[Congressional Record Volume 155, Number 54 (Tuesday, March 31, 2009)]
[Senate]
[Page S4080]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. ROCKEFELLER (for himself, Mr. Corker, and Mr. Kennedy):
  S. 754. A bill to provide for increased Federal oversight of 
methadone treatment; to the Committee on Health, Education, Labor, and 
Pensions.
  Mr. ROCKEFELLER. Mr. President, I rise today with my colleagues, 
Senator Corker and Senator Kennedy, to introduce the Methadone 
Treatment and Protection Act, legislation that provides a comprehensive 
solution to our country's growing problem of methadone-related deaths. 
In recent years, too many families have come to me with heartbreaking 
stories of mothers and fathers, sisters and brothers who have been 
seriously injured or who have died as a result of methadone. My State 
of West Virginia has been particularly hard-hit by the number of lives 
lost, with just seven methadone-related deaths in 1999 compared to 
approximately 120 deaths in 2005. In the face of such stark realities, 
we can no longer stand by and remain content with the status quo. Now 
is the time for a comprehensive strategy to address the misuse of 
methadone and prevent any additional avoidable deaths.
  Methadone is an FDA approved, synthetic opioid prescription drug that 
has been extensively tested and used in the U.S. for more than thirty 
years. While it was first prescribed for pain management, methadone is 
also widely used as a part of opioid addiction treatment. The high 
efficacy and low cost of methadone has resulted in a significant rise 
in the number of methadone prescriptions, up 700 percent since 1998. 
However, there has also been a steep increase in the number of 
methadone-related deaths. In 2005, there were 4,462 methadone deaths, 
representing a 468 percent increase in the number of deaths since 1999.
  Currently, oversight of methadone is fragmented between three federal 
agencies: the Food and Drug Administration, FDA, the Substances Abuse 
and Mental Health Services Administration, SAMHSA, and the Drug 
Enforcement Administration, DEA. Currently, these agencies lack the 
most effective tools necessary to properly monitor methadone usage and 
effectively prevent methadone-related deaths. The legislation we are 
introducing today will address this shortcoming in our public health 
infrastructure by providing the administrative direction, funding, 
education, and data necessary to effectively monitor for the potential 
misuse of methadone.
  The alarming number of accidental methadone-related overdoses 
indicates that both patients and practitioners do not fully understand 
the complex nature of this medication. Therefore, the Methadone 
Treatment and Protection Act will significantly improve patient and 
provider information about methadone by mandating the creation of a 
consumer education campaign and requiring additional training for 
practitioners who prescribe methadone and other opioids.
  The bill will also improve Federal oversight of methadone by creating 
the Controlled Substances Clinical Standards Commission--with 
membership comprised of the FDA, SAMHSA, and the National Institutes of 
Health, NIH. This new Commission will establish safe dosage levels for 
methadone and other opioids, determine appropriate conversion factors 
when transferring a patient from one opioid to another, and create 
specific guidelines for initiating pain management treatment with 
methadone. To curtail the problems of doctor shopping and diversion, 
this legislation also adequately funds the National All Schedules 
Prescription Drug Reporting Act, NASPER. Passed and signed into law in 
2005, NASPER requires providers to submit prescribing information for 
all schedule II, III, and IV drugs to State run controlled substance 
monitoring programs. NASPER also requires States to share this 
information with one another. Funding NASPER will serve as a deterrent 
to those who misuse methadone from crossing State lines in order to 
avoid being detected.

  Finally, to improve access to comprehensive data on methadone-related 
deaths, this legislation mandates the completion of a standard Model 
Opioid Treatment Program Mortality Report, and requires its submission 
to a newly created National Opioid Death Registry. Prior to 1999, 
methadone did not have separate classification from other opiate-
related deaths. Therefore, a study released by the Center for Disease 
Control and Prevention in 2006 was the first opportunity to examine the 
trends in methadone exclusively. By creating a National Opioid Death 
Registry, it will be possible to more carefully track--and hopefully 
prevent--methadone-related deaths.
  It is my belief that the multi-pronged approach provided in the 
Methadone Treatment and Protection Act will lead to a decrease in the 
number of opioid and methadone-related deaths. This legislation will 
improve the coordination of resources and information at the local, 
State and Federal level to stifle the rising death toll, while at the 
same time make certain methadone and other opioids remain accessible 
for those who truly need these medications. In light of the facts and 
the preventable nature of methadone-related deaths, Congress has a 
responsibility to the American people to guarantee individuals have 
access to the treatment they need in a manner that is both safe and 
effective. The time for action is now, and I urge my colleagues to join 
us in support of this important bill.
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