,,ii  #aadth ,,congress  #ast ,session  
,s4 #gii  ,,in ,,the ,,senate ,,of ,,the
 ,,united ,,states  ,march #ai1 #bjae   
,mr4 ,mc,connell 7for himself and ,mr4  
,casey7 introduced the following bill2  
which was read twice and referred to the
 ,committee on ,health1 ,education1     
,labor1 and ,pensions  ,a ,,bill  ,to   
combat the rise of prenatal opioid abuse
 and neonatal abstinence syndrome4  #a4 
,short title  ,this ,act may be cited as
 the ,protecting ,our ,infants ,act of  
#bjae4  #b4 ,findings ,congress finds as
 follows3 7#a7 ,opioid prescription     
rates have risen dramatically over the  
past several years4 ,according to the   
,centers for ,disease ,control and      
,prevention1 in some ,states1 there are 
as many as #if to #adc prescriptions for
 opioids per #ajj adults per year4  7#b7
 ,in recent years1 there has been a     
steady rise in the number of overdose   
deaths involving heroin4 ,according to  
the ,centers for ,disease ,control and  
,prevention1 the death rate for heroin  

overdose doubled from #bjaj to #bjab4   
7#c7 ,at the same time1 there has been  
an increase in cases of neonatal        
abstinence syndrome 7referred to in this
 section as ,,nas74 ,in the ,united     
,states1 the incidence of ,,nas has     
risen from #a4bj per #a1jjj hospital    
births in #bjjj to #c4ci per #a1jjj     
hospital births in #bjji4  7#d7 ,,nas   
refers to medical issues associated with
 drug withdrawal in newborns due to     
exposure to opioids or other drugs in   
utero4  7#e7 ,the average cost of       
treatment in a hospital for ,,nas       
increased from #ci1djj in #bjjj to      
#ec1djj in #bjji4 ,most of these costs  
are born by the ,medicaid program4  7#f7
 ,preventing opioid abuse among pregnant
 women and women of childbearing age is 
crucial4  7#g7 ,medically-appropriate   
opioid use in pregnancy is not uncommon1
 and opioids are often the safest and   
most appropriate treatment for moderate 
to severe pain for pregnant women4  7#h7
 ,addressing ,,nas effectively requires 

a focus on women of childbearing age1   
pregnant women1 and infants from        
preconception through early childhood4  
7#i7 ,,nas can result from the use of   
prescription drugs as prescribed for    
medical reasons1 from the abuse of      
prescription drugs1 or from the use of  
illegal opioids like heroin4  7#aj7 ,for
 pregnant women who are abusing opioids1
 it is most appropriate to treat and    
manage maternal substance use in a      
non-punitive manner4  7#aa7 ,according  
to a report of the ,government          
,accountability ,office 7referred to in 
this section as the ,,gao report71 more 
research is needed to optimize the      
identification and treatment of babies  
with ,,nas and to better understand     
long-term impacts on children4  7#ab7   
,according to the ,,gao report1 the     
,department of ,health and ,human       
,services does not have a focal point to
 lead planning and coordinating efforts 
to address prenatal opioid use and ,,nas
 across the department4  7#ac7          

,according to the ,,gao report1 given   
the increasing use of heroin and abuse  
of opioids prescribed for pain          
management1 as well as the increased    
rate of ,,nas in the ,united ,states1 it
 is important to improve the efficiency 
and effectiveness of planning and       
coordination of ,federal efforts on     
prenatal opioid use and ,,nas4  #c4     
,developing recommendations for         
preventing and treating prenatal opioid 
abuse and neonatal abstinence syndrome  
7a7 ,in general ,the ,secretary of      
,health and ,human ,services 7referred  
to in this ,act as the ,secretary71     
acting through the ,director of the     
,agency for ,healthcare ,research and   
,quality 7referred to in this section as
 the ,director71 shall conduct a study  
and develop recommendations for         
preventing and treating prenatal opioid 
abuse and neonatal abstinence syndrome1 
soliciting input from nongovernmental   
entities1 including organizations       
representing patients1 health care      

providers1 hospitals1 other treatment   
facilities1 and other entities1 as      
appropriate4  7b7 ,report ,not later    
than #a year after the date of enactment
 of this ,act1 the ,director shall      
publish on the ,internet ,web site of   
the ,agency for ,healthcare ,research   
and ,quality a report on the study and  
recommendations under subsection 7a74   
,such report shall address each of the  
issues described in paragraphs 7#a7     
through 7#c7 of subsection 7c74  7c7    
,contents ,the study described in       
subsection 7a7 and the report under     
subsection 7b7 shall include-- 7#a7 a   
comprehensive assessment of existing    
research with respect to the prevention1
 identification1 treatment1 and         
long-term outcomes of neonatal          
abstinence syndrome1 including the      
identification and treatment of pregnant
 women or women who may become pregnant 
who use opioids or other drugs2  7#b7 an
 evaluation of-- 7,a7 the causes of and 
risk factors for opioid use disorders   

among women of reproductive age1        
including pregnant women2  7,b7 the     
barriers to identifying and treating    
opioid use disorders among women of     
reproductive age1 including pregnant and
 postpartum women and women with young  
children2  7,c7 current practices in the
 health care system to respond to and   
treat pregnant women with opioid use    
disorders and infants born with neonatal
 abstinence syndrome2  7,d7 medically   
indicated use of opioids during         
pregnancy2  7,e7 access to treatment for
 opioid use disorders in pregnant and   
postpartum women2 and  7,f7 access to   
treatment for infants with neonatal     
abstinence syndrome2 and  7#c7          
recommendations on--  7,a7 preventing1  
identifying1 and treating neonatal      
abstinence syndrome in infants2  7,b7   
treating pregnant women who are         
dependent on opioids2 and  7,c7         
preventing opioid dependence among women
 of reproductive age1 including pregnant
 women1 who may be at risk of developing

 opioid dependence4  #d4 ,improving     
prevention and treatment for prenatal   
opioid abuse and neonatal abstinence    
syndrome  7a7 ,review of programs ,the  
,secretary shall lead a review of       
planning and coordination within the    
,department of ,health and ,human       
,services related to prenatal opioid use
 and neonatal abstinence syndrome4  7b7 
,strategy to close gaps in research and 
programming ,in carrying out subsection 
7a71 the ,secretary shall develop a     
strategy to address research and program
 gaps1 including such gaps identified in
 findings made by reports of the        
,government ,accountability ,office4    
,such strategy shall address--  7#a7    
gaps in research1 including with respect
 to-- 7,a7 the most appropriate         
treatment of pregnant women with opioid 
use disorders2  7,b7 the most           
appropriate treatment and management of 
infants with neonatal abstinence        
syndrome2 and  7,c7 the long-term       
effects of prenatal opioid exposure on  

children2 and  7#b7 gaps in programs1   
including-- 7,a7 the availability of    
treatment programs for pregnant and     
postpartum women and for newborns with  
neonatal abstinence syndrome2 and  7,b7 
guidance and coordination in ,federal   
efforts to address prenatal opioid use  
or neonatal abstinence syndrome4  7c7   
,report ,not later than #a year after   
the date of enactment of this ,act1 the 
,secretary shall submit to the          
,committee on ,health1 ,education1      
,labor1 and ,pensions of the ,senate and
 the ,committee on ,energy and ,commerce
 of the ,house of ,representatives a    
report on the findings of the review    
described in subsection 7a7 and the     
strategy developed under subsection 7b74
  #e4 ,improving data on and public     
health response to neonatal abstinence  
syndrome  7a7 ,data and surveillance    
,the ,director of the ,centers for      
,disease ,control and ,prevention shall1
 as appropriate-- 7#a7 provide technical
 assistance to ,states to improve the   

availability and quality of data        
collection and surveillance activities  
regarding neonatal abstinence syndrome1 
including--  7,a7 the incidence and     
prevalence of neonatal abstinence       
syndrome2  7,b7 the identification of   
causes for neonatal abstinence syndrome1
 including new and emerging trends2 and 
7,c7 the demographics and other relevant
 information associated with neonatal   
abstinence syndrome2  7#b7 collect      
available surveillance data described in
 paragraph 7#a7 from ,states1 as        
applicable2 and  7#c7 make surveillance 
data collected pursuant to paragraph    
7#b7 publically available on an         
appropriate ,internet ,web site4  7b7   
,public health response ,the ,director  
of the ,centers for ,disease ,control   
and ,prevention shall encourage         
increased utilization of effective      
public health measures to reduce        
neonatal abstinence syndrome4