113 S2755 IS: Overdose Prevention Act
U.S. Senate
2014-07-31
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.
This Act may be cited as the Overdose Prevention Act
.
2.
Congress finds the following:
(1)According to the Centers for Disease Control and Prevention, each day in the United States, more
than 100 people die from a drug overdose. Among people 25 to 64 years
old, drug overdose causes more deaths than motor vehicle accidents.(2)The Centers for Disease Control and Prevention reports that more than 41,000 people in the United
States died from a drug overdose in 2011 alone. Nearly 80 percent of
those deaths were due to unintentional drug overdoses, and many could have
been prevented.(3)Deaths resulting from unintentional drug overdoses increased more than 300 percent between 1980 and
1998, and nearly tripled between 1999 and 2011.(4)Ninety-one percent of all unintentional poisoning deaths are due to drugs. Since 1999, in the
United States the population of non-Hispanic Whites and the population of
Indians (as defined in section 4 of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 450b)) have seen the highest rates of
unintentional drug poisoning deaths.(5)Opioid medications such as oxycodone and hydrocodone are involved in 55 percent of all
unintentional drug poisoning deaths.(6)Between 1999 and 2010, opioid medication overdose fatalities increased by more than 400 percent
among women and 265 percent among men.(7)Military veterans are at elevated risk of experiencing a drug overdose. Veterans who served in
Vietnam, Iraq, or Afghanistan and who have combat injuries, posttraumatic
stress disorder, and other co-occurring mental health diagnoses are at
elevated risk of fatal drug overdose from opioid medications.(8)Rural and suburban regions are disproportionately affected by opioid medication overdoses. Urban
centers also continue to struggle with overdose, which is the leading
cause of death among homeless adults.(9)In the year 2009 alone, estimated lost productivity and direct medical costs from opioid medication
poisonings exceeded $20,000,000,000.(10)Both fatal and nonfatal overdoses place a heavy burden on public health and public safety
resources, yet there is no coordinated cross-Federal agency response to
prevent overdose fatalities.(11)Naloxone is a medication that rapidly reverses overdose from heroin and opioid medications.(12)In 2012, the Food and Drug Administration held a public workshop in collaboration with the National
Institute on Drug Abuse and the Centers for Disease Control and
Prevention, and with participation from the Substance Abuse and Mental
Health Services Administration and the Office of National Drug Control
Policy, to discuss making naloxone more widely available outside of
conventional medical settings to reduce the incidence of opioid overdose
fatalities.(13)Lawmakers in California, Colorado, Connecticut, Georgia, Illinois, Kentucky, Maine, Maryland,
Massachusetts,
Minnesota, New Jersey, New Mexico, New York, North
Carolina, Ohio, Oklahoma, Oregon, Rhode Island, Tennessee, Utah, Vermont,
Virginia, Washington, Wisconsin, and the District of Columbia have removed
legal impediments to increasing naloxone prescription and its use by
bystanders who are in a position to respond to an overdose.(14)The American Medical Association, the Nation’s largest physician organization, supports further
implementation of community-based programs that offer naloxone and other
opioid overdose prevention services.(15)Community-based overdose prevention programs have successfully prevented deaths from opioid
overdoses by making rescue training and naloxone available to first
responders, parents, and other bystanders who may encounter an overdose. A
study funded by the Centers for Disease Control and Prevention of
community-based overdose prevention programs provided by the Massachusetts
Department of Public Health found that communities with access to overdose
prevention programs experienced lower mortality rates from opioid
overdoses than communities that did not have access to overdose prevention
programs during the study period.(16)Over 50,000 potential bystanders have been trained by overdose prevention programs in the United
States. A Centers for Disease Control and Prevention report credits
overdose prevention programs with saving more than 10,000 lives since
1996.(17)At least 188 local overdose prevention programs are operating in the United States, including in
major cities such as Baltimore, Chicago, Los Angeles, New York City,
Boston, San Francisco, and Philadelphia, and statewide in New Mexico,
Massachusetts, and New York. Between 2006 and 2009, overdose prevention
programs facilitated by the Massachusetts Department of Public Health
trained more than 4,800 people who reported more than 500 rescues. Since
2004, a program administered by the Baltimore City Health Department has
trained more than 3,000 people who reported more than 220 rescues. Project
Lazarus, an overdose prevention program in Wilkes County, North Carolina,
reduced overdose deaths 69 percent between 2009 and 2011.(18)In Illinois, the Department of Human Services, Division of Alcoholism and Substance Abuse has
enrolled over 20 drug overdose prevention programs with over 100
designated sites across Illinois targeting multiple service populations.
These enrollees include police departments, county health departments,
medical facilities, licensed substance abuse treatment programs, and
community organizations. Statewide, over 2,000 police officers and more
than 600 others have been trained thus far. The DuPage County Illinois
Health Department has trained over 1,200 police officers and has reported
12 overdose reversals.(19)The Office of National Drug Control Policy supports equipping first responders to help reverse
overdoses. Police officers on patrol in Quincy, Massachusetts, have
conducted 170 overdose rescues with naloxone since 2010. The police
department has reported a 95-percent success rate with overdose rescue
attempts by police officers. In Suffolk County, New York, police officers
have saved more than 50 lives with naloxone.(20)Research shows that the cost per year of life gained by making naloxone available to reverse
overdoses is within the range of what people in the United States usually
pay for health treatments.(21)Overdose prevention programs are needed in correctional facilities, addiction treatment programs,
and other places where people are at higher risk of overdosing after a
period of abstinence.(22)People affected by drug overdose gather on August 31 of each year in communities nationwide for
Overdose Awareness Day, to mourn and pay tribute to loved ones and raise
awareness about overdose risk and prevention.
3.
Overdose prevention programsTitle III of the Public Health Service Act (42 U.S.C. 241 et seq.) is amended by adding at the end
the following:
WOverdose prevention programs399OO.Cooperative agreement program to reduce drug overdose deaths
(a)
The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall
enter into
cooperative agreements
with eligible entities to enable the eligible entities to reduce deaths
occurring from overdoses of drugs.
(b)To be eligible to receive a cooperative agreement under this section, an entity shall be a State,
local, or tribal government, a correctional institution, a law enforcement
agency, a community agency, a professional organization in the field of
poison control and surveillance, or a private nonprofit organization.(c)
(1)
An eligible entity desiring a cooperative agreement under this section shall submit to the
Secretary an application at such time, in such manner, and containing such
information as the Secretary may require.
(2)
An application under paragraph (1) shall include—
(A)
a description of the activities to be funded through the cooperative agreement; and
(B)
evidence that the eligible entity has the capacity to carry out such activities.
(d)
In entering into cooperative agreements under subsection (a), the Secretary
shall give
priority to eligible entities that—
(1)
are a public health agency or community-based organization; and
(2)
have expertise in preventing deaths occurring from overdoses of drugs in populations at high risk
of such deaths.
(e)
As a condition of receipt of a cooperative agreement under this section, an eligible
entity shall agree to use the cooperative agreement to do each of the
following:(1)Purchase
and distribute the drug naloxone or a similarly effective medication.(2)Carry out one or more of the following activities:
(A)
Educating prescribers and pharmacists about overdose prevention and naloxone prescription, or
prescription of a similarly effective medication.
(B)
Training first responders, other individuals in a position to respond to an overdose, and law
enforcement and corrections officials on the effective response to
individuals who have overdosed on drugs. Training pursuant to this
subparagraph may include any activity that is educational, instructional,
or consultative in nature, and may include volunteer training, awareness
building exercises, outreach to individuals who are at-risk of a drug
overdose, and distribution of educational materials.
(C)
Implementing and enhancing programs to provide overdose prevention, recognition, treatment, and
response to individuals in need of such services.
(D)
Educating the public and providing outreach to the public about overdose prevention and naloxone
prescriptions, or prescriptions of other similarly effective medications.
(f)
(1)
The Secretary shall establish and provide for the operation of a coordinating center responsible
for—
(A)
collecting, compiling, and disseminating data on the programs and activities under this section,
including tracking and evaluating the distribution and use of naloxone and
other similarly effective medication;
(B)
evaluating such data and, based on such evaluation, developing best practices for preventing deaths
occurring from drug overdoses;
(C)
making such best practices specific to the type of community involved;
(D)coordinating and harmonizing data collection measures;(E)evaluating the effects of the program on overdose rates: and(F)education and outreach to the public about overdose prevention and prescription of naloxone and
other similarly effective medication.
(2)
As a condition on receipt of a cooperative agreement under this section, an eligible entity shall
agree to prepare and submit, not later than 90 days after the end of the
cooperative agreement period, a report to such coordinating center and the
Secretary describing the results of the activities supported through the
cooperative agreement.
(g)
The period of a cooperative agreement under this section shall be 4 years.
(h)
In this part, the term drug means—
(1)
a drug, as defined in section 201 of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 321); and
(2)includes controlled substances, as defined in section 102 of the Controlled
Substances Act (21 U.S.C. 802).(i)Authorization of appropriations
There are authorized to be appropriated $20,000,000 to carry out this section for each of the
fiscal years 2015 through 2019.
399OO–1.
Surveillance capacity building
(a)
The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall
award cooperative agreements
to eligible entities to
improve fatal and nonfatal drug overdose surveillance and reporting
capabilities, including—
(1)
providing training to improve identification of drug overdose as the cause of death by coroners and
medical examiners;
(2)
establishing, in cooperation with the National Poison Data System, coroners, and medical examiners,
a comprehensive national program for surveillance of, and reporting to an
electronic database on, drug overdose deaths in the United States; and
(3)
establishing, in cooperation with the National Poison Data System, a comprehensive national program
for surveillance of, and reporting to an electronic database on, fatal and
nonfatal drug overdose occurrences, including epidemiological and
toxicologic analysis and trends.
(b)
To be eligible to receive a cooperative agreement under this section, an entity shall be—(1)a State, local, or tribal government; or(2)the National Poison Data System
working in conjunction with a State, local, or tribal government.(c)
(1)
An eligible entity desiring a
cooperative agreement under this section shall submit to the Secretary an
application at such time, in such manner, and containing such information
as the Secretary may require.
(2)
The application described in paragraph (1) shall include—
(A)
a description of the activities to be funded through the cooperative agreement; and
(B)
evidence that the eligible entity has
the capacity to carry out such activities.
(d)
As a condition of receipt of a cooperative agreement under this section, an eligible entity shall
agree to
prepare and submit, not later than 90 days after the end of the
cooperative agreement period, a report to the Secretary describing the
results of the activities supported through the cooperative
agreement.(e)National poison data systemIn this section, the term National Poison Data System means the system operated by the American Association of Poison Control Centers, in partnership
with the Centers for Disease Control and Prevention, for real-time local,
State, and national electronic
reporting, and the corresponding database network.(f)Authorization of appropriations
There are authorized to be appropriated to carry out this section $5,000,000 for each of the fiscal
years 2015 through 2019.
399OO–2.
(a)
Prevention of drug overdose
Not later than 180 days after the date of the enactment of this section, the Secretary, in
consultation with a task force comprised of stakeholders, shall develop a
plan to reduce the number of deaths occurring from overdoses of drugs and
shall submit the plan to Congress. The plan shall include—
(1)
a plan for implementation of a public health campaign to educate prescribers and the public about
overdose prevention and prescription of naloxone and other similarly
effective medication;
(2)
recommendations for improving and expanding overdose prevention programming; and
(3)
recommendations for such legislative or administrative action as the Secretary determines
appropriate.
(b)
Task force representation
(1)
The task force under subsection (a) shall include at least one representative of each of
the following:
(A)
Individuals directly impacted by drug overdose.
(B)
Direct service providers who engage individuals at risk of a drug overdose.
(C)
Drug overdose prevention advocates.
(D)
The National Institute on Drug Abuse.
(E)
The Center for Substance Abuse Treatment.
(F)
The Centers for Disease Control and Prevention.
(G)
The Health Resources and Services Administration.
(H)
The Food and Drug Administration.
(I)
The Office of National Drug Control Policy.
(J)
The American Medical Association.
(K)
The American Association of Poison Control Centers.
(L)
The Federal Bureau of Prisons.
(M)
The Centers for Medicare & Medicaid Services.
(N)
The Department of Justice.
(O)The Department of Defense.(P)The Department of Veterans Affairs.(Q)First responders.(R)Law enforcement.(S)State agencies responsible for drug overdose prevention.
(2)
In addition to the representatives required by paragraph (1), the task force under
subsection (a) may include other individuals with expertise relating to
drug overdoses or representatives of entities with expertise relating to
drug overdoses, as the Secretary determines appropriate.
.
4.
Overdose prevention researchSubpart 15 of part C of title IV of the Public Health Service Act (42 U.S.C. 285o et seq.) is
amended by adding at the end the following:
464Q.Overdose prevention research
(a)
The Director of the Institute shall prioritize and conduct or support
research on drug overdose and
overdose prevention. The primary aims of this research shall include—
(1)
an examination of circumstances that contribute to drug overdose and identification of drugs
associated with fatal overdose;
(2)
an evaluation of existing overdose prevention methods;
(3)
pilot programs or research trials on new overdose prevention strategies or programs that have not
been studied in the United States;
(4)
scientific research concerning the effectiveness of overdose prevention programs, including how to
effectively implement and sustain such programs;
(5)
comparative effectiveness research of model programs; and
(6)implementation of science research concerning effective overdose prevention programming examining
how to implement and sustain overdose prevention programming.
(b)
The Director of the Institute shall support research on the development of
formulations of naloxone, and other similarly effective medications, and
dosage delivery devices specifically intended to be used by lay persons or
first responders for the prehospital treatment of unintentional drug
overdose.
(c)
In this section, the term drug has the meaning given such term in section 399OO.(d)Authorization of appropriations
There are authorized to be appropriated to carry out this section $5,000,000 for each of the fiscal
years 2015 through 2019.
.