I 

111TH CONGRESS 

1ST SESSION H. R. 2855 

To reduce deaths occurring from drug overdoses. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 12, 2009 

Ms. EDWARDS of Maryland (for herself, Mr. SERRANO, Mr. HINCHEY, Mr. 

PIERLUISI, Mr. GRIJALVA, and Mr. LANGEVIN) introduced the following 

bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To reduce 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 ‘‘Drug Overdose Reduc5 tion Act’’. 

6 SEC. 2. FINDINGS. 

7 The Congress finds the following: 

8 (1) Drug overdose death is now second only to 

9 motor vehicle crashes as a leading cause of injury10 related death nationally. Both fatal and nonfatal 

11 overdoses place a heavy burden on public health reVerDate Nov 24 2008 05:02 Jun 13, 2009 Jkt 079200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2855.IH H2855

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1 sources, yet no Federal agency has been tasked with 

2 stemming this crisis. 

3 (2) The Centers for Disease Control and Pre4 vention reports that 33,541 deaths in the United 

5 States in 2005 were attributable to drug-induced 

6 causes. Sixty-seven percent of these deaths were due 

7 to unintentional drug poisonings and could have 

8 been prevented. 

9 (3) Deaths resulting from accidental drug 

10 overdoses increased more than 400 percent between 

11 1980 and 1999, and more than doubled between 

12 1999 and 2005. 

13 (4) Ninety-five percent of all unintentional and 

14 undetermined intent poisoning deaths are due to 

15 drugs, and poisoning deaths cost society more than 

16 $2,200,000,000 in direct medical costs and 

17 $23,000,000,000 in lost productivity costs in the 

18 year 2000 alone. 

19 (5) According to the Federal Drug Abuse 

20 Warning Network, most drug-related deaths involve 

21 multiple drugs including prescription opioids and al22 cohol. Opioid overdose deaths are occurring among 

23 those who are taking pharmaceutical opioid drugs, 

24 like oxycodone and hydrocodone, and among heroin 

25 users. 


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1 (6) Community-based programs working with 

2 high-risk populations have successfully prevented 

3 deaths from opioid overdoses through education and 

4 access to effective reversal agents, such as naloxone. 

5 (7) Naloxone is a highly effective opioid antago6 nist that reverses overdose from both prescription 

7 opioids and heroin. 

8 (8) Public health programs to make naloxone 

9 available to people at-risk of a drug overdose are 

10 currently operating in major cities including Balti11 more, Chicago, Los Angeles, New York City, Boston, 

12 San Francisco, and Philadelphia, and statewide in 3 

13 States including New Mexico, Massachusetts, and 

14 New York. A naloxone distribution program in Bos15 ton saved more than 170 lives in the last year alone. 

16 (9) Between 2001 and January 2008, it is esti17 mated that more than 2,600 overdoses have been re18 versed in 16 programs across the Nation. 

19 (10) Many fatal drug overdoses occur in the 

20 presence of witnesses who can respond effectively to 

21 an overdose when properly trained and equipped. 

22 (11) Overdose prevention programs are needed 

23 in correctional facilities, addiction treatment pro24 grams, and other places where people are at higher 

25 risk of overdosing after a period of abstinence. 


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1 SEC. 3. OVERDOSE PREVENTION GRANT PROGRAM. 

2 (a) PROGRAM AUTHORIZED.—The Director of the 

3 Centers for Disease Control and Prevention shall award 

4 grants or cooperative agreements to eligible entities to en5 able the eligible entities to reduce deaths occurring from 

6 overdoses of drugs. 

7 (b) APPLICATION.— 

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

9 grant or cooperative agreement under this section 

10 shall submit to the Director an application at such 

11 time, in such manner, and containing such informa12 tion as the Director 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 grant or cooperative agree17 ment; and 

18 (B) a demonstration that the eligible entity 

19 has the capacity to carry out such activities. 

20 (c) PRIORITY.—In awarding grants and cooperative 

21 agreements under subsection (a), the Director shall give 

22 priority to eligible entities that— 

23 (1) are public health agencies or community24 based organizations; and 


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

3 risk of such deaths. 

4 (d) ELIGIBLE ACTIVITIES.—As a condition on receipt 

5 of a grant or cooperative agreement under this section, 

6 an eligible entity shall agree to use the grant or coopera7 tive agreement to carry out one or more of the following 

8 activities: 

9 (1) Purchasing and distributing drug overdose 

10 reversal agents, such as naloxone. 

11 (2) Training first responders, other individuals 

12 in a position to respond to an overdose, and law en13 forcement and corrections officials on the effective 

14 response to individuals who have overdosed on 

15 drugs. 

16 (3) Implementing programs to provide overdose 

17 prevention, recognition, treatment, or response to in18 dividuals in need of such services. 

19 (4) Evaluating, expanding, or replicating a pro20 gram described in paragraph (1) or (2). 

21 (e) REPORT.—As a condition on receipt of a grant 

22 or cooperative agreement under this section, an eligible en23 tity shall agree to prepare and submit, not later than 90 

24 days after the end of the grant or cooperative agreement 

25 period, a report to the Director describing the results of 


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1 the activities supported through the grant or cooperative 

2 agreement. 

3 (f) AUTHORIZATION OF APPROPRIATIONS.—There 

4 are authorized to be appropriated to carry out this section 

5 $27,000,000 for each of the fiscal years 2010 and 2011, 

6 and such sums as may be necessary for each of the fiscal 

7 years 2012 through 2014. 

8 SEC. 4. SENTINEL SURVEILLANCE SYSTEM. 

9 (a) DATA COLLECTION.—The Director of the Centers 

10 for Disease Control and Prevention shall annually compile 

11 and publish data on both fatal and nonfatal overdoses of 

12 drugs for the preceding year. To the extent possible, the 

13 data shall be collected from all county, State, and tribal 

14 governments, the Federal Government, and private 

15 sources, shall be made available in the form of an Internet 

16 database that is accessible to the public, and shall in17 clude— 

18 (1) identification of the underlying drugs that 

19 led to fatal overdose; 

20 (2) identification of substance level specificity 

21 where possible; 

22 (3) analysis of trends in polydrug use in over23 dose victims, as well as identification of emerging 

24 overdose patterns; 


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1 (4) results of toxicology screenings in fatal 

2 overdoses routinely conducted by State medical ex3 aminers; 

4 (5) identification of— 

5 (A) drugs that were involved in both fatal 

6 and nonfatal unintentional poisonings; and 

7 (B) the number and percentage of such 

8 poisonings by drug; and 

9 (6) identification of the type of place where un10 intentional drug poisonings occur, as well as the age, 

11 race, and gender of victims. 

12 (b) AUTHORIZATION OF APPROPRIATIONS.—There 

13 are authorized to be appropriated to carry out this section 

14 $5,000,000 for each of the fiscal years 2010 and 2011, 

15 and such sums as may be necessary for each of the fiscal 

16 years 2012 through 2014. 

17 SEC. 5. SURVEILLANCE CAPACITY BUILDING. 

18 (a) PROGRAM AUTHORIZED.—The Director of the 

19 Centers for Disease Control and Prevention shall award 

20 grants or cooperative agreements to State, local, or tribal 

21 governments to improve fatal and nonfatal drug overdose 

22 surveillance capabilities, including the following: 

23 (1) Implementing or enhancing the material ca24 pacity of a coroner or medical examiner’s office to 


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1 conduct toxicological screenings where drug overdose 

2 is the suspected cause of death. 

3 (2) Training and other educational activities to 

4 improve identification of drug overdose as the cause 

5 of death by coroners and medical examiners. 

6 (3) Hiring epidemiologists and toxicologists to 

7 analyze and report on fatal and nonfatal drug over8 dose trends. 

9 (4) Purchasing resources and equipment that 

10 directly aid drug overdose surveillance and reporting. 

11 (b) APPLICATION.— 

12 (1) IN GENERAL.—A State, local, or tribal gov13 ernment desiring a grant or cooperative agreement 

14 under this section shall submit to the Director an 

15 application at such time, in such manner, and con16 taining such information as the Director may re17 quire. 

18 (2) CONTENTS.—The application described in 

19 paragraph (1) shall include— 

20 (A) a description of the activities to be 

21 funded through the grant or cooperative agree22 ment; and 

23 (B) a demonstration that the State, local, 

24 or tribal government has the capacity to carry 

25 out such activities. 


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1 (c) REPORT.—As a condition on receipt of a grant 

2 or cooperative agreement under this section, a State, local, 

3 or tribal government shall agree to prepare and submit, 

4 not later than 90 days after the end of the grant or coop5 erative agreement period, a report to the Director describ6 ing the results of the activities supported through the 

7 grant or cooperative agreement. 

8 (d) 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 2010 and 2011, 

11 and such sums as may be necessary for each of the fiscal 

12 years 2012 through 2014. 

13 SEC. 6. REDUCING OVERDOSE DEATHS. 

14 (a) IN GENERAL.—Not later than 180 days after the 

15 date of the enactment of this Act, the Director of the Cen16 ters for Disease Control and Prevention shall develop a 

17 plan in consultation with a task force comprised of stake18 holders to reduce the number of deaths occurring from 

19 overdoses of drugs and shall submit the plan to Congress. 

20 The plan shall include— 

21 (1) an identification of the barriers to obtaining 

22 accurate data regarding the number of deaths occur23 ring from overdoses of drugs; 


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1 (2) an identification of the barriers to imple2 menting more effective overdose prevention strate3 gies and programs; 

4 (3) an examination of overdose prevention best 

5 practices; 

6 (4) an analysis of the supply source of drugs 

7 that caused both fatal and nonfatal unintentional 

8 poisonings; 

9 (5) recommendations for improving and ex10 panding overdose prevention programming; and 

11 (6) recommendations for such legislative or ad12 ministrative action as the Director considers appro13 priate. 

14 (b) DEFINITION.—In this section, the term ‘‘stake15 holder’’ means any individual directly impacted by drug 

16 overdose, any direct service provider who engages individ17 uals at-risk of a drug overdose, any drug overdose preven18 tion advocate, the National Institute on Drug Abuse, the 

19 Center for Substance Abuse Treatment, the Centers for 

20 Disease Control and Prevention, the Food and Drug Ad21 ministration, and any other individual or entity with drug 

22 overdose expertise. 

23 SEC. 7. OVERDOSE PREVENTION RESEARCH. 

24 (a) OVERDOSE RESEARCH.—The Director of the Na25 tional Institute on Drug Abuse shall prioritize and conduct 


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1 or support research on drug overdose and overdose preven2 tion. The primary aims of this research shall include— 

3 (1) examinations of circumstances that contrib4 uted to drug overdose and identification of drugs as5 sociated with fatal overdose; 

6 (2) evaluations of existing overdose prevention 

7 program intervention methods; and 

8 (3) pilot programs or research trials on new 

9 overdose prevention strategies or programs that have 

10 not been studied in the United States. 

11 (b) DOSAGE FORMS OF NALOXONE.—The Director 

12 of the National Institute on Drug Abuse shall support re13 search on the development of dosage forms of naloxone 

14 specifically intended to be used by lay persons or first re15 sponders for the prehospital treatment of unintentional 

16 drug overdose. 

17 (c) AUTHORIZATION OF APPROPRIATIONS.—There 

18 are authorized to be appropriated to carry out this section 

19 $5,000,000 for each of the fiscal years 2010 and 2011, 

20 and such sums as may be necessary for each of the fiscal 

21 years 2012 through 2014. 

22 SEC. 8. DEFINITIONS. 

23 In this Act: 


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1 (1) DIRECTOR.—Unless otherwise specified, the 

2 term ‘‘Director’’ means the Director of the Centers 

3 for Disease Control and Prevention. 

4 (2) DRUG.—The term ‘‘drug’’— 

5 (A) means a drug (as that term is defined 

6 in section 201 of the Federal Food, Drug, or 

7 Cosmetic Act (21 U.S.C. 321)); and 

8 (B) includes any controlled substance (as 

9 that term is defined in section 102 of the Con10 trolled Substances Act (21 U.S.C. 802)). 

11 (3) ELIGIBLE ENTITY.—The term ‘‘eligible enti12 ty’’ means an entity that is a State, local, or tribal 

13 government, a correctional institution, a law enforce14 ment agency, a community agency, or a private non15 profit organization. 

16 (4) STATE.—The term ‘‘State’’ means any of 

17 the several States, the District of Columbia, Puerto 

18 Rico, the Northern Mariana Islands, the Virgin Is19 lands, Guam, American Samoa, and any other terri20 tory or possession of the United States. 

21 (5) TRAINING.—The term ‘‘training’’ means 

22 any activity that is educational, instructional, or 

23 consultative in nature, and may include volunteer 

24 trainings, awareness building exercises, outreach to 


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1 individuals who are at-risk of a drug overdose, and 

2 distribution of educational materials. 

Æ 


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