[Congressional Record Volume 155, Number 30 (Friday, February 13, 2009)]
[Senate]
[Pages S2343-S2345]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BAUCUS (for himself, Ms. Stabenow, Mr. Tester, Mr. Conrad, 
        Mr. Johnson, and Mr. Schumer):
  S. 450. A bill to understand and comprehensively address the oral 
health problems associated with methamphetamine use; to the Committee 
on Health, Education, Labor, and Pensions.
  Mr. BAUCUS. Mr. President, I rise today to re-introduce the Meth 
Mouth Prevention and Community Recovery Act in the 111th Congress.
  In December 2007, the U.S. Department of Justice's National Drug 
Intelligence Center, NDIC, reported the increasing availability of 
high-purity methamphetamine throughout the country and the expansion of 
methamphetamine networks. According to the 2005 National Survey on Drug 
Use and Health, NSDUH, an estimated 10.4 million Americans aged 12 or 
older used methamphetamine at least once in their lifetimes for 
nonmedical reasons, representing 4.3 percent of the U.S. population in 
that age group. Its use has been destructive to individual people, 
families and communities in our nation. Lung disease, fatal heart 
attacks, mental illness and decaying teeth have been implicated with 
its prevalent use.
  Dental problems are common among drug users. Many do not care for 
their teeth regularly and most do not see a dentist often. But 
methamphetamine seems to be taking a unique and horrific toll inside 
its user's mouths.
  In those populated areas where its use is highly concentrated, more 
and more dentists are encountering patients with a distinct, painful 
and often debilitating pattern of oral decay. The condition, known as 
``meth mouth'', is characterized by teeth that are blackened, stained, 
rotting and crumbling or falling apart. Some believe meth mouth is 
caused by 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 sugary drinks. Often the damage is so severe that 
extraction is the only viable treatment option.
  The Meth Mouth Prevention and Community Recovery Act authorizes 
funding for local, school-based initiatives to educate primary and 
elementary school students about the dangers of methamphetamine usage. 
It will also provide for enhanced research and professional training in 
substance use disorders, oral health and the provision of dental care.
  The bill I am putting forth here today will begin to address our 
Nation's need to better understand and educate our population along 
helping the dental health providers treat the oral disease originating 
from this drug's abuse. The studies funded and treatment offered here 
will begin to stem the tide on this terrible affliction.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
placed in the Record, as follows:

                                 S. 450

       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.

[[Page S2344]]

       (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

[[Page S2345]]

     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.

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