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Homelessness: Targeted Federal Programs [October 18, 2018]
"Federal assistance targeted to homeless individuals and families was largely nonexistent prior to the mid-1980s. Although the Runaway and Homeless Youth program was enacted in 1974 as part of the Juvenile Justice and Delinquency Prevention Act (P.L. 93-415), the first federal program focused on assisting all homeless people, no matter their age, was the Emergency Food and Shelter (EFS) program, established in 1983 through an emergency jobs appropriation bill (P.L. 98-8). The EFS program was and continues to be administered by the Federal Emergency Management Agency (FEMA) in the Department of Homeland Security (DHS) to provide emergency food and shelter to needy individuals."
Library of Congress. Congressional Research Service
Perl, Libby; Boyd, Eugene; Duff, Johnathan H. . . .
2018-10-18
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Opioid Treatment Programs and Related Federal Regulations [June 26, 2018]
"Federally certified opioid treatment programs (OTPs)-- often called methadone clinics--offer opioid medications, counseling, and other services for individuals addicted to heroin or other opioids. The use of opioid medications to treat opioid addiction is subject to federal regulations beyond those that apply to the same medications used for other purposes (e.g., treating pain). The medications methadone and buprenorphine are both opioids; their use to treat opioid addiction is often called opioid substitution therapy or opioid replacement therapy. With few exceptions, the use of methadone to treat opioid addiction is limited to OTPs; however, physicians who wish to treat opioid addiction using buprenorphine may obtain a waiver to do so outside an OTP. A non-opioid medication used in the treatment of opioid addiction, naltrexone, may be used by OTPs, physicians with waivers, or anyone with the authority to write prescriptions."
Library of Congress. Congressional Research Service
Duff, Johnathan H.
2018-06-26
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Buprenorphine and the Opioid Crisis: A Primer for Congress [August 3, 2018]
"Buprenorphine is one of three medications currently used in medication-assisted treatment of opioid use disorders. As such, buprenorphine's effectiveness, safety, and availability are of considerable interest to policymakers seeking to address the ongoing opioid crisis in the United States. During the 115th Congress, committees have held hearings on opioid-related topics such as implementation of the Comprehensive Addiction and Recovery Act of 2016 (CARA, P.L. 114198), the effects of the opioid crisis on families, and opioid use among veterans. Members have introduced more than 150 bills related to opioids. Congressional actions taken in recent years to address the opioid crisis have included attempts to increase access to buprenorphine."
Library of Congress. Congressional Research Service
Duff, Johnathan H.
2018-08-03
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Location of Medication-Assisted Treatment for Opioid Addiction: In Brief [June 24, 2019]
From the Introduction: "The substantial burden of opioid abuse related to the current opioid epidemic in the United States has resulted in a disparity between the need for substance abuse treatment and the current capacity of the health care delivery system to meet that need. In 2017, over 47,600 people died of opioid-related drug overdoses in the United States. In that same year, an estimated 11.4 million people aged 12 and older misused opioids, including 11.1 million misusers of prescription pain relievers and 886,000 heroin users. The majority of individuals in need of treatment do not receive it. In 2016, one-fifth (21.1%) of those with any opioid use disorder (OUD) received specialty substance abuse treatment, including 37.5% of those with heroin use disorder and 17.5% of those with prescription pain reliever use disorders."
Library of Congress. Congressional Research Service
Duff, Johnathan H.; Carter, Jameson A.
2019-06-24
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Buprenorphine and the Opioid Crisis: A Primer for Congress [December 7, 2018]
"Buprenorphine is one of three medications currently used in medication-assisted treatment of opioid use disorders. As such, buprenorphine's effectiveness, safety, and availability are of considerable interest to policymakers seeking to address the ongoing opioid crisis in the United States. During the 115th Congress, committees held hearings on opioid-related topics such as implementation of the Comprehensive Addiction and Recovery Act of 2016 (CARA, P.L. 114-198), the effects of the opioid crisis on families, and opioid use among veterans. Members have introduced more than 150 bills related to opioids. On October 24, 2018, President Trump signed into law H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (the SUPPORT Act; P.L. 115-271), a broad measure designed to address widespread over prescribing and abuse of opioids in the United States. Congressional actions taken in recent years to address the opioid crisis, including the SUPPORT Act, have included attempts to increase access to buprenorphine."
Library of Congress. Congressional Research Service
Duff, Johnathan H.
2018-12-07
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Public Health and Other Related Provisions in P.L 115-271, the SUPPORT for Patients and Communities Act [December 3, 2018]
"On October 24, 2018, President Donald J. Trump signed into law H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (P.L. 115-271; SUPPORT for Patients and Communities Act, or the SUPPORT Act). The final agreement on the bill was approved by the House 393-8 on September 28, 2018, and cleared by the Senate by a vote of 98-1 on October 3, 2018. Over the past several years, there has been growing concern among the public and lawmakers in the United States about rising drug overdose deaths. Opioid overdose deaths, in particular, have increased significantly in the past 15 years. In 2015, an estimated 33,091 Americans died of opioid-related overdoses. Provisional data for 2017 estimate 49,068 deaths involving opioids, representing a fourfold increase over 2002 during the beginning of the epidemic. In October of 2017, President Trump declared the opioid epidemic a national public health emergency."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-; Duff, Johnathan H.; Bradley, David H. . . .
2018-12-03
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Opioid Treatment Programs and Related Federal Regulations [Updated June 12, 2019]
From the Document: "The use of opioid medications to treat opioid addiction is subject to federal regulations beyond those that apply to the same medications used for other purposes (e.g., treating pain). The medications methadone and buprenorphine are both opioids; their use to treat opioid addiction is often called opioid substitution therapy, opioid replacement therapy, or opioid agonist treatment. Federally certified opioid treatment programs (OTPs)--often called methadone clinics--offer these opioid medications in addition to counseling and other services for individuals addicted to heroin or other opioids. [...] To understand how OTPs are regulated, it is helpful to have some background information about the medications used to treat opioid addiction and how each is regulated."
Library of Congress. Congressional Research Service
Duff, Johnathan H.
2019-06-12
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Changes to Behavioral Health Treatment During the COVID-19 Pandemic [Updated November 17, 2020]
From the Document: "Physical distancing measures and temporary stay-at-home orders associated with the Coronavirus Disease 2019 (COVID-19) pandemic have required changes in service delivery for mental health and substance use (collectively known as 'behavioral health') treatment. Changes have surrounded relaxing privacy requirements required by the Health Insurance Portability and Accountability Act (HIPAA) Rules and increasing use of telehealth to deliver behavioral health treatment and services. Some states have also employed other methods of service delivery--such as mobile units--for treatments that cannot be administered via telehealth, such as medication-assisted treatment (MAT) for opioid use disorder (OUD)."
Library of Congress. Congressional Research Service
Duff, Johnathan H.; Sarata, Amanda K.
2020-11-17
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Increase in Illicit Fentanyl Overdose Deaths [June 6, 2018]
"Fentanyl, heroin, and some prescription painkillers (such as morphine and oxycodone) belong to the class of drugs known as opioids, which act on receptors in the brain important in regulating pain and emotion. Opioids have susceptibility for abuse and potential for overdose. In 2016, more than 42,000 of the nearly 64,000 drug overdose deaths in the United States involved opioids. Led by fentanyl, a synthetic opioid 50-100 times more potent than morphine, synthetic opioids emerged as the leading cause of opioid-related overdose deaths in 2016. The steep increase in deaths involving fentanyl is seen as a 'new chapter' in the opioid epidemic."
Library of Congress. Congressional Research Service
Duff, Johnathan H.; Sacco, Lisa N.
2018-06-06
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Opioid Block Grants [May 23, 2022]
From the Document: "Beginning in the late 1990s, the United States experienced a significant increase in opioid-related drug overdose deaths, which rose from 8,050 in 1999 to 49,860 in 2019. To address the rising rates of opioid use and overdose deaths, Congress created new opioid-specific block grant programs that provide funding to increase access to substance use disorder (SUD) treatment such as medication-assisted treatment (MAT) for opioid-use disorder."
Library of Congress. Congressional Research Service
Duff, Johnathan H.
2022-05-23
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Federal Support for School Safety and Security [Updated May 27, 2022]
From the Summary: "In the United States, more than 70 million students are enrolled in public elementary and secondary (K-12) schools or degree-granting postsecondary institutions. School and campus safety and security for these students encompasses many issues, including violence prevention and response, school climate, and the physical and mental health of the school community. Students' safety and security while in school is an area of concern for the federal government and state and local governments, as well as school districts, institutions of higher education, students' families, and Members of Congress. [...] State and local governments oversee K-12 education in public schools. Colleges and universities are a mix of public, private nonprofit, and private for-profit entities with varying governance structures. The federal government's main avenue for supporting schools in general and school and campus safety specifically is through grant programs. This report provides an overview of grant programs at the U.S. Department of Education (ED), U.S. Department of Justice (DOJ), U.S. Department of Homeland Security (DHS), and U.S. Department of Health and Human Services (HHS) that provide direct or indirect funding for school and campus safety and security initiatives. The report also provides an overview of programs and initiatives administered by these departments that support school safety and security efforts in other ways, such as through data collection and reporting and technical assistance."
Library of Congress. Congressional Research Service
Dragoo, Kyrie E.; James, Nathan; Duff, Johnathan H. . . .
2022-05-27
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Federal Support for School Safety and Security [August 10, 2021]
From the Summary: "In the United States, more than 70 million students are enrolled in public elementary and secondary (K-12) schools or degree-granting postsecondary institutions. School and campus safety and security for these students encompasses many issues, including violence prevention and response, school climate, and the physical and mental health of the school community. Students' safety and security while in school is a paramount concern of the federal government and state and local governments, as well as school districts, institutions of higher education, students' families, and Members of Congress."
Library of Congress. Congressional Research Service
Dragoo, Kyrie E.; Reese, Shawn; James, Nathan . . .
2021-08-10
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Federal Support for School Safety and Security [Updated June 15, 2022]
From the Introduction: "In the United States, more than 50 million students are enrolled in public elementary and secondary schools that educate children from pre-kindergarten through 12th grade; nearly 20 million more students attend degree-granting postsecondary institutions. Students' safety and security is a paramount concern of federal, state, and local governments, as well as for school districts, institutions of higher education (IHEs), students' families, and Members of Congress. [...] The ED [U.S. Department of Education ], HHS [U.S. Department of Health and Human Services], DOJ [U.S. Department of Justice], and DHS programs discussed in this report encompass prevention, mitigation and response, or recovery efforts that provide direct or indirect funding for school and campus safety and security initiatives. The program summaries in this report are not comprehensive. In many cases, other Congressional Research Service (CRS) products are referenced as sources for more detailed information about individual programs. This report also provides an overview of federal programs and initiatives that support school safety and security efforts in other ways, such as data collection and technical assistance."
Library of Congress. Congressional Research Service
Dragoo, Kyrie E.; James, Nathan; Duff, Johnathan H. . . .
2022-06-15
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Changes to Behavioral Health Treatment During the COVID-19 Pandemic [July 7, 2020]
From the Document: "Physical distancing measures and temporary stay-at-home orders associated with the Coronavirus Disease 2019 (COVID-19) pandemic have required changes in service delivery for mental health and substance use (collectively known as 'behavioral health') treatment. Changes have surrounded relaxing privacy requirements required by the Health Insurance Portability and Accountability Act (HIPAA) Rules and increasing use of telehealth to deliver behavioral health treatment and services. Some states have also employed other methods of service delivery--such as mobile units--for treatments that cannot be administered via telehealth, such as medication-assisted treatment (MAT) for opioid use disorder (OUD)."
Library of Congress. Congressional Research Service
Duff, Johnathan H.; Elliott, Victoria L.; Sarata, Amanda K.
2020-07-07
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Substance Abuse and Mental Health Services Administration (SAMHSA): Overview of the Agency and Major Programs [June 23, 2020]
From the Background and Role: "The Substance Abuse and Mental Health Services Administration (SAMHSA) is the federal agency primarily responsible for supporting community-based mental health and substance abuse treatment and prevention services. Located within the Department of Health and Human Services (HHS), SAMHSA provides federal funding for these services by administering two large formula-based block grant programs(one for substance abuse prevention and treatment services, the other for mental health services) and other formula and discretionary grants to local communities, states, and private entities. SAMHSA does not directly deliver treatment services. Rather, it supports state and local efforts in providing mental health and substance abuse (collectively known as behavioral health) services, primarily through funding and technical assistance."
Library of Congress. Congressional Research Service
Duff, Johnathan H.
2020-06-23
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Prescription Drug Monitoring Programs [May 24, 2018]
"In the midst of national concern over the opioid epidemic, federal and state officials are paying greater attention to the manner in which opioids are prescribed. Nearly all prescription drugs involved in overdoses are originally prescribed by a physician (rather than, for example, being stolen from pharmacies). Thus, attention has been directed toward better understanding how opioids are being prescribed and preventing the diversion of prescription drugs after the prescriptions are dispensed. Prescription drug monitoring programs (PDMPs) maintain statewide electronic databases of prescriptions dispensed for controlled substances (i.e., prescription drugs with a potential for abuse that are subject to stricter government regulation). Information collected by PDMPs may be used to educate and inform prescribers, pharmacists, and the public; identify or prevent drug abuse and diversion; facilitate the identification of prescription drug-addicted individuals and enable intervention and treatment; outline drug use and abuse trends to inform public health initiatives; or educate individuals about prescription drug use, abuse, diversion, and PDMPs themselves."
Library of Congress. Congressional Research Service
Sacco, Lisa N.; Duff, Johnathan H.; Sarata, Amanda K.
2018-05-24
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Consumption of Prescription Opioids for Pain: A Comparison of Opioid Use in the United States and Other Countries [June 2, 2021]
From the Summary: "Beginning in the late 1990s, the consumption of medical opioids used to treat pain increased in many countries worldwide. Since that time, the United States has outpaced every other country in per capita opioid consumption. Most research suggests that high levels of prescription opioid consumption in the United States have contributed to the current epidemic of opioid misuse and overdose deaths. In response, several states and the U.S. federal government have demonstrated an interest in reducing opioid misuse and overdose deaths through legislation and executive initiatives. Understanding why the United States consumes more opioids per capita than other countries may help Congress construct effective legislation to reduce inappropriate or excess opioid consumption and mitigate related consequences, such as opioid misuse and overdose deaths. In addition, lawmakers in the United States could examine policies in peer countries for possible approaches to curb excessive prescription opioid use. A review of the scientific literature through February 2020 on international opioid consumption and prescribing practices pointed to several possible underlying reasons explaining the difference in opioid consumption per capita in the United States. [...] This report describes trends in opioids use across industrialized countries and identifies possible factors explaining the disproportionate use of prescription opioids in the United States."
Library of Congress. Congressional Research Service
Duff, Johnathan H.; Tharakan, Sara M.; Davis-Castro, Carla Y. . . .
2021-06-02
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U.S. Public Health Service: COVID-19 Supplemental Appropriations in the 116th Congress [March 11, 2021]
From the Introduction: "This report summarizes coronavirus supplemental funding for the public health service agencies and to the PHSSEF [ Public Health and Social Services Emergency Fund] in the 116th Congress. It also includes resources for tracking spending. Funding has been provided across five supplemental appropriations measures: [1] 'First Measure:' Division A of the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (P.L. [public law] 116-123), enacted on March 6, 2020. [2] 'Second Measure:' Division A of the Families First Coronavirus Response Act (FFCRA, P.L. 116-127), enacted on March 18, 2020. [3] 'Third Measure:' Division B of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act, P.L. 116-136), enacted on March 27, 2020. [4] 'Fourth Measure:' Division B, of the Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA, P.L. 116-139), enacted on April 24, 2020. [5] 'Fifth Measure:' Division M of Consolidated Appropriations Act, 2021 (P.L. 116- 260), enacted on December 27, 2020. This report provides an overview of each of the PHS [U.S. Public Health Service] agencies, as well as the PHSSEF."
Library of Congress. Congressional Research Service
Sekar, Kavya; Bodie, Agata; Cornell, Ada S. . . .
2021-03-11
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American Rescue Plan Act of 2021 (P.L. 117-2): Public Health, Medical Supply Chain, Health Services, and Related Provisions [July 2, 2021]
From the Introduction: "The American Rescue Plan Act of 2021 (ARPA; P.L. 117-2) is the sixth major legislative package in a series to address domestic public health and health system challenges related to the Coronavirus Disease 2019 (COVID-19) pandemic--the most consequential and widespread domestic infectious disease emergency in over a century. ARPA follows several earlier COVID-19 pandemic response measures enacted in 2020. ARPA includes provisions addressing a number of issues, such as tax credits, unemployment benefits, state fiscal relief, health, housing, education, and food assistance, among others. This report describes ARPA's public health, behavioral health, medical supply chain, and health-related workforce, services, and support provisions."
Library of Congress. Congressional Research Service
Duff, Johnathan H.; Cecire, Michael; Sekar, Kavya . . .
2021-07-02
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Behavioral Health During the COVID-19 Pandemic: Overview and Issues for Congress [July 2, 2021]
From the Summary: "Circumstances surrounding the Coronavirus Disease 2019 (COVID-19) pandemic--including mitigation strategies to prevent spread of the virus--appear to have adversely affected the mental health of many Americans. According to some studies, Americans experienced elevated levels of emotional distress, anxiety, depression, substance use, and drug-related overdoses in 2020 and 2021 compared with the same time period in previous years. Various stressors related to the pandemic may have contributed to decreased mental well-being, such as fears about contracting the virus, anxiety about its health effects, social isolation due to physical distancing measures, financial stress due to the economic consequences of the pandemic, grief and bereavement due to the death of a loved one, exposure to pandemic-related media coverage, and interruptions to substance use treatment and mental health care."
Library of Congress. Congressional Research Service
Duff, Johnathan H.; Romero, Paul D.; Sarata, Amanda K.
2021-07-02
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Mental Health Funding in the Bipartisan Safer Communities Act [July 20, 2022]
From the Document: "On June 25, 2022, the Bipartisan Safer Communities Act (BSCA; P.L. 117-159) was signed into law. In addition to provisions addressing firearms, education, and Medicaid, the act included appropriations for several existing mental health-related grant programs. Division B, Title II of the act appropriated $800 million to the Substance Abuse and Mental Health Services Administration (SAMHSA) within the Department of Health and Human Services (HHS)--the federal agency primarily responsible for supporting community or school-based mental health treatment and prevention services. SAMHSA provides funding to states, local communities, and service providers through block grants and other formula and competitive grants. For more information on SAMHSA, see CRS Report R46426, 'Substance Abuse and Mental Health Services Administration (SAMHSA): Overview of the Agency and Major Programs' [hyperlink]."
Library of Congress. Congressional Research Service
Duff, Johnathan H.
2022-07-20
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