,,ii #aahth ,,congress #ast ,session ,s4 #aghe ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #ca 7legislative day1 ,may #cj71 #bjbc ,mr4 ,markey 7for himself1 ,ms4 ,warren1 ,mr4 ,booker1 ,mr4 ,carper1 ,mr4 ,wyden1 ,mr4 ,welch1 ,mr4 ,menendez1 ,mr4 ,merkley1 ,mr4 ,blumenthal1 and ,mr4 ,heinrich7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to establish programs to address addiction and overdoses caused by illicit fentanyl and other opioids1 and for other purposes4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,stop ,fentanyl ,overdoses ,act of #bjbc4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4 ,sec4 #b4 ,definitions4 ,,title ,i--,fentanyl ,sec4 #aja4 ,enhanced fentanyl surveillance4 ,sec4 #ajb4 ,collection of overdose data4 ,sec4 #ajc4 ,public health support for law enforcement4 ,sec4 #ajd4 ,fentanyl detection4 ,sec4 #aje4 ,grants to improve public health surveillance in forensic laboratories4 ,,title ,,ii--,stemming the ,supply of ,fentanyl ,sec4 #bja4 ,report on countries that produce synthetic drugs4 ,sec4 #bjb4 ,,gao report on international mail and cargo screening4 ,,title ,,iii--,overdose prevention and substance use disorder treatment programs ,sec4 #cja4 ,opioid treatment education4 ,sec4 #cjb4 ,,gao study on naloxone access4 ,sec4 #cjc4 ,increasing access to medication for opioid overdose reversal2 exemption from requirements of the ,drug ,supply ,chain ,security ,act4 ,sec4 #cjd4 ,grant program on harms of drug misuse4 ,sec4 #cje4 ,good ,samaritan immunity4 ,sec4 #cjf4 ,report on overdose prevention centers4 ,sec4 #cjg4 ,prisons and substance use disorder treatment4 #b4 ,definitions ,in this ,act3 7#a7 ,fentanyl-related substance ,the term fentanyl-related substance has the meaning given the term in section #acjh4aa7;h77#cj77;i7 of title #ba1 ,code of ,federal ,regulations 7or successor regulations74 7#b7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 ,i ,fentanyl #aja4 ,enhanced fentanyl surveillance 7a7 ,,cdc surveillance program ,part ,j of title ,,iii of the ,public ,health ,service ,act is amended by inserting after section #cib;,a 7#db ,u4,s4,c4 #bhj;b-#a7 the following3 #cib;,b4 ,enhanced fentanyl surveillance 7a7 ,definition ,in this section1 the term fentanyl-related substance has the meaning given the term in section #acjh4aa7;h77#cj77;i7 of title #ba1 ,code of ,federal ,regulations 7or successor regulations74 7b7 ,data collection ,the ,director of the ,centers for ,disease ,control and ,prevention shall enhance the ,overdose ,data to ,action program and other drug surveillance programs of the ,centers for ,disease ,control and ,prevention by-- 7#a7 encouraging ,states1 political subdivisions of ,states1 and territories to participate in such programs2 7#b7 increasing and accelerating the collection of data on fentanyl1 fentanyl-related substances1 other synthetic opioids1 and new emerging drugs of abuse 7including harmful adulterants of fentanyl1 such as xylazine71 including the collection of related overdose data from medical examiners and drug treatment admissions and information regarding drug seizures2 and 7#c7 utilizing available and emerging information on fentanyl1 fentanyl-related substances1 other synthetic opioids1 and new emerging drugs of abuse1 including information from-- 7,a7 the ,high ,intensity ,drug ,trafficking ,areas program under section #gjg of the ,office of ,national ,drug ,control ,policy ,reauthorization ,act of #aiih2 7,b7 the ,national ,drug ,early ,warning ,system2 7,c7 ,state and local public health authorities2 7,d7 ,federal1 ,state1 and local public health laboratories2 and 7,e7 drug seizures by ,federal1 ,state1 and local law enforcement agencies1 including information from the ,national ,seizure ,system and the ,national ,forensic ,laboratory ,information ,system of the ,drug ,enforcement ,administration4 7c7 ,information sharing ,the ,director of the ,centers for ,disease ,control and ,prevention shall publicly disseminate data collected under this section4 7d7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section such sums as are necessary4 4 7b7 ,law enforcement reporting ,each ,federal law enforcement agency shall report information on all drug seizures by that agency to the ,drug ,enforcement ,administration for inclusion in the ,national ,seizure ,system4 7c7 ,,gao report ,not later than #b years after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall-- 7#a7 publish a report analyzing how ,federal agencies can improve their collection1 reporting1 sharing1 and analytic use of drug seizure data across ,federal agencies and with ,states and local governments2 and 7#b7 include in such report an analysis of how well available data on drug seizures can measure progress toward reducing drug trafficking into and within the ,united ,states1 as outlined in strategies such as the ,national ,drug ,control ,strategy of the ,office of ,national ,drug ,control ,policy4 #ajb4 ,collection of overdose data 7a7 ,in general ,not later than #b years after the date of enactment of this ,act1 the ,secretary shall commence a study on how to most efficiently track overdoses by type of drug1 including fentanyl4 7b7 ,grant program 7#a7 ,in general ,upon completion of the study under subsection 7a71 and taking into consideration the results of such study1 the ,secretary shall award grants to ,states to facilitate the collection of data with respect to fentanyl-involved overdoses4 7#b7 ,requirement ,as a condition on receipt of a grant under this subsection1 an applicant shall agree to share the data collected pursuant to the grant with the ,centers for ,disease ,control and ,prevention4 7#c7 ,preference ,in awarding grants under this subsection1 the ,secretary shall give preference to applicants whose grant proposals demonstrate the greatest need for collecting timely and accurate data on overdoses4 #ajc4 ,public health support for law enforcement 7a7 ,support for fentanyl detection and handling ,the ,secretary1 in consultation with the ,attorney ,general1 shall carry out a program to provide to ,federal1 ,state1 and local law enforcement agencies training on accurate information about fentanyl and how to detect and handle fentanyl4 7b7 ,evidence-,based ,the program under subsection 7a7 shall comply with evidence-based guidelines1 including the ,fentanyl ,safety ,recommendations for ,first ,responders 7or any successor guidelines7 of the ,office of ,national ,drug ,control ,policy4 #ajd4 ,fentanyl detection 7a7 ,testing of contaminants ,the ,secretary1 acting through the ,assistant ,secretary for ,mental ,health and ,substance ,use1 and in coordination with the ,director of the ,centers for ,disease ,control and ,prevention1 shall continue to improve efforts to enhance screening and identification of contaminants in drugs to prevent overdoses4 7b7 ,research into technologies 7#a7 ,definition of chemical screening device ,in this subsection1 the term chemical screening device means an infrared spectrophotometer1 mass spectrometer1 nuclear magnetic resonance spectrometer1 ,raman spectrophotometer1 ion mobility spectrometer1 or any other device or other technology that is able to determine the presence of1 or identify1 one or more contaminants in drugs4 7#b7 ,research ,the ,secretary shall conduct or support research for the development or improvement of portable and affordable technologies relating to testing drugs for fentanyl and fentanyl-related substances1 including chemical screening device methods4 7#c7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this subsection such sums as are necessary4 #aje4 ,grants to improve public health surveillance in forensic laboratories ,title ,i of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#cd ,u4,s4,c4 #ajaja et seq47 is amended by adding at the end the following3 ,,pp ,confronting the use of heroin1 fentanyl1 and associated synthetic drugs #cjfa4 ,authority to make grants to address public safety through improved forensic laboratory data 7a7 ,purpose ,the purpose of this section is to assist ,states and units of local government in-- 7#a7 carrying out programs to improve surveillance of heroin1 fentanyl1 fentanyl-related substances1 and associated synthetic drugs to enhance public health2 7#b7 improving the ability of ,states1 ,tribes1 and units of local government to carry out such programs2 and 7#c7 carrying out the activities as described in section #aja of the ,,stop ,fentanyl ,act of #bjbc4 7b7 ,grant authorization ,the ,attorney ,general1 acting through the ,director of the ,bureau of ,justice ,assistance1 may make grants to ,states and units of local government to improve surveillance of heroin1 fentanyl1 fentanyl-related substances1 and associated synthetic drugs to enhance public health4 7c7 ,grant projects ,to improve surveillance of seized heroin1 fentanyl1 and associated synthetic drugs ,grants made under subsection 7b7 shall be used for programs1 projects1 and other activities to-- 7#a7 reimburse ,state1 local1 or forensic science laboratories to help address backlogs of untested samples of heroin1 fentanyl1 and associated synthetic drugs2 7#b7 reimburse ,state1 local1 or other forensic science laboratories for procuring equipment1 technology1 or other support systems if the applicant for the grant demonstrates to the satisfaction of the ,attorney ,general that expenditures for such purposes would result in improved efficiency of laboratory testing and help prevent future backlogs2 7#c7 reimburse ,state1 local1 or other forensic science laboratories for improved1 real time data exchange with the ,centers for ,disease ,control and ,prevention on fentanyl1 fentanyl-related substances1 and other associated synthetic drugs present in the local communities2 and 7#d7 support ,state1 tribal1 and local health department services deployed to address the use of heroin1 fentanyl1 and associated synthetic drugs4 7d7 ,limitation ,not less than #fj percent of the amounts made available to carry out this section shall be awarded for the purposes under paragraph 7#a7 or 7#b7 of subsection 7c74 7e7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section such sums as are necessary4 7f7 ,allocation 7#a7 ,population allocation ,seventy-five percent of the amount made available to carry out this section in a fiscal year shall be allocated to each ,state that meets the requirements of section #bhjb so that each ,state shall receive an amount that bears the same ratio to the #ge percent of the total amount made available to carry out this section for that fiscal year as the population of the ,state bears to the population of all ,states4 7#b7 ,discretionary allocation ,twenty-five percent of the amount made available to carry out this section in a fiscal year shall be allocated pursuant to the discretion of the ,attorney ,general for competitive grants to ,states or units of local government with high rates of primary treatment admissions for polysubstance use1 including heroin and other opioids1 for use by ,state or local law enforcement agencies4 7#c7 ,minimum requirement ,notwithstanding paragraphs 7#a7 and 7#b71 each ,state shall receive not less than #j4f percent of the amount made available to carry out this section in each fiscal year4 7#d7 ,certain territories 7,a7 ,in general ,for purposes of the allocation under this section1 ,american ,samoa and the ,commonwealth of the ,northern ,mariana ,islands shall be considered as #a ,state4 7,b7 ,allocation amongst certain territories ,for purposes of subparagraph 7,a71 #fg percent of the amount allocated shall be allocated to ,american ,samoa and #cc percent shall be allocated to the ,commonwealth of the ,northern ,mariana ,islands4 4 ,,ii ,stemming the ,supply of ,fentanyl #bja4 ,report on countries that produce synthetic drugs ,not later than #a year after the date of enactment of this ,act1 the ,secretary of ,state shall submit to the ,committee on the ,judiciary and the ,committee on ,foreign ,relations of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives a report-- 7#a7 identifying the countries the ,secretary determines are the principal producers of synthetic drugs trafficked into the ,united ,states2 7#b7 assessing how and why those countries are producing such drugs2 and 7#c7 describing measures the ,secretary plans to take to reduce the flow of such drugs into the ,united ,states4 #bjb4 ,,gao report on international mail and cargo screening ,not later than #a year after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report reviewing the impact of the ,high ,intensity ,drug ,trafficking ,areas program on illicit fentanyl and fentanyl-related substances imported through international mail and cargo1 including discussion of the following3 7#a7 ,the volume of fentanyl and fentanyl-related substances being imported into the ,united ,states by means of international mail and cargo4 7#b7 ,the potential impact of increased screening for illicit fentanyl and fentanyl-related substances on-- 7,a7 deterring drug trafficking in the ,united ,states2 7,b7 interdicting fentanyl and fentanyl-related substances that were manufactured outside of the ,united ,states and intended1 or attempted1 to be imported into the ,united ,states2 7,c7 the number of ,federal criminal prosecutions based on the manufacture1 distribution1 or possession of fentanyl or fentanyl-related substances1 disaggregated by demographic data1 including sex1 race1 and ethnicity1 of the offender2 7,d7 the charges brought in such prosecutions2 7,e7 the impacts of prosecutions on reducing demand and availability to users2 and 7,f7 the development of new fentanyl-related substances4 7#c7 ,the need for noninvasive technology in screening for fentanyl and fentanyl-related substances1 taking into account the findings pursuant to paragraphs 7#a7 and 7#b74 ,,iii ,overdose prevention and substance use disorder treatment programs #cja4 ,opioid treatment education ,part ,d of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;dd et seq47 is amended by adding at the end the following3 #eec4 ,opioid treatment education 7a7 ,in general ,the ,secretary shall award grants to ,states and local governmental entities to provide education to stakeholders1 including health care providers1 criminal justice professionals1 and substance use disorder treatment personnel1 on the current state of research on treatment for opioid use disorder1 including-- 7#a7 the use of opioid agonists or partial agonists2 and 7#b7 the potential benefits of the use of opioid agonists or partial agonists for affected individuals4 7b7 ,report ,not later than #a year after the date of enactment of the ,,stop ,fentanyl ,act of #bjbc1 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 that includes the following data on the education programs funded pursuant to grants under subsection 7a73 7#a7 ,the number of people reached by educational materials funded pursuant to grants under subsection 7a74 7#b7 ,the geographic areas where people received such educational materials4 7#c7 ,the remaining populations and areas targeted for awareness of such educational materials1 including the characteristics of such populations and areas1 such as the type of stakeholder4 7#d7 ,the outcomes of education provided pursuant to grants under subsection 7a71 as determined by the ,secretary4 7c7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section such sums as are necessary4 4 #cjb4 ,,gao study on naloxone access 7a7 ,in general ,the ,comptroller ,general of the ,united ,states shall conduct a study on actions that may be taken to ensure appropriate access and affordability of naloxone for individuals seeking to purchase naloxone4 ,such study shall address what is known about-- 7#a7 coverage of naloxone 7in any available form71 including whether naloxone can be covered as an over-the-counter drug under a group health plan or group or individual health insurance coverage 7as such terms are defined in section #bgia of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#ia77 or for individuals entitled to benefits under part ,a or enrolled under part ,b of title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq471 or receiving medical assistance under a ,state plan under title ,,xix of such ,act 7#db ,u4,s4,c4 #acif et seq47 or a waiver of such plan2 7#b7 the out-of-pocket cost to consumers purchasing naloxone-- 7,a7 with a prescription1 with and without coverage under any such plan or coverage2 7,b7 over-the-counter1 with and without coverage under any such plan or coverage2 and 7,c7 via standing order2 and 7#c7 other factors impacting coverage1 including barriers in covering naloxone as an over-the-counter drug1 the relative net costs of naloxone when purchased over-the-counter without insurance coverage compared to when purchased with a prescription and covered under a group health plan or health insurance coverage1 and the availability of naloxone purchased and distributed through public health entities4 7b7 ,report ,not later than #b years after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report that contains the findings of the study conducted under subsection 7a74 #cjc4 ,increasing access to medication for opioid overdose reversal2 exemption from requirements of the ,drug ,supply ,chain ,security ,act 7a7 ,transactions ,section #eha7bd77;,b7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cfj;eee7#bd77;,b77 is amended-- 7#a7 by redesignating clauses 7xvii7 and 7xviii7 as clauses 7xviii7 and 7xix71 respectively2 and 7#b7 by inserting after clause 7xvi7 the following3 7xvii7 the distribution of an opioid antagonist indicated for emergency treatment of opioid overdose1 such as naloxone1 by or to an overdose prevention1 syringe services program1 or other harm reduction service2 4 7b7 ,wholesale distribution ,section #ejc7;e77#d7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cec7;e77#d77 is amended-- 7#a7 by redesignating subparagraphs 7,r7 and 7,s7 as subparagraphs 7,s7 and 7,t71 respectively2 and 7#b7 by inserting after subparagraph 7,q7 the following3 7,r7 the distribution of an opioid antagonist indicated for emergency treatment of opioid overdose1 such as naloxone1 by or to an overdose prevention1 syringe services program1 or other harm reduction service2 4 #cjd4 ,grant program on harms of drug misuse ,part ,d of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;dd et seq47 7as amended by section #cja7 is amended by adding at the end the following3 #eed4 ,grant program on harms of drug misuse 7a7 ,in general ,the ,assistant ,secretary1 in consultation with the ,director of the ,centers for ,disease ,control and ,prevention1 shall award grants to ,states and political subdivisions of ,states to support the delivery of overdose prevention services1 including distribution of opioid reversal agents approved by the ,food and ,drug ,administration1 such as naloxone1 fentanyl strips1 and other harm reduction services that address the harms of drug misuse1 including by-- 7#a7 connecting individuals at risk for1 or with1 a substance use disorder to overdose education1 counseling1 and health education2 and 7#b7 encouraging such individuals to take steps to reduce the harms associated with substance misuse4 7b7 ,considerations ,in awarding grants under this section1 the ,assistant ,secretary shall prioritize grants to applicants that are-- 7#a7 organizations providing culturally competent care in terms of considerations based on race1 language1 ethnicity1 gender1 sexuality1 or disability2 or 7#b7 proposing to serve areas with-- 7,a7 a higher proportion of the population who meet criteria for dependence on1 or abuse of1 illicit drugs2 7,b7 a higher drug overdose death rate2 and 7,c7 a greater behavioral health and substance use disorder workforce need4 7c7 ,special considerations ,a recipient of a grant under this section shall-- 7#a7 ensure that not less than #fj percent of the grant funds are used for harm reduction programs2 and 7#b7 prioritize the delivery of opioid antagonists to-- 7,a7 people who use opioids or illicit drugs2 7,b7 families of such people2 7,c7 first responders1 such as law enforcement personnel and nonemergency services1 such as firefighters and park rangers2 and 7,d7 community service providers1 such as library1 school1 and public transportation personnel4 7d7 ,use of grant awards ,a recipient of a grant under this section may use grant funds for the following3 7#a7 ,adapting1 maintaining1 and expanding essential services provided by harm reduction service organizations to address the risks of drug overdose and contraction of infectious disease4 7#b7 ,maintaining or hiring staff4 7#c7 ,supporting program operational costs1 including staff1 rent1 and vehicle purchase or maintenance4 7#d7 ,program supplies4 7#e7 ,support and case management services4 7e7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section such sums as are necessary4 4 #cje4 ,good ,samaritan immunity 7a7 ,in general ,part ,b of title ,,ii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bch et seq47 is amended by adding at the end the following3 #bdi4 ,good ,samaritan immunity 7a7 ,limitation on civil liability for individuals who administer opioid overdose reversal drugs 7#a7 ,in general ,notwithstanding any other provision of law1 except as provided in paragraph 7#b71 no individual shall be liable in any ,federal or ,state proceeding for harm caused by the emergency administration of an opioid overdose reversal drug to an individual who has or reasonably appears to have suffered an overdose from heroin or another opioid1 if the individual administers the opioid overdose reversal drug in good faith4 7#b7 ,exception ,paragraph 7#a7 shall not apply to an individual if the harm was caused by the gross negligence or reckless misconduct of the individual who administers the drug4 7#c7 ,definition of opioid overdose reversal drug ,in this subsection1 the term opioid overdose reversal drug means a drug approved under section #eje of the ,federal ,food1 ,drug1 and ,cosmetic ,act that is indicated for the partial or complete reversal of the pharmacological effects of an opioid overdose in the human body4 7b7 ,immunity from liability 7#a7 ,immunity 7,a7 ,in general ,an individual described in subparagraph 7,b7 shall not be cited1 arrested1 prosecuted1 criminally liable1 or subject to any sanction for a violation of a condition of supervised release under section #djd of the ,controlled ,substances ,act for the possession or use of a controlled substance1 or under any other provision of ,federal law regulating the misuse of prescription drugs1 as a result of seeking medical assistance as described in clause 7i71 7ii71 or 7iii7 of subparagraph 7,b74 7,b7 ,individual described ,an individual referred to in subparagraph 7,a7 is an individual who1 in good faith and in a timely manner-- 7i7 seeks medical assistance for another individual who is experiencing a drug overdose2 7ii7 seeks medical assistance for himself or herself for a drug overdose2 or 7iii7 is the subject of a request for medical assistance for another individual who is experiencing a drug overdose4 7#b7 ,preemption ,this subsection preempts the laws of a ,state or any political subdivision of a ,state to the extent that such laws are inconsistent with this subsection1 unless such laws provide greater protection from liability4 7#c7 ,definitions ,in this section3 7,a7 ,controlled substance ,the term controlled substance has the meaning given the term in section #ajb of the ,controlled ,substances ,act4 7,b7 ,drug overdose ,the term drug overdose means an acute condition resulting from or believed to be resulting from the use of a controlled substance1 which an individual1 who is not a health care professional1 would reasonably believe requires medical assistance4 7,c7 ,prescription drug ,the term prescription drug means a drug subject to section #ejc7;b77#a7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act4 7,d7 ,seeks medical assistance2 seeking medical assistance ,the terms seeks medical assistance and seeking such medical assistance include-- 7i7 reporting a drug or alcohol overdose or other medical emergency to a law enforcement authority1 the #i-a-a system1 a poison control center1 or a medical provider2 7ii7 assisting another individual who is making a report described in clause 7i72 or 7iii7 providing care by administering a drug to someone who is experiencing a drug or alcohol overdose or other medical emergency while awaiting the arrival of medical assistance4 4 7b7 ,public awareness campaign ,the ,secretary1 in coordination with the ,administrator of the ,drug ,enforcement ,administration1 shall carry out a campaign to increase public awareness of the limitations on civil and criminal liability established by section #bdi of the ,public ,health ,service ,act 7as added by subsection 7a774 #cjf4 ,report on overdose prevention centers ,the ,secretary shall enter into an agreement with the ,national ,academies of ,sciences1 ,engineering1 and ,medicine under which the ,national ,academies shall-- 7#a7 not later than #b years after the date of the agreement1 submit to ,congress a report on overdose prevention centers2 and 7#b7 include in the report required under paragraph 7#a7-- 7,a7 identification of barriers to operating overdose prevention centers2 7,b7 a compilation of the data available to measure effectiveness of overdose prevention centers on preventing and reducing regional rates of overdose deaths1 and practices utilized at overdose prevention centers to improve access to medication for opioid use disorder and recovery services2 7,c7 identification of best practices at overdose prevention centers to promote individual and public health1 provide resources to individuals and families1 improve access to substance use disorder and behavioral health services1 and reduce stigma2 7,d7 recommendations for developing integrated care settings inclusive of overdose prevention sites and incorporating overdose prevention sites into referral networks2 and 7,e7 recommended approaches to overdose prevention services that may serve as effective strategies for recovery for people using fentanyl1 fentanyl-related substances1 other synthetic opioids1 and new emerging drugs of abuse 7including harmful adulterants of fentanyl1 such as xylazine74 #cjg4 ,prisons and substance use disorder treatment 7a7 ,prisons and medication-,assisted treatment 7#a7 ,in general ,the ,director of the ,bureau of ,prisons1 in collaboration with the ,director of the ,office of ,national ,drug ,control ,policy1 shall establish a program to offer-- 7,a7 all drugs that are approved by the ,food and ,drug ,administration for treatment of a substance use disorder2 7,b7 counseling and other psychosocial treatments for the treatment of substance use disorder2 and 7,c7 evidence-based withdrawal management services to individuals in the custody of the ,bureau of ,prisons to provide a comprehensive treatment approach substance use disorders4 7#b7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this subsection such sums as are necessary4 7b7 ,residential substance abuse treatment for ,state prisoners ,section #aijd7;d7 of title ,i of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#cd ,u4,s4,c4 #ajdbd7;d77 is amended-- 7#a7 by striking means and inserting the following3 7#a7 means 2 7#b7 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following3 7#b7 includes any such course of comprehensive individual and group substance abuse treatment services using medication-assisted treatment for opioid use disorder 7including the use of any drug approved or licensed by the ,food and ,drug ,administration for such treatment74 4