I 
113TH CONGRESS 
2D SESSION 
H. R. 4169 
To prevent deaths occurring from drug overdoses. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 6, 2014 
Ms. EDWARDS (for herself, Ms. BASS, Mr. CARSON of Indiana, Mr. CUM-
MINGS, Mr. ELLISON, Mr. KEATING, Ms. LEE of California, Mr. LYNCH, 
Mr. MICHAUD, Mr. RANGEL, Mr. RYAN of Ohio, Ms. SCHWARTZ, Mr. 
SERRANO, Ms. SHEA-PORTER, Mr. TIERNEY, Mr. TONKO, Ms. WILSON 
of Florida, Mr. FOSTER, and Mr. BEN RAY LUJA´N of New Mexico) intro-
duced the following bill; which was referred to the Committee on Energy 
and Commerce 
A BILL 
To prevent deaths occurring from drug overdoses. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Stop Overdose Stat 
Act’’ or the ‘‘S.O.S. Act’’. 
SEC. 2. FINDINGS. 
The Congress finds the following: 
(1) According to the Centers for Disease Con-
trol and Prevention (CDC), each day in the United 
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(7) Military veterans are at elevated risk of ex-
periencing a drug overdose. Vietnam, Iraq, and Af-
ghanistan veterans with combat injuries, posttrau-
matic stress disorder (PTSD), and other co-occur-
ring mental health diagnoses are at elevated risk of 
fatal drug overdose from opioid medications. 
(8) Rural and suburban regions are dispropor-
tionately affected by opioid medication overdoses. 
Urban centers also continue to struggle with over-
dose, which is the leading cause of death among 
homeless adults. 
(9) In the year 2009 alone, estimated lost pro-
ductivity and direct medical costs from opioid medi-
cation poisonings exceeded $20,000,000,000. 
(10) Both fatal and nonfatal overdoses place a 
heavy burden on public health and public safety re-
sources, yet there is no coordinated cross-Federal 
agency response to prevent overdose fatalities. 
(11) Naloxone is a medication that rapidly re-
verses overdose from heroin and opioid medications. 
(12) In 2012, the Food and Drug Administra-
tion (FDA) held a public workshop in collaboration 
with the National Institute on Drug Abuse (NIDA) 
and the CDC, and with participation from the Sub-
stance Abuse and Mental Health Services Adminis-
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tration (SAMHSA) and the Office of National Drug 
Control Policy (ONDCP), to discuss making 
naloxone more widely available outside of conven-
tional medical settings to reduce the incidence of 
opioid overdose fatalities. 
(13) Lawmakers in California, Colorado, Con-
necticut, Illinois, Kentucky, Massachusetts, Mary-
land, New Jersey, New Mexico, New York, North 
Carolina, Oregon, Rhode Island, Vermont, Virginia, 
Washington, and the District of Columbia have re-
moved legal impediments to increasing naloxone pre-
scription and its use by bystanders who are in a po-
sition to respond to an overdose. 
(14) Health practitioners are often not fully 
aware of overdose symptoms and prevention meth-
ods, impacting their ability to adequately inform pa-
tients and caregivers on how to recognize symptoms, 
respond effectively by seeking emergency assistance, 
and provide naloxone and other first aid in order to 
save a life. 
(15) The American Medical Association (AMA), 
the Nation’s largest physician organization, supports 
further implementation of community-based pro-
grams that offer naloxone and other opioid overdose 
prevention services. 
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(16) Community-based overdose prevention pro-
grams have successfully prevented deaths from 
opioid overdoses by making rescue trainings and 
naloxone available to first responders, parents, and 
other bystanders who may encounter an overdose. 
Over 50,000 potential bystanders have been trained 
by overdose prevention programs in the United 
States. A CDC report credits overdose prevention 
programs with saving more than 10,000 lives since 
1996. 
(17) At least 188 local overdose prevention pro-
grams are operating in the United States, including 
in major cities such as Baltimore, Chicago, Los An-
geles, New York City, Boston, San Francisco, and 
Philadelphia, and statewide in New Mexico, Massa-
chusetts, and New York. Between 2006 and 2009, 
overdose prevention programs facilitated by the Mas-
sachusetts Department of Public Health trained 
nearly 3,000 people who reported more than 300 
rescues. Since 2004, a program administered by the 
Baltimore City Health Department has trained more 
than 3,000 people who reported more than 220 res-
cues. Project Lazarus, an overdose prevention pro-
gram in Wilkes County, North Carolina, reduced 
overdose deaths 69 percent between 2009 and 2011. 
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(18) The ONDCP supports equipping first re-
sponders to help reverse overdoses. Police officers on 
patrol in Quincy, Massachusetts, have conducted 
170 overdose rescues with naloxone since 2010. The 
police department has reported a 95-percent success 
rate with overdose rescue attempts by police officers. 
In Suffolk County, New York, police officers have 
saved more than 50 lives with naloxone. 
(19) Research shows that the cost per year of 
life gained by making naloxone available to reverse 
overdoses is within the range of what Americans 
usually pay for health treatments. 
(20) Overdose prevention programs are needed 
in correctional facilities, addiction treatment pro-
grams, and other places where people are at higher 
risk of overdosing after a period of abstinence. 
(21) People affected by drug overdose gather 
each year in communities nationwide on August 31st 
for Overdose Awareness Day to mourn and pay trib-
ute to loved ones and raise awareness about overdose 
risk and prevention. 
SEC. 3. OVERDOSE PREVENTION GRANT PROGRAM. 
(a) PROGRAM AUTHORIZED.—The Secretary, acting 
through the Director of the CDC, shall award grants or 
cooperative agreements to eligible entities to enable the eli-
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gible entities to reduce deaths occurring from overdoses 
of drugs. 
(b) APPLICATION.— 
(1) IN GENERAL.—An eligible entity desiring a 
grant or cooperative agreement under this section 
shall submit to the Secretary an application at such 
time, in such manner, and containing such informa-
tion as the Secretary may require. 
(2) CONTENTS.—An application under para-
graph (1) shall include— 
(A) a description of the activities to be 
funded through the grant or cooperative agree-
ment; and 
(B) a demonstration that the eligible entity 
has the capacity to carry out such activities. 
(c) PRIORITY.—In awarding grants and cooperative 
agreements under subsection (a), the Secretary shall give 
priority to eligible entities that— 
(1) are a public health agency or community- 
based organization; and 
(2) have expertise in preventing deaths occur-
ring from overdoses of drugs in populations at high 
risk of such deaths. 
(d) ELIGIBLE ACTIVITIES.— 
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(1) REQUIRED ACTIVITY.—As a condition on 
receipt of a grant or cooperative agreement under 
this section, an eligible entity shall agree to use the 
grant or cooperative agreement to purchase and dis-
tribute the drug naloxone. 
(2) ADDITIONAL
ACTIVITIES.—In addition to 
the activity described in paragraph (1), an eligible 
entity shall use a grant or cooperative agreement 
under this section to carry out one or more of the 
following activities: 
(A) Educating prescribers and pharmacists 
about overdose prevention and naloxone pre-
scription. 
(B) Training first responders, other indi-
viduals in a position to respond to an overdose, 
and law enforcement and corrections officials on 
the effective response to individuals who have 
overdosed on drugs. Training pursuant to this 
subparagraph may include any activity that is 
educational, instructional, or consultative in na-
ture, and may include volunteer trainings, 
awareness building exercises, outreach to indi-
viduals who are at-risk of a drug overdose, and 
distribution of educational materials. 
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(C) Implementing and enhancing programs 
to provide overdose prevention, recognition, 
treatment, and response to individuals in need 
of such services. 
(D) Expanding activities described in para-
graph (1). 
(E) Expanding activities described in sub-
paragraph (A) or (B). 
(e) COORDINATING CENTER.— 
(1) ESTABLISHMENT.—The Secretary shall es-
tablish and provide for the operation of a coordi-
nating center responsible for— 
(A) collecting, compiling, and dissemi-
nating data on the programs and activities 
under this section; 
(B) evaluating such data and, based on 
such evaluation, developing best practices for 
preventing 
deaths 
occurring 
from 
drug 
overdoses; and 
(C) making such best practices specific to 
the type of community involved. 
(2) REPORTS TO CENTER.—As a condition on 
receipt of a grant or cooperative agreement under 
this section, an eligible entity shall agree to prepare 
and submit, not later than 90 days after the end of 
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the grant or cooperative agreement period, a report 
to such coordinating center and the Secretary de-
scribing the results of the activities supported 
through the grant or cooperative agreement. 
(f) MATCHING FUNDS.— 
(1) IN GENERAL.—As a condition on receipt of 
a grant or cooperative agreement under this section, 
an eligible entity shall agree that, with respect to the 
costs to be incurred by the eligible entity in carrying 
out the activities for which the grant or cooperative 
agreement is awarded, the eligible entity will make 
available non-Federal contributions in an amount 
equal to not less than 50 percent of the Federal 
funds provided through the grant or cooperative 
agreement. 
(2) SATISFYING
MATCHING
REQUIREMENT.— 
The non-Federal contributions required under para-
graph (1) may be— 
(A) in cash or in-kind, including services, 
fairly evaluated; and 
(B) from— 
(i) any private source; or 
(ii) a State, tribal, or local agency. 
(3) WAIVER.—The Secretary may waive or re-
duce the non-Federal contribution required by para-
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graph (1) if the eligible entity involved demonstrates 
that the eligible entity cannot meet the contribution 
requirement due to financial hardship. 
(g) DURATION.—The period of a grant or cooperative 
agreement under this section shall be 4 years. 
(h) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated $10,000,000 to carry 
out this section for each of the fiscal years 2014 through 
2018. 
SEC. 4. SURVEILLANCE CAPACITY BUILDING. 
(a) PROGRAM AUTHORIZED.—The Secretary, acting 
through the Director of the CDC, shall award grants or 
cooperative agreements to State, local, or tribal govern-
ments, or the National Poison Data System working in 
conjunction with State, local, or tribal governments, to im-
prove fatal and nonfatal drug overdose surveillance and 
reporting capabilities, including the following: 
(1) Providing training to improve identification 
of drug overdose as the cause of death by coroners 
and medical examiners. 
(2) Establishing, in cooperation with the Na-
tional Poison Data System, coroners, and medical 
examiners, a comprehensive national program for 
surveillance of, and reporting to an electronic data-
base on, drug overdose deaths in the United States. 
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(3) Establishing, in cooperation with the Na-
tional Poison Data System, a comprehensive na-
tional program for surveillance of, and reporting to 
an electronic database on, fatal and nonfatal drug 
overdose occurrences, including epidemiological and 
toxicologic analysis and trends. 
(b) APPLICATION.— 
(1) IN GENERAL.—A State, local, or tribal gov-
ernment or the National Poison Data System desir-
ing a grant or cooperative agreement under this sec-
tion shall submit to the Secretary an application at 
such time, in such manner, and containing such in-
formation as the Secretary may require. 
(2) CONTENTS.—The application described in 
paragraph (1) shall include— 
(A) a description of the activities to be 
funded through the grant or cooperative agree-
ment; and 
(B) a demonstration that the State, local, 
or tribal government or the National Poison 
Data System has the capacity to carry out such 
activities. 
(c) REPORT.—As a condition on receipt of a grant 
or cooperative agreement under this section, a State, local, 
or tribal government or the National Poison Data System 
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