The bipartisan Comprehensive Addiction and Recovery Act 2.0 (CARA 2.0) will increase access to treatment, prevention, and bolster fight against addiction 

WASHINGTON — U.S. Senator Amy Klobuchar joined Senators Rob Portman (R-OH) and Sheldon Whitehouse (D-RI) to introduce the Comprehensive Addiction and Recovery Act (CARA) 2.0 to build on the original Comprehensive Addiction & Recovery Act (CARA) programs enacted in 2016 and put in place additional policy reforms to help combat addiction. Last year, CARA programs were funded at $658 million. CARA 2.0 builds on this effort by increasing the funding authorization levels and laying out new policy reforms to strengthen the federal government’s response to this crisis. 

“Every day, families across Minnesota and the country lose loved ones to addiction,” Klobuchar said. “The Comprehensive Addiction and Recovery Act 2.0 will give Americans access to vital treatment and recovery services. It will also ensure that commonsense prevention measures are implemented across the country, such as requiring the use of state prescription drug monitoring programs. We must continue to address this public health emergency and provide assistance to the millions of Americans who are suffering.”

“In recent years we have made real progress in fighting the scourge of addiction thanks to resources from the bipartisan CARA law, in addition to other bipartisan efforts in Congress. However, the COVID-19 pandemic has created unprecedented challenges and we are now seeing a heartbreaking surge in overdose deaths. That is why we must redouble our efforts to combat addiction and help those who are suffering during this crisis,” Portman said. “In the new Congress, we have a unique opportunity to work together in a bipartisan way and I believe that CARA 2.0 can help us make a real difference in combating this epidemic. I want to thank Senator Whitehouse and my bipartisan colleagues for their leadership and partnership on this important national effort.”

“Senator Portman’s and my CARA bill was the most wide-ranging federal addiction legislation ever passed,” Whitehouse said. “Now, it’s time to deepen CARA’s reach into communities where the opioid crisis rages, and add important new reforms like expanding treatment options for new mothers and building our recovery workforce.  I’m pleased to join Senator Portman and a bipartisan group of cosponsors to expand on the progress we’ve made in the fight against the opioid crisis.”

Senator Klobuchar has long led local and national efforts to curb drug abuse and help people overcome addiction.

In October 2018, three of Klobuchar’s bipartisan bills to combat the opioid epidemic were signed into law as part of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act. The Synthetic Abuse and Labeling of Toxic Substances (SALTS) Act, which Klobuchar introduced with Senator Lindsey Graham (R-SC), will make it easier to prosecute the sale and distribution of “analogue” drugs, which are synthetic substances that are substantially similar to illegal drugs. The Synthetics Trafficking & Overdose Prevention (STOP) Act, which Klobuchar introduced with Senator Rob Portman (R-OH), will help stop dangerous synthetic drugs like fentanyl and carfentanil from being shipped through our borders to drug traffickers here in the United States. The Eliminating Kickbacks in Recovery Act, which Klobuchar introduced with Senator Marco Rubio (R-FL), will help crack down on health care facilities or providers that try to game the system to take advantage of vulnerable patients.

To build on the monumental first step of CARA, Klobuchar also 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 other senators introduced the Budgeting for Opioid Addiction Treatment (LifeBOAT) Act, which would establish a reliable funding stream to provide and expand access to treatment for substance use disorders.

CARA 2.0 authorizes $765 million in dedicated resources to evidence-based prevention, enforcement, treatment, criminal justice, and recovery programs. CARA 2.0 is part of the necessary response to the urgent call for adequate and sustained resources that appropriately reflect the magnitude of the crisis.

CARA 2.0 Policy Changes:

  • New research into non-opioid pain management alternatives
  • New research on long-term treatment outcomes to sustain recovery from addiction
  • Establishes a National Commission for Excellence in Post-Overdose Response to improve the quality and safety of care for drug overdoses and substance use disorders.
  • Sets a three-day limit on initial opioid prescriptions for acute pain as recommended by the Centers for Disease Control and Prevention (CDC).
  • Requires physicians and pharmacists use their state PDMP upon prescribing or dispensing opioids.
  • Mandates physician education on addiction, treatment, and pain management.
  • Prohibits States from requiring prior authorization for medication-assisted treatment under Medicaid.
  • Establishes a pilot program to study the use of mobile methadone clinics in rural and underserved areas.
  • Removes the limit on the number patients a physician can treat with buprenorphine and methadone.
  • Creates a sense of Congress that an employee using medication-assisted treatment is not in violation of the drug-free workplace requirement.
  • Permanently allows providers to prescribe medication-assisted treatment and other necessary drugs without a prior in-person visit, and to bill Medicare for audio-only telehealth services.
  • Expands access to federal housing for individuals who have misused substances or have a drug-crime conviction.
  • Incorporates changes in grant programs to gather more data on who receives services to achieve more equitable outcomes across race and socioeconomic status and emphasizes delivering culturally competent services.

CARA 2.0 Authorization Levels:

  • $10 million to fund a National Education Campaign on the dangers of prescription opioid misuse, heroin, and lethal fentanyl.
  • $25 million for training and employment for substance abuse professionals, including peer recovery specialists.
  • $300 million to expand evidence-based medication-assisted treatment (MAT).
  • $200 million to build a national infrastructure for recovery support services to help individuals move successfully from treatment into long-term recovery.
  • $100 million to expand treatment for pregnant and postpartum women, including facilities that allow children to reside with their mothers.
  • $20 million to expand Veterans Treatment Courts.
  • $10 million for a National Youth Recovery Initiative to develop, support, and maintain youth recovery support services.
  • $50 million to provide quality treatment for addiction in correctional facilities and in community reentry programs. 
  • $30 million for deflection and pre-arrest diversion programs in the criminal justice system.