Comprehensive Addiction and Recovery Act of 2016 became law 526 days after introduction, with cosponsors split almost evenly between the parties

TITLE I--PREVENTION AND EDUCATION

(Sec. 101) This bill requires the Department of Health and Human Services (HHS), in cooperation with the Department of Veterans Affairs, the Department of Defense, and the Drug Enforcement Administration , to convene a Pain Management Best Practices Interagency Task Force to review, modify, and update best practices for pain management and prescription of pain medication. The task force does not have rulemaking authority.

(Sec. 102) It directs HHS to promote education and awareness of prescription opioid abuse. Such education and training must include information on the dangers, prevention, and early warning signs of opioid abuse. (Opioids are drugs with effects similar to opium, such as certain prescription pain medication, fentanyl [a synthetic opioid], and heroin.) The Office of National Drug Control Policy must establish a national drug awareness campaign that addresses the similarities between opioids and heroin, the link between prescription opioid abuse and heroin use, and the dangerous effects of mixing fentanyl with heroin.

(Sec. 103) The bill amends the Omnibus Crime Control and Safe Streets Act of 1968 to authorize HHS to award grants to community-based coalitions to enhance community-wide prevention strategies to address a high rate or rapid increase of opioid or methamphetamine abuse.

TITLE II--LAW ENFORCEMENT AND TREATMENT

(Sec. 201) HHS may award grants to state, local, or tribal governments or nonprofit organizations to develop, implement, or expand treatment alternative to incarceration programs and to enhance state criminal justice and substance abuse agency collaboration to address prescription opioid abuse and heroin use. HHS must give priority to joint applications from criminal justice and substance abuse agencies and applications from states that provide civil liability protection for trained first responders, health professionals, or family members who administer an opioid overdose reversal drug (e.g., naloxone) to counteract opioid overdose.

(Sec. 202) HHS may award grants to state, local, or tribal governments to allow appropriately trained first responders to administer an opioid overdose reversal drug to treat an opioid overdose. Grant funds must be used to equip first responders with opioid overdose reversal drugs, train first responders to administer such drugs, and develop protocols to refer overdose victims to appropriate treatment. HHS must provide technical assistance and training grants. At least 25% of grant funds must be awarded to entities in rural areas with limited access to emergency medical services.

(Sec. 203) The Department of Justice (DOJ) must expand or make available disposal sites for unwanted prescription medications.

(Sec. 204) DOJ may make grants to state law enforcement agencies to investigate illicit activities related to: (1) heroin, fentanyl, or unlawful prescription opioid distribution, and (2) precursor diversion, laboratories, or methamphetamine manufacture or distribution.

TITLE III--TREATMENT AND RECOVERY

(Sec. 301) The bill authorizes the Substance Abuse and Mental Health Services Administration (SAMHSA) to award grants to state, local, or tribal governments or community-based organizations to expand treatment programs, including medication-assisted treatment programs, in areas with a high rate or rapid increase in prescription opioid or heroin use. SAMHSA must equitably distribute grants geographically, evaluate grant-supported activities, and provide technical assistance.

(Sec. 302) HHS may award grants to state, local, or tribal governments to implement medication-assisted treatment programs through courts, prisons, jails, or other criminal justice agencies. HHS must prioritize entities in states that provide civil liability protection for trained first responders, health professionals, or family members who administer naloxone to counteract opioid overdose. Additionally, HHS must provide technical assistance and training to grant recipients.

(Sec. 303) HHS may award grants to high schools, institutions of higher education, or nonprofit organizations to provide recovery support services, build supportive communities, and promote sustained recovery for young people with substance use disorders.

(Sec. 304) HHS may award matching grants to recovery community organizations to expand, develop, and enhance state and community recovery support services to facilitate long-term recovery from substance use disorders. A recovery community organization is an independent nonprofit organization that is led by individuals who are in long-term recovery from substance abuse disorders.

TITLE IV--ADDRESSING COLLATERAL CONSEQUENCES

(Sec. 401) The bill authorizes DOJ to award grants to state, local, or tribal governments to design, implement, and expand educational programs for offenders in prisons, jails, and juvenile facilities. A grant recipient may restrict prisoners' Internet access to ensure public safety.

(Sec. 402) DOJ must establish a bipartisan Task Force on Recovery and Collateral Consequences to identify collateral consequences imposed on convicted drug offenders who are in recovery for a substance use disorder and develop and submit legislative and regulatory recommendations to modify such collateral consequences. A collateral consequence is a penalty imposed as a result of a criminal conviction but not as part of the court judgment.

TITLE V--ADDICTION AND TREATMENT SERVICES FOR WOMEN, FAMILIES, AND VETERANS

(Sec. 501) The bill authorizes SAMHSA to create a pilot program to award competitive grants to state substance abuse agencies to support family-based services for pregnant and postpartum women with a substance use disorder, address gaps in services provided to women in non-residential based settings, and encourage evidence-based services. The Center for Behavioral Health Statistics and Quality must evaluate the pilot program and report to Congress.

(Sec. 502) DOJ must annually report the number of grant awards under the Family-Based Adult Offender Substance Abuse Treatment Program and how such grants are used for family-based substance abuse treatment programs that serve as an alternative to incarceration for custodial parent drug offenders.

TITLE VI--INCENTIVIZING STATE COMPREHENSIVE INITIATIVES TO ADDRESS OPIOID AND HEROIN ABUSE

(Sec. 601) DOJ may award grants to states to establish and implement a comprehensive response to opioid abuse that includes prevention and education efforts, a prescription drug monitoring program, prescription drug and opioid addiction treatment programs, and overdose death prevention programs. DOJ must give priority to states that: (1) provide civil liability protection for trained first responders, health professionals, or family members who administer naloxone; (2) do not terminate Medicaid eligibility for individuals who are incarcerated for less than two years; (3) enroll incarcerated drug offenders in community-based treatment services prior to reentry; and (4) record, share, or analyze data from prescription drug monitoring database to identify potential abuse.

TITLE VII--MISCELLANEOUS

(Sec. 701) The Government Accountability Office must report to Congress on how the Medicaid institutions for mental disease (IMD) exclusion impacts access to inpatient treatment and quality of inpatient and outpatient treatment for Medicaid enrollees with substance use disorders. The Medicaid IMD exclusion bars Medicaid reimbursement for certain inpatient mental health care services (including substance use disorder treatment) for patients aged 21 to 64.

(Sec. 702) The bill authorizes addiction and recovery programs under this Act through FY2020.

(Sec. 704) It prohibits the use of DOJ and HHS grants under this Act for conferences that cost more than $20,000 without prior written approval. The Inspector General for DOJ and HHS must conduct annual audits of selected grant recipients. It bars DOJ and HHS grants to nonprofit organizations that hold money in an offshore account to avoid tax liability. Additionally, DOJ and HHS must identify and report on duplicative grant awards.

(Sec. 705) This bill amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to authorize a Medicare prescription drug plan (PDP) sponsor to establish a drug management program to limit the prescribers and pharmacies who provide frequently abused drugs to an at-risk beneficiary. A PDP sponsor must have in place a utilization management tool to prevent drug abuse. A PDP sponsor must: (1) notify a beneficiary who is identified as being at-risk for prescription drug abuse, (2) consider the beneficiary's preferences in selecting allowable prescribers and pharmacies, and (3) ensure the beneficiary has continued reasonable access to drugs. The bill exempts from identification as at-risk beneficiary an individual who is receiving hospice care or residing in a long-term care facility. HHS must establish procedures for PDP plan sponsors to share information about at-risk beneficiaries.

TITLE VIII--TRANSNATIONAL DRUG TRAFFICKING ACT Transnational Drug Trafficking Act of 2015

(Sec. 802) This bill amends the Controlled Substances Import and Export Act to broaden the scope of persons subject to criminal prosecution for manufacturing or distributing a controlled substance in schedule I or II, a precursor chemical, or flunitrazepam for unlawful import into the United States. The Controlled Substances Act classifies drugs, substances, and chemicals used to make drugs into one of five schedules based on the drug's medical use, potential for abuse, and risk of dependence. Current law prohibits such manufacture or distribution by a person who knows or intends that the substance or chemical will be unlawfully imported. This bill broadens the scope to also prohibit such manufacture or distribution by a person who reasonably believes that the substance or chemical will be unlawfully imported. In addition, this bill prohibits the manufacture or distribution of a precursor chemical by a person who: (1) knows or intends that the chemical will be used to manufacture a controlled substance; and (2) knows, intends, or reasonably believes that the controlled substance will be unlawfully imported into the United States.

(Sec. 803) The legislation amends the federal criminal code to replace statutory references to prohibited trafficking in a "counterfeit drug" with references to prohibited trafficking in a "drug that uses a counterfeit mark on or in connection with the drug."