the most recent data from the Centers for Disease Control and Prevention, across the United States, over 21,000 overdose deaths were caused by synthetic opioids between February 2016 and February 2017, twice as many as the previous 12-month period. One of the leading contributors to this number is fentanyl, 

a deadly synthetic opioid that can be up to 50 times stronger than heroin and 100 

times more powerful than morphine. Fentanyl has become the leading cause of overdose deaths nationwide, surpassing heroin in the summer of 2016. 

132 

Although pharmaceutical fentanyl can be misused, most fentanyl deaths are 

linked to illicitly manufactured fentanyl and illicit versions of chemically similar 

compounds known as fentanyl analogs. 

In Massachusetts, the proportion of overdose deaths attributed to fentanyl is rising at a meteoric rate. At its lowest, in the third quarter of 2014, fentanyl was 

present in 18 percent of opioid-related deaths in Massachusetts. However, in 2016, 

fentanyl was present in a staggering 69 percent of the State’s opioid-related deaths, 

resulting in 1,400 fentanyl-related deaths in the Commonwealth. 

The primary sources of fentanyl are outside the United States, principally Mexico 

and China. The drug is smuggled across the U.S. border or delivered through the 

mail or private carriers. Fentanyl can also be ordered online. And because of its extreme potency, fentanyl typically comes in small amounts, making it more difficult 

for authorities to detect. 

That is why earlier this year I introduced bipartisan legislation with Congressman Brian Fitzpatrick (R–PA) to provide Customs and Border Protection (CBP) with 

the latest in chemical screening devices and scientific support to detect and intercept fentanyl and other synthetic opioids. 

Not only would these devices allow law enforcement to detect and confiscate 

fentanyl before it enters the United States, but it would also protect law enforcement officers on the front lines from exposure to the deadly narcotic, which is so 

powerful that coming into contact with just a few grains can be fatal. 

The House Committee on Homeland Security recently passed our bill, the International Narcotics Trafficking Emergency Response by Detecting Incoming Contraband with Technology, or INTERDICT, Act by voice vote and we are now urging 

House leadership to bring it to the floor. 

The INTERDICT Act would be an important step towards stemming the rapid influx of illicit synthetic opioids, including fentanyl. However, to most effectively have 

an impact on this heart-wrenching epidemic, we must establish a comprehensive, 

fully funded plan at the local, State, and Federal level. Congress must continue to 

demonstrate its commitment to ending this epidemic by supporting the programs, 

agencies, organizations and individuals on the front lines. 

We cannot afford to let our friends, family members and neighbors suffer under 

the burden and stigma of addiction and mental illness—especially given the scope 

and magnitude of the issue nationwide. My colleagues from all parts of the country, 

both Democrats and Republicans, have heard similar stories from their districts and 

we owe it to our communities to do all we can to head off this national epidemic. 

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