[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.
* * * * * * *
[all]