[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 450 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                 S. 450

  To understand and comprehensively address the oral health problems 
                  associated with methamphetamine use.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           February 13, 2009

  Mr. Baucus (for himself, Ms. Stabenow, Mr. Tester, Mr. Conrad, Mr. 
Johnson, and Mr. Schumer) introduced the following bill; which was read 
 twice and referred to the Committee on Health, Education, Labor, and 
                                Pensions

_______________________________________________________________________

                                 A BILL


 
  To understand and comprehensively address the oral health problems 
                  associated with methamphetamine use.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; PURPOSES.

    (a) Short Title.--This Act may be cited as the ``Meth Mouth 
Prevention and Community Recovery Act''.
    (b) Purposes.--The purposes of this Act are--
            (1) to investigate and report on all aspects of meth mouth, 
        including its causes, public health impact, innovative models 
        for its prevention, and new and improved methods for its 
        treatment;
            (2) to ensure dentists and allied dental personnel are able 
        to recognize the signs of substance abuse in their patients, 
        discuss the nature of addiction as it relates to oral health 
        and dental care, and facilitate appropriate help for patients 
        (and family members of patients) who are affected by a 
        substance use disorder;
            (3) to determine whether, how, and to what degree educating 
        youth about meth mouth is an effective strategy for preventing 
        or reducing the prevalence of methamphetamine use; and
            (4) to underscore the many ways that dentists and other 
        oral health professionals can contribute to the general health 
        of their patients, their communities, and the country as a 
        whole.

SEC. 2. TABLE OF CONTENTS.

    The table of contents for this Act is as follows:

Sec. 1. Short title; purposes.
Sec. 2. Table of contents.
                   TITLE I--EVIDENCE-BASED PREVENTION

Sec. 101. Findings; purpose; definitions.
Sec. 102. Methamphetamine prevention demonstration projects.
Sec. 103. Education for American Indian and Alaska native children.
Sec. 104. Authorization of appropriations.
              TITLE II--METH MOUTH RESEARCH INVESTMENT ACT

Sec. 201. Findings; purpose; definitions.
Sec. 202. Research on substance abuse, oral health, and dental care.
Sec. 203. Study of methamphetamine-related oral health costs.
Sec. 204. Authorization of appropriations.
     TITLE III--SUBSTANCE ABUSE EDUCATION FOR DENTAL PROFESSIONALS

Sec. 301. Findings; purpose; definitions.
Sec. 302. Substance abuse training for dental professionals.
Sec. 303. Authorization of appropriations.

                   TITLE I--EVIDENCE-BASED PREVENTION

SEC. 101. FINDINGS; PURPOSE; DEFINITIONS.

    (a) Findings.--The Congress finds as follows:
            (1) According to the Substance Abuse and Mental Health 
        Services Administration, first-time methamphetamine use is most 
        likely to occur between the ages of 18 and 25. Prevention 
        efforts must therefore begin during the teen years.
            (2) Most young people do not realize that methamphetamine 
        use can quickly leave their teeth blackened, stained, rotting, 
        and crumbling or falling apart and that the treatment options 
        are often limited.
            (3) By educating youth about meth mouth, oral health 
        advocates can play a substantial role in helping to prevent 
        first-time methamphetamine use.
    (b) Purpose.--The purpose of this title is to provide for a number 
of projects to evaluate whether, how, and to what degree educating 
youth about meth mouth is an effective strategy for preventing or 
reducing methamphetamine use.
    (c) Definitions.--In this title:
            (1) Anti-drug coalition.--The term ``anti-drug coalition'' 
        has the meaning given to the term ``eligible coalition'' in 
        section 1023 of the National Narcotics Leadership Act of 1988 
        (21 U.S.C. 1523).
            (2) Dental organization.--The term ``dental organization'' 
        means a group of persons organized to represent the art and 
        science of dentistry or who are otherwise associated for the 
        primary purpose of advancing the public's oral health.
            (3) Director.--The term ``Director'' means the Director of 
        the Center for Substance Abuse Prevention.
            (4) Elementary school; secondary school.--The terms 
        ``elementary school'' and ``secondary school'' have the 
        meanings given to such terms in section 9101 of the Elementary 
        and Secondary Education Act of 1965 (20 U.S.C. 7801).
            (5) Indian; indian tribe; tribal organization.--The terms 
        ``Indian'', ``Indian tribe'', and ``tribal organization'' have 
        the meanings given to such terms in section 4 of the Indian 
        Self-Determination and Education Assistance Act (25 U.S.C. 
        450b).
            (6) Meth mouth.--The term ``meth mouth'' means a distinct 
        and often severe pattern of oral decay that is commonly 
        associated with methamphetamine use.
            (7) Substance use disorder.--The term ``substance use 
        disorder'' means any harmful pattern of alcohol or drug use 
        that leads to clinically significant impairment in physical, 
        psychological, interpersonal, or vocational functioning.
            (8) Youth.--The term ``youth'' has the meaning given to 
        such term in section 1023 of the National Narcotics Leadership 
        Act of 1988 (21 U.S.C. 1523).

SEC. 102. METHAMPHETAMINE PREVENTION DEMONSTRATION PROJECTS.

    (a) In General.--In carrying out section 519E of the Public Health 
Service Act (42 U.S.C. 290bb-25e), the Director of the Center for 
Substance Abuse Prevention shall make grants to public and private 
nonprofit entities to enable such entities to determine whether, how, 
and to what degree educating youth about meth mouth is an effective 
strategy for preventing or reducing methamphetamine use.
    (b) Use of Funds.--
            (1) Mandatory uses.--Amounts awarded under this title shall 
        be used for projects that focus on, or include specific 
        information about, the oral health risks associated with 
        methamphetamine use.
            (2) Authorized uses.--Amounts awarded under this title may 
        be used--
                    (A) to develop or acquire instructional aids to 
                enhance the teaching and learning process (including 
                audiovisual items, computer-based multimedia, 
                supplemental print material, and similar resources);
                    (B) to develop or acquire promotional items to be 
                used for display or distribution on school campuses 
                (including posters, flyers, brochures, pamphlets, 
                message-based apparel, buttons, stickers, and similar 
                items);
                    (C) to facilitate or directly furnish school-based 
                instruction concerning the oral health risks associated 
                with methamphetamine use;
                    (D) to train State and local health officials, 
                health professionals, members of anti-drug coalitions, 
                parents, and others how to carry messages about the 
                oral health risks associated with methamphetamine use 
                to youth; and
                    (E) to support other activities deemed appropriate 
                by the Director.
    (c) Grant Eligibility.--
            (1) Application.--To be eligible for grants under this 
        title, an entity shall prepare and submit an application at 
        such time, in such manner, and containing such information as 
        the Director may reasonably require.
            (2) Contents.--Each application submitted pursuant to 
        paragraph (1) shall include--
                    (A) a description of the objectives to be attained;
                    (B) a description of the manner in which the grant 
                funds will be used; and
                    (C) a plan for evaluating the project's success 
                using methods that are evidence-based.
            (3) Preference.--In awarding grants under this title, the 
        Director shall give preference to applicants that intend to--
                    (A) collaborate with one or more dental 
                organizations;
                    (B) partner with one or more anti-drug coalitions; 
                and
                    (C) coordinate their activities with one or more 
                national, State, or local methamphetamine prevention 
                campaigns or oral health promotion initiatives.
    (d) Limitations.--
            (1) Grant amounts.--The amount of an award under this title 
        may not exceed $50,000 per grantee.
            (2) Duration.--The Director shall award grants under this 
        title for a period not to exceed 3 years.
    (e) Evaluation and Dissemination.--The Director shall collect and 
widely disseminate information about the effectiveness of the 
demonstration projects assisted under this title.

SEC. 103. EDUCATION FOR AMERICAN INDIAN AND ALASKA NATIVE CHILDREN.

    Not less than 5 percent of the funds appropriated pursuant to 
section 104 for a fiscal year shall be awarded to Indian tribes and 
tribal organizations for the purpose of educating Indian youth about 
the oral health risks associated with methamphetamine use.

SEC. 104. AUTHORIZATION OF APPROPRIATIONS.

    There are authorized to be appropriated for the purpose of carrying 
out this title $1,000,000 for each of fiscal years 2010 through 2012. 
Amounts authorized to be appropriated under this section are in 
addition to any other amounts authorized to be appropriated for such 
purpose.

              TITLE II--METH MOUTH RESEARCH INVESTMENT ACT

SEC. 201. FINDINGS; PURPOSE; DEFINITIONS.

    (a) Findings.--The Congress finds as follows:
            (1) As the number of regular methamphetamine users has 
        increased, so has a peculiar set of dental problems linked to 
        the drug. The condition (known as ``meth mouth'') develops 
        rapidly and is attributed to the drug's acidic nature, its 
        ability to dry the mouth, the tendency of users to grind and 
        clench their teeth, and a drug-induced craving for sugar-laden 
        soft drinks.
            (2) Meth mouth is regarded by many as an anecdotal 
        phenomenon. Few peer-reviewed studies have been published that 
        examine its causes, its physical effects, its prevalence, or 
        its public health costs.
            (3) Enhanced research would help to identify the prevalence 
        and scope of meth mouth. Such research would also help 
        determine how substances of abuse can damage the teeth and 
        other oral tissues, and offer the possibility of developing new 
        and improved prevention, harm-reduction, and cost management 
        strategies.
    (b) Purpose.--The purpose of this title is to provide for enhanced 
research examining all aspects of meth mouth, including its causes, its 
public health impact, innovative models for its prevention, and new and 
improved methods for its treatment.
    (c) Definitions.--In this title:
            (1) Clinical research; health services research.--The terms 
        ``clinical research'' and ``health services research'' shall 
        have the meanings given to such terms in section 409 of the 
        Public Health Service Act (42 U.S.C. 284d).
            (2) Indian; indian tribe; tribal organization.--The terms 
        ``Indian'', ``Indian tribe'', and ``tribal organization'' shall 
        have the meanings given to such terms in section 4 of the 
        Indian Self-Determination and Education Assistance Act (25 
        U.S.C. 450b).
            (3) Meth mouth.--The term ``meth mouth'' means a distinct 
        and often severe pattern of oral decay that is commonly 
        associated with methamphetamine use.
            (4) Public health research.--The term ``public health 
        research'' means research that focuses on population-based 
        health measures.
            (5) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (6) Substance use disorder.--The term ``substance use 
        disorder'' means any harmful pattern of alcohol or drug use 
        that leads to clinically significant impairment in physical, 
        psychological, interpersonal, or vocational functioning.

SEC. 202. RESEARCH ON SUBSTANCE ABUSE, ORAL HEALTH, AND DENTAL CARE.

    (a) Expansion of Activity.--In carrying out part A of title III of 
the Public Health Service Act (42 U.S.C. 241 et seq.), the Secretary 
shall expand and intensify the clinical research, health services 
research, and public health research on associations between substance 
use disorders, oral health, and the provision of dental care.
    (b) Administration.--In carrying out subsection (a), the 
Secretary--
            (1) may enter into contracts or agreements with other 
        Federal agencies, including interagency agreements, to delegate 
        authority for the execution of grants and for such other 
        activities as may be necessary to carry out this section;
            (2) may carry out this section directly or through grants 
        or cooperative agreements with State, local, and territorial 
        units of government, Indian tribes, and tribal organizations, 
        or other public or nonprofit private entities; and
            (3) may request and use such information, data, and reports 
        from any Federal, State, local, or private entity as may be 
        required to carry out this section, with the consent of such 
        entity.

SEC. 203. STUDY OF METHAMPHETAMINE-RELATED ORAL HEALTH COSTS.

    (a) In General.--In carrying out section 202, the Secretary shall 
conduct a study to determine whether, how, and to what degree 
methamphetamine use affects the demand for (and provision of) dental 
care. The study shall account for both genders, all racial and ethnic 
groups (and subgroups), and persons of all ages and from all geographic 
areas as appropriate for the scientific goals of the research.
    (b) Report.--Not later than 1 year after the date of enactment of 
this Act, the Secretary shall publish a special report detailing the 
results of the study described in subsection (a), with findings that 
address--
            (1) the prevalence and severity of oral health problems 
        believed to be associated with methamphetamine use;
            (2) the criteria most commonly used to determine whether a 
        patient's oral health problems are associated with 
        methamphetamine use;
            (3) the therapies most commonly used to treat patients with 
        meth mouth;
            (4) the clinical prognosis for patients who received care 
        for meth mouth; and
            (5) the financial impact of meth mouth on publicly financed 
        dental programs.

SEC. 204. AUTHORIZATION OF APPROPRIATIONS.

    There are authorized to be appropriated for the purpose of carrying 
out this title, $200,000 for each of fiscal years 2010 through 2012. 
Amounts authorized to be appropriated under this section are in 
addition to any other amounts authorized to be appropriated for such 
purpose.

     TITLE III--SUBSTANCE ABUSE EDUCATION FOR DENTAL PROFESSIONALS

SEC. 301. FINDINGS; PURPOSE; DEFINITIONS.

    (a) Findings.--The Congress finds as follows:
            (1) The use of certain therapeutic agents in dental 
        treatment can jeopardize the health and affect the relapse 
        potential of patients with substance use disorders.
            (2) Screening patients for substance abuse is not a common 
        practice among dentists, according to several peer-reviewed 
        articles published in the ``Journal of the American Dental 
        Association''. Limited time, inadequate training, and the 
        potential for alienating patients are among the reasons often 
        cited.
            (3) Dentists receive little formal education and training 
        in screening patients for substance abuse, discussing the 
        nature of addiction as it relates to oral health and dental 
        care, and facilitating appropriate help for patients, and 
        family members of patients, who are affected by a substance use 
        disorder.
            (4) The American Dental Association maintains that dentists 
        should be knowledgeable about substance use disorders in order 
        to safely administer and prescribe controlled substances and 
        other medications. The American Dental Association further 
        recommends that dentists become familiar with their community's 
        substance abuse treatment resources and be able to make 
        referrals when indicated.
            (5) Training can greatly increase the degree to which 
        dentists, allied dental personnel, and other health 
        professionals can screen patients for substance abuse, discuss 
        the nature of addiction as it relates to oral health and dental 
        care, and facilitate appropriate help for patients, and family 
        members of patients, who are affected by a substance use 
        disorder.
    (b) Purpose.--The purpose of this title is to provide for enhanced 
training and technical assistance to ensure that dentists and allied 
dental personnel are able to recognize the signs of substance abuse in 
their patients, discuss the nature of addiction as it relates to oral 
health and dental care, and facilitate appropriate help for patients, 
and family members of patients, who are affected by a substance use 
disorder.
    (c) Definitions.--For the purposes of this title:
            (1) Allied dental personnel.--The term ``allied dental 
        personnel'' means individuals who assist the dentist in the 
        provision of oral health care services to patients, including 
        dental assistants, dental hygienists, and dental laboratory 
        technicians who are employed in dental offices or other patient 
        care facilities.
            (2) Continuing education.--The term ``continuing 
        education'' means extracurricular learning activities 
        (including classes, lecture series, conferences, workshops, 
        seminars, correspondence courses, and other programs) whose 
        purpose is to incorporate the latest advances in science, 
        clinical, and professional knowledge into the practice of 
        health care (and whose completion is often a condition of 
        professional licensing).
            (3) Continuing education credit.--The term ``continuing 
        education credit'' means a unit of study that is used to 
        officially certify or recognize the successful completion of an 
        activity that is consistent with professional standards for 
        continuing education.

SEC. 302. SUBSTANCE ABUSE TRAINING FOR DENTAL PROFESSIONALS.

    (a) In General.--In carrying out title V of the Public Health 
Service Act (42 U.S.C. 290 et seq.), the Administrator of the Substance 
Abuse and Mental Health Services Administration shall support training 
and offer technical assistance to ensure that dentists and allied 
dental personnel are prepared to--
            (1) recognize signs of alcohol or drug addiction in their 
        patients and the family members of their patients;
            (2) discuss the nature of substance abuse as it relates to 
        their area of expertise;
            (3) understand how certain dental therapies can affect the 
        relapse potential of substance dependent patients; and
            (4) help those affected by a substance use disorder to find 
        appropriate treatment for their condition.
    (b) Continuing Education Credits.--The Administrator of the 
Substance Abuse and Mental Health Services Administration may 
collaborate with professional accrediting bodies--
            (1) to develop and support substance abuse training courses 
        for oral health professionals; and
            (2) to encourage that the activities described in paragraph 
        (1) be recognized for continuing education purposes.

SEC. 303. AUTHORIZATION OF APPROPRIATIONS.

    There are authorized to be appropriated for the purpose of carrying 
out this title, $500,000 for each of fiscal years 2010 through 2012. 
Amounts authorized to be appropriated under this section are in 
addition to any other amounts authorized to be appropriated for such 
purpose.
                                 <all>