[House Report 117-181]
[From the U.S. Government Publishing Office]


117th Congress    }                                    {       Report
                        HOUSE OF REPRESENTATIVES
 1st Session      }                                    {      117-181

======================================================================



 
                 SYNTHETIC OPIOID DANGER AWARENESS ACT

                                _______
                                

 November 30, 2021.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

 Mr. Pallone, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 2364]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 2364) to amend title III of the Public Health 
Service Act to direct the Secretary, acting through the 
Director of the Centers for Disease Control and Prevention, to 
provide for a public education campaign to raise public 
awareness of synthetic opioids, having considered the same, 
reports favorably thereon with an amendment and recommends that 
the bill as amended do pass.

                                CONTENTS

                                                                     Page
  I. Purpose and Summary..............................................  3 
 II. Background and Need for the Legislation..........................  3 
III. Committee Hearings...............................................  4 
 IV. Committee Consideration..........................................  4 
  V. Committee Votes..................................................  5 
 VI. Oversight Findings...............................................  5 
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures  5 
VIII.Federal Mandates Statement.......................................  5 
 IX. Statement of General Performance Goals and Objectives............  5 
  X. Duplication of Federal Programs..................................  6 
 XI. Committee Cost Estimate..........................................  6 
XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits......  6  
XIII.Advisory Committee Statement.....................................  6 
XIV. Applicability to Legislative Branch..............................  6 
 XV. Section-by-Section Analysis of the Legislation...................  6 
XVI. Changes in Existing Law Made by the Bill, as Reported............  7 

    The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Synthetic Opioid Danger Awareness 
Act''.

SEC. 2. SYNTHETIC OPIOIDS PUBLIC AWARENESS CAMPAIGN.

  Part B of title III of the Public Health Service Act is amended by 
inserting after section 317U (42 U.S.C. 247b-23) the following new 
section:

``SEC. 317V. SYNTHETIC OPIOIDS PUBLIC AWARENESS CAMPAIGN.

  ``(a) In General.--Not later than one year after the date of the 
enactment of this section, the Secretary shall provide for the planning 
and implementation of a public education campaign to raise public 
awareness of synthetic opioids (including fentanyl and its analogues). 
Such campaign shall include the dissemination of information that--
          ``(1) promotes awareness about the potency and dangers of 
        fentanyl and its analogues and other synthetic opioids;
          ``(2) explains services provided by the Substance Abuse and 
        Mental Health Services Administration and the Centers for 
        Disease Control and Prevention (and any entity providing such 
        services under a contract entered into with such agencies) with 
        respect to the misuse of opioids, particularly as such services 
        relate to the provision of alternative, non-opioid pain 
        management treatments; and
          ``(3) relates generally to opioid use and pain management.
  ``(b) Use of Media.--The campaign under subsection (a) may be 
implemented through the use of television, radio, internet, in-person 
public communications, and other commercial marketing venues and may be 
targeted to specific age groups.
  ``(c) Consideration of Report Findings.--In planning and implementing 
the public education campaign under subsection (a), the Secretary shall 
take into consideration the findings of the report required under 
section 7001 of the SUPPORT for Patients and Communities Act (Public 
Law 115-271).
  ``(d) Consultation.--In coordinating the campaign under subsection 
(a), the Secretary shall consult with the Assistant Secretary for 
Mental Health and Substance Use to provide ongoing advice on the 
effectiveness of information disseminated through the campaign.
  ``(e) Requirement of Campaign.--The campaign implemented under 
subsection (a) shall not be duplicative of any other Federal efforts 
relating to eliminating the misuse of opioids.
  ``(f) Evaluation.--
          ``(1) In general.--The Secretary shall ensure that the 
        campaign implemented under subsection (a) is subject to an 
        independent evaluation, beginning 2 years after the date of the 
        enactment of this section, and every 2 years thereafter.
          ``(2) Measures and benchmarks.--For purposes of an evaluation 
        conducted pursuant to paragraph (1), the Secretary shall--
                  ``(A) establish baseline measures and benchmarks to 
                quantitatively evaluate the impact of the campaign 
                under this section; and
                  ``(B) conduct qualitative assessments regarding the 
                effectiveness of strategies employed under this 
                section.
  ``(g) Report.--The Secretary shall, beginning 2 years after the date 
of the enactment of this section, and every 2 years thereafter, submit 
to Congress a report on the effectiveness of the campaign implemented 
under subsection (a) towards meeting the measures and benchmarks 
established under subsection (e)(2).
  ``(h) Dissemination of Information Through Providers.--The Secretary 
shall develop and implement a plan for the dissemination of information 
related to synthetic opioids, to health care providers who participate 
in Federal programs, including programs administered by the Department 
of Health and Human Services, the Indian Health Service, the Department 
of Veterans Affairs, the Department of Defense, and the Health 
Resources and Services Administration, the Medicare program under title 
XVIII of the Social Security Act, and the Medicaid program under title 
XIX of such Act.''.

SEC. 3. TRAINING GUIDE AND OUTREACH ON SYNTHETIC OPIOID EXPOSURE 
                    PREVENTION.

  (a) Training Guide.--Not later than 18 months after the date of the 
enactment of this Act, the Secretary of Health and Human Services shall 
design, publish, and make publicly available on the internet website of 
the Institute, a training guide and webinar for first responders and 
other individuals who also may be at high risk of exposure to synthetic 
opioids that details measures to prevent that exposure.
  (b) Outreach.--Not later than 18 months after the date of the 
enactment of this Act, the Secretary of Health and Human Services shall 
also conduct outreach about the availability of the training guide and 
webinar published under subsection (a) to--
          (1) police and fire managements;
          (2) sheriff deputies in city and county jails;
          (3) ambulance transport and hospital emergency room 
        personnel;
          (4) clinicians; and
          (5) other high-risk occupations, as identified by the 
        Assistant Secretary for Mental Health and Substance Use.

                         I. Purpose and Summary

    H.R. 2364, the ``Synthetic Opioid Danger Awareness Act,'' 
requires the Secretary of Health and Human Services (HHS) to 
implement a public education campaign related to synthetic 
opioids, including fentanyl and its analogues, to help address 
the rising rates of overdose related to synthetic opioids. The 
campaign would promote awareness around the dangers of 
synthetic opioids, as well as make available additional 
information about services available to address the misuse of 
synthetic opioids. In addition, the Secretary of HHS (the 
Secretary) would be required to develop and implement a plan 
for disseminating information to health care providers who 
participate in Federal programs. Finally, H.R. 2364 would 
require the Secretary to publish a training guide and webinar 
for first responders and other individuals related to synthetic 
opioid exposure prevention.

                II. Background and Need for Legislation

    Substance use disorders (SUD) are complex, treatable 
diseases that impact physical and mental health.\1\ In 2019, 
roughly 20.3 million Americans--including over one million 
children ages 12 to 17--had a SUD.\2\ Of the 20.3 million with 
a SUD, over 10 million experienced opioid misuse.\3\ Around 80 
percent of people who use heroin first misused prescription 
opioids.\4\ If untreated, SUDs can lead to severe health 
outcomes and in the most tragic cases, death.
---------------------------------------------------------------------------
    \1\National Institute on Drug Abuse, The Science of Drug Use and 
Addiction: The Basics, (www.drugabuse.gov/publications/media-guide/
science-drug-use-addiction-basics) (accessed Aug. 17, 2021).
    \2\Substance Abuse and Mental Health Services Association, 2018-
2019 National Surveys on Drug Use and Health Estimated Totals by State, 
(Jan. 28, 2021). (www.samhsa.gov/data/sites/default/files/reports/
rpt32879/NSDUHsaeTotal2019/2019NSDUHsaeTotal.pdf).
    \3\Substance Abuse and Mental Health Services Administration, Dr. 
Elinore F. McCance-Katz Webcast Slides, National Survey on Drug Use and 
Health: 2019) (Sept. 11, 2020) (www.samhsa.gov/data/sites/default/
files/reports/rpt29392/Assistant-Secretary-nsduh2019_
presentation/Assistant-Secretary-nsduh2019_presentation.pdf).
    \4\National Institute on Drug Abuse, Opioid Overdose Crisis, 
(https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis).
---------------------------------------------------------------------------
    Prior to the coronavirus disease of 2019 (COVID-19) 
pandemic, opioid overdose deaths were increasing in the United 
States.\5\ Recent data from the Centers for Disease Control and 
Prevention (CDC) indicate an acceleration of overdose deaths 
during the pandemic. In the 12 months leading up to August 
2020, 88,000 drug overdose deaths were reported; the highest 
total ever recorded in a 12-month period.\6\ Recently, the 
Office of National Drug Control Policy (ONDCP) announced 
efforts to expand evidenced-based treatments, advance racial 
equity in drug policy, support evidence-based prevention and 
harm-reduction efforts, and enhance the addiction workforce and 
recovery support services.\7\
---------------------------------------------------------------------------
    \5\enters for Disease Control and Prevention, Trends and Geographic 
Patterns in Drug and Synthetic Opioid Overdose Deaths--United States, 
2013-2019, (Feb. 21, 2021) (www.cdc.gov/mmwr/volumes/70/wr/
mm7006a4.htm?s_cid=mm7006a4_w).
    \6\Centers for Disease Control and Prevention, National Center for 
Health Statistics, Provisional drug overdose death counts (www.cdc.gov/
nchs/nvss/vsrr/drug-overdose-data.htm) (accessed Aug. 17, 2021).
    \7\Executive Office of the President Office of National Drug 
Control Policy, The Biden-Harris Administration's Statement of Drug 
Policy Priorities for Year One, (https://www.whitehouse.gov/ondcp/
briefing-room/2021/04/01/biden-harris-administration-announces-first-
year-drug-policy-priorities/) (Apr. 1, 2021).
---------------------------------------------------------------------------
    In 2018, Congress also passed the Substance Use-Disorder 
Prevention that Promotes Opioid Recovery and Treatment for 
Patients and Communities Act (SUPPORT Act). The SUPPORT Act 
authorized opioid-specific funding and expanded access to SUD 
treatment and resources. The law also increased opioid abuse 
and overdose prevention training for providers; improved 
coordination and quality of care; supported e-prescribing of 
controlled-substances and strengthened both the Food and Drug 
Administration (FDA) and law enforcement's respective abilities 
to combat the trafficking of illicit opioids.\8\
---------------------------------------------------------------------------
    \8\Substance Use Disorder Prevention that Promotes Opioid Recovery 
and Treatment (SUPPORT) for Patients and Communities Act, Pub. L. No. 
115-271 (2018).
---------------------------------------------------------------------------
    Given the increasing risks associated with synthetic 
opioids, H.R. 2364 would authorize a public education campaign 
to raise awareness of synthetic opioids related to the dangers 
of synthetic opioids, including fentanyl and its analogues.

                        III. Committee Hearings

    For the purposes of section 3(c) of rule XIII of the Rules 
of the House of Representatives, the following hearing was used 
to develop or consider H.R. 2364:
    The Subcommittee on Health held a hearing on April 14, 
2021, entitled ``An Epidemic within a Pandemic: Understanding 
Substance Use and Misuse in America.'' The Subcommittee 
received testimony from the following witnesses:

Panel I

           Regina M. LaBelle, Acting Director, White 
        House Office of National Drug Control Policy.

Panel II

           Geoffrey M. Laredo, Principal, Santa Cruz 
        Strategies, LLC;
           Patricia L. Richman, National Sentencing 
        Resource Counsel, Federal Public and Community 
        Defenders;
           Mark Vargo, Pennington County State's 
        Attorney, Legislative Committee Chairman, National 
        District Attorneys Association;
           Timothy Westlake, M.D., F.F.S.M.B., 
        F.A.C.E.P., Emergency Department Medical Director, Pro 
        Health Care Oconomowoc Memorial Hospital;
           J. Deanna Wilson, M.D., M.P.H., Assistant 
        Professor of Medicine and Pediatrics, University of 
        Pittsburgh School of Medicine.

                      IV. Committee Consideration

    H.R. 2364, the ``Synthetic Opioid Danger Awareness Act,'' 
was introduced on April 5, 2021, by Representatives Andy Kim 
(D-NJ) and Chris Pappas (D-NH) and referred to the Committee on 
Energy and Commerce. Subsequently, on April 13, 2021, H.R. 2364 
was referred to the Subcommittee on Health. A legislative 
hearing was held on the bill on April 14, 2021.
    On July 15, 2021, the Subcommittee on Health met in open 
markup session, pursuant to notice, to consider H.R. 2364 and 
18 other bills. During consideration of the bill, an amendment 
in the nature of a substitute (AINS) offered by Representative 
Trahan (D-MA) was agreed to by a voice vote. Upon conclusion of 
consideration of the bill, the Subcommittee on Health agreed to 
report the bill favorably to the full Committee, amended, by a 
voice vote.
    On July 21, 2021, the full Committee met in open markup 
session, pursuant to notice, to consider H.R. 2364 and 23 other 
bills. No amendments were offered during consideration of the 
bill. Upon conclusion of consideration of the bill, the full 
Committee agreed to a motion on final passage offered by 
Representative Pallone (D-NJ), Chairman of the Committee, to 
order H.R. 2364 reported favorably to the House, as amended, by 
a voice vote.

                           V. Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list each record vote 
on the motion to report legislation and amendments thereto. The 
Committee advises that there were no record votes taken on H.R. 
2364.

                         VI. Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII and clause 2(b)(1) 
of rule X of the Rules of the House of Representatives, the 
oversight findings and recommendations of the Committee are 
reflected in the descriptive portion of the report.

 VII. New Budget Authority, Entitlement Authority, and Tax Expenditures

    Pursuant to 3(c)(2) of rule XIII of the Rules of the House 
of Representatives, the Committee adopts as its own the 
estimate of new budget authority, entitlement authority, or tax 
expenditures or revenues contained in the cost estimate 
prepared by the Director of the Congressional Budget Office 
pursuant to section 402 of the Congressional Budget Act of 
1974.
    The Committee has requested but not received from the 
Director of the Congressional Budget Office a statement as to 
whether this bill contains any new budget authority, spending 
authority, credit authority, or an increase or decrease in 
revenues or tax expenditures.

                    VIII. Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

       IX. Statement of General Performance Goals and Objectives

    Pursuant to clause 3(c)(4) of rule XIII, the general 
performance goal or objective of this legislation is to educate 
and protect high-risk providers through public education 
campaign and training materials of the dangers of synthetic 
opioids.

                   X. Duplication of Federal Programs

    Pursuant to clause 3(c)(5) of rule XIII, no provision of 
H.R. 2364 is known to be duplicative of another Federal 
program, including any program that was included in a report to 
Congress pursuant to section 21 of Public Law 111-139 or the 
most recent Catalog of Federal Domestic Assistance.

                      XI. Committee Cost Estimate

    Pursuant to clause 3(d)(1) of rule XIII, the Committee 
adopts as its own the cost estimate prepared by the Director of 
the Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974.

    XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits

    Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the 
Committee finds that H.R. 2364 contains no earmarks, limited 
tax benefits, or limited tariff benefits.

                   XIII. Advisory Committee Statement

    No advisory committee within the meaning of section 5(b) of 
the Federal Advisory Committee Act was created by this 
legislation.

                XIV. Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

           XV. Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 designates that the short title may be cited as 
the ``Synthetic Opioid Danger Awareness Act.''

Sec. 2. Establishes a synthetic opioids public awareness campaign

    Section 2 requires the Secretary to establish a public 
education campaign on the dangers of synthetic opioids and 
related issues not later than one year after enactment. The 
legislation specifies the campaign should promote awareness 
about the potency and dangers of fentanyl, its analogues, and 
other synthetic opioids. It should also explain available 
services under the Substance Abuse and Mental Health Services 
Administration (SAMHSA) and CDC with respect to misuse of 
opioids. The campaign may be implemented through different 
media platforms and targeted to specific age groups and should 
take into consideration the findings of the report required 
under the SUPPORT Act related to the health effects of 
synthetic drug use. The legislation also requires the Secretary 
to have an independent evaluation of the campaign two years 
after enactment and to submit a report to Congress on the 
campaign's effectiveness every two years thereafter. The 
Secretary is also required to develop and implement a plan for 
the dissemination of information related to synthetic opioids 
to health care providers who participate in Federal programs.

Sec. 3. Training guide and outreach on synthetic opioid exposure 
        prevention

    Section 3 requires the Secretary to design, publish, and 
make publicly available a training guide and webinar for first 
responders and other individuals who may be at high risk of 
exposure to synthetic opioids that details measures to prevent 
such exposure within. In addition, the Secretary must conduct 
outreach about the availability of the training guide and 
webinar to police and fire departments, sheriff deputies in 
city and county jails, ambulance transport and emergency room 
personnel, clinicians, and other high-risk occupations as 
identified by the Assistant Secretary for Mental Health and 
Substance Use.

       XVI. Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter is 
printed in italics and existing law in which no change is 
proposed is shown in roman):

                       PUBLIC HEALTH SERVICE ACT




           *       *       *       *       *       *       *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE

           *       *       *       *       *       *       *



Part B--Federal-State Cooperation

           *       *       *       *       *       *       *



SEC. 317V. SYNTHETIC OPIOIDS PUBLIC AWARENESS CAMPAIGN.

  (a) In General.--Not later than one year after the date of 
the enactment of this section, the Secretary shall provide for 
the planning and implementation of a public education campaign 
to raise public awareness of synthetic opioids (including 
fentanyl and its analogues). Such campaign shall include the 
dissemination of information that--
          (1) promotes awareness about the potency and dangers 
        of fentanyl and its analogues and other synthetic 
        opioids;
          (2) explains services provided by the Substance Abuse 
        and Mental Health Services Administration and the 
        Centers for Disease Control and Prevention (and any 
        entity providing such services under a contract entered 
        into with such agencies) with respect to the misuse of 
        opioids, particularly as such services relate to the 
        provision of alternative, non-opioid pain management 
        treatments; and
          (3) relates generally to opioid use and pain 
        management.
  (b) Use of Media.--The campaign under subsection (a) may be 
implemented through the use of television, radio, internet, in-
person public communications, and other commercial marketing 
venues and may be targeted to specific age groups.
  (c) Consideration of Report Findings.--In planning and 
implementing the public education campaign under subsection 
(a), the Secretary shall take into consideration the findings 
of the report required under section 7001 of the SUPPORT for 
Patients and Communities Act (Public Law 115-271).
  (d) Consultation.--In coordinating the campaign under 
subsection (a), the Secretary shall consult with the Assistant 
Secretary for Mental Health and Substance Use to provide 
ongoing advice on the effectiveness of information disseminated 
through the campaign.
  (e) Requirement of Campaign.--The campaign implemented under 
subsection (a) shall not be duplicative of any other Federal 
efforts relating to eliminating the misuse of opioids.
  (f) Evaluation.--
          (1) In general.--The Secretary shall ensure that the 
        campaign implemented under subsection (a) is subject to 
        an independent evaluation, beginning 2 years after the 
        date of the enactment of this section, and every 2 
        years thereafter.
          (2) Measures and benchmarks.--For purposes of an 
        evaluation conducted pursuant to paragraph (1), the 
        Secretary shall--
                  (A) establish baseline measures and bench-
                marks to quantitatively evaluate the impact of 
                the campaign under this section; and
                  (B) conduct qualitative assessments regarding 
                the effectiveness of strategies employed under 
                this section.
  (g) Report.--The Secretary shall, beginning 2 years after the 
date of the enactment of this section, and every 2 years 
thereafter, submit to Congress a report on the effectiveness of 
the campaign implemented under subsection (a) towards meeting 
the measures and benchmarks established under subsection 
(e)(2).
  (h) Dissemination of Information Through Providers.--The 
Secretary shall develop and implement a plan for the 
dissemination of information related to synthetic opioids, to 
health care providers who participate in Federal programs, 
including programs administered by the Department of Health and 
Human Services, the Indian Health Service, the Department of 
Veterans Affairs, the Department of Defense, and the Health 
Resources and Services Administration, the Medicare program 
under title XVIII of the Social Security Act, and the Medicaid 
program under title XIX of such Act.

           *       *       *       *       *       *       *


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