Republican Controlled Senate Overwhelmingly Passes Landmark Opioid Bill – the Comprehensive Addiction and Recovery Act (CARA)

Washington, D.C. – The U.S. Senate today passed the Comprehensive Addiction and Recovery Act (CARA). This bipartisan measure co-sponsored and championed by Senator Sheldon Whitehouse (D-RI), Senator Rob Portman (R-OH) and others next goes to the House where a companion measure has remained pending for over a year. CARA 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. The Drug Policy Alliance (DPA) has concerns with some of the provisions in the legislation but applauds the change in political discourse among both Democrats and Republicans on Capitol Hill as CARA has been considered. DPA also applauds the overall direction that CARA takes in favor of dealing with opioid and heroin misuse as the public health crisis that it is.

“The momentum behind CARA offers hope that lawmakers are starting to evolve toward treating drug use as a health issue, rather than a criminal justice issue,” said Grant Smith, deputy director of national affairs with the Drug Policy Alliance. “CARA will save many lives. The only regret is that this positive step forward didn’t come sooner, and many thousands of lives have already been tragically lost in communities impacted by heroin and opioid overdose,” said Smith.

DPA specifically supports three initiatives advanced in CARA and urges Congress to immediately appropriate funding for these initiatives:

• CARA supports the expansion of diversion programs that direct people accused of 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 law enforcement and first responders. 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 applauded passage of CARA out of the Senate Judiciary Committee last month, noting that the panel’s long track record of endorsing counterproductive punitive drug policies was largely set aside in favor of the health-centered measures advanced in CARA. This bill, however, does not appropriate federal funding. Senator Chuck Schumer (D-NY) and other Senate Democrats led an unsuccessful effort on the floor of the Senate to amend CARA with a $600 million emergency appropriation authored by Senator Jeanne Shaheen (D-NH). Advocates expressed disappointment that Senator Shaheen’s amendment included funding for federal law enforcement programs that have a long track record of perpetuating drug war abuses. Advocates instead urge lawmakers to appropriate emergency funds to CARA’s initiatives that would expand access to naloxone, the use of medication-assisted treatment and the diversion of people struggling with addiction away from the criminal justice system.

“Lawmakers in Congress should be looking at ways to build upon the bipartisan political will that CARA has cultivated for reducing the role that law enforcement plays in addressing substance use,” said Grant Smith, deputy director of national affairs with the Drug Policy Alliance. “Important work underway in Congress right now to reduce draconian mandatory drug sentences, roll back collateral consequences of a drug law conviction and enhance funding for evidence-based treatment and overdose prevention present critical opportunities to continue building upon the political momentum for change to our nation’s drug policies.”

As work on CARA continues in Congress, lawmakers in other parts of the country are exploring innovative solutions to dealing with problems stemming from opioid and heroin addiction. Earlier this week, the Maryland House of Delegates held legislative hearings on two bills that would create a safe and supervised space for people to use drugs and establish a pilot program to treat severe opioid dependence with pharmaceutical grade heroin.  Another bill pending before the Maryland legislature would decriminalize possession of personal amounts of any drug in an effort to shift drug policy towards a health-centered approach. Last month, Svante Myrick, the Mayor of Ithaca, New York became the first U.S. mayor to release a comprehensive drug policy plan to reduce overdose deaths, incarceration and addiction. The plan includes recommendations for a 24-hour crisis center, safe and supervised space for people to use drugs and greater access to medication assisted treatment.