Senator Kelly Ayotte Promotes Unconstitutional CARA

Trying to find something in the news these days that does not relate to the comedic kitsch the 2016 presidential nomination campaigns have become proves to be challenging.  The media can’t get enough of the back and forth insults between the Republican candidates and the scandal-ridden Clinton campaign trying to outshine Sanders.  In between the pages, garnering little notice, one finds Sen. Kelly Ayotte (R-NH) promoting the Comprehensive Addiction and Recovery Act or S. 564.   Known by its acronym CARA, the bill seeks to “authorize the Attorney General to award grants to address the national epidemics of prescription opioid abuse and heroin use.”

In her GOP address, Sen. Ayotte stated this bill was a “‘significant step forward, in the federal government’s response to the nation’s opioid epidemic.”  Ayotte, as a major sponsor of the bill, used her state of New Hampshire to justify this piece of legislation.  This legislation was introduced a couple of years ago, with Ayotte’s assistance, but did not pass.

“For the past few years, I’ve been working to bring attention to the heroin and prescription opioid abuse epidemic that is impacting my state and communities nationwide.  CARA will be a significant step forward in the federal response to this epidemic and will support local efforts to tackle this problem.”

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The pending legislation provides additional support to first responders and law enforcement officials, including expanding availability of the drug overdose reversal tool, Narcan, said Ayotte. Further, it will strengthen prescription drug monitoring programs that help prevent doctor shopping and expand drug take-back sites promoting safe disposal of unused or unwanted prescription drugs.

The law would also increase access to addiction treatment, expand prevention and education efforts, and bring awareness to the connection between prescription painkillers and heroin use, said Ayotte, noting that the legislation has strong support from several law enforcement agencies and more than 130 stakeholder groups.

Ayotte maintains, “This is a life and death issue.  In 2015, four hundred twenty New Hampshire residents lost their lives to a drug overdose —  more than the number of people killed in traffic accidents.  In February alone, there were 14 suspected opioid overdose deaths in Manchester – a record high in our state’s largest city.”  She insists there are similar trends in the States of West Virginia, Ohio and across the nation;  “Behind every statistic and behind every headline is a life that has been lost.”

Ayotte stated in her address that CARA has strong support from law enforcement agencies.  Agencies supporting the bill include the National Fraternal Order of Police, the Major County Sheriff’s Association, the New England Association of Chiefs of Police and the New Hampshire Police chiefs.

The findings of Congress in concocting this bill are found in the first 17 points of the italicized print, which replaces the strike out text.

Let’s look at number 2 on the list.

According to the National Institute on Drug Abuse (commonly known as NIDA), the number of prescriptions for opioids increased from approximately 76,000,000 in 1991 to nearly 207,000,000 in 2013, and the United States is the biggest consumer of opioids globally, accounting for almost 100 percent of the world total for hydrocodone and 81 percent for oxycodone.

This statistic counts for all prescriptions written in the United States for opioids, which includes prescriptions for individuals with cancer, chronic pain conditions, non-operable pain conditions, acute pain conditions and post-surgical patients.  Considering the aging population, the increase in cancer rates of 55% by the year 2030, and the fact that approximately 100 million Americans currently experience chronic pain, it is no surprise that the number of prescriptions written for opioid pain medication is increasing.  Chronic pain conditions affect older adults more than younger adults.  The more common complaints of chronic pain are headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the nerves, mainly peripheral – arms and legs – or central nervous system – brain and spinal cord).  There are also incidences of idiopathic chronic pain conditions as a result of surgery or other procedures that cannot be adequately diagnosed as to cause.

With the number of cancer patients in the United States at approximately 11.9 million individuals coupled with the 100 million Americans suffering chronic pain, some individuals, depending on diagnosis, may receive more than one prescription for opioid analgesics.   A patient may have an opioid analgesic that is long lasting in nature as well as a short acting opioid for use intermittently to supplement breakthrough pain.

Looking at the “findings” numbers 3,4,5 and 6, opioid analgesics are the most misused and abused controlled substance and involved in most overdose incidents from nonmedical usage.  Heroin use has spiked sharply and the supply of cheap heroin increased dramatically due to “activity of Mexican drug trafficking organizations.”  Law enforcement officials and treatment experts determined many prescription opioid analgesic users have turned to heroin “as a cheaper and more easily obtained” alternative.

Reading the remainder of the “bill” reads like a Chinese puzzle.  The one question Americans should ask Congress is “Where in the Constitution does it enumerate the power to combat substance abuse, substance abuse disorders, or substance abuse disorders as a result of mental disorder?”  The next question is “Where in the Constitution is Congress authorized to spend federal funds on an undertaking of this nature?”   There is no authorization for Congress to intervene or appropriate funds for grants to address this issue.  This issue is best addressed at the personal level with the family and physician.

Title VI provides incentives to the States for initiatives to address opioid and heroin abuse.  Under this section, dispensers and prescribers of opioid analgesics will register in the drug monitoring program initiated by the state, consult the monitoring program before dispensing/prescribing an opioid so the state may notify these entities “when overuse or abuse of such controlled substances by patients is suspected.”  One does not have to abuse or overuse an opioid to be on the list.  The state would only have to suspect one of the abuse or overuse.

Where in the Constitution of the united States does it declare the federal government could entice the State to exert dominion over anyone’s medical care?  It doesn’t.

While Ayotte and the congressional sponsors of this bill cite the increase of heroin in the nation due to Mexican drug trafficking, where are they on securing the southern border to stop the “free flow” of who knows who is crossing and with who knows what in their possession?  Instead of spending money and exerting control unconstitutionally over another aspect of Americans, these control freaks need to concentrate on performing their duty outlined in the enumerated powers and spending funds only on powers granted to the legislative body by the Constitution.  Since heroin is so readily available, close the barn door before the horse gets out.  Stop it at the border by enforcing immigration law, securing the border and building a wall, fence or other barrier.

This piece of legislation is a potential for disaster for many individual suffering chronic pain conditions who utilize their prescription opioid analgesics as their physician has prescribed.  It can also decrease the number of physicians who manage patients with chronic pain conditions due to the added burden of “clerical” duties leaving many patients without the needed care.  One wonders if this isn’t the plan as well as funneling more into “behavioral therapy” to gain another back door to implement gun control and gun confiscation.

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