WASHINGTON – The Comprehensive Addiction and Recovery Act, which aims to fight opioid addiction and promote opioid prevention and treatment programs comprehensively on several fronts, will soon become federal law. In 2014, CARA’s authors, U.S. Sens. Sheldon Whitehouse, Rob Portman (R-Ohio), Amy Klobuchar (D-Minn.) and Kelly Ayotte (R-N.H.), began consulting experts and practitioners in the prevention, treatment, recovery and law enforcement communities on such issues as the science of addiction, treatment and recovery services for veterans and addiction’s impact on women, children and incarcerated individuals.
Asked to name CARA’s most significant provisions, Whitehouse said, “The top one is [not part of the statutory language] … but … the underlying recognition that addiction is not a moral failing or an occasion for shame and condemnation, but rather a medical issue, and one that recovery from which requires considerable bravery, courage and determination,” an attitude essential to successfully address this issue. Other key components include an expansive array of grant programs, improvements to the prescription drug monitoring program and increased access to new medication-assisted treatments that hold huge promise, but are still untested, said Whitehouse.
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Learn MoreWith politicians in Washington proposing to put more cash into fighting the opioid epidemic (the U.S. House proposed half a billion dollars for one year, President Barack Obama sought $1 billion over two years), Whitehouse hopes appropriations to fund CARA’s programs will be approved this year. Currently, CARA proposes almost $490 million for fiscal 2017, to be allocated unequally for programs under the U.S. departments of Health and Human Services and Justice, a significant increase over the nearly $140 million allocated for fiscal 2016. According to a Whitehouse spokesperson, Sen. Jack F. Reed voted for CARA, and U.S. Reps. James R. Langevin and David N. Cicilline co-sponsored counterpart legislation in the House.
More people – 258 – died from overdoses than from homicides, suicides and car accidents combined last year in Rhode Island. “Everyone was affected … it was a real body blow to a small community … and we’re seeing more and more [of this],” said Whitehouse of Burrillville, where six people died of overdoses last year.
“The need for addiction treatment services affects 10 percent of the population, [yet] demand for access and utilization of services in any given year might be only 1 percent of the population,” said Daniel J. McCormick, senior vice president, Phoenix House, and executive director, Phoenix House New England. With 90 percent of those in need lacking access to services, Whitehouse’s leadership on CARA, which shines a brighter light on opioid addiction issues, is important, added McCormick.
“I think we’re dealing with a national epidemic. Opioid addiction isn’t something that’s out there outside of our neighborhoods,” said McCormick, noting that Suffolk and Nassau counties in New York State, which have two of the wealthiest zip codes, had the nation’s highest rates of overdose deaths.
Calling opioid addiction “a plague in so many states,” Rhode Island, Vermont, Tennessee and West Virginia among them, Whitehouse believes CARA survived “the partisan rancor of Washington” in part because of addiction’s far-reaching impact.
Earlier this month, Gov. Gina M. Raimondo, who established an Overdose Prevention and Intervention Task Force, signed a comprehensive package of bills focusing on strengthening and expanding opioid addiction prevention and treatment services. Raimondo’s efforts are closely aligned with CARA’s objectives, especially those that will strengthen the prescription drug monitoring program and expand community-based treatment programs, said Whitehouse.
Dr. Nicole Alexander-Scott, director of the Rhode Island Department of Health, agreed, confirming that medication-assisted treatment is one of Rhode Island’s major priorities in addressing this health crisis. “By opening up funding opportunities … to expand access to medication-assisted treatment, [CARA] will be life-changing for many people living with opioid use disorder.”
CARA also requires the General Accounting Office to comprehensively review all laws and regulations imposing collateral consequences on those with drug convictions. Whitehouse cites the example of a high school football captain who is injured, becomes addicted to his pain medication and cannot seek college loans, as a result of a drug conviction. “It’s hard to see how that has served society very well,” he said. After data are collected and analyzed, Whitehouse added, “We’ll have a significant task to … transition to a more effective and humane way of treating those [with] addictions.”