fight the zika virus. imagine if we applied the same commitment, urgency, and level of resources to the prescription drug and heroin epidemic. we need an immediate and comprehensive strategy that requires commitment from all levels of government -- state, local, federal -- and that means congress must step up and respond with leadership and with resources. we need to stop the overprescription of opioid pain medication. we must prevent addiction before it takes hold, and we must provide the funding necessary to ensure that we stem this tide of deadly addiction. the food and drug administration must change its decision not to seek expert advice about the risks of addiction before it approves abuse deterrent opioids. abuse deterrent opioid is a contradiction in terms. whether an opioid is abuse deterrent or not hasn't prevented tens of thousands of

people who have had their wisdom teeth removed or experienced lower back pain from getting addicted to these painkillers. by refusing to convene advisory committees to inform all of its opioid approval decisions, the f.d.a. continues to ignore outside experts who could help stem the tide of tragic deaths and overdoses plaguing this country. that's why i have filed annual amendment to require -- an amendment to require the f.d.a. to convene advisory committees of outside experts for all opioid approval decisions, period. now is the time to implement effective and common sense solutions, but we need funding to do that, funding for families, funding for treatment providers, funding for our sheriffs and our firefighters who carry the overdose prevention drugs that save lives. we need to provide the real resources necessary to address a crisis that is only growing in numbers and severity, and that

comes in the form of emergency funding. we are hemorrhaging lives by the day and supplemental funding is the first step needed to staunch the flow of suffering and death. ladies and gentlemen, we are at a watershed moment in this national debate to address the public health crisis of addition. so let's be clear. stopping the overprescription of pain medication that is fueling opioid addiction and overdoses starts with the prescribers. we need to require anyone who prescribes opioid pain medication and other control substances to undergo mandatory training on safe prescribing practices and the identification of possible substance use disorders. that's why i have filed an amendment that requires prescribers to get the education needed to help staunch this flow of suffering and death. the doctors will say that they don't want education be mandated, that it should be voluntary. well, the f.d.a. has had

voluntary education for opioid prescribers in place since 2013 and has been actively encouraging doctors to take these voluntary education modules. but in more than two years, less than 12% of prescribers have actually completed f.d.a.'s voluntary education program. a survey of 1,000 physicians nationwide found that nearly one half of doctors erroneously reported that abuse deterrent formulations were less addictive than their counter parts. it's uncongressable that our doctors know so little about these potentially deadly painkillers. and i intend to call up amendment number 3382 later so that we can make consideration of the bill. the amendment would ensure that as a condition of receiving a license to prescribe opioids, that the recipient of the

license is educated in the best practices for using opioids and the connection with addiction and with diversion. and i intend to call up that amendment later asking for consideration. so from my perspective, if we're going to have a real strategy, then we have to make sure that there is a requirement, that there is continuing education. we also need to remove the barriers to effective treatment, including outdated federal restrictions on medication assisted therapies, like sabaxone, medication assisted therapy for opioid addiction is cost effective. it decreases overdose deaths and it reduces transmission of h.i.v. and hepatitis c. that's why i filed an amendment that would lift the caps that are limiting the number of patients doctors can treat with medication assisted therapies.

if we're going to reduce the supply of heroin and illicit prescription drugs, we have to reduce the demand through effective treatment. i've been working with senator paul from kentucky on that amendment. also, fear of a lawsuit should not deter anyone from trying to save the life of someone suffering from an overdose. that's why i have filed an amendment that creates a federal good samaritan provision to shield from civil liability family members, friends and other bystanders who administer opioid overdose prevention treatments like narcan. the did he bait that we are having -- debate that we are having on this legislation this week is just the beginning. we must let prescribers know that unless they get basic education in opioids, they will have to turn off the spigot of painkillers that are flooding this country and leading to deadly overdoses. we must let law enforcement and the judicial system know that we cannot incarcerate our way out of this problem.

and we must let big pharma know that we are going to work to ensure that we have a lifting of awareness of this issue every single day. enough is enough in this country. enough is enough. we've just seen an explosion here in terms of this problem. we must now let all those struggling with addiction know that help is on the way and that no matter how dark life seems right now, that there is hope and sunlight will grace them once again. i thank you, madam president, for giving me the opportunity to speak at this time. and i yield back the balance of my time. a senator: mr. president? the presiding officer: the senator from oregon. a senator: i ask unanimous consent that tim brown, a research fellow on my team be allowed privileges to the floor. the presiding officer: without objection. a senator: thank you very much. madam president, the genius of america was a government designed as president lincoln so

eloquently summarized of the people, by the people and for the people. mr. merkley: i'll be rising periodically to address issues affecting americans across this country and that this chamber should be addressing. this week i'm using my speech to highlight the labeling of genetically modified foods. and this is truly a we the people versus the titans, we the titans battle because citizens routinely poll very high numbers about their desire to know what's in their food and like the idea of being alerted when their food contains genetically modified organize eufrpls or -- organisms or gmos but that's not necessarily the consequence as something goes through a legislative process, often the we the people common sense vision is lost in favor of pressures applied by powerful industries. and we're in the middle of a

debate like that right now. and so that's why i thought it appropriate to rise at this moment to address this. this is really a debate about whether you believe that in a democracy, citizens have a right to know or whether that right to know is going to be taken away from them. and i guess it goes to whether you feel that citizens have the minds that they're put on this earth with to make decisions of their own versus being told what decisions to make by a federal government. well, now, this debate over genetically modified organisms is a debate that gets complicated because there are tremendous differences in the types of genetic changes in plants. and so let me give you an example. you might have a crop where the

crop has been modified genetically in the laboratory to produce natural toxins that defend plants against root dwelling insect pests. and perhaps as a result of that, they -- farmers can reduce the amount of synthetic pesticides they apply to crop lands. that might be a very positive thing. it might save a lot of money and it also might save a lot of runoff of pesticides. that's one example. other crops have been modified to fortify foods with environment minutes -- with vitamins and nutrients. for example, golden rice developed by the international rice institute provides greater amounts of vitamin a to reduce the deficiency of this essential vitamin in our diets. there are other positive impacts. you have, for example, transgenic carrots, carrots that have been modified genetically

to produce drugs inside the carrot to treat the genetic disorder known as goucher's disease and other genetic modifications have been used to attempt to increase crop aoeld yields through more efficient photosynthesis. so that's a whole variety of different ways of trying to make plants contribute better to our nutrition and certainly in terms of the dynamic of the farming environment. but there's also changes that are made that raise concerns among some of our citizens. for example, most of the genetically modified crops grown in the u.s. have been altered to confer resistance to a chemical herbicide known as glyphosphate. i was looking at a chart. i don't have it to display so i'll describe it. but after the introduction of these gmo crops in the early 1990's, the amount of acreage that's been planted with

guyphosphate resistant crops has gone to nearly a hundred percent. with soybeans it went to a hundred percent by about 2005, just about every soybean planted in america. and glyphosphate resistant cotton. virtually all the cotton falls in that category. and a great deal of the corn, the vast majority of the corn planted here in our country falls into that category. and so now you have millions of acres being sprayed with glyphosphate. well, at first glance one might say that's a great thing because it's an easy way to reduce weeds, but often mother nature's complicated. for example, when you have all of that glyphosphate being sprayed on acre after acre, millions of acres, the weeds start to evolve a resistance to it, and then that resistance

means you have to put more herbicide on than before. so that's a concern. or, for example, as you put more glyphosphate on, you have more glygoes fate run -- runoff and that becomes a concern because you have herbicides running into our waterways and that can have an impact on sensitive aquatic species, fish, mussels, amphibians, mike crow organisms. it merits study but it's certainly something to be concerned about. you can also have the impact of going to a separate item in which you have and i mentioned as a positive the fact that plants had been genetically modified to resist certain bugs that attack the roots. well, so the western corn root

worm is an example of that. but now it appears to be evolving to eat the corn that was buy crow engineered to kill -- bioengineered to kill it. because over time with millions and millings of acres, there's some genetic change and some worm that would have been killed because it has a genetic diversity, genetic change is now resistant, it produces offspring. those offspring produce offspring and suddenly you have a bug sometimes referred to as super bugs that are evolving to be resister assistant to the pesticide -- resistant to the pesticide. and what is the impact of that? or let me give you another example. we've had a huge drop in the population of monarch butterflies, making any sent creatures. -- magnificent creatures. humans see a monarch and they fall in love. that's scene one, beautiful butterfly and of course these butterflies manage to travel thousands of miles in the course of their life which is just

stunning that such a fragile, beautiful creature could travel so far, to go way south in order to reproduce and come way back north. but when we apply huge amounts of glyphosphate herbicide, one of the side effects is it kills a lot of the plants that is the milk weed that the monarch eats so you have an impact on the monarch. that's not the only impact on the monarch but it's a contributing factor, and the result is that it has contributed to a crash in this population. so to summarize, you have many potential positive impacts of genetic engineering, and you have many potential concerns from genetically engineered crops. and so there's considerations that need to be balanced here. and some individuals hear that and they're not concerned at all and they say it's fine. i want to buy products that are

genetically engineered or i'd like to buy these but not those. and others say, you know, i'm really concerned about a specific feature of a genetically modified crop, and i don't want to use my dollars to buy that crop and contribute to the problem i'm concerned about. this is an adult conversation. this is a complex conversation. there are benefits and there are disadvantages. and there's more studies to be done to discover just how much the concern should be. some individuals are concerned that with all this huge amount of glia phosphate being sprayed and it is a known car sin jefnlt is there any residue that stays on any of the crops that people harvest a ngd eat? and so they're concerned about that. but that's why labeling is is leveling the field. it allows those who are concerned to know what's going

on. it allows those who are not concerned to not pay attention. my daughter happens to like to look at ingredient lists and try not to consume high priew fructe corn syrup. that's helpful for her to know what's in it and then she can exercise her consumer preference. other folks don't want to have excessive salt, or maybe they're allergic to peanuts. it's helpful toker them to be able to make that decision. but honoring our citizens' right to know seems to be disappearing here on capitol hill because we have powerful special interests that don't want to let citizens make these judgments, make these evaluations between the advantages and the disadvantages. last summer the house of

representatives, a few hundred yards from here, a majority voted for a law that blocks states from passing laws to provide this type of information 0en a label -- on a label. and just yesterday here in the senate, the senate agricultural committee voted out a law to block the right of citizens to know whether or not g.m.o.'s are in their food. and that's really an outrageous, outrageous bill. it would halt any progress in ensuring that consumers can simply and easy access information about g.m.o. ingredients through labeling. this bill that was passed out of committee also included a proposal that the secretary of agriculture do an education campaign, touting the economic and nutritional and humanitarian, scientific benefits of g.m.o.'s . but the bill didn't say and educate

consumers about the substantial concerns that the scientific community has, about the impact on the evolution of weeds, about the impact on the evolution of bugs, about potential residues on the crops, about the runoff that's in our waterways affecting how our -- how healthy our waterways are and the organisms that live in our streams in our rivers. so this would be a very unbalanced presentation to the american public, and that's really the type of thing that government shouldn't be involved in, basically running a promotional campaign on taxpayers' dollars to not create a balanced understanding of an issue but, instead, an imbalanced understanding of an issue. the truth is, all americans have the right to know what is in their food. they are buying food to feed

their children. they have the right to know the ingredients so they can make responsible decisions. and providing information regarding genetically modified ingredients is a commonsense way to empower consumers to make their own personal decisions on issues they care about on the food they purchase. it's a pretty emotional issue when you start talking about the food that you're putting into your own mouth or the food that you're feeding your children. campbell soup has begun taking steps to voluntarily disclose an all of their whether or not the products contain genetically modified ingredients? why are they doing this? they say they have a relationship of integrity with their customer. they want their customer to know full information about their products. and let the customer decide what

the customer wants. and they'll provide information about the type of genera genetic modifications and what they mean so the customer will have enough information to make a decision. like said, there's advantages and disadvantages to g.m.o. ingredients. our federal government already requires the labeling of ingredients in basic nutritional information in order to protect the public and to guard against false product marketing, and these food labels tell consumers many things. of course, they tell them how many calories, they tell how much there is of the variety of vitamins, they list the ingredients and do so in order of how prominent they are in the product, and, you know, our labeling laws even say that when fish are sold in large supermarkets, they have to state whether a fish is farm-raised or wild-caught. well, why -- why do we require

supermarkets to label the fish as farm-raised or wild-caught? because our consumers care about that. there are implications of whether a product was grown in an artificial lake or whether it was caught in the wild. and consumers want to know and use their own minds to make these decisions. that's something about being in a free society. you get to make your own decisions based on disclosure. we make the information available. well, this type of labeling about genetic modifications or genetically modified organisms and the ingredients is routine around the world. 64 other countries, including 28 members of the european union plus japan, plus australia, plus

china, plus brazil already require mandatory g.m.o. labeling. has it come to the point that we in america are denied information that is routinely required in china for consumers? is that really the point we're coming to on this bill, this dark act, deny americans the right to know act? this is not the direction we should be going. instead, we believe in our american citizens. we believe in education, we believe in individual decision making and consumer information on the label honors that. blocking states from being able to provide information that those state legislators or citizens by initiative say they want, that's an overstepping of federal authority to crush states' rights on an issue important to citizens.

that's why today i'm introducing a compromise bill, a bill trying to bring this conversation to a commonsense compromise. it's called the biotechnology food labeling and uniformity act. i'm introducing this bill today with senator tester, senator leahy, and it would give the f.d.a. the authority to develop a uniform federal standard for on-package disclosure of genetically modified ingredients. i have a a me met with the induy groups, the pro--labor groups, tried to find the area of compromise between the two. what i found was a great deal of flexibility on the labeling groups. those groups said, there does not have to be information on the front of the package. it's okay fits a on the ingredientsly, on the back of the can or the back of the package. it doesn't have to be in supersize print. it is okay if it's in the same

small print that the ingredients are printed in. in fact, they're top to many different -- they'r they're opeo many different versions. as long as a person can go to the store, pick up a package and turn it over and find out if there is a g.m.o. impact. so these are some of the ideas that are a hav variety, all acceptable to the labeling side of the world. on your ingredient area, after the ingredient you can say it is genetically modified or put in a code like "g.m." it doesn't take up much space. it is tucked into a long list of ingredients. or you have several ingredients, you'd rather use asterisks. just say down below what the asterisk means. the ingredient is genetically modified. or you could do a phrase at the bottom. "this contains or may contain he genetically modified ingredients. requestings "so a simple phrase

at the bottom. or a symbol. brazil uses a symbol. they hughe use a "t." any of these would be acceptable. not all of them at once. just each of them would be fine. it will take effort for consumers to look and see it. it is not up front. they have to pick up the product. they have to look. it can be tucked into small print, but it gives a person who cares the ability to get to the bottom of the question and then they can look up at the web site for the product if they want, through a quick response code, and get more details. that range of flexibility, that's where the compromise can be honoring citizens' right to know. while not taking up a lot of space on a package or not doing anything on the front of the package that says, this product is healthy or unhealthy or otherwise. it means that that share of americans who want this

information, just like there is a share of americans who want to know if there's high fructose corn syrup, if fish is wild or free, wild fish, that they can in fact find this out. and this also addresses the big issue that the manufacturers have been raising. they don't want a patchwork across the country of 50 different states having different labeling laws. our supplyinventory doesn't work that way. you don't have a supply industry that serves just one state. that's a legitimate concern. so there is a big concern about 50 different versions of a law, or maybe counties even have different laws is addressed. i'm going to simply conclude with this understanding:

citizens have a right to know in a free society what is in their food. let's honor that, and should the dark act -- the deny americans the righright to know, that past of the committee, come to this floor, many of us will stand up to fight it. it shortchanges american citizens, dens, dengz them denim fundamental information. it is a federal overreach and it is an assault on consumer information and consumer rights. it is just wrong and we will oppose it vigorously. thank you, mr. president. a senator: madam president? er spher sph the senatothe prese senator from virginia. mr. kaine: i tries offer some thoughts about a current vacancy on the supreme court. i had high hopes yesterday for

the meeting in the white house between the majority leader, the chairman of the judiciary committee, president obama, and vice president biden. i had high hopes that that meeting might lead to an opening and a willingness to entertain the important business of filling a vacancy on the supreme court. but the announcements made directly after that meeting suggested that, a phrase we sometimes use back home, that the schoolhouse door is going to stay closed; there will not be a debate, there will not be a vote, there will not be a committee hearing. in fact, there was even a suggestion, a commitment that the majority would refuse to even entertai entertain courtess visiting with the nominee that president obama is expected to send up soon. i was disappointed in that. and i want to take the floor today to just offer a simple message. it is very important that the

senate do its constitutional duty and do its job with respect to the supreme court vacancy. the job is pretty plain. we have a job description, like most people do who have jobs. the job description is contain mostly in article 1 of the constitution, but there are also descriptions of what we must do in the senate in article 2. article 2, section 2, clause 2, of the constitution says, the president shall nominate and, with the advice and consent of the senate, shall appoint a variety of officials, including supreme court justices. this is part of our job description, to entertain presidential nominations for supreme court justices. we volunteer for the job. we take an oath to do the job. we cash a paycheck written by the american people to pay for us to do the job. we frankly don't have the option

of refusing to do the job. is there anything unusual about this situation, a vacancy on the supreme court occurring during the last year of a president's term? the answer to that is no. on 17 occasions, this body has entertained and had a confirmation vote on a supreme court justice in the final year of a president's term -- 17 times. when this happened, people thought it seemed rare. but actually when you go back and look at the historical record, it's not rare at all. and on each of those occasions in a presidential election year, the senate has done its job under article 2, section 2, clause 2 and entertained a nominee. there is no reason why this senate should not do exactly the same thing, follow that

historical precedent. madam president, as i've traveled around virginia in the weeks since the vacancy became open, i've talked to a lot of citizens about this and it sometimes is helpful i think for us in this body to think about the way others, especially our citizens, look at what we're doing or not doing here. and citizens ask me, what possibly could be the reason why the senate would not follow its clear historical precedent and do a job description that is contained in the constitution? what would be the reason why congress would refuse a vote, refuse debate, refuse committee hearings, refuse even to meet with a nominee? why would congress not do its job? why would the senate not do its job? and madam president, i've been thinking about that and i can only conceive of two reasons why this senate would not do its job

and both of the reasons are highly illegitimate, in my opinion. the first reason -- and this is a reason that occurs to many citizens, and they're very, very concerned about this -- is that the senate is announcing that it will not do its job because of the identity of this particular president. the senate has been willing to do the job for other presidents. but is there something about this particular president that is making the senate decide to break its historical traditions, violate article 2, section 2, clause 2 and not do the job? this question is given some added umph because of another recent event. president obama in early february sent to the congress his budget. pursuant to the budget act of 1974 -- and this has been

followed uniformly by the senate and the house -- when the president sends up a budget, the budget committees have a hearing about the president's budget, even if they don't like it. and they often don't like it. but that's what you do. you have a hearing about the president's budget. if you don't like it, you criticize the budget and then you write a different budget. that's what's happened for every president since the budget control act of 1974 passed. in the last year of the bush administration, when there were two democratic majorities in both houses, when president bush sent his budget up, hearings were held on the budget. but in this instance, just within the last month, when the budget was sent up from president obama, both committees said, for this president, breaking the statute, breaking all tradition, we will not even have a hearing on this president's budget. so if we're going to break the

constitutional command and break a history in which 17 justices have been confirmed in a presidential year, and if we're going to break it for this president. and if we're going to break the budget control act and break a uniform history since 1974 of not according even a hearing for the budget submitted by this president, then a question that is being asked by the citizens of this country, certainly the citizens of this commonwealth, is whether the actions taken here on this supreme court nomination to not allow a vote, not allow a debate, not allow a committee hearing and not even allow courtesy office visits is actually not about the supreme court at all, not even about the nominee, whosoever it shall be, but it is a particular mark of disrespect for this president that is unprecedented in the history of this body.

that's an explanation that many of my citizens are deeply worried about, that many of my citizens are talking about and asking about. and, frankly, i don't have a good answer to that concern. there's a second reason that suggests itself to me with respect to breaking all of the historical precedent on this particular supreme court vacancy. and, madam president, it connects to another concern that i've taken to the floor many times to talk about as a member of the foreign relations and armed services committees. there's another clause of the constitution that i care deeply about. article 1, section, clause 11. we should not be at war without a vote of congress. we're now in the 20th month of a war and congress hasn't even voted. this war against isil. i go to hearings all the time where members of the senate

criticize the president for what he's doing or not doing in the war, but i see a complete unwillingness in this house and the house of representatives to actually do what the constitution commands and have a vote on the war. this circumstance reminds me of that, a clear constitutional command in article 2, section 2, clause 2, a clear historical precedent of the senate engaging. but now for this president, on this vacancy, a decision -- hold on a second. maybe we can just avoid voting "yes" or "no." if we vote "yes" for a nominee that the president might send up, we'll make some people made. if we vote "no" on a nominee the president sends up, we'll make some other people mad. maybe we can just avoid the commands of article 2, section 2, clause 2, avoid the uniform history of this body and not

vote at all. and if we can avoid voting at all, maybe we can evade accountability, maybe we can evade the criticism that might come to us from our constituents. that is also highly, highly troubling. but, madam president, i can't think of any other reasons why this body would violate the clear commands of article 2, section 2, clause 2 and violate a uniform history of approving 17 supreme court justices during a presidential year other than, a, it's fundamentally a sign of disrespect for this particular president. or, b, it is a desire by a senate that certainly has the votes to confirm or deny, consistent with the constitutional provision, to

avoid taking a vote and thereby think that we can avoid the accountability of our citizens for casting a vote on something that might be controversial. needless to say, both of those reasons are highly illegitimate and, in my view, are really beneath what we should be doing in this chamber. madam president, the last thing i'll say is this. the job description of a senator is laid out in the constitution but there are other parts of the job that may not be laid out so plainly but we all understand to be our job. for example, i don't think it's laid out that we should, you know, passionately represent our citizens and do constituent service for them but we all understand that's part of the job. well, another part of the job of a united states senator that may not be spelled out so directly, as the power to advise and consent on nominations or the power to declare war is that we

are elected guardians of this institution. and more than just the institution of the senate, we are elected to be guardians of the democratic traditions that are set out in the constitution, in this marvelous constitution that establishes three branches of government that have checks and balances against each other. we should always act, regardless of our disagreements, regardless of our debates and arguments, and the differences of opinion are legitimate, but we should always act to promote respect for our institutions and not only the institution of the senate, the institution of the court system that has a vacancy right now in the supreme court, the institution of the presideno we are sending a signal of disrespect toward by the actions that are being undertaken in this body. it is part of the job we need to do to build up the respect for the institutions of our government. if united states senators don't

respect the institutions of our government, why would anyone else respect them? if we act in a way that subvert or tear them down, why would we expect anyone else to respect the institution? i came here to this body because i do respect the institution. i respect its history. we're all humans. we can make mistakes. votes have been cast that in the light of day you could look and expect to be different. but compared to other systems in the world -- and i lived in a country that was a military dictatorship when i was a young man and can certainly see the great blessings we have to live here in this country and serve here in this body -- but i deeply, deeply fear that the actions that we are embarking on in connection with the supreme court nomination are expressing a profound disrespect for the article 3 branch, the courts, a

profound disrespect for the article 2 branch of the presidency and, frankly, a profound disrespect for our own history, traditions and job description in this article 1 branch of the legislature. it is not too late for us to turn this around. it is not too late for us to take a pause and when the president sends over a nomination for the supreme court to do what justice demands. if justice demands anything, it should be that we would analyze an individual on that person's own merits, instead of just saying the blanket rule is no matter who you are, no matter what your qualifications, because you are sent by this president, we will create a unique rule yo for you and refue to entertain you. we still have time to turn this around. i have no idea when the president will send a nominee over and i have no idea who that nominee will be.

but when that nominee is delivered and recommended to the senate, it is my prayer that this body will do what article 2, section 2, clause 2 demands, that we will do what we have done in every other instance when a president has sent a nominee over in a presidential election year, that we will not bar the schoolhouse door but we'll open the doors of our office to accord the nominee the courtesy of a discussion, that we will have hearings in the judiciary committee and that we will have a robust debate and a vote on this floor. if that vote is" yes," that will be great. if that vote is a "no," that vote will still fully be in accord with the constitutional job description of this congress. but to not entertain a nominee at all in my view would violate our oath, would violate the constitution and would express a significant disrespect for all three branches of government. and, madam president, with that, i yield the floor. a senator: madam president? the presiding officer: the senator from iowa.

mr. grassley: i call up the toomey amendment number 3367. the presiding officer: without objection, the pending amendment is set aside. the clerk will report. the clerk: the senator from iowa, mr. grassley, for mr. toomey, proposes an amendment numbered 3367 -- mr. grassley: i ask unanimous consent the reading of the amendment be dispensed with. the presiding officer: without objection. mr. grassley: i yield the floor. mr. wyden: madam president? the presiding officer: the senator from oregon. mr. wyden: madam president, i call up amendment number 3395. the presiding officer: without objection, the pending amendment is set aside. the clerk will report. the clerk: the senator from oregon, mr. wyden, proposes an amendment numbered 3395 to amendment numbered 3378. at the appropriate place, insert the following. mr. wyden: madam president? the presiding officer: the senator from oregon. mr. wyden: i ask unanimous consent that the reading of the amendment be dispensed with. the presiding officer: without objection. mr. wyden: madam president, i rise this morning to offer,

along with my colleague, senator schumer, what in my view are some needed changes to the amendment that senator toomey has now offered to the opioid bill. my bottom line for the opioid legislation is that a real solution has to include three priorities -- more prevention, better treatment, and tougher enforcement. to be successful, all three priorities must work in tandem. the toomey amendment, which is often called the part-d lock-in, would allow part-d plans to identify people in medicare who may be abusing opioids. these people would then be assigned to one prescriber and

one pharmacy to get their pills. this is an enforcement policy and it cracks down on those who game the system. what is important, what is critical for the senate is to understand that the story does not stop there. if someone is addicted to opioids, they need a path, a real path to treatment. without treatment, they may get their pills on the street or they may turn to heroin. this amendment ensures those who are at risk for opioid abuse are connected to meaningful treatment choices to better manage their pain and limit excessive prescriptions. those struggling with addiction need the health care system to be all hands on deck working to ensure that there is adequate

treatment. that means your doctor, your health plan, and your pharmacy all putting together a treatment plan that is going to ensure that americans are on a road to real recovery. without access to treatment, the toomey amendment alone would simply lock persons suffering from addiction into a pharmacy, and they would still be without a path out of addiction. real effective treatment has to be more than handing a pamphlet to somebody struggling with a condition as powerful as addiction. my amendment also aims to end the tide of overprescribing in the first place. it doubles the penalties for opioid manufacturers that provide kickbacks to prescribers in order to boost their profits by promoting the unapproved use

of these drugs at the expense of patient safety. the inappropriate practices of these companies have been well documented in recent years, and it is high time for real accountability when the opioid manufacturers go too far. i'll close, madam president, by saying that at the finance committee hearing, a hearing held last week, i asked the three panels -- one was a witness chosen by the distinguished chairman, chairman hatch. one was a witness i chose. one was an individual that both of us thought would make an important contribution rmt they they were a pharmacist and state attorney general and child abuse expert and i asked all of them one simple question and that question was does treatment and enforcement have to work in tandem to solve the opioid

crisis? each one of these witnesses, madam president, a witness chosen by chairman hatch, a witness that i chose, an independent witness, each one of them answered, yes, prevention, treatment and enforcement must work in tandem. and to do that, we have to pass this amendment. you ought to take action to improve policies in our government that actually will solve the opioid crisis. i hope all of my colleagues will support my perfecting amendment to the toomey amendment. and, madam president, with that, i yield the floor. i would note the absence of a quorum. the presiding officer: the clerk -- mr. wyden: i withdraw my request for a quorum call. the presiding officer: without objection.

mrs. gillibrand: madam president, i rise to speak in favor of amendment number 3554. i filed this amendment with my colleague from west virginia, senator capito, a leader in our fight against opioid addiction. the opioid addiction problem in our country is severe. it's growing and it's not going to end unless congress comes together to pass a law that targets the root causes of this epidemic. the stakes are simply too high to ignore. last year alone in communities all across our country, including many in new york, 1.4 million more americans started abusing opioids. every day 44 more people are killed by an overdose. we've seen enough data to know that our opioid addiction problem is spiraling out of control.

opioid addiction is destroying too many lives in our cities, too many families in our rural communities, and too many young men and women in our suburbs. madam president, i want to tell you the story of one of my constituents. his name is sean murdock. sean was a really special and gifted young man. he was cocaptain of his high school football team and had that rare ability to bring people together and to connect with anyone. sean didn't care if you were on the football team or if you had a disability, he was always the first one there to help you when you needed it. after high school, sean loved working with his hands, so he got a good job as a construction worker. one day sean broke his arm. sean's doctor gave him a prescription for oxycodone, a powerful opioid to mask his pain. by the time this prescription ran out, sean was already addicted, and he couldn't shake the addiction no matter how hard

he tried. he started using heroin, tried to quit many times. but the system failed. the system failed him at nearly every step of the way. and last fall sean overdosed and died. i'd like to tell you sean's story from the perspective of his parents. my hometown paper "times union" did an incredible story about his life. i can imagine the pain they suffer because i have two young sons. for the murdocks they had many questions but very few answers, and they have been lost in a fog of grief since their son's death two months ago. "times union" wrote "these parents want to speak out in sean's memory to reclaim what heroin stole from them in the hope that it might help other parents struggling with children's addiction.

his father said 'sean did not die in vain. we tried our best to save him but it wasn't enough.' his mother walked over, embraced her son and spoke soothing words to sean's older brother. the father buried his head in his hands. it is the sorrow we have seen far too often. when their sons spiral down into addiction, his parents could see that something was wrong. he lost weight, he was distant, if i fidgety. he nodded off at the dinner table. his father found a syringe and confronted him. sean said dad, i'm sick, i need help. this is not me. i don't want to be like this. the parents told their story to our paper. the paper says it was the revolving door of failure, detox, intensive outpatient

care, relapse. he did not qualify for the most intensive inpatient residential treatment. they denied him because he was not suicidal and had a stable home environment. they said it was a never ending battle. they treated him like the scum of the earth. now imagine being a parent and going through this with your son. into treatment center and treatment center. when sean finally died, he was in the best care. he was in a treatment center. when he called his mother, he said, mom, my steak's ready, i've got to go. i love you very much. and he went into the bathroom and he overdosed. sean did leave his parents with final solace. not long before he died, he thanked them for their unconditional love and how they supported him through the long road of misery. he said to them, "you did

everything right." now i don't know how a parent can hear those words and think they did everything right, but i can tell you as a senator that the u.s. congress is not doing everything right. too many parents are telling these stories about their children who have died, and for too many patients they're being prescribed opioids like percoset and vicodin and oxycontin for acute pain. they get prescribed as medication for getting a wisdom tooth out, for a broken wrist. a medicine that they really only need for two or three days. but why in heaven's name are they sent home with a dose of 30 oxycodone pills? what happens to those pills? are they given to kids at a party? are they sold to addicts? so we know there is a huge issue

with how prescriptions are being made, how much medicine is being given patients for this acute care. and right now there are no guidelines, no guidelines given to doctors. so i have a bill to create that guideline. we need a guideline for the c.d.c. our amendment is very simple. it would require the c.d.c. to issue clear guidelines to our medical community for when it is appropriate to prescribe opiates instead of something nonadingtive -- nonaddictive. our amendment requires the c.d.c. to issue these clear guidelines for how much opioid medication our medical professionals can prescribe without putting a patient at high risk for addiction. these guidelines are already being done for chronic pain, so they should do them also for acute pain. we need to do something here.

as members of congress, we need to respond to the suffering of so many of our constituents. it is truly an epidemic, and it needs a response. thank you, madam president. i yield the floor, and i suggest the absence of a quorum. the presiding officer: the clerk will call the roll.

mr. mcconnell: madam president? the presiding officer: the majority leader. mr. mcconnell: i ask that further proceedings under the quorum call be dispensed with. the presiding officer: without objection. mr. mcconnell: i have six unanimous consent requests for committees to meet during today's session of the senate. they have the approval of the majority and the minority leaders. i ask unanimous consent these requests be agreed to and printed in the record. the presiding officer: without objection. mr. mcconnell: madam president, i ask unanimous consent that at 2:30 today the senate vote in relation to the following amendments in the order listed: 3362 feinstein. 3395 wyden. 3367, toomey. 3345, shaheen. that there be no second-degree amendments in order to the amendments and that where applicable, senator enzi or his

designee be recognized to offer a budget point of order against the respective amendment and that the sponsor or their designee be recognized to make a motion to waive. further that all amendments be subject to a 60 affirmative vote threshold for adoption and that there be two minutes equally divided in the usual form prior to each vote. the presiding officer: is there objection? without objection, so ordered. a senator: madam president? the presiding officer: the senator from nebraska. mrs. fischer: thank you, madam president. i rise today to discuss a bipartisan bill that would ensure all americans can access 911 in emergencies. in december of 2013, carey hunt was attacked in her texas hotel room. as this was unfolding, her

nine-year-old daughter tried desperately to call 911 but the call did not go through. like millions of american children, carey's brave daughter was taught to dial 911 for emergency assistance, but because they were in a hotel room, the phone required her to dial 9 followed by 911. in any emergency, a few precious seconds can mean the difference between life and death. and although we cannot prevent tragic events from taking place, we do have the ability to make it easier to get help. and that's why i've teamed up with senators amy klobuchar, john cornyn, ted cruz and brian schatz to put forward a new bill that could save countless lives. our legislation, named in honor of carey hunt, would require that everyone has the ability to

call 911 in an emergency. this problem isn't isolated to one hotel room or a particular incident. as of march 2014, consumers could not directly dial 911 in 44.5% of hotel franchises and 32% of independent hotels. over the past two years, the hotel industry and phone manufacturers have undertaken voluntary efforts to improve the problem and i do commend those efforts. but we need to do more. if one person cannot call 911 in a lif life-or-death situation, t is one person too many. the bill that we've introduced, known as carey's law, would require a multiline telephone

system, such as those used in hotels and schools and office buildings, to have a default setting that enables people to directly call 911 without first dialing an access code, such as 9 or 1. the bill also requires that these phone systems be programmed to allow a central location, such as the hotel front desk, to be notified if a 911 call is made. through our legislation, first responders can more easily locate people during an emergency and then they face fewer barriers while this is unfolding. carey's law has already received generous support from across the country. for example, in nebraska, the bill is supported by the firefighters associations in omaha and lincoln. the buffalo county sheriff's office, the city of beatrice fire and rescue, cheyenne and

scott's bluff county 911 representatives, and the chairman of the scott's bluff county board of commissioners. the bill is also supported by the hotel industr industry's amn hotel and lodging association. and i'd also like to acknowledge the efforts of f.c.c. commissioner who has devoted time and resources to bring attention to this very important issue. the commissioner traveled to nebraska last june and he participated in a workshop on direct dial 911 issues while at the university of nebraska in lincoln. he's continued to encourage the industry to work with him in an effort to find solutions to this important issue. the nebraska public service commission, which led the workshop, has also been at the forefront of the discussion. and finally, we would not be

here discussing this bill without the tireless work of carey's father hank. hank has worked day in and day out to advocate for this legislation at both the state and the national level. hank has made it his mission to ensure that no other family will have to suffer through a similar tragedy. to paraphrase hank, it was the look o on my granddaughter's fae when we failed her. a nine-year-old did what she was instructed to do by her parents, teachers and adults. she was in a true dire emergency and followed instructions but it didn't work. i would call on all my colleagues to support this important legislation. we owe it to carey hunt, her family, and the americans who rely on their ability to call

911 for emergency help. mr. president, i also want to take a moment to speak about another bipartisan bill that is currently before the senate. this legislation also seeks to protect americans by updating our telecommunications laws. it would fix loopholes in our laws that are allowing scammers to take advantage of innocent americans through a practice known as caller i.d. spoofing. caller i.d. spoofing allows predators to deliberately falsify their identification and telephone numbers relayed through caller i.d. the scammers frequently ask for personal information and for money. often senior citizens and our veterans are the target of these predatory practices. caller i.d. spoofing has become a major problem for nebraskans and for law enforcement, which is why i am committed to

eliminating this practice. in september of 2013, "usa today" highlighted the story of marianne kerr from hastings, nebraska. miss occur is an 83-year-old retired hospital nursing administrator who fell victim to a spoofing scam. she received a call from individuals who claimed to work for the federal government and they asked for her bank account information. the scammers told her they were federal officials and already had her name, address and her phone number. and they used this information to have trick marianne into providing her bank account number. miss kerr had caller i.d. but it displayed a number in nevada, not washington, d.c., or hastings, nebraska. she attempted to call back repeatedly but she either received a busy signal or was sent to voicemail.

miss kerr reported the incident to the police but by then it was too late. her money was gone. and there was nothing that law enforcement could do. last fall the omaha f.b.i. issued a warning about the danger posed by scammers using the bureau's identification to target nebraskans. the callers claimed to be offering a grant from the federal government and they proceeded to solicit credit card and banking information. this practice is happening across the country and it needs to stop. whether it's hardworking nebraskans like miss kerr, or veterans who bravely served our country, no one -- no one -- is immune to this form of fraud. and that's why i'm very pleased to join with senator nelson last month to introduce the bipartisan spoofing prevention

act. this bill would amend the truth in caller i.d. act. currently, loopholes in this law are allowing scammers to manipulate caller i.d. information and to harass millions of americans. while the truth in caller i.d. act has helped to cush -- curb spoofing, the growth in new technologies has allowed scammers, especially those operating overseas, to continue this fraudulent practice. the spoofing prevention act would crack down on spoofing by prohibiting caller i.d. spoofing on all voice calls, including those originating outside the united states. and all calls made using i.p. enabled voice services. it would also prohibit caller i.d. spoofing done via text messaging, which is now becoming

a really common practice. additionally, the bill directs the g.a.o. to look at what the f.c.c. and the f.t.c. have done to combat spoofing. we must call for new solutions as technology continues to evolve and i urge all my colleagues to support this important legislation so we can ensure that our citizens are protected from fraud and abuse. thank you, mr. president. i yield the floor. a senator: mr. president? the presiding officer: the senator from indiana. mr. donnelly: mr. president, i'd like to recognize the assistant majority leader from illinois, senator durbin. the presiding officer: the senator from illinois. mr. durbin: i thank my colleague from indiana. the bill before us is the comprehensive addiction and recovery act. it's one of the few bills that you'll find so much bipartisanship on. it really is an issue that all of us understand back home is april major problem, wherever

home may be. in my state of illinois, there is no town too small and no suburb too wealthy to avoid the challenge of this heroin crisis. here is what's happened. over the last 10 years, we have seen the pharmaceutical industry dramatically increase the number of painkiller pills for sale. one classification of those, opioids, includes oxycontin, hydrocodone and other names that are pretty familiar to us. and it turns out that there have been so many of these pills produced that they have now created an industry of their o own, an illicit industry where people are buying and selling them to get high. and when they reach the point where they can't find these pills or they're too expensive, they switch in the same category of narcotics to heroin. and, of course, heroin can kill you if you have an overdose. we now have more people dying from overdoses of heroin across

the united states than people who are dying in traffic accidents. to give you an idea of the volume of this challenge. i've been all across my state. from one end to the other, from southern illinois all the way up to chicago and the suburbs and towns inbetween. there's hardly a single town that's been spared, where some teenager wasn't found dead because of a heroin overdose. there are things that we're doing to try to resolve this but we're not doing enough and we're not doing it fast enough. so the bill that's on the floor here, the comprehensive addiction and recovery act, is an attempt to find new ways for prevention, education and treatment of substance abuse. there will be an amendment offered by senator shaheen of new hampshire. it's really the test. all of us can agree on the goals. senator shaheen says, that's not enough. that's an empty promise unless you pay to achieve the goals. we have to put the money into substance abuse treatment. we've got to put the money into efforts with law enforcement to reduce the likelihood of these

drugs coming into the united states. and that's why i'll support her amendment. but i'll offer another amendment too. what we're finding is that there aren't enough treatment facilities for this huge growth in people who are addicted to heroin and other narcotics. there just aren't enough. and so my bill takes a look at medicaid. now, that's the health insurance plan for people in low-income categories. a few years ago, we changed that law and said you can't treat people for substance abuse if you have any more than 16 beds in your facility. 16. can you imagine in the city of chicago what that means? well, i went to haymarket, which is a wonderful operation, started by monday nearier ignatius mcdermott decades act, which treats people for alcoholism and substance abuse. they have empty beds now that can treat people who are addicted to heroin and help them to break away from this habit.

but if they're under medicaid, they can't offer these beds to these individuals. so i have an amendment with senator angus king of maine and this increases the number of beds in each facility to 40. this isn't a runaway number. it's a manageable number. and it's a realistic number. because if we're going to deal with heroin addiction, we have to deal with it in an honest fashion. let me give you an example of what i consider to be one of the more effective approaches. in glocester, massachusetts, the chief of police decided to try something new. they were having too many heroin overdose deaths and so he made the decision and announced that if you came to his police department or sheriff's office and announced your addiction, that they wouldn't arrest you, they would put you into treatment. well, what happened was a number of people came forward and went into treatment. it was a good outcome for them and for the community. i had a similar story in illinois with the town of dixon,

illinois. they had too many scary instances where people were either close to a heroin overdose or actually passed away. and so they tried the same thing as glocester, massachusetts, and offered, if you came in and confessed your need for help and treatment, that they wouldn't arrest you, they'd take you into treatment. it worked. over 20 local teenagers showed up because of their addiction. and they were put in treatment. the problem of course is there aren't enough treatment facilities. this amendment i have would expand the opportunities for treatment. and we have to do that. the good news about this, if there is a good part about this, is that we are finally dealing with addiction in reality. it is no longer viewed just as a moral failing or characterized as some omission of conscience. it's being viewed as a disease, a medical condition that should and can be treated. and that's why we're making a step in the right direction. we also, i think it bears

repeating, we also changed the law in this chamber not that many years ago, a law which was brought to the floor originally by senator paul wellstone of minnesota, senator pete domenici of new mexico. that bill required that health insurance policies in the united states in the future would cover mental health health counseling and substance abuse treatment. so now because that became the law, the health insurance plans we buy cover our families for those needs. many families who never dreamed that they would need substance abuse treatment for their kids thank goodness can turn to their health insurance plan for that kind of help. we've got to protect that. those who talk about repealing the affordable care act would be repealing this very protection that families are using now for substance abuse treatment. that isn't the answer to this. the answer is to have more treatment facilities available so that people can rid themselves of this addiction and get on with their lives.

i met so many of these people in my round tables. law enforcement, doctors, but the ones i remember the most are the young people addicted in high school who finally were able to break the habit. they have a chance now for a real life, but it's because there was treatment there when they needed it. i hope my colleagues will consider this amendment. it won't come up today but will soon. this is a good bill. i hope they'll vote for the shaheen amendment because it pays for the services which we're promising. i don't want to end up making an empty promise to america as we face this heroin crisis. mr. president, i yield the floor. a senator: mr. president? the presiding officer: the senator from indiana. mr. donnelly: i'd like to thank the assistant minority leader for those inspiring words and recognize the senator from virginia. the presiding officer: the senator from virginia. mr. warner: mr. president i'd like to speak for up to six minutes. let me join my colleague, the senator from indiana in agreeing

with the senator from illinois. i too will vote in favor of the shaheen amendment. it is important we not only take own this question -- take on this question of opioid drug abuse. mr. president, i want to take a couple moments today and join with many of my colleagues to talk about an issue of enormous importance, our constitutional obligation to fulfill our duty in terms of reviewing whomever the president of the united states nominates for the supreme court. i want to start, though, by saying a few words about the late supreme court justice antonin scalia and offer my condolences to his family. whether you agreed or disagreed with judge scalia's decisions, and mechanically i disagreed with many of them, he was a remarkable jurist, remarkable individual. over the last ten-plus years i got to know he and his wife

maureen more in a social setting. he was warm, witty, charming, brilliant, and he will be missed by all who agreed or disagreed with him. my thoughts continue to be with maureen and his family. but i also rise today, and i think almost in the mode of what justice scalia, i believe, would have said as someone who was a strict instructionallist and someone who believed so firmly in the words of the constitution the words of the constitution are quite clear in article 2, section 2, where the president shall nominate a judge to the supreme court, and it is the responsibility of the senate to advice and consent. so my request to all colleagues

in this body is to simply let's do our job. it's not an if the president will nominate. it is when the president will nominate. and i hope he nominates soon. we should give that nominee their due consideration, a fair hearing and then an up-or-down vote. the president has repeatedly voiced his strong commitment to nominating an eminently qualified jurist. that is his duty, and we must do ours. and to those who suggest that we should wait and let the american people decide, the truth is they already did. in 2012 the american people voted to return president obama to the white house for a second four-year term. and that four-year term doesn't end until january 20, 2017. this is ample time to vet a nominee and still wrap up a

process, this process. i believe this spring are we going to allow politics to totally overtake the work of this body? are we resigned to a complete and utter failure to govern until next january? the presiding officer and i both share a common background. that was a background in business. it's remarkable to me, no business in america, no business in the world would operate under the presumption that because it's a presidential year that somehow we're going to default on all our duties and simply kick over every issue until next year. if we operated a business that way, we'd be out of business. so i believe it is absolutely essential that when the president -- and i hope expeditiously -- nominates an individual to the supreme court, this body do its job

constitutionally, review that applicant, meet with that applicant, hold hearings on that nominee and then hear, give that nominee the up-or-down vote that the constitution requires. the remarkable thing is in a year where there's a lot of commentary about what the public wants, i can at least tell you what the public wants in virginia. they want us to do our job. i've received an overwhelming response from virginians from one end of the commonwealth to the other. they are expressing their opinion clearly about how the nomination process should move forward. a lot of virginians are expressing their thoughts about what kind of nominee the senate should confirm or not confirm. but what they are not saying is that the united states senate should punt on this constitutional responsibility. they want us to do our job.

what i found most striking in the past week is that this awkward public opposition held by so many people who otherwise claim to be advocates of a strict reading of the united states constitution somehow are saying, imagining something that doesn't appear in the constitution that a president in his last year, at least this president, we're not going to follow the constitution. we're going to kick it over until next year. i believe that is irresponsible. i believe it is inappropriate. i believe it is -- it does not follow the interpretation of the constitution. and quite honestly, i don't believe it would follow what justice scalia who was a strict constitutionalist would want to see this body take forward. yet we saw some on the other side of the aisle literally within hours of justice scalia's

passing say no vote, no proceeding. we're not going to do our job. and we saw certain members of the leadership meet yesterday with the president. again, reaffirming their unwillingness to do their job. this failure to act, this failure to do our constitutional duty could result, will result in a vacancy on the supreme court stretching close to a year across two distinct terms of our highest court. over that time the supreme court will be deciding extremely important cases, and in many ways they're not going to function as the constitution laid out. in many of my -- many of my friends on the other side of the aisle often quote president reagan. president reagan himself said -- i quote -- "every day that passes with the supreme court below full strength impairs the people's business in that crucially important body." as a matter of fact, if we don't do our job, in effect what we

will be doing is potentially shutting down another branch of government. regardless of where we fall on the political spectrum, if there was one message we heard loud and clear over the last couple of years, the american public does not abide us arbitrarily shutting down branches of government. the american people deserve better than this. so i would again urge that my colleagues on both sides of the aisle step up, do their job, let's give the president's supreme court nominee the appropriate respect, hear them out, have those hearings and give the senate a chance to exercise its will in a straight up-or-down vote. mr. president, with that i yield the floor back to my colleague, the senator from indiana. the presiding officer: the senator from indiana. mr. donnelly: mr. president, i rise today for all hoosiers who have been touched by addiction or suffered the loss of a loved one as a result of opioid abuse, heroin use, or other drug

epidemics. i am here for every hoosier community that has been gripped by addiction. i'm here for austin, indiana, a small town of 4,200, much like many small towns in the president's home state of north carolina. but in austin, more than 185 people tested positive for h.i.v. largely caused by injection drug users who shared needles. i'm here for connorsville which was devastated by a heroin epidemic that saw 41 overdoses and 8 deaths in a three-month span. i'm here for my hometown of granger which was shaken last year when two teenage brothers, nick and jack savage, died in just one night from a prescription drug related overdose. i'm h here for fort wayne, lafayette, terre haute,

indianapolis and every community across our state. no part of indiana or our country is immune from the pain of addiction and these drug epidemics. by now many of us have heard the staggering statistics. one person in america dies every 25 minutes from an opioid overdose. and overdose deaths in the united states now outnumber fatal auto accidents. ultimately this is about people, people like mike zoss of tipa canoe county. mike was the youngest of three boys. mike's creative, enjoyed reading, had a ton of friends. in high school, he began experimenting with prescription drugs. during his senior year, mike's mom donna got a call no parent wants to receive. mike had overdosed at a friend's

house from a combination of lyrica and methadone. he landed in intensive care and was in a coma for nearly three weeks. miraculously mike survived, but after struggling for nearly three more years with his addiction, mike died from another overdose. this scourge is about families and the heartbreak they endure and all the people whose lives are shattered by addiction or even cut short. it's why i've been working on this issue for over two years listening to hoosiers, introducing bipartisan legislation, partnering with federal and state and local officials and bringing stakeholders together. and these families are why i support the comprehensive addiction and recovery act. this bill provides states and local communities with the tools to prevent and treat drug addiction and to support individuals in recovery.

cara strengthens prevention empts, increases access to treatment and recovery services, develops best prescribing practices and expands access to nalaxone, also known as narcan, which can reverse the effects of an opioid overdose. in addition, cara expands disposal sites for unwanted and unused prescription drugs to keep them out of the hands of children and teens. cara strengthens prescription drug monitoring programs. this bill provides states and local communities with the tools to prevent and treat drug addiction and to support individuals in recovery. cara strengthens prevention efforts, increases access to treatment, develops best prescribing practices, and expands access to nalaxone, as i said. nalaxone can reverse the effects

of an opioid overdose. these are incredible steps that can make a huge change in what happens in the future of our country. and while this bipartisan bill includes many important provisions that helps families in my home state of indiana and across our entire country, it will take all of us working together to prevent and treat addiction. prescribers and pharmacists, law enforcement and first responders, parents and families and officials at the federal, state and local levels all have a role to play. i want to talk to you today about how cara can best help in these efforts. first, prescribers. our prescribers play a vital role in addressing addiction because they are partners in the fight to reduce the risk of prescription drug abuse. they have the knowledge and

authority to help patients, our friends, our neighbors, our family members understand both the benefits of prescription opioids and the potentially devastating dangers associated with opioid abuse. last year we hosted a roundtable discussion in indianapolis on prescriber practices with my colleague, congresswoman susan brooks. by bringing together state officials, doctors, pharmacists, all of them playing key roles in curbing overprescribing. we can better engage health professionals in the fight against the opioid epidemic. we want to make sure doctors have the training, the tools, and the resources to prevent overprescribing and also to help them make the best possible decisions about how to treat their patients. right now there's not one set of current nationally accepted best practices that can help

prescribers make the best informed decisions about prescribing these opioid drugs. and existing guidelines vary in the recommendations that are made. cara helps. it includes a provision adopted from my bipartisan legislation that i reintroduced last year with my friend and colleague, senator kelly ayotte from new hampshire, which brings experts together to review, to modify and update, where necessary, best practices for pain management and prescribing pain medication. second, i want to talk about our first responders and our law enforcement who are on the front lines of this crisis. frequently they're called to scenes where an individual has overdosed and they are working to find ways to address these drug epidemics. in northwest indiana, the porter

county sheriff's department is reaching out to educate families about the heroin crisis there with a video that includes first-person accounts about how the epidemic has impacted the local community. and in the northeast part of our state, over by the ohio border, the fort wayne fire department began using narcan just last august to try to help save people who had overdosed. in the first four days, they had to use it three different times and many times since then. in central indiana last year, indianapolis e.m.s. administered naloxone an astounding 1,227 times. over a thousand times. we need to make the overdose reversal drug naloxone more

readily available to first responders and law enforcement. cara includes a provision similar to one from my bill with senator ayotte that provides grants to train law enforcement and other first responders in the administration of naloxone to save lives. i've also offered an amendment that encourages first responder units receiving funding through this program to use outreach coordinators to ensure every individual who receives naloxone also receives in-person follow-up. indianapolis e.m.s. recently began a similar outreach program designed to connect overdose victims who receive naloxone with the help they need. cara assists law enforcement by expanding resources to identify and treat individuals facing addiction in criminal justice settings. i hear frequently from my friends, the police officers,

sheriffs, judges and court personnel throughout the hoosier state that more resources are sorely needed. third, i want to talk about families. there are countless personal stories across our state and almost every state, of moms and dads, brothers and sisters, wives and husbands and grandparents who have been impacted by this addiction. i just want to share a couple of these stories. our young friend aaron. just inphillips remembers her son -- justin phillips remembers her son, a talented athlete, dreams of playing football in the nfl. starting quarterback on north lawrence's varsity team. smart, charming, generous heart.

it started for aaron with the prescription pain medicine and then led to heroin. at the age of 20 years old, in october 2013, aaron died of a heroin overdose. his mom said, we can't pretend it's not our kid because it very well may be our kid who's next. and there are people like michelle standiford of lebanon, indiana, who lost her son and her nephew to addiction. her nephew, greg, died three years ago from a heroin overdose at the age of 21. and her son troy, 33, died following a long battle with addiction. his struggle began when he was prescribed opioids for a jet ski accident for the pain he was struggling with. this past christmas, michelle

visited troy, who is in south florida seeking treatment. she said he was in great spirits and he eager to reunite -- and eager to reunite with his family. but a few weeks after troy came back home to indiana, he passed away. think of this. he left behind parents, a wife, two sons -- two and four years old. these stories are way too comm common. as donna zozz of lafayette sai said -- as donna zoss of lafayette said, there are way too many kids dying and as a community we need to do something about it. she wants to make sure other families learn from her experience before it's too late. cara helps families by raising awareness about opioid abuse and heroin abuse and expanding access to treatment. it includes a provision from our bipartisan bill with senator ayotte that establishes a national drug awareness program.

by helping families learn about the serious effects of opioid abuse and its connection to heroin, it can make a difference. cara strengthens additional prevention efforts and increases access to treatment and recovery services with the goal of helping more people overcome addiction and that includes specific initiatives for women, youth and vets. mr. president, we're not doing enough and the burden of addressing the opioid abuse and heroin abuse epidemic has fallen heavily on our criminal justice system which is clearly not equipped to treat all those struggling with addiction. that's why cara's so important and why we need to pass this critical legislation quickly. we have an opportunity to work together, all of us, to pass a good bipartisan bill that helps confront opioid abuse, heroin

abuse and other drug epidemics. on the federal level, it's our job to support and strengthen partnerships on the state and local level to make sure every town in every state is accounted for and can heal. cara will do just that. it's a significant step forward. although i think we can all agree that it's just a first step. mr. president, i yield back. a senator: mr. president? the presiding officer: the senator from pennsylvania. mr. toomey: mr. president, i rise on the same topic that the senator from indiana was addressing very eloquently and the absolutely heart wrenching story that he told of his constituent and the families. this is a story we hear all across america. i hear it all across pennsylvania. it's -- it's day in and day out. this is an enormous problem. it's devastating families and

communities in our entire states. i share the view of the senator from indiana that this legislation is very, very important. it takes a number of steps that are very instructive. i congratulate senator whitehouse and senator portman for a very good piece of legislation that is going to help -- it's going to help save lives. it's going to help save families and communities. i've got an amendment that i'm going to address that's going to take another step to save lives and i hope my colleagues will overwhelmingly support this because it's an epidemic the likes of which i don't know if we've seen in a very, very long time. last october i convened a field hearing of the senate finance subcommittee on health care to learn more about this very epidemic of opioid addiction and heroin addiction and the yoaf doses that are -- and the overdoses that are resulting. we did it out in pittsburgh and senator casey joined me. and we reserved a very large

auditorium and we invited some of the leading local experts and doctors who are dealing with people who are suffering from addiction, law enforcement folks and recovering addicts. and we had a standing-room-only crowd in that room. such was the intens intensity os issue and the concern about it because we all know people who are affected by this terrible scourge. a couple of things that i learned in that hearing, two that are important to me is we've got to figure out how we can crew reduce some of the overprescribing of these narcotics, these prescription opioids upon which people then become addicted, and we've got to find ways to reduce the diversion from prescription as that are obtained through the conventional process to the black markets, the streets, the places where it feeds the addiction. i think that one of the overlooked elements of this problem has been the opioid epidemic that's affecting older

folks. aging baby boomers, senior citizens who become addicted to opioids for a variety of reasons. the headlines have screamed about this. "usa today" said -- and i quote -- "many seniors hooked on prescription drugs." that was their headline. the "wall street journal" headline recently, "aging baby boomers bring drug habits into middle age." from a tv news channel, "senior citizens getting hooked on painkillers." this is a growing problem and it doesn't know any demographic limits. it affects senior citizens as well as young people. in fact, in 2013, to give a sense of one of the perhaps contributing elements to this, there were 55 million opioid prescriptions written in america for americans over the age of 65. it's a stunning number. it's a 20% increase in just five years. we have not had a comparable increase in the number of senior citizens. it's a huge increase in the number of prescriptions per

person. and this is probably related to the fact that opioid addicted seniors has itself tripled in the last decade. so one of the problems has been identified by the government accountability office. they estimate that in one year alone, 170,000 medicare enrollees -- 170,000 -- engaged in doctor shopping. that's the process by which beneficiaries go to multiple doctors to get multiple prescriptions for the same or similar powerful narcotics. then they go to multiple pharmacies to get them all filled and they end up with these commercial quantities of prescription drugs vastly beyond anything that any individual could need. one -- one beneficiary that g.a.o. discovered had visited 89 different doctors in one year just to get prescription pain kills. 89 doctors in one year. that's almost two a week.

another beneficiary received prescriptions for 1,289 hydrocodone pills. that's -- that's like almost a two-year supply. it makes no sense. so i could go on and on with cases in which fraud is being committed for the purpose of obtaining these prescriptions, which are then sold on the -- in the black market. but there's also a subset of medicare beneficiaries who are innocently getting duplicate opioid prescriptions because they are being treated by different doctors for different maladies. they have multiple illnesses. they get multiple prescriptions because in many cases there's nobody providing adequate oversight and coordination. for their care. so we have both people who are intentionally and fraudulently getting multiple prescriptions and then we have people who are innocently getting it. so there's a way we can deal with this, mr. president, a way we can deal with this inappropriate prescription and

diversion into the black market. and the administration has asked us to do this. this administration, the obama administration, has asked congress to give them in medicare the power to limit certain beneficiaries who are engaged in doctor shopping, exactly as people already can do so within medicaid and private health care providers. so the simple idea is give medicare the power when it identifies a beneficiary that is engaged in doctor shopping, getting multiple duplicative prescriptions either intentionally or unintentionally. allow medicare to lock that medication in to one prescriber and one pharmacy. that way you don't have this problem. and that's what the administration has asked us to do, so i have introduced a bill that does exactly that. it's called the stopping medication abuse and protecting seniors act. senator brown from ohio is the lead democrat on this bill.

i want to thank senators portman and kaine also for their work on this, and this is the amendment we are offering to this bill, to give medicare the very same tool that medicaid has, the tool that the administration is asking for, the tool that all experts say will make sense. as i said, medicaid and commercial users already do this. we're not inventing something new. what we are doing is applying a proven technique that has overprescribing and diversion, applying that to medicare where it does not exist today. no one who legitimately needs a prescription for opioids will not deny that. that would be completely unreasonable and inappropriate. in fact, we exempt seniors in nursing homes where the nursing home can provide the monitoring, seniors who are in hospice or cancer patients who might need unusually large quantities, they are exempted. in fact, this legislation would only lock in a small fraction of 1% of medicare enrollees, but that is the fraction that is

engaging in this very dangerous behavior. so, first of all, i'm grateful for the very broad bipartisan support that we have. as a result, if we get this passed today, which i certainly hope we will, we will help opioid-addicted seniors find treatment because they will be notified when they come up on this list when it is discovered that they are going to multiple doctors and multiple pharmacies. we'll stop the diversion of these powerful narcotics. it will save taxpayer money because taxpayers reimburse for all of these prescriptions even those that are fraudulent, and maybe most importantly it's going to reduce the availability of these opioids. we have 25 republican and democratic cosponsors on the bill. we have the support of the national governors' association. nearly identical language was already passed in the house. it was embedded in the 21st century cures legislation where

it passed overwhelmingly. the president's budget has asked for this very mechanism repeatedly. the c.m.s. acting administrator was before our committee and administrator slavitz said this legislation makes every bit of sense in the world. that's a quote. the c.d.c. director is for it, the white house drug czar is for it, the pew charitable trust testified on behalf of our legislation, and so do physicians for responsible opioid prescribing, not to mention many law enforcement groups and senior groups like the medicare rights center. this is a tool, mr. president, that is just overdue. we've got this tool in private health care insurance coverage, we have got this tool in medicaid. we just need to have this tool in medicare. i really want to single out for a special thanks my co-author sherrod brown. senator brown and his staff worked very hard, did a tremendous job. they provided in fact very valuable feedback to make sure that all the stakeholders were going to be treated fairly and

specifically, that beneficiary rights would be properly respected, and that's very important and a very constructive contribution that senator brown made to this legislation, but he also helped to secure many endorsements from outside groups. my fellow pensian, senator casey. again, very, very helpful, passionate about this issue. he has seen firsthand the damage that's being done across pennsylvania from opioid abuse, and he is a cosponsor of the legislation. we had a very successful hearing in the finance committee and i want to thank senator hatch for having this very topic of how we can limit the diversion through medicare of these very dangerous narcotics, and i thought that that was a very constructive hearing. also senator kaine through his work on the senate aging committee has been very active and extremely helpful on this issue. so again, mr. president, this is an amendment that has broad bipartisan support, it's been vetted by the stakeholders, it's been vetted by and requested by

the administration, it's endorsed by numerous health care and law enforcement groups, and the reason it has such broad support is because it will save lives, it will protect seniors from opioid overprescriptions, it will stop fraud and it will dramatically reduce pill diversion. so to vote no on this would be to allow the continued flooding of very dangerous prescription opioids onto the black market, and i can't think of any reason we would want to do that. so, mr. president, i urge my colleagues to support the bipartisan toomey-brown-portman-kaine amendment. let's get this passed and then let's pass this underlying bill which is very, very constructive as well, and i yield the floor. mr. whitehouse: mr. president? the presiding officer: the senator from rhode island. mr. whitehouse: as one of the authors of the bill that's on the floor before us, let me say i appreciate and welcome the senator's amendment and appreciate the bipartisan way in which it was achieved with sherrod brown and tim kaine as well as with other cosponsors of the bill. so with that, i will yield the

floor back so that we may hear from another co-author of this legislation who was with us through the long and arduous process of preparing this bill and running the seminars and putting the advisory committee and crafting the legislation. i yield to the senator from new hampshire. the presiding officer: the senator from new hampshire. ms. ayotte: mr. president, i would very much like to -- i would very much like to thank the senator from rhode island for the work that we were able to do together on this important piece of legislation for his leadership and really his passion for this issue that's devastating my state, the heroin and opiate epidemic that's facing all of us, and i thank him for really a thoughtful approach in bringing people together around this, and i am so glad we are debating this on the senate floor today. but, mr. president, i come to the senate floor today to

discuss with great sadness, i want to honor the life of two of our outstanding law enforcement officers from new hampshire that were taken from us far too soon. one is new hampshire state police lieutenant jimmy garretty, a u.s. army veteran and outstanding public servant, and the other is prince william county police officer ashley guindon of merrimack, new hampshire. she is a merrimack native, a marine corps veteran who was killed in the line of duty in virginia one day after being sworn in as a police officer to serve in the prince william county department. these individuals represent the very best of law enforcement and it is with such a heavy heart that i pause to remember ashley guindon, an incredible young woman whose life was tragically cut short. ashley was killed in the line of duty last week, tragically on

her first day as a police officer with the prince william county police department in virginia. ashley could not have known her fate when she responded to an emergency call, but she responded to the call with the same sense of duty and resolve that all of our faithful law enforcement officers do every single day because they don't know whether that next stop, that next house that they respond to to help someone in need, what they're going to be confronted with. ashley's death is a terrible, unthinkable tragedy and serves as a somber reminder of the tremendous sacrifices that our law enforcement officers make every single day, by putting their lives on the line to keep us safe. my heart breaks, breaks for officer guindon's mother,

sharon, for her family, for her friends, for the public safety community as they mourn the loss of this tremendous young woman whose life ended far, far too soon. and i will keep them in my thoughts and players, as i know everyone in this chamber will. but officer guindon should not be remembered because of the circumstances of her death. rather, she should be remembered for her tremendous life of service, to her nation, to the people whose community she worked to keep safe, for the sacrifices that she has made and her family have made on behalf of all of us. officer guindon demonstrated an incredible commitment to her country in so many ways. following her graduation from

merrimack high school in 2005, she joined the marine corps. in doing so, she was honoring the life of her father and the service of her father who deployed to iraq as a member of the new hampshire air national guard. so she comes from a family of service. her father lost his life after returning home from serving in iraq, and officer guindon felt that she could honor his memory by joining the armed services herself, and so she joined and became a marine. in her high school yearbook, she wrote as i take flight, it only takes me closer to daddy. mom, thanks for everything. it will be a long road, but we can manage and it will only make you stronger. underneath her picture in her high school yearbook, the caption read "live for something

rather than die for nothing." think about that. "live for something rather than day for nothing." well, absolutely officer guindon, she did live for something. she lived for our country in her service as a marine. she lived for members of her community giving of herself and making the ultimate sacrifice to keep others in her community safe. she lived with such honor and distinction, and she answered the call to duty. officer guindon was taken from us far too soon, but by working to ensure that we honor her service, her heroism, her commitment and the sacrifice that both she and all law enforcement officers make on our

behalf every single day, we can ensure that her inspiring legacy of dedication to others, of service to her country and to her community will never be forgotten, and we will never forget her service or her sacrifice, and we will continue to honor her family and her for what they have done for our nation every single day. mr. president, i would also like to take a moment to honor another law enforcement officer, someone who i had the privilege of working with personally when i served as attorney general of our state, someone who i -- i proudly called a friend who has been taken from us also far too soon. i want to honor lieutenant jimmy geraghty, who passed away recently following a courageous

battle with cancer. i join his family, his friends, i join the law enforcement community in new hampshire who mourn his death. talk about someone who touched so many people in our state, who really lived a life of service, a life of heroism, a life of integrity. i want to honor his service, his integrity and his dedication to excellence. he was a member of the new hampshire state police for 24 years and rose to the rank of commander of the new hampshire state police major crimes unit. the state police major crimes unit is the unit that handles the most difficult cases in our state -- murder cases, very, very difficult cases. it's a unit where you are called upon at every hour of the day in the most difficult of

circumstances. he has -- lieutenant geraghty handled some of the most troubling cases and the most horrific cases that you can imagine as a law enforcement officer, and he handled them with such incredible dedication, compassion, commitment, and he did his job so well. in the most high-profile case of his career, lieutenant geraghty led the investigation into the brutal 2009 mount vernon homicide, a horrific, horrific case. it was a complex and extremely time-consuming investigation that focused on multiple juvenile defendants. because of the thoroughness, professionalism and dedication brought to the case by lieutenant geraghty and the major crime unit, the prosecution was able to pursue the successful conviction of all the defendants involved.

for their work on the 2009 mount vernon case, lieutenant geraghty and the major crimes unit were presented with the new hampshire congressional law enforcement award for unit citations. and i had the privilege of being there when lieutenant geraghty received that award when he was there with his family, and really the incredible work that he did on that case made such a difference in bringing to justice defendants who committed horrific, horrific crimes and keeping our nation -- keeping new hampshire safe. lieutenant geraghty will also be remembered for his entire, entire outstanding career of service to both new hampshire and the nation. lieutenant geraghty also served very honorably in the united states army for five years, holding posts at fort benning in georgia, fort polk in louisiana and at fort richardson in arkansas.