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House Passes Bill to Address Fentanyl Overdoses— But critics say the HALT Fentanyl Act is the wrong way to approach the problem

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Abigail Nobel
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Increasing penalties for fentanyl, and classifying them as Schedule I. That class is defined as drugs with no current medical use with high potential for abuse and/or addiction."The ultimate impact of this bill is taking fentanyl permanently away from pain and surgery patients.

What could possibly go wrong?

by Joyce Frieden, Washington Editor, MedPage Today 

 

 A photo of bags of fentanyl seized by customs officials.

The House passed a bill Thursday that proponents say is designed to reduce the number of people who become addicted to fentanyl, but opponents say it won't solve the problem and will just increase the number of people incarcerated for drug-related crimes.

The Halt All Lethal Trafficking of Fentanyl (HALT Fentanyl) Act passed by a vote of 289-133, with 215 Republicans and 74 Democrats voting in favor. The measure would:

  • Permanently put fentanyl-related substances into Schedule I of the Controlled Substances Act. Currently, fentanyl is on Schedule I through Dec. 31, 2024, thanks to a temporary scheduling order issued by the Drug Enforcement Administration (DEA).
  • Establish a new, alternative registration process for Schedule I research that is funded by HHS or the Department of Veterans Affairs or that is conducted under an investigative new drug exemption from the FDA.
  • Clarify that offenses involving fentanyl-related substances are triggered by the same quantity thresholds and subject to the same penalties as offenses involving fentanyl analogues. For example, offenses involving 100 g or more of a fentanyl-related substance will trigger a 10-year mandatory minimum prison term.

The bill also makes several other changes to registration requirements for conducting research with controlled substances, including permitting a single registration for related research sites in certain situations, and waiving the requirement for a new inspection in some cases.

"With today's bipartisan vote in the House to advance the HALT Fentanyl Act, we are one step closer to curbing the devastating fentanyl poisoning crisis and saving American lives," Rep. Bob Latta (R-Ohio) said in a statement. "Illicit fentanyl is now the leading cause of death for people in the United States aged 18 to 49 ... This permanent labeling change is significant and needed because it will help get fentanyl-related substances off our streets and out of our communities. I now urge the Senate to take up this bill and send it to the president's desk to be signed into law."

House Speaker Kevin McCarthy (R-Calif.) applauded the bill's law enforcement provisions. "Due to the Biden administration's incompetence at the border, fentanyl has flowed into American communities and destroyed lives," he said in a statement. "The HALT Fentanyl Act is one needed tool to help stop the flow of fentanyl and provides law enforcement agencies the authority they need to help them adequately address this crime."

The Biden administration also praised the bill, specifically the permanent scheduling provision and a provision to make fentanyl research easier. "These two provisions are critical components of the Biden-Harris Administration's 2021 recommendations to Congress to combat the supply of illicit FRS [fentanyl-related substances] and save lives," the White House said in a statement. "The administration calls on Congress to pass all of these critical measures to improve public safety."

But others were not so happy. Despite multiple extensions of the Schedule I designation, "overdoses have not gone down, and we have unfortunately [not] made a dent in the incidence of opioid use disorders," Rep. Frank Pallone, Jr. (D-N.J.), ranking member of the House Energy & Commerce Committee, said on the House floor.

"Fentanyl and synthetic opioids continue to flood into the country. In testimony before our committee, the DEA administrator noted that DEA seized more than 50 million fake pills and 10,000 pounds of fentanyl in 2022 ... The HALT Fentanyl Act is a partisan distraction from the hard, bipartisan work that actually has to be done to address a long standing, intractable problem that faces our communities," he said.

"We simply cannot incarcerate our way out of a public health crisis," Pallone said. "The HALT Fentanyl Act does not provide any resources for research, prevention, treatment, recovery, or harm reduction. It also does not provide law enforcement or public health agencies with any additional resources to detect and intercept illicit drugs entering the country."

Several advocacy groups agreed. "Passage of the HALT Fentanyl Act and the draconian expansion of mandatory minimum sentencing for fentanyl-related substances contained in it would be a reckless repetition of the costly mistakes of the war on drugs that disproportionately impacts Black and Brown communities and creates the conditions for even more harmful illicit substances to enter the drug supply," Drew Gibson, director of advocacy for AIDS United, said in a statement.

"Any hope that we have of ending the overdose, HIV, and viral hepatitis epidemics in the United States lies in an embrace of evidence-based best practices and a rejection of the punitive and racially inequitable policies that have destroyed millions of lives over the last half-century," Gibson added.

"In passing the HALT Fentanyl Act, the House seems intent on doubling down on the same failed strategies that got us here to begin with," Maritza Perez Medina, director of the Office of Federal Affairs at the Drug Policy Alliance, said in a statement. "Increasing criminal penalties and expanding the use of mandatory minimums, as this bill does, has never reduced the supply or demand of illicit drugs. Instead, it only exacerbates racial disparities in the criminal legal system and creates the conditions for an even more unknown, and more potent, drug supply to flourish."

AIDS United, the Drug Policy Alliance, and other organizations are supporting the Support, Treatment, and Overdoses Prevention of Fentanyl Overdoses (STOP Fentanyl Overdoses) Act sponsored by Rep. Annie Kuster (D-N.H.). That bill would expand testing for fentanyl and related substances; increase information-sharing by public health departments and law enforcement in order to identify public health threats and prevent overdoses; and improve access to overdose reversal medications and substance use disorder treatment.

On the other side of the Capitol, the Senate version of the HALT Fentanyl Act was introduced by Sen. Bill Cassidy (R-La.) on March 30. It has been referred to the Senate Judiciary Committee but no other action has been taken on it. 

https://www.medpagetoday.com/washington-watch/washington-watch/104730

 

And not a word about the border.

 

Joyce Frieden oversees MedPage Today’s Washington coverage, including stories about Congress, the White House, the Supreme Court, healthcare trade associations, and federal agencies. She has 35 years of experience covering health policy.



   
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Abigail Nobel
(@mhf)
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Michigan testimony on border concerns did contribute to this bill.

The Detroit News in February highlighted Rebecca Kiessling. New Detroit Congressman Shri Thanadar gets a line at the end.

https://www.detroitnews.com/story/news/local/oakland-county/2023/02/28/southern-border-crisis-michigan-mother-rebecca-kiessling-testifies-sons-fentanyl-overdose-deaths/69953671007/

'You're not protecting our children': Rochester Hills mom testifies about 2 sons' fentanyl deaths

Feb. 28, 2023

Washington― A Michigan mother tearfully told House lawmakers the story Tuesday of her two sons' deaths from an accidental overdose of the opioid fentanyl, saying the government isn't doing enough to combat the opioid crisis and halt illegal drugs at the border.

"My children were taken away from me," saidRebecca Kiessling, a family law attorney and conservative activist from Rochester Hills.

"This should not be politicized. It's not about race. Fentanyl doesn't care about race. You talk about welcoming those crossing our border seeking protection? You're welcoming drug dealers across our border. You're giving them protection. You're not protecting our children."

Kiessling said her two sons, Caleb, 20, and Kyler, 18, died July 29, 2020, from fentanyl poisoning, along with 17-year-old Sophia Harris, when they took what they thought were Percocet pills that turned out to contain the drug fentanyl, a potent synthetic opioid drug that can be lethal in tiny amounts.

She said her sons' "dealer" was saved by a dose of the overdose-reversing spray Narcan and is serving prison time. Lorenzo Brabo was sentenced in 2021 to eight to 15 years in prison for providing the fentanyl that led to the three overdose deaths, according to reports.

"I don't use the term 'drug overdose' because this was not an overdose. This was murder," she said. "This is a war. Act like it. Do something."

Kiessling testified Tuesday morning before the Republican-led U.S. House Committee on Homeland Security, urging Congress and the White House to take the flow of illegal drugs over the Southern border more seriously. Prior to her sons' deaths, Kiessling said she didn't know what fentanyl was.

"I had heard of the opioid epidemic. I thought, you know, people are getting prescription drugs and getting addicted and then getting it on the streets, and that it affects their ability to work. I didn't know that people were dying," she said.

"I didn't know that my boys were taking anything that could kill them. They didn't think that they were either. They thought that they were safe with pills. ... But the government knew. The government's known for years and years."

Michigan experienced a 23% increase in opioid-related deaths from 1,768 in 2019 to 2,171 in 2020, when Kiessling's two sons died, according to state Department of Health and Human Services' statistics. The number rose to 2,539 deaths in 2021, a 17% jump. U.S. opioid-related deaths rose from 68,630 in 2020 to 80,411 in 2021, according to theNational Institute on Drug Abuse.

Kiessling highlighted the tally of drug-related deaths the year that Caleb was born — 20,000 in 2000 — and the surge of 100,000 like deaths in 2020.

"If we had Chinese troops lining up along our Southern border with weapons aimed at our people, with weapons of mass destruction aimed at our cities, you damn well know you would do something about it," she said.

"We have a weather balloon from China going across the country. Nobody died, and everybody's freaking out about it. But 100,000 die every year, and nothing's being done. Not enough is being done."

Kiessling started crying as she read from a paper written by Kyler weeks before his death, advising to "stay away from drugs and alcohol."

"It's not worth it," he wrote.

Kyler, who had graduated from high school the day before his death, also wrote in a list that he wanted to start working more to stay focused, have a better relationship with his parents, to report to all drug tests and "find another method to cope that works for me," according to his mother.

Caleb, Kiessling said, had started speaking in schools to encourage kids not to try drugs. He wrote a testimony to share with them, saying that he'd "dabbled" in drugs but had stayed away from crack and heroine because he'd grown up "watching my birth mother ruin her life and watch all her friends pass away from heroin overdoses."

Kiessling said later in the hearing that the boys' birth mother died six months after they did.

Lawmakers respond

Committee Chairman Mark Green, R-Tennessee, blamed the Biden administration for border policies that he said have contributed to the "surge" in migrants at the border, "and the drug cartels have taken advantage of the situation."

Kiessling's sons died in 2020, when Donald Trump was president and was trying to extend a wall across the Southern border.

The Biden administration has touted itsoverdose epidemic strategy, which has included spending $1.5 billion on grants for aid to treatment programs and law enforcement. The U.S. Department of the Treasury is using sanctions to target the global fentanyl supply chain, especially in Mexico, administration officials have said.

The Biden administration in February also proposed a rule that migrants seeking to enter the United States will be assumed inadmissible if they "circumvent available, established pathways to lawful migration," including entering the country between ports of entry or arriving at a port of entry without a scheduled appointment.The proposal also rejects those who fail to seek protection in countries through which they pass while heading to the United States.

Green asked Kiessling how her community has been affected by the opioid crisis. She replied that some parents and siblings whom she knows from support groups had committed suicide.

"It's devastating families," she said. "It's been very difficult for my (three) daughters. One daughter, she went off to Michigan State and came home after a semester. It was just too painful."

One of Kyler's friends approached her at a restaurant last summer and said he'd stopped doing any kind of drugs in response to his death, Kiessling said.

"He said, 'I want you to know that your son's death started a movement in our hometown, so that when people show up with pills, they're ostracized, and they're condemned,' he said," Kiessling recounted. "But, you know, for how long? How many of the kids in the high schools now know about my son's deaths?"

Rep. Marjorie Taylor Greene, R-Georgia, also lamented the surge in fentanyl deaths, saying it's become a top cause of death for Americans ages 18 to 45 years old.

"This is unforgivable," said Greene, thanking Kiessling for sharing her story and saying her sons' deaths "should never have happened."

Kiessling responded in part by criticizing witness testimony from the Cato Institute's David Bier, who suggested that policymakers should focus on demand and not supply to reduce drug deaths.

"What I'm hearing him saying is, 'They asked for it.' Seriously, are you kidding me?" Kiessling said. "We need to protect our children. They didn't ask for that. This wasn't demand that they wanted the fentanyl. They thought they were getting Percocet, OK?"

Rep. Donald Payne Jr., D-New Jersey, said most illegal drugs are smuggled through ports of entry into the United States "unfortunately" by U.S. citizens, and usually hidden in vehicles, cargo, or on a person in the hopes "it won't be detected."

Payne suggested lawmakers should focus on what policy changes can be made to allow personnel at ports of entry to focus on the interdiction of drugs.

It was the first full committee hearing for freshman Rep. Shri Thanedar, D-Detroit, a former businessman and Indian immigrant who spoke of the importance of the Northern border.

"Unfortunately, a shortage of pathways for immigration has made our borders very difficult to manage. CBP has had to rely on temporary duty assignments to surge employees where they are most needed, which has often pulled resources away from the northern border," Thanedar said. "As an immigrant myself, I'm a proud example of how immigrants contribute to American society."

 

Melissa Nann Burke covers Washington for The Detroit News, including Michigan's congressional delegation, the White House and U.S. Supreme Court.



   
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