If the bipartisan legislation passes, it will have a sweeping impact on how addiction treatment is administered
By Jason LangendorfApril 12, 2021
As overdoses and substance use complications in the United States continue to accelerate through the COVID-19 pandemic, lawmakers have responded by introducing powerful legislation—the Comprehensive Addiction and Recovery Act (CARA) 3.0—to address drug prevention, treatment access and funding for related training and support services.
Last month a bipartisan group of senators including Rob Portman (R-Ohio), Sheldon Whitehouse (D-R.I.), Shelley Moore Capito (R-W.Va.), Amy Klobuchar (D-Minn.) and Jeanne Shaheen (D-N.H.) introduced CARA 3.0, proposing sweeping policy changes and a $785 million funding authorization above that of the 2016 CARA Act.
“In recent years, we have made progress in fighting the scourge of addiction thanks to resources from the bipartisan CARA law, in addition to other bipartisan efforts in Congress,” Portman said in a news release. “However, the COVID-19 pandemic has created unprecedented challenges, and we are now seeing another 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.”
If passed, CARA 3.0 would dedicate $785 million to “evidence-based prevention, enforcement, treatment, criminal justice and recovery programs,” the bill states. It comes after two failed attempts at a CARA 2.0, in February 2018 (a $1 billion proposal) and December 2020 (a $765 million proposal). Neither of those efforts was brought to a vote in Congress.
The COVID-19 pandemic has created unprecedented challenges, and we are now seeing another 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.”—Sen. Rob Portman (R-Ohio)
How CARA 3.0 Would Help
Among its key measures, the bill would:
- Fund new research into non-opioid pain management alternatives
- Provide for new research on long-term treatment outcomes to sustain recovery from addiction
- Establish a National Commission for Excellence in Post-Overdose Response, to improve the quality and safety of care for drug overdoses and substance use disorders (SUDs)
- Mandate physician education on addiction, treatment and pain management
- Establish a pilot program to study the use of mobile methadone clinics in rural and underserved areas
- Remove the limit on the number of patients a physician can treat with buprenorphine and methadone
- Create a resolution that ensures an employee using medication-assisted treatment (MAT) is not in violation of the drug-free workplace requirement
- Permanently allow providers to prescribe medication via audio-only telehealth following an initial in-person or audio-visual appointment, and to bill Medicare for audio-only telehealth services
- Gather more data to achieve more equitable outcomes across race and socioeconomic status
Every day, families across Minnesota and the country lose loved ones to addiction. The Comprehensive Addiction and Recovery Act 3.0 will give Americans access to vital treatment and recovery services.”—Sen. Amy Klobuchar (D-Minn.)
Some key authorization levels in the bill:
- $10 million or more to fund a National Education Campaign on the dangers of prescription opioid misuse, heroin and lethal fentanyl
- $55 million for training and employment for treatment professionals, including peer recovery specialists, and $5 million set aside for workforce retention efforts
- $300 million for 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
- $50 million to provide quality treatment for addiction in correctional facilities and in community reentry programs
“Every day, families across Minnesota and the country lose loved ones to addiction,” said Klobuchar. “The Comprehensive Addiction and Recovery Act 3.0 will give Americans access to vital treatment and recovery services.”
Will CARA 3.0 Pass?
The bill tacks on another $20 million in funding to the CARA 2.0 proposal that was introduced and stalled out in Congress over the winter. And although CARA 3.0 is a bipartisan effort, Republican leaders might be reluctant to concede what could be perceived as a legislative win for President Joe Biden.
Still, several important developments suggest this latest attempt at updating the original CARA Act might have legs.
The pandemic has fueled an increase in overdose deaths and substance-related issues across the country, a crisis that knows no state borders or party lines. Lawmakers are beginning to understand the drug epidemic as a local threat to their constituents, and they might be more motivated than ever to respond. Additionally, the removal or alteration of certain provisions from previous proposals of CARA that take pressure off drug makers and prescribers might help legislators find enough common ground to pass this latest version of the bill, to everyone’s benefit.
Photo: Mika Baumeister