On July 22, 2016, CARA- Comprehensive Addiction and Recovery Act was signed into law by President Obama. It was the first federal addiction act in 40 years presented by Senator Sheldon Whitehouse and Representative Jim Sensenbrenner. The law addresses the opioid addiction and implementing programs for prevention, treatment, recovery, criminal justice reform, and law enforcement, and overdose reversal.

The CARA establishes a coordinated strategy through grant programs that will enable education efforts while promoting overall opioid treatment and recovery. It declares that over $80 million each year will be funded to end the opioid epidemic.

A brief summary of the Act-

  • Improved Awareness Efforts- Take effective measures to expand the educational efforts among teens, parents, caretakers, and senior populations—to prevent the use of opioids, methamphetamines, and heroin. Promoting recovery and treatment options available for them.
  • Making naloxone available to enforcement agencies and other responders for overdose reversal to save lives.
  • Invest in resources to identify imprisoned individuals suffering from opioid/drug addiction disorders by working with criminal justice representatives and offer evidence-based treatment.
  • Strengthen prescription drug monitoring programs to help states monitor and track prescription drug diversion and to help at-risk individuals access services.
  • Launch an evidence-based treatment and intervention programs for opioid and heroin treatment. We have the medications and services for addiction treatment, but the critical need is to get the necessary resources and training to strengthen evidence-based treatment and improve recovery across the country.
  • Launch a medication-assisted treatment and intervention demonstration program.

Here are the key highlights from CARA-

Part 1- Prevention and Education

  • The Department of Health and Human Services and the Attorney General will work together to accelerate education and awareness of the risk of opioid drugs if not taken more than prescribed. The awareness camp will work on opioid misuse, heroin, and fentanyl. 
  • Making resources available to young sportsmen and their families to understand the use of prescription opioids. 
  • Collaborate with pharmacies to implement a plan of action to distribute opioids overdose reversal drugs. 
  • Provide training on how to monitor overdose reversal drugs and educate the people on the availability of overdose reversal drugs or devices.
  • Prepare an interagency task force to develop and follow a set of best practices for acute and chronic pain management, and pain medication. 
  • Implement community-wide strategies for prevention, misuse, and make grants to entities suffering from a drug overdose. 
  • Helping veterans with medical specialties to gain civilian certification and other medical licensing as civilians. 
  • Under “Grants for Reducing Overdose Deaths,” eligible healthcare entities will be awarded grants to expand the access to opioid overdose reversal drugs or devices (such as Naloxone). 
  • Launch a coordinated research plan to focus on understanding the pain, finding alternatives for pain treatment, and development of chronic pain therapies. 
  • Implement Prescription Drug Monitoring Programs (PDMPs) be administered by HHS in consultation with SAMHSA and CDC.

Part 2- Law Enforcement and Treatment 

  • Create a grant program to develop and implement strategies for treatment alternatives, enhance collaboration between criminal justice, substance misuse, and state agencies to combat opioid misuse, offer resources, and training on reversal drugs or devices. 
  • Enhancing law enforcement efforts to fight illegal distribution of opioids, implementing medication-assisted treatment programs, and prevent youth opioids misuse. 
  • Encourage innovation for the development of secure containers for prescription drugs, creating drug take-back programs, and creating comprehensive opioid misuse response programs. 
  • Offer training in the use of naloxone and for the purchase of naloxone. 
  • Coordinate with DEA, HHS, ONDCP, law enforcement agencies, and pharmacies to develop or expand disposal sites for unwanted prescription medications.

Part 3- Treatment and Recovery 

  • Evidence-based treatments and interventions for prescription opioid and heroin treatment in geographic areas that show a high rate of heroin or other opioids addiction and making medication-assisted treatment available in the relevant areas. 
  • Grant independent nonprofit organizations for the development and expansion of recovery services. Restrict the prescriber to dispense buprenorphine from 30 up to 100 per year.   

Part 4- Addiction and Treatment Services for Women, Families, and Veterans 

  • Launch a Residential Treatment Program for Pregnant and Postpartum Women that will launch a pilot program to enhance treatment for pregnant and postpartum women suffering from substance use disorder. 
  • Omnibus Crime Control and Safe Streets Act of 1968 to allow DOJ to expand substance use treatment programs and rehabilitation for veterans.
  • Implement best practices for the care of infants born with substance use disorders or showing withdrawal symptoms. Address the health and substance use disorder of the infant.
  • Submit a report that will include a detailed layout of on prevalence, treatment, costs, and recommendations for improvements for Neonatal Abstinence Syndrome (NAS).

Part 5- Miscellaneous 

  • Excluding or restricting abuse-deterrent formulations and research on new formulations of prescription drugs.
  • Grant $5 million to the Medicaid Improvement Fund for FY 2021 and on. 
  • Implementing analytics technologies and predictive modeling to identify and Prevent Waste, Fraud, and Abuse.” This section exempts certain algorithms used by States to target waste, fraud, and abuse from being disclosed. 
  • Sense of Congress demonstrates a fiscally responsible way to handle drug epidemics and treat them as a public health emergency that requires prevention, treatment, and recovery. 

For additional info, you can track the bill here.