I 118th CONGRESS 1st Session H. R. 3570 IN THE HOUSE OF REPRESENTATIVES May 22, 2023 Ms. Jackson Lee (for herself, Ms. Clarke of New York , Mrs. Beatty , Ms. Moore of Wisconsin , Mr. Horsford , Mr. Jackson of Illinois , Mrs. Cherfilus-McCormick , and Mr. Payne ) introduced the following bill; which was referred to the Committee on Energy and Commerce , and in addition to the Committee on the Judiciary , for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To provide public awareness and outreach regarding the dangers of fentanyl, to expand the grants authorized under the Comprehensive Opioid Abuse Grant Program, to expand treatment and recovery services for people with opioid addictions, and to increase and to provide enhanced penalties for certain offenses involving counterfeit pills.

1. Short title This Act may be cited as the Comprehensive Response to Fentanyl-Related Substances and Fentanyl-Laced Substances Act . 2. Findings Congress finds the following: (1) The United States is in the midst of the worst opioid epidemic in history. (2) Illicit fentanyl is typically mixed into heroin or pressed into counterfeit pills made to look like controlled prescription drugs such as oxycodone, hydrocodone, and Xanax. (3) From September 29 through December 15, 2021, the DEA seized more than 1,500 pounds of substances containing fentanyl and 8.4 million fentanyl-laced, fake prescription pills. The seizures were directly linked to at least 39 overdose deaths and included at least 76 cases that involved buying and selling drugs on social media apps. Over the course of that year, the DEA seized over 15,000 pounds of substances containing fentanyl and 20.4 million fake pills, with roughly four out of every 10 pills containing lethal doses of fentanyl. (4) The widespread availability of illicit fentanyl, the proliferation of counterfeit pills resembling prescription drugs but containing illicit fentanyl or other illicit drugs, and the ease of purchasing pills through social media have increased fatal overdose risk among adolescents. (5) According to the Centers for Disease Control, overdose deaths reached a historic high of more than 90,000 drug overdose deaths in 2020, a 31 percent increase compared with the previous year and in 2021, there were more than 106,000 reported drug overdose deaths in the U.S., with deaths involving synthetic opioids (primarily fentanyl) numbering 70,601. (6) Between 2019 and 2021, more than 2,200 adolescents overdosed, 96 percent of whom were between the ages of 15 and 19. Fentanyl was involved in 84 percent of the deaths. While counterfeit pill evidence was present in 25 percent of adolescent overdose deaths, this is likely an underestimate because pills present at the scenes of the overdose deaths were not always tested. (7) Many overdose deaths are preventable with public health interventions such as education, harm reduction, and treatment access. (8) Public education campaigns can teach teenagers, parents, and others on the dangers of fentanyl and counterfeit pills and educating individuals on mitigating practices can be beneficial, including emphasis on not initiating drug use, not using drugs while alone, using fentanyl test strips, and having overdose reversal drugs readily available. (9) Opioid antagonists, such as naloxone, can be used during emergencies to reverse opioid overdoses and are effective at preventing fatal drug overdoses. (10) The Centers for Disease Control and Prevention reported that despite an increase in prescriptions for emergency opioid antagonists, not enough of the medication is getting into the hands of those who need it most. (11) Expanding access to emergency opioid antagonists and encouraging people to obtain emergency opioid antagonists are in the best interest of the health and safety of the public. (12) Increasing access to medications like methadone and buprenorphine that effectively treat opioid use disorder can save lives. (13) Greater access to drug detection tools such as fentanyl strips are a low-cost method of helping prevent drug overdoses and reducing harm. 3. Comprehensive Opioid Abuse Grant Program Section 3021 of title I of the Omnibus Crime Control and Safe Streets Act of 1968 ( 34 U.S.C. 10701(a) ) is amended— (1) in subsection (a), by adding at the end the following: (11) Developing, implementing, or expanding a program that provides training and resources for teachers and other school officials in public or private middle schools, high schools, institutions of higher education (as such term is defined in section 101 of the Higher Education Act of 1965), or area career and technical education schools (as such term is defined in section 3 of the Carl D. Perkins Career and Technical Education Act of 2006) on— (A) carrying and administering an opioid overdose reversal drug or device approved or cleared by the Food and Drug Administration; or (B) acquiring such a drug or device for teachers and other school officials who have received such training to so carry and administer such a drug or device. ; and (2) by adding at the end the following: (g) Preferential consideration In awarding grants under this part, the Attorney General may give preferential consideration to an application from an applicant in a State that has in effect a law that exempts from criminal and civil liability teachers and other school officials who carry or administer in good faith an opioid overdose reversal drug or device approved or cleared by the Food and Drug Administration if trained to carry or administer such drug or device. . 4. Prevention and treatment of fentanyl-laced substance use (a) Prevention The Secretary of Health and Human Services, in consultation with the Attorney General, shall develop and implement a national strategy to prevent the use of fentanyl-laced substances. The strategy shall include the following elements: (1) Education and outreach to the public about the dangers of fentanyl-laced substances. (2) Development of treatment programs for individuals who are addicted to fentanyl-laced substances. (b) Treatment The Secretary of Health and Human Services shall provide grants to States and localities to support the development and implementation of treatment programs for individuals who are addicted to fentanyl-laced substances. 5. Enhanced law enforcement efforts (a) Increased resources The Attorney General shall increase the resources available to law enforcement agencies to combat the trafficking of fentanyl-laced substances. The Attorney General shall prioritize the following activities: (1) Investigation and prosecution of individuals who traffic fentanyl-laced substances. (2) Disruption of the supply chain for fentanyl-laced substances. (3) Prevention of the importation of fentanyl-laced substances into the United States. (b) Interagency coordination The Attorney General shall establish an interagency task force to coordinate the efforts of Federal, State, and local law enforcement agencies to combat the trafficking of fentanyl-laced substances. 6. Research The Secretary of Health and Human Services shall conduct research on the following topics: (1) The effects of fentanyl-laced substances on human health. (2) The development of new treatments for individuals who are addicted to fentanyl-laced substances. (3) The best practices for preventing the use of fentanyl-laced substances. 7. Increase in punishment Section 303(b) of the Federal Food, Drug, and Cosmetic Act ( 21 U.S.C. 333(a) ) is amended by adding at the end the following: (9) (A) Notwithstanding subsection (a)(1), any person who violates subsection (a), (b), (c), or (g) of section 301 with respect to any drug, if such violation results in— (i) serious bodily injury, shall be imprisoned not more than 10 years, fined not more than $1,000,000, or both; or (ii) death, shall be imprisoned for any term of years or for life, fined not more than $5,000,000, or both. (B) Notwithstanding subsection (a)(2), any person who violates subsection (a), (b), (c), or (g) of section 301 with respect to any drug with the intent to defraud or mislead, if such violation results in— (i) serious bodily injury, shall be imprisoned not more than 20 years, fined not more than $5,000,000, or both; or (ii) death, shall be imprisoned for any term of years or for life, fined not more than $10,000,000, or both. (C) Any person who violates subsection (a), (b), (c), or (g) of section 301 with respect to any drug promoted or sold online shall, in addition the punishment provided for such violation, be sentenced to a term of imprisonment of not more than 5 years. . 8. Sense of Congress It is the sense of Congress that fentanyl deaths should be addressed by— (1) increasing funding for prevention and treatment programs, including— (A) programs that provide education and treatment for people who are at risk of opioid addiction or overdose; and (B) school-based programs, community outreach programs, and treatment centers; (2) expanding access to naloxone (a medication that can reverse the effects of an opioid overdose) such as by making naloxone available over-the-counter or by providing subsidies for its purchase; (3) cracking down on the trafficking of fentanyl, including— (A) increased efforts both domestically and internationally; (B) increased funding for law enforcement agencies; (C) increased penalties for fentanyl trafficking; and (D) working with other countries to stop the flow of fentanyl across borders; (4) improving data collection and analysis, including the improvement of Federal data collection and analysis on fentanyl deaths, to better understand the scope of the problem and identify effective prevention and treatment strategies; and (5) supporting research on new treatment options, including— (A) support for research on new treatment options for opioid addiction and overdose; and (B) funding for research on new medications, new delivery methods, and new approaches to treatment.