Ed Markey

Mr. MARKEY

Mr. MARKEY. Mr. President, I rise today to discuss a number of my amendments to the FAA reauthorization bill. I filed Markey amendment No. 3467 to protect consumers from ridiculously high airline fees. In recent years, fees have gone up despite the fact that gas prices and airline choices have gone down. Regrettably, the only thing competitive about the current airline industry is the battle for overhead compartment space. Since 2001, 10 major airlines have become 4, allowing air carriers to charge ridiculous fees and act in uncompetitive ways. The four major airlines now control 80 percent of the seat capacity in the United States. At some major airports, passengers only have one or two airlines to choose from. Airline fees have climbed as high as the planes on which passengers are traveling. We must stop their rapid ascent to protect the everyday airline passenger. According to an excellent report released by Ranking Member Nelson last year, three airlines increased checked baggage fees by 67 percent between 2009 and 2014 and four airlines increased domestic cancellation fees by 33 percent. One increased its fee by 50 percent, and one increased its fee by 66 percent. Airlines should not be allowed to overcharge captive passengers just because they need to change their flight or check a couple of bags. It is just not fair. There is no justification for charging consumers a $200 fee to resell a $150 ticket that was cancelled well in advance when the airline can then resell that ticket for a higher fare to a different traveler. Further, airlines such as Delta, United, and American charge as much as $25 for the first checked bag and $35 for the second bag even though there appears to be no appreciable cost increase for processing the second bag. That is $60 to check two bags one-way or $120 round-trip to check two bags. My amendment prohibits airlines from imposing fees that are not reasonable and proportional to the costs of the services provided. This commonsense consumer protection does not prevent airlines from charging fees; the amendment simply caps airline fees at a fair rate to ensure that passengers are not getting tipped upside down at the ticket counter. I am pleased that Senators Blumenthal and Klobuchar have cosponsored my amendment. I offered this amendment in the Commerce Committee, and it received a vote of 12 to 12. It is time to break this tie on the Senate floor. Further, my amendment enjoys broad support from several groups, including the National Consumers League, the Consumer Federation of America, and Travelers United. Mr. President, I intend to offer my cyber security amendments as well, Markey amendment Nos. 3468, 3469, and 3470. In December, I sent letters to 12 domestic airlines and two airplane manufactures requesting information on the cyber security protections on their aircraft and computer systems. What I found was startling. Currently, airlines are not required to report attempted or successful cyber attacks to the government. Let me say that again. Airlines are not required to report attempted or successful cyber attacks to the Federal Government. According to the National Air Carrier Association, which represents Allegiant, Spirit, and Sun Country--some of the country's smaller airlines--some of their carriers experience several hundred hacking attempts into their system every single day, but since there is no requirement to share this information with the FAA, potentially valuable cyber security information may not get to the other airlines, manufacturers, and regulators. My amendments address these concerns by mandating that airlines disclose cyber attacks to the FAA, directing the FAA to establish comprehensive cyber security standards, and commissioning a study to evaluate the safety and security risks associated with Wi-Fi on planes. My amendments enjoy broad support from the Association of Flight Attendants, the Federal Law Enforcement Officers Association, and the International Association of Machinists and Aerospace Workers. Mr. President, finally, on drone privacy, in committee we added a requirement that government operators disclose where they fly drones, the purpose of the flight, and whether the drone contains cameras, thermal imaging, or cell phone interceptors. My amendment would extend those requirements to commercial drone operators. I encourage all Senators to support my amendments. I thank the Chair for giving me this opportunity to address the Chamber. I yield back the remainder of my time. Mr. President, I suggest the absence of a quorum.

Mr. MARKEY

Mr. MARKEY. Mr. President, today I am introducing the Ghost Army Congressional Gold Medal Act to honor the 23rd Headquarters Special Troops, called the ''Ghost Army,'' which was a top-secret unit of the United States Army that served in the European Theater of Operations during World War II. The unit was actively engaged in battlefield operations from June of 1944 through March of 1945. The deceptive activities of the Ghost Army were essential to several Allied victories across Europe and are estimated to have saved thousands of lives. I was inspired to introduce this bill after hearing the story of Jack McGlynn of Medford, MA. I have known Jack for decades going back to my time in the Massachusetts State Legislature, but I never knew that he was a member of the Ghost Army. Like many World War II Veterans, Jack returned home to Massachusetts after the War, started a family, and got involved in local politics. Jack was a city councilor, Mayor, and State Representative. He kept his service in the Ghost Army a secret from everyone, even his wife and 6 children. Finally in 2008, Jack read that it was declassified and he finally shared the story with his family and friends. In evaluating the performance of the Ghost Army after the War, a U.S. Army analysis found that ``Rarely, if ever, has there been a group of such a few men which had so great an influence on the outcome of a major military campaign.''. Many Ghost Army soldiers were specially selected for their mission, and were recruited from art schools, advertising agencies, communications companies, and other creative and technical professions. The first four members of the Ghost Army landed on D-day and two became casualties while camouflaging early beach installations. The Ghost Army's secret deception operations commenced in France on June 14, 1944, when Task Force Mason landed at Omaha Beach to draw enemy fire and protect the 980th Artillery. Task Force Mason was a prelude to full scale tactical deceptions completed by the Ghost Army. Often operating on or near the front lines, the Ghost Army used inflatable tanks, artillery, air planes and other vehicles, advanced engineered soundtracks, and skillfully crafted radio trickery to create the illusion of sizable American forces where there were none and to draw the enemy away from Allied troops. Ghost Army soldiers impersonated other, larger Army units by sewing counterfeit patches onto their uniforms, painting false markings on their vehicles, and creating phony headquarters staffed by fake generals, all in an effort to feed false information to Axis spies. During the Battle of the Bulge, the Ghost Army created counterfeit radio traffic to mask the efforts of General George Patton's Third Army as it mobilized to break through to the 101st Airborne. It also provided assistance to elements of 10th Armored Division in the besieged Belgian town of Bastogne. In its final mission, Operation Viersen, the Ghost Army deployed a tactical deception that drew German units down the Rhine River and away from the 9th Army, allowing the 9th Army to cross the Rhine into Germany. On this mission, the 1,100 men of the Ghost Army, with the assistance of other units, impersonated forty thousand men, or two complete divisions of American forces, by using fabricated radio networks, soundtracks of construction work and artillery fire, and more than 600 inflatable vehicles. Three Ghost Army soldiers gave their lives and dozens were injured in carrying out their mission. Their activities remained classified for more than forty years after the war and I believe the extraordinary accomplishments of this unit are deserving of belated recognition. The United States will be eternally grateful to the Ghost Army for their proficient use of innovative tactics throughout World War II, which saved thousands of lives and were instrumental in the defeat of Nazi Germany. I ask all my colleagues to cosponsor this legislation to give a Congressional Gold Medal to the members of the Ghost Army.

Mr. MARKEY

Mr. MARKEY. Mr. President, Gary Braasch, a gifted photographer of the natural world, died on March 7, 2016. Gary dedicated his career to capturing visually striking portrayals of the devastating effects of climate change. His work has been published in Time, LIFE, the New York Times, National Geographic, and Discover and featured in the Boston Museum of Science, the Chicago Field Museum, and the California Academy of Sciences. Some of Gary's most well-known photos depict the retreat of glaciers. The juxtaposition of old photos from the turn of the 20th century with Gary's modern photos dramatically demonstrated large amounts of glacial melting. Some of these photos were featured in Al Gore's ``An Inconvenient Truth.'' Gary also documented the environmental effects of the fossil fuel industry. He famously captured the first images of Shell's ill-fated Kulluk oil rig, as it prepared to drill an exploratory oil well in the Arctic Ocean. The Kulluk is now regarded as a symbol of the recklessness and dangers of Arctic oil drilling and has become a powerful image of our need to transition to low-carbon, renewable energy. Gary's photographs were also influential in the scientific and policy communities. He worked with scientists to determine how to use photography to accurately portray the science of climate change. He also visited Capitol Hill on numerous occasions, providing visual evidence of our changing environment to me and my colleagues in the House and Senate. His 2007 book ``Earth Under Fire'' graced my office for many years. Gary died capturing breathtaking photos on Australia's Great Barrier Reef, a region particular vulnerable to the effects of climate change. His images resonated in a way words and data could never do alone and will stand on as a key component of our planet's record of climate change. Gary may no longer be with us but his work will continue to inspire the next generation of photographers and all of us who want to protect our planet and its people.

Mr. MARKEY

Mr. MARKEY. Mr. President, today I am introducing the Ghost Army Congressional Gold Medal Act to honor the 23rd Headquarters Special Troops, called the ''Ghost Army,'' which was a top-secret unit of the United States Army that served in the European Theater of Operations during World War II. The unit was actively engaged in battlefield operations from June of 1944 through March of 1945. The deceptive activities of the Ghost Army were essential to several Allied victories across Europe and are estimated to have saved thousands of lives. I was inspired to introduce this bill after hearing the story of Jack McGlynn of Medford, MA. I have known Jack for decades going back to my time in the Massachusetts State Legislature, but I never knew that he was a member of the Ghost Army. Like many World War II Veterans, Jack returned home to Massachusetts after the War, started a family, and got involved in local politics. Jack was a city councilor, Mayor, and State Representative. He kept his service in the Ghost Army a secret from everyone, even his wife and 6 children. Finally in 2008, Jack read that it was declassified and he finally shared the story with his family and friends. In evaluating the performance of the Ghost Army after the War, a U.S. Army analysis found that ``Rarely, if ever, has there been a group of such a few men which had so great an influence on the outcome of a major military campaign.''. Many Ghost Army soldiers were specially selected for their mission, and were recruited from art schools, advertising agencies, communications companies, and other creative and technical professions. The first four members of the Ghost Army landed on D-day and two became casualties while camouflaging early beach installations. The Ghost Army's secret deception operations commenced in France on June 14, 1944, when Task Force Mason landed at Omaha Beach to draw enemy fire and protect the 980th Artillery. Task Force Mason was a prelude to full scale tactical deceptions completed by the Ghost Army. Often operating on or near the front lines, the Ghost Army used inflatable tanks, artillery, air planes and other vehicles, advanced engineered soundtracks, and skillfully crafted radio trickery to create the illusion of sizable American forces where there were none and to draw the enemy away from Allied troops. Ghost Army soldiers impersonated other, larger Army units by sewing counterfeit patches onto their uniforms, painting false markings on their vehicles, and creating phony headquarters staffed by fake generals, all in an effort to feed false information to Axis spies. During the Battle of the Bulge, the Ghost Army created counterfeit radio traffic to mask the efforts of General George Patton's Third Army as it mobilized to break through to the 101st Airborne. It also provided assistance to elements of 10th Armored Division in the besieged Belgian town of Bastogne. In its final mission, Operation Viersen, the Ghost Army deployed a tactical deception that drew German units down the Rhine River and away from the 9th Army, allowing the 9th Army to cross the Rhine into Germany. On this mission, the 1,100 men of the Ghost Army, with the assistance of other units, impersonated forty thousand men, or two complete divisions of American forces, by using fabricated radio networks, soundtracks of construction work and artillery fire, and more than 600 inflatable vehicles. Three Ghost Army soldiers gave their lives and dozens were injured in carrying out their mission. Their activities remained classified for more than forty years after the war and I believe the extraordinary accomplishments of this unit are deserving of belated recognition. The United States will be eternally grateful to the Ghost Army for their proficient use of innovative tactics throughout World War II, which saved thousands of lives and were instrumental in the defeat of Nazi Germany. I ask all my colleagues to cosponsor this legislation to give a Congressional Gold Medal to the members of the Ghost Army.

Mr. MARKEY

Mr. MARKEY. Madam President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. MARKEY. Madam President, as we consider the CARA bill on the floor at this time--the bill that deals with the opioid epidemic in our country--I thought it might be useful to bring a few statistics forward so we can consider the nature of the epidemic we are dealing with. In 2014, 29,267 people died from prescription opioid and heroin overdoses in our country, with 10,574 of those people dying from heroin. That is a 28-percent increase from 2013. Can I say that again? There was a 28-percent increase in heroin deaths in our country in 1 year. That is the trendline we are talking about with this epidemic. Deaths from synthetic opioids like fentanyl increased 79 percent from 2013 to 2014. Can I say that again? A synthetic opioid, fentanyl, had an increase of 79 percent in deaths from 2013 to 2014. Here is another statistic: Today's young White adults age 25 to 34 are experiencing the highest death rates since the Vietnam war. Can I say that again? White adults between the ages of 25 and 34 are experiencing the highest death rates since the Vietnam war. In 2014, an estimated 1.9 million people had an opioid use disorder related to prescription pain relievers and an estimated 586,000 had an opioid use disorder related to heroin use. This is the profile of the epidemic we have in our country right now. In the 5-year period between 2008 and 2013, overdose deaths from prescription painkillers and heroin combined increased 37 percent. In 2010, enough opioid painkillers were sold to medicate every American adult with a typical dose of hydrocodone every 4 hours for 1 month. In 2012, health care providers wrote 259 million prescriptions for opioid painkillers--enough for every American adult in our country to have a bottle of opioid painkillers in 2012. Can I say that again? Enough of these opioid painkillers were prescribed so that every adult could have a bottle on their shelf in 2012. Pick a number of how many 10-milligram opioid painkillers were approved by the Drug Enforcement Agency in the year 2014. Just pick a number in your brain of how many pills were authorized to be manufactured in our country in 2014. Just pick a number in your brain of 10-milligram pills, of opioids. Here is the answer. You were wrong. The number is 14 billion 10 milligram-equivalent pills that were authorized to be manufactured in our country by the Federal Government--by the Drug Enforcement Agency--in the year 2014. Again, all this is part of the recipe. Stir well, ignore it for about 15 years, and let our country finally recognize that there is an epidemic in their house, on their street, with their relative, with their friend that should never have happened because we know what the cause of this issue is. This unparalleled rise in overdose deaths in the United States parallels a fourfold increase from 1999 to 2010 in the sale of opioid painkillers. We know there has been a tripling in the number of overdose deaths from 1999 to 2012 in our country, but we also know this: America is only 5 percent of the world's population, and yet we now consume 80 percent of all of the opioid painkillers on the planet. Again, this is not some big puzzle in terms of what has caused this problem. This is all very simple, easy-to-understand stuff that ordinary families have been grappling with, especially over the last 10 years, beginning with their understanding that OxyContin and Percocet and all these other drugs that are allegedly ``abuse-deterrent'' in fact, when they are swallowed pursuant to a prescription, if done on an extended basis, can cause an addiction that is worse than the underlying problem of the individual taking these painkillers. Roughly 480,000 emergency room visits in 2011 were attributable to the misuse and abuse of opioid painkillers in our country--488,000 emergency room visits on that one issue. The prescription painkiller epidemic is killing more women than ever before, and it is estimated that about 18 women die every day from a prescription painkiller overdose. The numbers are staggering. We should create a requirement that if the DEA is going to license physicians to prescribe opioids--and every physician in America must go to the DEA to get a license--if they are going to be allowed to prescribe, the physician must prove he or she has been educated to do so. Two years ago, the FDA authorized their voluntary education program for physicians. Pick a number in your mind of what percentage of all physicians in America have taken advantage of a voluntary education program for opioids. You are wrong, whatever number you just picked. Only 12 percent of all physicians have actually taken the voluntary education program. The FDA continues to authorize new opioids on the market without even having an expert advisory panel to deal with the issue, even as the DEA continues to authorize 14 billion 10-milligram pills per year. This issue is one that we have to deal with. We should have physician education. We should have tighter standards for what the FDA does in allowing for new drugs to go out on the market. We have to ensure that they are safe, and we have to ensure there is a proper understanding of their abuse potential. We have to have a day of reckoning with the costs of all of this. We have to make sure that the funding level is there for families who are already suffering. We have to provide the help for them. We just have to. This is an epidemic that was largely created at the Federal level, largely created by physicians and pharmaceutical companies. It is time for us to finally begin to provide the help these families so desperately need. Here is what I know most: It will not even be those who have the problem right now, although those families will get the help they need; it is all the families who will never need the help because we did put the right recipe on the books. We did put the right prevention measures on the books. We did put the preventative measures on the books so that their families never even knew this day arrived in their history. I hope as we go through this whole process that we can keep those thoughts in mind. That is what we can do from the Federal Government. We should strive to do this. We should try our best to stand up and provide the help that these families need at the local level. Madam President, I yield the remainder of my time.

Mr. MARKEY. Madam President, I suggest the absence of a quorum.

Mr. MARKEY

Mr. MARKEY. Madam President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. MARKEY. Madam President, before I begin, as we discuss the Comprehensive Addiction and Recovery Act, I would like to take a moment to thank Senator Whitehouse for his role in developing the bill and bringing it this far. I also convey my gratitude to Minority Leader Reid and the ranking member of the Judiciary Committee, Senator Leahy, for their excellent staffs and for urging that my amendments--which I will address momentarily--be a part of the discussion and for managing the negotiations on this bill. I also thank Senator Murray, the ranking member of the HELP Committee, for help and counsel on amendments. Let us pause for a moment and consider the causes of the prescription opioid and heroin epidemic gripping our country. Understanding the causes will help us focus on the right solutions. Three distinct parties bear much of the blame for this public health crisis. First, there is Big Pharma. In the mid-1990s, the seeds of this epidemic were planted with the aggressive, misleading, and ultimately criminal marketing of the powerful opioid painkiller, OxyContin by Purdue Pharma. Perdue claimed OxyContin was not addictive and couldn't be abused. Neither of those claims turned out to be true. Purdue Pharma built a massive marketing and sales program for OxyContin. From 1996 to 2000, Purdue Pharma's sales force more than doubled from more than 300 sales representatives to almost 700 sales representatives. In 2001 alone, Purdue gave out $40 million in bonuses to its burgeoning sales force. As a result of these sales and marketing efforts, from 1997 to 2002, OxyContin prescriptions increased almost tenfold, from 670,000 in 1997 to 6.2 million in 2002. Purdue's marketing of OxyContin broke the law. In 2007, Purdue Pharma paid $600 million in fines and other payments after pleading guilty in Federal court to misleading regulators, doctors, and patients about the risks of addiction to OxyContin and its potential for abuse. Second, Purdue Pharma's criminal wrongdoing did not occur in a vacuum. The Federal Government helped to enable this epidemic. The Federal Drug Enforcement Administration is responsible for approving the annual production quotas for pharmaceutical companies to manufacture oxycodone, the principal ingredient in OxyContin. From 1996 to 2016, the Drug Enforcement Administration obliged Big Pharma and increased by almost 150 percent the amount of oxycodone authorized for manufacture. In 1996, the DEA authorized U.S. pharmaceutical companies to make the equivalent of 6 billion 10-milligram OxyContin pills. By 2016, that figure had increased to almost 14 billion 10-milligram pills. That is right. Today the Drug Enforcement Administration is telling Big Pharma it is OK to make 14 billion OxyContin pills to sell in the United States in 1 year. The Federal Food and Drug Administration was also complicit, approving new opioid after new opioid. In the process, the FDA, charged with ensuring the safety of all prescription drugs on the U.S. market, began turning a blind eye to outside experts who were warning of the dangers these drugs posed. In 2013, an expert panel established to review the powerful new opioid painkiller Zohydro, voted 11 to 2 against recommending its approval, but the FDA approved the drug anyway, overruling the concerns voiced by experienced physicians on the panel. In 2014, in the wake of the Zohydro decision, the FDA twice skipped the advisory committee process altogether when it approved two new prescription opioids. Then, in August of 2015, the FDA did it again. This time it bypassed an advisory committee of outside experts on the question of a new use for OxyContin for children aged 11 to 16. The FDA even ignored its own rules that specifically call for advisory committee advice when a committee of pediatric dosing is involved. It was clear that the FDA was intentionally choosing to forgo advisory committees in order to avoid another overwhelming Zohydro-like vote, recommending against approval of a prescription opioid and in order to avoid any impediments to new opioids being sold in the United States. Finally, the medical profession must bear its fair share of responsibility for this crisis. Doctors are prescribing opioids at an alarming rate. In 2012, America's doctors wrote 259 million prescriptions for opioid pain relievers, enough pills for every single American adult to have a bottle of opioid pills given to them in the year 2012. And America's doctors are dangerously uninformed about the drugs they are prescribing. A recent survey of 1,000 physicians nationwide found that ``only two-thirds correctly reported that the most common route of abuse was swallowing pills whole.'' It is unconscionable that our doctors are so ill-informed. Nearly half of the doctors surveyed also erroneously reported that so-called abuse-deterrent formulations of opioids were less addictive than their counterparts. Abuse-deterrent opioids are supposed to be harder to crush, so they are harder to snort or to mix with liquid and inject, but abuse-deterrent formulations of opioids are just as addictive as non-abuse-deterrent opioids. 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 simply by swallowing them. So what is the result of the combination of Big Pharma's marketing of prescription opioids, the Federal Government's repeatedly approving them in ever-increasing numbers, and our doctors writing millions of prescriptions for them? Today, the United States is less than 5 percent of the world's population but we consume 80 percent of the world's opioid painkillers. We have become the United States of Oxy. When prescriptions run out or the price of Oxy pills on the street become too high for those who have become addicted, they turn to cheaper heroin, which shares the same molecular structure as OxyContin. Eighty percent of the people suffering from heroin addiction started with opioid pain medications approved by the FDA and prescribed by doctors. In 2014, nearly 33,000 people died of an opioid overdose in this country. Almost 1,300 of those deaths were in my home State of Massachusetts. I had hoped to offer amendments to CARA to address both the causes of this epidemic and to provide treatment for those suffering from the results. One of my amendments would have required the FDA to convene advisory committees for all prescription opioid approval questions. After I placed a hold on the nomination of Dr. Robert Califf to serve as FDA Commissioner, the agency announced it would only commit to convene advisory committees for non-abuse-deterrent opioids. The FDA refused to agree to convene advisory committees to inform all of its opioid-approval decisions. We need legislation requiring the FDA to seek expert advice about the risk of addiction before it approves any and all opioids, and I will continue to fight to require advisory committees at the FDA. We also need legislation requiring doctors to get and stay educated about the dangers of the pills they are prescribing in record numbers. Stopping the overprescription of opioid painkillers is a critical step. We need to ensure that all prescribers of these opioid painkillers are educated in the dangers of these drugs, how easily individuals can become addicted, and when and how to appropriately prescribe. The doctors say that they do not want education to be mandated, that it should be voluntary. Well, the FDA has had voluntary education for opioid prescribers in place since 2013 and has been actively encouraging doctors to take these voluntary education programs, but in more than 2 years, only 12 percent of prescribers have actually completed FDA's voluntary education program. It is imperative that any provider who is applying for a Federal DEA license to prescribe opioids have completed mandatory education on the basics of opioid prescribing and the inherent risk of addiction. My amendment would have done just that. It would have required basic education as a condition of a DEA license to prescribe these painkillers, and I will continue to fight to require prescriber education. Finally, we need to remove the barriers to effective treatment, including outdated Federal restrictions on medication-assisted therapies such as Suboxone. Medication-assisted therapy for opioid addiction is cost effective, decreases overdose deaths, and reduces transmission of HIV and hepatitis C. Unlike other treatment regimens for any other disease, physicians are severely limited in the number of patients they can treat with medication-assisted therapies such as Suboxone, contributing to long wait-lists and an inability of patients to get treatment for their addiction when they need it. Of approximately 2.5 million Americans who abused or were dependent on opioids, fewer than 1 million received treatment for their condition, partly because of the already existing Federal instructions. Senator Rand Paul of Kentucky and I have a bipartisan bill, the Recovery Enhancement for Addiction Treatment Act, or TREAT Act, which has broad stakeholder support, including the American Medical Association and nurse practitioners. It emphasizes quality of care and closes this gaping hole in our addiction treatment system. We had hoped to offer TREAT as an amendment to CARA. We will continue to fight for it and are hopeful the HELP Committee will include it in the substance abuse legislation the committee will soon consider. My collaboration with Senator Paul shows that whether it is the Commonwealth of Massachusetts or the Commonwealth of Kentucky, this crisis is the same. It doesn't discriminate by geography, by age, by race, by socioeconomic status, or by employment. It requires a bipartisan effort. Thirty years ago, Nancy Reagan told us to just say no to drugs. Today we have to go further. We have to say enough is enough. We have to recognize what has worked and what hasn't worked. In the past, we believed we could incarcerate our way out of the problem. That did not work. So instead of ignoring and incarcerating, let's avow and act. Let's destigmatize, not criminalize. Let's treat, not retreat. Let's have a comprehensive plan which we put in place that deals with the pharmaceutical companies, the physicians, and the kinds of treatment patients need across our country so that they get the help they need. That is our job. I continue to believe we can do this in a bipartisan fashion as long as we understand the magnitude of the problem and what the causes of it were and continue to be and will be into the future unless and until we put these safeguards in place. So I am looking forward to continuing to work with my colleagues on the other side of the aisle. I compliment them for the work they have done so far in bringing this bill to the floor of the Senate this week, but I do believe there is more to be done. As long as this many Americans are addicted, as long as this much OxyContin and opioids are put into our system, then we are going to find that this heroin epidemic we have in our country, which is directly related, will continue to spiral out of control. I want to work with all my colleagues. I thank my colleagues for all the work they have done so far, but there is much work to be done in the future. Madam President, I yield the floor.

Mr. MARKEY

Mr. MARKEY. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. MARKEY. Mr. President, I would like to start my remarks on the Comprehensive Addiction and Recovery Act today by complimenting all of the Members--Senator Whitehouse, Senator Grassley, Senator Portman, Senator Ayotte, Senator Shaheen, and all the Members who have been working so hard on this legislation to produce something which is very much needed by our country. I will start my remarks by telling a little story of a constituent who wants to remain anonymous. This is her story: On July 20, 2009, I was the passenger in a vehicle with my close friend at the time behind the wheel. The light turned green and as expected he hit the gas. While he was hitting the gas, the oncoming car never hit their brakes to stop at the red light they were approaching. I was painfully pinned in the passenger's seat. All I could hear was my friend asking me if I was OK. Upon arriving in the ER I was quickly poked, prodded, and injected with high- level painkillers. This is where it all began. Walking out of the hospital, I wasn't only walking out with crutches, but a prescription that changed the next 5 years of my life. I was prescribed OxyContin to help manage the pain I was experiencing. With continuing follow-up appointments and check-ins, also came more prescriptions for ``pain management prescriptions.'' Two months after getting into a car accident, I was a heroin addict. How quickly all things I knew changed. In September of 2009 I not only began shooting heroin but I also began my first semester of college. I was a freshman at UMass Boston, worked full time, but, secretly, I was also a heroin addict. I kept my addiction a secret from everyone I knew including my close friends and family. On August 31, 2014 I woke up and said to myself ``enough is enough.'' It took three overdoses in order to open my eyes. Since leaving treatment in November of 2014, my recovery has not stopped; I continue to learn and to grow daily. I have also learned of the medical issues and complications that my heroin use has led to. I now suffer from seizures because the excessive drug use over 5 years has led to minor brain damage. Along with the seizures, I have tested positive for Hepatitis C and HIV, which is common with injection drug users. At the end of the day, all I want to do is to help others who are struggling because I know what they are going through. Mr. President, she is one of the fortunate ones. She found the help she needed and had the strength and support to get clean. But I am hearing enormous frustration from people who don't feel that sufficient resources are being brought to bear on this enormous epidemic of prescription drug and heroin addiction. All week we have heard the statistics here in this Chamber. Our Nation is experiencing more deaths from drug overdoses than from gun violence or auto accidents. Eighty percent of the people suffering from heroin addiction started with opioid pain medications approved by the FDA and prescribed by doctors, with 27,000 people dying from an opioid overdose in 2014 and 1,300 of those coming from the State of Massachusetts. This issue is one that doesn't just affect the Bay State. America is drowning in a tsunami of heroin and prescription drug addiction that we must stop before it drowns any more families and communities. Let us compare what we are did as a nation when confronted with other deadly epidemics. A bipartisan majority in Congress funded more than $5 billion to respond to Ebola. We dispatched the medical community and public health experts. Today the Obama administration is asking Congress for $1.8 billion in emergency funding to fight the Zika virus. Imagine if we applied the same commitment, the same urgency, and the same 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, and Federal. That means Congress must step up to 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- deterring opioids. Abuse-deterring opioids is a contradiction in terms. Whether an opioid is used as a deterrent or not, it has not 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 the advisory committee to inform all of its opioid approval decisions, the FDA continues to ignore outside experts who could help stem the tide of tragic deaths and overdoses plaguing this country. That is why I have filed an amendment to require the FDA to convene advisory committees of outside experts for all opioid approval decisions--period. Now is the time to implement effective and commonsense solutions, but we need funding to do that; funding for families, funding for treatment providers, funding for our sheriffs and firefighters who carry 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 addiction. So let us 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 controlled substances to undergo mandatory training on safe prescribing practices and the identification of possible substance abuse disorders. That is why I have filed an amendment that requires prescribers to get the education needed to help staunch this wall of suffering and death. The doctors will say they don't want education to be mandated; that it should be voluntary. Well, the FDA 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 2 years, less than 12 percent of prescribers have actually completed the FDA'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 counterparts. It is unconscionable that our doctors know so little about these potentially deadly painkillers. I intend to call up amendment No. 3382 later so we can make consideration of the bill. The amendment would ensure that as a condition of receiving a license to prescribe opioids, the recipient of the license is educated in the best practices for using opioids and the connection with addiction and with diversion. I intend to call up that amendment later, asking for consideration. From my perspective, if we are going to have a real strategy, then we have to make sure 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 SUBOXONE. Medication-assisted therapy for opioid addition is cost-effective, it decreases overdose deaths, and it reduces transmission of HIV and hepatitis C. That is why I have filed an amendment that would lift the caps that are limiting the number of patients doctors can treat with medication-assisted therapy. If we are going to reduce the supply of heroin and illicit prescription drugs, we have to reduce the demand through effective treatment. I have 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 is why I have filed an amendment that creates a Federal Good Samaritan provision that shields from civil liability family members, friends, and other bystanders who administer opioid prevention treatments like Narcan. The debate 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 we cannot incarcerate our way out of this problem. We must let Big Pharma know 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 have just seen an explosion in terms of this problem. We must now let all of those struggling with addiction know that help is on the way and that no matter how dark life seems right now, there is hope and the Sun will rise for them once again. I thank the Presiding Officer for giving me the opportunity to speak for some time, and I yield the floor.

Mr. MARKEY

Mr. MARKEY. Mr. President, former Chief Justice Warren Burger once explained the historical significance of the U.S. Constitution as follows. He wrote that ``in the last quarter of the 18th century, no nation in the world was governed with separated and divided powers providing checks and balances on the exercise of authority by those who governed.'' The Chief Justice went on to call the Constitution ``a remarkable document--the first of its kind in all of human history.'' Chief Justice Burger was right. The Constitution is remarkable, and it is remarkable not only for what it says but how it says it. In some places the Constitution speaks in poetry, like the Preamble that begins with ``We the People of the United States,'' and talks of ``a more perfect Union'' and ``the Blessings of Liberty.'' In other places, the Constitution is simple prose, but given the importance of every single word in the text of the Constitution, the Founding Fathers wrote in plain, concise, and understandable language. That clarity can be found in the advice and consent clause of article II, section 2. Its words could not be clearer. It simply states that the President of the United States ``shall nominate, and by and with the Advice and Consent of the Senate, shall appoint Ambassadors, other public Ministers and Consuls, and Judges of the supreme Court.'' There is no ambiguity there. It is not an invitation to reinterpretation. The President's obligation under the Constitution is crystal clear. He shall nominate someone to fill a vacancy on the Supreme Court. President Obama has stated that he will fulfill his obligation and send the Senate an eminently qualified nominee to fill the vacancy created by the unfortunate passing of Justice Antonin Scalia. When President Obama does that, it will be the Senate's turn to fulfill its obligation under the Constitution. The text of the Constitution on the Senate's responsibility is similarly clear. The Senate is to provide its advice and consent. Let me repeat that. The Senate is to provide its advice and consent. Advice and consent does not mean the Senate disregards the Constitution and ignores a nomination to the Supreme Court. It is advice and consent, not avoid and contempt. The advice and consent clause is not the constitutional equivalent of Roger Maris's home run statistics. There is no asterisk in the Constitution that directs readers to small print that says ``except in an election year.'' There is no fine print in the Constitution that says the Senate is to give its advice and consent except in the last year of a President's term. Despite the clear constitutional instruction on how the executive and legislative branches are to handle a vacancy on the Supreme Court, the Republicans on the Judiciary Committee yesterday unilaterally decided they would not hold a hearing on a Supreme Court nominee to fill Justice Scalia's seat until after the upcoming Presidential election. This partisan decision to obstruct is a drastic departure from long- established practice and procedure in filling Supreme Court vacancies. The Senate has routinely confirmed Supreme Court Justices in the final year of a Presidency. In fact, it has happened more than a dozen times, most recently with the confirmation of Justice Anthony Kennedy during the last year of Ronald Reagan's second term as President. In the last 100 years, the Senate has taken action on every Supreme Court nominee regardless of whether the nomination was made in a Presidential election year. So the American people now have to deal with two vacancies: one on the Supreme Court and the other in the judgment of Senate Republicans because they seem willing to go to unprecedented lengths to stop this constitutionally mandated process from moving forward. Republican Senators' reading words into the Constitution to reach the result they want is no different from the so-called judicial activism on the bench they routinely decry. The Republicans would rather shirk their constitutional responsibility than let President Obama appoint another Justice to the Court. They would rather deprive the country of a fully functioning Supreme Court than fulfill their constitutional duty, not just for the remainder of this term but for the next term of the Supreme Court as well. Now, why is that? Well, because a Justice of the Supreme Court has only one vote, but a single seat on the Court and a single vote that comes with it can carry enormous significance. We need only look at this divided Supreme Court's recent 5-to-4 decisions to understand why Republicans prefer a vacancy on the Supreme Court. With only eight justices instead of nine, the Court's decisions can deadlock with a 4- to-4 vote. A tie vote leaves in place the lower court decision that has been appealed to the Supreme Court. A 4-to-4 deadlock can have far- reaching consequences. Take Bush v. Gore, the 2000 decision that stopped Florida's vote recount in the 2000 Presidential election. Bush v. Gore was decided by a 5-to-4 vote. If a seat on the Supreme Court had been vacated, resulting in a 4-to-4 vote, then the outcome of that election could have been different. So that is pretty much the consequence here. It is going to have, without question, some impact on how these decisions are going to be made, but it is without any full comprehension of what that change could be, only because nine human beings are involved, but there is a responsibility that we have in the Senate to ensure that we, in fact, have a full Supreme Court. The President shall nominate. That is without question the duty he has. We shall provide advice and consent. That is our duty. We don't have to give consent at the end of the day. We can have a vote on the Senate floor to determine whether someone is, in fact, going to be confirmed, but we have that constitutional responsibility. There is still ample time for the President to submit a nomination, for the Judiciary Committee to hold hearings on it, and for the full Senate to vote on it. The U.S. Constitution remains a remarkable document. Let us treasure it, not twist it. Let us respect it, not run from it. Let us fulfill our constitutional obligations and have a hearing on the President's nominee and a vote by the Senate. In other words, to the U.S. Senate: Do your job. It is in the Constitution. There is no way you can run from a clear interpretation of what the Constitution requires us to do once the President has nominated a new candidate for the Supreme Court. There are direct instructions for the President in the Constitution and there are direct instructions for us in the Senate. Let us hope that after the President nominates a candidate, that this body deliberates, listens to all the testimony, and then has a vote on whether that person is qualified to serve on the Supreme Court, but the only way that is going to happen is if this body does its job. So we ask the Members of the majority to ensure that happens. Mr. President, I yield the floor. I suggest the absence of a quorum.

Mr. MARKEY

Mr. MARKEY. Mr. President, I want to follow on with the discussion that Senator Ayotte from New Hampshire was bringing to the Senate floor. What she is saying is just so accurate in terms of the pervasive nature of this opioid-driven epidemic--pandemic--in the United States of America. It is time for us to come together in a bipartisan fashion to deal with what is now the great medical storm sweeping across this country. There has been a quadrupling of opioid-related deaths in just the last 14 years in our country. This is something that has to be understood. I heard Senator Ayotte mention it, but we can't say it enough: 80 percent of all people in the United States who die from heroin overdoses begin with prescription painkillers--opioids--that have been given to them by physicians. Let me say that again. Eighty percent of the people who die from heroin overdoses started on prescription pills. They got addicted to the prescription painkiller. It deals with the same receptors in the brain. It creates the same kind of need in the brain, and when people get addicted to prescription pain medicine, it is ultimately a very short to a product which is much less expensive--heroin--on the streets of the United States. This epidemic has to be dealt with and it has to be dealt with where it starts and it starts at the FDA. It starts at the Food and Drug Administration. It starts with the agency that approves these drugs for sale in the United States of America. Yes, the FDA stands for Food and Drug Administration, but over the last 20 years it really stands for ``Fostering Drug Addiction,'' and it has to end. This is why the nomination right now of Dr. Robert Califf to be the new head of the FDA gives us an opportunity to talk about this issue, to talk about where it all starts, how it began, and what we are going to have to do in this body to reverse this trend, which last year led to the deaths of 30,000 people in our country. Again, I say to my colleagues that between 2000 and 2014, the heroin overdose death rate has quadrupled in the United States of America. This is something that is recent. It is related to the FDA, and we have to now have an honest discussion about the role that agency is playing because we have become the ``United States of Oxy.'' We have become a nation of 5 percent of the world's population that consumes 80 percent of the prescription painkillers in the world. This overprescribing, this consumption of Oxy and Percocet, down the line has led to this epidemic, this contagion that is killing people on a daily basis in our country who otherwise would never have even contemplated using heroin or using any of these other more dangerous drugs. That is why we are here. That is why I am recommending a ``no'' vote on Dr. Robert Califf. The FDA has a chance to change its policies. Thus far, it is saying it will not change its policies. In 2012, health care providers wrote 259 million prescriptions for opioid painkillers. That is enough for every single adult in America to have a bottle of these pills in their medicine cabinet. We should understand as we talk about this that the molecular composition of OxyContin is very similar to heroin. In fact, Oxycodone is the sole ingredient in OxyContin. OxyContin stands for oxycodone continuously in the bloodstream of the patient who is taking these pills. It creates this sense that you are able to deal with the pain. It creates this sense that you are being taken care of, but if it is not handled correctly over time, it then creates an addiction, and that addiction then leads to, once you are off these pills, to being out on the street buying the heroin or buying the Oxy you need in order to continue this habit. So we have to start to deal with the issue very realistically in terms of this pathway that has been created into the minds of millions of people all across this country. Thirteen hundred people died in Massachusetts in 2014, of the 30,000 people in our country, as a result of this issue. We have the FDA, going back to the year 1996, accepting the misrepresentation of the pharmaceutical company Purdue, which represented to the FDA that OxyContin, in its original formulation, was abuse deterrent, meaning that since it was time-released inside of the patient, that, therefore, it was abuse deterrent and it could be prescribed safely to people all across our country. Well, it turned out that not only was that a misrepresentation to the FDA, but Purdue Pharma subsequently was fined millions of dollars and its executives punished for the misrepresentation they made to the Food and Drug Administration. That was a brief 20 years ago, but that is pretty much where it all started. That is the original sin--accepting this whole notion of abuse deterrent. Let's go to the FDA in more recent times. In 2012, there was a new opioid that the FDA had to consider for approval. That new opioid's name is Zohydro. The FDA impaneled 13 experts to examine that drug for the FDA. When those 13 experts concluded their examination of the drug by an 11-to-2 vote, the expert advisory panel voted, no, do not allow this new Zohydro drug out on to the marketplace. They said the standards for abuse are too low. The standards to deal with addiction are too low. The standards to deal with a diversion of the drug are too low. What did the FDA do in 2012? It approved Zohydro for sale in the United States over the objections of the advisory panel that had voted 11 to 2 against it--and these are experts. Moving forward, the FDA decided to reexamine what it was going to do. So when it was considering Targiniq, when it was considering Hysinla, it decided to solve the problem by having no expert advisory panels which it would convene to examine the impacts of that drug before it got approved. That is a good way to solve the problem--just accept the representations of the company that it had abuse deterrent in it, and then you don't have to worry because you will not have to talk to experts on the outside again. So those two drugs got approved. Then, in August of 2015, there was an application by Purdue Pharma, once again--that company's name just keeps coming back into the equation--they wanted approval to sell OxyContin to children ages 11 to 16. Now mind you, the actual standards at the FDA require an outside expert panel to look at approval for opioids being sold in America if it is controversial, if it could have a huge social impact in our society. And it specifically says in the FDA's own guidelines that if pediatric doses--if the proper dose for a child is involved--then the FDA should have an expert panel. What did the FDA do? The FDA decided no expert panel would examine the appropriateness of OxyContin being prescribed for children ages 11 to 16 in our country--no expert advisory panel, which brings us to the nomination of Dr. Robert Califf. We are now in a process where we are examining his nomination and his qualifications. This Senator leaves aside his own personal qualifications. This is not a debate, really, over Dr. Califf. It is a debate over the agency because the agency is saying--even today as we will be voting on Dr. Califf's nomination--they will not change. They will not convene expert outside advisory panels to look at this new generation of opioids with abuse deterrents built into them to determine whether or not they are actually appropriately being put into our society. Today is the day to begin this debate. This nomination is the occasion that we can use in order to debate what has gone wrong at the Food and Drug Administration. If we don't start with a brandnew definition that gets created for abuse, for addiction, for what the standards should be for the use of these opioids, then this issue is just going to escalate until we are losing a Vietnam war's number of people every single year in the United States. This is a pharmaceutical industry-created problem. This is a physician-created problem. This is an FDA-created problem. It is created by men and women, and it can be solved by men and women. This is not Zika, this is not Ebola, and this is not some disease that you can't really point to that is responsible. This is us, this is our country, and this is our culture. We did it. We created this problem. We are 5 percent of the world's population consuming 80 percent of all opioids--crazy. Really, it is crazy. We have to finally come to the recognition that this is no longer some inner city heroin epidemic. This disease knows no barrier--racial, income, geography, employment--no barriers at all. It is spread across every single segment of the American population, top to bottom. There is no discrimination whatsoever. We have to decide what we are going to do in order to make sure that we put the proper safeguards in place. Senator Manchin and I, Senators Ayotte, Sanders, Blumenthal, and others have been raising these questions. To the credit of the Senate Judiciary Committee, they are considering legislation to bring to the floor. I thank Senators Whitehouse, Portman, Shaheen, Ayotte, and Senators Grassley and Leahy for their work on that legislation, but that legislation does not conclude anything on this issue that I am talking about right now. This has to be solved by the FDA. That is why this Senator has put a hold on this nomination, saying that they will not get this nomination until they change their policies. We are in the eighth year of this administration, and the policies still remain in place. Abuse deterrent is really a contradiction in terms. If you take these pills--you are a carpenter or an ironworker, and you have a bad back-- you start taking these OxyContin pills right now, and you take them as they are prescribed, and you keep going month after month after month. You are increasing the likelihood on a daily basis that you are going to become addicted to these pills. We have heard these stories over and over again about the pathway in from family members. They come into the office and talk about the pathway in that their child, husband, or son took. It all starts with the same story. They were given the prescribed pills. Right now the industry is saying: Don't worry; there is an abuse deterrent. Tell that to these family members. Tell that to the families who have lost their loved ones. The drugs are not abuse deterrent. It is a contradiction in terms, like jumbo shrimp. There is no such thing. You need to be realistic about what this drug represents once it is consumed over and over again by people in our country who think that because the doctor has given them a bottle of pills, that is going to help them. That is one of the stories we hear over and over again from family members. They say that they question themselves. Could they have done more themselves to help their family member before they became addicted? The common theme from each of them is that you have to assume, when a doctor is giving you a bottle of pills for your family member, that it must be good for them. It must be good for them. It turns out that for 30,000 people in 2014, it wasn't good for them. This number is going to continue to escalate because we haven't put tough enough standards on the books in order to deal with these issues. By refusing to convene expert advisory boards to come in and to create the guidance which is going to be needed in our country going forward, we are going to have a continued flood of opioid deaths that could have been stemmed if we had dealt with this issue in the proper fashion. This is not a hypothetical concern. The policy announced last week by the FDA would not have guaranteed an advisory panel for OxyContin on the market today. The FDA must change its decision not to seek expert advice against the risk of addiction before it approves any and all opioids. I want to tell a little story. It is a story about one of maybe the five greatest basketball players ever to come out of the State of Massachusetts. His name is Chris Herren. Chris became a Boston Celtic. He was the greatest basketball player in Fall River history, was drafted in the first round by the NBA, and went to the same college I went to--Boston College. In an excerpt of remarks he recently made in DC at the Unite to Face Addiction rally on the National Mall, here is what Chris Herren said: I truly believe when it comes to prevention and educating our kids, we need to stop focusing on the worst days and start educating about the first day. At 18 years old, on the campus of Boston College I was introduced to cocaine. I promised myself one time--just one line. That one line took me 14 years to walk away from. Despite myself at 22, my dream came true. I was 33rd pick in the NBA draft, but that same year I was introduced to a little yellow pill--a 40 milligram OxyContin that cost a 20 dollar bill. That 40 milligrams turned into 1600 milligrams a day. And that 20 dollars became a $20,000-a-month Oxy habit. And just 2 years later, that pill turned into a needle and that needle stayed in my arm for the next 8 years. I often say if you can't find it in your heart to have empathy for someone who is battling their illness, then you must know that he or she has a mother, father, son or daughter that is at home with a broken heart that wants them back. Just one pill, lives impacted, some recover and many are lost. Another story--Kaitlyn Oberle from Scituate, MA. Here is what she says: I have survived a fatal opiate overdose, yet I never abused opiates. On November 13, 2015 I spoke to my 27-year-old brother for the last time. Less than 30 minutes after our final conversation, he passed away from an opiate overdose. He was only 16 years old when he first encountered the demon that consumed the better part of his adult life; sadly, that same demon ultimately killed him. Injuries from a dirt bike accident left him with two broken arms, a knee injury, and what felt like an unending supply of prescription opiate painkillers. After his bones mended, he was left with an untreated gaping open wound that would never fully heal itself: an opiate addiction. During my brother's recovery he painted a picture for me of how easy it was for him as a high school teenager and student athlete to call his doctor and request refills for his pain pill prescriptions. When he no longer had injuries to substantiate a prescription, he turned to illegal forms of opiates in both pill and intravenous form. Unfortunately, the damage to his brain had been done. There are many facets to what may cause someone to become addicted to opiates, and there are equally as many angles of attack before there is substantial progress to a viable solution. Mr. Senator, I am writing to you because I am a survivor. I've lived through my worst fear by knowing I can be a voice in helping prevent future deaths caused by opiate addiction. As you convene to debate the fitness of Dr. Robert Califf's nomination for head of the Food and Drug Administration, please ask the Senate to reflect on his time as deputy commissioner. As second in power at the FDA, he has had a chance to do something about these issues. It is time for a change in culture at that agency. A third letter--final letter written by Stephen Jesi, from Malden, MA: I am writing to you as a longtime Maldonian and a father of a 33-year-old daughter Stephenie who passed away on December 13, 2015 of a heroin overdose. Stephenie overdosed on Thursday, two days prior to her death and was released by the hospital at 11:39 p.m. on to the streets. We've experienced this first hand many times. Thank God for Chief Campanello of the Gloucester Police Department who picked up the phone, talked to us, talked to Stephenie, and assisted us in every way he could to get her into treatment. Everybody else just said sorry, there is nothing we can do. I believe that our medical community along with the pharmaceutical industry are grooming and developing drug addicts and putting them right into the hands of the cartels and the drug dealers. Way too many prescriptions are written for more narcotics than are necessary after surgeries with no follow up. Many of those who are predisposed to addiction, either by genetics or co-existing mental health issues, are easy prey for these drugs that begin as legally prescribed. Once they are addicted and can no longer afford the medically prescribed version of the medication they fall into illegal drugs and from there too often the addiction has taken control of their lives. The pharmaceutical industry along with our medical community has to prescribe these highly addictive narcotics much more carefully and offer less addictive medication whenever possible. Most patients take these narcotics for just a couple of days after the surgery but are provided a much longer supply where they can easily fall into the hands of the addict. Our legislators and government officials cannot be tied to the desires of the pharmaceutical lobbyists. This is the cry that is coming out from every community in America. Individuals are saying: How did this happen to my family? How could that accident with the broken leg or the back pain turn into an opioid overdose? How could it have happened? Well, it happened because the medical community and the pharmaceutical industry have not put the protections in place for us to be able to deal with it. Let me give you this number. This is a crazy number. It is a crazy number. Over the last 15, 20 years, there has been a dramatic increase in the number of prescription opioid pills that have been allowed to be sold in America. So I am just going to ask people who are listening to this, pick a number. How many 10 milligram prescription opioids were allowed to be made in America last year? Just pick a number. We have 300 million people in America. How many of these pills were allowed or given the permission to be made by pharmaceutical companies? Here is the answer-- 14 billion. May I say that again--14 billion opioid pills for our country. The numbers are out of control. The overprescribing is out of control. We have to find a way to dramatically reduce the amount of drugs that are being sold legally in our country. Before we even reach illegal, you have to start with legal. That is the problem because the Drug Enforcement Administration, the agency responsible for deciding how much each pharmaceutical company can manufacture each year, doesn't even announce how much each company is given permission to manufacture; instead they just announce the gross number of total opioid materials that can be put into pills in our country each year. Does anyone understand this in America, that that is the process? The FDA allows the company to sell it. Then it goes over to the DEA. Then the DEA picks a number of pills that can be sold, and then physicians are allowed to prescribe these pills, but this is the FDA's own number. Listen to this. The FDA asks for voluntary guidelines to be put together for physicians' education so they know what they are doing with these opioids. Pick a number in your brain as to how many physicians have voluntarily accepted medical education on the consequences of prescribing opioids. Pick a number. Here is the correct answer: 10 percent of physicians. That is it. On something that is so catastrophic, something that is creating an epidemic in our country, you would think this would be mandatory; that the medical associations at the State level, the national level had created some kind of mandatory education. It hasn't happened. Is it mandatory in medical schools across America that they receive education as to what the consequences are of prescribing opioids? Not at all. So who would think a physician would have to be trained in how to handle pain? I mean, a physician is only dealing with the issue all day long, every single day. You would think there would be some understanding then of what the consequences were of the medicines they were prescribing. No courses in medical school are mandated. No courses are mandated after you have graduated, you are practicing medicine, and now you are licensed by the DEA to prescribe opiates--no courses. So as we move forward on the legislation that is going to be coming out on the floor of the Senate, I intend to make an amendment--Senator Blumenthal and I tried to make it in the Judiciary Committee, and we are going to be making it on the Senate floor--requiring the Drug Enforcement Administration to require mandatory education for any physician who wants to prescribe these drugs. That is the minimum, the minimum that the medical profession should have to accept as a responsibility before they are allowed to prescribe these drugs. There is another amendment which I am working on with Senator Paul of Kentucky, and that is an amendment that is going to increase access to medication that can help people deal with their addictions. Again, that is a classic example of a Democrat and Republican working together on these issues. Senator Ayotte and I have an amendment that would create a Good Samaritan protection for any American, any family member who wants to apply Narcan to a family member or someone who has overdosed and would die in the absence of Narcan, the antidote, being applied to them. Senator Ayotte and I are working on that amendment. We are trying hard to find ways where, unfortunately, legislatively we can act. This should have happened at the agencies. This should have happened in the medical profession. We shouldn't be forced to debate this on the Senate floor, but it is absolutely, indispensably necessary for us to take this action. This is the epidemic of our time. The death rates now in the age group that is affected by this epidemic are now declining at the same rates as they did during the war in Vietnam. We haven't seen anything like this since the war in Vietnam in the death rates--30,000 people-- quadrupling in 14 years, escalating on a daily basis. It is time for the Senate to take real action on this issue so we can deal with it. In Boston, MA, we had a police chief who saw that something had gone wrong, Chief Campanello. He said that incarceration doesn't work and instead treatment should be substituted. So beginning last June, what Chief Campanello said in Gloucester, MA, was that if you come in and you are an addict, you have a problem, you come into the police station, bring your drugs with you, we are not going to arrest you, we are going to put you into treatment immediately--no arrests. Four hundred people have walked into that police station in Gloucester, MA, in just 8 months--400 people. By shifting the paradigm from arrests to treatment, 800 more people--800 total across the country--as city after city, town after town adopts this model, have now accepted that as a better route for them in their lives, to just turn themselves in at the local police stations. He has partnered with a man named John Rosenthal. John Rosenthal is an activist in our State, and he helps to fund this program. Last Wednesday night, tragically, John Rosenthal's own nephew, Nathan Huggins-Rosenthal, age 34, died of an overdose in Calgary, Canada. My heart goes out to the Rosenthal family because obviously they were committed to dealing with this issue, pioneering ways to have addicts be able to have a place they can go. Yet in John Rosenthal's own family, his nephew overdosed just last Wednesday night. As Senator Ayotte was saying, there is no neighborhood immunity. There is no family who is completely protected. This epidemic has been created by pharmaceutical companies, by physicians, by the agencies responsible to deal with it, and it is now time for us to put in place the protections which are needed to deal with it. Let me give you opioids 101 so you can understand how we get to this--what are opioids, how do they work, and why do they lead to heroin abuse. Here is how it works. It starts with a seed pod of the opium poppy. We get the morphine, a naturally occurring opiate pain reliever from that pod seed. The morphine interacts with so-called opioid receptors that are found in high concentrations in areas of the brain that control pain and emotions. Taking opiates can increase the levels of dopamine in the brain's reward areas and produce euphoria or a rush of pain relief and relaxation. In fact, morphine, which was first identified in the early 1800s is named after Morpheus, the Greek god of dreams. In 1895, the Bayer Corporation, Bayer Aspirin--the Bayer Corporation in Germany introduced a new cough suppressant marketed as a safer alternative to morphine. This new wonder drug was called heroin. In the 1920s, drug manufacturers began making fully synthetic analogs to morphine. They were called opioids. These drugs contain the same basic chemical framework as morphine, and they have exactly the same mechanism of action in the brain. They share common chemical features that allow them to buy into the brain's opioid receptors, and they all are considered highly addictive. These drugs vary widely in potency. That is the amount of the drug required to reach the same level of pain relief and sedation as morphine. OxyContin, for example, is 150 percent as strong as morphine. Heroin is also an opioid. They share the same fundamental chemical structure. Heroin binds to the very same receptors in the brain and produces the same euphoria and sedation, and heroin is plagued by the same addiction potential. Heroin is classified as a schedule I drug, the most dangerous class, because it has no accepted medical use and a high potential for abuse and addiction. So this is the pathway between opioids and heroin and why that pathway is very short. It is all about the chemistry because OxyContin has the nearly identical molecular constitution as heroin. Over time, the brain, the receptors are saying: I need to have to continue to have that hit. Thus, we have this epidemic where 80 percent of all people in the United States who are dying from heroin overdoses started on prescription opioid drugs that had been prescribed by their physicians. Physicians should have to be educated. The FDA should have expert advisory panels that give the strongest possible guidance to the pharmaceutical companies. That is what is missing in this equation. It starts there. We need a debate on $1.1 billion for more treatment and more education, and we are going to have that debate on the Senate floor. These local families, these local groups, they are heroes, but heroes need help, and it is time for us to fund those programs in the same way we funded the Ebola crisis and the same way we are being asked to help to fund the Zika crisis. We have a crisis in America ourselves, but if we don't deal with the issue right from the beginning at the FDA, at the DEA, and at the AMA, we are not going to solve this problem. We are just putting medical facilities in place to deal with the consequences of having no policy. This is our great opportunity to have a debate in our country. I can't thank the Members enough for beginning to deal with this issue on a serious basis, but we can't be afraid of the pharmaceutical industry. We can't be afraid of the American Medical Association. We can't be afraid of the bureaucrats in these agencies who say: Oh, Mr. or Ms. Senator, we are the experts. You don't know what you are talking about. Well, just let me tell you this. The people of the United States don't trust the experts anymore in these agencies. They want more accountability. They want other experts to come in to check those experts, to ask the tough questions on behalf of the American people. That is why I have a hold on Dr. Robert Califf's nomination for the FDA, because right now the FDA is saying it is going to continue business as usual and that is just wrong. That is just plain wrong. It has to stop there. The signal must come from this administration. I thank all the Members for this discussion, for where we are today and where we are going to have to go in the months ahead, but I don't think we should end this year without a fundamental change that has taken place in our society in this relationship. I will just add one final issue, and that is the issue of how many pills, how many pills a doctor can prescribe initially to a patient. We are now debating that issue in the State of Massachusetts. Governor Baker has been saying it should only be 3 days' worth of pills. One of the counterproposals is 7 days of pills that can be used by the patient. I do know this. We have to start here because right now doctors are handing out bottles of 60 to patients who only need a week's worth or 3 days' worth. When you leave a dentist's office, you don't need 60 days' worth of pills for your wisdom teeth that have been removed. When you have some pain that you just got from playing a softball game and you have twisted your back, you don't need a bottle of 60 or 30. You might need a few pills for 3 days or 7 days, but you don't need the 60. Having that 60 in that medicine cabinet is the beginning of the problem. I thank Governor Baker for what he is doing on this issue. They haven't resolved it in Massachusetts. I think we have to debate that in the Halls of Congress as well. They are all related, how these pills get into the blood system of our country. Again, I thank all of the Members for their consideration of this issue. Mr. President, I yield back the remainder of my time. I suggest the absence of a quorum.

Mr. MARKEY

Mr. MARKEY. Madam President, today we are about to begin consideration of the nomination of Dr. Robert Califf to lead the Food and Drug Administration. This is a historic time at that agency. It has a record which is not enviable in terms of the way in which it has been dealing with the opioid prescription drug epidemic in our country. I want to give just a very brief history of what has been happening on that issue. About 20 years ago, the FDA was asked to approve OxyContin--which is just a shortened form of oxycodone--continuously going into the bloodstreams of Americans. Purdue Pharma represented that this would be a safer way of having prescription opioids go into the American medical system. Nothing could have been further from the truth because oxycodone--the material inside of OxyContin--is molecularly very similar to heroin. So when one has a bottle of OxyContin or oxycodone continuously in your cabinet--30 pills, 60 pills or more--you are talking about having a bottle in your medicine cabinet that is very close to being heroin. Now if someone said to you that your child or family member is now taking something that is very close to heroin, that would have a profound impact on you--but that is never quite explained to the American public. That is something that was not understood at the time because Purdue Pharmaceutical company was representing that it was safe to take OxyContin. It turned out that was not the case. Today we have an epidemic in the United States. More than 30,000 people in 2014 died from this prescription drug heroin epidemic which is ravaging our country. This is a dramatic increase from 1996, when we really didn't even talk about it in our country. More than 30,000 people died in 2014. The number most likely was much higher last year. The number, most likely, will be even higher this year as well. Here is the story--80 percent of all people who are dying in the United States from heroin overdoses started on prescription opioids. Eighty percent of all people who died in 2014 from heroin overdoses started on prescription opioid painkillers. So the pathway into this heroin epidemic is quite clear. It is the Food and Drug Administration approving these new prescription opioid pills without the proper safeguards having been put in place to ensure that it doesn't make the problem worse rather than improving the problem. That is why the debate on Dr. Robert Califf is so important. The Food and Drug Administration is saying they will not empanel expert advisory panels to review the approval of each one of the new prescription opiates that are in the pipeline right now at the FDA. What is the evidence that will cause big problems? Well, back in 2012 the FDA had to consider Zohydro. Zohydro was a new prescription pain opioid. They empaneled a group of advisers--experts--to look at the drug. By 11 to 2, the expert advisory panel said: No, do not approve this new drug, unless we establish a whole new system or standard in America for addiction, abuse, for diversion of these drugs. Don't do it. The FDA ignored the advisory panel and approved Zohydro, with experts all across America attacking the FDA for not understanding how fundamentally the culture in our country had changed since 1996 with the first approval of OxyContin. Moving forward, the FDA decided it would not empanel expert advisory panels at all because they knew most likely they would vote no. So on new drugs such as Hysingla or Targiniq, there were no advisory panels at all because it was said by those companies that there are abuse deterrents that are inside those new opioids. What does that mean? Abuse deterrent is basically going to the issue of whether that new pill--that new drug--can be crushed to be used for purposes other than what is intended, which is to be a painkiller. However, if the individual just continues to take the pills in the bottle as they are prescribed and they do it on a continuous basis, they run a high risk of becoming addicted. The warning went out from all of these outside groups that expert advisory panels were needed. The FDA ignored them. Then we hit August of 2015. Believe it or not, Purdue Pharma wanted to get approval for 11- to 16-year-olds to have OxyContin. Remember, this is heroin equivalent. This would go to 11- to 16-year-olds. What they decided to do was to not have any advisory panel at all on that issue in August of 2015. This is despite the fact that it was controversial, that it had tremendous social impact on our society, and that the FDA's own guidance says that expert advisory panels are needed on drugs of that nature when pediatric dosing or child prescribing is in question. The FDA just ignored it. I put my hold on Dr. Califf's nomination. Senator Manchin put his hold. We are raising this issue. We are saying to the FDA that we need advisory panels. We need a change of culture at the FDA. This just cannot continue. The FDA said they would look at it. The FDA said they would study it. Then the FDA announced 2 weeks ago that there would be no advisory panels for any of the new opioids which are in the pipeline over at the FDA because they are ``abuse deterrent.'' Abuse deterrent is an oxymoron. It is a contradiction in terms. It is like jumbo shrimp. There is no such thing as an abuse deterrent inside of a bottle of pills that have the same molecular constitution as heroin, especially if we are talking about giving it to kids age 11 to 16 in our society. By the way, if you want to know why there has been a spike in the number of breaking-and-entering crimes in people's homes, with people breaking in and looking for these bottles of pills, I will tell you why. Each one of these pills can be worth upward of $80 apiece on the streets of America. Hear that number? For a bottle of 60 with 80 milligrams is worth between $4,000 and $5,000 on the streets of America. That is why they want to break into your house. They don't take the TV. They are looking for that bottle of medicine because that is how much it is worth. That is how much they can sell it for. When do we begin to get real about the fact that it is a bottle of heroin-equivalent in people's homes? Ultimately, when all their prescriptions are finished off and they can't get it anymore from the doctor, they wind up with heroin at $5 a bag in the street. So America, it doesn't matter which community in America we are talking about. It can be Boston, West Virginia, Kentucky, California, it is all the same story, the same pathway in, for 80 percent of all those who overdose on heroin in our society. They are still looking for that heroin-like experience. So we have a big issue that the FDA is not responding to, which is why I don't believe Dr. Califf should be confirmed until we have a change at the FDA, and they are not going to do it. We have to make sure they understand it is a coalition of pharmaceutical companies and physicians which have created this epidemic in our country. We are reaching a point where we are going to have a Vietnam war equivalent of people dying every single year inside of the United States on an issue created largely by the pharmaceutical and physician community in our society. So when do we start getting real about it? When do we start having a reality check, that while we are 5 percent of the world's population here in the United States, we consume 80 percent of all of the prescription painkillers in the world? Mix well, wait 20 years, and a pandemic has broken out across our country. The FDA has a responsibility to ensure that we put the protections in place, that the warnings are there, that the dosage is correct, and that the preventive measures are used to reduce dramatically the number of families who are going to be devastated by this issue. When people have back pains, when people have issues other than the most life threatening, we have to begin to discuss how long we want these people to be on something that has the same molecular constitution as heroin. It is a big issue. Lower back pain, broken legs--there is perhaps a greater danger from the prescribing than there is from the actual underlying injury in terms of the long-term consequences for these families. We have to have this discussion in our country. We have to have the kind of discussion that says that heroin overdoses in our country have quadrupled in the last 14 years--quadrupled--and 80 percent of it started with prescription opioids. We have to have this discussion. Dr. Califf has been nominated as the new head of the FDA. They are not going to change business as usual at the FDA. They are not going to do it. They have already announced it. They don't want to hear from experts. Their slogan at the FDA is no experts need apply to come in and give advice to the pharmaceutical companies and to the FDA. No warnings are needed from anyone with regard to what this industry has been doing to our country and what the FDA has been approving. So this issue is one that absolutely is at the top of the list of the things we have to deal with in our country. Last year, the Food and Drug Administration, the agency that actually approves how much of this opioid painkiller can be sold in--and the way the system works is individual companies go to the Food and Drug Administration, tell them how much they want to have approved, and then the FDA never tells the rest of the world how much they allowed each company to, in fact, manufacture in terms of the painkiller, the opioid. They give an aggregate number, but they never tell you how much each company got approved. What I would like people to do in their minds right now is to think for a moment how many prescription opioid pain pills--equivalent in oxycodone, other opioids--were approved by the Food and Drug Administration last year. Just pick a number. How many pills total? Do you have a number in your head? I am going to give you the answer: 14 billion. Can I repeat that? There were 14 billion prescription opioid pills approved for a country of 300 million. That is a bottle for every single adult--a bottle, again I tell you--with the material that has the molecular equivalency of heroin inside the cabinets of people inside the United States of America. This has to stop. It has to end. I understand it is a good business model for the companies manufacturing these things, but it is not good for America, and it is not good for the families in our country. The FDA has to stop them. That is why Senator Manchin, Senator Blumenthal, and others who are going to be speaking on this issue--we don't think Dr. Califf should be approved until they change business as usual, until they make a commitment that they are going to change business as usual at the Food and Drug Administration. They are supposed to be the guardian of our public health. They are supposed to be the arbiters of what is safe for Americans to consume, but they have not been doing the job. I am not talking about 1996 anymore; I am talking about 2015 and 2016. I am talking about right now with the evidence of this national tragedy manifesting itself in every community in our country. The least that the Senate should be able to say is that it tried, really tried, to deal with this issue that has been created by the pharmaceutical and the physician community. It will not be enough to say that we are going to authorize $1.1 billion for treatment, although we need treatment because there are millions of people who are going to need it in our society. We have to go back to the root causes of this problem, this flood of drugs that have gone into this society, the lack of prescribing education that physicians have to undergo. The FDA indicates that only 10 percent of physicians in America voluntarily even get educated with regard to what are the consequences of having a bottle of molecularly similar heroin pills to be put inside the cabinets of Americans--10 percent of physicians. That is just plain wrong, ladies and gentlemen. We have to make sure that the education is there for the physicians who need it. We have to make sure that the pharmaceutical companies do not get permission to be able to get these new pills approved until there is a new standard for abuse, a new standard for addiction, a new standard for the diversion of these pills, a new standard for what abuse deterrent means because right now, again, it is a contradiction in terms. You can still get addicted by taking an Oxy or a Percocet over and over again, day by day. You are going to get just as addicted. It is not an abuse deterrent if that is how you are going to be taking it. You still wind up with the same problem. We need to get real here. There is no bigger issue in our country. There is no more profound change that has taken place on the streets of our country. When it increases by fourfold in just 14 years, what is on the horizon for our society if we don't put an end to it? Working with other Senators, I intend to continue to explain this problem to other Members. I could not have a better partner than the Senator from Connecticut, Senator Blumenthal, who as attorney general in the State of Connecticut and now as a Senator has focused laserlike on this issue. We are both committed to making sure that education of physicians becomes an indispensable part of the remedy--the Rx that we in the Senate put on the books--so that at a minimum that education is made mandatory for every physician who is going to be handing out these pills to otherwise unsuspecting Americans. I will just finish this way. One patient came up to me and said: You know, when a doctor says to you that these pills for your family member are good, you are not going to second-guess the physician. You are going to assume that because the physician gave them to you, they must be good. And then this man said to me that he and his wife looked back and said: Should we have known more? Should we have done something different? Should we have tried to protect that other family member? No, it should be the FDA. It should be the DEA. It should be the physicians. It should be the prescribers. They are the ones that should have the responsibility, not the guilt that they are giving to families all across the country that they should have known more. No, ladies and gentlemen, this is the time for us to finally act on this issue. I yield to the great Senator from the State of Connecticut, Senator Blumenthal.

Mr. MARKEY. I thank the Senator from Connecticut, and we intend on continuing this battle right through this entire confirmation process and beyond. Unless we stop it now, FDA is not going to stand for ``Food and Drug Administration,'' it is going to stand for ``fostering drug addiction.'' That is what it has been doing. It has to change the way it does business. It has to respond to this addiction and abuse crisis in our country. It has to be the cop on the beat. It has to understand its responsibility to not allow this flood of drugs to go into our society, and we have to begin the battle now. I urge all Members to vote no on this nomination. This is not directed personally at Dr. Califf but directed at an agency which has allowed this flood of drugs into our society without putting the proper protections in place. I now yield to the great Senator from West Virginia, who has dedicated his career as Governor and as Senator to leading on this issue.

Mr. MARKEY

Mr. MARKEY. Mr. President, more than 100 years ago, Albert Einstein proposed the theory of relativity. He predicted that violent events in the early universe shocked the cosmos, sending gravity waves rippling through the fabric of space time. By the time these waves reached Earth, they would be ``vanishingly small,'' and, with the technology available in Einstein's day, impossible to detect. But after 100 more years of science and innovation, scientists announced yesterday that, with their new cosmic hearing aid, they have heard the first ripples from space. I congratulate the men and women of the LIGO Scientific Collaboration, an international project of over 900 scientists led by MIT and Caltech, for their hard work and dedication. Using cutting-edge facilities in Louisiana and Washington State, scientists detected a vibration in the space-time continuum, opening our ears, not just our eyes, to space. A billion years ago in a distant galaxy, two black holes spiraled inward on each other. Their eventual collapse released the energy of a billion trillion suns in a fraction of a second and sent gravity waves rippling through space and time. Gravity waves compress space in one direction and stretch it in the other. Since this push and pull weakens with distance, scientists have long thought gravity waves would be too faint to measure on Earth. But yesterday scientists proved such skepticism wrong. With their latest detector at the ready, scientists were waiting and listening for any faint sign of these waves. And on September 14, 2015, scientists heard a short chirp on their instruments that turned out to be the billion-year echo of a faraway past. For the first time, we can hear the Musica Universalis because of our investment in basic science research. Throughout the 40-year, $1.1 billion project, the National Science Foundation withstood harsh criticism about their funding to support the detection of gravitational waves that were thought to be undetectable on Earth. But it was NSF's commitment to basic science research and the dedication of Dr. Rainer Weiss of MIT, Dr. Kip Thorne of Caltech, Dr. Ronald Drever of the University of Glasgow, and an international team of scientists that has made yesterday's announcement possible. This discovery is a triumph for science and a testament to the payoff of long-term public investment in basic science research. It further illuminates our understanding of the universe and opens the door for a whole new way of peering into the cosmos. I congratulate all those involved in turning on the sound to the stars.

Mr. MARKEY

Mr. MARKEY. Mr. President, I am here to speak in opposition to the nomination of Dr. Robert Califf to be the head of the Food and Drug Administration. I understand that Leader McConnell has asked that cloture be filed on Dr. Califf's nomination. I understand that. I appreciate it. But we need to have a debate in this country on opioids. While I am disappointed that the majority leader is taking this step, I am committed to continuing to work on this issue, and using Dr. Robert Califf's nomination is the means by which we can have a debate here on the floor of the Senate on these issues. (Mr. McCONNELL assumed the Chair.) I am here to speak about a public health epidemic that every year kills more people in the United States than gun violence or motor vehicle accidents. What does this epidemic look like? Well, it looks like this: Last year 30,000 Americans died of an opioid overdose. More than 1,300 of those were from my home State of Massachusetts. In the city of Brockton, MA, last month, in January, in the span of 48 hours, 40 people overdosed on opioids. I will say that again. In Brockton, in 48 hours, 40 people overdosed on opioids. Between 2000 and 2013, the rate of death from heroin overdoses nearly quadrupled. The United States is less than 5 percent of the world's population, but we consume 80 percent of the world's opioid pain killers. Drug overdoses are increasing the death rates of young adults in the United States to levels not experienced since the AIDS epidemic more than 20 years ago. These skyrocketing death rates make these young adults the first generation since the time of the Vietnam war to experience higher death rates in early adulthood than the generation that preceded it. Let's compare what we did as a nation when we confronted other deadly epidemics. A bipartisan majority in Congress funded more than $5 billion to respond to Ebola. We dispatched the medical community and public health experts. We built entire facilities to ensure we stopped the spread of the deadly virus. Today, the Obama administration is asking Congress for $1.8 billion in emergency funding to fight the Zika virus. Imagine if we applied the same commitment, the same urgency, the same level of resources to the prescription drug and heroin epidemic. Yet, despite this raging epidemic, one would think the Food and Drug Administration--the agency responsible for the safety of all prescription drugs in the United States--would welcome every bit of expert advice it can get from doctors and other public health professionals. In fact, the FDA's own rules call for it to establish an independent advisory committee of experts to assist the agency when it considers a question that is controversial or of great public interest, such as whether to allow a new addictive prescription painkiller to be marketed in the United States. Instead, the FDA has put a sign in its window: No Help Wanted. That is what this nomination of Dr. Robert Califf is all about. The FDA began turning its back on advisory committees in 2013 when an advisory panel to review the powerful opioid painkiller Zohydro voted 11 to 2 against recommending its approval. But the agency approved the drug anyway, overruling the concerns voiced by experienced physicians on the panel. Those experts criticized the agency for ignoring the growing epidemic fueled by OxyContin--the heavily abused prescription painkiller the FDA first approved back in 1995. They warned about the growing dangers of addiction, of abuse and dependence associated with this entire class of opioid painkillers. Justifiably, the FDA was lambasted for its decision to approve Zohydro by public health experts, doctors, Governors, and Members of Congress. But despite those warnings of the real-world dangers of abuse and dependence on these new, supercharged opioid painkillers, the FDA willfully blinded itself to the warning signs. In 2014, in the wake of the Zohydro decision, the FDA twice skipped the advisory committee process altogether when it approved the new prescription opioids Targiniq and Hysingla. Then, in August of 2015, the FDA did it again, this time by bypassing an advisory committee on the question of a new use for OxyContin for children aged 11 to 16. This time the FDA even ignored its own rules that specifically call for advisory committee advice when a question of ``pediatric dosing'' is involved. At this point, it became clear that the FDA was intentionally choosing to forgo an advisory committee in order to avoid another overwhelming vote recommending against approval of a prescription opioid. And why did they do it? Well, because the FDA would then have had to ignore yet another group of experts in order to continue its relentless march to put more drugs on the market. With the OxyContin-for-kids decision, the FDA's reckless attitude toward expert advice on drug safety went too far. Children whose brains are not yet fully developed are especially vulnerable to drug dependency and abuse. Yet the agency focused its so-called safety analysis only on concerns about proper dosing, saying that it needed to tell doctors the proper doses for children who needed the drug. That is just plain wrong. We use experts to determine if child car seats are safe, if toothpaste is safe, and if vaccines are safe. We should also use experts to determine if those opioid painkillers are safe for the children in the United States of America. We need to immediately reform the Food and Drug Administration's opioid approval process if we want to stop this epidemic of prescription drug and heroin addiction in the United States. When I placed a hold on the nomination of Dr. Califf to head the FDA, I called on the FDA to commit to convening an advisory panel of outside experts for every single opioid approval question it reviewed. Here is how the FDA responded: It responded by committing to convene outside experts but only for opioids that are not abuse-deterrent. Let's be clear. I want everyone in this Chamber to understand this: ``Abuse- deterrent opioid'' is an oxymoron, like ``jumbo shrimp'' or ``congressional expert.'' There is no such thing. When we hear the term ``abuse-deterrent,'' think of pills that are tamper-resistant. They are supposed to be difficult to crush or chew or cut open or tamper with. But nothing about abuse-deterrent opioid prevents addiction. There is no such thing as abuse deterrence if you are suffering from addiction and have access to the Internet, where you can find out just how easy these painkillers are to manipulate and abuse. Whether an opioid is abuse-deterrent or not hasn't prevented tens of thousands of people who have had their wisdom teeth extracted or experienced lower back pain from getting addicted to these painkillers. By refusing to convene advisory committees to reform all of its opioid approval decisions, the FDA continues to ignore outside experts who could help stem the tide of tragic deaths and overdoses plaguing this country. This all started back with the FDA's 1995 approval of the original OxyContin--the moment in history that is widely recognized as the starting point for the prescription opioid and heroin overdose epidemic in the United States. It started with the FDA. The FDA approved the original version of OxyContin--an extended-release opioid--believing that it ``would result in less abuse potential, since the drug would be absorbed slowly and there would not be an immediate `rush' or high that would promote abuse.'' Since then, the claims that opioid is abuse- deterrent have time and again proven oxymoronic. FDA's own guidelines recognize the inherent contradiction in the term ``abuse-deterrent,'' explaining: It should be noted that [abuse-deterrent] technologies have not yet been proven successful at deterring the most common form of abuse--swallowing a number of intact capsules or tablets to achieve a feeling of euphoria. Moreover, the fact that a product has abuse-deterrent properties does not mean there is no risk of abuse. That is from the FDA's own guidelines. In many cases, the FDA approved so-called abuse-deterrent opioids despite warnings from the medical community about the potential for abuse. And when it wasn't turning a blind eye to the warnings of experts, the FDA simply didn't engage them at all in approval of opioids with abuse-deterrent properties. With numerous approvals of so- called abuse-deterrent opioids since 2010, the agency convened advisory committees for less than half of them. This issue of abuse deterrence is not a hypothetical concern. The new policy announced by the FDA would not have guaranteed an advisory panel for the OxyContin that is on the market today and being sold in tens of millions of doses or for the other recently approved opioids that have raised serious concerns from public health and medical experts from around our country. The FDA is attempting to set up a system where nothing really changes. We will not solve the prescription drug crisis with an FDA that operates with business as usual and continues to turn its back to external experts. The FDA needs to welcome outside expert advice and must convene expert advisory panels for all opioid approval decisions, period. Until the FDA makes that commitment, I am going to continue to raise my voice in opposition to the nomination of Dr. Califf. This is an issue that is central in our country. The terrorist phone call that families in America are afraid of getting is not one from overseas; it is that a member of their family has fallen victim to this prescription drug opioid crisis. It is in every city, every town in our country. We have seen a quadrupling of the number of heroin deaths in our country in the last 13 years, and 80 percent of them started with OxyContin, with Percocet, with one of these prescription drugs. We need the FDA to do the right thing, and until they do, we need to debate out here on the floor what the responsibilities will be of this new FDA Commissioner, because they have been unwilling to change their policy. Until they do, these people and communities all across our country are going to be helpless. They are going to be helpless because families think that if a bottle is given to them by an expert, they can trust it. And when their children die--when their children die--they ask themselves the question: Could I have done more? It starts with the FDA. It starts with MEA, mandatory education for physicians. It starts there. If we don't do this, then those families are still going to be having the same result year after year after year. I thank the majority leader for sitting and hearing my objections. The majority leader and I have had many conversations about this subject, and I know of his deep concern on this issue. I think this is something that can be corrected. I hope it can be corrected. It must be corrected. I thank the majority leader for staying to hear my presentation. I yield the floor.

Mr. MARKEY

Mr. MARKEY. Mr. President, let me begin by thanking the chairman of the Foreign Relations Committee, the gentleman from Tennessee, for the focus he has brought to these issues of nuclear proliferation and for his great service to our country, having all of our people understand the threats that can come from Iran, from North Korea, and from other places across our planet. It is the ultimate issue. If we get it wrong, the consequences will be catastrophic. So I thank the chairman for continuing to have the hearings and continuing to develop legislation that focuses our people on this issue. We are the global leader. We have to set the example for the rest of the world to follow. I thank him for his great leadership on these issues. The sanctions in this bill represent a firm response to North Korea's latest nuclear test on January 6 and to its launch of a long-range rocket last weekend. These brazen actions remind us of the serious threat Pyongyang poses to global and regional security and underscore the urgency of ending North Korea's nuclear and missile programs. Together with our international partners, we must be vigilant against North Korea's development of boosted nuclear bombs which would allow Kim Jong Un's regime to shrink its weapons and load them onto missiles. And we must unequivocally convey to North Korea that any proliferation of nuclear technologies to other countries will lead to the gravest of consequences. North Korea's nuclear and missile programs violate numerous U.N. Security Council resolutions. Those include Resolution 2094, which required North Korea to abandon ``all nuclear weapons and existing nuclear programs'' and imposed sanctions to pressure Kim to return to disarmament negotiations. These measures have not yet persuaded Kim to abandon his nuclear ambitions, in part because major gaps remain in the sanctions regime, particularly its enforcement by China. In 2009 the Security Council imposed a conventional arms embargo on North Korea, but China insisted on a loophole allowing North Korea to import ``small arms and light weapons.'' North Korea has exploited this loophole to continue its lucrative international trade in conventional arms. According to the U.N.'s own council of experts on North Korea, this trade remains ``one of the country's most profitable revenue sources.'' North Korea is especially well known for purchasing light weapons from China, which it then sells to other countries for cash. Although North Korea's arms exports violate U.N. sanctions, the Chinese companies that sell the arms in the first place get off scot- free. The involvement of Chinese companies in North Korean arms smuggling is part of a larger pattern of China's lax enforcement of nonproliferation sanctions against North Korea. As Assistant Secretary of State Tom Countryman acknowledged in a Foreign Relations Committee hearing last May and again in December, Chinese entities continue to sell technologies to North Korea that could assist in its development of nuclear-capable ballistic missiles. China's efforts to clamp down on these activities remain feeble at best. If the United States is to continue to provide extensive assistance to China's nuclear power industry, China must in return crack down on those who enable North Korea's nuclear provocations and its weapons- smuggling networks. The United States must also take action on our own. That is why I worked to include an amendment in this bill that will impose sanctions on anyone who facilitates North Korea's arms trade, including Chinese corporations. My provision will further reduce North Korea's access to revenue, undermine its international arms smuggling, and put pressure on Kim to return to negotiations. We must also put financial pressure on North Korea by designating the country as a ``primary money laundering concern.'' This would allow the Treasury Department to exclude North Korea from using the dollar-based financial system. The use of this designation in 2005 against the Banco Delta Asia in Macao disrupted North Korea's access to revenue and led one North Korean negotiator to admit that ``you finally found a way to hurt us.'' North Korea is one of the leading counterfeiters of U.S. currency. It uses front companies to hide its illicit earnings from trade in narcotics, weapons, and proliferation technologies. Although the Treasury has designated 18 financial institutions and 4 countries-- including Iran--as primary money laundering concerns, it has never designated North Korea. For this reason, I filed an amendment in the Foreign Relations Committee--which I will work to include in the final version of this bill--that would require the Treasury Secretary to determine on an annual basis whether North Korea is a primary money laundering concern and to provide Congress with information about that determination, as well as any financial restrictions that result from it. Just as we protect the international financial system from North Korea's counterfeit currency and money laundering, we must protect American investors who may unknowingly invest their money in companies that do business with North Korea. The prospect of American companies investing in North Korea is quite real. One American company, Firebird Management, has publicly declared its intention to invest in North Korea's oil industry. That is why I introduced another amendment in committee that would require companies that issue securities in the United States to annually disclose any investments in North Korea to the Securities and Exchange Commission. This requirement would not impose any regulatory burden on companies that do not invest in North Korea, but those companies that do should have that information made public because the American people deserve to know which American companies are investing in North Korea. Again, I hope to strengthen this bill down the line by incorporating that requirement. We know that sanctions are not an end in and of themselves; rather, they are meant to pressure the Kim regime to return to disarmament negotiations. But at the same time, as we pursue that critical goal, we must work to reduce the risk that North Korea will use its nuclear weapon, whether deliberately or through miscalculation. First and foremost, we must make clear to Kim that his regime will not survive any use of nuclear weapons. We must also reduce the risk of Kim lashing out in desperation. If he comes to believe that we intend to destroy his nuclear weapons in a preventive war, he will face pressure to ``use them or lose them.'' Thus, even as we work to deter Kim, we must establish a means of communicating during crises to avoid the risk of accidental nuclear war. Ensuring deescalation at the same time as we pursue deterrence and denuclearization will not be easy. Nevertheless, given the devastating consequences of nuclear war, it is critical that we take a comprehensive approach. Without additional sanctions, Kim will never disarm, but without a means of controlling escalation, we could one day wake up to a nuclear disaster that no one wants and everyone would lament. We should work on a continuous basis to make sure that--in the same way the Soviet President and the President of the United States were able to communicate to reduce the likelihood that we would have an accidental nuclear war, we have to make sure we have done everything in our power to accomplish the same goal with the North Korean Government, whether we like them or not. I want to compliment the chairman, the Senator from Colorado, and the Senator from New Jersey for their great work on this legislation. It is going to be a long struggle to ultimately deal with that regime. I think we will have to return to it over and over again, but I think, as we are going forward, it is critical--through the Chinese or through others--to make sure we have maximum communication. We could have an accidental nuclear war. It could happen. We have to make sure that is avoided. Mr. President, I yield the floor.

Mr. MARKEY

Mr. MARKEY. Mr. President, I ask unanimous consent that Gene Gerzhoy, a fellow working in my office, have full privileges during this session of the 114th Congress.

Mr. MARKEY

Mr. MARKEY. Mr. President, I want to thank Senator Cantwell for her tireless work on this Energy bill and for her help in improving the biomass amendment that the Senate adopted last night. Biomass energy is already contributing to the U.S. energy mix in ways that help reduce carbon pollution that causes global warming. There are great examples of electricity generation coming from wood residues like at the Fort Drum Army installation in New York and the Gainesville Renewable Energy Center in Florida. Both of these projects have included efforts to ensure that their biomass material promotes land stewardship and responsible forestry practices. Projects like these are generating biomass electricity, jobs, and economic value in their local communities. These are the type of projects that we need to encourage to meet the climate change challenge. But not all biomass energy is created equal. I understand the amendment's intent to support biomass energy that is determined to be carbon neutral. I appreciate the modifications made to the amendment to ensure that U.S. bioenergy policy is not encouraging conversion of forest lands to non-forest uses. This protection is important to acknowledge. But it is also important to acknowledge that the timeframe for any climate benefits from biomass energy can vary. In many instances that timeframe can be very long--on the order of 50 to 100 years. Some practices like clear-cutting forests and burning whole trees for energy should never be considered carbon neutral. That is why it is critical to incorporate what science tells us about forests and their interaction with the global carbon cycle into policies governing biomass energy. EPA has a scientific advisory board working on this issue of bioenergy carbon accounting right now. They will have a meeting in April to hear from stakeholders about their experience in using biomass to reduce carbon pollution. The results of the advisory board's work will be crucial to inform policy across agencies. It is important to have agencies working together on cross-cutting issues like this one. But efforts to make policies more consistent across Federal agencies shouldn't interfere with individual agency's statutory responsibilities. The amendment should not be interpreted as enabling one agency to block another agency's rulemaking or guidance. I want to thank Senators Collins, Klobuchar, King, and the other co- sponsors of the amendment for working with other concerned Senators like myself on modifications to improve the amendment. I look forward to continuing working with them to ensure that the United States has a smart, sustainable, and scientifically backed policy for biomass energy.

Mr. MARKEY

Mr. MARKEY. Madam President, I ask unanimous consent to speak for up to 10 minutes.

Mr. MARKEY

Mr. MARKEY. Madam President, I am here to talk about a public health epidemic that kills more people in the United States every year than gun violence or motor vehicle accidents. Last year, drug overdoses killed nearly 50,000 Americans. Almost 60 percent of those overdoses were caused by prescription opioids or heroin. Drug overdoses are increasing the death rate of young adults in the United States to levels not experienced since the AIDS epidemic, more than 20 years ago. These skyrocketing death rates make them the first generation since the time of the Vietnam war to experience higher death rates in early adulthood than the generation that preceded them. So we ask ourselves: What specifically is causing this tidal wave of addiction and overdoses? Well, the answer is clear. Over the last 10 years, the Drug Enforcement Agency has increased the amount of oxycodone it has approved for manufacturing by 150 percent. For 2016, the DEA has told Big Pharma it is OK to make nearly 1.4 million grams of oxy. That is enough for almost 15 billion 10-milligram pills. Let me say that again: That is enough for almost 15 billion 10- milligram pills to be sold in America this year. That is a full bottle of potent painkillers for every man, woman, and child in the United States of America for 2016. This tsunami of opioid addiction is swallowing families as quickly as Big Pharma wants Americans to swallow its pills. Yet, despite this raging epidemic, you would think the Food and Drug Administration, the agency responsible for the safety of all prescription drugs in the United States, would welcome every bit of expert advice it can get from doctors and other public health professionals. In fact, the FDA's own rules call for it to establish an independent advisory committee of experts to assist the agency when it considers a question that is controversial or of great public interest, such as whether to allow a new addictive prescription painkiller to be marketed in the United States. Instead, the FDA has put up a sign in its window: ``No Help Wanted.'' The FDA began turning its back on advisory committees in 2013 when an expert panel established to review the powerful new opioid painkiller Zohydro voted 11 to 2 against recommending its approval, but the FDA approved the drug anyway, overruling the concerns voiced by experienced physicians on the panel. Those experts criticized the agency for ignoring this incredible growing epidemic. The advisory panel warned that this Oxycontin epidemic--this heavily abused prescription painkiller that the FDA first approved back in 1995--needed a new test for safety. They warned about the growing dangers of addiction, abuse, and dependence associated with the entire class of opioid painkillers. Justifiably, the FDA was lambasted for its decision to approve Zohydro by public health experts, doctors, Governors, and Members of Congress. But despite the warning of real-world dangers of abuse and dependence on these new supercharged opioid painkillers, the FDA willfully blinded itself to warning signs. In 2014, in the wake of the Zohydro decision, the FDA twice skipped the advisory committee process altogether when it approved the new prescription opioids Targiniq and Hysingla. Then, in August 2015, the FDA did it again. This time it bypassed an advisory committee on the question of a new use for Oxycontin for children aged 11 to 16. This time the FDA even ignored its own rules that specifically called for an advisory committee when a question of pediatric dosing is involved. In other words, there is a special category when children are involved that calls for advisory committees, and the FDA ignored that. At this point it became clear that the FDA was intentionally choosing to forgo an advisory committee in order to avoid another overwhelming vote recommending against approval of a prescription opioid. Why? Because the FDA would then have had to ignore yet another group of experts in order to continue its relentless march to put more drugs into the marketplace. With the Oxycontin-for-kids decision, the FDA's reckless attitude toward expert advice on drug safety went too far. Children whose brains are not yet fully developed are especially vulnerable to drug dependency and abuse. Yet the agency focused its so-called safety analysis only on concerns about proper dosing, saying that it needed only to tell doctors the proper doses for children who needed the drug. Well, that is just plain wrong. We use experts to determine if child car seats are safe, if toothpaste is safe, and if vaccines are safe. We should use experts to determine if the opioid painkillers are safe for our families. We need to immediately reform the Food and Drug Administration opioid approval process if we want to stop this epidemic of prescription drug and heroin addiction. Last week I placed a hold on the nomination of Dr. Robert Califf to head the FDA. Before I can support this nomination, the FDA must make three needed changes to its opioid approval process. First, the FDA needs to make sure that every opioid approval question is reviewed by an external panel of experts. Second, the FDA needs to consider addiction, abuse, and dependence as part of its determination of whether an opioid is safe. The FDA cannot continue to operate as if safety just means dosage, when it should include all of the dangers, as well, of these painkillers. And third, the FDA should rescind its decision on Oxycontin for kids and then convene an advisory panel, as it should have done in the first place. Then the FDA can consider the Oxycontin-for-kids decision with the benefit of that panel's independent advice and with the proper meaning of safety in mind. The FDA must commit to shift the way it approaches and evaluates addiction before I can consider supporting Dr. Califf's nomination. The prescription drug and heroin epidemic knows no geographic boundaries, and our response should know no political boundary. That is why Majority Leader Mitch McConnell and I worked together to identify solutions to this crisis. Last spring, Senator McConnell and I joined together in calling for a Surgeon General's report on the opioid crisis. Last fall, Surgeon General Vivek Murthy announced that he will be issuing a new report on the substance abuse crisis this year. Fifty years ago, there was a historic report on smoking that changed the way our country viewed that. This is the same kind of report that we need from our Surgeon General for our country to see, but that is just the first step in a larger comprehensive national strategy that I am fighting for this year. We need to stop the overprescription of pain medication that is leading to heroin addiction and fueling this crisis. That starts with the prescribers. We need to ensure that all prescribers of opioid painkillers are educated about the dangers of addiction and appropriate and responsible prescribing practices. I have a bill that requires every prescriber of opioid pain medication in this country, as a condition of receiving their DEA prescribing license, to be trained in the best practices of using pain medications and methods to identify and manage an opioid-use disorder. Stopping overprescription also includes narrowing the pipeline at the front end.

Mr. MARKEY. Mr. President, I ask unanimous consent to continue for 2 additional minutes.

Mr. MARKEY. Mr. President, this means that the DEA needs to reduce the quotas of oxycodone and hydrocodone that it approves for manufacture each year. The DEA is allowing Big Pharma to manufacture too many of these pain pills. Although the United States is less than 5 percent of the world's population, Americans consume 80 percent of the global supply of opioid painkillers and 99 percent of the world's supply of hydrocodone, the active ingredient in Vicodin. Tragically, we have become the ``United States of oxy.'' With the opioid epidemic reaching epic proportions, our Federal budget should reflect the magnitude and importance of investing in treatment and recovery services. In Massachusetts, approximately 65,000 people are currently dependent on opioids. Some 50,000 need treatment but are not receiving it. Treatment for prescription drug and heroin addiction is absolutely at the top of the list of the things this Congress should deal with, and that is why we need to work together. We need to make sure that the treatment is there for each of these patients, and that includes ensuring that patients receive from a physician the help they may need from Suboxone. Right now, that is denied to many different patients. I have been in Congress for 39 years. I have never actually seen an issue like this that has grown so quickly and affects so many families in our country. Not a day goes by in the State of Massachusetts where someone doesn't come up to me and talk to me about a family member who has been affected by this epidemic. It is time for us to join together in a bipartisan fashion to produce the kind of legislation to give hope to families and let them know that relief is on the way, and that prevention and treatment will be there to help their families deal with this crisis. I hope we can accomplish that goal this year, and I believe we can do it on a bipartisan basis. I yield back the remainder of my time with thanks to the Senator from Alaska for her indulgence.

Mr. MARKEY

Mr. MARKEY. Mr. President, I want to take a moment to acknowledge the life of Massachusetts' Christa McAuliffe. She lost her life, along with six other crewmembers, 30 years ago today when the space shuttle Challenger exploded. She was an extraordinary teacher and was selected out of a pool of 11,000 applicants to lead the ultimate field trip as the first teacher in space. Her legacy lives on in many ways but especially at the Christa McAuliffe Center for Education and Teaching Excellence at her alma mater, Framingham State University. Amendment No. 2982 Mr. President, the omnibus spending bill that was enacted into law in December lifted the 40-year-old restriction on exporting U.S. oil overseas. During that debate, concerns were raised regarding the impact that exporting American oil abroad could have on U.S. consumers and refining fuel prices, independent refineries, and other sectors of the U.S. economy, such as shipbuilding. However, the final language that became law did not include any requirement for analyzing and reporting on any potential impacts that exports could have on the industry or on U.S. consumers. The Markey amendment No. 2982 to the Energy bill would create such a review. The amendment would require the GAO to review and report back annually for 3 years on the impacts of crude oil exports on U.S. consumers, independent refineries, shipbuilders, and energy production. The language of my amendment is language that is bipartisan. The language of my amendment is identical to language included in legislation sponsored by Chairman Murkowski. It is also identical to language included in legislation introduced by other Senators. Exporting American crude oil could be a disaster for independent refineries in regions such as the east coast. Upwards of 55 percent of our refining capacity on the east coast could potentially close as a result of oil exports. The Energy Department has said that exports could lead to as much as $9 billion less investment and 1.6 million barrels less refining capacity in 10 years. It could lead to up to $200 billion less revenue for the U.S. refining sector over the next decade. It could raise prices for consumers, who are currently saving $700 a year at the pump and $500 a year on home heating oil this winter because of low prices. It could harm U.S. shipbuilders. We have been having a shipbuilding renaissance in this country. We are currently seeing the biggest shipbuilding boom in 20 years, and it has been because of our increasing oil production and the Jones Act, which requires shipments between U.S. ports to be on U.S.-built, U.S.-flagged, and U.S.-crewed ships. This means that producing more oil is leading to investment in U.S.-built ships to move that oil around the country. Right now, U.S. shipbuilders have orders to expand our domestic tanker fleet capable of transporting crude oil by 40 percent. Each oil tanker can represent an investment of $100 to $200 million. Five years ago there were zero orders. Now one company alone in Pennsylvania--Aker ASA--has nearly $1 billion in back orders and has tripled employment over the last 3 years. Exports could stop all of this in its tracks, so that GAO report is very important. I also want to compliment Chairman Murkowski and Ranking Member Cantwell for their excellent work in partnering to produce the legislation which we are considering here on the floor. It represents bipartisanship in the way it is meant to operate. Toward that goal, I have an amendment that I am going to speak to right now, which is one that Senator Cassidy from Louisiana and I have introduced. It is an amendment to improve the way we are going to be selling oil from the Strategic Petroleum Reserve. Our Nation's oil stockpile is supposed to be there to protect American consumers and our security in the event of an emergency. We should not be using it as a piggy bank to pay for other priorities. But if we are going to sell oil from the Strategic Petroleum Reserve, we should at least make sure that we do so strategically, to get the best deal for taxpayers and American consumers. Last year, Senator Cassidy and I offered a nearly identical amendment to the Transportation bill, which was adopted on the Senate floor and ultimately became law. That amendment protects taxpayers by improving the way the sales required under the bill--sales of oil from the Strategic Petroleum Reserve--are, in fact, conducted. The Cassidy- Markey fix gives the Secretary of Energy more flexibility to sell oil when prices are high and directs the Department to stop selling oil when the revenue targets required by the bill are reached. This fix should allow us to sell fewer overall barrels from the Strategic Petroleum Reserve and get a better return on those sales. However, the roughly $5 million worth of SPRO that was required to be sold as part of the Budget Act that passed in November did not include this commonsense fix. The current Cassidy-Markey amendment that is pending to the Energy bill contains language virtually identical to the amendment to the Transportation bill that was adopted on the Senate floor. It would apply the same fix to the sales required by the Budget Act in order to protect taxpayers. Too often our policy with respect to SPRO has been to buy high and sell low. Taxpayers have paid an inflation-adjusted average of roughly $75 a barrel for the oil that is in our Nation's stockpile. We should ensure that we get the best return for our taxpayers in those SPRO sales. That is what our amendment would do. I yield the floor.