II 

114TH CONGRESS 

1ST SESSION S. 1654 

To prevent deaths occurring from drug overdoses. 

IN THE SENATE OF THE UNITED STATES 

JUNE 23, 2015 

Mr. REED (for himself, Mr. DURBIN, Mr. MARKEY, Mr. WHITEHOUSE, and 

Mr. LEAHY) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To prevent deaths occurring from drug overdoses. 

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 ‘‘Overdose Prevention 

5 Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 

8 (1) According to the Centers for Disease Con9 trol and Prevention, each day in the United States, 

10 more than 100 people die from a drug overdose. 


smartinez on DSK4TPTVN1PROD with BILLS
2 

•S 1654 IS

1 Among people 25 to 64 years old, drug overdose 

2 causes more deaths than motor vehicle accidents. 

3 (2) The Centers for Disease Control and Pre4 vention reports that nearly 44,000 people in the 

5 United States died from a drug overdose in 2013 

6 alone. More than 80 percent of those deaths were 

7 due to unintentional drug overdoses, and many could 

8 have been prevented. 

9 (3) Deaths resulting from unintentional drug 

10 overdoses increased more than 300 percent between 

11 1980 and 1998, and more than tripled between 1999 

12 and 2013. 

13 (4) Nearly 92 percent of all unintentional poi14 soning deaths are due to drugs. Since 1999, in the 

15 United States the population of non-Hispanic 

16 Whites and the population of Indians (as defined in 

17 section 4 of the Indian Self-Determination and Edu18 cation Assistance Act (25 U.S.C. 450b)) have seen 

19 the highest rates of unintentional drug poisoning 

20 deaths. 

21 (5) Opioid medications such as oxycodone and 

22 hydrocodone were involved in nearly 46 percent of 

23 all unintentional drug poisoning deaths in 2013. 

24 (6) Unintentional drug poisoning deaths involv25 ing heroin nearly tripled between 2010 and 2013 


smartinez on DSK4TPTVN1PROD with BILLS
3 

•S 1654 IS

1 and were 23 percent of all unintentional drug poi2 soning deaths in 2013. 

3 (7) Between 1999 and 2010, opioid medication 

4 overdose fatalities increased by more than 400 per5 cent among women and 265 percent among men. 

6 (8) Military veterans are at elevated risk of ex7 periencing a drug overdose. Veterans who served in 

8 Vietnam, Iraq, or Afghanistan and who have combat 

9 injuries, posttraumatic stress disorder, and other co10 occurring mental health diagnoses are at elevated 

11 risk of fatal drug overdose from opioid medications. 

12 (9) Rural and suburban regions are dispropor13 tionately affected by opioid medication and heroin 

14 overdoses. From 2000 through 2013, the age-ad15 justed rate for drug poisoning deaths involving her16 oin has increased nearly 11-fold in the Midwest re17 gion and more than 3-fold in the South region. 

18 (10) Urban centers also continue to struggle 

19 with overdose, which is the leading cause of death 

20 among homeless adults. 

21 (11) In 2009 alone, estimated lost productivity 

22 and direct medical costs from opioid medication 

23 poisonings exceeded $20,000,000,000. 


smartinez on DSK4TPTVN1PROD with BILLS
4 

•S 1654 IS

1 (12) Opioid medication poisonings cost health 

2 insurers an estimated $72,000,000,000 annually in 

3 medical costs. 

4 (13) Both fatal and nonfatal overdoses place a 

5 heavy burden on public health and public safety re6 sources, yet there is no coordinated cross-Federal 

7 agency response to prevent overdose fatalities. 

8 (14) Naloxone is a medication that rapidly re9 verses overdose from heroin and opioid medications. 

10 (15) Naloxone has no pharmacological effect if 

11 administered to a person who has not taken opioids 

12 and has no potential for abuse. Naloxone provides 

13 additional time to obtain necessary medical assist14 ance during an overdose. 

15 (16) Lawmakers in Arkansas, California, Colo16 rado, Connecticut, Delaware, Georgia, Idaho, Illi17 nois, Indiana, Kentucky, Maine, Maryland, Massa18 chusetts, Michigan, Minnesota, Mississippi, Nevada, 

19 New Jersey, New Mexico, New York, North Caro20 lina, North Dakota, Ohio, Oklahoma, Oregon, Penn21 sylvania, Rhode Island, Tennessee, Utah, Vermont, 

22 Virginia, Washington, West Virginia, Wisconsin, and 

23 the District of Columbia have removed legal impedi24 ments to increasing naloxone prescription and its 


smartinez on DSK4TPTVN1PROD with BILLS
5 

•S 1654 IS

1 use by bystanders who are in a position to respond 

2 to an overdose. 

3 (17) The American Medical Association and the 

4 American Public Health Association support further 

5 implementation of community-based programs that 

6 offer naloxone and other opioid overdose prevention 

7 services. 

8 (18) Community-based overdose prevention pro9 grams have successfully prevented deaths from 

10 opioid overdoses by making rescue training and 

11 naloxone available to first responders, parents, and 

12 other bystanders who may encounter an overdose. A 

13 study funded by the Centers for Disease Control and 

14 Prevention of community-based overdose prevention 

15 programs provided by the Massachusetts Depart16 ment of Public Health found that communities with 

17 access to overdose prevention programs experienced 

18 lower mortality rates from opioid overdoses than 

19 communities that did not have access to overdose 

20 prevention programs during the study period. 

21 (19) Over 150,000 potential bystanders have 

22 been trained by overdose prevention programs in the 

23 United States. A Centers for Disease Control and 

24 Prevention report credits overdose prevention proVerDate Sep 11 2014 07:12 Jun 25, 2015 Jkt 049200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1654.IS S1654

smartinez on DSK4TPTVN1PROD with BILLS
6 

•S 1654 IS

1 grams with reversing more than 26,000 overdoses 

2 since 1996. 

3 (20) At least 188 local overdose prevention pro4 grams are operating in the United States, including 

5 in major cities such as Baltimore, Chicago, Los An6 geles, New York City, Boston, San Francisco, and 

7 Philadelphia, and statewide in New Mexico, Massa8 chusetts, and New York. Between December 2007 

9 and March 2014, overdose prevention programs fa10 cilitated by the Massachusetts Department of Public 

11 Health trained more than 22,500 people who re12 ported more than 2,655 rescues. Since 2004, a pro13 gram administered by the Baltimore City Health 

14 Department has trained more than 11,000 people 

15 who reported more than 220 rescues. Project Laz16 arus, an overdose prevention program in Wilkes 

17 County, North Carolina, reduced overdose deaths 69 

18 percent between 2009 and 2011. 

19 (21) In Illinois, the Department of Human 

20 Services, Division of Alcoholism and Substance 

21 Abuse has enrolled over 20 drug overdose prevention 

22 programs with over 100 designated sites across Illi23 nois targeting multiple service populations. These 

24 enrollees include police departments, county health 

25 departments, medical facilities, licensed substance 


smartinez on DSK4TPTVN1PROD with BILLS
7 

•S 1654 IS

1 abuse treatment programs, and community organiza2 tions. Statewide, over 2,000 police officers and more 

3 than 600 others have been trained thus far. The 

4 DuPage County Illinois Health Department has 

5 trained over 1,200 police officers and has reported 

6 34 overdose reversals in 2014 alone. 

7 (22) The Office of National Drug Control Pol8 icy supports equipping first responders to help re9 verse overdoses. Police officers on patrol in Quincy, 

10 Massachusetts, have conducted 300 overdose rescues 

11 with naloxone since 2011. The police department has 

12 reported a 95-percent success rate with overdose res13 cue attempts by police officers. In Suffolk County, 

14 New York, police officers have saved more than 563 

15 lives with naloxone in 2013 alone. 

16 (23) Research shows that the cost per year of 

17 life gained by making naloxone available to reverse 

18 overdoses is within the range of what people in the 

19 United States usually pay for health treatments. 

20 (24) Prompt administration of naloxone and 

21 provision of emergency care by a bystander can re22 duce health complications and health care costs that 

23 arise when a person is deprived of oxygen for an ex24 tended period of time. 


smartinez on DSK4TPTVN1PROD with BILLS
8 

•S 1654 IS

1 (25) Overdose prevention programs are needed 

2 in correctional facilities, addiction treatment pro3 grams, and other places where people are at higher 

4 risk of overdosing after a period of abstinence. 

5 (26) Timely, drug-specific fatal and nonfatal 

6 surveillance data at the local, State, and regional 

7 level is critically needed to target prevention efforts. 

8 (27) People affected by drug overdose gather on 

9 August 31 of each year in communities nationwide 

10 for Overdose Awareness Day, to mourn and pay 

11 tribute to loved ones and raise awareness about 

12 overdose risk and prevention. 

13 SEC. 3. OVERDOSE PREVENTION PROGRAMS. 

14 Title III of the Public Health Service Act (42 U.S.C. 

15 241 et seq.) is amended by adding at the end the fol16 lowing: 

17 ‘‘PART W—OVERDOSE PREVENTION PROGRAMS 

18 ‘‘SEC. 399OO. COOPERATIVE AGREEMENT PROGRAM TO RE19 DUCE DRUG OVERDOSE DEATHS. 

20 ‘‘(a) PROGRAM AUTHORIZED.—The Secretary, acting 

21 through the Administrator of the Substance Abuse and 

22 Mental Health Services Administration, shall enter into 

23 cooperative agreements with eligible entities to enable the 

24 eligible entities to reduce deaths occurring from overdoses 

25 of drugs. 


smartinez on DSK4TPTVN1PROD with BILLS
9 

•S 1654 IS

1 ‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive 

2 a cooperative agreement under this section, an entity shall 

3 be a State, local, or tribal government, a correctional insti4 tution, a law enforcement agency, a community agency, 

5 a professional organization in the field of poison control 

6 and surveillance, or a private nonprofit organization. 

7 ‘‘(c) APPLICATION.— 

8 ‘‘(1) IN GENERAL.—An eligible entity desiring a 

9 cooperative agreement under this section shall sub10 mit to the Secretary an application at such time, in 

11 such manner, and containing such information as 

12 the Secretary may require. 

13 ‘‘(2) CONTENTS.—An application under para14 graph (1) shall include— 

15 ‘‘(A) a description of the activities to be 

16 funded through the cooperative agreement; and 

17 ‘‘(B) evidence that the eligible entity has 

18 the capacity to carry out such activities. 

19 ‘‘(d) PRIORITY.—In entering into cooperative agree20 ments under subsection (a), the Secretary shall give pri21 ority to eligible entities that— 

22 ‘‘(1) are a public health agency or community23 based organization; and 


smartinez on DSK4TPTVN1PROD with BILLS
10 

•S 1654 IS

1 ‘‘(2) have expertise in preventing deaths occur2 ring from overdoses of drugs in populations at high 

3 risk of such deaths. 

4 ‘‘(e) ELIGIBLE ACTIVITIES.—As a condition of re5 ceipt of a cooperative agreement under this section, an eli6 gible entity shall agree to use the cooperative agreement 

7 to do each of the following: 

8 ‘‘(1) Purchase and distribute the drug naloxone 

9 or a similarly effective medication. 

10 ‘‘(2) Carry out one or more of the following ac11 tivities: 

12 ‘‘(A) Educating prescribers and phar13 macists about overdose prevention and naloxone 

14 prescription, or prescriptions of a similarly ef15 fective medication. 

16 ‘‘(B) Training first responders, other indi17 viduals in a position to respond to an overdose, 

18 and law enforcement and corrections officials on 

19 the effective response to individuals who have 

20 overdosed on drugs. Training pursuant to this 

21 subparagraph may include any activity that is 

22 educational, instructional, or consultative in na23 ture, and may include volunteer training, 

24 awareness building exercises, outreach to indiVerDate Sep 11 2014 07:12 Jun 25, 2015 Jkt 049200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1654.IS S1654

smartinez on DSK4TPTVN1PROD with BILLS
11 

•S 1654 IS

1 viduals who are at risk of a drug overdose, and 

2 distribution of educational materials. 

3 ‘‘(C) Implementing and enhancing pro4 grams to provide overdose prevention, recogni5 tion, treatment, and response to individuals in 

6 need of such services. 

7 ‘‘(D) Educating the public and providing 

8 outreach to the public about overdose preven9 tion and naloxone prescriptions, or prescriptions 

10 of other similarly effective medications. 

11 ‘‘(f) COORDINATING CENTER.— 

12 ‘‘(1) ESTABLISHMENT.—The Secretary shall es13 tablish and provide for the operation of a coordi14 nating center responsible for— 

15 ‘‘(A) collecting, compiling, and dissemi16 nating data on the programs and activities 

17 under this section, including tracking and eval18 uating the distribution and use of naloxone and 

19 other similarly effective medication; 

20 ‘‘(B) evaluating such data and, based on 

21 such evaluation, developing best practices for 

22 preventing deaths occurring from drug 

23 overdoses; 

24 ‘‘(C) making such best practices specific to 

25 the type of community involved; 


smartinez on DSK4TPTVN1PROD with BILLS
12 

•S 1654 IS

1 ‘‘(D) coordinating and harmonizing data 

2 collection measures; 

3 ‘‘(E) evaluating the effects of the program 

4 on overdose rates; and 

5 ‘‘(F) education and outreach to the public 

6 about overdose prevention and prescription of 

7 naloxone and other similarly effective medica8 tion. 

9 ‘‘(2) REPORTS TO CENTER.—As a condition on 

10 receipt of a cooperative agreement under this sec11 tion, an eligible entity shall agree to prepare and 

12 submit, not later than 90 days after the end of the 

13 cooperative agreement period, a report to such co14 ordinating center and the Secretary describing the 

15 results of the activities supported through the coop16 erative agreement. 

17 ‘‘(g) DURATION.—The period of a cooperative agree18 ment under this section shall be 4 years. 

19 ‘‘(h) DEFINITION.—In this part, the term ‘drug’— 

20 ‘‘(1) means a drug, as defined in section 201 of 

21 the Federal Food, Drug, and Cosmetic Act (21 

22 U.S.C. 321); and 

23 ‘‘(2) includes controlled substances, as defined 

24 in section 102 of the Controlled Substances Act (21 

25 U.S.C. 802). 


smartinez on DSK4TPTVN1PROD with BILLS
13 

•S 1654 IS

1 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated $20,000,000 to carry 

3 out this section for each of the fiscal years 2016 through 

4 2020. 

5 ‘‘SEC. 399OO–1. SURVEILLANCE CAPACITY BUILDING. 

6 ‘‘(a) PROGRAM AUTHORIZED.—The Secretary, acting 

7 through the Director of the Centers for Disease Control 

8 and Prevention, shall award cooperative agreements to eli9 gible entities to improve fatal and nonfatal drug overdose 

10 surveillance and reporting capabilities, including— 

11 ‘‘(1) providing training to improve identification 

12 of drug overdose as the cause of death by coroners 

13 and medical examiners; 

14 ‘‘(2) establishing, in cooperation with the Na15 tional Poison Data System, coroners, and medical 

16 examiners, a comprehensive national program for 

17 surveillance of, and reporting to an electronic data18 base on, drug overdose deaths in the United States; 

19 and 

20 ‘‘(3) establishing, in cooperation with the Na21 tional Poison Data System, a comprehensive na22 tional program for surveillance of, and reporting to 

23 an electronic database on, fatal and nonfatal drug 

24 overdose occurrences, including epidemiological and 

25 toxicologic analysis and trends. 


smartinez on DSK4TPTVN1PROD with BILLS
14 

•S 1654 IS

1 ‘‘(b) ELIGIBLE ENTITY.—To be eligible to receive a 

2 cooperative agreement under this section, an entity shall 

3 be— 

4 ‘‘(1) a State, local, or tribal government; or 

5 ‘‘(2) the National Poison Data System working 

6 in conjunction with a State, local, or tribal govern7 ment. 

8 ‘‘(c) APPLICATION.— 

9 ‘‘(1) IN GENERAL.—An eligible entity desiring a 

10 cooperative agreement under this section shall sub11 mit to the Secretary an application at such time, in 

12 such manner, and containing such information as 

13 the Secretary may require. 

14 ‘‘(2) CONTENTS.—The application described in 

15 paragraph (1) shall include— 

16 ‘‘(A) a description of the activities to be 

17 funded through the cooperative agreement; and 

18 ‘‘(B) evidence that the eligible entity has 

19 the capacity to carry out such activities. 

20 ‘‘(d) REPORT.—As a condition of receipt of a cooper21 ative agreement under this section, an eligible entity shall 

22 agree to prepare and submit, not later than 90 days after 

23 the end of the cooperative agreement period, a report to 

24 the Secretary describing the results of the activities sup25 ported through the cooperative agreement. 


smartinez on DSK4TPTVN1PROD with BILLS
15 

•S 1654 IS

1 ‘‘(e) NATIONAL POISON DATA SYSTEM.—In this sec2 tion, the term ‘National Poison Data System’ means the 

3 system operated by the American Association of Poison 

4 Control Centers, in partnership with the Centers for Dis5 ease Control and Prevention, for real-time local, State, 

6 and national electronic reporting, and the corresponding 

7 database network. 

8 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 

9 are authorized to be appropriated to carry out this section 

10 $5,000,000 for each of the fiscal years 2016 through 

11 2020. 

12 ‘‘SEC. 399OO–2. REDUCING OVERDOSE DEATHS. 

13 ‘‘(a) PREVENTION OF DRUG OVERDOSE.—Not later 

14 than 180 days after the date of the enactment of this sec15 tion, the Secretary, in consultation with a task force com16 prised of stakeholders, shall develop a plan to reduce the 

17 number of deaths occurring from overdoses of drugs and 

18 shall submit the plan to Congress. The plan shall in19 clude— 

20 ‘‘(1) a plan for implementation of a public 

21 health campaign to educate prescribers and the pub22 lic about overdose prevention and prescription of 

23 naloxone and other similarly effective medication; 

24 ‘‘(2) recommendations for improving and ex25 panding overdose prevention programming; and 


smartinez on DSK4TPTVN1PROD with BILLS
16 

•S 1654 IS

1 ‘‘(3) recommendations for such legislative or 

2 administrative action as the Secretary determines 

3 appropriate. 

4 ‘‘(b) TASK FORCE REPRESENTATION.— 

5 ‘‘(1) REQUIRED MEMBERS.—The task force 

6 under subsection (a) shall include at least one rep7 resentative of each of the following: 

8 ‘‘(A) Individuals directly impacted by drug 

9 overdose. 

10 ‘‘(B) Direct service providers who engage 

11 individuals at risk of a drug overdose. 

12 ‘‘(C) Drug overdose prevention advocates. 

13 ‘‘(D) The National Institute on Drug 

14 Abuse. 

15 ‘‘(E) The Center for Substance Abuse 

16 Treatment. 

17 ‘‘(F) The Centers for Disease Control and 

18 Prevention. 

19 ‘‘(G) The Health Resources and Services 

20 Administration. 

21 ‘‘(H) The Food and Drug Administration. 

22 ‘‘(I) The Office of National Drug Control 

23 Policy. 

24 ‘‘(J) The American Medical Association. 


smartinez on DSK4TPTVN1PROD with BILLS
17 

•S 1654 IS

1 ‘‘(K) The American Association of Poison 

2 Control Centers. 

3 ‘‘(L) The Federal Bureau of Prisons. 

4 ‘‘(M) The Centers for Medicare & Medicaid 

5 Services. 

6 ‘‘(N) The Department of Justice. 

7 ‘‘(O) The Department of Defense. 

8 ‘‘(P) The Department of Veterans Affairs. 

9 ‘‘(Q) First responders. 

10 ‘‘(R) Law enforcement. 

11 ‘‘(S) State agencies responsible for drug 

12 overdose prevention. 

13 ‘‘(2) ADDITIONAL MEMBERS.—In addition to 

14 the representatives required by paragraph (1), the 

15 task force under subsection (a) may include other in16 dividuals with expertise relating to drug overdoses or 

17 representatives of entities with expertise relating to 

18 drug overdoses, as the Secretary determines appro19 priate.’’. 

20 SEC. 4. OVERDOSE PREVENTION RESEARCH. 

21 Subpart 15 of part C of title IV of the Public Health 

22 Service Act (42 U.S.C. 285o et seq.) is amended by adding 

23 at the end the following: 


smartinez on DSK4TPTVN1PROD with BILLS
18 

•S 1654 IS

1 ‘‘SEC. 464Q. OVERDOSE PREVENTION RESEARCH. 

2 ‘‘(a) OVERDOSE RESEARCH.—The Director of the In3 stitute shall prioritize and conduct or support research on 

4 drug overdose and overdose prevention. The primary aims 

5 of this research shall include— 

6 ‘‘(1) an examination of circumstances that con7 tribute to drug overdose and identification of drugs 

8 associated with fatal overdose; 

9 ‘‘(2) an evaluation of existing overdose preven10 tion methods; 

11 ‘‘(3) pilot programs or research trials on new 

12 overdose prevention strategies or programs that have 

13 not been studied in the United States; 

14 ‘‘(4) scientific research concerning the effective15 ness of overdose prevention programs, including how 

16 to effectively implement and sustain such programs; 

17 ‘‘(5) comparative effectiveness research of 

18 model programs; and 

19 ‘‘(6) implementation of science research con20 cerning effective overdose prevention programming 

21 examining how to implement and sustain overdose 

22 prevention programming. 

23 ‘‘(b) FORMULATIONS OF NALOXONE.—The Director 

24 of the Institute shall support research on the development 

25 of formulations of naloxone, and other similarly effective 

26 medications, and dosage delivery devices specifically inVerDate Sep 11 2014 07:12 Jun 25, 2015 Jkt 049200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6201 E:\BILLS\S1654.IS S1654

smartinez on DSK4TPTVN1PROD with BILLS
19 

•S 1654 IS

1 tended to be used by lay persons or first responders for 

2 the prehospital treatment of unintentional drug overdose. 

3 ‘‘(c) DEFINITION.—In this section, the term ‘drug’ 

4 has the meaning given such term in section 399OO. 

5 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 

6 are authorized to be appropriated to carry out this section 

7 $5,000,000 for each of the fiscal years 2016 through 

8 2020.’’. 

Æ 


smartinez on DSK4TPTVN1PROD with BILLS