Q: Is progress being made on America’s opioid crisis?
A: The Trump administration continues making progress to end America’s opioid crisis and save lives. The alarming number of fatalities tied to overdose deaths has claimed nearly 770,000 lives since 1999. Since taking office, President Trump has worked to raise public awareness and mobilize federal efforts to combat addiction, overdose deaths and alleviate the toll it takes on families, the workforce, public health and law enforcement. The President’s Commission on Combatting Drug Addiction and the Opioid Crisis continues to implement drug control efforts, prevention, treatment and recovery. In 2016, at the height of the opioid crisis, Congress passed the Comprehensive Addiction and Recovery Act (CARA) and 21st Century Cures Act to improve partnerships and resources for addiction care in communities across the country and strengthen efforts at our nation’s borders to stop drugs from entering the country in the first place. As the president noted in his State of the Union address in February, progress is moving in the right direction, particularly for painkiller overdose deaths. The genesis of the U.S. opioid crisis can be traced to widespread over-prescribing practices of opioid painkillers to American patients. That’s a primary reason Congress passed the SUPPORT for Patients and Communities Act of 2018 to improve treatment services for substance abuse disorders and provide guidance for hospitals to develop best practices for non-opioid pain management protocols. New federal reporting requirements also help track patient risk and trace “waste” and diversion of controlled substances in health care settings through electronic health record documentation. What’s more, I held an oversight hearing on scams in addiction treatment on the one-year anniversary of the SUPPORT Act’s implementation last October. I have shepherded a number of related bills through the Judiciary Committee, including one that will empower the Drug Enforcement Administration (DEA) to consider additional factors when setting annual quotas for opioid drug production in the United States. Another provision, which I co-sponsored with my fellow Iowan, Senator Joni Ernst, increases access to safe disposal locations of unused medications. I also worked with a bipartisan group of senators on the Substance Abuse Prevention Act, which reauthorizes the federal agency charged with formulating and carrying out a national drug control strategy. Although America’s report card on the opioid crisis shows we’re making progress on overdose deaths caused by prescription painkillers, we must remember that addiction, substance abuse, and illicit drug use are not unique to only opioids. Deadly synthetic opioids, fentanyl and its analogues, and other dangerous drugs like methamphetamine continue to ravage communities across the country.
Q: What efforts are underway to address the surge in synthetic opioids?
A: As Iowa’s senior U.S. Senator, I have worked for more than two decades to help coordinate anti-drug efforts with local community coalitions across our state. As former co-chair of the Senate Caucus on International Narcotics Control and top Republican on the Senate Judiciary Committee, I’ve led bipartisan efforts to dismantle drug trafficking organizations along the southern border and overseas with specific focus on stopping methamphetamine production, use and demand and curbing the emerging threat of synthetic drugs, such as fentanyl. Reducing drug abuse and addiction requires incessant vigilance and comprehensive solutions to address demand, prevention, treatment and recovery. According to the National Institute on Drug Abuse (NIDA), fentanyl is a powerful synthetic opioid similar to morphine, but 50 to 100 times more potent. In some cases, fentanyl users don’t respond to naloxone, the drug used to reverse overdoses. The NIDA says synthetic opioids are now the most common drugs involved in drug overdose deaths in the U.S. The CDC reports 60 percent of U.S. opioid deaths in 2017 involved fentanyl, increasing from 14 percent in 2010. One reason for the spike is attributed to drug traffickers who make slight changes to the recipes in their labs to circumvent federal laws. I am leading a bipartisan, bicameral bill to stop this workaround and give law enforcement another tool to root out drug trafficking in their communities. The Stop Importation and Manufacturing of Synthetic Analogues (SIMSA) Act would allow substances substantially similar to controlled drugs to be temporarily added to a new category of already-regulated or outlawed drugs. This would help stem the flow of rapidly evolving synthetic, deadly products on our streets. We must do more to save lives, restore hope and protect the public health in communities overcome with drug addiction and substance abuse. In response to the rapidly evolving use of synthetic opioids, the DEA issued an emergency declaration in 2018 to create a scheduling system for fentanyl analogues. I’m glad President Trump signed in February a bipartisan bill I cosponsored that extends the temporary classification of fentanyl-related substances as a Schedule I substance for another 15 months. This paints an important bulls-eye on these illicit substances. A Schedule I designation puts in place the highest federal restrictions on access, manufacture and use. It’s reserved for substances that have no currently accepted medical use and high potential for abuse. From Mexican drug cartels to Chinese chemists producing and importing fentanyl into the United States, we need to make sure our communities are ready and able to respond to save lives and protect the public health.