Comprehensive Addiction and Recovery Act Passes Senate

By Zachary Siegel 03/11/16

While the bill may have passed the Senate, it still has to go through the House of Representatives where it is expected to face even more debate. 

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Comprehensive Addiction and Recovery Act Passes Senate
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The U.S. Senate nearly unanimously passed a major piece of legislation that aims to combat America’s current opiate crisis—a stark contrast from the tired “War on Drugs” rhetoric seen in past decades.

Known as the Comprehensive Addiction and Recovery Act (CARA), the bill was approved Thursday in a 94 to 1 vote. If enacted into law, CARA would be the government’s most incisive step yet to move drug policy away from punishment and toward humane, public health solutions.

“This is a strong signal that the United States Congress now understands this issue,” Rob Portman (R-Ohio) who co-sponsored the bill, told reporters after the vote.

Between 2010 and 2014, heroin and opioid overdose rates skyrocketed, according to the CDC. There was a 14% spike in opiate poisonings during 2014 alone, an all-time high in America.

Senate Majority Leader Mitch McConnell (R-Ky.) is confident the bill will make a difference. “This authorization bill, in conjunction with the $400 million appropriated for opioid-specific programs just a few months ago, can make important strides in combating the growing addiction and overdose problem we’ve seen in all 50 states,” he said on the Senate floor.

To attack this problem effectively, drastic changes in the way opiate use disorder is treated are necessary. The dominant ideology in the American treatment industry is currently 12 step, abstinence-based. While this may be effective for some, it has less and less shown its efficacy when applied to young heroin users, many of whom overdose and die after leaving abstinence-only treatment facilities.

CARA seeks to undo this tragedy, and move patients addicted to opiates onto medication-assisted treatments such as methadone, Suboxone, and naltrexone.

In an interview with the Huffington Post, Dr. Kelly Clark, president-elect of the American Society of Addiction Medicine, said that her organization sees CARA as a “down payment on really attacking the epidemic.” She emphasized a point of contention, however, that the bill makes no mention of lifting the cap on the number of patients a doctor can treat with buprenorphine, which is currently 100, not nearly enough to make a dent in the vulnerable population of opiate users.

“There’s still a lack of access to the most evidence-based treatment for opioid addiction, which is medication used in the treatment of opioid addiction,” said Clark. “Funding from the federal government in and of itself will not increase access to that treatment ... It’s imperative that this Congress addresses that 100-patient limit.”

To address opiate-related mortality, Sen. Joe Donnelly (D-Ind.) attached an amendment to the bill that would provide follow-up services for people who have been given naloxone, an opiate overdose reversal drug. An amendment to increase funding for law enforcement was shot down.

The bill now moves on to the House of Representatives, where it is expected to face even more debate. If it does reach the White House, President Obama is expected to sign it.

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Zachary Siegel is a freelance journalist specializing in science, health and drug policy. His reporting has also appeared in Slate, The Daily Beast, Salon, Huffington Post, among others. He writes often about addiction, sometimes drawing from his own experience. You can find out more about Zachary on Linkedin or follow him on Twitter.

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