[Congressional Record Volume 162, Number 74 (Wednesday, May 11, 2016)]
[House]
[Pages H2273-H2275]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
REDUCING UNUSED MEDICATIONS ACT OF 2016
Mr. GUTHRIE. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 4599) to amend the Controlled Substances Act to permit
certain partial fillings of prescriptions, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 4599
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 ``Reducing Unused Medications
Act of 2016''.
SEC. 2. PARTIAL FILLS OF SCHEDULE II CONTROLLED SUBSTANCES.
(a) In General.--Section 309 of the Controlled Substances
Act (21 U.S.C. 829) is amended by adding at the end the
following:
``(f) Partial Fills of Schedule II Controlled Substances.--
``(1) Partial fills.--
``(A) In general.--A prescription for a controlled
substance in schedule II may be partially filled if--
``(i) it is not prohibited by State law;
``(ii) the prescription is written and filled in accordance
with the Controlled Substances Act (21 U.S.C. 801 et seq.),
regulations prescribed by the Attorney General, and State
law;
``(iii) the partial fill is requested by the patient or the
practitioner that wrote the prescription; and
``(iv) the total quantity dispensed in all partial fillings
does not exceed the total quantity prescribed.
``(B) Other circumstances.--A prescription for a controlled
substance in schedule II may be partially filled in
accordance with section 1306.13 of title 21, Code of Federal
Regulations (as in effect on the date of enactment of the
Reducing Unused Medications Act of 2016).
``(2) Remaining portions.--
``(A) In general.--Except as provided in subparagraph (B),
remaining portions of a partially filled prescription for a
controlled substance in schedule II--
``(i) may be filled; and
``(ii) shall be filled not later than 30 days after the
date on which the prescription is written.
``(B) Emergency situations.--In emergency situations, as
described in subsection (a), the remaining portions of a
partially filled prescription for a controlled substance in
schedule II--
``(i) may be filled; and
``(ii) shall be filled not later than 72 hours after the
prescription is issued.''.
(b) Rule of Construction.--Nothing in this section shall be
construed to affect the authority of the Attorney General to
allow a prescription for a controlled substance in schedule
III, IV, or V of section 202(c) of the Controlled Substances
Act (21 U.S.C. 812(c)) to be partially filled.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Kentucky (Mr. Guthrie) and the gentleman from Texas (Mr. Gene Green)
each will control 20 minutes.
The Chair recognizes the gentleman from Kentucky.
General Leave
Mr. GUTHRIE. Mr. Speaker, I ask unanimous consent that all Members
have 5 legislative days in which to revise and extend their remarks and
insert extraneous materials in the Record on the bill.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Kentucky?
There was no objection.
Mr. GUTHRIE. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in support of H.R. 4599, the Reducing Unused
Medications Act of 2016, introduced by Ms. Clark of Massachusetts and
Mr. Stivers of Ohio.
The number of prescriptions for opioids has significantly increased
in recent years. While opioids can benefit patients when used
appropriately, once their pain is subsided, there may be unused pills
that could be misused and diverted.
Several States have considered enabling pharmacies to partially fill
such prescriptions to minimize the number of pills in circulation while
continuing to address the patient needs. However, current DEA
regulations are not entirely clear about when such partial fills are
permitted.
H.R. 4599 amends the Controlled Substances Act to clarify when
schedule II controlled substances, including opioid pain medications,
can be partially filled. This is a commonsense, bipartisan bill that
will help save lives.
[[Page H2274]]
I urge my colleagues to join me in support.
I reserve the balance of my time.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself such time as I
may consume.
Mr. Speaker, I rise to voice my support for H.R. 4599, Reducing
Unused Medications Act.
Opioid abuse in the United States is rising at alarming rates. In
2014, nearly 2 million Americans abused or were addicted to
prescription opioids. Opioids are now one of the most prescribed
classes of medications, and the National Institute on Drug Abuse
estimates that over 70 percent of adults who misuse prescription
opioids get them from a friend or relative.
A promising step to reduce the number of prescription opioids is a
permanent partial filling of these prescriptions. Current Drug
Enforcement Administration regulations allow pharmacists to partially
fill prescriptions for schedule III, IV, and V substances, however,
only allow partial fulfillment of schedule II substances in long-term-
care settings or to terminally ill patients and when the full
prescription cannot be supplied.
While these regulations do not explicitly prohibit a pharmacist from
partially filling prescriptions for schedule II substances outside of
these certain limited circumstances, DEA recognizes that the
regulations lack clarity as to when partial filling of schedule II
substances is permitted. This bill would provide clarity.
The Reducing Unused Medications Act would allow pharmacists, at the
request of patients or doctors, to partially fill prescriptions for
schedule II drugs, such as opioids, meaning that a patient or doctor
can request to receive a 10-day supply of a 30-day prescription
initially and then return later to receive the remaining portion, if
needed. This flexibility may help reduce the number of unused pills in
circulation and reduce the risk of substance misuse, diversion, and
overdose.
The bipartisan bill before us reflects a careful compromise that
holds the potential to reduce the amount of unused opioid medications
in circulation and is an important step in helping curb a growing
opioid epidemic.
I want to thank Representatives Clark and Stivers for their
leadership in sponsoring this bill.
I urge my colleagues to support the Reducing Unused Medications Act.
Mr. Speaker, I yield 3 minutes to the gentlewoman from Massachusetts
(Ms. Clark), the sponsor of this bill.
Ms. CLARK of Massachusetts. Mr. Speaker, I thank the gentleman from
Texas for yielding.
Mr. Speaker, over the last decade, we have seen a staggering increase
of opioid overdose deaths. In 2015, this epidemic claimed 125 lives in
my district alone. There are a lot of different causes of this crisis,
but the number of prescription opioids in circulation is a critical
factor.
Over the last 15 years, the amount of prescription painkillers has
quadrupled and generic Vicodin is now the most prescribed drug to
Medicare beneficiaries.
Now, we know that often patients don't use all the opioids they are
prescribed. According to the National Institute on Drug Abuse, over 70
percent of adults who misuse prescription drugs get them from friends
or relatives.
Millions of half-filled bottles of unused and unwanted prescription
drugs line our families' medicine cabinets, and too often that is where
opioid addiction begins.
One promising way to reduce the amount of unused and unwanted
painkillers that are fueling this public health crisis is by allowing
patients and doctors to only partially fill opioid prescriptions.
By allowing pharmacists to partially fill a prescription for opioids
at the request of a patient or doctor, we can reduce the number of
unused pills and help stop pill diversion and misuse.
Currently, the DEA allows partial filling of prescriptions for many
drugs, but the regulations are narrower and less clear for opioid
drugs. That is why I, along with Representative Stivers, have
introduced the Reducing Unused Medications Act.
This legislation will resolve any ambiguity and clearly establish
that a prescription for schedule II substances, like opioid
painkillers, may be partially filled upon the request of a patient or
doctor.
We have all heard the stories. Just last weekend I ran into a dad
whose son had been given a 30-day prescription of opioid painkillers
for having a wisdom tooth taken out, and he had just received an
unwanted prescription, also for 30 days, after having minor surgery.
This bill will empower patients to manage their prescriptions and can
be a critical tool in an effort to address the opioid epidemic. This is
a commonsense bill that will help us stop the misuse of prescription
drugs that has fueled the use of heroin and this opioid epidemic.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield back the balance of my
time.
Mr. GUTHRIE. Mr. Speaker, I encourage all my colleagues to vote for
H.R. 4599, and I yield back the balance of my time.
Mr. PALLONE. Mr. Speaker, I rise to voice my support for H.R. 4599,
commonsense legislation that offers the potential to reduce the number
of unused and unwanted prescription opioids that have been misused or
diverted as a part of the opioid epidemic.
The number of prescription opioids dispensed in the U.S. has nearly
quadrupled in the last 15 years, and over 70 percent of adults who
misuse prescription opioids get them from a friend or a relative. This
is often due to the fact that many patients fill legitimate
prescriptions for opioids and for one reason or another do not use the
entirety of the prescription.
One way to help reduce the amount of unused opioid medications in
home medicine cabinets is to permit the partial filling of Schedule II
prescriptions. Partial fill policies allow providers, pharmacists, and
patients the option to dispense a portion of a prescription with the
option of filling the total amount of the prescription at a later time.
For example, a patient or practitioner could request that 10 or 15 days
of a 30-day prescription be dispensed initially with the remaining
portion available later if needed. It is hoped that this additional
flexibility would reduce the number of unused pills in circulation and
ultimately reduce misuse and diversion of these prescription opioids.
Current Drug Enforcement Administration regulations allow pharmacists
to partially fill prescriptions for Schedule III, IV, and V substances,
however, Schedule II substances can only be partially filled in long
term care settings, for terminally ill patients, or when the full
prescription cannot be supplied. While these regulations do not
prohibit partially filling prescriptions for Schedule II substances in
other situations, the DEA has acknowledged that the regulations may
need to be amended to provide clarity as to when partial fill of
Schedule II substances is allowable.
The Reducing Unused Medications Act of 2015 was introduced in the
House by Representatives Katherine Clark (D-MA) and Steve Stivers (R-
OH) to do just that--provide additional clarity regarding when Schedule
II prescriptions may be partially filled under the Controlled
Substances Act.
In addition to the circumstances outlined in current DEA regulations,
H.R. 4599 would also allow partial fill of Schedule II substances if
requested by a doctor or patient, as long as the prescription is
written and dispensed according to federal and state law. It further
makes clear that remaining portions of a partially filled prescription
for a Schedule II substance may not be filled later than 30 days after
the date the prescription is written.
Partial fills would also be allowed in emergency situations, with the
remaining portion to be filled not later than 72 hours after the
prescription is issued. This legislation does not impact the ability of
Schedule III, IV, or V prescriptions to be partially filled.
H.R. 4599 is the result of careful compromise among the authors of
this legislation, the stakeholders, and our Committee members, and I
urge my colleagues to support it.
Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 4599 the
``Reducing Unused Medication Act of 2016''.
This bill is an important measure that will decrease the number of
unused medications available for misuse to the public by setting
limitations on the most frequent avenues used to secure unused
medication.
As we know, many times patients are prescribed medication far beyond
their needs.
Unused prescription medication creates a lethal danger to households
and communities across America, and failing to properly dispose of
unfinished medications can have dire consequences on the environment
and our ecosystem.
According to a new study conducted by Geisinger Health System and
published in the Journal of the American Pharmacists Association just
11 percent of unused prescription drugs were disposed of via drug take-
back programs, while 55 percent were left in the
[[Page H2275]]
medicine cabinet, 14 percent were thrown in the trash, and 9 percent
were flushed down the toilet.
As we have heard many unfortunate stories as we bring greater
awareness to this issue, we know that abuse of medicine among teenagers
is a growing problem.
Easy access to parents' and grandparents' leftover medications is
just throwing gasoline on the fire.
Meanwhile, more than 60,000 young children are taken to the emergency
room each year after ingesting a family member's medication.
With respect to the environment, the FDA no longer recommends
flushing drugs down the toiler because sewage treatment plants lack the
capacity to remove pharmaceuticals and personal care products' residue.
H.R. 4599 will amend the Controlled Substances Act to permit certain
fillings of prescriptions--such that a prescription for a controlled
substance may be partially filled if:
It is not prohibited by state law;
The prescription is written and filled in accordance with the
Controlled Substances Act, regulations prescribed by the Attorney
General, and State law;
The partial fill is requested by the patient or the practitioner that
wrote the prescription; and
The total quantity dispensed in all partial fillings does not exceed
the total quantity prescribed.
Mr. Speaker, enacting this legislation will work to not only combat a
number of prescription drug abuses, but also deal a debilitating blow
to the mounting opioid abuse epidemic.
The SPEAKER pro tempore (Mr. Zinke). The question is on the motion
offered by the gentleman from Kentucky (Mr. Guthrie) that the House
suspend the rules and pass the bill, H.R. 4599, as amended.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill, as amended, was passed.
A motion to reconsider was laid on the table.
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