Search SciPol

Brought to you by
What it does 

H.R. 5956, the Youth Opioid Use Treatment Health (YOUTH) Act of 2016, seeks to develop better resources for the understanding and treatment of opioid use disorders in children, adolescents, and young adults.

Section 2 of H.R. 5956 aims to amend Section 514 of the Public Health Service Act (42 U.S.C. 201 et seq.); Section 514 originally intended to award grants in 2002 and 2003 for substance use treatment services benefitting children and adolescents. Section 2 would amend Section 514 by reauthorizing the appropriations in the original Section 514 for 2017 through 2022, expanding the treatment services to cover "young adults" in addition to "children and adolescents", and replacing the phrase substance “abuse” with substance “use” each place it appears.

Section 3 of the YOUTH Act creates new provisions that provide five million dollars in grants to governmental and non-governmental entities for programs to:

  • Expand access to medication-assisted treatments for opioid use disorders among adolescents and young adults;
  • Identify and test solutions to overcoming implementation barriers of medication-assisted treatments for opioid use disorders among adolescents and young adults; and
  • Create and distribute medication-assisted treatment training and implementation resources for pediatric healthcare providers.

Section 3 defines “adolescents and young adults” as people between 10 and 26 years of age. This sections also details eligibility and guidelines for such grant allocation, including submitting progress reports and evaluations of the programs.

Section 4 of H.R. 5956 requires that the U.S. Government Accountability Office (GAO) study current federal response regarding youth substance use by evaluating and assessing each of the following:

  • Previous and ongoing research conducted by the Federal government regarding substance use disorder prevention, treatment, and recovery among adolescents and young adults;
  • Federal research regarding the social and biological circumstances that make adolescent- and young adult-specific treatment protocols necessary, including research concerning the effects of substance use disorders on brain development and the effectiveness of treatment;
  • Federal non-research programs and actions addressing substance use disorder prevention, treatment, and recovery among adolescents and young adults; and
  • Gaps in Federal efforts surrounding substance use disorder prevention, treatment, and recovery among young adults, including gaps in research, data collection, and methods evaluating the effectiveness of such efforts.

The GAO must submit a finalized report to appropriate committees of Congress no later than 2 years following the bill’s date of enactment, and the report must include both a summary of findings and recommendations based on those findings.

Relevant Science 

Opioids are compounds that bind to opioid receptors. Opioids come in 4 different classes:

  1. Opiates, drugs derived from opium poppy (e.g., morphine and codeine);
  2. Semi-synthetic opioids, drugs that are synthesized from naturally occurring opiates (e.g., heroin, oxycodone, and buprenorphine);
  3. Synthetic opioids, drugs that are manufactured to mimic opiates (e.g., methadone, propoxyphene, and fentanyl); and
  4. Endogenous opioids, chemicals that are produced naturally by the body (e.g., endorphins).

Endogenous opioids bind to opioid receptors on nerve cells in the brain and other organs. This interaction is the body’s natural control response to pain. When opioid drugs enter the body (synthetic, semi-synthetic, and opiates), they can fool opioid receptors and attach to the nerve cells, mimicking natural endogenous opioids. The result of attachment causes an abnormal blocking of the perception of pain by flooding the nerve cells with dopamine. The flood of dopamine in turn can produce euphoria by affecting brain regions that mediate pleasure and rewards, but can also cause drowsiness and, occasionally, lowered respiration.

Prescribed use of opioid drugs by doctors can often produce dependence; when abused or overused, these drugs can lead to overdose and result in long-term neurological and physiological effects, such as permanent brain damage, coma, or death. The Center for Disease Control and Prevention estimates that around 78 Americans die every day form an opioid drug overdose.

According to the National Institute on Drug Abuse (NIDA), young adults (age 18 to 25) are the most frequent abusers of prescription opioids. The 2014 National Survey on Drug Use and Health reported that the average age of first use of prescription opioids was 21.2 years, and the average age of first heroin use was 28. In 2014, more than 1,700 young adults died from prescription drug overdoses.

NIDA research has shown that the incidence of heroin initiation was 19 times higher among those individuals who report prior use of prescription opioids than those with no prior use. Additionally, more than 80 percent of heroin users reported using prescription opioids prior to heroin. When opioids drugs are used in adolescence, brain development and maturation can be obstructed.

Medication-assisted treatment is the use of medications with behavioral therapy and counseling to treat substance use disorders and prevent opioid overdose. The Substance Abuse and Mental Health Services Administration indicates that early intervention through medication-assisted treatment greatly increases patient survival, increases retention in treatment, and decreases illicit opiate use. However, NIDA research has revealed that fewer than 1 million of the 2.5 million Americans that abuse opioids in 2012 received medication-assisted treatments.

Relevant Experts 

Li-Tzy Wu, D.Sc.

  • Wu, Li-Tzy, Dan G. Blazer, Ting-Kai Li, and George E. Woody. 2011. “Treatment Use and Barriers among Adolescents with Prescription Opioid Use Disorders.” Addictive Behaviors 36(12): 1233 – 1239. doi: 10.1016/j.addbeh.2011.07.033
  • Wu, Li-Tzy, Christopher L. Ringwalt, Chongming Yang, Bryce B. Reeve, Jeng-Jong Pan, and Dan G. Blazer. 2009. “Construct and Differential Item Functioning in the Assessment of Prescription Opioid Use Disorders among American Adolescents.” Journal of the American Academy of Child & Adolescent Psychiatry 48(5): 563 – 572. doi: 10.1097/CHI.0b013e31819e3f45
  • Wu, Li-Tzy, Daniel J. Pilowsky, and Ashwin A. Patkar. 2008. “Non-Prescribed Use of Pain Relievers among Adolescents in the United States.” Drug and Alcohol Dependence 94(1-3): 1 – 11. doi: 10.1016/j.drugalcdep.2007.09.023
  • Wu Li-Tzy, Chistopher L. Ringwalt, Mannelli P, Patkar AA. “Prescription Pain Reliever Abuse and Dependence Among Adolescents: A Nationally Representative Study.” Journal of the American Academy of Child & Adolescent Psychiatry 47(9): 1020 – 1029. doi: 10.1097/CHI.0b013e31817eed4d

Nicole Schramm-Sapyta, Ph.D. 

  • Schramm-Sapyta, Nicole, Q. David Walker, Joseph M. Caster, Edward D. Levin, and Cynthia M. Kuhn. 2009. “Are Adolescents More Vulnerable to Drug Addiction Than Adults? Evidence from Animal Models.” Psychopharmacology 206(1): 1 – 21. doi: 10.1007/s00213-009-1585-5

Wilkie Wilson, Ph.D.

Endorsements & Opposition 

There are currently no publicly reported endorsements or oppositions to this bill.

Status 

H.R. 5956 was introduced and refered to the House Energy and Commerce Committee on September 8, 2016.

Sponsors 

H.R. 5956 is sponsored by Representative Katherine M. Clark (D-MA-5). The original cosponsor of the bill is Representative Larry Bucshon (R-IN-8).

Primary Author 
Carson Martinez, MA Candidate
Editor(s) 
Amy Hafez, PhD Candidate; Andrew Pericak, MEM
Recommended Citation 

Duke SciPol, “Youth Opioid Use Treatment Help (YOUTH) Act of 2016  (H.R. 5956, 114th Congress)” available at http://scipol.duke.edu/content/youth-opioid-use-treatment-help-youth-act-2016-hr-5956-114th-congress (11/14/2016).