STOP Fentanyl Act of 2021

II 117TH CONGRESS 1ST SESSION S. 1457 To establish programs to address addiction and overdoses caused by illicit fentanyl and other opioids, and for other purposes. IN THE SENATE OF THE UNITED STATES APRIL 29, 2021 Mr. MARKEY (for himself, Ms. WARREN, Mr. WHITEHOUSE, Ms. BALDWIN, and Mr. BOOKER) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 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 Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 3 (a) SHORT TITLE.—This Act may be cited as the 4 ‘‘Support, Treatment, and Overdose Prevention of 5 Fentanyl Act of 2021’’ or the ‘‘STOP Fentanyl Act of 6 2021’’. 7 (b) TABLE OF CONTENTS.—The table of contents for 8 this Act is as follows: 9 VerDate Sep 11 2014 01:23 May 25, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1457.IS S1457 kjohnson on DSK79L0C42PROD with BILLS 2 •S 1457 IS Sec. 1. Short title; table of contents. Sec. 2. Definitions. Sec. 3. Findings. TITLE I—FENTANYL RESEARCH AND EDUCATION Sec. 101. Enhanced fentanyl surveillance. Sec. 102. Collection of overdose data. Sec. 103. Fentanyl detection. Sec. 104. GAO report on international mail and cargo screening. Sec. 105. Contingency management program. TITLE II—OVERDOSE PREVENTION AND SUBSTANCE USE DISORDER TREATMENT PROGRAMS Sec. 201. NAM report on overdose prevention centers. Sec. 202. Naloxone. Sec. 203. Good Samaritan immunity. Sec. 204. Medication-assisted treatment. Sec. 205. Telehealth for substance use disorder treatment. Sec. 206. Grant program on harms of drug misuse. Sec. 207. Opioid treatment education. TITLE III—PUBLIC HEALTH DATA AND TRAINING SUPPORT FOR FENTANYL DETECTION Sec. 301. Public health support for law enforcement. Sec. 302. Report on countries that produce synthetic drugs. Sec. 303. Grants to improve public health surveillance in forensic laboratories. SEC. 2. DEFINITIONS. 1 In this Act, except as otherwise provided: 2 (1) The term ‘‘Assistant Secretary’’ means the 3 Assistant Secretary for Mental Health and Sub- 4 stance Use. 5 (2) The term ‘‘Secretary’’ means the Secretary 6 of Health and Human Services. 7 (3) The term ‘‘fentanyl-related substance’’ has 8 the meaning given the term in section 9 1308.11(h)(30)(i) of title 21, Code of Federal Regu- 10 lations (or successor regulations). 11 VerDate Sep 11 2014 01:23 May 25, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1457.IS S1457 kjohnson on DSK79L0C42PROD with BILLS 3 •S 1457 IS SEC. 3. FINDINGS. 1 Congress finds the following: 2 (1) The opioid epidemic has led to a rise in 3 overdose deaths across the Nation. 4 (2) In 2017, the number of overdose deaths in- 5 volving opioids, including fentanyl, was 6 times high- 6 er than in 1999. 7 (3) The age-adjusted rate of drug overdose 8 deaths involving synthetic opioids other than metha- 9 done increased by 10 percent from 2017 to 2018. 10 (4) The COVID–19 pandemic has been associ- 11 ated with substance use. According to the Centers 12 for Disease Control and Prevention (CDC), 13 per- 13 cent of surveyed adults had started or increased sub- 14 stance use to cope with stress or emotions related to 15 COVID–19. 16 (5) Federal agencies, along with Federal, State, 17 and local lawmakers, have worked together to re- 18 spond to the rise in overdose deaths through in- 19 creased funding and targeted policy initiatives. 20 (6) This includes the successful passage of the 21 Comprehensive Addiction and Recovery Act of 2016 22 (CARA), the 21st Century Cures Act, and the Sub- 23 stance Use-Disorder Prevention that Promotes 24 Opioid Recovery and Treatment for Patients and 25 VerDate Sep 11 2014 01:23 May 25, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1457.IS S1457 kjohnson on DSK79L0C42PROD with BILLS 4 •S 1457 IS Communities Act (SUPPORT for Patient and Com- 1 munities Act). 2 (7) These efforts have helped prevent, treat, 3 and combat the opioid epidemic, but the rise in over- 4 dose deaths involving synthetic opioids like fentanyl 5 means that not all communities are seeing a reduc- 6 tion in fatalities. 7 (8) Drug overdose deaths in the United States 8 involving fentanyl have risen from 2011 through 9 2016, growing from 1,600 fentanyl overdose related 10 deaths in 2011 and 2012 to 18,000 deaths in 2016. 11 (9) This rise in fentanyl overdose related deaths 12 has disproportionately impacted communities of 13 color. 14 (10) According to the Centers for Disease Con- 15 trol and Prevention (CDC), drug overdose death 16 rates involving fentanyl for non-Hispanic African 17 Americans had the largest annual percentage in- 18 crease from 2011 to 2016 at 140.6 percent per year, 19 followed by Hispanic persons at 118.3 percent per 20 year. Fentanyl-involved overdose rates for non-His- 21 panic White persons increased by 108.8 percent 22 from 2013 to 2016. 23 (11) According to the CDC, rates of drug over- 24 dose deaths involving fentanyl increased exponen- 25 VerDate Sep 11 2014 01:23 May 25, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1457.IS S1457 kjohnson on DSK79L0C42PROD with BILLS 5 •S 1457 IS tially from 2011 through 2016 for most regions of 1 the United States. 2 (12) Fentanyl is increasingly being identified in 3 nonopioid substances, like methamphetamine and co- 4 caine. 5 (13) By 2017, over half of heroin and cocaine 6 overdose death records involved synthetic opioids. 7 (14) Previous policies to counter the widespread 8 use of illicit substances through tougher sentencing 9 guidelines disproportionately impact communities of 10 color. 11 (15) There is a growing need for a comprehen- 12 sive plan focused on monitoring, researching, treat- 13 ing, and preventing fentanyl overdose deaths. 14 (16) Taking a public health approach to revers- 15 ing overdose death trends and promoting equity 16 should emphasize increasing research and expanding 17 access to treatment. 18 TITLE I—FENTANYL RESEARCH 19 AND EDUCATION 20 SEC. 101. ENHANCED FENTANYL SURVEILLANCE. 21 (a) IN GENERAL.—The Director of the Centers for 22 Disease Control and Prevention shall enhance the drug 23 surveillance program of the Centers by— 24 VerDate Sep 11 2014 01:23 May 25, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1457.IS S1457 kjohnson on DSK79L0C42PROD with BILLS 6 •S 1457 IS (1) expanding such surveillance program to in- 1 clude all 50 States, the territories of the United 2 States, and all Tribes and Tribal organizations; 3 (2) increasing and accelerating the collection of 4 data on fentanyl, fentanyl-related substances, other 5 synthetic opioids, and new emerging drugs of abuse, 6 including related overdose data from medical exam- 7 iners and drug treatment admissions and informa- 8 tion regarding drug seizures; and 9 (3) utilizing available and emerging information 10 on fentanyl, fentanyl-related substances, other syn- 11 thetic opioids, and new emerging drugs of abuse, in- 12 cluding information from— 13 (A) the National Drug Early Warning Sys- 14 tem; 15 (B) State and local public health authori- 16 ties; 17 (C) Federal, State, and local public health 18 laboratories; and 19 (D) drug seizures by Federal, State, and 20 local law enforcement agencies, including infor- 21 mation from the National Seizure System and 22 the National Forensic Laboratory Information 23 System of the Drug Enforcement Administra- 24 tion. 25 VerDate Sep 11 2014 01:23 May 25, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1457.IS S1457 kjohnson on DSK79L0C42PROD with BILLS 7 •S 1457 IS (b) INFORMATION SHARING.—The Director of the 1 Centers for Disease Control and Prevention shall share 2 the information collected through the drug surveillance 3 program of the Centers with entities including the Office 4 of National Drug Control Policy, State and local public 5 health agencies, and Federal, State, and local law enforce- 6 ment agencies. 7 (c) LAW ENFORCEMENT REPORTING.—Each Federal 8 law enforcement agency shall report information on all 9 drug seizures by that agency to the Drug Enforcement 10 Administration for inclusion in the National Seizure Sys- 11 tem. 12 (d) GAO REPORT.—Not later than 2 years after the 13 date of enactment of this Act, the Comptroller General 14 of the United States shall— 15 (1) publish a report analyzing how Federal 16 agencies can improve their collection, reporting, 17 sharing, and analytic use of drug seizure data across 18 Federal agencies and with State and local govern- 19 ments; and 20 (2) include in such report an analysis of how 21 well available data on drug seizures can measure 22 progress toward reducing drug trafficking into and 23 within the country, as outlined in strategies such as 24 VerDate Sep 11 2014 01:23 May 25, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1457.IS S1457 kjohnson on DSK79L0C42PROD with BILLS 8 •S 1457 IS the National Drug Control Strategy of the Office of 1 National Drug Control Policy. 2 (e) AUTHORIZATION OF APPROPRIATIONS.—To carry 3 out this section, there is authorized to be appropriated 4 $125,000,000 for each of fiscal years 2022 through 2026. 5 SEC. 102. COLLECTION OF OVERDOSE DATA. 6 (a) IN GENERAL.—Not later than one year after the 7 date of enactment of this Act, the Secretary shall conduct 8 a study on how to most efficiently track overdoses by type 9 of drug, including fentanyl. 10 (b) GRANT PROGRAM.— 11 (1) IN GENERAL.—Upon completion of the 12 study under subsection (a), and taking into consider- 13 ation the results of such study, the Secretary shall 14 award grants to States to facilitate the collection of 15 data with respect to fentanyl-involved overdoses. 16 (2) REQUIREMENT.—As a condition on receipt 17 of a grant under this subsection, an applicant shall 18 agree to share the data collected pursuant to the 19 grant with the Centers for Disease Control and Pre- 20 vention. 21 (3) PREFERENCE.—In awarding grants under 22 this subsection, the Secretary shall give preference 23 to applicants whose grant proposals demonstrate the 24 VerDate Sep 11 2014 01:23 May 25, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1457.IS S1457 kjohnson on DSK79L0C42PROD with BILLS 9 •S 1457 IS greatest need for collecting timely and accurate data 1 on overdoses. 2 SEC. 103. FENTANYL DETECTION. 3 (a) TESTING OF CONTAMINANTS.— 4 (1) IN GENERAL.—The Secretary, acting 5 through the Assistant Secretary and in coordination 6 with the Director of the Centers for Disease Control 7 and Prevention, shall establish a pilot program 8 through which 5 entities, in 5 States representing 9 diverse regions, use chemical screening devices to 10 identify contaminants, including fentanyl and 11 fentanyl-related substances, in illicit street drugs. 12 (2) EVALUATION.—Not later than the end of 13 fiscal year 2025, the Secretary shall— 14 (A) complete an evaluation of the most ef- 15 fective ways of expanding the pilot program 16 under this subsection to decrease rates of over- 17 dose; and 18 (B) submit a report to the appropriate 19 congressional committees on the results of such 20 evaluation. 21 (3) DEFINITION.— In this subsection, the term 22 ‘‘chemical screening device’’ means an infrared spec- 23 trophotometer, mass spectrometer, nuclear magnetic 24 resonance spectrometer, Raman spectrophotometer, 25 VerDate Sep 11 2014 01:23 May 25, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1457.IS S1457 kjohnson on DSK79L0C42PROD with BILLS 10 •S 1457 IS ion mobility spectrometer, or any other device or 1 other technology that is able to determine the pres- 2 ence of, or identify, one or more contaminants in il- 3 legal street drugs. 4 (4) AUTHORIZATION OF APPROPRIATIONS.—To 5 carry out this subsection, there is authorized to be 6 appropriated $5,000,000 for each of fiscal years 7 2022 through 2026. 8 (b) RESEARCH INTO TECHNOLOGIES.— 9 (1) IN GENERAL.—The Secretary shall conduct 10 or support research for the development or improve- 11 ment of portable and affordable technologies related 12 to testing drugs for fentanyl and fentanyl-related 13 substances, including chemical screening device 14 methods. 15 (2) AUTHORIZATION OF APPROPRIATIONS.—To 16 carry out this subsection, there is authorized to be 17 appropriated $25,000,000 for each of fiscal years 18 2022 through 2026. 19 SEC. 104. GAO REPORT ON INTERNATIONAL MAIL AND 20 CARGO SCREENING. 21 Not later than 1 year after the date of enactment 22 of this Act, the Comptroller General of the United States 23 shall submit to Congress a report reviewing the impact 24 of illicit fentanyl and fentanyl-related substances imported 25 VerDate Sep 11 2014 01:23 May 25, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1457.IS S1457 kjohnson on DSK79L0C42PROD with BILLS 11 •S 1457 IS through international mail and cargo, including discussion 1 of the following: 2 (1) The volume of fentanyl and fentanyl-related 3 substances being imported into the United States by 4 means of international mail and cargo. 5 (2) The potential impact of increased screening 6 for illicit fentanyl and fentanyl-related substances 7 on— 8 (A) deterring drug trafficking in the 9 United States; 10 (B) interdicting fentanyl and fentanyl-re- 11 lated substances that were manufactured out- 12 side of the United States and intended, or at- 13 tempted, to be imported into the United States; 14 (C) the number of Federal criminal pros- 15 ecutions based on the manufacture, distribu- 16 tion, or possession of fentanyl or fentanyl-re- 17 lated substances, disaggregated by demographic 18 data, including sex, race, and ethnicity, of the 19 offender; 20 (D) the charges brought in prosecutions 21 described in subparagraph (C); 22 (E) the impacts of prosecutions described 23 in subparagraph (C) on reducing demand for, 24 VerDate Sep 11 2014 01:23 May 25, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1457.IS S1457 kjohnson on DSK79L0C42PROD with BILLS 12 •S 1457 IS and availability to users of, fentanyl and 1 fentanyl-related substances; and 2 (F) the development of new fentanyl-re- 3 lated substances. 4 (3) The need for non-invasive technology in 5 screening for fentanyl and fentanyl-related sub- 6 stances, taking into account the findings under para- 7 graphs (1) and (2). 8 SEC. 105. CONTINGENCY MANAGEMENT PROGRAM. 9 (a) IN GENERAL.—The Secretary shall— 10 (1) develop and implement a program of using 11 contingency management principles to discourage 12 the use of illicit drugs; and 13 (2) [Text truncated for display. Full text available on Congress.gov.]