Washington, DC – Today, U.S. Senators Sheldon Whitehouse (D-RI), Rob Portman (R-OH), Shelley Moore Capito (R-WV), Amy Klobuchar (D-MN), Jeanne Shaheen (D-NH), and Maria Cantwell (D-WA) introduced the Comprehensive Addiction and Recovery Act (CARA) 3.0 to increase the funding authorization levels for the Comprehensive Addiction & Recovery Act (CARA) programs enacted in 2016 and put in place additional policy reforms to help combat the opioid epidemic that has worsened during the coronavirus pandemic. CARA was a bipartisan, national effort designed to ensure that federal resources were devoted to evidence-based education, treatment and recovery programs that work. In FY 2021, CARA programs were funded at $782 million. Several key provisions of CARA 2.0 were enacted as part of the SUPPORT Act on October 24, 2018. CARA 3.0 builds on these efforts by increasing the funding authorization levels and laying out new policy reforms to strengthen the federal government’s response to this crisis. The CARA 3.0 bill text is here, section-by-section here, and a summary here.
“The passage of Senator Portman’s and my CARA law represented a big step forward in the federal response to the opioid crisis,” said Whitehouse. “Now, the convergence of the opioid epidemic with the COVID-19 pandemic reveals the need for new reforms, like expanding treatment options for new mothers and bolstering telehealth medication-assisted treatment programs. I’m grateful to Senator Portman and a bipartisan group of cosponsors for working with me on this important issue.”
“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. 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,” said Portman. “In the new Congress, we have a unique opportunity to work together in a bipartisan way and I believe that CARA 3.0 can help us make a real difference in combating this epidemic. I want to thank Senators Whitehouse and Klobuchar for their leadership and partnership on this important national effort.”
“Despite our needed focus on the COVID pandemic and the other challenges facing our nation, we must remain committed to addressing the substance use disorder epidemic which continues to impact far too many of our communities,” said Capito. “The rise in overdose deaths we have seen over the past year in West Virginia and across the country must be reversed and the progress we were seeing in combatting addiction resumed. I believe this bipartisan legislation will provide the resources necessary to achieve these goals and help individuals and families find the help they desperately need.”
“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. 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.”
“Over the last year, we’ve witnessed the COVID-19 pandemic exacerbate the substance use disorder epidemic in New Hampshire. Essentially, we’ve experienced one public health crisis exacerbate another. It has taken a devastating toll on our communities and it demands Congress’ attention and action,” said Shaheen. “The CARA 3.0 Act comes at a critical time, providing the resources needed to invest in substance use disorder education, prevention, treatment and recovery programs across the country. I’m also proud this new package includes provisions from bipartisan legislation I worked on with Senator Capito, the NO PAIN Act, to improve access to alternatives for opioids for pain management through Medicare. Turning the tide on the substance use disorder crisis requires an all-hands-on-deck approach, and I hope Congress acts swiftly to pass this bipartisan legislation to address this public health crisis.”
CARA 3.0 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.
- 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 (MAT) 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 MAT is not in violation of the drug-free workplace requirement.
- Permanently allows providers to prescribe MAT 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 3.0 Authorization Levels:
- $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 substance abuse professionals, including peer recovery specialists and $5 million set aside for workforce retention efforts.
- $10 million for community-based coalition enhancement grants to address local drug crises.
- $300 million to expand evidence-based 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.
