Prepared Statement by Senator Chuck Grassley of Iowa
Chairman, Senate Judiciary Committee
Hearing on “Attacking America’s Epidemic of
Heroin and Prescription Drug Abuse”
January 27, 2016

The United States is experiencing an historic epidemic of drug overdose deaths.  Over 47,000 Americans died from overdoses in 2014, an all-time high.  To put that in perspective, it’s more deaths than resulted from either car crashes or gun violence.

Addiction to opioids, primarily prescription pain killers and heroin, is driving this epidemic, which is destroying lives, families, and the fabric of entire communities.  It’s something I’m hearing about in Iowa, although other parts of the country have been hit even harder.

At today’s hearing, the committee hopes to learn more about this terrible epidemic, what’s being done to address it, and how Congress can help.  I look forward to learning more about the Comprehensive Addiction and Recovery Act, which is the result of the leadership of Senators Whitehouse, Portman, Klobuchar and Ayotte on this issue. 

Over the last 20 years or so, doctors have increasingly prescribed opioids to help their patients manage pain.  For many, these medicines have been the answer to their prayers.  But for others, they have led to a nightmare of addiction.

According to a recent article in the New England Journal of Medicine, it’s estimated that over 10 million persons reported abusing prescription opioids at some point in 2014.  Emergency room visits involving the misuse of prescription opioids increased over 150 percent between 2004 and 2011.  Treatment admissions linked to them more than quadrupled between 2002 and 2012.

The use of heroin has also spiked sharply recently.  According to the most recent National Survey on Drug Use and Health, over 900,000 Americans reported using heroin in 2014, nearly a 35 percent increase from the previous year.  Heroin overdose deaths more than tripled from 2010 to 2014.  In 2007, only 8% of state and local law enforcement officials across the country identified heroin as the greatest drug threat in their area.  In 2015, that number rose to 38%, more than any other drug.

According to numerous studies, prescription opioid addiction is a strong risk factor for heroin addiction.  In some cases, those addicted to painkillers turn to heroin to get a similar high, because recently, it’s become cheaper and more easily available.  

But why has cheap heroin begun flooding into our communities?  Mexican cartels are expanding into new territory in the United States because the Obama administration hasn’t secured the border.  Indeed, heroin seizures at the border have more than doubled since 2010.  The Senate Caucus on International Narcotics Control, joined by Senator Ayotte, sought accountability for this alarming development at a hearing in November.

So this is a complex crisis that requires a multifaceted solution.  The first and most important part must be prevention, to head off addiction before it can even begin.  Prevention includes educating the public about the dangers of these substances, including through the important work of anti-drug coalitions.  It also includes educating doctors, and taking a hard look at perverse incentives that may lead to overprescribing.

For example, a few weeks ago, Senators Feinstein, Ayotte, and I wrote to the Department of Health and Human Services to seek a progress report on a federal review exploring whether patient satisfaction surveys linked to higher Medicare payments encourage doctors to prescribe opioids.   

Many people who abuse prescription drugs get them from friends or relatives.  So prevention also involves support for initiatives that allow patients to safely dispose of old or unused medications.  I’m proud to have helped start these “take back” programs by working with Senators Klobuchar and Cornyn in 2010 to pass the Secure and Responsible Drug Disposal Act.  And I was very pleased when DEA Acting Administrator Rosenberg voiced his support for them recently.

At the same time, it’s concerning that the Obama administration is muddling prevention efforts by sending mixed signals to young people about the dangers of addiction to marijuana.  The President has excused smoking marijuana as just another bad habit, and the Department of Justice continues to decline to enforce our federal drug laws in this area.  But young people don’t need increasing access to another potential pathway to addiction.  According to a Centers for Disease Control report from last July, a person who is addicted to marijuana is three times more likely to be addicted to heroin.

Another part of the solution needs to include better treatment options for those who become addicted.  The use of medication-assisted treatment appears to show promise.
In addition, overdose deaths may be reduced by the more widespread use of Naloxone, a drug proven highly effective at reversing overdoses.

And finally, law enforcement will play a critical role.  We can’t arrest our way out of this epidemic.  But we can continue to crack down on unlawful prescribing practices, enforce our border with Mexico, and target the violent cartels that are trafficking heroin into the United States.  This is in part why Senator Feinstein and I introduced the Transnational Drug Trafficking Act of 2015.  Our bill would make it easier for the Department of Justice to prosecute cartels who harm our communities from abroad by trafficking heroin, other drugs, and precursor chemicals, for ultimate delivery here.

In October, our bill passed the Senate for the third straight Congress by unanimous consent.  It’s critical that the House finally pass this legislation, which will help protect our communities from transnational drug trafficking threats.  I welcome our witnesses to this discussion about how we can work together to attack this awful epidemic.