,,ii #aacth ,,congress #b;d ,session ,s4 #bgee ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,july #ca1 #bjad ,mr4 ,reed 7for himself1 ,mr4 ,durbin1 ,mr4 ,whitehouse1 ,mr4 ,markey1 and ,mr4 ,leahy7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to prevent deaths occurring from drug overdoses4 #a4 ,short title ,this ,act may be cited as the ,overdose ,prevention ,act4 #b4 ,findings ,congress finds the following3 7#a7 ,according to the ,centers for ,disease ,control and ,prevention1 each day in the ,united ,states1 more than #ajj people die from a drug overdose4 ,among people #be to #fd years old1 drug overdose causes more deaths than motor vehicle accidents4 7#b7 ,the ,centers for ,disease ,control and ,prevention reports that more than #da1jjj people in the ,united ,states died from a drug overdose in #bjaa alone4 ,nearly #hj percent of those deaths were due to unintentional drug overdoses1 and many could have been prevented4 7#c7 ,deaths resulting from unintentional drug overdoses increased more than #cjj percent between #aihj and #aiih1 and nearly tripled between #aiii and #bjaa4 7#d7 ,ninety-one percent of all unintentional poisoning deaths are due to drugs4 ,since #aiii1 in the ,united ,states the population of non-,hispanic ,whites and the population of ,indians 7as defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #dej;b77 have seen the highest rates of unintentional drug poisoning deaths4 7#e7 ,opioid medications such as oxycodone and hydrocodone are involved in #ee percent of all unintentional drug poisoning deaths4 7#f7 ,between #aiii and #bjaj1 opioid medication overdose fatalities increased by more than #djj percent among women and #bfe percent among men4 7#g7 ,military veterans are at elevated risk of experiencing a drug overdose4 ,veterans who served in ,vietnam1 ,iraq1 or ,afghanistan and who have combat injuries1 posttraumatic stress disorder1 and other co-occurring mental health diagnoses are at elevated risk of fatal drug overdose from opioid medications4 7#h7 ,rural and suburban regions are disproportionately affected by opioid medication overdoses4 ,urban centers also continue to struggle with overdose1 which is the leading cause of death among homeless adults4 7#i7 ,in the year #bjji alone1 estimated lost productivity and direct medical costs from opioid medication poisonings exceeded #bj1jjj1jjj1jjj4 7#aj7 ,both fatal and nonfatal overdoses place a heavy burden on public health and public safety resources1 yet there is no coordinated cross-,federal agency response to prevent overdose fatalities4 7#aa7 ,naloxone is a medication that rapidly reverses overdose from heroin and opioid medications4 7#ab7 ,in #bjab1 the ,food and ,drug ,administration held a public workshop in collaboration with the ,national ,institute on ,drug ,abuse and the ,centers for ,disease ,control and ,prevention1 and with participation from the ,substance ,abuse and ,mental ,health ,services ,administration and the ,office of ,national ,drug ,control ,policy1 to discuss making naloxone more widely available outside of conventional medical settings to reduce the incidence of opioid overdose fatalities4 7#ac7 ,lawmakers in ,california1 ,colorado1 ,connecticut1 ,georgia1 ,illinois1 ,kentucky1 ,maine1 ,maryland1 ,massachusetts1 ,minnesota1 ,new ,jersey1 ,new ,mexico1 ,new ,york1 ,north ,carolina1 ,ohio1 ,oklahoma1 ,oregon1 ,rhode ,island1 ,tennessee1 ,utah1 ,vermont1 ,virginia1 ,washington1 ,wisconsin1 and the ,district of ,columbia have removed legal impediments to increasing naloxone prescription and its use by bystanders who are in a position to respond to an overdose4 7#ad7 ,the ,american ,medical ,association1 the ,nation's largest physician organization1 supports further implementation of community-based programs that offer naloxone and other opioid overdose prevention services4 7#ae7 ,community-based overdose prevention programs have successfully prevented deaths from opioid overdoses by making rescue training and naloxone available to first responders1 parents1 and other bystanders who may encounter an overdose4 ,a study funded by the ,centers for ,disease ,control and ,prevention of community-based overdose prevention programs provided by the ,massachusetts ,department of ,public ,health found that communities with access to overdose prevention programs experienced lower mortality rates from opioid overdoses than communities that did not have access to overdose prevention programs during the study period4 7#af7 ,over #ej1jjj potential bystanders have been trained by overdose prevention programs in the ,united ,states4 ,a ,centers for ,disease ,control and ,prevention report credits overdose prevention programs with saving more than #aj1jjj lives since #aiif4 7#ag7 ,at least #ahh local overdose prevention programs are operating in the ,united ,states1 including in major cities such as ,baltimore1 ,chicago1 ,los ,angeles1 ,new ,york ,city1 ,boston1 ,san ,francisco1 and ,philadelphia1 and statewide in ,new ,mexico1 ,massachusetts1 and ,new ,york4 ,between #bjjf and #bjji1 overdose prevention programs facilitated by the ,massachusetts ,department of ,public ,health trained more than #d1hjj people who reported more than #ejj rescues4 ,since #bjjd1 a program administered by the ,baltimore ,city ,health ,department has trained more than #c1jjj people who reported more than #bbj rescues4 ,project ,lazarus1 an overdose prevention program in ,wilkes ,county1 ,north ,carolina1 reduced overdose deaths #fi percent between #bjji and #bjaa4 7#ah7 ,in ,illinois1 the ,department of ,human ,services1 ,division of ,alcoholism and ,substance ,abuse has enrolled over #bj drug overdose prevention programs with over #ajj designated sites across ,illinois targeting multiple service populations4 ,these enrollees include police departments1 county health departments1 medical facilities1 licensed substance abuse treatment programs1 and community organizations4 ,statewide1 over #b1jjj police officers and more than #fjj others have been trained thus far4 ,the ,du,page ,county ,illinois ,health ,department has trained over #a1bjj police officers and has reported #ab overdose reversals4 7#ai7 ,the ,office of ,national ,drug ,control ,policy supports equipping first responders to help reverse overdoses4 ,police officers on patrol in ,quincy1 ,massachusetts1 have conducted #agj overdose rescues with naloxone since #bjaj4 ,the police department has reported a #ie-percent success rate with overdose rescue attempts by police officers4 ,in ,suffolk ,county1 ,new ,york1 police officers have saved more than #ej lives with naloxone4 7#bj7 ,research shows that the cost per year of life gained by making naloxone available to reverse overdoses is within the range of what people in the ,united ,states usually pay for health treatments4 7#ba7 ,overdose prevention programs are needed in correctional facilities1 addiction treatment programs1 and other places where people are at higher risk of overdosing after a period of abstinence4 7#bb7 ,people affected by drug overdose gather on ,august #ca of each year in communities nationwide for ,overdose ,awareness ,day1 to mourn and pay tribute to loved ones and raise awareness about overdose risk and prevention4 #c4 ,overdose prevention programs ,title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bda et seq47 is amended by adding at the end the following3 ,w ,overdose prevention programs #cii,,oo4 ,cooperative agreement program to reduce drug overdose deaths 7a7 ,program authorized ,the ,secretary1 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 shall enter into cooperative agreements with eligible entities to enable the eligible entities to reduce deaths occurring from overdoses of drugs4 7b7 ,eligible entities ,to be eligible to receive a cooperative agreement under this section1 an entity shall be a ,state1 local1 or tribal government1 a correctional institution1 a law enforcement agency1 a community agency1 a professional organization in the field of poison control and surveillance1 or a private nonprofit organization4 7c7 ,application 7#a7 ,in general ,an eligible entity desiring a cooperative agreement under this section shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,contents ,an application under paragraph 7#a7 shall include-- 7,a7 a description of the activities to be funded through the cooperative agreement2 and 7,b7 evidence that the eligible entity has the capacity to carry out such activities4 7d7 ,priority ,in entering into cooperative agreements under subsection 7a71 the ,secretary shall give priority to eligible entities that-- 7#a7 are a public health agency or community-based organization2 and 7#b7 have expertise in preventing deaths occurring from overdoses of drugs in populations at high risk of such deaths4 7e7 ,eligible activities ,as a condition of receipt of a cooperative agreement under this section1 an eligible entity shall agree to use the cooperative agreement to do each of the following3 7#a7 ,purchase and distribute the drug naloxone or a similarly effective medication4 7#b7 ,carry out one or more of the following activities3 7,a7 ,educating prescribers and pharmacists about overdose prevention and naloxone prescription1 or prescription of a similarly effective medication4 7,b7 ,training first responders1 other individuals in a position to respond to an overdose1 and law enforcement and corrections officials on the effective response to individuals who have overdosed on drugs4 ,training pursuant to this subparagraph may include any activity that is educational1 instructional1 or consultative in nature1 and may include volunteer training1 awareness building exercises1 outreach to individuals who are at-risk of a drug overdose1 and distribution of educational materials4 7,c7 ,implementing and enhancing programs to provide overdose prevention1 recognition1 treatment1 and response to individuals in need of such services4 7,d7 ,educating the public and providing outreach to the public about overdose prevention and naloxone prescriptions1 or prescriptions of other similarly effective medications4 7f7 ,coordinating center 7#a7 ,establishment ,the ,secretary shall establish and provide for the operation of a coordinating center responsible for-- 7,a7 collecting1 compiling1 and disseminating data on the programs and activities under this section1 including tracking and evaluating the distribution and use of naloxone and other similarly effective medication2 7,b7 evaluating such data and1 based on such evaluation1 developing best practices for preventing deaths occurring from drug overdoses2 7,c7 making such best practices specific to the type of community involved2 7,d7 coordinating and harmonizing data collection measures2 7,e7 evaluating the effects of the program on overdose rates3 and 7,f7 education and outreach to the public about overdose prevention and prescription of naloxone and other similarly effective medication4 7#b7 ,reports to center ,as a condition on receipt of a cooperative agreement under this section1 an eligible entity shall agree to prepare and submit1 not later than #ij days after the end of the cooperative agreement period1 a report to such coordinating center and the ,secretary describing the results of the activities supported through the cooperative agreement4 7g7 ,duration ,the period of a cooperative agreement under this section shall be #d years4 7h7 ,definition ,in this part1 the term drug means-- 7#a7 a drug1 as defined in section #bja of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cba72 and 7#b7 includes controlled substances1 as defined in section #ajb of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hjb74 7i7 ,authorization of appropriations ,there are authorized to be appropriated #bj1jjj1jjj to carry out this section for each of the fiscal years #bjae through #bjai4 #cii,,oo-#a4 ,surveillance capacity building 7a7 ,program authorized ,the ,secretary1 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 shall award cooperative agreements to eligible entities to improve fatal and nonfatal drug overdose surveillance and reporting capabilities1 including-- 7#a7 providing training to improve identification of drug overdose as the cause of death by coroners and medical examiners2 7#b7 establishing1 in cooperation with the ,national ,poison ,data ,system1 coroners1 and medical examiners1 a comprehensive national program for surveillance of1 and reporting to an electronic database on1 drug overdose deaths in the ,united ,states2 and 7#c7 establishing1 in cooperation with the ,national ,poison ,data ,system1 a comprehensive national program for surveillance of1 and reporting to an electronic database on1 fatal and nonfatal drug overdose occurrences1 including epidemiological and toxicologic analysis and trends4 7b7 ,eligible entity ,to be eligible to receive a cooperative agreement under this section1 an entity shall be-- 7#a7 a ,state1 local1 or tribal government2 or 7#b7 the ,national ,poison ,data ,system working in conjunction with a ,state1 local1 or tribal government4 7c7 ,application 7#a7 ,in general ,an eligible entity desiring a cooperative agreement under this section shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,contents ,the application described in paragraph 7#a7 shall include-- 7,a7 a description of the activities to be funded through the cooperative agreement2 and 7,b7 evidence that the eligible entity has the capacity to carry out such activities4 7d7 ,report ,as a condition of receipt of a cooperative agreement under this section1 an eligible entity shall agree to prepare and submit1 not later than #ij days after the end of the cooperative agreement period1 a report to the ,secretary describing the results of the activities supported through the cooperative agreement4 7e7 ,national poison data system ,in this section1 the term ,national ,poison ,data ,system means the system operated by the ,american ,association of ,poison ,control ,centers1 in partnership with the ,centers for ,disease ,control and ,prevention1 for real-time local1 ,state1 and national electronic reporting1 and the corresponding database network4 7f7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section #e1jjj1jjj for each of the fiscal years #bjae through #bjai4 #cii,,oo-#b4 ,reducing overdose deaths 7a7 ,prevention of drug overdose ,not later than #ahj days after the date of the enactment of this section1 the ,secretary1 in consultation with a task force comprised of stakeholders1 shall develop a plan to reduce the number of deaths occurring from overdoses of drugs and shall submit the plan to ,congress4 ,the plan shall include-- 7#a7 a plan for implementation of a public health campaign to educate prescribers and the public about overdose prevention and prescription of naloxone and other similarly effective medication2 7#b7 recommendations for improving and expanding overdose prevention programming2 and 7#c7 recommendations for such legislative or administrative action as the ,secretary determines appropriate4 7b7 ,task force representation 7#a7 ,required members ,the task force under subsection 7a7 shall include at least one representative of each of the following3 7,a7 ,individuals directly impacted by drug overdose4 7,b7 ,direct service providers who engage individuals at risk of a drug overdose4 7,c7 ,drug overdose prevention advocates4 7,d7 ,the ,national ,institute on ,drug ,abuse4 7,e7 ,the ,center for ,substance ,abuse ,treatment4 7,f7 ,the ,centers for ,disease ,control and ,prevention4 7,g7 ,the ,health ,resources and ,services ,administration4 7,h7 ,the ,food and ,drug ,administration4 7,i7 ,the ,office of ,national ,drug ,control ,policy4 7,j7 ,the ,american ,medical ,association4 7,k7 ,the ,american ,association of ,poison ,control ,centers4 7,l7 ,the ,federal ,bureau of ,prisons4 7,m7 ,the ,centers for ,medicare ,medicaid ,services4 7,n7 ,the ,department of ,justice4 7,o7 ,the ,department of ,defense4 7,p7 ,the ,department of ,veterans ,affairs4 7,q7 ,first responders4 7,r7 ,law enforcement4 7,s7 ,state agencies responsible for drug overdose prevention4 7#b7 ,additional members ,in addition to the representatives required by paragraph 7#a71 the task force under subsection 7a7 may include other individuals with expertise relating to drug overdoses or representatives of entities with expertise relating to drug overdoses1 as the ,secretary determines appropriate4 4 #d4 ,overdose prevention research ,subpart #ae of part ,c of title ,,iv of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bheo et seq47 is amended by adding at the end the following3 #dfd,q4 ,overdose prevention research 7a7 ,overdose research ,the ,director of the ,institute shall prioritize and conduct or support research on drug overdose and overdose prevention4 ,the primary aims of this research shall include-- 7#a7 an examination of circumstances that contribute to drug overdose and identification of drugs associated with fatal overdose2 7#b7 an evaluation of existing overdose prevention methods2 7#c7 pilot programs or research trials on new overdose prevention strategies or programs that have not been studied in the ,united ,states2 7#d7 scientific research concerning the effectiveness of overdose prevention programs1 including how to effectively implement and sustain such programs2 7#e7 comparative effectiveness research of model programs2 and 7#f7 implementation of science research concerning effective overdose prevention programming examining how to implement and sustain overdose prevention programming4 7b7 ,formulations of naloxone ,the ,director of the ,institute shall support research on the development of formulations of naloxone1 and other similarly effective medications1 and dosage delivery devices specifically intended to be used by lay persons or first responders for the prehospital treatment of unintentional drug overdose4 7c7 ,definition ,in this section1 the term drug has the meaning given such term in section #cii,,oo4 7d7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section #e1jjj1jjj for each of the fiscal years #bjae through #bjai4 4