I 

115TH CONGRESS 

2D SESSION H. R. 5865 

To establish programs related to prevention of prescription opioid misuse, 

and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 17, 2018 

Mr. CARTWRIGHT introduced the following bill; which was referred to the 

Committee on Energy and Commerce, and in addition to the Committees 

on the Judiciary, Ways and Means, and Education and the Workforce, 

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 related to prevention of prescription 

opioid misuse, 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 Prevention 

5 and Responsible Opioid Practices Act’’. 


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1 SEC. 2. FEDERAL LICENSURE OF PHARMACEUTICAL REP2 RESENTATIVES WHO PROMOTE CERTAIN 

3 OPIOIDS. 

4 Subchapter E of chapter V of the Federal Food, 

5 Drug, and Cosmetic Act (21 U.S.C. 360bbb et seq.) is 

6 amended by adding at the end the following: 

7 ‘‘SEC. 569D. FEDERAL LICENSURE OF PHARMACEUTICAL 

8 REPRESENTATIVES WHO PROMOTE CERTAIN 

9 OPIOIDS. 

10 ‘‘(a) IN GENERAL.—The Secretary, in consultation 

11 with the Attorney General, shall establish a licensure pro12 gram for pharmaceutical representatives described in sub13 section (b). 

14 ‘‘(b) LICENSURE PROGRAM.— 

15 ‘‘(1) REQUIREMENT.—Beginning on January 1, 

16 2020, no individual described in paragraph (2) may 

17 engage in the marketing or promoting of opioid 

18 drugs unless such individual is licensed under this 

19 section. 

20 ‘‘(2) INDIVIDUALS REQUIRED TO OBTAIN LI21 CENSURE.—An individual required to obtain a li22 cense under this section is any individual who, on 

23 behalf of a drug manufacturer, engaged, on more 

24 than 15 days in a calendar year, in the marketing 

25 or promotion to health care professionals, including 

26 educational or sales communications, meetings or 


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1 paid events, and the provision of goods, gifts, and 

2 samples, of any opioid drug (other than methadone) 

3 that is listed in schedule II of section 202(c) of the 

4 Controlled Substances Act. 

5 ‘‘(3) LICENSURE PERIOD.—Each license issued 

6 under this section shall be valid for 3 years, and 

7 may be renewed for additional 3-year periods. 

8 ‘‘(c) REQUIREMENTS.—An individual required to ob9 tain a license under this section shall— 

10 ‘‘(1) submit to the Secretary, at such time and 

11 in such manner as the Secretary may require— 

12 ‘‘(A) such information as the Secretary 

13 may require; and 

14 ‘‘(B) a registration fee in the amount of 

15 $3,000; 

16 ‘‘(2) certify that such individual has completed 

17 training on ethics, pharmaceutical marketing regula18 tions, the ‘CDC Guidelines for Prescribing Opioids 

19 for Chronic Pain’, published by the Centers for Dis20 ease Control and Prevention in 2016 (or any suc21 cessor document) or the ‘FDA Blueprint for Pre22 scriber Education for Extended-Release and Long23 Acting Opioid Analgesics’, and applicable Federal 

24 laws pertaining to drug marketing, labeling, and 

25 clinical trials, as the Secretary may require; 


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1 ‘‘(3) certify that such individual will not engage 

2 in any illegal, fraudulent, misleading, or other decep3 tive marketing of schedule II opioid drugs; and 

4 ‘‘(4) file with the Secretary annual reports dis5 closing the names of providers visited and any drug 

6 samples or gifts such individual gives any such pro7 vider. 

8 ‘‘(d) MANUFACTURER REPORTING REQUIRE9 MENTS.—The manufacturer who employs or contracts 

10 with any individual required to obtain a license under this 

11 section shall include in reports required under section 

12 1128G of the Social Security Act the name of each such 

13 licensed individual that provides payments or other trans14 fers of value required to be reported under such section 

15 1128G that relates to an opioid drug that is listed in 

16 schedule II of the Controlled Substances Act.’’. 

17 SEC. 3. WITHDRAWAL OF APPROVAL OF CERTAIN OPIOIDS. 

18 (a) IN GENERAL.—Notwithstanding any other provi19 sion of law, any ultra-high-dose opioid shall be considered 

20 a drug that presents an imminent hazard to the public 

21 health within the meaning of section 505(e) of the Federal 

22 Food, Drug, and Cosmetic Act (21 U.S.C. 355(e)), and 

23 the Secretary of Health and Human Services shall sus24 pend the approval of such drug, in accordance with such 

25 section 505(e). 


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1 (b) DEFINITION.—In this section, the term ‘‘ultra2 high-dose opioid’’ means an opioid drug for which the 

3 daily dosage provided for in the approved label exceeds 

4 the morphine milligram equivalents per day outlined in the 

5 report entitled ‘‘CDC Guidelines for Prescribing Opioids 

6 for Chronic Pain’’, published by the Centers for Disease 

7 Control and Prevention in 2016 (or any successor docu8 ment). 

9 SEC. 4. EXPANDING AVAILABILITY OF INFORMATION IN 

10 THE ARCOS DATABASE. 

11 Section 307(d) of the Controlled Substances Act (21 

12 U.S.C. 827(d)) is amended by adding at the end the fol13 lowing: 

14 ‘‘(3) The Attorney General shall make available to 

15 the medical licensing board and board of pharmacy for 

16 each State the information in the Automation of Reports 

17 and Consolidated Orders System, or any subsequent auto18 mated system developed by the Attorney General to mon19 itor the sale, delivery, and disposal of controlled sub20 stances within such State.’’. 


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1 SEC. 5. CONTINUING MEDICAL EDUCATION AND PRESCRIP2 TION DRUG MONITORING PROGRAM REG3 ISTRATION FOR PRESCRIBERS. 

4 Section 303 of the Controlled Substances Act (21 

5 U.S.C. 823) is amended by adding at the end the fol6 lowing: 

7 ‘‘(k)(1) The Attorney General shall not register, or 

8 renew the registration of, a practitioner under subsection 

9 (f) who is licensed under State law to prescribe controlled 

10 substances in schedule II, III, or IV, unless the practi11 tioner submits to the Attorney General, for each such reg12 istration or renewal request, a written certification that— 

13 ‘‘(A)(i) the practitioner has, during the 1-year 

14 period preceding the registration or renewal request, 

15 completed a training program described in para16 graph (2); or 

17 ‘‘(ii) the practitioner, during the applicable reg18 istration period, will not prescribe such controlled 

19 substances in amounts in excess of a 72-hour supply 

20 (for which no refill is available); and 

21 ‘‘(B) the practitioner has registered with the 

22 prescription drug monitoring program of the State 

23 in which the practitioner practices, if the State has 

24 such program. 

25 ‘‘(2) A training program described in this paragraph 

26 is a training program that— 


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1 ‘‘(A) follows the best practices for pain manage2 ment, as described in the ‘Guideline for Prescribing 

3 Opioids for Chronic Pain’ as published by the Cen4 ters for Disease Control and Prevention in 2016, or 

5 any successor thereto, or the ‘FDA Blueprint for 

6 Prescriber Education for Extended-Release and 

7 Long-Acting Opioid Analgesics’ as published by the 

8 Food and Drug Administration in 2017, or any suc9 cessor thereto; 

10 ‘‘(B) includes information on— 

11 ‘‘(i) recommending non-opioid and non12 pharmacological therapy; 

13 ‘‘(ii) establishing treatment goals and eval14 uating patient risks; 

15 ‘‘(iii) prescribing the lowest dose and few16 est number of pills considered effective; 

17 ‘‘(iv) addictive and overdose risks of 

18 opioids; 

19 ‘‘(v) diagnosing and managing substance 

20 use disorders, including linking patients to evi21 dence-based treatment; 

22 ‘‘(vi) identifying narcotics-seeking behav23 iors; and 

24 ‘‘(vii) using prescription drug monitoring 

25 programs; and 


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1 ‘‘(C) is approved by the Secretary of Health 

2 and Human Services.’’. 

3 SEC. 6. REPORT ON PRESCRIBER EDUCATION COURSES 

4 FOR MEDICAL AND DENTAL STUDENTS. 

5 Each school of medicine, school of osteopathic medi6 cine, and school of dentistry participating in a program 

7 under title IV of the Higher Education Act of 1965 (20 

8 U.S.C. 1070a et seq.), as a condition for such participa9 tion, shall submit an annual report to the Secretary of 

10 Education and the Secretary of Health and Human Serv11 ices on any prescriber education courses focused specifi12 cally on pain management and responsible opioid pre13 scribing practices that such school requires students to 

14 take, and whether such courses are consistent with the 

15 most recently published version of the ‘‘Guideline for Pre16 scribing Opioids for Chronic Pain’’ of the Centers for Dis17 ease Control and Prevention or the ‘‘FDA Blueprint for 

18 Prescriber Education for Extended-Release and Long-Act19 ing Opioid Analgesics’’, as published by the Food and 

20 Drug Administration in 2017. The Secretary of Education 

21 and the Secretary of Health and Human Services shall 

22 compile the reports submitted by such schools and submit 

23 an annual summary of such reports to Congress. 


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1 SEC. 7. REQUIREMENTS UNDER PRESCRIPTION DRUG MON2 ITORING PROGRAMS. 

3 (a) IN GENERAL.—Beginning 1 year after the date 

4 of enactment of this Act, each State that receives funding 

5 under any of the programs described in subsection (c) 

6 shall— 

7 (1) require practitioners, or their designees, in 

8 the State to consult the database of the prescription 

9 drug monitoring program before writing prescrip10 tions for controlled substances (as such term is de11 fined in section 102 of the Controlled Substances 

12 Act (21 U.S.C. 802)) in schedule II, III, or IV 

13 under section 202 of such Act (21 U.S.C. 812); 

14 (2) require dispensers of controlled substances 

15 in schedule II, III, or IV, or their designees, to input 

16 data into the database of the prescription drug mon17 itoring program within 24 hours of filling a quali18 fying prescription, as required by the Attorney Gen19 eral and the Secretary of Health and Human Serv20 ices, including patient identifier information, the na21 tional drug code of the dispensed drug, date of dis22 pensing the drug, quantity and dosage of the drug 

23 dispensed, form of payment, Drug Enforcement Ad24 ministration registration number of the practitioner, 

25 Drug Enforcement Administration registration num26 ber of the dispenser; 


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1 (3) allow practitioners and dispensers to des2 ignate other appropriate individuals to act as agents 

3 of such practitioners and dispensers for purposes of 

4 obtaining and inputing data from the database for 

5 purposes of complying with paragraphs (1) and (2), 

6 as applicable; 

7 (4) provide informational materials for practi8 tioners and dispensers to identify and refer patients 

9 with possible substance use disorders to professional 

10 treatment specialists; 

11 (5) establish formal data sharing agreements to 

12 foster electronic connectivity with the prescription 

13 drug monitoring programs of each State (if such 

14 State has such a program) with which the State 

15 shares a border, to facilitate the exchange of infor16 mation through an established technology architec17 ture that ensures common data standards, privacy 

18 protection, and secure and streamlined information 

19 sharing; 

20 (6) notwithstanding section 399O(f)(1)(B) of 

21 the Public Health Service Act (42 U.S.C. 280g– 

22 3(f)(1)(B)), authorize direct access to the State’s 

23 database of the prescription drug monitoring pro24 gram to all State law enforcement agencies, State 

25 boards responsible for the licensure, regulation, or 


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1 discipline of practitioners, pharmacists, or other per2 sons authorized to prescribe, administer, or dispense 

3 controlled substances; and 

4 (7) in order to enhance accountability in pre5 scribing and dispensing patterns, not fewer than 4 

6 times per year, proactively provide informational re7 ports on aggregate trends and individual outliers, 

8 based on information available through the State 

9 prescription drug monitoring program to— 

10 (A) the State entities and persons de11 scribed in paragraph (6); and 

12 (B) the Medicaid agency and the depart13 ment of public health of the State. 

14 (b) TRANSPARENCY IN PRESCRIBING PRACTICES AND

15 INTERVENTION FOR HIGH PRESCRIBERS.— 

16 (1) STATE REPORTING REQUIREMENT.—Each 

17 State that receives funding under any of the pro18 grams described in subsection (c) shall, twice per 

19 year, submit to the Secretary of Health and Human 

20 Services and the Administrator of the Drug Enforce21 ment Administration— 

22 (A) a list of all practitioners and dis23 pensers who, in the applicable reporting period, 

24 have prescribed or dispensed schedule II, III, or 

25 IV opioids in the State; 


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1 (B) the amount of schedule II, III, or IV 

2 opioids that were prescribed and dispensed by 

3 each individual practitioner and dispenser de4 scribed in subparagraph (A); and 

5 (C) any additional information that the 

6 Secretary and Administrator may require to 

7 support surveillance and evaluation of trends in 

8 prescribing or dispensing of schedule II, III, or 

9 IV opioids, or to identify possible non-medical 

10 use and diversion of such substances. 

11 (2) ANNUAL REPORT.—Not later than 1 year 

12 after the date of enactment of this Act, and annually 

13 thereafter, the Secretary of Health and Human 

14 Services, in consultation with the Administrator of 

15 the Drug Enforcement Administration, the Secretary 

16 of Defense, the Secretary of Veterans Affairs, and 

17 the Director of the Indian Health Service, shall sub18 mit to Congress, and make public, a report identi19 fying outliers among the medical specialties and geo20 graphic areas with the highest rates of opioid pre21 scribing in the Nation, by ZIP code. 

22 (3) DEVELOPMENT OF ACTION PLAN.— 

23 (A) INITIAL PLAN.—Not later than 1 year 

24 after the date of enactment of this Act, the Sec25 retary of Health and Human Services, in conVerDate Sep 11 2014 18:10 May 31, 2018 Jkt 079200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H5865.IH H5865

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1 sultation with the Administrator of the Drug 

2 Enforcement Administration, the Secretary of 

3 Defense, the Secretary of Veterans Affairs, and 

4 the Director of the Indian Health Service, shall 

5 submit to Congress a plan of action, including 

6 warning letters and enforcement mechanisms, 

7 for addressing outliers in opioid prescribing 

8 practices and ensuring an adequate Federal re9 sponse to protect the public health. 

10 (B) UPDATED PLAN.—The Secretary of 

11 Health and Human Services shall submit to 

12 Congress updates to the plan of action de13 scribed in subparagraph (A), as such Secretary, 

14 in consultation with the heads of agencies de15 scribed in such subparagraph, determines ap16 propriate. 

17 (c) PROGRAMS DESCRIBED.—The programs de18 scribed in this subsection are— 

19 (1) the Harold Rogers Prescription Drug Moni20 toring Program established under the Departments 

21 of Commerce, Justice, and State, the Judiciary, and 

22 Related Agencies Appropriations Act, 2002 (Public 

23 Law 107–77; 115 Stat. 748); 


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1 (2) the controlled substance monitoring pro2 gram under section 399O of the Public Health Serv3 ice Act (42 U.S.C. 280g–3); 

4 (3) the Prescription Drug Overdose: Prevention 

5 for States program of the Centers for Disease Con6 trol and Prevention; 

7 (4) the Prescription Drug Overdose: Data-Driv8 en Prevention Initiative of Centers for Disease Con9 trol and Prevention; 

10 (5) the Enhanced State Opioid Overdose Sur11 veillance program of the Centers for Disease Control 

12 and Prevention; 

13 (6) the opioid grant program under section 

14 1003 of the 21st Century Cures Act (Public Law 

15 114–255); and 

16 (7) the State Opioid Response Grant program 

17 described under the heading ‘‘SUBSTANCE ABUSE

18 TREATMENT’’ under the heading ‘‘SUBSTANCE

19 ABUSE AND MENTAL HEALTH SERVICES ADMINIS20 TRATION’’ of title II of division H of the Consoli21 dated Appropriations Act, 2018 (Public Law 115– 

22 141). 

23 (d) DEFINITIONS.—In this section, the terms ‘‘dis24 penser’’ and ‘‘practitioner’’ have the meanings given such 


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1 terms in section 102 of the Controlled Substances Act (21 

2 U.S.C. 802). 

3 SEC. 8. INTEROPERABILITY OF CERTIFIED HEALTH INFOR4 MATION TECHNOLOGY. 

5 Section 3001(c)(5) of the Public Health Service Act 

6 (42 U.S.C. 300jj–11(c)(5)) is amended by adding at the 

7 end the following: 

8 ‘‘(F) INTEROPERABILITY.—Beginning on 

9 January 1, 2021, the National Coordinator 

10 shall not certify electronic health records as 

11 health information technology that is in compli12 ance with applicable certification criteria under 

13 this paragraph unless such technology is inter14 operable with the prescription drug monitoring 

15 programs of each State that, at the time of the 

16 request for such certification, has such a pro17 gram.’’. 

18 SEC. 9. STUDIES RELATED TO OVERDOSE DISCHARGE AND 

19 FOLLOW-UP POLICIES. 

20 (a) STUDY.—Not later than January 1, 2021, the 

21 Secretary of Health and Human Services shall— 

22 (1) conduct a study on the scope and cir23 cumstances of non-fatal opioid overdoses, the policies 

24 and procedures that States, health care systems, and 

25 first responders have implemented; and 


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1 (2) in partnership with stakeholder organiza2 tions with subject matter expertise, establish guide3 lines for hospital procedures following non-fatal 

4 opioid overdose and the administration of overdose 

5 reversal medication. 

6 (b) STUDY AND DEVELOPMENT OF QUALITY MEAS7 URES UNDER MEDICARE RELATED TO OPIOID ABUSE

8 AND SUBSTANCE USE DISORDER.—Section 1890A(e) of 

9 the Social Security Act (42 U.S.C. 1395aaa–1(e)) is 

10 amended— 

11 (1) by striking ‘‘MEASURES.—The Adminis12 trator’’ and inserting ‘‘MEASURES.— 

13 ‘‘(1) IN GENERAL.—The Administrator’’; and 

14 (2) by adding at the end the following new 

15 paragraph: 

16 ‘‘(2) STUDY AND DEVELOPMENT OF QUALITY

17 MEASURES RELATED TO OPIOID ABUSE AND SUB18 STANCE USE DISORDER.—Beginning not later than 

19 1 year after the date of enactment of this para20 graph, the Administrator of the Center for Medicare 

21 and Medicaid Services shall study and through con22 tracts develop, in coordination with appropriate sub23 ject matter organizations (such as the entity with a 

24 contract under section 1890), for use under this Act, 

25 quality measures related to standards of care for 


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1 treating individuals with non-fatal opioid overdose, 

2 discharge procedures, and linkages to appropriate 

3 substance use disorder treatment and community 

4 support services.’’. 

5 SEC. 10. MEDICAID OPIOID DRUG MAPPING TOOL. 

6 (a) IN GENERAL.—The Secretary of Health and 

7 Human Services shall create an interactive opioid drug 

8 mapping tool, which shall be made publicly available on 

9 the internet website of the Centers for Medicare & Med10 icaid Services, showing prescribing practices of providers 

11 that participate in State Medicaid programs and geo12 graphic comparisons, at the State, county, and ZIP code 

13 levels, of de-identified opioid prescription claims made 

14 under State Medicaid programs under title XIX of the So15 cial Security Act (42 U.S.C. 1396 et seq.). 

16 (b) COLLECTION OF DATA FROM STATES.—The Sec17 retary of Health and Human Services may request from 

18 States such data as the Secretary determines necessary 

19 to create the opioid mapping tool described in subsection 

20 (a). 

21 SEC. 11. NATIONAL ACADEMY OF MEDICINE STUDY. 

22 (a) STUDY.—The Secretary of Health and Human 

23 Services shall enter into a contract with the National 

24 Academy of Medicine to carry out a study on the addition 

25 of coverage under the Medicare program under title XVIII 


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1 of the Social Security Act of alternative treatment modali2 ties (such as integrative medicine, including acupuncture 

3 and exercise therapy, neural stimulation, biofeedback, ra4 diofrequency ablation, and trigger point injections) fur5 nished to Medicare beneficiaries who suffer from acute or 

6 chronic lower back pain. Such study shall, pursuant to the 

7 contract under this paragraph, include an analysis of— 

8 (1) scientific research on the short-term and 

9 long-term impact of the addition of such coverage on 

10 clinical efficacy for pain management of such bene11 ficiaries; 

12 (2) whether the lack of Medicare coverage for 

13 alternative treatment modalities impacts the volume 

14 of opioids prescribed for beneficiaries; and 

15 (3) the cost to the Medicare program of the ad16 dition of such coverage to treat pain and mitigate 

17 the progression of chronic pain, as weighed against 

18 the cost of opioid use disorder, overdose, readmis19 sion, subsequent surgeries, and utilization and ex20 penditures under parts B and D of such title. 

21 (b) REPORT.—Not later than 1 year after the date 

22 of enactment of this Act, pursuant to the contract under 

23 subsection (a), the National Academy of Medicine shall 

24 submit to Congress a report on the study under subsection 

25 (a). 


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1 (c) AUTHORIZATION OF APPROPRIATIONS.—To carry 

2 out this section, there are authorized to be appropriated 

3 such sums as may be necessary. 

4 SEC. 12. EXCISE TAX ON OPIOID PAIN RELIEVERS. 

5 (a) IN GENERAL.—Subchapter E of chapter 32 of the 

6 Internal Revenue Code of 1986 is amended by adding at 

7 the end the following new section: 

8 ‘‘SEC. 4192. OPIOID PAIN RELIEVERS. 

9 ‘‘(a) IN GENERAL.—There is hereby imposed on the 

10 manufacturer or producer of any taxable active opioid a 

11 tax equal to the amount determined under subsection (b). 

12 ‘‘(b) AMOUNT DETERMINED.—The amount deter13 mined under this subsection with respect to a manufac14 turer or producer for a calendar year is 1 cent per milli15 gram of taxable active opioid in the production or manu16 facturing quota determined for such manufacturer or pro17 ducer for the calendar year under section 306 of the Con18 trolled Substances Act (21 U.S.C. 826). 

19 ‘‘(c) TAXABLE ACTIVE OPIOID.—For purposes of this 

20 section— 

21 ‘‘(1) IN GENERAL.—The term ‘taxable active 

22 opioid’ means any controlled substance (as defined 

23 in section 102 of the Controlled Substances Act (21 

24 U.S.C. 802), as in effect on the date of the enact25 ment of this section) manufactured in the United 


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1 States which is opium, an opiate, or any derivative 

2 thereof. 

3 ‘‘(2) EXCLUSIONS.— 

4 ‘‘(A) OTHER INGREDIENTS.—In the case 

5 of a product that includes a taxable active 

6 opioid and another ingredient, subsection (a) 

7 shall apply only to the portion of such product 

8 that is a taxable active opioid. 

9 ‘‘(B) DRUGS USED IN ADDICTION TREAT10 MENT.—The term ‘taxable active opioid’ shall 

11 not include any controlled substance (as so de12 fined) which is used exclusively for the treat13 ment of opioid addiction as part of a medica14 tion-assisted treatment.’’. 

15 (b) CLERICAL AMENDMENTS.— 

16 (1) The heading of subchapter E of chapter 32 

17 of the Internal Revenue Code of 1986 is amended by 

18 striking ‘‘Medical Devices’’ and inserting 

19 ‘‘Other Medical Products’’. 

20 (2) The table of subchapters for chapter 32 of 

21 such Code is amended by striking the item relating 

22 to subchapter E and inserting the following new 

23 item: 

‘‘SUBCHAPTER E. OTHER MEDICAL PRODUCTS’’. 


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1 (3) The table of sections for subchapter E of 

2 chapter 32 of such Code is amended by adding at 

3 the end the following new item: 

‘‘Sec. 4192. Opioid pain relievers.’’. 

4 (c) EFFECTIVE DATE.—The amendments made by 

5 this section shall apply to calendar years beginning after 

6 the date of the enactment of this Act. 

7 SEC. 13. OPIOID CONSUMER ABUSE REDUCTION PROGRAM. 

8 (a) OPIOID TAKE-BACK PROGRAM.—Section 302 of 

9 the Controlled Substances Act (21 U.S.C. 822) is amend10 ed by adding at the end the following: 

11 ‘‘(h)(1) The Attorney General shall establish a na12 tional take-back program for the safe and environmentally 

13 responsible disposal of controlled substances. 

14 ‘‘(2) In establishing the take-back program required 

15 under paragraph (1), the Attorney General— 

16 ‘‘(A) shall consult with the Secretary and the 

17 Administrator of the Environmental Protection 

18 Agency; and 

19 ‘‘(B) may coordinate with States, law enforce20 ment agencies, water resource management agencies, 

21 manufacturers, practitioners, pharmacists, public 

22 health entities, transportation and incineration serv23 ice contractors, and other entities and individuals, as 

24 appropriate. 


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1 ‘‘(3) The take-back program established under para2 graph (1)— 

3 ‘‘(A) shall— 

4 ‘‘(i) ensure appropriate geographic dis5 tribution so as to provide— 

6 ‘‘(I) reasonably convenient and equi7 table access to permanent take-back loca8 tions, including not less than 1 disposal 

9 site for every 25,000 residents and not less 

10 than 1 physical disposal site per town, city, 

11 county, or other unit of local government, 

12 where possible; and 

13 ‘‘(II) periodic collection events and 

14 mail-back programs, including public no15 tice of such events and programs, as a sup16 plement to the permanent take-back loca17 tions described in subclause (I), particu18 larly in areas in which the provision of ac19 cess to such locations at the level described 

20 in that subclause is not possible; 

21 ‘‘(ii) establish a process for the accurate 

22 cataloguing and reporting of the quantities of 

23 controlled substances collected; and 


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1 ‘‘(iii) include a public awareness campaign 

2 and education of practitioners and pharmacists; 

3 and 

4 ‘‘(B) may work in coordination with State and 

5 locally implemented public and private take-back 

6 programs. 

7 ‘‘(4) From time to time, beginning in the second cal8 endar year that begins after the date of enactment of this 

9 subsection, the Secretary of the Treasury shall transfer 

10 from the general fund of the Treasury an amount equal 

11 to one-half of the total amount of taxes collected under 

12 section 4192 of the Internal Revenue Code of 1986 to the 

13 Attorney General to carry out this subsection. Amounts 

14 transferred under this subparagraph shall remain avail15 able until expended.’’. 

16 (b) FUNDING OF SUBSTANCE ABUSE PROGRAMS.— 

17 From time to time, beginning in the second calendar year 

18 that begins after the date of enactment of this Act, the 

19 Secretary of the Treasury shall transfer from the general 

20 fund of the Treasury an amount equal to one-half of the 

21 total amount of taxes collected under section 4192 of the 

22 Internal Revenue Code of 1986, as added by this Act, to 

23 the Director of the Center for Substance Abuse Treatment 

24 of the Substance Abuse and Mental Health Services Ad25 ministration for programs of the Center, including the 


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1 Block Grants for Prevention and Treatment of Substance 

2 Abuse program under subpart II of part B of title XIX 

3 of the Public Health Service Act (42 U.S.C. 300x–21 et 

4 seq.) and Programs of Regional and National Significance. 

5 Amounts transferred under this subsection shall remain 

6 available until expended. 

7 SEC. 14. GAO STUDY. 

8 Not later than 1 year after the date of enactment 

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

10 shall conduct a study evaluating the various State laws, 

11 commercial insurance methods, and existing research on 

12 requirements that place limitations on opioid prescribing 

13 practices and provide analysis on best practices to address 

14 over-prescribing of opioids, while ensuring that individuals 

15 who need such opioids can access them safely. Such study 

16 shall provide recommendations, including with respect 

17 to— 

18 (1) requiring non-opioid pain treatments to be 

19 front line therapies; 

20 (2) limiting first-time opioid prescriptions to a 

21 patient for acute pain to a 72-hour supply; and 

22 (3) pain management treatment contracts be23 tween practitioners and patients that establish in24 formed consent regarding the expectations, risks, 

25 long-term effects, and benefits of the course of 


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1 opioid treatment, treatment goals, the potential for 

2 opioid misuse, abuse, or diversion, and requirements 

3 and responsibilities of patients, such as submitting 

4 to a urine drug screening. 

Æ 


sradovich on DSK3GMQ082PROD with BILLS