House Conferees Announced, Senate Not Yet Announced Republicans: Leader: Majority Leader Rep. Kevin McCarthy Rep. Fred Upton (R-MI) Rep. Robert Goodlatte (R-VA) Rep. Jim Sensenbrenner (R-WI) Rep. Lamar Smith (R-TX) Rep. Tom Marino (R-PA) Rep. Doug Collins (R-GA) Rep. Dave Trott (R-MI) Rep. Mike Bishop (R-PA) Rep. Joe Pitts (R-PA) Rep. Leonard Lance (R-NJ) Democrats: Leader: Rep. Frank Pallone Ranking Member of the Energy and Commerce Committee Rep. John Conyers (D-MI) Rep. Robert Scott (D-VA) Rep. Jim McDermott (D-WA) Rep. Gene Green (D-TX) Rep. Sheila Jackson Lee (D-TX) Rep. Joe Courtney (D-CT) Rep. Steve Cohen (D-TN) Rep. John Sarbanes (D-MD) PASSED OPIOID LEGISLATION TO BE RECONCILED Senate and House to Reconcile Opioid Legislation; Faces Major Differences and Lack Of Funding S. 524 and 17 Opioid Bills to be Reconciled Before Going to President May 17, 2016 | Emilia Varrone Sources: Congress.gov, 2016; The Week in Congress, 2016; Tanya Snyder, “Congress Passed 18 bills to Address the Opioid Epidemic, but Where’s the Money?” Patch, May 16, 2016; Laura Litvan, "Opioid Abuse Bill Passes U.S. House Without Funds Attached," Bloomberg, May 12, 2016; Matt Fuller et al., "The House Just Passed Opioid Legislation, But There's Still a Fight Ahead," Huffington Post, May 11, 2016; "Comprehensive Addiction and Recovery Act (CARA)" CADCA, May 17, 2016; Lindsay McPherson, “ House Names Members to Opioids Conference Committee,” Roll Call, May 18, Reconciliation of Opioid Bills The Senate bill is focused on treatment and recovery. House bills emphasize prevention and law enforcement aspects. These initiatives may be difficult to reconcile in the conference committee Importantly, the bills do not indicate where the funding for the initiatives will come from. However, Republicans say the federal budget has several funding sources that can be made available if the bills pass. The fight for new funding will continue during conference committee discussions Rep. Kevin McCarthy (R- CA) Rep. Frank Pallone (D-NJ) Rep. Ben Ray Lujan (D-NM) Rep. Judy Chu (D-CA) Rep. Elizabeth Esty (D-CT) Rep. Ann Kuster (D-NH) Rep. Raul Ruiz (D-CA) Rep. Brett Guthrie (R-KY) Rep. Adam Kinzinger (R-IL) Rep. Larry Bucshon (R-IN) Rep. Susan Brooks (R-IN) Rep. Lou Barletta (R-PA) Rep. Earl Carter (R-GA) Rep. Gus Bilirakis (R-FL) Rep. Jackie Walorski (R-IN) Rep. Patrick Meehan (R-PA) Rep. Robert Dold (R-IL)

SENATE OPIOID LEGISLATION Senate Passed Comprehensive Addiction and Recovery Act to Respond to Opioid Crisis Details on S.524 – Comprehensive Addiction and Recovery Act May 17, 2016 | Emilia Varrone Sources: Congress.gov, 2016; The Week in Congress, 2016; Tanya Snyder, “Congress Passed 18 bills to Address the Opioid Epidemic, but Where’s the Money?” Patch, May 16, 2016; Laura Litvan, "Opioid Abuse Bill Passes U.S. House Without Funds Attached," Bloomberg, May 12, 2016; Matt Fuller et al., "The House Just Passed Opioid Legislation, But There's Still a Fight Ahead," Huffington Post, May 11, 2016; "Comprehensive Addiction and Recovery Act (CARA)" CADCA, May 17, 2016, Lynn Arditi, “CARA One Pager” Providence Journal, March 10, Senate Passed Comprehensive Bill on Opioid Crisis S.524: Comprehensive Addiction & Recovery Act (CARA) Sponsored by Senators Sheldon Whitehouse (D- RI) and Rob Portman (R- OH) CARA is focused on treatment and recovery and amends several older pieces of legislation to award grants to local, state and federal treatment programs Main initiatives of CARA: Authorizes grants to states to implement comprehensive prevention of opioid abuse and recovery promotion plans Expands prevention, awareness & educational efforts Strengthens law enforcement tools, allows development of treatment alternatives to incarcerations, expands availability of overdose reversal drug Naloxone to first responders, and expands take-back programs for unwanted prescriptions. Launches evidence-based treatment and intervention programs nationally, as well as expands recovery support services for youth. Strengthens state prescription drug monitoring programs (PDMPs) Targets treatment of women and veterans, specifically pregnant and post-partum women. Senator Sheldon Whitehouse (D- RI) Senator Rob Portman (R- OH) CARA passed by a 91-1 vote

OPIOID LEGISLATION PASSES THE HOUSE 18 Public Health Bills Pass in the House, 17 of Which Are Specifically Aimed at Fighting Opioid Epidemic List of Opioid-Related Bills that Passed House, to be Reconciled with Senate May 17, 2016 | Emilia Varrone Sources: Congress.gov, 2016; The Week in Congress, 2016; Tanya Snyder, “Congress Passed 18 bills to Address the Opioid Epidemic, but Where’s the Money?” Patch, May 16, 2016; govtrack.us, 2016; Laura Litvan, "Opioid Abuse Bill Passes U.S. House Without Funds Attached," Bloomberg, May 12, House BillDescription H.R Co-Prescribing to Reduce Overdoses Act of 2015: Provides funding for overdose reversal drugs to be co-prescribed with opioid painkillers H.R Improving Treatment for Pregnant and Post Partum Women Act of 2015: Reauthorizes residential treatment programs for pregnant & post-partum women as well as provides grants for substance abuse agency pilot programs H.R. 4063Jason Simcakoski PROMISE Act: Improves safety oversight in opioid use in veteran’s hospitals H.R. 4586Lali’s Law: Increases availability of overdose reversal drugs & trains people in their use H.R. 4599Reducing Unused Medications Act of 2016: Allows for partial filling prescriptions to reduce excess opioids in circulation H.R. 4641To provide for the establishment of an inter-agency task force to review, modify and update best practices for pain management and prescribing pain medication and other purposes: Studies best practices for prescribing opiate painkillers, based on guidelines from the CDC H.R. 4843Improving Safe Care for the Prevention of Infant Abuse and Neglect Act: Requires HHS to maintain and disseminate information relating to safe care for infants affected by illegal substance abuse. H.R. 4969John Thomas Decker Act of 2016: Directs CDC to provide information to educate and prevent addiction in youth who are injured playing sports and prescribed an opioid. H.R. 4976Opioid Review Modernization Act of 2016: FDA must refer new drug applications for opioids to advisory counsel before approval & develop recommendations regarding education programs. H.R. 4978NAS Healthy Babies Act: Authorizes GAO to report on the effect of taking opioids during pregnancy in affected children. To be continued on the next slide

OPIOID LEGISLATION PASSES THE HOUSE Cont. 18 Public Health Bills Pass in the House, 17 of Which Are Specifically Aimed at Fighting Opioid Epidemic List of Opioid-Related Bills that Passed House, to be Reconciled with Senate May 17, 2016 | Emilia Varrone Sources: Congress.gov, 2016; The Week in Congress, 2016; Tanya Snyder, “Congress Passed 18 bills to Address the Opioid Epidemic, but Where’s the Money?” Patch, May 16, 2016; govtrack.us, 2016; Laura Litvan, "Opioid Abuse Bill Passes U.S. House Without Funds Attached," Bloomberg, May 12, House BillDescription H.R.4981Opioid Use Disorder Treatment Expansion and Modernization Act: Aims to amend the Controlled Substances Act, expanding access to medications that can help treat addiction and overdoses. H.R. 4982Examining Opioid Treatment Infrastructure Act of 2016: Authorizes the Comptroller General to conduct studies on the availability of drug treatment and what is necessary to improve the system H.R. 4985Kingpin Designation Improvement Act of 2016: Keeps information classified in face of Federal Court challenges when deciding whether to designate a drug trafficker a “kingpin” H.R. 5046Comprehensive Opioid Abuse Reduction Act of 2016: Authorizes grant program for state services to address opioid epidemic, including collaboration between criminal justice and substance abuse agencies H.R. 5048Good Samaritan Assessment Act: Studies effectiveness of “Good Samaritan” laws, specifically on states’ expansion on opioid overdoses. H.R. 5052OPEN Act: Requires HHS Secretary, the Attorney General and National Academy of Sciences to evaluate outcomes for legislation addressing opioid abuse S.32Transnational Drug Trafficking Act of 2015: Targets transnational drug trafficking activity by prohibiting manufacture/distribution of chemicals with the intent to manufacture a controlled substance *H.R. 1818Veteran Emergency Medical Technician Support Act of 2016: Is not explicitly an opioid bill, but was included in package as it is a public health measure to help veterans become emergency responders