Comprehensive Addiction and Recovery Act of 2015
Introduced on 2-12-15 by James Sensenbrenner [R-WI-5] and referred to the Committees on Judiciary, Energy and Commerce, Education and the Workforce, then to the Subcommittee on Higher Education and Workforce. Cosponsors are Tim Ryan [D-OH-13], Tammy Duckworth [D-IL-8], Steve Chabot [R-OH-1], Tom Marino [R-PA-10], Bobby Scott [D-VA-3], David Joyce [R-OH-14], Frank Guinta [R-NH-1], John Sarbanes [D-MD-3], Niki Tsongas [D-MA-3], Charles Dent [R-PA-15], Ann Kuster [D-NH-2], Paul Tonko [D-NY-20], Donald Norcross [D-NJ-1], Katherine Clark [D-MA-5], Lee Zeldin [R-NY-1], Matt Cartwright [D-PA-17], David Cicilline [D-RI-1], Leonard Lance [R-NJ-7], Richard Nolan [D-MN-8], Patrick Meehan [R-PA-7], Tom Emmer [R-MN-6], Michael Fitzpatrick [R-PA-8], Barbara Comstock [R-VA-10], Joseph Heck [R-NV-3], Steve Stivers [R-OH-15], Steve Israel [D-NY-3], Peter King [R-NY-2], Eleanor Norton [D-DC-At Large], Richard Hanna [R-NY-22], Richard Neal [D-MA-1], Alcee Hastings [D-FL-20], James Langevin [D-RI-2], Lois Frankel [D-FL-22], David Scott [D-GA-13], Suzan DelBene [D-WA-1], Keith Ellison [D-MN-5], Mark DeSaulnier [D-CA-11], Joyce Beatty [D-OH-3], John Yarmuth [D-KY-3], Ann Kirkpatrick [D-AZ-1], Barbara Lee [D-CA-13], Earl Blumenauer [D-OR-3], Cedric Richmond [D-LA-2], Louise Slaughter [D-NY-25], Rich Larsen [D-WA-2], Kathleen Rice [D-NY-4], Mark Pocan [D-WI-2], Bill Pascrell [D-NJ-9], Zoe Lofgren [D-CA-19], Collin Peterson [D-MN-7], Brendan Boyle [D-PA-13], John Lewis [D-GA-5], Lamar Smith [R-TX-21], Hakeem Jeffries [D-NY-8], Beto O’Rourke [D-TX-16], Debbie Schultz [D-FL-23], Michael Turner [R-OH-10], Sander Levin [D-MI-9], Peter Welch [D-VT-At Large], Dennis Ross [R-FL-15], Ted Lieu [D-CA-33], Ryan Costello [R-PA-6], James Himes [D-CT-4], Joseph Kennedy [D-MA-4], Robert Brady [D-PA-1], William Keating [D-MA-9], Gregory Meeks [D-NY-5], Marcy Kaptur [D-OH-9], Joe Courtney [D-CT-2], Chris Van Hollen [D-MD-8], Robert Dold [R-IL-10], Daniel Donovan [R-NY-11], Eliot Engel [D-NY-16], Sean Patrick Maloney [D-NY-18], John Larson [D-CT-1], Donna Edwards [D-MD-4], David Loebsack [D-IA-2], Brenda Lawrence [D-MI-14], John Katko [R-NY-24], Adam Smith [D-WA-9], James McGovern [D-MA-2], Elijah Cummings [D-MD-7], Cheri Bustos [D-IL-17], Andy Barr [R-KY-6], Derek Kilmer [D-WA-6], Vern Buchanan [R-FL-16], Elizabeth Esty [D-CT-5], Theodore Deutch [D-FL-21], Doris Matsui [D-CA-6], Mike Bishop [R-MI-8], Luis Gutierrez [D-IL-4], Sean Duffy [R-WI-7], Chellie Pingree [D-ME-1], Alan Grayson [D-FL-9], Steve Cohen [D-TN-9], Jared Polis [D-CO-2], Suzanne Bonamici [D-OR-1], Darin LaHood [R-IL-18], Stephen Knight [R-CA-25], Charles Rangel [D-NY-13], Brian Higgins [D-NY-26], Christopher Gibson [R-NY-19], Randy Forbes [R-VA-4], Seth Moulton [D-MA-6], Jose Serrano [D-NY-15], David Trott [R-MI-11], Tom Rice [R-SC-7], Sheila Jackson Lee [D-TX-18], Danny Davis [D-IL-7], Ken Calvert [R-CA-42], Ryan Zinke [R-MT-At Large], Elise Stefanik [R-NY-21], Gerald Connolly [D-VA-11], John Delaney [D-MD-6], Mike Kelly [R-PA-3], Bruce Poliquin [R-ME-2], Bill Foster [D-IL-11], Grace Napolitano [D-CA-32], Brad Ashford [D-NE-2], C.A. Dutch Ruppersberger [D-MD-2], Paul Cook [R-CA-8], Mike Quigley [D-IL-5], Evan Jenkins [R-WV-3], Glenn Thompson [R-PA-5], Keith Rothfus [R-PA-12], Diana DeGette [D-CO-1], J. French Hill [R-AR-2], Alma Adams [D-NC-12], Michael Honda [D-CA-17], Pete Aguilar [D-CA-31], and Kathy Castor [D-FL-14]. Related bills are H.R.2463 and Identical bill S.524.
Purpose: To authorize the Attorney General to award grants to address the national epidemics of prescription opioid abuse and heroin use.
SEC. 2. Findings.
(1) Opioid abuse is devastating on public health. Overdose now surpasses traffic accidents in deaths in the US. In 2014, 120 people died from drug overdoses daily.
(2) Prescriptions for opioids increased from 76,000,000 in 1991 to nearly 207,000,000 in 2013. The US is the biggest consumer of opioids globally–almost 100 percent of the hydrocodone and 81 percent of oxycodone.
(3) Opioid pain relievers are the most widely misused or abused controlled prescription drugs and are involved in overdose incidents.
(4) The use of heroin has also spiked sharply in recent years–more than 900,000 people in 2014, nearly a 35 percent increase from the previous year. Heroin overdose deaths more than tripled from 2010 to 2014. The supply of cheap heroin available in the United States has increased dramatically.
(5) Research indicates that combating the opioid crisis requires a multipronged approach of prevention, education, monitoring, law enforcement and treatment.
(6) Substance use disorders are a treatable disease. Current treatment services are not adequate to meet demand.
(7) The overall cost of drug abuse is more than $700,000,000,000 a year. Effective substance abuse prevention can yield major economic dividends.
(8) Diverting certain individuals with substance use disorders from criminal justice systems into community-based treatment can save billions of dollars and prevent sizeable numbers of crimes, arrests, and re-incarcerations over the course of those individuals’ lives.
(9) Faith-based, holistic, or drug-free models can provide a critical path to successful recovery. Treatment approaches must be tailored to address the drug abuse patterns and drug-related medical, psychiatric, and social problems of each individual.
(10) Rural communities are especially susceptible to heroin and opioid abuse.
TITLE I—Prevention and education
SEC. 101. Development of best practices for the prescribing of prescription opioids.
An Interagency Task Force comprised of representatives of DHHS, VA, FDA, DoD, CDC, NIH, ONDCP (Office of National Drug Control Policy), Office of Rural Health Policy, physicians, dentists, non-physician prescribers, pharmacists, pain and addiction research specialists, pain management professional organizations, the mental health treatment community, the addiction treatment community, pain advocacy groups, overdose reversal experts, and other stakeholders as appropriate will be formed to determine best practices for pain management and prescribing pain medication.
The task force shall use existing pain management research, existing relevant evidence-based guidelines, improved pain management strategies of organizations including alternatives to opioids, management of high-risk populations, the Proposed 2016 Guideline for Prescribing Opioids for Chronic Pain issued by the Centers for Disease Control and Prevention (80 Fed. Reg. 77351 (December 14, 2015)) to determine best practices. A report will then be submitted to Congress.
SEC. 102. Awareness campaigns.
(1) In general.—The Secretary of HHS shall advance education and awareness of the risk of abuse of prescription opioid drugs including the dangers of opioid abuse, how to prevent opioid abuse including safe disposal of prescription medications, and detection of early warning signs of addiction.
(2) The Office of National Drug Control Policy, shall establish a national drug awareness campaign that shall take into account the association between prescription opioid abuse and heroin use, the effects of heroin and prescription opioids on the human body and the dangerous effects of fentanyl when mixed with heroin.
SEC. 103. Community-based coalition enhancement grants to address local drug crises.
Provides grants to eligible entities to implement comprehensive community-wide strategies that address local drug crises within the area served by the eligible entity. These should provide comprehensive community-wide prevention strategies to address the local drug crisis in the area and obtain specialized training and technical assistance.
TITLE II—Law enforcement and treatment
SEC. 201. Treatment alternative to incarceration programs.
Provides for grants to develop, implement, or expand a treatment alternative to incarceration program for eligible participants. An eligible participant is an individual who is charged with an offense that is not violent, a serious drug offense, has been determined to suffer from a substance use disorder and has been approved for participation in a program.
SEC. 202. First responder training for the use of overdose reversal drugs
Provides for grants to allow trained first responders to administer an opioid overdose reversal drug to an individual who has overdosed. The funds can be used to make opioid overdose reversal drugs available; train and provide resources for first responders on administering the drug and establish processes, protocols, and mechanisms for referral to follow-up services. The Secretary shall conduct an evaluation of grants.
SEC. 203. Prescription drug take back expansion.
The Attorney General shall coordinate available disposal sites for unwanted prescription medications.
SEC. 204. Heroin and methamphetamine task forces.
Grants to law enforcement agencies for investigative purposes to locate or investigate illicit activities related to the distribution of heroin or fentanyl, the unlawful distribution of prescription opioids; unlawful heroin, fentanyl, and prescription opioid traffickers; precursor diversion, laboratories, or methamphetamine traffickers.
TITLE III—Treatment and recovery
SEC. 301. Evidence-based prescription opioid and heroin treatment and interventions demonstration.
Grants to State substance abuse agencies, local government, nonprofit organizations in areas that have a high rate of heroin use to expand the availability of medication assisted treatment and other clinically appropriate services.
SEC. 302. Criminal justice medication assisted treatment and interventions demonstration.
Grants to eligible entities to implement medication assisted treatment programs through criminal justice agencies such as courts, prisons, jails, or other agencies.
SEC. 303. National youth recovery initiative.
Grants to provide substance use disorder recovery support services to young people in high school and enrolled in institutions of higher education; help build communities of support for young people in recovery; and encourage initiatives designed to help young people achieve and sustain recovery from substance use disorders.
SEC. 304. Building communities of recovery.
Grants to recovery community organizations to develop, expand, and enhance recovery services to advocate for individuals in recovery, build connections between recovery networks, between recovery community organizations, and with other recovery support services; reduce the stigma associated with substance use disorders; conduct public education and outreach on issues relating to substance use disorders and recovery,
TITLE IV—Addressing collateral consequences
SEC. 401. Correctional education demonstration grant program.
Grants to eligible entities to design, implement, and expand educational programs for offenders in prisons, jails, and juvenile facilities, including to pay for: basic education, secondary level academic education, high school equivalency examination preparation, career technical education, and English language learner instruction for adult and juvenile populations; screening and assessment of inmates to assess education level and needs, occupational interest or aptitude, risk level, and other needs, and case management services; hiring and training of instructors and aides; instructional supplies and equipment; partnerships and agreements with community colleges, universities, and career technology education program providers; certification programs providing recognized high school equivalency certificates and industry recognized credentials; and
SEC. 402. National Task Force on Recovery and Collateral Consequences.
Form a Task Force on Recovery and Collateral Consequences consisting of 10 members including members who have national recognition and expertise in areas of health care, housing, employment, substance use disorders, mental health, law enforcement, and law; not fewer than 2 members who have personally experienced a substance abuse disorder or addiction and are in recovery; and not fewer than 1 of whom has benefitted from medication assisted treatment; and to the extent practicable, members who formerly served as elected officials at the State and Federal levels.
The Task Force shall identify collateral consequences for individuals with Federal or State convictions for drug-related offenses who are in recovery for substance use disorder; and examine any policy basis for the imposition of collateral consequences and their effect on individuals in recovery in resuming their personal and professional activities.
The Task Force shall develop recommendations for proposed legislative and regulatory changes related to the collateral consequences identified.
TITLE V—Addiction and treatment services for women, families, and veterans
SEC. 501. Improving treatment for pregnant and postpartum women.
Grants to State substance abuse agencies to support family-based services for pregnant and postpartum women with a primary diagnosis of a substance use disorder, identify gaps in services to such women along the continuum of care; and encourage new approaches and models of service delivery that are evidence-based, including effective family-based programs for women involved with the criminal justice system.
SEC. 502. Report on grants for family-based substance abuse treatment.
The Attorney General shall submit to Congress an annual report that describes the number of grants awarded and how such grants are used by the recipients for family-based substance abuse treatment programs that serve as alternatives to incarceration for custodial parents to receive treatment and services as a family.
SEC. 503. Veterans’ treatment courts.
Amends the Omnibus Crime Control and Safe Streets Act of 1968 for veterans who were discharged or released from service under dishonorable conditions, if the reason for that discharge or release is a substance use disorder.
TITLE VI—Incentivizing State comprehensive initiatives to address prescription opioid and heroin abuse
SEC. 601. State demonstration grants for comprehensive opioid abuse response.
Grants to States to prepare a comprehensive plan for and implement an integrated opioid abuse response initiative shall include:
(1) prevention and education
(2) treatment and recovery by expanding programs for medication assisted treatment and training of providers; developing, implementing, or expanding programs for behavioral health therapy; screen for hepatitis C and HIV, providing treatment as indicated; developing, implementing, or expanding programs that provide screening, early intervention, and referral to treatment to teenagers and young adults in schools, and developing, implementing, and expanding programs to prevent overdose death.
(3) education of residents, medical students, and physicians and other prescribers of schedule II, III, or IV controlled substances on prescribing guidelines and the prescription drug monitoring program.
(4) a comprehensive prescription drug monitoring program to track dispensing of schedule II, III, or IV controlled substances, which shall provide for data sharing with other States by statute, regulation, or interstate agreement; and allow for access to all individuals authorized to write prescriptions for controlled substances.
(5) $5,000,000 per fiscal year total appropriation for these grants
The Bill then goes through how the PMP (prescription monitoring program) will be used. If a prescriber is repeatedly falling outside of expected norms or standard practices, he/she would be directed to educational resources on appropriate prescribing of controlled substances. A report of these prescribers will be sent to the licensing board of the State.
SEC. 702. Funding.
Authorizes appropriation of $62,000,000 for each of fiscal years 2016 through 2020.
SEC. 705. Programs to prevent prescription drug abuse under the Medicare program.
(a) Drug Management Program for At-Risk Beneficiaries puts the control of prescriptions received by “at-risk” beneficiaries in the hands of the PDP sponsor.
TITLE VIII—Transnational Drug Trafficking Act of 2015
SEC. 802. Possession, manufacture or distribution for purposes of unlawful importations.
Section 1009 of the Controlled Substances Import and Export Act (21 U.S.C. 959) is amended to
“It shall be unlawful for any person to manufacture or distribute a controlled substance in schedule I or II or flunitrazepam or a listed chemical intending, knowing, or having reasonable cause to believe that such substance or chemical will be unlawfully imported into the United States.
SEC. 803. Trafficking in counterfeit goods or services.
Chapter 113 of title 18, United States Code, is amended to cover drugs knowingly using a counterfeit mark on or in connection with such drug.