Letter to the Editor in Response to editorial entitled, "Rubio, Bilirakis Owe Floridians Answers on Drug Law”
I appreciate the opportunity to provide additional clarity regarding my position on the Ensuring Patient Access and Effective Drug Enforcement Act, a bi-partisan bill I co-sponsored in 2015 and was signed into law by President Obama in 2016, after passing unanimously in Congress. At the time, I never received any objection from the DEA, law enforcement community or public health advocates while working on this bill. Until this week’s story in the Post featuring former DEA employee, Mr. Rannazzisi, no one has ever questioned the law or indicated to me that it has hampered the DEA’s ability to go after bad actors within the health care industry. I am concerned about these recent allegations and about this week’s comments from the Acting DEA Director, which indicate that while they have not been prevented from targeting those within the industry who have done wrong, they have had to use other tools at their disposal to do so since enactment of this law. The DEA is scheduled to testify at a hearing next week about the opioid crisis and I plan to obtain additional information from them as to the impact of the law and whether or not they need Congress to revisit this policy issue. To be clear, I want law enforcement to have every tool they need to tackle this public health crisis.
We have an addiction problem in our country and within our community, and opioid abuse is a serious, multi-faceted issue that warrants the action and attention of leaders at all levels of government. I have been extremely active in this fight, championing legislation to combat systemic problems that contribute to the crisis. I have long been a proponent of the Prescription Drug Monitoring Program (PDMP) and federal funding of this important tool to help fight prescription drug abuse. My PROMISE Act, signed into law last year, requires the VA to use best prescribing practices when working with our Veterans and supports the use of alternative treatment methods. It passed as part of the Comprehensive Addiction and Recovery Act, which I took an active role in pushing through Congress. I also successfully fought for funding to help battle addiction within the 21st Century Cures Act, which resulted in $27 million coming to Florida for this purpose. I will continue to fight for additional funding and policy reforms that are needed to win this battle. What we have seen in working on this issue is that when we make progress in addressing one aspect of the problem, we see concerns in other areas pop-up. For example, when we cracked down on pill mills in Florida, we saw a rise in abuse of other drugs, such as crystal methamphetamines and heroin.
We also saw that many people with legitimate pain and prescriptions had difficulty getting their medications filled at their local pharmacies. These were mostly seniors, Veterans, cancer patients and people suffering with debilitating conditions. I received letters and calls from over 150 frustrated constituents in my district who were facing this problem, and I met with countless others who expressed similar concerns. Their stories prompted me to co-sponsor the bill in question because it contained a provision that specifically required stakeholders to discuss ways they could combat prescription drug abuse while identifying and removing barriers to people with legitimate prescriptions being able to have access to the medication they needed. The need for action was documented in a June 2015 Government Accountability Office (GAO) report which concluded that, “DEA communication with and guidance for its registrants are essential to help ensure that registrants take actions that prevent abuse and diversion but do not unnecessarily diminish patients’ access to controlled substances for legitimate use because of their uncertainty about how to appropriately meet their [Controlled Substances Act (CSA)] roles and responsibilities.” The bill provided a clear definition of what constituted improper conduct and imminent danger. My hope was this would ensure all stakeholders were operating with a shared understanding of expectations, roles and responsibilities. In fact, when I questioned DEA Agent Rannazzissi in January 2015 during an Energy and Commerce Subcommittee on Health hearing, he stated that there must be corresponding responsibilities between drug distributors, pharmacies, doctors, patients and law enforcement. Section 3 of the legislation called for stakeholders to discuss and report the following to Congress: “(1) obstacles to legitimate patient access to controlled substances; (2) issues with diversion of controlled substances; (3) how collaboration between Federal, State, local, and tribal law enforcement agencies and the pharmaceutical industry can benefit patients and prevent diversion and abuse of controlled substances;” And, as the DEA Acting Director has pointed out, they have continued to go after those who are perpetuating abuse by using the tools available to them. I am particularly encouraged by the fact that the overall volume of opioids produced since 2016 has decreased by 25%. This is a step in the right direction, as the annual quota increase for oxycodone production increased by 200 percent during previous administrations.
Tackling addiction and treating the root causes has to be a primary focus of our efforts moving forward. This means more funding, better access to treatment, education and the strengthening of tools that are most effective for cracking down on abuse and getting people the help they need. I look forward to the input and guidance from DEA during next week’s hearing in order to inform my decisions about responsible steps forward. I will continue to fight on behalf of my constituents and my community to achieve this moral imperative.
Member of Congress