Health and Fitness

Congress Passes Landmark Opioid Bill – the Comprehensive Addiction and Recovery Act (CARA)

Measure Promotes Expanded Use of Diversion from the Criminal Justice System for Drug Law Violations, Medication Assisted Treatment for Opioid Addiction and Naloxone to Reverse Opioid Overdose; Advocates to Congress: Now Show Us the Money to Make CARA Work

Washington, D.C. –(ENEWSPF)–July 14, 2016.   Last night, the U.S. Senate voted to send opioid legislation known as the Comprehensive Addiction and Recovery Act (CARA) to President Obama for his signature. The U.S. House voted last week 407-5 to approve CARA. This bipartisan measure co-sponsored and championed by Senator Sheldon Whitehouse (D-RI), Senator Rob Portman (R-OH), Congressman Jim Sensenbrenner (R-WI), Congressman John Conyers (D-MI) and many other lawmakers advances a large number of treatment and prevention measures intended to reduce prescription opioid and heroin misuse, including evidence-based interventions for the treatment of opioid and heroin addiction and prevention of overdose deaths. This bill, however, does not provide federal funding. Republican leadership have maintained that opioid funding must be appropriated through regular order and have repeatedly pledged to fund the programs authorized in CARA this year. Advocates urge Congress to deliver on this promise.

“CARA promotes many evidence-based interventions that have the potential to more effectively address opioid and heroin dependence and save lives,” said Grant Smith, deputy director, national affairs with the Drug Policy Alliance. “Lawmakers in Congress now must deliver on promises to fully fund CARA if we are to realize its potential,” said Smith.

CARA contains many interventions but three stand out as crucial for turning the tide on the opioid and heroin crisis, provided these interventions are fully funded by Congress:

  • CARA supports the expansion of diversion programs, such as Law Enforcement Assisted Diversion, that direct people stopped by law enforcement for low-level drug law violations away from the criminal justice system and into evidence-based treatment and other services.
  • CARA supports the expanded provision of buprenorphine, methadone and other forms of medication-assisted treatment, including to people involved with the criminal justice system. The vast majority of correctional facilities do not provide medication-assisted treatment despite an overwhelming need among incarcerated people and the strong evidence base supporting medication-assisted therapy to treat opioid dependence.
  • CARA supports the expanded use of naloxone by first responders and community members such as family members in a position to administer naloxone to a person experiencing an opioid overdose. Naloxone effectively reverses opioid overdoses and is safe to use but people who are at-risk of experiencing or witnessing an overdose often cannot access this lifesaving drug.

Advocates urge lawmakers to fully fund these interventions:

“A massive infusion of funding this year for medication-assisted treatment, naloxone and diversion programs by Congress is essential if we are to truly turn the tide on the opioid crisis,” said Grant Smith, deputy director, national affairs with the Drug Policy Alliance.

CARA also includes a provision that permits nurse practitioners and physician assistants to prescribe buprenorphine for the first time. This change, along with a separate decision by the Obama Administration to raise next month the number of patients that a practitioner can treat with buprenorphine from 100 to 275, should improve patient access to this form of treatment.


Related Material:

New York Times

Senate Approves Bill to Combat Opioid Addiction Crisis, By EMMARIE HUETTEMAN, JULY 13, 2016®ion=stream&module=stream_unit&version=latest&contentPlacement=10&pgtype=sectionfront&_r=0

WASHINGTON — The Senate on Wednesday approved a bill to tackle the nation’s opioid crisis, sending to the president’s desk the most sweeping drug legislation in years in a rare instance of consensus in Congress.

The measure, which passed, 92 to 2, would strengthen prevention, treatment and recovery efforts, largely by empowering medical professionals and law enforcement officials with more tools to help drug addicts. It would also expand access to a drug that emergency medical workers could use to help reverse overdoses and improve treatment for the incarcerated. Senator Ben Sasse, Republican of Nebraska, and Senator Mike Lee, Republican of Utah, voted against the measure. President Obama is expected to sign the bill.

“This is a historic moment, the first time in decades that Congress has passed comprehensive addiction legislation, and the first time Congress has ever supported long-term addiction recovery,” said Senator Rob Portman, Republican of Ohio, whose state has been plagued by opioid addiction. “This is also the first time that we’ve treated addiction like the disease that it is, which will help put an end to the stigma that has surrounded addiction for too long.”

Tensions over spending threatened to derail the measure as Democrats insisted the Senate also vote on immediate funding to pay for the programs the bill authorizes. Republicans said funding would be addressed in the appropriations process later this year.

Congress has yet to send a spending bill to President Obama for his signature this year. With the fiscal year ending Sept. 30, Congress will have just a few weeks to do so when it returns from a seven-week recess, which begins at the end of this week.

Mr. Portman, who has long pushed for improved policies on opioid and heroin addiction, said he was optimistic the Senate Appropriations Committee would fully fund the policy measure — which, he said, calls for increasing overall funding by 47 percent.

“This is an authorization bill,” Mr. Portman said. “It authorizes more money than we’ve ever even dreamed about for opioids.”

Democrats were unmoved, citing Congress’s chronic difficulties in passing spending bills. The Obama administration has urged Congress to add funding into this bill, including $920 million for states to help treat addicts.

Democrats pressed to start on Wednesday with a measure that would devote $600 million in emergency funding, which typically means the money would not need to be made up with cuts to other programs. Senator Chuck Schumer, Democrat of New York, said the bill was an empty promise without the funding to increase the number of hospital beds and treatment providers — resources necessary to really address the crisis.

“What it says is this: that colleagues on the other side of the aisle are more interested in showing voters they’re doing something about opioids than actually doing something,” Mr. Schumer said on the Senate floor.

Senator John Cornyn of Texas, the No. 2 Republican, dismissed the idea that the drug programs would ultimately not receive the funding needed. “There’s plenty of money,” he said.

The bill, which the House passed on Friday, is a compromise between the House and the Senate, combining 18 measures that passed the House in May with the Senate’s more comprehensive legislation, which was approved in March.

Marvin Ventrell, the executive director of the National Association of Addiction Treatment Providers, said the measure was an “extraordinary” step forward for a nation that largely does not address addiction as a health problem. But while advocates were pleased with it, they remain concerned that the funding that would make this bill a reality could ultimately fail to materialize, he said.

“To say that this bill without the additional funding is meaningless would be a gross overstatement,” Mr. Ventrell said. “But to say that it would fulfill its purpose without additional funding would also be incorrect.”