Senate Report 116-248 - EXPANDING FINDINGS FOR FEDERAL OPIOID RESEARCH AND TREATMENT ACT

[Senate Report 116-248]
[From the U.S. Government Publishing Office]

Calendar No. 510

116th Congress } { REPORT
SENATE
2d Session } { 116-248
_______________________________________________________________________

EXPANDING FINDINGS FOR FEDERAL OPIOID RESEARCH AND TREATMENT ACT

__________

R E P O R T

of the

COMMITTEE ON COMMERCE, SCIENCE, AND TRANSPORTATION

H.R. 3153

August 6, 2020.--Ordered to be printed

______

U.S. GOVERNMENT PUBLISHING OFFICE
99-010 WASHINGTON : 2020

SENATE COMMITTEE ON COMMERCE, SCIENCE, AND TRANSPORTATION
one hundred sixteenth congress
second session

ROGER F. WICKER, Mississippi, Chairman
JOHN THUNE, South Dakota MARIA CANTWELL, Washington
ROY BLUNT, Missouri AMY KLOBUCHAR, Minnesota
TED CRUZ, Texas RICHARD BLUMENTHAL, Connecticut
DEB FISCHER, Nebraska BRIAN SCHATZ, Hawaii
JERRY MORAN, Kansas EDWARD J. MARKEY, Massachusetts
DAN SULLIVAN, Alaska TOM UDALL, New Mexico
CORY GARDNER, Colorado GARY C. PETERS, Michigan
MARSHA BLACKBURN, Tennessee TAMMY BALDWIN, Wisconsin
SHELLEY MOORE CAPITO, West Virginia TAMMY DUCKWORTH, Illinois
MIKE LEE, Utah JON TESTER, Montana
RON JOHNSON, Wisconsin KYRSTEN SINEMA, Arizona
TODD C. YOUNG, Indiana JACKY ROSEN, Nevada
RICK SCOTT, Florida
John Keast, Staff Director
David Strickland, Minority Staff Director

Calendar No. 510

116th Congress } { Report
SENATE
2d Session } { 116-248

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EXPANDING FINDINGS FOR FEDERAL OPIOID RESEARCH AND TREATMENT ACT

_______

August 6, 2020.--Ordered to be printed

_______

Mr. Wicker, from the Committee on Commerce, Science, and
Transportation, submitted the following

R E P O R T

[To accompany H.R. 3153]

[Including cost estimate of the Congressional Budget Office]

The Committee on Commerce, Science, and Transportation, to
which was referred the bill (H.R. 3153) to direct the Director
of the National Science Foundation to support research on
opioid addiction, and for other purposes, having considered the
same, reports favorably thereon with an amendment (in the
nature of a substitute) and recommends that the bill (as
amended) do pass.

PURPOSE OF THE BILL

The purpose of this bill would be to direct the Director of
the National Science Foundation (NSF) to support further
research on opioid addiction and other purposes.

BACKGROUND AND NEEDS

Every day, over 192 deaths occur due to drug overdoses in
the United States.\1\ In 2017, there were 70,237 deaths
associated with drug use in the United States.\2\ According to
the Centers for Disease Control and Prevention (CDC), there
have been three distinct waves of increases in opioid deaths in
the modern era.\3\ Beginning in the 1990s, opioid deaths were
attributed mostly to overdose of prescription drugs (e.g.,
natural and semi-synthetic opioids and methadone).\4\ The
second wave began in 2010, when overdose deaths involving
heroin increased dramatically.\5\ Then, in 2013, there were
significant increases in deaths related to synthetic opioids,
specifically those containing illicitly manufactured fentanyl
(IMF), which has been consistently found in combination with
heroin, counterfeit pills, and cocaine.\6\ The CDC continues to
fight the opioid epidemic, which persists today. The agency has
partnered with States and communities to identify outbreaks,
collect data, and respond to overdoses. The CDC's main focus
lies in building prevention efforts, improving data quality and
tracking trends, supporting healthcare providers and health
systems, partnering with public safety, and encouraging
consumers to make safe choices.\7\ However, the worsening state
of the epidemic has revealed large inconsistencies and gaps in
research needed to fully understand and address critical
problems.
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\1\U.S. Department of Health and Human Services, Centers for
Disease Control and Prevention, ``Opioid Overdose: Drug Overdose
Deaths,'' (https://www.cdc.gov/drugoverdose/data/statedeaths.html)
(accessed Apr. 2, 2020).
\2\U.S. Department of Health and Human Services, Centers for
Disease Control and Prevention, ``Drug and Opioid-Involved Overdose
Deaths--United States, 2017-2018,'' (https://www.cdc.gov/mmwr/volumes/
69/wr/mm6911a4.htm) (accessed Apr. 2, 2020).
\3\U.S. Department of Health and Human Services, Centers for
Disease Control and Prevention, ``Three Waves of Opioid Overdose
Deaths,'' (https://www.cdc.gov/drugoverdose/epidemic/index.html)
(accessed Apr. 2, 2020).
\4\Id.
\5\Id.
\6\Id. See also Rudd RA, Aleshire N, Zibbell JE, Gladden RM,
``Increases in Drug and Opioid Overdose Deaths--United States, 2000-
2014,'' MMWR, Jan. 1, 2016, 64(50); 1378-82 (https://www.cdc.gov/mmwr/
preview/mmwrhtml/mm6450a3.htm) (accessed Apr. 2, 2020).
\7\U.S. Department of Health and Human Services, Centers for
Disease Control and Prevention, ``Opioid Overdose: Understanding the
Epidemic,'' (https://www.cdc.gov/drugoverdose/
epidemic/index.html) (accessed Apr. 2, 2020).
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In response to the knowledge gaps relating to opioids, the
Office of Science and Technology Policy (OSTP) established a
Fast-Track Action Committee on Health Science and Technology
Response to the Opioid Crisis (Opioid FTAC) under the National
Science and Technology Council (NSTC). The Opioid FTAC
published a research roadmap identifying seven priority
research areas in order to support the response to the crisis.
These areas include the biology and chemistry of pain and
opioid addiction, non-biological contributors to opioid
addiction, pain management, prevention of opioid addiction,
treatment of opioid addiction and withdrawal, overdose
prevention and recovery, community consequences of opioid
addiction, and opportunities for enhanced coordination.\8\ In
addition, a separate interagency committee, the Interagency
Pain Research Coordinating Committee (IPRCC), published a
Federal Pain Research Strategy (FPRS). The FPRS is intended to
provide a long term strategic plan on advancing Federal pain
research.\9\
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\8\National Science and Technology Council, Fast Track Action
Committee on Health Science and Technology Response to the Opioid
Crisis Committee on Science, ``Health Research and Development to Stem
the Opioid Crisis: A National Roadmap,'' pg. vi, Oct. 2018 (https://
www.nih.gov/sites/default/files/Health-RD-to-Stem-Opioid-Crisis-2018-
Roadmap-for-Public-Comment.pdf) (accessed Apr. 2, 2020).
\9\National Science and Technology Council, Interagency Pain
Research Coordinating Committee, ``Federal Pain Research Strategy
Overview,'' Dec. 12, 2018 (https://www.iprcc.nih.gov/Federal-Pain-
Research-Strategy/Overview) (accessed Apr. 2, 2020).
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As the agency focused on health research, the National
Institute of Health (NIH) is the Federal lead for research on
the opioid epidemic, but the NSF plays a role as well. For
example, the NSF has funded research exploring the connection
between the healthcare system and law enforcement workers to
develop solutions that will positively impact both fields,
which requires analyzing social problems, socio-ecological and
socio-legal factors, and intersections between law and
medicine.\10\ The Opioid FTAC roadmap highlighted interagency
collaboration as an important facet of improving all agencies'
research on this topic, as each agency brings its own strengths
to the research bench.\11\
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\10\National Science Foundation, Sociology, LSS-Law and Social
Sciences, ``CAREER: The Influence of Social Problems on Healthcare and
Legal Institutions, Abstract Award,'' Sep. 11, 2019 (https://
www.nsf.gov/awardsearch/
showAward?AWD_ID=1753308&HistoricalAwards=false) (accessed Apr. 2,
2020).
\11\National Science and Technology Council, Fast Track Action
Committee on Health Science and Technology Response to the Opioid
Crisis Committee on Science, ``Health Research and Development to Stem
the Opioid Crisis: A National Roadmap,'' pg. vi, Oct. 2018 (https://
www.nih.gov/sites/default/files/Health-RD-to-Stem-Opioid-Crisis-2018-
Roadmap-for-Public-Comment.pdf) (accessed Apr. 2, 2020).
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SUMMARY OF PROVISIONS

This legislation would direct the Director of the NSF, in
conjunction with the Director of the NIH, to support merit-
reviewed and competitively awarded research on the science of
opioid addiction.

LEGISLATIVE HISTORY

H.R. 3153 was introduced on June 6, 2019, by Representative
Wexton (for herself and Representatives Baird, Dean, Connolly,
Fitzpatrick, and Kilmer) and was referred to the Committee on
Science, Space, and Technology of the House of Representatives.
There are 20 additional cosponsors. On June 20, 2019, that
Committee met in Executive Session and, by voice vote, ordered
H.R. 3153 reported favorably without amendment. H.R. 3153 was
reported by that Committee on June 27, 2019, and it was passed
under suspension of the rules on July 23, 2019, in the House of
Representatives.
On July 24, 2019, H.R. 3153 was received in the Senate and
referred to the Committee on Commerce, Science, and
Transportation of the Senate. On November 13, 2019, the
Committee met in open Executive Session and, by voice vote,
ordered H.R. 3153 reported favorably with an amendment (in the
nature of a substitute) offered by Senator Gardner.
A companion bill, S. 2354, was introduced on July 31, 2019,
by Senator Coons (for himself and Senator Gardner) and was
referred to the Committee on Commerce, Science, and
Transportation of the Senate.

ESTIMATED COSTS

In accordance with paragraph 11(a) of rule XXVI of the
Standing Rules of the Senate and section 403 of the
Congressional Budget Act of 1974, the Committee provides the
following cost estimate, prepared by the Congressional Budget
Office:

H.R. 3153 would authorize the appropriation of $10 million
annually over the 2020-2024 period for the National Science
Foundation (NSF) to support research on the science of opioid
addiction.
Using information from the NSF, CBO estimates that the
agency allocated $5 million in 2019 for those purposes. Because
CBO estimates the budgetary effects of continuing resolutions
on an annualized basis, in 2020 CBO assumes that the NSF will
allocate the same amount from funds made available under the
current continuing resolution (Public Law 116-69). As a result,
CBO estimates that H.R. 3153 would authorize an increase in
spending subject to appropriation in 2020 of $5 million, the
difference between the authorized amount and the annualized
amount under the continuing resolution. Assuming appropriation
of the authorized amounts, and based on historical spending
patterns for similar activities, CBO estimates that
implementing the legislation would cost $27 million over the
2020-2024 period and $18 million after 2024.
The costs of the legislation (detailed in Table 1) fall
within budget function 250 (science, space, and technology).

Table 1.--ESTIMATED INCREASES IN SPENDING SUBJECT TO APPROPRIATION UNDER H.R. 3153
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By fiscal year, millions of dollars--
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2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2020-2024 2020-2029
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Authorization1a............................................. 5 10 10 10 10 0 0 0 0 0 45 45
Estimated Outlays........................................... 1 3 6 8 9 8 5 3 1 1 27 45
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aH.R. 3153 would authorize the appropriation of $10 million in 2020 for the NFS to support research on opiod addiction. However using information from
the NSF, CBO estimates that $5 million has been allocated on an annualized basis from funds made available under the current continuing resolution
(Public Law 116-69), which provided appropriations through December 20, 2019. Thus, the estimated authorization for 2020, ($5 million) is equal to the
specified amount ($10 million) minus the annualized amount from the continuing resolution ($5 million).

On June 25, 2019, CBO transmitted a cost estimate for H.R.
3153, the EFFORT Act, as ordered reported by the House
Committee on Science, Space, and Technology on June 20, 2019.
Both versions of the legislation would direct the NSF to
support research on the science of opioid addiction, however,
H.R. 3153 as ordered reported by the Senate Committee on
Commerce, Science, and Transportation also would authorize
appropriations for that purpose. Accordingly, CBO's estimates
of the budgetary effects reflect that difference.
The CBO staff contact for this estimate is Janani
Shankaran. The estimate was reviewed by H. Samuel Papenfuss,
Deputy Assistant Director for Budget Analysis.

REGULATORY IMPACT STATEMENT

Because H.R. 3153 does not create any new programs, the
legislation will have no additional regulatory impact, and will
result in no additional reporting requirements. The legislation
will have no further effect on the number or types of
individuals and businesses regulated, the economic impact of
such regulation, the personal privacy of affected individuals,
or the paperwork required from such individuals and businesses.

CONGRESSIONALLY DIRECTED SPENDING

In compliance with paragraph 4(b) of rule XLIV of the
Standing Rules of the Senate, the Committee provides that no
provisions contained in the bill, as reported, meet the
definition of congressionally directed spending items under the
rule.

SECTION-BY-SECTION ANALYSIS

Section 1. Short title; findings.

This section would provide that the bill may be cited as
the ``Expanding Findings for Federal Opioid Research and
Treatment Act'' or the ``EFFORT Act''.
This section also would describe congressional findings
which detail that there are gaps in opioid addiction research
and notes that the NSF and NIH have been influential in
providing expertise to develop understanding in many key areas
relating to the opioid crisis. The findings note that NSF and
NIH have recognized that this research would benefit from
multidisciplinary collaboration.

Section 2. NSF support of research on opioid addiction.

This section would direct NSF and NIH to support merit-
reviewed and competitively awarded research on the science of
opioid addiction. This section also authorizes to be
appropriated $10 million for each of fiscal years 2020 through
2024 in order to carry out the section.

CHANGES IN EXISTING LAW

In compliance with paragraph 12 of rule XXVI of the
Standing Rules of the Senate, the Committee states that the
bill as reported would make no change to existing law.