I 

117TH CONGRESS 

1ST SESSION H. R. 2366 

To establish programs to address addiction and overdoses caused by illicit 

fentanyl and other opioids, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 5, 2021 

Ms. KUSTER (for herself and Ms. BLUNT ROCHESTER) 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. 

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

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Support, Treatment, and Overdose Prevention of 

6 Fentanyl Act of 2021’’ or the ‘‘STOP Fentanyl Act of 

7 2021’’. 


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1 (b) TABLE OF CONTENTS.—The table of contents for 

2 this Act is as follows: 

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. 

3 SEC. 2. DEFINITIONS. 

4 In this Act, except as otherwise provided: 

5 (1) The term ‘‘Assistant Secretary’’ means the 

6 Assistant Secretary for Mental Health and Sub7 stance Use. 

8 (2) The term ‘‘Secretary’’ means the Secretary 

9 of Health and Human Services. 

10 (3) The term ‘‘fentanyl-related substance’’ has 

11 the meaning given the term in section 


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1 1308.11(h)(30)(i) of title 21, Code of Federal Regu2 lations (or successor regulations). 

3 SEC. 3. FINDINGS. 

4 Congress finds the following: 

5 (1) The opioid epidemic has led to a rise in 

6 overdose deaths across the Nation. 

7 (2) In 2017, the number of overdose deaths in8 volving opioids, including fentanyl, was six times 

9 higher than in 1999. 

10 (3) The age-adjusted rate of drug overdose 

11 deaths involving synthetic opioids other than metha12 done increased by 10 percent from 2017 to 2018. 

13 (4) The COVID–19 pandemic has been associ14 ated with substance use. According to the Centers 

15 for Disease Control and Prevention (CDC), 13 per16 cent of surveyed adults had started or increased sub17 stance use to cope with stress or emotions related to 

18 COVID–19. 

19 (5) Federal agencies, along with Federal, State, 

20 and local lawmakers, have worked together to re21 spond to the rise in overdose deaths through in22 creased funding and targeted policy initiatives. 

23 (6) This includes the successful passage of the 

24 Comprehensive Addiction and Recovery Act of 2016 

25 (CARA), the 21st Century Cures Act, and the SubVerDate Sep 11 2014 18:34 Jun 05, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2366.IH H2366

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1 stance Use-Disorder Prevention that Promotes 

2 Opioid Recovery and Treatment for Patients and 

3 Communities Act (SUPPORT for Patient and Com4 munities Act). 

5 (7) These efforts have helped prevent, treat, 

6 and combat the opioid epidemic, but the rise in over7 dose deaths involving synthetic opioids like fentanyl 

8 means that not all communities are seeing a reduc9 tion in fatalities. 

10 (8) Drug overdose deaths in the United States 

11 involving fentanyl have risen from 2011 through 

12 2016, growing from 1,600 fentanyl overdose related 

13 deaths in 2011 and 2012 to 18,000 deaths in 2016. 

14 (9) This rise in fentanyl overdose related deaths 

15 has disproportionately impacted communities of 

16 color. 

17 (10) According to the Centers for Disease Con18 trol and Prevention (CDC), drug overdose death 

19 rates involving fentanyl for non-Hispanic African 

20 Americans had the largest annual percentage in21 crease from 2011 to 2016 at 140.6 percent per year, 

22 followed by Hispanic persons at 118.3 percent per 

23 year. Fentanyl-involved overdose rates for non-His24 panic White persons increased by 108.8 percent 

25 from 2013 to 2016. 


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1 (11) According to the CDC, rates of drug over2 dose deaths involving fentanyl increased exponen3 tially from 2011 through 2016 for most regions of 

4 the United States. 

5 (12) Fentanyl is increasingly being identified in 

6 nonopioid substances, like methamphetamine and co7 caine. 

8 (13) By 2017, over half of heroin and cocaine 

9 overdose death records involved synthetic opioids. 

10 (14) Previous policies to counter the widespread 

11 use of illicit substances through tougher sentencing 

12 guidelines disproportionately impact communities of 

13 color. 

14 (15) There is a growing need for a comprehen15 sive plan focused on monitoring, researching, treat16 ing, and preventing fentanyl overdose deaths. 

17 (16) Taking a public health approach to revers18 ing overdose death trends and promoting equity 

19 should emphasize increasing research and expanding 

20 access to treatment. 


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1 TITLE I—FENTANYL RESEARCH 

2 AND EDUCATION 

3 SEC. 101. ENHANCED FENTANYL SURVEILLANCE. 

4 (a) IN GENERAL.—The Director of the Centers for 

5 Disease Control and Prevention shall enhance the drug 

6 surveillance program of the Centers by— 

7 (1) expanding such surveillance program to in8 clude all 50 States, the territories of the United 

9 States, and all Tribes and Tribal organizations; 

10 (2) increasing and accelerating the collection of 

11 data on fentanyl, fentanyl-related substances, other 

12 synthetic opioids, and new emerging drugs of abuse, 

13 including related overdose data from medical exam14 iners and drug treatment admissions and informa15 tion regarding drug seizures; and 

16 (3) utilizing available and emerging information 

17 on fentanyl, fentanyl-related substances, other syn18 thetic opioids, and new emerging drugs of abuse, in19 cluding information from— 

20 (A) the National Drug Early Warning Sys21 tem; 

22 (B) State and local public health authori23 ties; 

24 (C) Federal, State, and local public health 

25 laboratories; and 


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1 (D) drug seizures by Federal, State, and 

2 local law enforcement agencies, including infor3 mation from the National Seizure System and 

4 the National Forensic Laboratory Information 

5 System of the Drug Enforcement Administra6 tion. 

7 (b) INFORMATION SHARING.—The Director of the 

8 Centers for Disease Control and Prevention shall share 

9 the information collected through the drug surveillance 

10 program of the Centers with entities including the Office 

11 of National Drug Control Policy, State and local public 

12 health agencies, and Federal, State, and local law enforce13 ment agencies. 

14 (c) LAW ENFORCEMENT REPORTING.—Each Federal 

15 law enforcement agency shall report information on all 

16 drug seizures by that agency to the Drug Enforcement 

17 Administration for inclusion in the National Seizure Sys18 tem. 

19 (d) GAO REPORT.—Not later than 2 years after the 

20 date of enactment of this Act, the Comptroller General 

21 of the United States shall— 

22 (1) publish a report analyzing how Federal 

23 agencies can improve their collection, reporting, 

24 sharing, and analytic use of drug seizure data across 


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1 Federal agencies and with State and local govern2 ments; and 

3 (2) include in such report an analysis of how 

4 well available data on drug seizures can measure 

5 progress toward reducing drug trafficking into and 

6 within the country, as outlined in strategies such as 

7 the National Drug Control Strategy of the Office of 

8 National Drug Control Policy. 

9 (e) AUTHORIZATION OF APPROPRIATIONS.—To carry 

10 out this section, there is authorized to be appropriated 

11 $125,000,000 for each of fiscal years 2022 through 2026. 

12 SEC. 102. COLLECTION OF OVERDOSE DATA. 

13 (a) IN GENERAL.—Not later than one year after the 

14 date of enactment of this Act, the Secretary shall conduct 

15 a study on how to most efficiently track overdoses by type 

16 of drug, including fentanyl. 

17 (b) GRANT PROGRAM.— 

18 (1) IN GENERAL.—Upon completion of the 

19 study under subsection (a), and taking into consider20 ation the results of such study, the Secretary shall 

21 award grants to States to facilitate the collection of 

22 data with respect to fentanyl-involved overdoses. 

23 (2) REQUIREMENT.—As a condition on receipt 

24 of a grant under this subsection, an applicant shall 

25 agree to share the data collected pursuant to the 


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1 grant with the Centers for Disease Control and Pre2 vention. 

3 (3) PREFERENCE.—In awarding grants under 

4 this subsection, the Secretary shall give preference 

5 to applicants whose grant proposals demonstrate the 

6 greatest need for collecting timely and accurate data 

7 on overdoses. 

8 SEC. 103. FENTANYL DETECTION. 

9 (a) TESTING OF CONTAMINANTS.— 

10 (1) IN GENERAL.—The Secretary, acting 

11 through the Assistant Secretary and in coordination 

12 with the Director of the Centers for Disease Control 

13 and Prevention, shall establish a pilot program 

14 through which 5 entities, in 5 States representing 

15 diverse regions, use chemical screening devices to 

16 identify contaminants, including fentanyl and 

17 fentanyl-related substances, in illicit street drugs. 

18 (2) EVALUATION.—Not later than the end of 

19 fiscal year 2025, the Secretary shall— 

20 (A) complete an evaluation of the most ef21 fective ways of expanding the pilot program 

22 under this subsection to decrease rates of over23 dose; and 


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1 (B) submit a report to the appropriate 

2 congressional committees on the results of such 

3 evaluation. 

4 (3) DEFINITION.— In this subsection, the term 

5 ‘‘chemical screening device’’ means an infrared spec6 trophotometer, mass spectrometer, nuclear magnetic 

7 resonance spectrometer, Raman spectrophotometer, 

8 ion mobility spectrometer, or any other device or 

9 other technology that is able to determine the pres10 ence of, or identify, one or more contaminants in il11 legal street drugs. 

12 (4) AUTHORIZATION OF APPROPRIATIONS.—To 

13 carry out this subsection, there is authorized to be 

14 appropriated $5,000,000 for each of fiscal years 

15 2022 through 2026. 

16 (b) RESEARCH INTO TECHNOLOGIES.— 

17 (1) IN GENERAL.—The Secretary shall conduct 

18 or support research for the development or improve19 ment of portable and affordable technologies related 

20 to testing drugs for fentanyl and fentanyl-related 

21 substances, including chemical screening device 

22 methods. 

23 (2) AUTHORIZATION OF APPROPRIATIONS.—To 

24 carry out this subsection, there is authorized to be 


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1 appropriated $25,000,000 for each of fiscal years 

2 2022 through 2026. 

3 SEC. 104. GAO REPORT ON INTERNATIONAL MAIL AND 

4 CARGO SCREENING. 

5 Not later than one year after the date of enactment 

6 of this Act, the Comptroller General of the United States 

7 shall submit to the Congress a report reviewing the impact 

8 of illicit fentanyl and fentanyl-related substances imported 

9 through international mail and cargo, including discussion 

10 of the following: 

11 (1) The volume of fentanyl and fentanyl-related 

12 substances being imported into the country by 

13 means of international mail and cargo. 

14 (2) The potential impact of increased screening 

15 for illicit fentanyl and fentanyl-related substances 

16 on— 

17 (A) deterring drug trafficking in the 

18 United States; 

19 (B) interdicting fentanyl and fentanyl-re20 lated substances that were manufactured out21 side of the United States and intended, or at22 tempted, to be imported into the United States; 

23 (C) the number of Federal criminal pros24 ecutions based on the manufacture, distribu25 tion, or possession of fentanyl or fentanyl-reVerDate Sep 11 2014 18:34 Jun 05, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H2366.IH H2366

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1 lated substances, disaggregated by demographic 

2 data, including sex, race, and ethnicity, of the 

3 offender; 

4 (D) the charges brought in such prosecu5 tions; 

6 (E) the impacts of prosecutions on reduc7 ing demand and availability to users; and 

8 (F) the development of new fentanyl-re9 lated substances. 

10 (3) The need for non-invasive technology in 

11 screening for fentanyl and fentanyl-related sub12 stances, taking into account the findings pursuant to 

13 paragraphs (1) and (2). 

14 SEC. 105. CONTINGENCY MANAGEMENT PROGRAM. 

15 (a) IN GENERAL.—The Secretary shall— 

16 (1) develop and implement a program of using 

17 contingency management principles to discourage 

18 the use of illicit drugs; and 

19 (2) as part of such program use incentive-based 

20 interventions— 

21 (A) to increase substance misuse treatment 

22 retention; and 

23 (B) to promote adherence to treatment 

24 goals, including negative urinalysis. 


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1 (b) AUTHORIZATION OF APPROPRIATIONS.—To carry 

2 out this section, there is authorized to be appropriated 

3 $25,000,000 for each of fiscal years 2022 through 2026. 

4 TITLE II—OVERDOSE PREVEN5 TION AND SUBSTANCE USE 

6 DISORDER TREATMENT PRO7 GRAMS 

8 SEC. 201. NAM REPORT ON OVERDOSE PREVENTION CEN9 TERS. 

10 Not later than one year after the date of enactment 

11 of this Act, the Comptroller General of the United States 

12 shall enter into an arrangement with the National Acad13 emy of Medicine (or, if the Academy declines, another ap14 propriate entity) to— 

15 (1) submit to the Congress a report on overdose 

16 prevention centers; and 

17 (2) include in such report— 

18 (A) a review of the effectiveness of legally 

19 authorized overdose prevention centers in the 

20 United States and abroad on lowering overdose 

21 deaths; and 

22 (B) an assessment of the effectiveness of 

23 overdose prevention centers on improving access 

24 to medication-assisted treatment and recovery 

25 services. 


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1 SEC. 202. NALOXONE. 

2 (a) NALOXONE PRICING TRANSPARENCY.— 

3 (1) REPORTING REQUIREMENT.—Not later than 

4 the date that is one year after the date of enactment 

5 of this Act, and annually thereafter, to better under6 stand how research and development costs, manufac7 turing and marketing costs, acquisitions, Federal in8 vestments, revenues and sales, and other factors in9 fluence drug prices, each manufacturer of naloxone 

10 or any other drug approved by the Food and Drug 

11 Administration for opioid overdose reversal shall re12 port to the Secretary— 

13 (A) with respect to naloxone (or such other 

14 drug)— 

15 (i) total expenditures of the manufac16 turer on— 

17 (I) materials and manufacturing 

18 for such drug; 

19 (II) acquiring patents and licens20 ing; and 

21 (III) costs to purchase or acquire 

22 the drug from another company, if ap23 plicable; 

24 (ii) the percentage of total expendi25 tures of the manufacturer on research and 


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1 development for such drug that was de2 rived from Federal funds; 

3 (iii) the total expenditures of the man4 ufacturer on research and development for 

5 such drug; 

6 (iv) the total revenue and net profit 

7 generated from the applicable drug for 

8 each calendar year since drug approval; 

9 (v) the total expenditures of the man10 ufacturer that are associated with mar11 keting and advertising for such drug; 

12 (vi) the wholesale acquisition cost for 

13 such drug; 

14 (vii) the average out-of-pocket cost of 

15 such drug to the consumer; 

16 (viii) patient utilization rates for such 

17 drug; and 

18 (B) additional information specific to the 

19 manufacturer as the Secretary may require, to 

20 include at a minimum— 

21 (i) the total revenue and net profit of 

22 the manufacturer for the reporting period; 

23 (ii) metrics used to determine execu24 tive compensation; and 


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1 (iii) any additional information related 

2 to drug pricing decisions of the manufac3 turer, such as total expenditures on— 

4 (I) drug research and develop5 ment; or 

6 (II) clinical trials on drugs that 

7 failed to receive approval by the Food 

8 and Drug Administration. 

9 (2) REPORTING PERIOD.—The reporting period 

10 for the reports under paragraph (1) shall be as fol11 lows: 

12 (A) For the initial report under paragraph 

13 (1), the 10-year period preceding the report. 

14 (B) For subsequent reports, the 12-month 

15 period preceding the respective reports. 

16 (3) PUBLICLY AVAILABLE.— 

17 (A) IN GENERAL.—Subject to subpara18 graph (B), not later than 30 days after receiv19 ing the information under paragraph (1), the 

20 Secretary shall post on the internet website of 

21 the Centers for Medicare & Medicaid Services 

22 the information reported under paragraph (1) 

23 in written format and using language that is 

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1 tles XVIII and XIX of the Social Security Act 

2 (42 U.S.C. 1395 et seq.; 1396 et seq.). 

3 (B) EXCLUSION OF PROPRIETARY INFOR4 MATION.—The Secretary shall exclude propri5 etary information, such as trade secrets and in6 tellectual property, submitted by the manufac7 turer under paragraph (1) from the posting de8 scribed in subparagraph (A). 

9 (b) STUDY ON CLASSIFICATION OF NALOXONE AS A

10 PRESCRIPTION DRUG.—The Commissioner of Food and 

11 Drugs shall— 

12 (1) not later one year after the date of enact13 ment of this Act, determine whether naloxone should 

14 remain subject to the requirements of section 

15 503(b)(1) of the Federal Food, Drug, and Cosmetic 

16 Act (21 U.S.C. 353(b)(1)) or be reclassified as an 

17 over-the-counter drug; and 

18 (2) take such actions as may be appropriate, 

19 consistent with such determination. 

20 SEC. 203. GOOD SAMARITAN IMMUNITY. 

21 (a) LIMITATION ON CIVIL LIABILITY FOR INDIVID22 UALS WHO ADMINISTER OPIOID OVERDOSE REVERSAL

23 DRUGS.— 

24 (1) IN GENERAL.—Notwithstanding any other 

25 provision of law, except as provided in paragraph 


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1 (2), no individual shall be liable in any Federal or 

2 State proceeding for harm caused by the emergency 

3 administration of an opioid overdose reversal drug to 

4 an individual who has or reasonably appears to have 

5 suffered an overdose from heroin or another opioid, 

6 if— 

7 (A) the individual who administers the 

8 opioid overdose reversal drug obtained the drug 

9 from— 

10 (i) a health care professional as part 

11 of an opioid overdose prevention program; 

12 or 

13 (ii) any source as permitted under ap14 plicable State law; or 

15 (B) the individual administers the opioid 

16 overdose reversal drug in good faith. 

17 (2) EXCEPTION.—Paragraph (1) shall not 

18 apply to an individual if the harm was caused by the 

19 gross negligence or reckless misconduct of the indi20 vidual who administers the drug. 

21 (3) DEFINITIONS.—In this subsection: 

22 (A) The term ‘‘health care professional’’ 

23 means a person licensed by a State to prescribe 

24 prescription drugs. 


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1 (B) The term ‘‘opioid overdose reversal 

2 drug’’ means a drug approved under section 

3 505 of the Federal Food, Drug, and Cosmetic 

4 Act (21 U.S.C. 355) that is indicated for the 

5 partial or complete reversal of the pharma6 cological effects of an opioid overdose in the 

7 human body. 

8 (C) The term ‘‘opioid overdose prevention 

9 program’’ means a program operated by a local 

10 health department, harm reduction or other 

11 community-based organization, substance abuse 

12 treatment organization, law enforcement agen13 cy, fire department, other first responder de14 partment, or voluntary association, or a pro15 gram funded by a Federal, State, or local gov16 ernment, that works to prevent opioid overdoses 

17 by in part providing opioid overdose reversal 

18 drugs and education— 

19 (i) to individuals at risk of experi20 encing an opioid overdose; or 

21 (ii) to an individual in a position to 

22 assist another individual at risk of experi23 encing an opioid overdose. 

24 (b) IMMUNITY FROM LIABILITY.— 


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1 (1) IN GENERAL.—An individual who, in good 

2 faith and in a timely manner— 

3 (A) seeks medical assistance for another 

4 individual who is experiencing a drug overdose 

5 shall not be cited, arrested, prosecuted, crimi6 nally liable, or subject to any sanction for a vio7 lation of a condition of supervised release under 

8 section 404 of the Controlled Substances Act 

9 (21 U.S.C. 844) for the possession or use of a 

10 controlled substance, or under any other provi11 sion of Federal law regulating the misuse of 

12 prescription drugs, as a result of seeking such 

13 medical assistance; or 

14 (B) seeks medical assistance for himself or 

15 herself for a drug overdose, or is the subject of 

16 a request for medical assistance described in 

17 subparagraph (A), shall not be cited, arrested, 

18 prosecuted, criminally liable, or subject to any 

19 sanction for a violation of a condition of super20 vised release, under section 404 of the Con21 trolled Substances Act (21 U.S.C. 844) for the 

22 possession or use of a controlled substance, or 

23 under any other provision of Federal law regu24 lating the misuse of prescription drugs, as a re25 sult of seeking such medical assistance. 


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1 (2) PREEMPTION.—This subsection preempts 

2 the laws of a State or any political subdivision of a 

3 State to the extent that such laws are inconsistent 

4 with this section, unless such laws provide greater 

5 protection from liability. 

6 (3) DEFINITIONS.—In this section: 

7 (A) The term ‘‘controlled substance’’ has 

8 the meaning given the term in section 102 of 

9 the Controlled Substances Act (21 U.S.C. 802). 

10 (B) The term ‘‘drug overdose’’ means an 

11 acute condition resulting from or believed to be 

12 resulting from the use of a controlled sub13 stance, which an individual, who is not a health 

14 care professional, would reasonably believe re15 quires medical assistance. 

16 (C) The term ‘‘prescription drug’’ means a 

17 drug subject to section 503(b)(1) of the Federal 

18 Food, Drug, and Cosmetic Act (21 U.S.C. 

19 353(b)(1)). 

20 (D) The terms ‘‘seeks medical assistance’’ 

21 and ‘‘seeking such medical assistance’’ in22 clude— 

23 (i) reporting a drug or alcohol over24 dose or other medical emergency to a law 

25 enforcement authority, the 9–1–1 system, 


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1 a poison control center, or a medical pro2 vider; 

3 (ii) assisting another individual who is 

4 making a report described in clause (i); or 

5 (iii) providing care to someone who is 

6 experiencing a drug or alcohol overdose or 

7 other medical emergency while awaiting 

8 the arrival of medical assistance. 

9 (c) SEEKING ASSISTANCE AS A MITIGATING FAC10 TOR.—Section 3553 of title 18, United States Code, is 

11 amended— 

12 (1) by redesignating subsection (g) as sub13 section (h); and 

14 (2) by inserting after subsection (f) the fol15 lowing: 

16 ‘‘(g) SEEKING MEDICAL ASSISTANCE.— 

17 ‘‘(1) IN GENERAL.—Notwithstanding any other 

18 provision of law, in imposing a sentence pursuant to 

19 guidelines promulgated by the United States Sen20 tencing Commission under section 994 of title 28 

21 against a defendant convicted of an offense as a re22 sult of seeking medical assistance for another indi23 vidual who is experiencing a drug overdose, or for 

24 himself or herself for a drug overdose, other than an 

25 offense described in section 203(b)(1)(A) of the 


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1 STOP Fentanyl Act of 2021, the court shall con2 sider the act of seeking medical assistance as a miti3 gating factor. 

4 ‘‘(2) DEFINITIONS.—In this subsection, the 

5 terms ‘drug overdose’ and ‘seeking medical assist6 ance’ have the meanings given to such terms in sec7 tion 203(b) of the STOP Fentanyl Act of 2021.’’. 

8 SEC. 204. MEDICATION-ASSISTED TREATMENT. 

9 (a) OPIOID TREATMENT PROGRAM REGULATIONS.— 

10 (1) DEFINITION.—In this subsection, the term 

11 ‘‘opioid treatment program’’ means a program or 

12 practitioner engaged in opioid treatment of individ13 uals with an opioid agonist treatment medication 

14 registered under section 303(g)(1) of the Controlled 

15 Substances Act (21 U.S.C. 823(g)(1)). 

16 (2) ELIMINATION OF PATIENT ELIGIBILITY RE17 QUIREMENT.—The Secretary shall amend section 

18 8.12(e)(1) of title 42, Code of Federal Regulations 

19 (and such other regulations in part 8 of such title 

20 42 as may be necessary) to eliminate the require21 ment that the person became addicted at least 1 

22 year before admission for maintenance treatment 

23 under an opioid treatment program. 

24 (3) SURVEY.— 


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1 (A) IN GENERAL.—Not later than one year 

2 after the date of enactment of this Act, the As3 sistant Secretary shall— 

4 (i) complete a survey of the use in 

5 opioid treatment programs of ‘‘take-home’’ 

6 prescription medications; and 

7 (ii) submit a report to Congress on 

8 the findings of the survey. 

9 (B) REQUIRED ASSESSMENT.—The survey 

10 under paragraph (1) shall assess— 

11 (i) the frequency of use of ‘‘take12 home’’ medication, as allowed under sec13 tion 8.12(i) of title 42, Code of Federal 

14 Regulations; 

15 (ii) the extent to which the limitations 

16 on doses for ‘‘take-home’’ use listed in sec17 tion 8.12(i)(3)(i), (ii), (iii), and (iv) of such 

18 title 42 unduly burden treatment of indi19 viduals with opioid use disorder; and 

20 (iii) whether and how individuals re21 ceiving medications for ‘‘take-home’’ use 

22 receive all services listed in section 8.12(f) 

23 of such title 42. 

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1 ment of this Act, the Assistant Secretary shall complete 

2 a study and submit a report to the Congress on ways in 

3 which the Substance Abuse and Mental Health Services 

4 Administration can provide and support health services, 

5 including treatment for substance use disorders, to indi6 viduals in rural (including agricultural) and medically un7 derserved communities (as defined in section 799B of the 

8 Public Health Service Act (42 U.S.C. 295p)), taking into 

9 account the following: 

10 (1) Stigma. 

11 (2) Using data. 

12 (3) Telemedicine. 

13 (4) Managing fiscal resources in a community 

14 impacted by addiction. 

15 (5) Workforce development. 

16 (6) Broadband. 

17 (7) Overcoming economic challenges. 

18 (8) Prevention. 

19 (9) Transportation. 

20 (10) Nutritional services. 

21 (11) Medication-assisted treatment. 

22 (12) Educating law enforcement personnel 

23 about addiction. 

24 (13) Drug courts. 


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1 (14) Educating the faith community about ad2 diction. 

3 (15) Recovery support. 

4 (16) Housing. 

5 (17) Harm reduction services. 

6 (c) PRISONS AND MEDICATION-ASSISTED TREAT7 MENT.— 

8 (1) IN GENERAL.—The Director of the Bureau 

9 of Prisons shall establish a program to offer— 

10 (A) medication-assisted treatment for 

11 opioid use disorder to individuals in the custody 

12 of the Bureau of Prisons and include in such 

13 treatment all drugs that are approved by the 

14 Food and Drug Administration to treat opioid 

15 use disorder; and 

16 (B) withdrawal management services to in17 dividuals in the custody of the Bureau of Pris18 ons to provide a comprehensive treatment ap19 proach substance use disorders. 

20 (2) AUTHORIZATION OF APPROPRIATIONS.—To 

21 carry out this subsection, there is authorized to be 

22 appropriated to the Director of the Bureau of Pris23 ons $150,000,000 for each of fiscal years 2022 

24 through 2026. 


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1 (d) RESIDENTIAL SUBSTANCE ABUSE TREATMENT

2 FOR STATE PRISONERS.—Section 1904(d) of title I of the 

3 Omnibus Crime Control and Safe Streets Act of 1968 (34 

4 U.S.C. 10424(d)) is amended— 

5 (1) by striking ‘‘means’’ and inserting the fol6 lowing: 

7 ‘‘(1) means’’; 

8 (2) by striking the period at the end and insert9 ing ‘‘; and’’; and 

10 (3) by adding at the end the following: 

11 ‘‘(2) includes any such course of comprehensive 

12 individual and group substance abuse treatment 

13 services using medication-assisted treatment for 

14 opioid use disorder (including the use of any drug 

15 approved or licensed by the Food and Drug Admin16 istration for such treatment).’’. 

17 SEC. 205. TELEHEALTH FOR SUBSTANCE USE DISORDER 

18 TREATMENT. 

19 Section 309(e)(2) of the Controlled Substances Act 

20 (21 U.S.C. 829(e)(2)) is amended— 

21 (1) in subparagraph (A)(i)— 

22 (A) by striking ‘‘at least 1 in-person med23 ical evaluation’’ and inserting the following: ‘‘at 

24 least— 


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1 ‘‘(I) 1 in-person medical evalua2 tion’’; and 

3 (B) by adding at the end the following: 

4 ‘‘(II) for purposes of prescribing 

5 a controlled substance in schedule III 

6 or IV, 1 telehealth evaluation; or’’; 

7 and 

8 (2) by adding at the end the following: 

9 ‘‘(D)(i) The term ‘telehealth evaluation’ 

10 means a medical evaluation that is conducted in 

11 accordance with applicable Federal and State 

12 laws by a practitioner (other than a phar13 macist) who is at a location remote from the 

14 patient and is communicating with the patient 

15 using a telecommunications system referred to 

16 in section 1834(m) of the Social Security Act 

17 that includes, at a minimum, audio and video 

18 equipment permitting two-way, real-time inter19 active communication between the patient and 

20 distant site practitioner. 

21 ‘‘(ii) Nothing in clause (i) shall be con22 strued to imply that 1 telehealth evaluation 

23 demonstrates that a prescription has been 

24 issued for a legitimate medical purpose within 

25 the usual course of professional practice. 


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1 ‘‘(iii) A practitioner who prescribes the 

2 drugs or combination of drugs that are covered 

3 under section 303(g)(2)(C) using the authority 

4 under subparagraph (A)(i)(II) of this para5 graph shall adhere to nationally recognized evi6 dence-based guidelines for the treatment of pa7 tients with opioid use disorders and a diversion 

8 control plan, as those terms are defined in sec9 tion 8.2 of title 42, Code of Federal Regula10 tions, as in effect on the date of enactment of 

11 this subparagraph.’’. 

12 SEC. 206. GRANT PROGRAM ON HARMS OF DRUG MISUSE. 

13 (a) IN GENERAL.—The Assistant Secretary for Men14 tal Health and Substance Use (referred to in this section 

15 as the ‘‘Assistant Secretary’’), in consultation with the Di16 rector of the Centers for Disease Control and Prevention, 

17 shall award grants to States, political subdivisions of 

18 States, Tribes, Tribal organizations, and community-based 

19 entities to support the delivery of overdose prevention, sy20 ringe services programs, and other harm reduction serv21 ices that address the harms of drug misuse, including 

22 by— 

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1 titis, and the consequences of such diseases for indi2 viduals with substance use disorder; 

3 (2) distributing opioid antagonists, such as 

4 naloxone, to individuals at risk of overdose; 

5 (3) connecting individuals at risk for, or with, 

6 a substance use disorder to overdose education, 

7 counseling, and health education; and 

8 (4) encouraging such individuals to take steps 

9 to reduce the negative personal and public health 

10 impacts of substance use or misuse. 

11 (b) CONSIDERATIONS.—In awarding grants under 

12 this section, the Assistant Secretary shall prioritize grants 

13 to applicants that are— 

14 (1) culturally specific organizations, Tribal be15 havioral health and substance use disorder providers, 

16 or organizations that are intentional about serving 

17 populations where COVID–19 has had the most im18 pact; or 

19 (2) proposing to serve areas with— 

20 (A) a higher proportion of the population 

21 who meet criteria for dependence on, or abuse 

22 of, illicit drugs; 

23 (B) a higher drug overdose death rate; 

24 (C) a greater telemedicine infrastructure 

25 need; and 


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1 (D) a greater behavioral health and sub2 stance use disorder workforce need. 

3 (c) USE OF GRANT AWARDS.—A recipient of a grant 

4 under this section may use such grant funds for the fol5 lowing purposes: 

6 (1) Adapt, maintain, and expand essential serv7 ices provided by harm reduction service organiza8 tions to address the risks of COVID–19, drug over9 dose, and contraction of infectious disease. 

10 (2) Maintain or hire staff. 

11 (3) Support program operational costs, includ12 ing staff, rent, and vehicle purchase or maintenance. 

13 (4) Program supplies. 

14 (5) Support and case management services. 

15 (d) AUTHORIZATION OF APPROPRIATIONS.—To carry 

16 out this section, there is authorized to be appropriated 

17 $50,000,000 for fiscal year 2022, to remain available until 

18 expended. 

19 SEC. 207. OPIOID TREATMENT EDUCATION. 

20 (a) IN GENERAL.—The Secretary shall award grants 

21 to States and local governmental entities to provide edu22 cation to stakeholders, including health care providers, 

23 criminal justice professionals, and substance use disorder 

24 treatment personnel, on the current state of research on 

25 treatment for opioid dependence, including— 


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1 (1) the use of opioid agonists or partial 

2 agonists; and 

3 (2) the potential benefits of the use of opioid 

4 agonists or partial agonists for affected individuals. 

5 (b) AUTHORIZATION OF APPROPRIATIONS.—To carry 

6 out this section, there is authorized to be appropriated 

7 $100,000,000 for each of fiscal years 2022 through 2026. 

8 TITLE III—PUBLIC HEALTH 

9 DATA AND TRAINING SUP10 PORT FOR FENTANYL DETEC11 TION 

12 SEC. 301. PUBLIC HEALTH SUPPORT FOR LAW ENFORCE13 MENT. 

14 (a) SUPPORT FOR FENTANYL DETECTION AND HAN15 DLING.—The Secretary, in consultation with the Attorney 

16 General, shall establish a program to provide to Federal, 

17 State, and local law enforcement agencies public health 

18 training on how to detect and handle fentanyl. 

19 (b) EVIDENCE-BASED.—The program under sub20 section (a) shall comply with evidence-based guidelines, in21 cluding the ‘‘Fentanyl Safety Recommendations for First 

22 Responders’’ (or any successor guidelines) of the Office 

23 of National Drug Control Policy. 


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1 (c) AUTHORIZATION OF APPROPRIATIONS.—To carry 

2 out this section, there is authorized to be appropriated 

3 $5,000,000 for each of fiscal years 2022 through 2026. 

4 SEC. 302. REPORT ON COUNTRIES THAT PRODUCE SYN5 THETIC DRUGS. 

6 Not later than 1 year after the date of enactment 

7 of this Act, the Secretary of State shall submit to the Con8 gress a report— 

9 (1) identifying the countries the Secretary de10 termines are the principal producers of synthetic 

11 drugs trafficked into the United States; 

12 (2) assessing how and why those countries are 

13 producing such drugs; and 

14 (3) describing measures the Secretary plans to 

15 take to reduce the flow of such drugs into the 

16 United States. 

17 SEC. 303. GRANTS TO IMPROVE PUBLIC HEALTH SURVEIL18 LANCE IN FORENSIC LABORATORIES. 

19 Title I of the Omnibus Crime Control and Safe 

20 Streets Act of 1968 (34 U.S.C. 10101 et seq.) is amended 

21 by adding at the end the following: 


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1 ‘‘PART PP—CONFRONTING THE USE OF HEROIN, 

2 FENTANYL, AND ASSOCIATED SYNTHETIC DRUGS 

3 ‘‘SEC. 3061. AUTHORITY TO MAKE GRANTS TO ADDRESS 

4 PUBLIC SAFETY THROUGH IMPROVED FO5 RENSIC LABORATORY DATA. 

6 ‘‘(a) PURPOSE.—The purpose of this section is to as7 sist States and units of local government in— 

8 ‘‘(1) carrying out programs to improve surveil9 lance of seized heroin, fentanyl, and associated syn10 thetic drugs to enhance public health; and 

11 ‘‘(2) improving the ability of State, tribal, and 

12 local government institutions to carry out such pro13 grams. 

14 ‘‘(b) GRANT AUTHORIZATION.—The Attorney Gen15 eral, acting through the Director of the Bureau of Justice 

16 Assistance, may make grants to States and units of local 

17 government to improve surveillance of seized heroin, 

18 fentanyl, and associated synthetic drugs to enhance public 

19 health. 

20 ‘‘(c) GRANT PROJECTS TO IMPROVE SURVEILLANCE

21 OF SEIZED HEROIN, FENTANYL, AND ASSOCIATED SYN22 THETIC DRUGS.—Grants made under subsection (b) shall 

23 be used for programs, projects, and other activities to— 

24 ‘‘(1) reimburse State, local, or other forensic 

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1 tested samples of heroin, fentanyl, and associated 

2 synthetic drugs; 

3 ‘‘(2) reimburse State, local, or other forensic 

4 science laboratories for procuring equipment, tech5 nology, or other support systems if the applicant for 

6 the grant demonstrates to the satisfaction of the At7 torney General that expenditures for such purposes 

8 would result in improved efficiency of laboratory 

9 testing and help prevent future backlogs; 

10 ‘‘(3) reimburse State, local, or other forensic 

11 science laboratories for improved, real time data ex12 change with the Centers for Disease Control and 

13 Prevention on fentanyl, fentanyl-related substances, 

14 and other synthetic drugs present in the local com15 munities; and 

16 ‘‘(4) support State, tribal, and local health de17 partment services deployed to address the use of 

18 heroin, fentanyl, and associated synthetic drugs. 

19 ‘‘(d) LIMITATION.—Not less than 60 percent of the 

20 amounts made available to carry out this section shall be 

21 awarded for the purposes under paragraph (1) or (2) of 

22 subsection (c). 

23 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

24 are authorized to be appropriated to carry out this section 

25 $10,000,000 for each of fiscal years 2022 and 2023. 


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1 ‘‘(f) ALLOCATION.— 

2 ‘‘(1) POPULATION ALLOCATION.—Seventy-five 

3 percent of the amount made available to carry out 

4 this section in a fiscal year shall be allocated to each 

5 State that meets the requirements of section 2802 

6 so that each State shall receive an amount that 

7 bears the same ratio to the 75 percent of the total 

8 amount made available to carry out this section for 

9 that fiscal year as the population of the State bears 

10 to the population of all States. 

11 ‘‘(2) DISCRETIONARY ALLOCATION.—Twenty12 five percent of the amount made available to carry 

13 out this section in a fiscal year shall be allocated 

14 pursuant to the discretion of the Attorney General 

15 for competitive grants to States or units of local gov16 ernment with high rates of primary treatment ad17 missions for heroin and other opioids, for use by 

18 State or local law enforcement agencies. 

19 ‘‘(3) MINIMUM REQUIREMENT.—Each State 

20 shall receive not less than 0.6 percent of the amount 

21 made available to carry out this section in each fis22 cal year. 

23 ‘‘(4) CERTAIN TERRITORIES.— 

24 ‘‘(A) IN GENERAL.—For purposes of the 

25 allocation under this section, American Samoa 


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1 and the Commonwealth of the Northern Mar2 iana Islands shall be considered as 1 State. 

3 ‘‘(B) ALLOCATION AMONGST CERTAIN TER4 RITORIES.—For purposes of subparagraph (A), 

5 67 percent of the amount allocated shall be al6 located to American Samoa and 33 percent 

7 shall be allocated to the Commonwealth of the 

8 Northern Mariana Islands.’’. 

Æ 


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