[Congressional Record (Bound Edition), Volume 162 (2016), Part 4]
[House]
[Pages 5717-5720]
[From the U.S. Government Publishing Office, www.gpo.gov]




     OPIOID USE DISORDER TREATMENT EXPANSION AND MODERNIZATION ACT

  Mr. GUTHRIE. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 4981) to amend the Controlled Substances Act to improve 
access to opioid use disorder treatment, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 4981

       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 ``Opioid Use Disorder 
     Treatment Expansion and Modernization Act''.

     SEC. 2. FINDING.

       The Congress finds that opioid use disorder has become a 
     public health epidemic that must be addressed by increasing 
     awareness and access to all treatment options for opioid use 
     disorder, overdose reversal, and relapse prevention.

     SEC. 3. OPIOID USE DISORDER TREATMENT MODERNIZATION.

       (a) In General.--Section 303(g)(2) of the Controlled 
     Substances Act (21 U.S.C. 823(g)(2)) is amended--
       (1) in subparagraph (B), by striking clauses (i), (ii), and 
     (iii) and inserting the following:
       ``(i) The practitioner is a qualifying practitioner (as 
     defined in subparagraph (G)).
       ``(ii) With respect to patients to whom the practitioner 
     will provide such drugs or combinations of drugs, the 
     practitioner has the capacity to provide directly, by 
     referral, or in such other manner as determined by the 
     Secretary--
       ``(I) all schedule III, IV, and V drugs, as well as 
     unscheduled medications approved by the Food and Drug 
     Administration, for the treatment of opioid use disorder, 
     including such drugs and medications for maintenance, 
     detoxification, overdose reversal, and relapse prevention, as 
     available; and
       ``(II) appropriate counseling and other appropriate 
     ancillary services.
       ``(iii)(I) The total number of such patients of the 
     practitioner at any one time will not exceed the applicable 
     number. Except as provided in subclause (II), the applicable 
     number is 30.
       ``(II) The applicable number is 100 if, not sooner than 1 
     year after the date on which the practitioner submitted the 
     initial notification, the practitioner submits a second 
     notification to the Secretary of the need and intent of the 
     practitioner to treat up to 100 patients.
       ``(III) The Secretary may by regulation change such total 
     number.
       ``(IV) The Secretary may exclude from the applicable number 
     patients to whom such drugs or combinations of drugs are 
     directly administered by the qualifying practitioner in the 
     office setting.
       ``(iv) If the Secretary by regulation increases the total 
     number of patients which a qualifying practitioner is 
     permitted to treat pursuant to clause (iii)(II), the 
     Secretary shall require such a practitioner to obtain a 
     written agreement from each patient, including the patient's 
     signature, that the patient--
       ``(I) will receive an initial assessment and treatment plan 
     and periodic assessments and treatment plans thereafter;
       ``(II) will be subject to medication adherence and 
     substance use monitoring;
       ``(III) understands available treatment options, including 
     all drugs approved by the Food and Drug Administration for 
     the treatment of opioid use disorder, including their 
     potential risks and benefits; and
       ``(IV) understands that receiving regular counseling 
     services is critical to recovery.
       ``(v) The practitioner will comply with the reporting 
     requirements of subparagraph (D)(i)(IV).'';
       (2) in subparagraph (D)--
       (A) in clause (i), by adding at the end the following:
       ``(IV) The practitioner reports to the Secretary, at such 
     times and in such manner as specified by the Secretary, such 
     information and assurances as the Secretary determines 
     necessary to assess whether the practitioner continues to 
     meet the requirements for a waiver under this paragraph.'';
       (B) in clause (ii), by striking ``Upon receiving a 
     notification under subparagraph (B)'' and inserting ``Upon 
     receiving a determination from the Secretary under clause 
     (iii) finding that a practitioner meets all requirements for 
     a waiver under subparagraph (B)''; and
       (C) in clause (iii)--
       (i) by inserting ``and shall forward such determination to 
     the Attorney General'' before the period at the end of the 
     first sentence; and
       (ii) by striking ``physician'' and inserting 
     ``practitioner'';
       (3) in subparagraph (G)--
       (A) by amending clause (ii)(IV) to read as follows:
       ``(IV) The physician has, with respect to the treatment and 
     management of opiate-dependent patients, completed not less 
     than eight hours of training (through classroom situations, 
     seminars at professional society meetings, electronic 
     communications, or otherwise) that is provided by the 
     American Society of Addiction Medicine, the American Academy 
     of Addiction Psychiatry, the American Medical Association, 
     the American Osteopathic Association, the American 
     Psychiatric Association, or any other organization that the 
     Secretary determines is appropriate for purposes of this 
     subclause. Such training shall address--
       ``(aa) opioid maintenance and detoxification;
       ``(bb) appropriate clinical use of all drugs approved by 
     the Food and Drug Administration for the treatment of opioid 
     use disorder;
       ``(cc) initial and periodic patient assessments (including 
     substance use monitoring);
       ``(dd) individualized treatment planning; overdose 
     reversal; relapse prevention;
       ``(ee) counseling and recovery support services;
       ``(ff) staffing roles and considerations;
       ``(gg) diversion control; and
       ``(hh) other best practices, as identified by the 
     Secretary.''; and
       (B) by adding at the end the following:
       ``(iii) The term `qualifying practitioner' means--
       ``(I) a qualifying physician, as defined in clause (ii); or
       ``(II) during the period beginning on the date of the 
     enactment of the Opioid Use Disorder Treatment Expansion and 
     Modernization Act and ending on the date that is three years 
     after such date of enactment, a qualifying other 
     practitioner, as defined in clause (iv).
       ``(iv) The term `qualifying other practitioner' means a 
     nurse practitioner or physician assistant who satisfies each 
     of the following:
       ``(I) The nurse practitioner or physician assistant is 
     licensed under State law to prescribe schedule III, IV, or V 
     medications for the treatment of pain.
       ``(II) The nurse practitioner or physician assistant 
     satisfies 1 or more of the following:
       ``(aa) Has completed not fewer than 24 hours of initial 
     training addressing each of the topics listed in clause 
     (ii)(IV) (through classroom situations, seminars at 
     professional society meetings, electronic communications, or 
     otherwise) provided by the American Society of Addiction 
     Medicine, the American Academy of Addiction Psychiatry, the 
     American Medical Association, the American Osteopathic 
     Association, the American Nurses Credentialing Center, the 
     American Psychiatric Association, the American Association of 
     Nurse Practitioners, the American Academy of Physician 
     Assistants, or any other organization that the Secretary 
     determines is appropriate for purposes of this subclause.
       ``(bb) Has such other training or experience as the 
     Secretary determines will demonstrate the ability of the 
     nurse practitioner

[[Page 5718]]

     or physician assistant to treat and manage opiate-dependent 
     patients.
       ``(III) The nurse practitioner or physician assistant is 
     supervised by or works in collaboration with a qualifying 
     physician, if the nurse practitioner or physician assistant 
     is required by State law to prescribe medications for the 
     treatment of opioid use disorder in collaboration with or 
     under the supervision of a physician.

     The Secretary may review and update the requirements for 
     being a qualifying other practitioner under this clause.''; 
     and
       (4) in subparagraph (H)--
       (A) in clause (i), by inserting after subclause (II) the 
     following:
       ``(III) Such other elements of the requirements under this 
     paragraph as the Secretary determines necessary for purposes 
     of implementing such requirements.''; and
       (B) by amending clause (ii) to read as follows:
       ``(ii) Not later than one year after the date of enactment 
     of the Opioid Use Disorder Treatment Expansion and 
     Modernization Act, the Secretary shall update the treatment 
     improvement protocol containing best practice guidelines for 
     the treatment of opioid-dependent patients in office-based 
     settings. The Secretary shall update such protocol in 
     consultation with experts in opioid use disorder research and 
     treatment.''.
       (b) Recommendation of Revocation or Suspension of 
     Registration in Case of Substantial Noncompliance.--The 
     Secretary of Health and Human Services may recommend to the 
     Attorney General that the registration of a practitioner be 
     revoked or suspended if the Secretary determines, according 
     to such criteria as the Secretary establishes by regulation, 
     that a practitioner who is registered under section 303(g)(2) 
     of the Controlled Substances Act (21 U.S.C. 823(g)(2)) is not 
     in substantial compliance with the requirements of such 
     section, as amended by this Act.
       (c) Opioid Defined.--Section 102(18) of the Controlled 
     Substances Act (21 U.S.C. 802(18)) is amended by inserting 
     ``or `opioid''' after ``The term `opiate'''.
       (d) Reports to Congress.--
       (1) In general.--Not later than 2 years after the date of 
     enactment of this Act and not less than over every 5 years 
     thereafter, the Secretary of Health and Human Services, in 
     consultation with the Drug Enforcement Administration and 
     experts in opioid use disorder research and treatment, 
     shall--
       (A) perform a thorough review of the provision of opioid 
     use disorder treatment services in the United States, 
     including services provided in opioid treatment programs and 
     other specialty and nonspecialty settings; and
       (B) submit a report to the Congress on the findings and 
     conclusions of such review.
       (2) Contents.--Each report under paragraph (1) shall 
     include an assessment of--
       (A) compliance with the requirements of section 303(g)(2) 
     of the Controlled Substances Act (21 U.S.C. 823(g)(2)), as 
     amended by this Act;
       (B) the measures taken by the Secretary of Health and Human 
     Services to ensure such compliance;
       (C) whether there is further need to increase or decrease 
     the number of patients a waivered practitioner is permitted 
     to treat, as provided for by the amendment made by subsection 
     (a)(1);
       (D) the extent to which, and proportions with which, the 
     full range of Food and Drug Administration-approved 
     treatments for opioid use disorder are used in routine health 
     care settings and specialty substance use disorder treatment 
     settings;
       (E) access to, and use of, counseling and recovery support 
     services, including the percentage of patients receiving such 
     services;
       (F) changes in State or local policies and legislation 
     relating to opioid use disorder treatment;
       (G) the use of prescription drug monitoring programs by 
     practitioners who are permitted to dispense narcotic drugs to 
     individuals pursuant to a waiver under section 303(g)(2) of 
     the Controlled Substances Act (21 U.S.C. 823(g)(2));
       (H) the findings resulting from inspections by the Drug 
     Enforcement Administration of practitioners described in 
     subparagraph (G); and
       (I) the effectiveness of cross-agency collaboration between 
     Department of Health and Human Services and the Drug 
     Enforcement Administration for expanding effective opioid use 
     disorder treatment.

     SEC. 4. SENSE OF CONGRESS.

       It is the Sense of Congress that, with respect to the total 
     number of patients that a qualifying physician (as defined in 
     subparagraph (G)(iii) of section 303(g)(2) of the Controlled 
     Substances Act (21 U.S.C. 823(g)(2)) can treat at any one 
     time pursuant to such section, the Secretary of Health and 
     Human Services should consider raising such total number to 
     250 patients following a third notification to the Secretary 
     of the need and intent of the physician to treat up to 250 
     patients that is submitted to the Secretary not sooner than 1 
     year after the date on which the physician submitted to the 
     Secretary a second notification to treat up to 100 patients.

     SEC. 5. 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. 4981, the Opioid Use Disorder 
Treatment Expansion and Modernization Act, introduced by the gentleman 
from Indiana (Mr. Bucshon) and the gentleman from New York (Mr. Tonko).
  More than 2 million Americans are living with a substance use 
disorder. Evidence strongly suggests that medication-assisted treatment 
can have a significant impact on combating this epidemic.
  H.R. 4981 would amend the Controlled Substance Act to expand access 
to medication-assisted treatment for patients with substance use 
disorders while improving the quality of care provided and minimizing 
the potential for drug diversion.
  For the first time, this bill would authorize nurse practitioners and 
physician assistants to prescribe maintenance treatment in an office-
based setting after meeting certain training requirements.
  H.R. 4981 would improve the training that all qualifying 
practitioners receive, and it would maintain the critical role 
counseling and other recovery support services play in the provision of 
quality medication-assisted treatment.
  Further, the bill would require HHS to perform a thorough review of 
opioid use disorder so we know what is working well and where there is 
a need for further improvement.
  H.R. 4981 is the product of extensive bipartisan discussion at the 
Energy and Commerce Committee, and I urge my colleagues to join me in 
supporting it.
  I reserve the balance of my time.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself such time as I 
may consume.

[[Page 5719]]

  Mr. Speaker, I rise in support of H.R. 4981, the Opioid Use Disorder 
Treatment Expansion and Modernization Act.
  Despite the fact that we are in the middle of an unprecedented opioid 
and heroin crisis, we know that treatment gaps continue to limit our 
ability to address the growing crisis. Only 1 in 10 people struggling 
with addiction receive any form of treatment, despite the fact that we 
have evidence-based, medication-assisted treatment for those struggling 
with prescription drug or heroin addiction.
  One available treatment is buprenorphine. The medication is safely 
prescribed from an office setting similar to any other medication a 
patient might take.
  Unfortunately, in the midst of our current opioid epidemic, 
currently, physicians are restricted to how many patients they are 
allowed to treat with this medication, and nurse practitioners and 
physician assistants are not allowed to treat patients with this 
medication at all.
  As a result, many patients are placed on prolonged waiting lists with 
addiction specialists as they await access to this treatment. This is 
not acceptable.
  We must significantly increase the cap of the number of patients a 
physician can treat, as well as permanently allow nurse practitioners 
and physician assistants to treat patients with this medication.
  Today's legislation is not perfect, but it is the first step toward 
reaching bicameral, bipartisan agreement on a package that meets these 
goals. I remain committed to working with my colleagues to expand 
access to this important evidence-based treatment as we move to 
conference with the Senate.
  I want to thank the bill's sponsors, fellow members of the Committee 
on Energy and Commerce, Representative Paul Tonko and Representative 
Larry Bucshon, for introducing this legislation. I urge my colleagues 
to support the Opioid Use Disorder Treatment Expansion and 
Modernization Act.
  I reserve the balance of my time.
  Mr. GUTHRIE. Mr. Speaker, I yield 5 minutes to the gentleman from 
Indiana (Mr. Bucshon), a cosponsor of this piece of legislation.
  Mr. BUCSHON. Mr. Speaker, H.R. 4981, the Opioid Use Disorder 
Treatment Expansion and Modernization Act, is the product of months of 
stakeholder engagement, expert input, and bipartisan negotiation.
  The opioid epidemic has left no area of this Nation untouched. Day in 
and day out, we hear from our constituents and see in the news the 
direct impact this has on the everyday lives of our fellow citizens.
  The evidence is clear that this epidemic is growing and it will 
continue to grow unless immediate action is taken.
  As a doctor, a father, and a public policymaker, I want to do my part 
to help our communities overcome this challenge. That is why I am proud 
to offer H.R. 4981, the Opioid Use Disorder Treatment Expansion and 
Modernization Act today with my colleague from New York (Mr. Tonko).
  We have worked together over the past several months to find common 
ground and move forward with a well-crafted policy solution. Our final 
bill represents months of stakeholder engagement and bipartisan work to 
improve access and quality treatment for opioid use disorder while 
limiting diversion of treatment medications for abuse themselves.
  H.R. 4981 targets four main areas:
  Increase access to opioid use disorder treatment where it is most 
needed;
  Empower physicians through education, training, and quality-of-care 
measures;
  Encourage a multi-pronged approach to opioid use disorder treatment;
  Deter bad actors and reduce diversion, as previously was mentioned.
  This is a positive step toward increasing access for treatment for 
opioid use disorder while raising the quality of care and reducing 
diversion.
  Again, I want to thank Mr. Tonko and all those who have worked with 
us throughout this process. I urge my colleagues to support H.R. 4981's 
passage, and I look forward to productive discussions with the Senate 
to get critical opioid legislation to the President's desk.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield 5 minutes to the 
gentleman from New York (Mr. Tonko), a fellow member on the Committee 
on Energy and Commerce.
  Mr. TONKO. Mr. Speaker, I thank the gentleman from Texas for 
yielding.
  I rise in support of H.R. 4981, Opioid Use Disorder Treatment 
Expansion and Modernization Act, which I have had the honor of working 
on with my colleague and friend, Representative Larry Bucshon, in 
introducing.
  At the outset, I would like to thank Representative Bucshon and his 
staff, as well as the hard work of individuals on the committee staff, 
and our committee leaders, Chairman Upton and Ranking Member Pallone, 
to get this bill to this point.
  I would also like to praise my colleague and fellow New Yorker, 
Representative Brian Higgins, for his introduction and leadership on 
the TREAT Act, without which we would not be making this progress 
today.
  It is no hyperbole to announce that we are in a crisis when it comes 
to the opioid epidemic sweeping our Nation. More than 47,000 people 
have died of drug overdoses in 2014--family members, friends, and 
neighbors within that 47,000, for each and every one of us--a vast 
majority of which were opioid-related.
  It is a sign of the times that when you drive down the thruway in my 
district in upstate New York, instead of billboards advertising for 
McDonald's or Taco Bell, you see billboards advising to you call 911 in 
case of an opioid overdose.
  It is disturbing how quickly this has become the new normal. This 
crisis has affected our neighbors, our families, and our beloved 
communities.
  Having worked with the addiction recovery community, I know that one 
of the most important things we can do as policymakers is to ensure 
that when an individual struggling with addiction cries out for help, 
that there is someone there to answer the call. That is what this bill 
endeavors to do.
  Right now, treatment capacity for those seeking help for opioid use 
disorder in an office-based setting is artificially capped at 100 
patients. What this means in reality is that if you are patient 101 or 
102, you get a closed door and have to wait weeks, if not months, for 
treatment. Expectedly, these delays can be deadly.
  The legislation before us will support the goal of raising the caps 
for qualified physicians to 250, expanding existing opioid treatment 
capacity by some 150 percent, all while ensuring the care that 
individuals receive is high quality and minimizes the risk of 
diversion.
  In addition, this legislation will, for the first time, expand 
buprenorphine-prescribing authority to nurse practitioners and 
physician assistants who meet certain training requirements and comply 
with applicable State laws.
  By bringing these practitioners into the fold, we can expand 
treatment capacity, especially in rural areas where physicians 
oftentimes might be few and far between.
  Importantly, this bill expands access to high-quality addiction 
treatment, promoting the full range of psychosocial services that makes 
recovery possible, and providing HHS with new tools to remove bad 
actors from the system.
  Any Member interested in decreasing the unlawful diversion of 
buprenorphine should support this legislation.
  This legislation is not perfect, and I would still like to see a 
higher patient limit for the top class of physicians.
  In the midst of this crisis, ensuring access for all needs to be our 
utmost top priority. No matter where we ultimately land on this 
arbitrary number, we will still be closing the door on someone who 
needs our help. We would not accept this in any other field of 
medicine, so we all need to think long and hard about why we are 
allowing this situation to persist in the field of addiction.
  In addition, I would like to draw attention to two changes made to 
this bill before floor consideration. First, instead of statutorily 
lifting the DATA

[[Page 5720]]

2000 caps, this legislation includes a sense of Congress, if you will, 
that the caps should be lifted.
  Secondly, this legislation would time-limit the expansion of 
prescribing authority to nurse practitioners and physician assistants 
to some 3 years.
  Both of these temporary changes were made to bring the bill into 
compliance with PAYGO procedures for floor consideration and must be 
fixed as we move this bill into conference.

                              {time}  1845

  I would just ask, Mr. Speaker, are we firm in our commitment to 
combat the addiction to heroin? Are we firm in our efforts to assist 
those who struggle with the illness of addiction? Do we stand for 
providing true hope to individuals who count on us to provide the 
resources along with the legislation to make life available to them?
  I would suggest that this House and the Senate look hard and fast at 
providing resources that are real and that provide for an effective 
outcome. If we fail to find a path forward for a meaningful expansion 
of the physician caps and certainly the nurse practitioners' and 
physician assistants' prescribing authority, then we are rationing 
care, pure and simple.
  The starting point for any conference discussion should be the bill 
as reported out of the House Energy and Commerce Committee. In any 
final legislation, we must include a statutory lifting of the DATA 2000 
caps as well as full authority for our NPs and PAs. I would ask for the 
commitment of my colleagues on the other side of the aisle in 
continuing to work toward these goals.
  Notwithstanding these issues, I believe it is critically important to 
keep up the momentum and to pass this bill. Even in its imperfect form, 
this bill will make a huge difference in the lives of those who 
struggle with this disease. If we cannot find a way to get a bill to 
the President's desk that will provide needed relief in the midst of 
this epidemic, shame on us.
  While this legislation is not a cure-all for the opioid epidemic, I 
believe the Opioid Use Disorder Treatment Expansion and Modernization 
Act will go far in helping to alleviate our acute treatment capacity 
issues and put more people on the path to recovery. I ask my colleagues 
in this House and down the hall in the Senate to support a bill--this 
bill--so that we can bring hope, truly bring hope into the lives of 
those individuals, those families, and those communities who grapple 
with this crisis on a daily basis.
  Mr. GUTHRIE. Mr. Speaker, as I said earlier, people come here to the 
people's House from all walks of life. We are blessed to have a 
pharmacist amongst us. The only pharmacist here. These are difficult 
issues. Legal prescription drugs are diverted and abused, and heroin is 
illegal. It is great to have his expertise.
  Mr. Speaker, I yield such time as he may consume to the gentleman 
from Georgia (Mr. Carter).
  Mr. CARTER of Georgia. I thank the gentleman from Kentucky for 
yielding and for his efforts, along with Dr. Bucshon and others across 
the aisle, Congressman Gene Green and all those who have been involved 
in this. This is a very important subject.
  Mr. Speaker, I rise today in support of H.R. 4981 because making sure 
modern treatments are available for opioid addiction should be one of 
our top priorities in the fight against opioid drug abuse.
  H.R. 4981 makes reforms to the Controlled Substances Act that would 
modernize the way doctors approach opioid addiction and how patients 
obtain treatment. These reforms, which make treatment tools more 
available to patients, are one more step we can take to improve 
treatment services for patients. With these reforms, more patients will 
receive higher quality care, increasing the success of overall 
treatment.
  As a lifelong healthcare professional, I have witnessed patients 
firsthand who have struggled with receiving care for their addiction. 
We must stop the cycle of failing to provide patients with proper care 
because the system is not adequately structured to provide it.
  The only way we are able to provide the appropriate care is if we 
continue to support the evolution of treatment and care for this ever-
changing opioid abuse epidemic. That is why I am supporting H.R. 4981. 
By reforming the way treatment is provided, we can begin to truly help 
all patients with opioid addiction.
  Mr. Speaker, I encourage my colleagues to support this bill.
  Mr. GENE GREEN of Texas. Mr. Speaker, I have no further speakers.
  Mr. Speaker, I yield back the balance of my time.
  Mr. GUTHRIE. Mr. Speaker, I encourage and urge my colleagues to 
support this very important bill, H.R. 4981.
  I yield back the balance of my time.
  Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 4981 the 
``Opioid Use Disorder Treatment Expansion and Modernization Act''.
  This bill highlights the abuse of opioids that has become a public 
health epidemic.
  Opioids are drugs with effects similar to opium, such as heroin and 
certain pain medications.
  H.R. 4981 would encourage and train health care providers to 
prescribe overdose reversal drugs, such as Naloxone, when they 
prescribe common opioids-like pain medication to patients at risk of 
addiction.
  The plague of opioid overdose deaths across the nation is disturbing, 
but there are ways to combat this trend.
  Any party receiving treatment assessments under this legislation will 
be privy to the following.
  1. A treatment plan and periodic assessments.
  2. Will also be subject to medication adherence and substance use 
monitoring.
  3. Treatment options, including all drugs approved by the Food and 
Drug Administration for the treatment of opioid use disorder, including 
their potential risks and benefits.
  4. Receiving regular counseling services is critical to recovery.
  The Centers for Disease Control and Prevention reports that nearly 
259 million opioid prescriptions were written in 2012, more than enough 
for every adult in the United States.
  Enacting this legislation will implement a diversion control plan 
that contains specific measures to reduce the likelihood of the 
diversion of controlled substances prescribed by the physician for the 
treatment of opioid use disorder.
  In 2013 nearly 4.5 million people in the United States without a 
valid medical need were using prescription painkillers.
  Both states and the federal government have begun responding to this 
growing public health crisis.
  The Obama administration has awarded $94 million to community health 
centers to improve and expand the delivery of substance abuse services.
  Mr. Speaker, the mounting number of people adversely affected and the 
over 25,000 lives lost expressly demonstrates the need for this type of 
legislation.
  H.R. 4981 is a positive step in the right direction and I urge all 
members to support this important legislation.
  The SPEAKER pro tempore. 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. 4981, 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.

                          ____________________