REDUCING UNUSED MEDICATIONS ACT OF 2016; Congressional Record Vol. 162, No. 74
(House of Representatives - May 11, 2016)

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[Pages H2273-H2275]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                REDUCING UNUSED MEDICATIONS ACT OF 2016

  Mr. GUTHRIE. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 4599) to amend the Controlled Substances Act to permit 
certain partial fillings of prescriptions, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 4599

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Reducing Unused Medications 
     Act of 2016''.

     SEC. 2. PARTIAL FILLS OF SCHEDULE II CONTROLLED SUBSTANCES.

       (a) In General.--Section 309 of the Controlled Substances 
     Act (21 U.S.C. 829) is amended by adding at the end the 
     following:
       ``(f) Partial Fills of Schedule II Controlled Substances.--
       ``(1) Partial fills.--
       ``(A) In general.--A prescription for a controlled 
     substance in schedule II may be partially filled if--
       ``(i) it is not prohibited by State law;
       ``(ii) the prescription is written and filled in accordance 
     with the Controlled Substances Act (21 U.S.C. 801 et seq.), 
     regulations prescribed by the Attorney General, and State 
     law;
       ``(iii) the partial fill is requested by the patient or the 
     practitioner that wrote the prescription; and
       ``(iv) the total quantity dispensed in all partial fillings 
     does not exceed the total quantity prescribed.
       ``(B) Other circumstances.--A prescription for a controlled 
     substance in schedule II may be partially filled in 
     accordance with section 1306.13 of title 21, Code of Federal 
     Regulations (as in effect on the date of enactment of the 
     Reducing Unused Medications Act of 2016).
       ``(2) Remaining portions.--
       ``(A) In general.--Except as provided in subparagraph (B), 
     remaining portions of a partially filled prescription for a 
     controlled substance in schedule II--
       ``(i) may be filled; and
       ``(ii) shall be filled not later than 30 days after the 
     date on which the prescription is written.
       ``(B) Emergency situations.--In emergency situations, as 
     described in subsection (a), the remaining portions of a 
     partially filled prescription for a controlled substance in 
     schedule II--
       ``(i) may be filled; and
       ``(ii) shall be filled not later than 72 hours after the 
     prescription is issued.''.
       (b) Rule of Construction.--Nothing in this section shall be 
     construed to affect the authority of the Attorney General to 
     allow a prescription for a controlled substance in schedule 
     III, IV, or V of section 202(c) of the Controlled Substances 
     Act (21 U.S.C. 812(c)) to be partially filled.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Kentucky (Mr. Guthrie) and the gentleman from Texas (Mr. Gene Green) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Kentucky.


                             General Leave

  Mr. GUTHRIE. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days in which to revise and extend their remarks and 
insert extraneous materials in the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Kentucky?
  There was no objection.
  Mr. GUTHRIE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of H.R. 4599, the Reducing Unused 
Medications Act of 2016, introduced by Ms. Clark of Massachusetts and 
Mr. Stivers of Ohio.
  The number of prescriptions for opioids has significantly increased 
in recent years. While opioids can benefit patients when used 
appropriately, once their pain is subsided, there may be unused pills 
that could be misused and diverted.
  Several States have considered enabling pharmacies to partially fill 
such prescriptions to minimize the number of pills in circulation while 
continuing to address the patient needs. However, current DEA 
regulations are not entirely clear about when such partial fills are 
permitted.
  H.R. 4599 amends the Controlled Substances Act to clarify when 
schedule II controlled substances, including opioid pain medications, 
can be partially filled. This is a commonsense, bipartisan bill that 
will help save lives.

[[Page H2274]]

  I urge my colleagues to join me in support.
  I reserve the balance of my time.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself such time as I 
may consume.
  Mr. Speaker, I rise to voice my support for H.R. 4599, Reducing 
Unused Medications Act.
  Opioid abuse in the United States is rising at alarming rates. In 
2014, nearly 2 million Americans abused or were addicted to 
prescription opioids. Opioids are now one of the most prescribed 
classes of medications, and the National Institute on Drug Abuse 
estimates that over 70 percent of adults who misuse prescription 
opioids get them from a friend or relative.
  A promising step to reduce the number of prescription opioids is a 
permanent partial filling of these prescriptions. Current Drug 
Enforcement Administration regulations allow pharmacists to partially 
fill prescriptions for schedule III, IV, and V substances, however, 
only allow partial fulfillment of schedule II substances in long-term-
care settings or to terminally ill patients and when the full 
prescription cannot be supplied.
  While these regulations do not explicitly prohibit a pharmacist from 
partially filling prescriptions for schedule II substances outside of 
these certain limited circumstances, DEA recognizes that the 
regulations lack clarity as to when partial filling of schedule II 
substances is permitted. This bill would provide clarity.
  The Reducing Unused Medications Act would allow pharmacists, at the 
request of patients or doctors, to partially fill prescriptions for 
schedule II drugs, such as opioids, meaning that a patient or doctor 
can request to receive a 10-day supply of a 30-day prescription 
initially and then return later to receive the remaining portion, if 
needed. This flexibility may help reduce the number of unused pills in 
circulation and reduce the risk of substance misuse, diversion, and 
overdose.
  The bipartisan bill before us reflects a careful compromise that 
holds the potential to reduce the amount of unused opioid medications 
in circulation and is an important step in helping curb a growing 
opioid epidemic.
  I want to thank Representatives Clark and Stivers for their 
leadership in sponsoring this bill.
  I urge my colleagues to support the Reducing Unused Medications Act.
  Mr. Speaker, I yield 3 minutes to the gentlewoman from Massachusetts 
(Ms. Clark), the sponsor of this bill.
  Ms. CLARK of Massachusetts. Mr. Speaker, I thank the gentleman from 
Texas for yielding.
  Mr. Speaker, over the last decade, we have seen a staggering increase 
of opioid overdose deaths. In 2015, this epidemic claimed 125 lives in 
my district alone. There are a lot of different causes of this crisis, 
but the number of prescription opioids in circulation is a critical 
factor.
  Over the last 15 years, the amount of prescription painkillers has 
quadrupled and generic Vicodin is now the most prescribed drug to 
Medicare beneficiaries.
  Now, we know that often patients don't use all the opioids they are 
prescribed. According to the National Institute on Drug Abuse, over 70 
percent of adults who misuse prescription drugs get them from friends 
or relatives.
  Millions of half-filled bottles of unused and unwanted prescription 
drugs line our families' medicine cabinets, and too often that is where 
opioid addiction begins.
  One promising way to reduce the amount of unused and unwanted 
painkillers that are fueling this public health crisis is by allowing 
patients and doctors to only partially fill opioid prescriptions.
  By allowing pharmacists to partially fill a prescription for opioids 
at the request of a patient or doctor, we can reduce the number of 
unused pills and help stop pill diversion and misuse.
  Currently, the DEA allows partial filling of prescriptions for many 
drugs, but the regulations are narrower and less clear for opioid 
drugs. That is why I, along with Representative Stivers, have 
introduced the Reducing Unused Medications Act.
  This legislation will resolve any ambiguity and clearly establish 
that a prescription for schedule II substances, like opioid 
painkillers, may be partially filled upon the request of a patient or 
doctor.
  We have all heard the stories. Just last weekend I ran into a dad 
whose son had been given a 30-day prescription of opioid painkillers 
for having a wisdom tooth taken out, and he had just received an 
unwanted prescription, also for 30 days, after having minor surgery.
  This bill will empower patients to manage their prescriptions and can 
be a critical tool in an effort to address the opioid epidemic. This is 
a commonsense bill that will help us stop the misuse of prescription 
drugs that has fueled the use of heroin and this opioid epidemic.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield back the balance of my 
time.
  Mr. GUTHRIE. Mr. Speaker, I encourage all my colleagues to vote for 
H.R. 4599, and I yield back the balance of my time.
  Mr. PALLONE. Mr. Speaker, I rise to voice my support for H.R. 4599, 
commonsense legislation that offers the potential to reduce the number 
of unused and unwanted prescription opioids that have been misused or 
diverted as a part of the opioid epidemic.
  The number of prescription opioids dispensed in the U.S. has nearly 
quadrupled in the last 15 years, and over 70 percent of adults who 
misuse prescription opioids get them from a friend or a relative. This 
is often due to the fact that many patients fill legitimate 
prescriptions for opioids and for one reason or another do not use the 
entirety of the prescription.
  One way to help reduce the amount of unused opioid medications in 
home medicine cabinets is to permit the partial filling of Schedule II 
prescriptions. Partial fill policies allow providers, pharmacists, and 
patients the option to dispense a portion of a prescription with the 
option of filling the total amount of the prescription at a later time. 
For example, a patient or practitioner could request that 10 or 15 days 
of a 30-day prescription be dispensed initially with the remaining 
portion available later if needed. It is hoped that this additional 
flexibility would reduce the number of unused pills in circulation and 
ultimately reduce misuse and diversion of these prescription opioids.
  Current Drug Enforcement Administration regulations allow pharmacists 
to partially fill prescriptions for Schedule III, IV, and V substances, 
however, Schedule II substances can only be partially filled in long 
term care settings, for terminally ill patients, or when the full 
prescription cannot be supplied. While these regulations do not 
prohibit partially filling prescriptions for Schedule II substances in 
other situations, the DEA has acknowledged that the regulations may 
need to be amended to provide clarity as to when partial fill of 
Schedule II substances is allowable.
  The Reducing Unused Medications Act of 2015 was introduced in the 
House by Representatives Katherine Clark (D-MA) and Steve Stivers (R-
OH) to do just that--provide additional clarity regarding when Schedule 
II prescriptions may be partially filled under the Controlled 
Substances Act.
  In addition to the circumstances outlined in current DEA regulations, 
H.R. 4599 would also allow partial fill of Schedule II substances if 
requested by a doctor or patient, as long as the prescription is 
written and dispensed according to federal and state law. It further 
makes clear that remaining portions of a partially filled prescription 
for a Schedule II substance may not be filled later than 30 days after 
the date the prescription is written.
  Partial fills would also be allowed in emergency situations, with the 
remaining portion to be filled not later than 72 hours after the 
prescription is issued. This legislation does not impact the ability of 
Schedule III, IV, or V prescriptions to be partially filled.
  H.R. 4599 is the result of careful compromise among the authors of 
this legislation, the stakeholders, and our Committee members, and I 
urge my colleagues to support it.
  Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 4599 the 
``Reducing Unused Medication Act of 2016''.
  This bill is an important measure that will decrease the number of 
unused medications available for misuse to the public by setting 
limitations on the most frequent avenues used to secure unused 
medication.
  As we know, many times patients are prescribed medication far beyond 
their needs.
  Unused prescription medication creates a lethal danger to households 
and communities across America, and failing to properly dispose of 
unfinished medications can have dire consequences on the environment 
and our ecosystem.
  According to a new study conducted by Geisinger Health System and 
published in the Journal of the American Pharmacists Association just 
11 percent of unused prescription drugs were disposed of via drug take-
back programs, while 55 percent were left in the

[[Page H2275]]

medicine cabinet, 14 percent were thrown in the trash, and 9 percent 
were flushed down the toilet.
  As we have heard many unfortunate stories as we bring greater 
awareness to this issue, we know that abuse of medicine among teenagers 
is a growing problem.
  Easy access to parents' and grandparents' leftover medications is 
just throwing gasoline on the fire.
  Meanwhile, more than 60,000 young children are taken to the emergency 
room each year after ingesting a family member's medication.
  With respect to the environment, the FDA no longer recommends 
flushing drugs down the toiler because sewage treatment plants lack the 
capacity to remove pharmaceuticals and personal care products' residue.
  H.R. 4599 will amend the Controlled Substances Act to permit certain 
fillings of prescriptions--such that a prescription for a controlled 
substance may be partially filled if:
  It is not prohibited by state law;
  The prescription is written and filled in accordance with the 
Controlled Substances Act, regulations prescribed by the Attorney 
General, and State law;
  The partial fill is requested by the patient or the practitioner that 
wrote the prescription; and
  The total quantity dispensed in all partial fillings does not exceed 
the total quantity prescribed.
  Mr. Speaker, enacting this legislation will work to not only combat a 
number of prescription drug abuses, but also deal a debilitating blow 
to the mounting opioid abuse epidemic.
  The SPEAKER pro tempore (Mr. Zinke). The question is on the motion 
offered by the gentleman from Kentucky (Mr. Guthrie) that the House 
suspend the rules and pass the bill, H.R. 4599, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________