IIB 

114TH CONGRESS 

2D SESSION H. R. 4641 

IN THE SENATE OF THE UNITED STATES 

MAY 12, 2016 

Received; read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

AN ACT 

To provide for the establishment of an inter-agency task 

force to review, modify, and update best practices for 

pain management and prescribing pain medication, and 

for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. DEVELOPMENT OF BEST PRACTICES FOR THE 

2 USE OF PRESCRIPTION OPIOIDS. 

3 (a) DEFINITIONS.—In this section— 

4 (1) the term ‘‘Secretary’’ means the Secretary 

5 of Health and Human Services; and 

6 (2) the term ‘‘task force’’ means the Pain Man7 agement Best Practices Inter-Agency Task Force 

8 convened under subsection (b). 

9 (b) INTER-AGENCY TASK FORCE.—Not later than 

10 December 14, 2018, the Secretary, in cooperation with the 

11 Secretary of Veterans Affairs, the Secretary of Defense, 

12 and the Administrator of the Drug Enforcement Adminis13 tration, shall convene a Pain Management Best Practices 

14 Inter-Agency Task Force to review, modify, and update, 

15 as appropriate, best practices for pain management (in16 cluding chronic and acute pain) and prescribing pain 

17 medication. 

18 (c) MEMBERSHIP.—The task force shall be comprised 

19 of— 

20 (1) representatives of— 

21 (A) the Department of Health and Human 

22 Services; 

23 (B) the Department of Veterans Affairs; 

24 (C) the Food and Drug Administration; 

25 (D) the Department of Defense; 

26 (E) the Drug Enforcement Administration; 


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1 (F) the Centers for Disease Control and 

2 Prevention; 

3 (G) the Health Resources and Services Ad4 ministration; 

5 (H) the Indian Health Service; 

6 (I) the National Academy of Medicine; 

7 (J) the National Institutes of Health; 

8 (K) the Office of National Drug Control 

9 Policy; 

10 (L) the Substance Abuse and Mental 

11 Health Services Administration; and 

12 (M) the Office of Women’s Health; 

13 (2) State medical boards; 

14 (3) subject to subsection (e), physicians, den15 tists, and nonphysician prescribers; 

16 (4) hospitals; 

17 (5) subject to subsection (e), pharmacists and 

18 pharmacies; 

19 (6) first responders; 

20 (7) experts in the fields of pain research and 

21 addiction research; 

22 (8) experts in the fields of adolescent and young 

23 adult addiction research; 

24 (9) representatives of— 


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1 (A) pain management professional organi2 zations; 

3 (B) the mental health treatment commu4 nity; 

5 (C) the addiction treatment and recovery 

6 community; 

7 (D) pain advocacy groups; 

8 (E) veteran service organizations; and 

9 (F) groups with expertise on overdose re10 versal; 

11 (10) a person in recovery from addiction to 

12 medication for chronic pain; 

13 (11) a person in recovery from addiction to 

14 medication for chronic pain, whose addiction began 

15 in adolescence or young adulthood; 

16 (12) a person with chronic pain; 

17 (13) an expert on active duty military, armed 

18 forces personnel, and veteran health and prescription 

19 opioid addiction; 

20 (14) an expert in the field of minority health; 

21 and 

22 (15) other stakeholders, as the Secretary deter23 mines appropriate. 

24 (d) CONDITION ON PARTICIPATION ON TASK

25 FORCE.—An individual representing a profession or entity 


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1 described in paragraph (3) or (5) of subsection (c) may 

2 not serve as a member of the task force unless such indi3 vidual— 

4 (1) is currently licensed in a State in which 

5 such individual is practicing (as defined by such 

6 State) such profession (or, in the case of an indi7 vidual representing an entity, a State in which the 

8 entity is engaged in business); and 

9 (2) is currently practicing (as defined by such 

10 State) such profession (or, in the case of an indi11 vidual representing an entity, the entity is in oper12 ation). 

13 (e) DUTIES.—The task force shall— 

14 (1) not later than 180 days after the date on 

15 which the task force is convened under subsection 

16 (b), review, modify, and update, as appropriate, best 

17 practices for pain management (including chronic 

18 and acute pain) and prescribing pain medication, 

19 taking into consideration— 

20 (A) existing pain management research; 

21 (B) research on trends in areas and com22 munities in which the prescription opioid abuse 

23 rate and fatality rate exceed the national aver24 age prescription opioid abuse rate and fatality 

25 rate; 


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1 (C) recommendations from relevant con2 ferences and existing relevant evidence-based 

3 guidelines; 

4 (D) ongoing efforts at the State and local 

5 levels and by medical professional organizations 

6 to develop improved pain management strate7 gies, including consideration of differences with8 in and between classes of opioids, the avail9 ability of opioids with abuse deterrent tech10 nology, and pharmacological, nonpharma11 cological, medical device alternatives to opioids 

12 to reduce opioid monotherapy in appropriate 

13 cases and the coordination of information col14 lected from State prescription drug monitoring 

15 programs for the purpose of preventing the di16 version of pain medication; 

17 (E) ongoing efforts at the Federal, State, 

18 and local levels to examine the potential bene19 fits of electronic prescribing of opioids, includ20 ing any public comments collected in the course 

21 of those efforts; 

22 (F) the management of high-risk popu23 lations, other than populations who suffer pain, 

24 who— 


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1 (i) may use or be prescribed 

2 benzodiazepines, alcohol, and diverted 

3 opioids; or 

4 (ii) receive opioids in the course of 

5 medical care; 

6 (G) the distinct needs of adolescents and 

7 young adults with respect to pain management, 

8 pain medication, substance use disorder, and 

9 medication-assisted treatment; 

10 (H) the 2016 Guideline for Prescribing 

11 Opioids for Chronic Pain issued by the Centers 

12 for Disease Control and Prevention; 

13 (I) the practice of co-prescribing naloxone 

14 for both pain patients receiving chronic opioid 

15 therapy and patients being treated for opioid 

16 use disorders; 

17 (J) research that has been, or is being, 

18 conducted or supported by the Federal Govern19 ment on prevention of, treatment for, and re20 covery from substance use by and substance use 

21 disorders among adolescents and young adults 

22 relative to any unique circumstances (including 

23 social and biological circumstances) of adoles24 cents and young adults that may make adoles25 cent-specific and young adult-specific treatment 


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1 protocols necessary, including any effects that 

2 substance use and substance use disorders may 

3 have on brain development and the implications 

4 for treatment and recovery; 

5 (K) Federal non-research programs and 

6 activities that address prevention of, treatment 

7 for, and recovery from substance use by and 

8 substance use disorders among adolescents and 

9 young adults, including an assessment of the ef10 fectiveness of such programs and activities in— 

11 (i) preventing substance use by and 

12 substance use disorders among adolescents 

13 and young adults; 

14 (ii) treating such adolescents and 

15 young adults in a way that accounts for 

16 any unique circumstances faced by adoles17 cents and young adults; and 

18 (iii) supporting long-term recovery 

19 among adolescents and young adults; and 

20 (L) gaps that have been identified by Fed21 eral officials and experts in Federal efforts re22 lating to prevention of, treatment for, and re23 covery from substance use by and substance use 

24 disorders among adolescents and young adults, 

25 including gaps in research, data collection, and 


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1 measures to evaluate the effectiveness of Fed2 eral efforts, and the reasons for such gaps; 

3 (2) solicit and take into consideration public 

4 comment on the practices developed under para5 graph (1), amending such best practices if appro6 priate; 

7 (3) develop a strategy for disseminating infor8 mation about the best practices developed under 

9 paragraphs (1) and (2) to prescribers, pharmacists, 

10 State medical boards, educational institutions that 

11 educate prescribers and pharmacists, and other par12 ties, as the Secretary determines appropriate; 

13 (4) review, modify, and update best practices 

14 for pain management and prescribing pain medica15 tion, specifically as it pertains to physician education 

16 and consumer education; and 

17 (5) examine and identify— 

18 (A) the extent of the need for the develop19 ment of new pharmacological, nonpharma20 cological, and medical device alternatives to 

21 opioids; 

22 (B) the current status of research efforts 

23 to develop such alternatives; and 

24 (C) the pharmacological, nonpharma25 cological, and medical device alternatives to 


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1 opioids that are currently available that could 

2 be better utilized. 

3 (f) CONSIDERATION OF STUDY RESULTS.—In review4 ing, modifying, and updating, best practices for pain man5 agement and prescribing pain medication, the task force 

6 shall take into consideration existing private sector, State, 

7 and local government efforts related to pain management 

8 and prescribing pain medication. 

9 (g) LIMITATION.—The task force shall not have rule10 making authority. 

11 (h) REPORT.—Not later than 270 days after the date 

12 on which the task force is convened under subsection (b), 

13 the task force shall submit to Congress a report that in14 cludes— 

15 (1) the strategy for disseminating best practices 

16 for pain management (including chronic and acute 

17 pain) and prescribing pain medication, as developed 

18 under subsection (e); 

19 (2) the results of a feasibility study on linking 

20 the best practices described in paragraph (1) to re21 ceiving and renewing registrations under section 

22 303(f) of the Controlled Substances Act (21 U.S.C. 

23 823(f)); 

24 (3) recommendations for effectively applying 

25 the best practices described in paragraph (1) to imVerDate Sep 11 2014 01:55 May 13, 2016 Jkt 059200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H4641.RFS H4641

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1 prove prescribing practices at medical facilities, in2 cluding medical facilities of the Veterans Health Ad3 ministration and Indian Health Service; 

4 (4) the modified and updated best practices de5 scribed in subsection (e)(4); and 

6 (5) the results of the examination and identi7 fication conducted pursuant to subsection (e)(4), 

8 and recommendations regarding— 

9 (A) the development of new pharma10 cological, nonpharmacological, and medical de11 vice alternatives to opioids; and 

12 (B) the improved utilization of pharma13 cological, nonpharmacological, and medical de14 vice alternatives to opioids that are currently 

15 available. 

Passed the House of Representatives May 11, 2016. 

Attest: KAREN L. HAAS, 

Clerk. 


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