Thursday, Sept. 26, 2013

WASHINGTON - Sen. Chuck Grassley of Iowa has written to two drug companies on behalf of an Iowa hospital that is not receiving required discounts on two drugs, despite a federal program to help uninsured patients with deeply discounted drugs.  Grassley is seeking information from the companies and also more oversight from the federal agency in charge of the drug program to ensure the companies provide the required discounts.

"The program is designed to help patients who have no means of receiving prescription drugs except through a hospital or community health center that agrees to treat them," Grassley said.  "The federal agency in charge of the program has to make sure the program is working.  That means making sure hospitals get the discounted drugs they're entitled to receive so they can treat patients in need."

Grassley wrote to CSL Behring, the maker of a drug called Kcentra, used as an antidote for blood thinner poisoning; and to Pacira Pharmaceuticals, the maker of a drug called Exparel, used in surgical closings, on behalf of an Iowa hospital that is having difficulty obtaining the required discounts on the drugs through the federal 340B program.  The constituent hospital, which prefers not to be named at this time, brought the concerns to Grassley's attention in July, and Grassley's staff has been working with the Health Resources Services Administration, which oversees the 340B program, and the constituent hospital since that time to resolve the problem.

Grassley, a long-time supporter of the 340B program to extend the Medicaid drug discount to the most vulnerable of patients at covered entities, has worked on his own and with other members to bring greater transparency and federal agency oversight to the program.  Over the past several years, he has written letters seeking information on uses of the program by both drug manufacturers and hospitals and other entities eligible for the drug discounts under the program.

The letters are available here and here.

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Senate Caucus on International Narcotics Control

Hearing on "Dangerous Synthetic Drugs"

Wednesday, September 25, 2013

Prepared Statement of

Co-Chairman Chuck Grassley of Iowa

Madam Chairman, it's been over two years since this caucus held its first hearing on synthetic drug abuse.  At that hearing, we heard testimony from a constituent of mine named Michael Rozga.  Mr. Rozga's son David committed suicide shortly after smoking "K2."  "K2" is synthetic marijuana that is very different from the naturally occurring plant.  David had legally purchased this synthetic drug at a local shopping mall.  He then had a very rapid and negative reaction to it.  I said then that David may have been the first person in the United States to die from using this kind of synthetic drug, but surely he wouldn't be the last.

Sadly, my concerns were validated, as the abuse of synthetic drugs continued to escalate.  From 2010 to 2011, the number of calls received by poison control centers related to synthetic marijuana increased from 2,906 to 6,959.  And similar calls about the synthetic drugs known as "bath salts" increased from 304 to 6,138.  Emergency room visits associated with these synthetic drugs rose sharply as well.

In 2012, Congress responded to this crisis.  I worked with you, Madam Chairman, as well as Senators Schumer, Klobuchar and many others, to pass the Synthetic Drug Abuse Prevention Act of 2012.  That legislation placed many of these synthetic drugs on Schedule I, making them illegal.  That was an important step to help protect our young people from the effects of these drugs.

There is some evidence that that legislation had a positive effect.  In 2012, calls to poison control centers related to synthetic marijuana dropped from 6,959 to 5,205.  Similar calls related to "bath salts" dropped from 6,138 to 2,657.

But new synthetic drugs have emerged since we passed that legislation.  Traffickers need only to alter the chemical structure of their drugs to effectively circumvent the law.  And these drugs continue to ruin lives in communities across the country.

In just the past few weeks, news reports have linked a synthetic form of ecstasy called "Molly" to the deaths of at least four young people in Boston, New York, and here in Washington.  What seems especially concerning is that authorities may not yet have a clear understanding of precisely what substances are contained in "Molly."  Regardless of its precise chemical makeup, there appears little doubt that "Molly" is a clear and present threat to the health and safety of our young people.

My home state of Iowa also continues to be affected by synthetic drugs.   On a single weekend last May, three teenagers in the Des Moines area were sent to emergency rooms after smoking synthetic marijuana.  One of them reportedly suffered cardiac arrest.

There is some good news, however.  In communities across the country, citizens are helping to sound the alarm about the dangers of synthetic drugs.

The Rozga family continues to share David's story.  They have also started a website, K2drugfacts.com, which provides a forum for folks who've survived encounters with synthetic drugs to share their stories.

A community group called "Iowans Against Synthetics" has successfully pushed to have this week declared "Synthetic Drugs Awareness Week" in Johnson County, Iowa.

The Iowa Governor's Office of Drug Control Policy has also taken steps to raise awareness about emerging drug trends such as synthetics.  Beginning this month, the office is issuing a monthly newsletter called The Connection. The newsletter will publish the latest news about new drugs in Iowa and trends among young people.

But despite these positive actions, synthetic drug manufacturers still have the ability to circumvent the law by slightly altering their chemical compounds.  A change of a molecule or two to a banned drug is sometimes enough to make a new and legal alternative.  This is a difficult problem without an easy solution.  But I look forward to hearing from the witnesses and working with you, Madam Chairman, to explore how we can continue to be effective in combatting the abuse of these dangerous synthetic drugs.

As we recognize World Rabies Day on September 28, we are reminded that our furry feline friends  -- cats -- are a serious rabies risk.  While that may be surprising to some, the fact is that cats remain the top carrier of rabies among domestic animals in the United States. The number of rabid dogs has declined by 37% since 1999?according to data from the Centers for Disease Control and Prevention (CDC)?but the number of reported rabid cats has actually increased and now surpasses dogs by a ratio of over 4 to 1.

Wild animals?such as raccoons?still harbor rabies far more frequently than cats. However, a study published this year by researchers from the CDC stated that "cats pose a disproportionate risk for potential human exposures compared with wildlife...in part because people, especially children, are more likely to approach them."

It is critical to vaccinate all domestic cats for rabies and keep those vaccinations current, but any cat that roams outdoors is at a much higher risk of contracting rabies than cats kept safely indoors. Feral cats, in particular, present a major public health risk. Feral cats are outdoors all the time, and the management of feral cat colonies through Trap, Neuter, Release (TNR) programs "[does] not provide effective rabies vaccination coverage or cat population control," according to the CDC-led study. On the contrary, TNR only increases the likelihood of interaction between feral cats and rabid wildlife.

In honor of World Rabies Day and for public health, we must recognize the risks posed by domestic cats roaming outdoors and effectively protect communities by removing feral cats from the landscape.

Dr. George Fenwick

President, American Bird Conservancy

1731 Conn. Avenue

Washington, D.C. 20009

202-234-7181