[Congressional Record Volume 162, Number 32 (Monday, February 29, 2016)]
[Senate]
[Pages S1090-S1092]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SA 3328. Mr. REED (for himself and Mr. Durbin) submitted an amendment
intended to be proposed by him to the bill S. 524, to authorize the
Attorney General to award grants to address the national epidemics of
prescription opioid abuse and heroin use; which was ordered to lie on
the table; as follows:
At the appropriate place, insert the following:
TITLE __--OVERDOSE PREVENTION
SEC. _01. SHORT TITLE.
This title may be cited as the ``Overdose Prevention Act''.
SEC. _02. FINDINGS.
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 nearly 44,000 people in the United States died from a
drug overdose in 2013 alone. More than 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
more than tripled between 1999 and 2013.
(4) Nearly 92 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
were involved in nearly 46 percent of all unintentional drug
poisoning deaths in 2013.
(6) Unintentional drug poisoning deaths involving heroin
nearly tripled between 2010 and 2013 and were 23 percent of
all unintentional drug poisoning deaths in 2013.
(7) Between 1999 and 2010, opioid medication overdose
fatalities increased by more than 400 percent among women and
265 percent among men.
(8) 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.
(9) Rural and suburban regions are disproportionately
affected by opioid medication and heroin overdoses. From 2000
through 2013, the age-adjusted rate for drug poisoning deaths
involving heroin has increased nearly 11-fold in the Midwest
region and more than 3-fold in the South region.
(10) Urban centers also continue to struggle with overdose,
which is the leading cause of death among homeless adults.
(11) In 2009 alone, estimated lost productivity and direct
medical costs from opioid medication poisonings exceeded
$20,000,000,000.
(12) Opioid medication poisonings cost health insurers an
estimated $72,000,000,000 annually in medical costs.
(13) 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.
(14) Naloxone is a medication that rapidly reverses
overdose from heroin and opioid medications.
(15) Naloxone has no pharmacological effect if administered
to a person who has not taken opioids and has no potential
for abuse. Naloxone provides additional time to obtain
necessary medical assistance during an overdose.
(16) Lawmakers in Arkansas, California, Colorado,
Connecticut, Delaware, Georgia, Idaho, Illinois, Indiana,
Kentucky, Maine, Maryland, Massachusetts, Michigan,
Minnesota, Mississippi, Nevada, New Jersey, New Mexico, New
York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon,
Pennsylvania, Rhode Island, Tennessee, Utah, Vermont,
Virginia, Washington, West Virginia, 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.
(17) The American Medical Association and the American
Public Health Association support further implementation of
community-based programs that offer naloxone and other opioid
overdose prevention services.
(18) 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.
(19) Over 150,000 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 reversing more than 26,000 overdoses
since 1996.
(20) 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 December 2007
and March 2014, overdose prevention programs facilitated by
the Massachusetts Department of Public Health trained more
than 22,500 people who reported more than 2,655 rescues.
Since 2004, a program administered by the Baltimore City
Health Department has trained more than 11,000 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.
(21) 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 34 overdose reversals in 2014 alone.
(22) The Office of National Drug Control Policy supports
equipping first responders to help reverse overdoses. Police
officers on patrol in Quincy, Massachusetts, have conducted
300 overdose rescues with naloxone since 2011. 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 563
lives with naloxone in 2013 alone.
(23) 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.
(24) Prompt administration of naloxone and provision of
emergency care by a bystander can reduce health complications
and health care costs that arise when a person is deprived of
oxygen for an extended period of time.
(25) 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.
(26) Timely, drug-specific fatal and nonfatal surveillance
data at the local, State, and regional level is critically
needed to target prevention efforts.
(27) 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
[[Page S1091]]
raise awareness about overdose risk and prevention.
SEC. _03. OVERDOSE PREVENTION PROGRAMS.
Title III of the Public Health Service Act (42 U.S.C. 241
et seq.) is amended by adding at the end the following:
``PART W--OVERDOSE PREVENTION PROGRAMS
``SEC. 399OO. COOPERATIVE AGREEMENT PROGRAM TO REDUCE DRUG
OVERDOSE DEATHS.
``(a) Program Authorized.--The Secretary, acting through
the Administrator of the Substance Abuse and Mental Health
Services Administration, shall enter into cooperative
agreements with eligible entities to enable the eligible
entities to reduce deaths occurring from overdoses of drugs.
``(b) Eligible Entities.--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) Application.--
``(1) In general.--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) Contents.--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) Priority.--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) Eligible Activities.--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 prescriptions 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) Coordinating Center.--
``(1) Establishment.--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) Reports to center.--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) Duration.--The period of a cooperative agreement
under this section shall be 4 years.
``(h) Definition.--In this part, the term `drug'--
``(1) means 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 2016 through 2020.
``SEC. 399OO-1. SURVEILLANCE CAPACITY BUILDING.
``(a) Program Authorized.--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) Eligible Entity.--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) Application.--
``(1) In general.--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) Contents.--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) Report.--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 System.--In 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 2016 through 2020.
``SEC. 399OO-2. REDUCING OVERDOSE DEATHS.
``(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) Required members.--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) Additional members.--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.''.
SEC. _04. OVERDOSE PREVENTION RESEARCH.
Subpart 15 of part C of title IV of the Public Health
Service Act (42 U.S.C. 285o et seq.)
[[Page S1092]]
is amended by adding at the end the following:
``SEC. 464Q. OVERDOSE PREVENTION RESEARCH.
``(a) Overdose Research.--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) Formulations of Naloxone.--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) Definition.--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 2016 through 2020.''.
______