II

106TH CONGRESS

1ST SESSION S. 423

To prohibit certain Federal payments for certain methadone maintenance

programs, and for other purposes.

IN THE SENATE OF THE UNITED STATES

FEBRUARY 11, 1999

Mr. MCCAIN introduced the following bill; which was read twice and referred

to the Committee on Finance

A BILL

To prohibit certain Federal payments for certain methadone

maintenance programs, 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.

4 This Act may be cited as the ‘‘Addiction Free Treat5 ment Act of 1999’’.

6 SEC. 2. FINDINGS.

7 Congress makes the following findings:

8 (1) Heroin use in the United States continues

9 to increase.
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1 (2) Drug use among teenagers in the United

2 States is increasing and the number of teenagers

3 that are using heroin for the first time is higher

4 than at any previous time in history.

5 (3) Between 1992 and 1996 heroin use among

6 college-age students increased an estimated 10 per7 cent.

8 (4) There are an estimated 810,000 chronic

9 heroin users in the United States, with an estimated

10 115,000 heroin addicts in the United States cur11 rently participating in methadone programs.

12 (5) Methadone is a synthetic opiate and the use

13 of methadone in the treatment of heroin addiction

14 results in the transfer of addiction from 1 narcotic

15 to another.

16 (6) Methadone addicts attempting detoxification

17 experience the same difficult withdrawal process as

18 would be experienced with heroin detoxification.

19 (7) The Federal Government should adopt a

20 zero-tolerance, non-pharmacological policy that has

21 as its defined objective independence from drug ad22 diction.

23 (8) The approach of the Federal Government

24 should be to address a range of human needs and

25 conditions that contribute to recidivism among re-
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1 covering heroin addicts and that should be designed

2 to provide opportunities for former heroin addicts to

3 become drug-free, self-sufficient, productive mem4 bers of society.

5 SEC. 3. PROHIBITION ON THE USE OF MEDICAID FUNDS

6 FOR CERTAIN METHADONE MAINTENANCE

7 PROGRAMS.

8 Section 1903(i) of the Social Security Act (42 U.S.C.

9 1396b(i)) is amended—

10 (1) in paragraph (18), by striking the period

11 and inserting ‘‘; or’’; and

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

13 ‘‘(19) with respect to any amount expended for

14 any drug treatment or rehabilitation program that

15 utilizes methadone or Levo-Alpha Acetyl-Methadol

16 unless the program—

17 ‘‘(A) has as its primary objective the elimi18 nation of drug addiction, including addiction to

19 methadone or Levo-Alpha Acetyl-Methadol;

20 ‘‘(B) has a specifically defined timetable

21 (not to exceed 6 months from the date of an in22 dividual’s enrollment as a patient in the pro23 gram) for achieving complete termination of

24 methadone or Levo-Alpha Acetyl-Methadol

25 treatment; davis
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1 ‘‘(C) conducts random and frequent com2 prehensive drug testing for all narcotics;

3 ‘‘(D) provides documentation of the results

4 of such testing;

5 ‘‘(E) requires that patients who are par6 ticipating in the program be drug-free for the

7 duration of their methadone or Levo-Alpha Ace8 tyl-Methadol treatment; and

9 ‘‘(F) terminates the methadone or Levo10 Alpha Acetyl-Methadol treatment of any patient

11 who tests positive for any other illegal narcotic

12 during the duration of their methadone or

13 Levo-Alpha Acetyl-Methadol treatment.’’.

14 SEC. 4. PROHIBITION ON THE USE OF CERTAIN PUBLIC

15 HEALTH SERVICE ACT FUNDS FOR CERTAIN

16 METHADONE MAINTENANCE PROGRAMS.

17 Section 501 of the Public Health Service Act (42

18 U.S.C. 290aa) is amended by adding at the end the follow19 ing:

20 ‘‘(n) LIMITATION.—Notwithstanding any other provi21 sion of law, amounts appropriated under this title or title

22 XIX and administered by the Substance Abuse and Men23 tal Health Services Administration may not be expended

24 for any drug treatment or rehabilitation program that uti-
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1 lizes methadone or Levo-Alpha Acetyl-Methadol unless the

2 program—

3 ‘‘(1) has as its primary objective the elimination

4 of drug addiction, including addiction to methadone

5 or Levo-Alpha Acetyl-Methadol;

6 ‘‘(2) has a specifically defined timetable (not to

7 exceed 6 months from the date of an individual’s en8 rollment as a patient in the program) for achieving

9 complete termination of methadone or Levo-Alpha

10 Acetyl-Methadol treatment;

11 ‘‘(3) conducts random and frequent comprehen12 sive drug testing for all narcotics;

13 ‘‘(4) provides documentation of the results of

14 such testing;

15 ‘‘(5) requires that patients who are participat16 ing in the program be drug-free for the duration of

17 their methadone or Levo-Alpha Acetyl-Methadol

18 treatment; and

19 ‘‘(6) terminates the methadone or Levo-Alpha

20 Acetyl-Methadol treatment of any patient who tests

21 positive for any other illegal narcotic during the du22 ration of their methadone or Levo-Alpha Acetyl23 Methadol treatment.’’.
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1 SEC. 5. STUDY OF TREATMENT PROGRAMS.

2 Not later than 3 years after the date of enactment

3 of this Act, the Director of the National Institute of Drug

4 Abuse shall have conducted and completed a study

5 concerning—

6 (1) the methods and effectiveness of non7 pharmacological heroin rehabilitation programs; and

8 (2) the methods and effectiveness of metha9 done-to-abstinence programs.

10 SEC. 6. ANNUAL REPORT ON EFFECTIVENESS OF HEROIN

11 REHABILITATION PROGRAMS.

12 (a) IN GENERAL.—Not later than January 1, 2000,

13 and each January 1 thereafter, the Secretary of Health

14 and Human Services acting through the Center for Sub15 stance Abuse Treatment shall prepare and submit to Con16 gress a report concerning the effectiveness of heroin reha17 bilitation programs. Each such report shall focus on both

18 nonpharmacological and methadone-to-abstinence based

19 approaches to heroin rehabilitation.

20 (b) TERMINATION.—The requirement under sub21 section (a) shall terminate after the Secretary of Health

22 and Human Services submits the 5th annual report under

23 such subsection.
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1 SEC. 7. EFFECTIVE DATE.

2 The amendments made by this Act apply to amounts

3 expended on and after the date that is 6 months after

4 the date of enactment of this Act.

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