Title: STOP Fentanyl Act of 2021
Policy area: Health

Summary:
Support, Treatment, and Overdose Prevention of Fentanyl Act of 2021 or the STOP Fentanyl Act of 2021
This bill addresses data collection, treatment, harm reduction, and other issues related to substance misuse and addiction. It particularly focuses on opioids, fentanyl, and related substances.
Specifically, the bill expands surveillance of fentanyl and related substances. This includes establishing a pilot program to screen for contaminants in illicit drugs and a grant program to collect data on fentanyl-involved overdoses. The bill also specifies requirements concerning the collection and use of information about drugs seized by law enforcement.
Additionally, the bill establishes and modifies requirements to increase access to treatment and prevention services. For example, the Bureau of Prisons must make certain services, including medication-assisted treatments, available to individuals in its custody. The bill also
Furthermore, the bill limits civil and criminal liability under specified laws for individuals who administer opioid overdose reversal drugs to an individual who reasonably appears to be experiencing an overdose, as well as for individuals who seek medical attention for themselves or on behalf of another for a drug overdose.
The bill also requires multiple reports, including a report by the Department of State on foreign sources of certain drugs.

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 1457 Introduced in Senate (IS)]

<DOC>






117th CONGRESS
  1st Session
                                S. 1457

  To establish programs to address addiction and overdoses caused by 
      illicit fentanyl and other opioids, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 29, 2021

 Mr. Markey (for himself, Ms. Warren, Mr. Whitehouse, Ms. Baldwin, and 
  Mr. Booker) introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
  To establish programs to address addiction and overdoses caused by 
      illicit fentanyl and other opioids, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Support, 
Treatment, and Overdose Prevention of Fentanyl Act of 2021'' or the 
``STOP Fentanyl Act of 2021''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Definitions.
Sec. 3. Findings.
                TITLE I--FENTANYL RESEARCH AND EDUCATION

Sec. 101. Enhanced fentanyl surveillance.
Sec. 102. Collection of overdose data.
Sec. 103. Fentanyl detection.
Sec. 104. GAO report on international mail and cargo screening.
Sec. 105. Contingency management program.
  TITLE II--OVERDOSE PREVENTION AND SUBSTANCE USE DISORDER TREATMENT 
                                PROGRAMS

Sec. 201. NAM report on overdose prevention centers.
Sec. 202. Naloxone.
Sec. 203. Good Samaritan immunity.
Sec. 204. Medication-assisted treatment.
Sec. 205. Telehealth for substance use disorder treatment.
Sec. 206. Grant program on harms of drug misuse.
Sec. 207. Opioid treatment education.
    TITLE III--PUBLIC HEALTH DATA AND TRAINING SUPPORT FOR FENTANYL 
                               DETECTION

Sec. 301. Public health support for law enforcement.
Sec. 302. Report on countries that produce synthetic drugs.
Sec. 303. Grants to improve public health surveillance in forensic 
                            laboratories.

SEC. 2. DEFINITIONS.

    In this Act, except as otherwise provided:
            (1) The term ``Assistant Secretary'' means the Assistant 
        Secretary for Mental Health and Substance Use.
            (2) The term ``Secretary'' means the Secretary of Health 
        and Human Services.
            (3) The term ``fentanyl-related substance'' has the meaning 
        given the term in section 1308.11(h)(30)(i) of title 21, Code 
        of Federal Regulations (or successor regulations).

SEC. 3. FINDINGS.

    Congress finds the following:
            (1) The opioid epidemic has led to a rise in overdose 
        deaths across the Nation.
            (2) In 2017, the number of overdose deaths involving 
        opioids, including fentanyl, was 6 times higher than in 1999.
            (3) The age-adjusted rate of drug overdose deaths involving 
        synthetic opioids other than methadone increased by 10 percent 
        from 2017 to 2018.
            (4) The COVID-19 pandemic has been associated with 
        substance use. According to the Centers for Disease Control and 
        Prevention (CDC), 13 percent of surveyed adults had started or 
        increased substance use to cope with stress or emotions related 
        to COVID-19.
            (5) Federal agencies, along with Federal, State, and local 
        lawmakers, have worked together to respond to the rise in 
        overdose deaths through increased funding and targeted policy 
        initiatives.
            (6) This includes the successful passage of the 
        Comprehensive Addiction and Recovery Act of 2016 (CARA), the 
        21st Century Cures Act, and the Substance Use-Disorder 
        Prevention that Promotes Opioid Recovery and Treatment for 
        Patients and Communities Act (SUPPORT for Patient and 
        Communities Act).
            (7) These efforts have helped prevent, treat, and combat 
        the opioid epidemic, but the rise in overdose deaths involving 
        synthetic opioids like fentanyl means that not all communities 
        are seeing a reduction in fatalities.
            (8) Drug overdose deaths in the United States involving 
        fentanyl have risen from 2011 through 2016, growing from 1,600 
        fentanyl overdose related deaths in 2011 and 2012 to 18,000 
        deaths in 2016.
            (9) This rise in fentanyl overdose related deaths has 
        disproportionately impacted communities of color.
            (10) According to the Centers for Disease Control and 
        Prevention (CDC), drug overdose death rates involving fentanyl 
        for non-Hispanic African Americans had the largest annual 
        percentage increase from 2011 to 2016 at 140.6 percent per 
        year, followed by Hispanic persons at 118.3 percent per year. 
        Fentanyl-involved overdose rates for non-Hispanic White persons 
        increased by 108.8 percent from 2013 to 2016.
            (11) According to the CDC, rates of drug overdose deaths 
        involving fentanyl increased exponentially from 2011 through 
        2016 for most regions of the United States.
            (12) Fentanyl is increasingly being identified in nonopioid 
        substances, like methamphetamine and cocaine.
            (13) By 2017, over half of heroin and cocaine overdose 
        death records involved synthetic opioids.
            (14) Previous policies to counter the widespread use of 
        illicit substances through tougher sentencing guidelines 
        disproportionately impact communities of color.
            (15) There is a growing need for a comprehensive plan 
        focused on monitoring, researching, treating, and preventing 
        fentanyl overdose deaths.
            (16) Taking a public health approach to reversing overdose 
        death trends and promoting equity should emphasize increasing 
        research and expanding access to treatment.

                TITLE I--FENTANYL RESEARCH AND EDUCATION

SEC. 101. ENHANCED FENTANYL SURVEILLANCE.

    (a) In General.--The Director of the Centers for Disease Control 
and Prevention shall enhance the drug surveillance program of the 
Centers by--
            (1) expanding such surveillance program to include all 50 
        States, the territories of the United States, and all Tribes 
        and Tribal organizations;
            (2) increasing and accelerating the collection of data on 
        fentanyl, fentanyl-related substances, other synthetic opioids, 
        and new emerging drugs of abuse, including related overdose 
        data from medical examiners and drug treatment admissions and 
        information regarding drug seizures; and
            (3) utilizing available and emerging information on 
        fentanyl, fentanyl-related substances, other synthetic opioids, 
        and new emerging drugs of abuse, including information from--
                    (A) the National Drug Early Warning System;
                    (B) State and local public health authorities;
                    (C) Federal, State, and local public health 
                laboratories; and
                    (D) drug seizures by Federal, State, and local law 
                enforcement agencies, including information from the 
                National Seizure System and the National Forensic 
                Laboratory Information System of the Drug Enforcement 
                Administration.
    (b) Information Sharing.--The Director of the Centers for Disease 
Control and Prevention shall share the information collected through 
the drug surveillance program of the Centers with entities including 
the Office of National Drug Control Policy, State and local public 
health agencies, and Federal, State, and local law enforcement 
agencies.
    (c) Law Enforcement Reporting.--Each Federal law enforcement agency 
shall report information on all drug seizures by that agency to the 
Drug Enforcement Administration for inclusion in the National Seizure 
System.
    (d) GAO Report.--Not later than 2 years after the date of enactment 
of this Act, the Comptroller General of the United States shall--
            (1) publish a report analyzing how Federal agencies can 
        improve their collection, reporting, sharing, and analytic use 
        of drug seizure data across Federal agencies and with State and 
        local governments; and
            (2) include in such report an analysis of how well 
        available data on drug seizures can measure progress toward 
        reducing drug trafficking into and within the country, as 
        outlined in strategies such as the National Drug Control 
        Strategy of the Office of National Drug Control Policy.
    (e) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $125,000,000 for each of fiscal 
years 2022 through 2026.

SEC. 102. COLLECTION OF OVERDOSE DATA.

    (a) In General.--Not later than one year after the date of 
enactment of this Act, the Secretary shall conduct a study on how to 
most efficiently track overdoses by type of drug, including fentanyl.
    (b) Grant Program.--
            (1) In general.--Upon completion of the study under 
        subsection (a), and taking into consideration the results of 
        such study, the Secretary shall award grants to States to 
        facilitate the collection of data with respect to fentanyl-
        involved overdoses.
            (2) Requirement.--As a condition on receipt of a grant 
        under this subsection, an applicant shall agree to share the 
        data collected pursuant to the grant with the Centers for 
        Disease Control and Prevention.
            (3) Preference.--In awarding grants under this subsection, 
        the Secretary shall give preference to applicants whose grant 
        proposals demonstrate the greatest need for collecting timely 
        and accurate data on overdoses.

SEC. 103. FENTANYL DETECTION.

    (a) Testing of Contaminants.--
            (1) In general.--The Secretary, acting through the 
        Assistant Secretary and in coordination with the Director of 
        the Centers for Disease Control and Prevention, shall establish 
        a pilot program through which 5 entities, in 5 States 
        representing diverse regions, use chemical screening devices to 
        identify contaminants, including fentanyl and fentanyl-related 
        substances, in illicit street drugs.
            (2) Evaluation.--Not later than the end of fiscal year 
        2025, the Secretary shall--
                    (A) complete an evaluation of the most effective 
                ways of expanding the pilot program under this 
                subsection to decrease rates of overdose; and
                    (B) submit a report to the appropriate 
                congressional committees on the results of such 
                evaluation.
            (3) Definition.-- In this subsection, the term ``chemical 
        screening device'' means an infrared spectrophotometer, mass 
        spectrometer, nuclear magnetic resonance spectrometer, Raman 
        spectrophotometer, ion mobility spectrometer, or any other 
        device or other technology that is able to determine the 
        presence of, or identify, one or more contaminants in illegal 
        street drugs.
            (4) Authorization of appropriations.--To carry out this 
        subsection, there is authorized to be appropriated $5,000,000 
        for each of fiscal years 2022 through 2026.
    (b) Research Into Technologies.--
            (1) In general.--The Secretary shall conduct or support 
        research for the development or improvement of portable and 
        affordable technologies related to testing drugs for fentanyl 
        and fentanyl-related substances, including chemical screening 
        device methods.
            (2) Authorization of appropriations.--To carry out this 
        subsection, there is authorized to be appropriated $25,000,000 
        for each of fiscal years 2022 through 2026.

SEC. 104. GAO REPORT ON INTERNATIONAL MAIL AND CARGO SCREENING.

    Not later than 1 year after the date of enactment of this Act, the 
Comptroller General of the United States shall submit to Congress a 
report reviewing the impact of illicit fentanyl and fentanyl-related 
substances imported through international mail and cargo, including 
discussion of the following:
            (1) The volume of fentanyl and fentanyl-related substances 
        being imported into the United States by means of international 
        mail and cargo.
            (2) The potential impact of increased screening for illicit 
        fentanyl and fentanyl-related substances on--
                    (A) deterring drug trafficking in the United 
                States;
                    (B) interdicting fentanyl and fentanyl-related 
                substances that were manufactured outside of the United 
                States and intended, or attempted, to be imported into 
                the United States;
                    (C) the number of Federal criminal prosecutions 
                based on the manufacture, distribution, or possession 
                of fentanyl or fentanyl-related substances, 
                disaggregated by demographic data, including sex, race, 
                and ethnicity, of the offender;
                    (D) the charges brought in prosecutions described 
                in subparagraph (C);
                    (E) the impacts of prosecutions described in 
                subparagraph (C) on reducing demand for, and 
                availability to users of, fentanyl and fentanyl-related 
                substances; and
                    (F) the development of new fentanyl-related 
                substances.
            (3) The need for non-invasive technology in screening for 
        fentanyl and fentanyl-related substances, taking into account 
        the findings under paragraphs (1) and (2).

SEC. 105. CONTINGENCY MANAGEMENT PROGRAM.

    (a) In General.--The Secretary shall--
            (1) develop and implement a program of using contingency 
        management principles to discourage the use of illicit drugs; 
        and
            (2) as part of such program use incentive-based 
        interventions--
                    (A) to increase substance misuse treatment 
                retention; and
                    (B) to promote adherence to treatment goals, 
                including negative urinalysis.
    (b) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $25,000,000 for each of fiscal 
years 2022 through 2026.

  TITLE II--OVERDOSE PREVENTION AND SUBSTANCE USE DISORDER TREATMENT 
                                PROGRAMS

SEC. 201. NAM REPORT ON OVERDOSE PREVENTION CENTERS.

    Not later than one year after the date of enactment of this Act, 
the Comptroller General of the United States shall enter into an 
arrangement with the National Academy of Medicine (or, if the Academy 
declines, another appropriate entity) to--
            (1) submit to Congress a report on overdose prevention 
        centers; and
            (2) include in such report--
                    (A) a review of the effectiveness of legally 
                authorized overdose prevention centers in the United 
                States and abroad on lowering overdose deaths; and
                    (B) an assessment of the effectiveness of overdose 
                prevention centers on improving access to medication-
                assisted treatment and recovery services.

SEC. 202. NALOXONE.

    (a) Naloxone Pricing Transparency.--
            (1) Reporting requirement.--Not later than the date that is 
        one year after the date of enactment of this Act, and annually 
        thereafter, to better understand how research and development 
        costs, manufacturing and marketing costs, acquisitions, Federal 
        investments, revenues and sales, and other factors influence 
        drug prices, each manufacturer of naloxone or any other drug 
        approved by the Food and Drug Administration for opioid 
        overdose reversal shall report to the Secretary--
                    (A) with respect to naloxone (or such other drug)--
                            (i) total expenditures of the manufacturer 
                        on--
                                    (I) materials and manufacturing for 
                                such drug;
                                    (II) acquiring patents and 
                                licensing; and
                                    (III) costs to purchase or acquire 
                                the drug from another company, if 
                                applicable;
                            (ii) the percentage of total expenditures 
                        of the manufacturer on research and development 
                        for such drug that was derived from Federal 
                        funds;
                            (iii) the total expenditures of the 
                        manufacturer on research and development for 
                        such drug;
                            (iv) the total revenue and net profit 
                        generated from the applicable drug for each 
                        calendar year since drug approval;
                            (v) the total expenditures of the 
                        manufacturer that are associated with marketing 
                        and advertising for such drug;
                            (vi) the wholesale acquisition cost for 
                        such drug;
                            (vii) the average out-of-pocket cost of 
                        such drug to the consumer; and
                            (viii) patient utilization rates for such 
                        drug; and
                    (B) additional information specific to the 
                manufacturer as the Secretary may require, to include 
                at a minimum--
                            (i) the total revenue and net profit of the 
                        manufacturer for the reporting period;
                            (ii) metrics used to determine executive 
                        compensation; and
                            (iii) any additional information related to 
                        drug pricing decisions of the manufacturer, 
                        such as total expenditures on--
                                    (I) drug research and development; 
                                or
                                    (II) clinical trials on drugs that 
                                failed to receive approval by the Food 
                                and Drug Administration.
            (2) Reporting period.--The reporting period for the reports 
        under paragraph (1) shall be as follows:
                    (A) For the initial report under paragraph (1), the 
                10-year period preceding the report.
                    (B) For subsequent reports, the 12-month period 
                preceding the respective reports.
            (3) Publicly available.--
                    (A) In general.--Subject to subparagraph (B), not 
                later than 30 days after receiving the information 
                under paragraph (1), the Secretary shall post on the 
                internet website of the Centers for Medicare & Medicaid 
                Services the information reported under paragraph (1) 
                in written format and using language that is easily 
                understandable by beneficiaries under titles XVIII and 
                XIX of the Social Security Act (42 U.S.C. 1395 et seq.; 
                1396 et seq.).
                    (B) Exclusion of proprietary information.--The 
                Secretary shall exclude proprietary information, such 
                as trade secrets and intellectual property, submitted 
                by the manufacturer under paragraph (1) from the 
                posting described in subparagraph (A).
    (b) Study on Classification of Naloxone as a Prescription Drug.--
The Commissioner of Food and Drugs shall--
            (1) not later one year after the date of enactment of this 
        Act, determine whether naloxone should remain subject to the 
        requirements of section 503(b)(1) of the Federal Food, Drug, 
        and Cosmetic Act (21 U.S.C. 353(b)(1)) or be reclassified as an 
        over-the-counter drug; and
            (2) take such actions as may be appropriate, consistent 
        with such determination.

SEC. 203. GOOD SAMARITAN IMMUNITY.

    (a) Limitation on Civil Liability for Individuals Who Administer 
Opioid Overdose Reversal Drugs.--
            (1) In general.--Notwithstanding any other provision of 
        law, except as provided in paragraph (2), no individual shall 
        be liable in any Federal or State proceeding for harm caused by 
        the emergency administration of an opioid overdose reversal 
        drug to an individual who has or reasonably appears to have 
        suffered an overdose from heroin or another opioid, if--
                    (A) the individual who administers the opioid 
                overdose reversal drug obtained the drug from--
                            (i) a health care professional as part of 
                        an opioid overdose prevention program; or
                            (ii) any source as permitted under 
                        applicable State law; or
                    (B) the individual administers the opioid overdose 
                reversal drug in good faith.
            (2) Exception.--Paragraph (1) shall not apply to an 
        individual if the harm was caused by the gross negligence or 
        reckless misconduct of the individual who administers the drug.
            (3) Definitions.--In this subsection:
                    (A) The term ``health care professional'' means a 
                person licensed by a State to prescribe prescription 
                drugs.
                    (B) The term ``opioid overdose reversal drug'' 
                means a drug approved under section 505 of the Federal 
                Food, Drug, and Cosmetic Act (21 U.S.C. 355) that is 
                indicated for the partial or complete reversal of the 
                pharmacological effects of an opioid overdose in the 
                human body.
                    (C) The term ``opioid overdose prevention program'' 
                means a program operated by a local health department, 
                harm reduction or other community-based organization, 
                substance abuse treatment organization, law enforcement 
                agency, fire department, other first responder 
                department, or voluntary association, or a program 
                funded by a Federal, State, or local government, that 
                works to prevent opioid overdoses by in part providing 
                opioid overdose reversal drugs and education--
                            (i) to individuals at risk of experiencing 
                        an opioid overdose; or
                            (ii) to an individual in a position to 
                        assist another individual at risk of 
                        experiencing an opioid overdose.
    (b) Immunity From Liability.--
            (1) In general.--An individual who, in good faith and in a 
        timely manner--
                    (A) seeks medical assistance for another individual 
                who is experiencing a drug overdose shall not be cited, 
                arrested, prosecuted, criminally liable, or subject to 
                any sanction for a violation of a condition of 
                supervised release under section 404 of the Controlled 
                Substances Act (21 U.S.C. 844) for the possession or 
                use of a controlled substance, or under any other 
                provision of Federal law regulating the misuse of 
                prescription drugs, as a result of seeking such medical 
                assistance; or
                    (B) seeks medical assistance for himself or herself 
                for a drug overdose, or is the subject of a request for 
                medical assistance described in subparagraph (A), shall 
                not be cited, arrested, prosecuted, criminally liable, 
                or subject to any sanction for a violation of a 
                condition of supervised release, under section 404 of 
                the Controlled Substances Act (21 U.S.C. 844) for the 
                possession or use of a controlled substance, or under 
                any other provision of Federal law regulating the 
                misuse of prescription drugs, as a result of seeking 
                such medical assistance.
            (2) Preemption.--This subsection preempts the laws of a 
        State or any political subdivision of a State to the extent 
        that such laws are inconsistent with this section, unless such 
        laws provide greater protection from liability.
            (3) Definitions.--In this section:
                    (A) The term ``controlled substance'' has the 
                meaning given the term in section 102 of the Controlled 
                Substances Act (21 U.S.C. 802).
                    (B) The term ``drug overdose'' means an acute 
                condition resulting from or believed to be resulting 
                from the use of a controlled substance, which an 
                individual, who is not a health care professional, 
                would reasonably believe requires medical assistance.
                    (C) The term ``prescription drug'' means a drug 
                subject to section 503(b)(1) of the Federal Food, Drug, 
                and Cosmetic Act (21 U.S.C. 353(b)(1)).
                    (D) The terms ``seeks medical assistance'' and 
                ``seeking such medical assistance'' include--
                            (i) reporting a drug or alcohol overdose or 
                        other medical emergency to a law enforcement 
                        authority, the 9-1-1 system, a poison control 
                        center, or a medical provider;
                            (ii) assisting another individual who is 
                        making a report described in clause (i); or
                            (iii) providing care to someone who is 
                        experiencing a drug or alcohol overdose or 
                        other medical emergency while awaiting the 
                        arrival of medical assistance.
    (c) Seeking Assistance as a Mitigating Factor.--Section 3553 of 
title 18, United States Code, is amended--
            (1) by redesignating subsection (g) as subsection (h); and
            (2) by inserting after subsection (f) the following:
    ``(g) Seeking Medical Assistance.--
            ``(1) In general.--Notwithstanding any other provision of 
        law, in imposing a sentence pursuant to guidelines promulgated 
        by the United States Sentencing Commission under section 994 of 
        title 28 against a defendant convicted of an offense as a 
        result of seeking medical assistance for another individual who 
        is experiencing a drug overdose, or for himself or herself for 
        a drug overdose, other than an offense described in section 
        203(b)(1)(A) of the STOP Fentanyl Act of 2021, the court shall 
        consider the act of seeking medical assistance as a mitigating 
        factor.
            ``(2) Definitions.--In this subsection, the terms `drug 
        overdose' and `seeking medical assistance' have the meanings 
        given to such terms in section 203(b) of the STOP Fentanyl Act 
        of 2021.''.

SEC. 204. MEDICATION-ASSISTED TREATMENT.

    (a) Opioid Treatment Program Regulations.--
            (1) Definition.--In this subsection, the term ``opioid 
        treatment program'' means a program or practitioner engaged in 
        opioid treatment of individuals with an opioid agonist 
        treatment medication registered under section 303(g)(1) of the 
        Controlled Substances Act (21 U.S.C. 823(g)(1)).
            (2) Elimination of patient eligibility requirement.--The 
        Secretary shall amend section 8.12(e)(1) of title 42, Code of 
        Federal Regulations (and such other regulations in part 8 of 
        such title 42 as may be necessary) to eliminate the requirement 
        that the person became addicted at least 1 year before 
        admission for maintenance treatment under an opioid treatment 
        program.
            (3) Survey.--
                    (A) In general.--Not later than one year after the 
                date of enactment of this Act, the Assistant Secretary 
                shall--
                            (i) complete a survey of the use in opioid 
                        treatment programs of ``take-home'' 
                        prescription medications; and
                            (ii) submit a report to Congress on the 
                        findings of the survey.
                    (B) Required assessment.--The survey under 
                paragraph (1) shall assess--
                            (i) the frequency of use of ``take-home'' 
                        medication, as allowed under section 8.12(i) of 
                        title 42, Code of Federal Regulations;
                            (ii) the extent to which the limitations on 
                        doses for ``take-home'' use listed in section 
                        8.12(i)(3)(i), (ii), (iii), and (iv) of such 
                        title 42 unduly burden treatment of individuals 
                        with opioid use disorder; and
                            (iii) whether and how individuals receiving 
                        medications for ``take-home'' use receive all 
                        services listed in section 8.12(f) of such 
                        title 42.
    (b) Treatment in Rural and Underserved Populations.--Not later than 
1 year after the date of enactment of this Act, the Assistant Secretary 
shall complete a study and submit a report to Congress on ways in which 
the Substance Abuse and Mental Health Services Administration can 
provide and support health services, including treatment for substance 
use disorders, to individuals in rural (including agricultural) and 
medically underserved communities (as defined in section 799B of the 
Public Health Service Act (42 U.S.C. 295p)), taking into account the 
following:
            (1) Stigma.
            (2) Using data.
            (3) Telemedicine.
            (4) Managing fiscal resources in a community impacted by 
        addiction.
            (5) Workforce development.
            (6) Broadband.
            (7) Overcoming economic challenges.
            (8) Prevention.
            (9) Transportation.
            (10) Nutritional services.
            (11) Medication-assisted treatment.
            (12) Educating law enforcement personnel about addiction.
            (13) Drug courts.
            (14) Educating the faith community about addiction.
            (15) Recovery support.
            (16) Housing.
            (17) Harm reduction services.
    (c) Prisons and Medication-Assisted Treatment.--
            (1) In general.--The Director of the Bureau of Prisons 
        shall establish a program to offer--
                    (A) medication-assisted treatment for opioid use 
                disorder to individuals in the custody of the Bureau of 
                Prisons and include in such treatment all drugs that 
                are approved by the Food and Drug Administration to 
                treat opioid use disorder; and
                    (B) withdrawal management services to individuals 
                in the custody of the Bureau of Prisons to provide a 
                comprehensive treatment approach to substance use 
                disorders.
            (2) Authorization of appropriations.--To carry out this 
        subsection, there is authorized to be appropriated to the 
        Director of the Bureau of Prisons $150,000,000 for each of 
        fiscal years 2022 through 2026.
    (d) Residential Substance Abuse Treatment for State Prisoners.--
Section 1904(d) of title I of the Omnibus Crime Control and Safe 
Streets Act of 1968 (34 U.S.C. 10424(d)) is amended--
            (1) by striking ``means'' and inserting the following:
            ``(1) means''; and
            (2) by striking the period at the end and inserting ``; 
        and''; and
            (3) by adding at the end the following:
            ``(2) includes any such course of comprehensive individual 
        and group substance abuse treatment services using medication-
        assisted treatment for opioid use disorder (including the use 
        of any drug approved or licensed by the Food and Drug 
        Administration for such treatment).''.

SEC. 205. TELEHEALTH FOR SUBSTANCE USE DISORDER TREATMENT.

    Section 309(e)(2) of the Controlled Substances Act (21 U.S.C. 
829(e)(2)) is amended--
            (1) in subparagraph (A)(i)--
                    (A) by striking ``at least 1 in-person medical 
                evaluation'' and inserting the following: ``at least--
                                    ``(I) 1 in-person medical 
                                evaluation''; and
                    (B) by adding at the end the following:
                                    ``(II) for purposes of prescribing 
                                a controlled substance in schedule III 
                                or IV, 1 telehealth evaluation; or''; 
                                and
            (2) by adding at the end the following:
                    ``(D)(i) The term `telehealth evaluation' means a 
                medical evaluation that is conducted in accordance with 
                applicable Federal and State laws by a practitioner 
                (other than a pharmacist) who is at a location remote 
                from the patient and is communicating with the patient 
                using a telecommunications system referred to in 
                section 1834(m) of the Social Security Act (42 U.S.C. 
                1395m(m)) that includes, at a minimum, audio and video 
                equipment permitting two-way, real-time interactive 
                communication between the patient and distant site 
                practitioner.
                    ``(ii) Nothing in clause (i) shall be construed to 
                imply that 1 telehealth evaluation demonstrates that a 
                prescription has been issued for a legitimate medical 
                purpose within the usual course of professional 
                practice.
                    ``(iii) A practitioner who prescribes the drugs or 
                combination of drugs that are covered under section 
                303(g)(2)(C) using the authority under subparagraph 
                (A)(i)(II) of this paragraph shall adhere to nationally 
                recognized evidence-based guidelines for the treatment 
                of patients with opioid use disorders and a diversion 
                control plan, as those terms are defined in section 8.2 
                of title 42, Code of Federal Regulations, as in effect 
                on the date of enactment of this subparagraph.''.

SEC. 206. GRANT PROGRAM ON HARMS OF DRUG MISUSE.

    (a) In General.--The Assistant Secretary, in consultation with the 
Director of the Centers for Disease Control and Prevention, shall award 
grants to States, political subdivisions of States, Tribes, Tribal 
organizations, and community-based entities to support the delivery of 
overdose prevention, syringe services programs, and other harm 
reduction services that address the harms of drug misuse, including 
by--
            (1) preventing and controlling the spread of infectious 
        diseases, such as HIV/AIDS and viral hepatitis, and the 
        consequences of such diseases for individuals with substance 
        use disorder;
            (2) distributing opioid antagonists, such as naloxone, to 
        individuals at risk of overdose;
            (3) connecting individuals at risk for, or with, a 
        substance use disorder to overdose education, counseling, and 
        health education; and
            (4) encouraging such individuals to take steps to reduce 
        the negative personal and public health impacts of substance 
        use or misuse.
    (b) Considerations.--In awarding grants under this section, the 
Assistant Secretary shall prioritize grants to applicants that are--
            (1) culturally specific organizations, Tribal behavioral 
        health and substance use disorder providers, or organizations 
        that are intentional about serving populations where COVID-19 
        has had the most impact; or
            (2) proposing to serve areas with--
                    (A) a higher proportion of the population who meet 
                criteria for dependence on, or abuse of, illicit drugs;
                    (B) a higher drug overdose death rate;
                    (C) a greater telemedicine infrastructure need; and
                    (D) a greater behavioral health and substance use 
                disorder workforce need.
    (c) Use of Grant Awards.--A recipient of a grant under this section 
may use such grant funds for the following purposes:
            (1) Adapt, maintain, and expand essential services provided 
        by harm reduction service organizations to address the risks of 
        COVID-19, drug overdose, and contraction of infectious disease.
            (2) Maintain or hire staff.
            (3) Support program operational costs, including staff, 
        rent, and vehicle purchase or maintenance.
            (4) Program supplies.
            (5) Support and case management services.
    (d) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $50,000,000 for fiscal year 
2022, to remain available until expended.

SEC. 207. OPIOID TREATMENT EDUCATION.

    (a) In General.--The Secretary shall award grants to States and 
local governmental entities to provide education to stakeholders, 
including health care providers, criminal justice professionals, and 
substance use disorder treatment personnel, on the current state of 
research on treatment for opioid dependence, including--
            (1) the use of opioid agonists or partial agonists; and
            (2) the potential benefits of the use of opioid agonists or 
        partial agonists for affected individuals.
    (b) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $100,000,000 for each of fiscal 
years 2022 through 2026.

    TITLE III--PUBLIC HEALTH DATA AND TRAINING SUPPORT FOR FENTANYL 
                               DETECTION

SEC. 301. PUBLIC HEALTH SUPPORT FOR LAW ENFORCEMENT.

    (a) Support for Fentanyl Detection and Handling.--The Secretary, in 
consultation with the Attorney General, shall establish a program to 
provide to Federal, State, and local law enforcement agencies public 
health training on how to detect and handle fentanyl.
    (b) Evidence-Based.--The program under subsection (a) shall comply 
with evidence-based guidelines, including the ``Fentanyl Safety 
Recommendations for First Responders'' (or any successor guidelines) of 
the Office of National Drug Control Policy.
    (c) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $5,000,000 for each of fiscal 
years 2022 through 2026.

SEC. 302. REPORT ON COUNTRIES THAT PRODUCE SYNTHETIC DRUGS.

    Not later than 1 year after the date of enactment of this Act, the 
Secretary of State shall submit to Congress a report--
            (1) identifying the countries the Secretary determines are 
        the principal producers of synthetic drugs trafficked into the 
        United States;
            (2) assessing how and why those countries are producing 
        such drugs; and
            (3) describing measures the Secretary plans to take to 
        reduce the flow of such drugs into the United States.

SEC. 303. GRANTS TO IMPROVE PUBLIC HEALTH SURVEILLANCE IN FORENSIC 
              LABORATORIES.

    Title I of the Omnibus Crime Control and Safe Streets Act of 1968 
(34 U.S.C. 10101 et seq.) is amended by adding at the end the 
following:

  ``PART PP--CONFRONTING THE USE OF HEROIN, FENTANYL, AND ASSOCIATED 
                            SYNTHETIC DRUGS

``SEC. 3061. AUTHORITY TO MAKE GRANTS TO ADDRESS PUBLIC SAFETY THROUGH 
              IMPROVED FORENSIC LABORATORY DATA.

    ``(a) Purpose.--The purpose of this section is to assist States and 
units of local government in--
            ``(1) carrying out programs to improve surveillance of 
        seized heroin, fentanyl, and associated synthetic drugs to 
        enhance public health; and
            ``(2) improving the ability of State, tribal, and local 
        government institutions to carry out such programs.
    ``(b) Grant Authorization.--The Attorney General, acting through 
the Director of the Bureau of Justice Assistance, may make grants to 
States and units of local government to improve surveillance of seized 
heroin, fentanyl, and associated synthetic drugs to enhance public 
health.
    ``(c) Grant Projects To Improve Surveillance of Seized Heroin, 
Fentanyl, and Associated Synthetic Drugs.--Grants made under subsection 
(b) shall be used for programs, projects, and other activities to--
            ``(1) reimburse State, local, or other forensic science 
        laboratories to help address backlogs of untested samples of 
        heroin, fentanyl, and associated synthetic drugs;
            ``(2) reimburse State, local, or other forensic science 
        laboratories for procuring equipment, technology, or other 
        support systems if the applicant for the grant demonstrates to 
        the satisfaction of the Attorney General that expenditures for 
        such purposes would result in improved efficiency of laboratory 
        testing and help prevent future backlogs;
            ``(3) reimburse State, local, or other forensic science 
        laboratories for improved, real-time data exchange with the 
        Centers for Disease Control and Prevention on fentanyl, 
        fentanyl-related substances, and other synthetic drugs present 
        in the local communities; and
            ``(4) support State, tribal, and local health department 
        services deployed to address the use of heroin, fentanyl, and 
        associated synthetic drugs.
    ``(d) Limitation.--Not less than 60 percent of the amounts made 
available to carry out this section shall be awarded for the purposes 
under paragraph (1) or (2) of subsection (c).
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $10,000,000 for each of fiscal 
years 2022 and 2023.
    ``(f) Allocation.--
            ``(1) Population allocation.--Seventy-five percent of the 
        amount made available to carry out this section in a fiscal 
        year shall be allocated to each State that meets the 
        requirements of section 2802 so that each State shall receive 
        an amount that bears the same ratio to the 75 percent of the 
        total amount made available to carry out this section for that 
        fiscal year as the population of the State bears to the 
        population of all States.
            ``(2) Discretionary allocation.--Twenty-five percent of the 
        amount made available to carry out this section in a fiscal 
        year shall be allocated pursuant to the discretion of the 
        Attorney General for competitive grants to States or units of 
        local government with high rates of primary treatment 
        admissions for heroin and other opioids, for use by State or 
        local law enforcement agencies.
            ``(3) Minimum requirement.--Each State shall receive not 
        less than 0.6 percent of the amount made available to carry out 
        this section in each fiscal year.
            ``(4) Certain territories.--
                    ``(A) In general.--For purposes of the allocation 
                under this section, American Samoa and the Commonwealth 
                of the Northern Mariana Islands shall be considered as 
                1 State.
                    ``(B) Allocation amongst certain territories.--For 
                purposes of subparagraph (A), 67 percent of the amount 
                allocated shall be allocated to American Samoa and 33 
                percent shall be allocated to the Commonwealth of the 
                Northern Mariana Islands.''.
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