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

Washington, D.C. – 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.