Comprehensive Addiction and Recovery Act (CARA) 2.0 Act builds on the momentum of CARA by increasing opioid funding, limiting opioid prescriptions to three days, and bolstering the fight against the opioid epidemic
CARA 2.0 includes provisions from Klobuchar’s Prescription Drug Monitoring Act
WASHINGTON — U.S. Senator Amy Klobuchar (D-MN) joined Senators Rob Portman (R-OH), Sheldon Whitehouse (D-RI), Shelley Moore Capito (R-WV), Dan Sullivan (R-AK), Maggie Hassan (D-NH), Bill Cassidy (R-LA), and Maria Cantwell (D-WA) today to introduce the bipartisan Comprehensive Addiction and Recovery Act (CARA) 2.0 Act. The bill will increase the funding authorization levels for the CARA programs enacted in 2016 and put in place additional policy reforms to help combat the opioid epidemic — including limiting opioid prescriptions to three days. CARA was a bipartisan, national effort designed to ensure that federal resources were devoted to evidence-based education, treatment, and recovery programs that work. CARA 2.0 builds on this effort by increasing the funding authorization levels to better coincide with the recent budget agreement while laying out new policy reforms to strengthen the federal government’s response to this crisis.
“Opioid addiction has increased exponentially in the last decade, rising to the level of a public health emergency and affecting millions of Americans across the county,” Klobuchar said. “The Comprehensive Addiction and Recovery Act (CARA) has made real strides in tackling this epidemic, and CARA 2.0 will increase our investment and commitment to proven strategies for combating opioid addition. Doubling down on the opioid crisis is as critical as ever, and this bill will help more families to access the treatment and recovery services they need.”
CARA, which became law on July 22, 2016, authorized an additional $181 million for these evidence-based programs, and were funded at $267 million for FY 2017. There is bipartisan agreement that more resources will be necessary to help turn the tide of this epidemic. The recent budget agreement includes $6 billion in additional resources for FYs 2018-2019.
CARA 2.0 will build on the original law by increasing the funding authorization levels for CARA’s evidence-based programs to better coincide with the recent budget agreement and laying out new policy reforms to strengthen the federal government’s response to this crisis. CARA 2.0 will authorize $1 billion in dedicated resources to evidence-based prevention, enforcement, treatment, and recovery programs. Below is a brief summary of CARA 2.0:
CARA 2.0 Policy Reforms:
• Imposes three-day limit on initial opioid prescriptions for acute pain as recommended by the Centers for Disease Control and Prevention (CDC), with exceptions for chronic pain or pain for other ongoing illnesses.
• Makes permanent Section 303 of CARA which allows physician assistance and nurse practitioners to prescribe buprenorphine under the direction of a qualified physician.
• Allows states to waive the limit on the number patients a physician can treat with buprenorphine so long as they follow evidence-based guidelines. There is currently a cap of 100 patients per physician.
• Require physicians and pharmacists use their state PDMP upon prescribing or dispensing opioids.
• Increases civil and criminal penalties for opioid manufacturers that fail to report suspicious orders for opioids or fail to maintain effective controls against diversion of opioids.
• Creates a national standard for recovery residence to ensure quality housing for individuals in long-term recovery.
CARA 2.0 Authorization Levels:
• $10 million to fund a National Education Campaign on the dangers of prescription opioid misuse, heroin, and lethal fentanyl (up from $5 million in the original CARA).
• $300 million to expand evidence-based medication-assisted treatment (up from $25 million in the original CARA).
• $300 million to expand first responder training and access to naloxone (up from $12 million in the original CARA).
• $200 million to build a national infrastructure for recovery support services to help individuals move successfully from treatment into long-term recovery (up from $1 million in the original CARA).
• $20 million to expand Veterans Treatment Courts (up from 6$ million in the original CARA).
• $100 million to expand treatment for pregnant and postpartum women, including facilities that allow children to reside with their mothers (up from $17.9 million in the original CARA).
• $60 million to help states develop an Infant Plan of Safe Care to assist states, hospitals and social services to report, track and assist newborns exposed to substances and their families (no authorization in the original CARA).
• $10 million for a National Youth Recovery Initiative to develop, support, and maintain youth recovery support services (no authorization in the original CARA).
As a former Hennepin County Attorney, Klobuchar has long led local and national efforts to curb drug abuse and help people overcome addiction. To build on the monumental first step of CARA, Klobuchar introduced the Prescription Drug Monitoring Act, which would require the use of strong prescription drug monitoring programs (PDMPs) in all states that receive certain federal funding to combat opioid abuse and also requires states to make their PDMP data available to other states.
Last year, she and ten other senators introduced the Budgeting for Opioid Addiction Treatment (LifeBOAT) Act, which would establish a reliable funding stream to provide and expand access to substance abuse treatment. She and a bipartisan group of senators also introduced the Synthetic Abuse and Labeling of Toxic Substances (SALTS) Act. The SALTS Act would make it easier to prosecute the sale of “analogue” drugs, which are synthetic substances that are substantially similar to illegal drugs.
Last year, Klobuchar and Senators Rob Portman (R-OH), Marco Rubio (R-FL), and Maggie Hassan (D-NH) introduced the bipartisan Synthetics Trafficking & Overdose Prevention (STOP) Act to help stop dangerous synthetic drugs like fentanyl and carfentanil from being shipped through our borders to drug traffickers in the United States.
In September 2014, the DEA implemented Klobuchar’s bipartisan Secure and Responsible Drug Disposal Act. Under the legislation, consumers are provided with more safe and responsible ways to dispose of unused prescription medications and controlled substances.