Sen. Sheldon Whitehouse, D-R.I., recently introduced the Comprehensive Addiction and Recovery Act (CARA) 2.0 Act to increase the funding authorization levels for the CARA programs enacted in 2016 and add new policy reforms to further aid efforts to curb the opioid epidemic, including limiting opioid prescriptions to three days.
CARA was a bipartisan, national effort designed to ensure 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, which includes $6 billion in additional resources for fiscal years 2018 and 2019, while 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.
As a result of CARA, Rhode Island has received $3 million over three years to create 10 Centers of Excellence for Opioid Use Disorders, which are a cornerstone of Gov. Gina M. Raimondo’s action plan to address opioid addiction. The centers provide rapid access to treatment and comprehensive services for people struggling with opioid addiction.
PBN: The consensus to add $6 billion in funding to CARA marks fighting the opioid epidemic as a rare bipartisan effort. What about this problem is driving this level of cooperation?
WHITEHOUSE: There is enormous bipartisan support in Congress for preventing and treating opioid addiction. Opioids are taking a toll on families from all walks of life in red and blue states across the country. At a time when very little legislation was able to gather enough bipartisan momentum to become law, the Comprehensive Addiction and Recovery Act (CARA) I authored with Republican Sen. Rob Portman to combat the opioid epidemic passed the Senate 94-1 and was signed by President [Barack] Obama in 2016. Our new bipartisan legislation to further address this public health crisis, CARA 2.0, has also received a strong show of support from members on both sides of the aisle.
PBN: Rhode Island is one of the few states reporting a drop in opioid deaths this year. Has that drawn national leaders’ attention to Ocean State successes with this funding?
WHITEHOUSE: I hosted the U.S. Surgeon General, Jerome Adams, for a visit to Rhode Island in January, and he was deeply impressed by the approach our state has taken to fighting the opioid crisis. Gov. Gina Raimondo, Director of Health Dr. Nicole Alexander-Scott, and BHDDH [Behavioral Healthcare, Developmental Disabilities and Hospitals] Director Rebecca Boss have shown great leadership, police departments and emergency rooms have stepped up and we are moving in the right direction as a result.
We are fortunate to have a dedicated, compassionate recovery community, including the specialists at CODAC, The Providence Center and Phoenix House. The expertise of local recovery advocates [such as] the late Jim Gillen of Anchor Recovery was instrumental in writing CARA.
PBN: CARA 2.0 makes Section 303 of CARA permanent – physicians have noted the federal limit for prescribing buprenorphine is a stigmatized holdover from the War on Drugs. Do you see a possible return for this limit sometime in the future?
WHITEHOUSE: While medication-assisted treatment is just one piece of the puzzle, it has proved to be a hugely important tool for helping people in recovery stay on track. The trend is toward expanding access to medication-assisted treatment, while limiting the risk of the medication getting into the wrong hands.
PBN: To what degree will the Infant Plan of Safe Care affect the opioid addiction problem in Rhode Island?
WHITEHOUSE: Some of the most heartbreaking images I have seen from this crisis are of babies born suffering from opiate withdrawal because their mothers were grappling with addiction. These infants through no fault of their own start life from a very difficult place. The Infant Plan of Safe Care requires that a tailored action plan be put in place to keep these newborns and their families safe and healthy.
PBN: What part of this legislation stands to aid the effort to curb opioid addiction in Rhode Island the most?
WHITEHOUSE: Better prescription-drug monitoring and prescribing practices, more support for people in recovery, and increasing civil and criminal penalties for opioid manufacturers that negligently allow addictive pills to get into the wrong hands. Pharmaceutical companies have not met their responsibility to keep unnecessary pills off the market, and I wanted this legislation to hold manufacturers more accountable and help avoid a lot of harm.
The bottom line is that we need a well-funded and comprehensive approach to preventing addiction and supporting those on the long, noble path of recovery. Between the existing CARA law, added funding and our new CARA 2.0 bill, we are moving in the right direction in the way we treat addiction in Rhode Island and across the country.
Rob Borkowski is a PBN staff writer. Email him at Borkowski@PBN.com.