Congress signs off on CARA: What they’re saying

Following the passage of the Comprehensive Addiction and Recovery Act (CARA) by the Senate on Wednesday, the most ambitious piece of addiction legislation from Congress in years now heads to President Barack Obama’s desk for final approval.

Legislators and behavioral healthcare officials offered the following statements on the landmark bill:

Josh Earnest, White House press secretary: “The administration has consistently said that turning the tide of the prescription opioid and heroin epidemic requires real resources to help those Americans seeking treatment get the care that they need. We continue to believe this bill falls far short. That's why the administration strongly supported Democratic efforts to add $920 million in funding for states to provide treatment for Americans struggling with opioid addiction. … While the president will sign this bill once it reaches his desk because some action is better than none, he won’t stop fighting to secure the resources this public health crisis demands. Congressional Republicans have not done their jobs until they provide the funding for treatment that communities need to combat this epidemic.”

Speaker Newt Gingrich, Rep. Patrick Kennedy and Van Jones, co-founders of Advocates for Opioid Recovery: “We are encouraged that the bill authorizes nurse practitioners and physician assistants to prescribe medication for recovery, which will help ease some of the waiting list issues patients face. It also authorizes the Department of health and Human Services (HHS) to exempt certain forms of recovery medications, such as implantable devices, from the arbitrary caps on the number of patients that health providers can treat—an immediate action that we urge HHS to take. However, the fact remains that we should not have these caps at all for any certified providers. Public policy that prevents healthcare providers from practicing medicine according to the clinical guidelines, which includes buprenorphine, is an injustice. Because the CARA bill does not include any new funds to implement the interventions it contains, Congress should and must act through the appropriations process, including state block grants, to ensure the programs authorized in the bill can be implemented.”

Jeffrey Goldsmith, American Society of Addiction Medicine (ASAM) president: “It has been a privilege to be a part of the process as Congress has considered how best to respond to the epidemic of opioid overdoses that has been ravaging our nation, our communities and our families. It’s not a perfect bill, and we still need Congress to act to fund it this year, but it is a major step forward to help promote prevention, expand access to treatment, and enhance crucial recovery support services. With adequate funding, we believe this bill will help save lives.”

Linda Rosenberg, president and CEO, National Council for Behavioral Health: “The National Council for Behavioral Health applauds Congress for its hard work to bring this bill to passage. Yet today, we must also recognize that our work is far from over. ... We must support states in their efforts to expand addiction care by fully funding CARA. The House says it will appropriate $581 million when it returns to Washington in September. While we’re waiting, more than 6,000 Americans will die from opioid overdose, and thousands more from alcohol-related deaths. We must finish the process, and give CARA teeth.”

Marvin Ventrell, National Association of Addiction Treatment Providers (NAATP) executive director: "While the long-term significance of CARA cannot be known at this time, the legislation is seminal in its potential to reframe national addiction policy as a health care condition that demands a comprehensive health care response. Blame, stigmatization and certainly criminalization should no longer be our national response. Of course now, we must redouble our advocacy efforts to produce the necessary funding to effectuate the policy."