(1) New research shows that a dramatic rise in 
opioid overdose deaths among veterans in recent 
years has happened increasingly among veterans 
dying from heroin and synthetic opioids. 
(2) Furthermore, patients of the Veterans 
Health Administration of the Department of Vet-
erans Affairs are seven more times likely to suffer 
from an opioid use disorder than commercially in-
sured patients. 
(3) Using records of the Veterans Health Ad-
ministration linked to National Death Index data, 
the veterans’ rate of overdose deaths from all opioids 
increased by 65 percent from 2010 to 2016, a rate 
change that includes adjustments for demographic 
changes in the veteran population over time. 
(4) Furthermore, among all opioid overdose de-
cedents, prescription opioid receipt within three 
months before death declined from 54 percent in 
2010 to 26 percent in 2016, yet veteran overdoses 
resulting in death from heroin, synthetic opioids 
such as fentanyl, and nonprescription opioids still 
occurred. 
(5) In fact, between 2010 and 2016, the vet-
eran death rate from heroin or from taking multiple 
opioids almost quintupled and the death rate from 
VerDate Sep 11 2014 
04:12 Nov 21, 2023
Jkt 049200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
kjohnson on DSK7ZCZBW3PROD with $$_JOB
synthetic opioids such as fentanyl increased by more 
than five-fold. 
(6) Trends would suggest that, while the aggre-
gate rise in opioid overdose deaths among veterans 
parallel those seen in the general population, the in-
crease occurred mainly because of a rise in deaths 
from nonprescribed sources such as heroin, fentanyl, 
other powerful synthetic opioids, or multiple opioids 
in concurrent use. 
(b) SENSE OF CONGRESS.—It is the sense of Con-
gress that further veterans overdose prevention efforts and 
research should extend beyond patients actively receiving 
opioid prescriptions. 
SEC. 3. REVIEW OF DEATHS OF VETERANS RELATING TO 
OPIOID USE. 
(a) REVIEW.—Not later than 18 months after the 
date of the enactment of this Act, the Secretary of Vet-
erans Affairs shall complete a review of the deaths of all 
covered veterans who died from opioid overdoses during 
the five-year period preceding the date of the enactment 
for this Act. 
(b) MATTERS INCLUDED.—The review under sub-
section (a) shall include the following: 
VerDate Sep 11 2014 
04:12 Nov 21, 2023
Jkt 049200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
kjohnson on DSK7ZCZBW3PROD with $$_JOB
(1) The total number of covered veterans who 
died from opioid overdoses during the five-year pe-
riod preceding the date of the enactment of this Act. 
(2) A summary of such veterans that includes 
the age, sex, and race, and ethnicity of each such 
veteran. 
(3) A comprehensive list of the medications pre-
scribed to, and found in the bodies of, such veterans 
at the time of death, specifically listing any medica-
tions that carry a black box warning, are off-label, 
or are psychotropic. 
(4) A summary of medical diagnoses by physi-
cians of the Department of Veterans Affairs that led 
to any prescribing of the medications referred to in 
paragraph (3). 
(5) The number of instances in which such a 
veteran was concurrently on multiple medications 
prescribed by physicians of the Department. 
(6) A summary of— 
(A) the average period that elapsed be-
tween the last prescription opioid receipt and 
the date of the death of such a veteran; and 
(B) the cause of death for each such vet-
eran. 
VerDate Sep 11 2014 
04:12 Nov 21, 2023
Jkt 049200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
kjohnson on DSK7ZCZBW3PROD with $$_JOB
(7) The percentage of such veterans with com-
bat experience or trauma (including military sexual 
trauma, traumatic brain injury, and post-traumatic 
stress). 
(8) Identification of medical facilities of the De-
partment with high prescription and drug abuse 
treatment rates for patients being treated at those 
facilities. 
(9) A description of policies of the Department 
governing the prescribing of medications referred to 
in paragraph (3). 
(10) A description of efforts by the Secretary to 
electronically track, collect, and properly dispose of 
prescription opioids that are either unused, past the 
prescription date, or not in the possession of the 
properly prescribed patient. 
(11) A description of any patterns apparent to 
the Secretary based on the review. 
(12) Recommendations for further action that 
would improve the safety and well-being of veterans 
and reduce opioid overdose rates for veterans, espe-
cially concerning research regarding such veterans 
who had not filed for a opioid prescription in the 
three months before death by overdose. 
VerDate Sep 11 2014 
04:12 Nov 21, 2023
Jkt 049200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
kjohnson on DSK7ZCZBW3PROD with $$_JOB
(c) PUBLIC AVAILABILITY.—Not later than 45 days 
after the completion of the review under subsection (a), 
the Secretary shall— 
(1) submit to Congress a report on the results 
of the review; 
(2) make such report publicly available; and 
(3) provide to the Committees on Veterans’ Af-
fairs of the House of Representatives and the Senate 
a briefing on such review. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘black box warning’’ means a 
warning displayed within a box in the prescribing in-
formation for drugs that have special problems, par-
ticularly ones that may lead to death or serious in-
jury. 
(2) The term ‘‘covered veteran’’ means any vet-
eran who received hospital care or medical services 
furnished by the Department of Veterans Affairs 
during the five-year period preceding the death of 
the veteran. 
Æ 
VerDate Sep 11 2014 
04:12 Nov 21, 2023
Jkt 049200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6301
E:\BILLS\H6353.IH
H6353
kjohnson on DSK7ZCZBW3PROD with $$_JOB