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                                                      Calendar No. 510


116th Congress  }                                             {   REPORT
                                SENATE                          
2d Session      }                                             {   116-248
_______________________________________________________________________

                                     

                                                       

    EXPANDING FINDINGS FOR FEDERAL OPIOID RESEARCH AND TREATMENT ACT

                               __________

                              R E P O R T

                                 of the

           COMMITTEE ON COMMERCE, SCIENCE, AND TRANSPORTATION

                                   on

                               H.R. 3153
                               




                 August 6, 2020.--Ordered to be printed
                 
                 
                            ______

              U.S. GOVERNMENT PUBLISHING OFFICE 
 99-010                  WASHINGTON : 2020                  
                 
                 
                 
                 
                 
       SENATE COMMITTEE ON COMMERCE, SCIENCE, AND TRANSPORTATION
                     one hundred sixteenth congress
                             second session

                 ROGER F. WICKER, Mississippi, Chairman
JOHN THUNE, South Dakota             MARIA CANTWELL, Washington
ROY BLUNT, Missouri                  AMY KLOBUCHAR, Minnesota
TED CRUZ, Texas                      RICHARD BLUMENTHAL, Connecticut
DEB FISCHER, Nebraska                BRIAN SCHATZ, Hawaii
JERRY MORAN, Kansas                  EDWARD J. MARKEY, Massachusetts
DAN SULLIVAN, Alaska                 TOM UDALL, New Mexico
CORY GARDNER, Colorado               GARY C. PETERS, Michigan
MARSHA BLACKBURN, Tennessee          TAMMY BALDWIN, Wisconsin
SHELLEY MOORE CAPITO, West Virginia  TAMMY DUCKWORTH, Illinois
MIKE LEE, Utah                       JON TESTER, Montana
RON JOHNSON, Wisconsin               KYRSTEN SINEMA, Arizona
TODD C. YOUNG, Indiana               JACKY ROSEN, Nevada
RICK SCOTT, Florida
                       John Keast, Staff Director
               David Strickland, Minority Staff Director
               
               

                                                       Calendar No. 510
                                                       
                                                       
116th Congress   }                                             {   Report
                                 SENATE
 2d Session      }                                             {  116-248

======================================================================



 
    EXPANDING FINDINGS FOR FEDERAL OPIOID RESEARCH AND TREATMENT ACT

                                _______
                                

                 August 6, 2020.--Ordered to be printed

                                _______
                                

       Mr. Wicker, from the Committee on Commerce, Science, and 
                Transportation, submitted the following

                              R E P O R T

                        [To accompany H.R. 3153]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Commerce, Science, and Transportation, to 
which was referred the bill (H.R. 3153) to direct the Director 
of the National Science Foundation to support research on 
opioid addiction, and for other purposes, having considered the 
same, reports favorably thereon with an amendment (in the 
nature of a substitute) and recommends that the bill (as 
amended) do pass.

                          PURPOSE OF THE BILL

    The purpose of this bill would be to direct the Director of 
the National Science Foundation (NSF) to support further 
research on opioid addiction and other purposes.

                          BACKGROUND AND NEEDS

    Every day, over 192 deaths occur due to drug overdoses in 
the United States.\1\ In 2017, there were 70,237 deaths 
associated with drug use in the United States.\2\ According to 
the Centers for Disease Control and Prevention (CDC), there 
have been three distinct waves of increases in opioid deaths in 
the modern era.\3\ Beginning in the 1990s, opioid deaths were 
attributed mostly to overdose of prescription drugs (e.g., 
natural and semi-synthetic opioids and methadone).\4\ The 
second wave began in 2010, when overdose deaths involving 
heroin increased dramatically.\5\ Then, in 2013, there were 
significant increases in deaths related to synthetic opioids, 
specifically those containing illicitly manufactured fentanyl 
(IMF), which has been consistently found in combination with 
heroin, counterfeit pills, and cocaine.\6\ The CDC continues to 
fight the opioid epidemic, which persists today. The agency has 
partnered with States and communities to identify outbreaks, 
collect data, and respond to overdoses. The CDC's main focus 
lies in building prevention efforts, improving data quality and 
tracking trends, supporting healthcare providers and health 
systems, partnering with public safety, and encouraging 
consumers to make safe choices.\7\ However, the worsening state 
of the epidemic has revealed large inconsistencies and gaps in 
research needed to fully understand and address critical 
problems.
---------------------------------------------------------------------------
    \1\U.S. Department of Health and Human Services, Centers for 
Disease Control and Prevention, ``Opioid Overdose: Drug Overdose 
Deaths,'' (https://www.cdc.gov/drugoverdose/data/statedeaths.html) 
(accessed Apr. 2, 2020).
    \2\U.S. Department of Health and Human Services, Centers for 
Disease Control and Prevention, ``Drug and Opioid-Involved Overdose 
Deaths--United States, 2017-2018,'' (https://www.cdc.gov/mmwr/volumes/
69/wr/mm6911a4.htm) (accessed Apr. 2, 2020).
    \3\U.S. Department of Health and Human Services, Centers for 
Disease Control and Prevention, ``Three Waves of Opioid Overdose 
Deaths,'' (https://www.cdc.gov/drugoverdose/epidemic/index.html) 
(accessed Apr. 2, 2020).
    \4\Id.
    \5\Id.
    \6\Id. See also Rudd RA, Aleshire N, Zibbell JE, Gladden RM, 
``Increases in Drug and Opioid Overdose Deaths--United States, 2000-
2014,'' MMWR, Jan. 1, 2016, 64(50); 1378-82 (https://www.cdc.gov/mmwr/
preview/mmwrhtml/mm6450a3.htm) (accessed Apr. 2, 2020).
    \7\U.S. Department of Health and Human Services, Centers for 
Disease Control and Prevention, ``Opioid Overdose: Understanding the 
Epidemic,'' (https://www.cdc.gov/drugoverdose/
epidemic/index.html) (accessed Apr. 2, 2020).
---------------------------------------------------------------------------
    In response to the knowledge gaps relating to opioids, the 
Office of Science and Technology Policy (OSTP) established a 
Fast-Track Action Committee on Health Science and Technology 
Response to the Opioid Crisis (Opioid FTAC) under the National 
Science and Technology Council (NSTC). The Opioid FTAC 
published a research roadmap identifying seven priority 
research areas in order to support the response to the crisis. 
These areas include the biology and chemistry of pain and 
opioid addiction, non-biological contributors to opioid 
addiction, pain management, prevention of opioid addiction, 
treatment of opioid addiction and withdrawal, overdose 
prevention and recovery, community consequences of opioid 
addiction, and opportunities for enhanced coordination.\8\ In 
addition, a separate interagency committee, the Interagency 
Pain Research Coordinating Committee (IPRCC), published a 
Federal Pain Research Strategy (FPRS). The FPRS is intended to 
provide a long term strategic plan on advancing Federal pain 
research.\9\
---------------------------------------------------------------------------
    \8\National Science and Technology Council, Fast Track Action 
Committee on Health Science and Technology Response to the Opioid 
Crisis Committee on Science, ``Health Research and Development to Stem 
the Opioid Crisis: A National Roadmap,'' pg. vi, Oct. 2018 (https://
www.nih.gov/sites/default/files/Health-RD-to-Stem-Opioid-Crisis-2018-
Roadmap-for-Public-Comment.pdf) (accessed Apr. 2, 2020).
    \9\National Science and Technology Council, Interagency Pain 
Research Coordinating Committee, ``Federal Pain Research Strategy 
Overview,'' Dec. 12, 2018 (https://www.iprcc.nih.gov/Federal-Pain-
Research-Strategy/Overview) (accessed Apr. 2, 2020).
---------------------------------------------------------------------------
    As the agency focused on health research, the National 
Institute of Health (NIH) is the Federal lead for research on 
the opioid epidemic, but the NSF plays a role as well. For 
example, the NSF has funded research exploring the connection 
between the healthcare system and law enforcement workers to 
develop solutions that will positively impact both fields, 
which requires analyzing social problems, socio-ecological and 
socio-legal factors, and intersections between law and 
medicine.\10\ The Opioid FTAC roadmap highlighted interagency 
collaboration as an important facet of improving all agencies' 
research on this topic, as each agency brings its own strengths 
to the research bench.\11\
---------------------------------------------------------------------------
    \10\National Science Foundation, Sociology, LSS-Law and Social 
Sciences, ``CAREER: The Influence of Social Problems on Healthcare and 
Legal Institutions, Abstract Award,'' Sep. 11, 2019 (https://
www.nsf.gov/awardsearch/
showAward?AWD_ID=1753308&HistoricalAwards=false) (accessed Apr. 2, 
2020).
    \11\National Science and Technology Council, Fast Track Action 
Committee on Health Science and Technology Response to the Opioid 
Crisis Committee on Science, ``Health Research and Development to Stem 
the Opioid Crisis: A National Roadmap,'' pg. vi, Oct. 2018 (https://
www.nih.gov/sites/default/files/Health-RD-to-Stem-Opioid-Crisis-2018-
Roadmap-for-Public-Comment.pdf) (accessed Apr. 2, 2020).
---------------------------------------------------------------------------

                         SUMMARY OF PROVISIONS

    This legislation would direct the Director of the NSF, in 
conjunction with the Director of the NIH, to support merit-
reviewed and competitively awarded research on the science of 
opioid addiction.

                          LEGISLATIVE HISTORY

    H.R. 3153 was introduced on June 6, 2019, by Representative 
Wexton (for herself and Representatives Baird, Dean, Connolly, 
Fitzpatrick, and Kilmer) and was referred to the Committee on 
Science, Space, and Technology of the House of Representatives. 
There are 20 additional cosponsors. On June 20, 2019, that 
Committee met in Executive Session and, by voice vote, ordered 
H.R. 3153 reported favorably without amendment. H.R. 3153 was 
reported by that Committee on June 27, 2019, and it was passed 
under suspension of the rules on July 23, 2019, in the House of 
Representatives.
    On July 24, 2019, H.R. 3153 was received in the Senate and 
referred to the Committee on Commerce, Science, and 
Transportation of the Senate. On November 13, 2019, the 
Committee met in open Executive Session and, by voice vote, 
ordered H.R. 3153 reported favorably with an amendment (in the 
nature of a substitute) offered by Senator Gardner.
    A companion bill, S. 2354, was introduced on July 31, 2019, 
by Senator Coons (for himself and Senator Gardner) and was 
referred to the Committee on Commerce, Science, and 
Transportation of the Senate.

                            ESTIMATED COSTS

    In accordance with paragraph 11(a) of rule XXVI of the 
Standing Rules of the Senate and section 403 of the 
Congressional Budget Act of 1974, the Committee provides the 
following cost estimate, prepared by the Congressional Budget 
Office:

 


    H.R. 3153 would authorize the appropriation of $10 million 
annually over the 2020-2024 period for the National Science 
Foundation (NSF) to support research on the science of opioid 
addiction.
    Using information from the NSF, CBO estimates that the 
agency allocated $5 million in 2019 for those purposes. Because 
CBO estimates the budgetary effects of continuing resolutions 
on an annualized basis, in 2020 CBO assumes that the NSF will 
allocate the same amount from funds made available under the 
current continuing resolution (Public Law 116-69). As a result, 
CBO estimates that H.R. 3153 would authorize an increase in 
spending subject to appropriation in 2020 of $5 million, the 
difference between the authorized amount and the annualized 
amount under the continuing resolution. Assuming appropriation 
of the authorized amounts, and based on historical spending 
patterns for similar activities, CBO estimates that 
implementing the legislation would cost $27 million over the 
2020-2024 period and $18 million after 2024.
    The costs of the legislation (detailed in Table 1) fall 
within budget function 250 (science, space, and technology).

                                   Table 1.--ESTIMATED INCREASES IN SPENDING SUBJECT TO APPROPRIATION UNDER H.R. 3153
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                         By fiscal year, millions of dollars--
                                                             -------------------------------------------------------------------------------------------
                                                               2020   2021   2022   2023   2024   2025   2026   2027   2028   2029  2020-2024  2020-2029
--------------------------------------------------------------------------------------------------------------------------------------------------------
Authorization1a.............................................      5     10     10     10     10      0      0      0      0      0       45         45
Estimated Outlays...........................................      1      3      6      8      9      8      5      3      1      1       27        45
--------------------------------------------------------------------------------------------------------------------------------------------------------
aH.R. 3153 would authorize the appropriation of $10 million in 2020 for the NFS to support research on opiod addiction. However using information from
  the NSF, CBO estimates that $5 million has been allocated on an annualized basis from funds made available under the current continuing resolution
  (Public Law 116-69), which provided appropriations through December 20, 2019. Thus, the estimated authorization for 2020, ($5 million) is equal to the
  specified amount ($10 million) minus the annualized amount from the continuing resolution ($5 million).

    On June 25, 2019, CBO transmitted a cost estimate for H.R. 
3153, the EFFORT Act, as ordered reported by the House 
Committee on Science, Space, and Technology on June 20, 2019. 
Both versions of the legislation would direct the NSF to 
support research on the science of opioid addiction, however, 
H.R. 3153 as ordered reported by the Senate Committee on 
Commerce, Science, and Transportation also would authorize 
appropriations for that purpose. Accordingly, CBO's estimates 
of the budgetary effects reflect that difference.
    The CBO staff contact for this estimate is Janani 
Shankaran. The estimate was reviewed by H. Samuel Papenfuss, 
Deputy Assistant Director for Budget Analysis.

                      REGULATORY IMPACT STATEMENT

    Because H.R. 3153 does not create any new programs, the 
legislation will have no additional regulatory impact, and will 
result in no additional reporting requirements. The legislation 
will have no further effect on the number or types of 
individuals and businesses regulated, the economic impact of 
such regulation, the personal privacy of affected individuals, 
or the paperwork required from such individuals and businesses.

                   CONGRESSIONALLY DIRECTED SPENDING

    In compliance with paragraph 4(b) of rule XLIV of the 
Standing Rules of the Senate, the Committee provides that no 
provisions contained in the bill, as reported, meet the 
definition of congressionally directed spending items under the 
rule.

                      SECTION-BY-SECTION ANALYSIS

Section 1. Short title; findings.

    This section would provide that the bill may be cited as 
the ``Expanding Findings for Federal Opioid Research and 
Treatment Act'' or the ``EFFORT Act''.
    This section also would describe congressional findings 
which detail that there are gaps in opioid addiction research 
and notes that the NSF and NIH have been influential in 
providing expertise to develop understanding in many key areas 
relating to the opioid crisis. The findings note that NSF and 
NIH have recognized that this research would benefit from 
multidisciplinary collaboration.

Section 2. NSF support of research on opioid addiction.

    This section would direct NSF and NIH to support merit-
reviewed and competitively awarded research on the science of 
opioid addiction. This section also authorizes to be 
appropriated $10 million for each of fiscal years 2020 through 
2024 in order to carry out the section.

                        CHANGES IN EXISTING LAW

    In compliance with paragraph 12 of rule XXVI of the 
Standing Rules of the Senate, the Committee states that the 
bill as reported would make no change to existing law.