II 118th CONGRESS 1st Session S. 1766 IN THE SENATE OF THE UNITED STATES May 31 (legislative day, May 30), 2023 Mr. Markey (for himself, Ms. Murkowski , Ms. Warren , Mr. Braun , Mr. Van Hollen , Mr. King , Ms. Baldwin , Mrs. Capito , and Mr. Heinrich ) introduced the following bill; which was read twice and referred to the Committee on Armed Services A BILL To require the Secretary of Defense to submit a report on overdoses among members of the Armed Forces.

1. Short title This Act may be cited as the Department of Defense Overdose Data Act of 2023 . 2. Annual report on military overdoses (a) In general Not later than 1 year after the date of the enactment of this Act, and annually thereafter, the Secretary of Defense shall submit to the appropriate congressional committees a report on the number of annual overdoses among servicemembers. (b) Contents The report required by subsection (a) shall include the following: (1) The total number of servicemembers who suffered a fatal overdose during the previous calendar year, including— (A) demographic information, including gender, race, age, military department, military rank, pay grade, station, number of previous deployments, and whether such member was a victim of military sexual assault; (B) the location of the fatal overdose, including whether the overdose was on a military base; and (C) a list of the substances involved in the fatal overdose. (2) Of the servicemembers identified in paragraph (1)— (A) the number of servicemembers who previously had a non-fatal overdose; (B) the number of servicemembers who received mental health or substance use disorder services prior to a fatal or non-fatal overdose, including a description of whether such services were received from a private sector provider; (C) the number of servicemembers with co-morbid mental health diagnoses; (D) the number of servicemembers who had been prescribed opioids, benzodiazepines, or stimulants; (E) the number of servicemembers who were previously prescribed or provided naloxone; (F) the number of servicemembers who had a positive drug test prior to the fatal overdose, including any substance identified in such test; (G) the number of servicemembers referred, including by self-referral, to medical treatment, including medication treatment for opioid use disorder; (H) with respect to each servicemember identified in subparagraph (G), whether the servicemember was referred after a positive drug test and the source of such referral; (I) of the servicemembers identified in subparagraph (G), the number of servicemembers who engaged in such medical treatment; (J) the number of servicemembers who suffered a fatal overdose in which a bystander was present; and (K) the number of fatal overdoses. (3) The total number of servicemembers who suffered a non-fatal overdose during the previous calendar year, including— (A) demographic information, including gender, race, age, military department, military rank, pay grade, station, number of previous deployments, and whether such member was a victim of military sexual assault; (B) a list of the substances involved in the non-fatal overdose; and (C) a determination of whether the non-fatal overdose was intentional. (4) Of the servicemembers identified in paragraph (3)— (A) the number of servicemembers who previously had a non-fatal overdose; (B) the number of servicemembers who received mental health or substance use disorder services prior to a non-fatal overdose; (C) the number of servicemembers with co-morbid mental health diagnoses prior to a non-fatal overdose; (D) the number of servicemembers who had been prescribed opioids, benzodiazepines, or stimulants prior to a non-fatal overdose; (E) the number of servicemembers who had a positive drug test prior to the non-fatal overdose, including any substance identified in such test; (F) the number of servicemembers who suffered a non-fatal overdose in which a bystander was present; (G) the number of servicemembers who had been categorized as high risk and prescribed or provided naloxone prior to a non-fatal overdose; (H) the number of servicemembers who suffered a non-fatal overdose in which naloxone was administered; (I) the number of servicemembers referred to medical treatment, including medication treatment for opioid use disorder, following a non-fatal overdose; (J) of the servicemembers identified in subparagraph (I), the number of servicemembers who engaged in such medical treatment; (K) the number of servicemembers referred, including by self-referral, to medical treatment, including medication treatment for opioid use disorder; (L) with respect to each servicemember identified in subparagraph (K), whether the servicemember was referred after a positive drug test and the source of such referral; (M) of the servicemembers identified in subparagraph (K), the number of servicemembers who engaged in such medical treatment; and (N) the number of intentional overdoses. (5) An analysis of discernable patterns in fatal and non-fatal overdoses of servicemembers, and existing or anticipated responses to such patterns by the Secretary of Defense. (6) A description of existing or anticipated response efforts to fatal and non-fatal overdoses at military bases that have rates of fatal overdoses that exceed the average rate of fatal overdoses in the United States. (7) The number of servicemembers who are in recovery or currently taking a prescription medication for opioid use disorder. (8) The number of military family members of servicemembers who receive substance use disorder treatment at a medical facility of the Department of Defense. (9) An assessment of the availability of substance use disorder treatment for servicemembers who— (A) transferred military bases; or (B) returned to the United States following an overseas tour. (10) The number of medical facilities of, or affiliated with, the Department of Defense that have opioid treatment programs. (11) A description of punitive measures taken by the Secretary of Defense in response to substance misuse, substance use disorder, or overdose by servicemembers. (12) The number of military family members who live on a military base who suffered a fatal or non-fatal overdose during the previous calendar year, including— (A) demographic information, including gender, race, age, and relationship to a servicemember; (B) the location of the overdose; (C) a list of the substances involved in the overdose; and (D) a determination of whether the overdose was intentional. (13) Of the military family members identified in paragraph (12)— (A) of military family members who suffered a fatal overdose, the numbers of military family members who had a previous non-fatal overdose; (B) the number of military family members who received mental health services prior to an overdose; (C) the number of military family members who have co-morbid mental health diagnoses; (D) the number of military family members who had been prescribed opioids, benzodiazepines, or stimulants prior to an overdose; (E) the number of military family members who suffered an overdose in which a bystander was present; (F) the number of military family members who suffered an overdose in which naloxone was administered; and (G) the number of intentional overdoses. (c) Reporting on fewer than 5 servicemembers If the number of servicemembers or military family members identified under any paragraph or subparagraph of subsection (b) is fewer than 5, the Secretary of Defense shall for such paragraph or subparagraph— (1) not report the exact number of servicemembers or military family members identified; and (2) report that fewer than 5 servicemembers or military family members were identified. (d) Privacy (1) In general Nothing in this section shall be construed to authorize the disclosure by the Secretary of Defense of personally identifiable information of servicemembers or military family members, including anonymized personal information that could be used to re-identify servicemembers or military family members. (2) Application of HIPAA In carrying out this section, the Secretary of Defense shall take steps to protect the privacy of servicemembers and military family members pursuant to regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 ( 42 U.S.C. 1320d–2 note; Public Law 104–191 ). 3. Report on improved access to data, treatment, and overdose prevention Not later than 1 year after the date of the enactment of this Act, the Secretary of Defense shall contract with a federally funded research and development center to prepare a report that includes— (1) an assessment of current barriers to determining the information required under section 2 and recommendations for improved tracking and reporting of substance misuse, substance use disorders, overdoses, and treatment within the Department of Defense; (2) recommendations for— (A) legislative and administrative actions to increase access to mental and behavioral health care for servicemembers who— (i) are at risk of overdose or substance use disorder; (ii) have experienced a non-fatal overdose; or (iii) have been diagnosed with a substance use disorder; (B) expanding non-opioid pain management treatment and physical therapy at medical facilities of the Department of Defense; (C) organizing interagency coordination— (i) to address overdoses and substance use disorders among veterans servicemembers; and (ii) to reduce stigma associated with substance use disorders and treatment access among servicemembers and their military family members; (D) addressing concerns among servicemembers regarding the consequences of seeking or receiving care for a substance use disorder or overdose; (E) educating servicemembers on prevention strategies, tools to reduce or prevent overdose or substance use disorder, available mental and behavioral healthcare and substance use disorder care, including medication treatment for opioid use disorder, recovery support services, psychotherapy, inpatient rehabilitation services, and family support services; (F) potential supports for servicemembers in recovery; (G) improving continuity of care for substance use disorders from during the transition to veteran status; and (H) improving access to death investigation occurring outside the jurisdiction of the Armed Forces Medical Examiner System; (3) an identification of causes of fatal and non-fatal overdoses that are unique to servicemembers; (4) an identification of the barriers to care for substance use disorders for military family members of servicemembers and suggestions for additional data elements for the annual report required under section 2; (5) any other information that the Comptroller General of the United States considers appropriate with respect to the reduction of overdoses among servicemembers; and (6) qualitative data from servicemembers. 4. Standards for the use of materials to prevent overdose and substance use disorder Not later than 1 year after the date of the enactment of this Act, the Secretary of Defense shall establish standards for the distribution of, and training for the use of, naloxone or other medication for overdose reversal, opioid disposal materials, fentanyl test strips, and other materials to prevent or reverse overdoses, substance use disorder, or impacts related to substance misuse. 5. Definitions In this Act: (1) Appropriate congressional committees The term appropriate congressional committees means— (A) the congressional defense committees; (B) the Committee on Health, Education, Labor, and Pensions of the Senate; and (C) the Committee on Energy and Commerce of the House of Representatives. (2) Military family member The term military family member means a family member of a servicemember, including the spouse, parent, dependent, or child of a servicemember, or anyone who has legal responsibility for the child of a servicemember. (3) Servicemember The term servicemember means— (A) a member of the Armed Forces; or (B) a member of the National Guard.