WASHINGTON, D.C. – U.S. Sen. Sherrod Brown (D-OH) is supporting new legislation to boost funding and supports for communities battling the opioid epidemic, and to limit opioid prescriptions for acute pain to three days to curb addiction.
The bill, introduced by U.S. Sen. Rob Portman (R-OH), builds on the bipartisan Comprehensive Addiction and Recovery Act (CARA), which Brown supported in 2016 to direct funding toward the opioid epidemic. The bill, known as CARA 2.0, will increase the funding authorization levels for the CARA programs enacted in 2016 so they better coincide with the recent budget agreement. The bill also includes a provision that would make permanent provisions in CARA taken from Brown’s TREAT Act, which increased access to medication-assisted therapy (MAT).
“Ohioans know too well the devastation the opioid epidemic has brought on our state, and communities on the frontlines need our help. CARA is already helping states tackle this epidemic – from putting more people into treatment and supporting law enforcement, to boosting prevention and education,” said Brown. “We must build on CARA’s strides by directing additional resources toward this public health crisis before it takes more lives.”
The Brown provisions included in CARA expanded access to MAT by allowing qualified physicians to treat larger numbers of patients struggling with addiction, and for the first time, allow certain nurse practitioners and physician assistants to administer MAT. When passed in CARA, these provisions were only temporary. CARA 2.0 will permanently expand access to this treatment, as Brown’s TREAT Act called for, so more patients have access to effective therapies.
CARA, which became law in July 2016, authorized an additional $181 million for these evidence-based treatment, prevention, law enforcement and recovery programs, and were funded at $267 million for FY 2017. There is bipartisan agreement that more resources will be necessary to help turn the tide of this epidemic. The recent budget agreement includes $6 billion in additional resources for fiscal years 2018-2019.
CARA 2.0 will build on the original law by increasing the funding authorization levels for CARA’s evidence-based programs to better coincide with the recent budget agreement and 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.
CARA 2.0 also:
- Imposes three-day limit on initial opioid prescriptions for acute pain as recommended by the Centers for Disease Control and Prevention (CDC), with exceptions for chronic pain or pain for other ongoing illnesses.
- Makes permanent Section 303 of CARA which allows physician assistance and nurse practitioners to prescribe buprenorphine under the direction of a qualified physician.
- Allows states to waive the limit on the number patients a physician can treat with buprenorphine so long as they follow evidence-based guidelines. There is currently a cap of 100 patients per physician.
- Require physicians and pharmacists use their state PDMP upon prescribing or dispensing opioids.
- Increases civil and criminal penalties for opioid manufacturers that fail to report suspicious orders for opioids or fail to maintain effective controls against diversion of opioids.
- Creates a national standard for recovery residence to ensure quality housing for individuals in long-term recovery.
CARA 2.0 authorizes:
- $10 million to fund a National Education Campaign on the dangers of prescription opioid misuse, heroin, and lethal fentanyl (up from $5 million in the original CARA).
- $300 million to expand evidence-based medication-assisted treatment (up from $25 million in the original CARA).
- $300 million to expand first responder training and access to naloxone (up from $12 million in the original CARA).
- $200 million to build a national infrastructure for recovery support services to help individuals move successfully from treatment into long-term recovery (up from $1 million in the original CARA).
- $20 million to expand Veterans Treatment Courts (up from 6$ million in the original CARA).
- $100 million to expand treatment for pregnant and postpartum women, including facilities that allow children to reside with their mothers (up from $17.9 million in the original CARA).
- $60 million to help states develop an Infant Plan of Safe Care to assist states, hospitals and social services to report, track and assist newborns exposed to substances and their families (no authorization in the original CARA).
- $10 million for a National Youth Recovery Initiative to develop, support, and maintain youth recovery support services (no authorization in the original CARA).