,i  #aafth ,,congress  #b;d ,session    
,h4 ,r4 #eggd  ,,in ,,the ,,house ,,of  
,,representatives  ,february #f1        
#bjbj,mr4 ,murphy of ,north ,carolina   
7for himself and ,mr4 ,peterson7        
introduced the following bill2 which was
 referred to the ,committee on          
,veterans' ,affairs  ,a ,,bill  ,to     
direct the ,secretary of ,veterans      
,affairs to conduct a review on opioid  
overdose deaths among veterans1 and for 
other purposes4  #a4 ,short title ,this 
,act may be cited as the ,veterans      
,heroin ,overdose ,prevention           
,examination ,act or the ,veterans      
,,hope ,act4  #b4 ,findings2 sense of   
,congress  7a7 ,findings ,congress finds
 the following3  7#a7 ,new research     
shows that a dramatic rise in opioid    
overdose deaths among veterans in recent
 years has happened increasingly among  
veterans dying from heroin and synthetic
 opioids4  7#b7 ,furthermore1 patients  
of the ,veterans ,health ,administration
 of the ,department of ,veterans        

,affairs are seven more times likely to 
suffer from an opioid use disorder than 
commercially insured patients4  7#c7    
,using records of the ,veterans ,health 
,administration linked to ,national     
,death ,index data1 the veterans' rate  
of overdose deaths from all opioids     
increased by #fe percent from #bjaj to  
#bjaf1 a rate change that includes      
adjustments for demographic changes in  
the veteran population over time4  7#d7 
,furthermore1 among all opioid overdose 
decedents1 prescription opioid receipt  
within three months before death        
declined from #ed percent in #bjaj to   
#bf percent in #bjaf1 yet veteran       
overdoses resulting in death from       
heroin1 synthetic opioids such as       
fentanyl1 and nonprescription opioids   
still occurred4  7#e7 ,in fact1 between 
#bjaj and #bjaf1 the veteran death rate 
from heroin or from taking multiple     
opioids almost quintupled and the death 
rate from synthetic opioids such as     
fentanyl increased by more than         

five-fold4  7#f7 ,trends would suggest  
that1 while the aggregate rise in opioid
 overdose deaths among veterans parallel
 those seen in the general population1  
the increase occurred mainly because of 
a rise in deaths from nonprescribed     
sources such as heroin1 fentanyl1 other 
powerful synthetic opioids1 or multiple 
opioids in concurrent use4  7b7 ,sense  
of ,congress ,it is the sense of        
,congress that further veterans overdose
 prevention efforts and research should 
extend beyond patients actively         
receiving opioid prescriptions4  #c4    
,review of deaths of veterans relating  
to opioid use  7a7 ,review ,not later   
than #ah months after the date of the   
enactment of this ,act1 the ,secretary  
of ,veterans ,affairs shall complete a  
review of the deaths of all covered     
veterans who died from opioid overdoses 
during the five-year period preceding   
the date of the enactment for this ,act4
  7b7 ,matters included ,the review     
under subsection 7a7 shall include the  

following3 7#a7 ,the total number of    
covered veterans who died from opioid   
overdoses during the five-year period   
preceding the date of the enactment of  
this ,act4  7#b7 ,a summary of such     
veterans that includes the age1 sex1 and
 race1 and ethnicity of each such       
veteran4  7#c7 ,a comprehensive list of 
the medications prescribed to1 and found
 in the bodies of1 such veterans at the 
time of death1 specifically listing any 
medications that carry a black box      
warning1 are off-label1 or are          
psychotropic4  7#d7 ,a summary of       
medical diagnoses by physicians of the  
,department of ,veterans ,affairs that  
led to any prescribing of the           
medications referred to in paragraph    
7#c74  7#e7 ,the number of instances in 
which such a veteran was concurrently on
 multiple medications prescribed by     
physicians of the ,department4  7#f7 ,a 
summary of-- 7,a7 the average period    
that elapsed between the last           
prescription opioid receipt and the date

 of the death of such a veteran2 and    
7,b7 the cause of death for each such   
veteran4  7#g7 ,the percentage of such  
veterans with combat experience or      
trauma 7including military sexual       
trauma1 traumatic brain injury1 and     
post-traumatic stress74  7#h7           
,identification of medical facilities of
 the ,department with high prescription 
and drug abuse treatment rates for      
patients being treated at those         
facilities4  7#i7 ,a description of     
policies of the ,department governing   
the prescribing of medications referred 
to in paragraph 7#c74  7#aj7 ,a         
description of efforts by the ,secretary
 to electronically track1 collect1 and  
properly dispose of prescription opioids
 that are either unused1 past the       
prescription date1 or not in the        
possession of the properly prescribed   
patient4  7#aa7 ,a description of any   
patterns apparent to the ,secretary     
based on the review4  7#ab7             
,recommendations for further action that

 would improve the safety and well-being
 of veterans and reduce opioid overdose 
rates for veterans1 especially          
concerning research regarding such      
veterans who had not filed for a opioid 
prescription in the three months before 
death by overdose4  7c7 ,public         
availability ,not later than #de days   
after the completion of the review under
 subsection 7a71 the ,secretary shall-- 
7#a7 submit to ,congress a report on the
 results of the review2  7#b7 make such 
report publicly available2 and  7#c7    
provide to the ,committees on ,veterans'
 ,affairs of the ,house of              
,representatives and the ,senate a      
briefing on such review4  7d7           
,definitions ,in this section3 7#a7 ,the
 term black box warning means a warning 
displayed within a box in the           
prescribing information for drugs that  
have special problems1 particularly ones
 that may lead to death or serious      
injury4  7#b7 ,the term covered veteran 
means any veteran who received hospital 

care or medical services furnished by   
the ,department of ,veterans ,affairs   
during the five-year period preceding   
the death of the veteran4