[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3375 Introduced in House (IH)]
<DOC>
118th CONGRESS
1st Session
H. R. 3375
To establish programs to address addiction and overdoses caused by
illicit fentanyl and other opioids, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 16, 2023
Ms. Kuster (for herself, Ms. Blunt Rochester, Mr. Bacon, Mr. Tonko, Mr.
Trone, Mr. Panetta, Mrs. Trahan, Mr. Allred, Ms. Craig, Ms. Pettersen,
Ms. Barragan, and Mr. Norcross) introduced the following bill; which
was referred to the Committee on Energy and Commerce, and in addition
to the Committee on the Judiciary, for a period to be subsequently
determined by the Speaker, in each case for consideration of such
provisions as fall within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To establish programs to address addiction and overdoses caused by
illicit fentanyl and other opioids, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Support,
Treatment, and Overdoses Prevention of Fentanyl Overdoses Act of 2023''
or the ``STOP Fentanyl Overdoses Act of 2023''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Definitions.
TITLE I--IMPROVING FENTANYL SURVEILLANCE
Sec. 101. Enhanced drug surveillance.
Sec. 102. Collection of overdose data.
Sec. 103. Public health support for law enforcement.
Sec. 104. Fentanyl detection.
Sec. 105. Grants to improve public health surveillance in forensic
laboratories.
TITLE II--STEMMING THE SUPPLY OF FENTANYL
Sec. 201. Report on countries that produce synthetic drugs.
Sec. 202. GAO report on international mail and cargo screening.
TITLE III--OVERDOSE PREVENTION AND SUBSTANCE USE DISORDER TREATMENT
PROGRAMS
Sec. 301. Opioid treatment education.
Sec. 302. Study on naloxone access.
Sec. 303. Increasing access to medication for opioid overdose reversal.
Sec. 304. Grant program on harms of drug misuse.
Sec. 305. Good Samaritan immunity.
Sec. 306. Report on overdose prevention centers.
Sec. 307. Prisons and substance use disorder treatment.
SEC. 2. DEFINITIONS.
In this Act, except as otherwise provided:
(1) The term ``Assistant Secretary'' means the Assistant
Secretary for Mental Health and Substance Use.
(2) The term ``Secretary'' means the Secretary of Health
and Human Services.
(3) The term ``fentanyl-related substance'' has the meaning
given the term in section 1308.11(h)(30)(i) of title 21, Code
of Federal Regulations (or successor regulations).
TITLE I--IMPROVING FENTANYL SURVEILLANCE
SEC. 101. ENHANCED DRUG SURVEILLANCE.
(a) CDC Surveillance Program.--Title III of the Public Health
Service Act (42 U.S.C. 241 et seq.) is amended by inserting after
section 317V of such Act (42 U.S.C. 247b-24) the following:
``SEC. 317W. ENHANCED DRUG SURVEILLANCE.
``(a) In General.--The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, shall enhance the
Overdose Data to Action drug surveillance program of the Centers and
other drug surveillance programs by--
``(1) encouraging States, political subdivisions of States,
and territories to participate;
``(2) increasing and accelerating the collection of data on
fentanyl, fentanyl-related substances, other synthetic opioids,
and new emerging drugs of use (including harmful adulterants of
fentanyl such as xylazine), including the collection of related
overdose data from medical examiners and drug treatment
admissions and information regarding drug seizures; and
``(3) utilizing available and emerging information on
fentanyl, fentanyl-related substances, other synthetic opioids,
and new emerging drugs of abuse, including information from--
``(A) the High Intensity Drug Trafficking Areas
program;
``(B) the National Drug Early Warning System;
``(C) State and local public health authorities;
``(D) Federal, State, and local public health
laboratories; and
``(E) drug seizures by Federal, State, and local
law enforcement agencies, including information from
the National Seizure System and the National Forensic
Laboratory Information System of the Drug Enforcement
Administration.
``(b) Information Sharing.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, shall
publicly disseminate findings collected through the Overdose Data to
Action drug surveillance program of the Centers for Disease Control and
Prevention.
``(c) Definition.--In this section, the term `fentanyl-related
substance' has the meaning given the term in section 1308.11(h)(30)(i)
of title 21, Code of Federal Regulations (or successor regulations).''.
(b) 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
System.
(c) GAO Report.--Not later than 2 years after the date of enactment
of this Act, the Comptroller General of the United States shall--
(1) publish a report analyzing how Federal agencies can
improve their collection, reporting, sharing, and analytic use
of drug seizure data across Federal agencies and with State and
local governments; and
(2) 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 country, as
outlined in strategies such as the National Drug Control
Strategy of the Office of National Drug Control Policy.
SEC. 102. COLLECTION OF OVERDOSE DATA.
(a) In General.--Not later than 2 years after the date of enactment
of this Act, the Secretary shall commence a study on how to most
efficiently track overdoses by type of drug, including fentanyl.
(b) Grant Program.--
(1) In general.--Upon completion of the study under
subsection (a), and taking into consideration the results of
such study, the Secretary shall award grants to States to
facilitate the collection of data with respect to fentanyl-
involved overdoses.
(2) Requirement.--As a condition on receipt of a grant
under this subsection, an applicant shall agree to share the
data collected pursuant to the grant with the Centers for
Disease Control and Prevention.
(3) Preference.--In awarding grants under this subsection,
the Secretary shall give preference to applicants whose grant
proposals demonstrate the greatest need for collecting timely
and accurate data on overdoses.
SEC. 103. PUBLIC HEALTH SUPPORT FOR LAW ENFORCEMENT.
(a) Support for Fentanyl Detection and Handling.--The Secretary, in
consultation with the Attorney General, shall carry out a program to
provide to Federal, State, and local law enforcement agencies training
on accurate information about fentanyl and how to detect and handle
fentanyl.
(b) Evidence-Based.--The program under subsection (a) shall comply
with evidence-based guidelines, including the ``Fentanyl Safety
Recommendations for First Responders'' (or any successor guidelines) of
the Office of National Drug Control Policy.
SEC. 104. FENTANYL DETECTION.
(a) Testing of Contaminants.--The Secretary, acting through the
Assistant Secretary and in coordination with the Director of the
Centers for Disease Control and Prevention, shall continue to improve
efforts to enhance screening and identification of contaminants in
drugs to prevent overdoses.
(b) Research Into Technologies.--The Secretary shall conduct or
support research for the development or improvement of portable and
affordable technologies related to checking drugs for fentanyl and
fentanyl-related substances, including chemical screening device
methods.
SEC. 105. GRANTS TO IMPROVE PUBLIC HEALTH SURVEILLANCE IN FORENSIC
LABORATORIES.
Title I of the Omnibus Crime Control and Safe Streets Act of 1968
(34 U.S.C. 10101 et seq.) is amended by adding at the end the
following:
``PART PP--CONFRONTING THE USE OF HEROIN, FENTANYL, AND ASSOCIATED
SYNTHETIC DRUGS
``SEC. 3061. GRANTS TO ADDRESS PUBLIC SAFETY THROUGH IMPROVED FORENSIC
LABORATORY DATA.
``(a) Purpose.--The purpose of a grant awarded under this section
shall be to promote public health by assisting a State or unit of local
government--
``(1) establish or improve a surveillance program in order
to facilitate the seizure of covered controlled substances; and
``(2) carry out the activities described in section 101 of
the STOP Fentanyl Overdoses Act of 2023.
``(b) Establishment of Grant.--The Attorney General, acting through
the Director of the Bureau of Justice Assistance, may make a grant to a
State or unit of local government to promote public health by
establishing or improving a surveillance program in order to facilitate
the seizure of covered controlled substances.
``(c) Eligible Projects.-- A grant awarded under this section shall
be used for a program, project, or other activity to--
``(1) reimburse a State, local, or other forensic science
laboratory for costs associated with testing to help address
any backlog of untested samples of covered controlled
substances;
``(2) reimburse a State, local, or other forensic science
laboratory for the procurement of equipment, technology, or
other support systems;
``(3) reimburse State, local, or other forensic science
laboratory for improved, real time data exchange with the
Centers for Disease Control and Prevention on covered
controlled substances; and
``(4) support a State or local health departments deployed
to address the use of covered controlled substances.
``(d) Additional Requirement.--A program, project, or other
activity pursuant to subsection (c)(2) shall require that the State,
unit of local government, or Tribe demonstrate, to the satisfaction of
the Attorney General, that any reimbursement would result in improved
efficiency of laboratory testing and help prevent future backlogs.
``(e) Allocation.--
``(1) 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 or unit of local
government that meets the requirements of section 2802 so that
each State or unit of local government shall receive an amount
that bears the same ratio to the 75 percent of the total amount
made available to carry out this section for that fiscal year
as the population of the State or unit of local government
bears to the population of all States or units of local
governments.
``(2) 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 use, including for covered
controlled substances, for use by State, local, or Tribal law
enforcement agencies.
``(3) Limitation.--Not less than 60 percent of any amounts
made available to carry out this section shall be awarded for a
program, project, or other activity under paragraph (1) or (2)
of subsection (c).
``(4) Minimum requirement.--Notwithstanding paragraphs (1),
(2), and (3), each State receiving funds shall not receive less
than 0.6 percent of the amount made available to carry out this
section in each fiscal year.
``(f) Covered Controlled Substance Defined.--In this section, the
term `covered controlled substance' means heroin, fentanyl, a fentanyl-
related substance, and any associated synthetic drug.''.
TITLE II--STEMMING THE SUPPLY OF FENTANYL
SEC. 201. REPORT ON COUNTRIES THAT PRODUCE SYNTHETIC DRUGS.
Not later than one year after the date of enactment of this Act,
the Secretary of State shall submit to the Committee on Energy and
Commerce of the House of Representatives and the Committee on the
Judiciary of the Senate a report--
(1) identifying the countries the Secretary determines are
the principal producers of synthetic drugs trafficked into the
United States;
(2) assessing how and why those countries are producing
such drugs; and
(3) describing measures the Secretary plans to take to
reduce the flow of such drugs into the United States.
SEC. 202. GAO REPORT ON INTERNATIONAL MAIL AND CARGO SCREENING.
Not later than one year after the date of enactment of this Act,
the Comptroller General of the United States shall submit to the
Congress a report reviewing the impact of High Intensity Drug
Trafficking Areas program on illicit fentanyl and fentanyl-related
substances imported through international mail and cargo, including
discussion of the following:
(1) The volume of fentanyl and fentanyl-related substances
being imported into the country by means of international mail
and cargo.
(2) The potential impact of increased screening for illicit
fentanyl and fentanyl-related substances on--
(A) deterring drug trafficking in the United
States;
(B) interdicting fentanyl and fentanyl-related
substances that were manufactured outside of the United
States and intended, or attempted, to be imported into
the United States;
(C) the number of Federal criminal prosecutions
based on the manufacture, distribution, or possession
of fentanyl or fentanyl-related substances,
disaggregated by demographic data, including sex, race,
and ethnicity, of the offender;
(D) the charges brought in such prosecutions;
(E) the impacts of prosecutions on reducing demand
and availability to users; and
(F) the development of new fentanyl-related
substances.
(3) The need for non-invasive technology in screening for
fentanyl and fentanyl-related substances, taking into account
the findings pursuant to paragraphs (1) and (2).
TITLE III--OVERDOSE PREVENTION AND SUBSTANCE USE DISORDER TREATMENT
PROGRAMS
SEC. 301. OPIOID TREATMENT EDUCATION.
Part D of title V of the Public Health Service Act (42 U.S.C. 290dd
et seq.) is amended by adding at the end the following:
``SEC. 553. OPIOID TREATMENT EDUCATION.
``(a) In General.--The Secretary shall award grants to States and
local governmental entities to provide education to stakeholders,
including health care providers, criminal justice professionals, and
substance use disorder treatment personnel, on the current state of
research on treatment for opioid use disorder, including--
``(1) the use of opioid agonists or partial agonists; and
``(2) the potential benefits of the use of opioid agonists
or partial agonists for affected individuals.
``(b) Report.--Not later than one year after the date of enactment
of the STOP Fentanyl Overdoses Act of 2023, the Secretary shall submit
a report to the Committee on Energy and Commerce of the House of
Representatives and the Committee on Health, Education, Labor, and
Pensions of the Senate, including the following data:
``(1) The number of people reached by educational materials
funded pursuant to this section.
``(2) The geographic areas where people received such
educational materials.
``(3) The remaining populations and areas targeted for
awareness of educational materials, including the
characteristics of such populations and areas such as the type
of stakeholder and geographic area.
``(4) The select outcomes of education funded pursuant to
this section as determined by the Secretary.''.
SEC. 302. STUDY ON NALOXONE ACCESS.
(a) 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 naloxone. Such study shall address what is known about--
(1) coverage of naloxone (in any available form), including
whether naloxone can be covered as an over-the-counter drug
under a group health plan or group or individual health
insurance coverage (as such terms are defined in section 2791
of the Public Health Service Act (42 U.S.C. 300gg-91)) or for
individuals entitled to benefits under part A or enrolled under
part B of title XVIII of the Social Security Act (42 U.S.C.
1395 et seq.) or receiving medical assistance under a State
plan under title XIX of such Act (42 U.S.C. 1396 et seq.) or a
waiver of such plan;
(2) the out-of-pocket cost to consumers purchasing
naloxone--
(A) with a prescription, with and without coverage
under any such plan or coverage;
(B) over-the-counter, with and without coverage
under any such plan or coverage; and
(C) pursuant to a standing order; and
(3) other factors impacting coverage, including barriers in
covering naloxone as an over-the-counter drug, 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 coverage, and the availability of naloxone purchased
and distributed through public health entities.
(b) Report.--Not later than 2 years after the date of the enactment
of this Act, the Comptroller General of the United States shall submit
to Congress a report that contains the findings of the study conducted
under subsection (a).
SEC. 303. INCREASING ACCESS TO MEDICATION FOR OPIOID OVERDOSE REVERSAL.
(a) Transactions.--Section 581(24)(B) of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 360eee(24)(B)) is amended--
(1) by redesignating clauses (xvii) and (xviii) as clauses
(xviii) and (xix), respectively; and
(2) by inserting after clause (xvi) the following:
``(xvii) the distribution of an opioid
antagonist indicated for emergency treatment of
opioid overdose, such as naloxone, by or to an
overdose prevention, syringe services program,
or other harm reduction service;''.
(b) Wholesale Distribution.--Section 503(e)(4) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 353(e)(4)) is amended--
(1) by redesignating subparagraphs (R) and (S) as
subparagraphs (S) and (T), respectively; and
(2) by inserting after subparagraph (Q) the following:
``(R) the distribution of an opioid antagonist
indicated for emergency treatment of opioid overdose,
such as naloxone, by or to an overdose prevention,
syringe services program, or other harm reduction
service;''.
SEC. 304. GRANT PROGRAM ON HARMS OF DRUG MISUSE.
Part D of title V of the Public Health Service Act (42 U.S.C. 290dd
et seq.), as amended by section 301, is further amended by adding at
the end the following:
``SEC. 554. GRANT PROGRAM ON HARMS OF DRUG MISUSE.
``(a) In General.--The Assistant Secretary, in consultation with
the Director of the Centers for Disease Control and Prevention, shall
award grants to States and political subdivisions of States to support
the delivery of overdose prevention services, including distribution of
Food and Drug Administration-approved opioid reversal agents such as
naloxone, fentanyl strips, and other harm reduction services that
address the harms of drug misuse, including by--
``(1) connecting individuals at risk for, or with, a
substance use disorder to overdose education, counseling, and
health education; and
``(2) encouraging such individuals to take steps to reduce
the harms associated with substance misuse.
``(b) Considerations.--In awarding grants under this section, the
Assistant Secretary shall prioritize grants to applicants that are--
``(1) organizations providing culturally competent care in
terms of considerations based on race, language, ethnicity,
gender, sexuality, or disability; or
``(2) proposing to serve areas with--
``(A) a higher proportion of the population who
meet criteria for dependence on, or abuse of, illicit
drugs;
``(B) a higher drug overdose death rate; and
``(C) a greater behavioral health and substance use
disorder workforce need.
``(c) Special Considerations.--A recipient of a grant under this
section for the purposes described in subsection (a)(2) shall provide
overdose prevention services, as follows:
``(1) Ensure that not less than 60 percent of the grant
funds are used for harm reduction programs.
``(2) Prioritize the delivery of opioid antagonists to--
``(A) people who use opioids or illicit drugs;
``(B) families of such people;
``(C) first responders such as law enforcement
personnel and nonemergency services such as fire
fighters and park rangers; and
``(D) community service providers, such as library,
school, and public transportation personnel.
``(d) Use of Grant Awards.--A recipient of a grant under this
section may use grant funds for the following:
``(1) Adapting, maintaining, and expanding essential
services provided by harm reduction service organizations to
address the risks of drug overdose and contraction of
infectious disease.
``(2) Maintaining or hiring staff.
``(3) Supporting program operational costs, including
staff, rent, and vehicle purchase or maintenance.
``(4) Program supplies.
``(5) Support and case management services.''.
SEC. 305. GOOD SAMARITAN IMMUNITY.
(a) In General.--Part B of title II of the Public Health Service
Act is amended by inserting after section 248 of such Act (42 U.S.C.
238q) the following:
``SEC. 249. GOOD SAMARITAN IMMUNITY.
``(a) Limitation on Civil Liability for Individuals Who Administer
Opioid Overdose Reversal Drugs.--
``(1) In general.--Notwithstanding any other provision of
law, except as provided in paragraph (2), 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 opioid, if the
individual who administers the opioid overdose reversal drug
does so in good faith.
``(2) Exception.--Paragraph (1) shall not apply to an
individual if the harm was caused by the gross negligence or
reckless misconduct of the individual who administers the drug.
``(3) Definitions.--In this subsection:
``(A) The term `health care professional' means a
person licensed by a State to prescribe prescription
drugs.
``(B) The term `opioid overdose reversal drug'
means a drug approved under section 505 of the Federal
Food, Drug, and Cosmetic Act that is indicated for the
partial or complete reversal of the pharmacological
effects of an opioid overdose in the human body.
``(C) The term `opioid overdose prevention program'
means a program operated by a local health department,
harm reduction or other community-based organization,
substance abuse treatment organization, law enforcement
agency, fire department, other first responder
department, or voluntary association, or a program
funded by a Federal, State, or local government, that
works to prevent opioid overdoses by in part providing
opioid overdose reversal drugs and education--
``(i) to individuals at risk of
experiencing an opioid overdose; or
``(ii) to an individual in a position to
assist another individual at risk of
experiencing an opioid overdose.
``(b) Immunity From Liability.--
``(1) In general.--An individual who, in good faith and in
a timely manner--
``(A) seeks medical assistance for another
individual who is experiencing a drug overdose, or
``(B) seeks medical assistance for himself or
herself for a drug overdose, or is the subject of a
request for medical assistance described in
subparagraph (A),
shall not be cited, arrested, prosecuted, criminally liable, or
subject to any sanction for a violation of a condition of
supervised release under section 404 of the Controlled
Substances Act for the possession or use of a controlled
substance, or under any other provision of Federal law
regulating the misuse of prescription drugs, as a result of
seeking such medical assistance.
``(2) 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 section, unless such
laws provide greater protection from liability.
``(3) Definitions.--In this section:
``(A) The term `controlled substance' has the
meaning given the term in section 102 of the Controlled
Substances Act.
``(B) The term `drug overdose' means an acute
condition resulting from or believed to be resulting
from the use of a controlled substance, which an
individual, who is not a health care professional,
would reasonably believe requires medical assistance.
``(C) The term `prescription drug' means a drug
subject to section 503(b)(1) of the Federal Food, Drug,
and Cosmetic Act.
``(D) The terms `seeks medical assistance' and
`seeking such medical assistance' include--
``(i) reporting a drug or alcohol overdose
or other medical emergency to a law enforcement
authority, the 9-1-1 system, a poison control
center, or a medical provider;
``(ii) assisting another individual who is
making a report described in clause (i); or
``(iii) providing care to someone who is
experiencing a drug or alcohol overdose or
other medical emergency while awaiting the
arrival of medical assistance.''.
(b) Public Awareness Campaign.--The Secretary of Health and Human
Services, in coordination with the Administrator of the Drug
Enforcement Administration, shall carry out a campaign to increase
public awareness of the limitations on civil and criminal liability
established by section 249 of the Public Health Service Act, as added
by subsection (a).
SEC. 306. REPORT ON OVERDOSE PREVENTION CENTERS.
The Secretary of Health and Human Services shall enter into
appropriate arrangements with the National Academies of Sciences,
Engineering, and Medicine under which the Academies agree to--
(1) not later than two years after the date of enactment of
this Act, submit to the Congress a report on overdose
prevention centers; and
(2) include in such report--
(A) identification of barriers to operating
overdose prevention centers;
(B) a compilation of the data available to measure
effectiveness of overdose prevention centers on
reducing overdose deaths, and improving access to
medication for opioid use disorder and recovery
services;
(C) identification of best practices to promote
individual and community public health, provide
resources to individuals and families, improve access
to substance use disorder and behavioral health
services, and reduce stigma;
(D) recommendations for developing integrated care
settings inclusive of overdose prevention sites and
incorporating overdose prevention sites into referral
networks; and
(E) approaches to overdose prevention services that
may serve as effective strategies for recovery for
people using fentanyl.
SEC. 307. PRISONS AND SUBSTANCE USE DISORDER TREATMENT.
(a) Prisons and Medication-Assisted Treatment.--The Director of the
Bureau of Prisons, in collaboration with the Director of the Office of
National Drug Control Policy, shall establish a program to offer to
individuals in the custody of the Bureau of Prisons--
(1) drugs that are approved by the Food and Drug
Administration for treatment of a substance use disorder;
(2) counseling and other psychosocial treatments for the
treatment of substance use disorders; and
(3) evidence-based withdrawal management services.
(b) Residential Substance Abuse Treatment for State Prisoners.--
Section 1904(d) of title I of the Omnibus Crime Control and Safe
Streets Act of 1968 (34 U.S.C. 10424(d)) is amended--
(1) by striking ``means'' and inserting the following:
``(1) means'';
(2) by striking the period at the end and inserting ``;
and''; and
(3) by adding at the end the following:
``(2) includes any drug approved by the Food and Drug
Administration for the treatment of substance use disorder.''.
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