[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6353 Introduced in House (IH)]

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118th CONGRESS
  1st Session
                                H. R. 6353

  To direct the Secretary of Veterans Affairs to conduct a review on 
     opioid overdose deaths among veterans, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            November 9, 2023

Mr. Murphy (for himself, Mr. Courtney, Mr. Davis of North Carolina, and 
  Mrs. Kiggans of Virginia) introduced the following bill; which was 
             referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
  To direct the Secretary of Veterans Affairs to conduct a review on 
     opioid overdose deaths among veterans, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Veterans Heroin Overdose Prevention 
Examination Act'' or the ``Veterans HOPE Act''.

SEC. 2. FINDINGS; SENSE OF CONGRESS.

    (a) Findings.--Congress finds the following:
            (1) New research shows that a dramatic rise in opioid 
        overdose deaths among veterans in recent years has happened 
        increasingly among veterans dying from heroin and synthetic 
        opioids.
            (2) Furthermore, patients of the Veterans Health 
        Administration of the Department of Veterans Affairs are seven 
        more times likely to suffer from an opioid use disorder than 
        commercially insured patients.
            (3) Using records of the Veterans Health Administration 
        linked to National Death Index data, the veterans' rate of 
        overdose deaths from all opioids increased by 65 percent from 
        2010 to 2016, a rate change that includes adjustments for 
        demographic changes in the veteran population over time.
            (4) Furthermore, among all opioid overdose decedents, 
        prescription opioid receipt within three months before death 
        declined from 54 percent in 2010 to 26 percent in 2016, yet 
        veteran overdoses resulting in death from heroin, synthetic 
        opioids such as fentanyl, and nonprescription opioids still 
        occurred.
            (5) In fact, between 2010 and 2016, the veteran death rate 
        from heroin or from taking multiple opioids almost quintupled 
        and the death rate from synthetic opioids such as fentanyl 
        increased by more than five-fold.
            (6) Trends would suggest that, while the aggregate rise in 
        opioid overdose deaths among veterans parallel those seen in 
        the general population, the increase occurred mainly because of 
        a rise in deaths from nonprescribed sources such as heroin, 
        fentanyl, other powerful synthetic opioids, or multiple opioids 
        in concurrent use.
    (b) Sense of Congress.--It is the sense of Congress that further 
veterans overdose prevention efforts and research should extend beyond 
patients actively receiving opioid prescriptions.

SEC. 3. REVIEW OF DEATHS OF VETERANS RELATING TO OPIOID USE.

    (a) Review.--Not later than 18 months after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall complete 
a review of the deaths of all covered veterans who died from opioid 
overdoses during the five-year period preceding the date of the 
enactment for this Act.
    (b) Matters Included.--The review under subsection (a) shall 
include the following:
            (1) The total number of covered veterans who died from 
        opioid overdoses during the five-year period preceding the date 
        of the enactment of this Act.
            (2) A summary of such veterans that includes the age, sex, 
        and race, and ethnicity of each such veteran.
            (3) A comprehensive list of the medications prescribed to, 
        and found in the bodies of, such veterans at the time of death, 
        specifically listing any medications that carry a black box 
        warning, are off-label, or are psychotropic.
            (4) A summary of medical diagnoses by physicians of the 
        Department of Veterans Affairs that led to any prescribing of 
        the medications referred to in paragraph (3).
            (5) The number of instances in which such a veteran was 
        concurrently on multiple medications prescribed by physicians 
        of the Department.
            (6) A summary of--
                    (A) the average period that elapsed between the 
                last prescription opioid receipt and the date of the 
                death of such a veteran; and
                    (B) the cause of death for each such veteran.
            (7) The percentage of such veterans with combat experience 
        or trauma (including military sexual trauma, traumatic brain 
        injury, and post-traumatic stress).
            (8) Identification of medical facilities of the Department 
        with high prescription and drug abuse treatment rates for 
        patients being treated at those facilities.
            (9) A description of policies of the Department governing 
        the prescribing of medications referred to in paragraph (3).
            (10) A description of efforts by the Secretary to 
        electronically track, collect, and properly dispose of 
        prescription opioids that are either unused, past the 
        prescription date, or not in the possession of the properly 
        prescribed patient.
            (11) A description of any patterns apparent to the 
        Secretary based on the review.
            (12) Recommendations for further action that would improve 
        the safety and well-being of veterans and reduce opioid 
        overdose rates for veterans, especially concerning research 
        regarding such veterans who had not filed for a opioid 
        prescription in the three months before death by overdose.
    (c) Public Availability.--Not later than 45 days after the 
completion of the review under subsection (a), the Secretary shall--
            (1) submit to Congress a report on the results of the 
        review;
            (2) make such report publicly available; and
            (3) provide to the Committees on Veterans' Affairs of the 
        House of Representatives and the Senate a briefing on such 
        review.
    (d) Definitions.--In this section:
            (1) The term ``black box warning'' means a warning 
        displayed within a box in the prescribing information for drugs 
        that have special problems, particularly ones that may lead to 
        death or serious injury.
            (2) The term ``covered veteran'' means any veteran who 
        received hospital care or medical services furnished by the 
        Department of Veterans Affairs during the five-year period 
        preceding the death of the veteran.
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