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The CARA Bill: What is it and What Does it Mean?

Back in March, the United States Senate passed the Comprehensive Addiction and Recovery Act, or CARA for short, in response to the rampant opioid addiction that has swept this nation over the past 10 years. This bill is the first step towards addressing the rampant prescription opioid addiction that more often than not leads to heroin. The Bill was passed almost unanimously and was the result of three years of bipartisan work in the Senate.

This past Friday, July 8th, the Bill was placed before the House of Representatives for a vote and it passed by a landslide majority of 407 to 5. In the weeks to come, the bill is expected to be signed by President Obama for approval, which will then lead to its implementation.

The need for a comprehensive overhaul of the way we have gone about dealing with drug addiction in this country has been long overdue. From 2010 to 2014 heroin overdoses tripled among African Americans, among Hispanics overdoses went up 137%, among Native Americans 236%, and among Whites 267%. Initially, harsher restrictions were put into place in an attempt to combat these increases and better regulate prescription drug usage, but like similar laws in the past, these tactics did little to deal with rehabilitation and only dealt in punishment.

This is where the CARA Bill differs from many of its predecessors in dealing with drug addiction more importantly opioid addiction, in that it is attempting to put forth a dialogue where drug addiction is viewed as a public health concern rather than a criminal concern. This is a dramatic departure from the “Just Say No” and “War on Drugs” philosophy that the country has partaken in for the past 30 years and is a necessary step, proponents say, towards properly tackling the issue of drug addiction in this country.

President Obama and rapper Macklemore echoed this same sentiment when they met in May of this year in order to address their concerns over the opioid epidemic. Macklemore, who had a former opioid addiction, discussed how opiate addiction affects all Americans and that something must be done in order to stop its rise. In response, President Obama expressed a desire to move away from criminalizing drug addiction and move towards getting treatment to more people. Both believed that a change in Governmental policy was necessary and the CARA Bill represents this.

The CARA Bill “sends a strong message that medication-assisted treatment [should be] the standard of care for opioid use disorders.” This is a shift from the traditional 12-Step based treatment model, which due to advice from the medical community has been usurped in the Bill by medication-assisted treatment.

For those of you who do not know, medication-assisted treatment combines behavioral therapy and medications in order to treat substance abuse disorders. Often these medications are focused on opioid abuse and they consist of using Suboxone and Methadone in either the short term or long term in order to treat the cravings that opioid addicts experience in order to keep them performing dangerous and illegal drug seeking behaviors. The thought behind this is that abstinence-only programs are not the only way in which someone can get sober and that sometimes medication may be necessary in order to treat opioid addiction.

Growing evidence has shown that the medication-assisted model of treatment may be more effective than traditional models for treatment and one study even showed that 40-60% of people who participated in a particular medication-assisted treatment program stayed sober throughout the year following discharge.

Although the Bill hopes to direct treatment for opioid abuse in a different direction, it does not directly give any new money to treatment or prevention. It does, however, offer state and local governments grants in order to make medication-assisted treatments available for prisoners. This is a something that has been wanting among the prison population for years because the medication was never available to them in the past. Many drug addicts in prison had to go through withdrawal without any medical assistance and unfortunately there has also been a rising number of deaths due to complications from withdrawal. The Bill will hopefully do away with this cruel and arcane treatment of prisoners, which will also hopefully help stem the tide of drug smuggling in American Prisons.

As great as a step this Bill is in fighting the opioid epidemic in this country, Senator Sheldon Whitehouse points out that the funding for it still has to be allocated in the 2017 budget. This means that until this is done funding for the programs outlined in the Bill will be nonexistent. However, with the bipartisan support that the CARA Bill has received thus far, allocating the funds should not be an issue.

Two things that critics of the bill say that it is missing is a lessening of restrictions on prescribing drugs like Suboxone, and funding for needle exchange programs. Critics maintain that there are still only 32,000 doctors across the country that are able to prescribe these drugs and this has caused a waiting list with people desperate to get treatment which in turn is just feeding this opioid addiction to people. In order to appropriately enact the spirit of the Bill more doctors would be needed in order to achieve its goals, and so this is something that The Department of Health and Human Services, who is in charge of such regulations, is looking into. Congress did end a ban on funding for needle exchange programs this year, but they are still not directing federal dollars towards these programs as of yet. Hopefully in the months to come this will change and more federal money will be made available to fund much-needed needle exchange programs across the nation.

The CARA Bill is an important piece of legislation that seems to represent a shifting in understanding about drug addiction in this country. It will hopefully lead to a reduction in the amount of prisoners in this country that are incarcerated for nonviolent drug-related offenses and start to get these people the help that they need. There is still a long road ahead in order to truly enact a meaningful change in the way that drug addiction is dealt with in this country, but the CARA Bill is a great start.  

Rose Lockinger is a passionate member of the recovery community. A rebel who found her cause, she uses blogging and social media to raise the awareness about the disease of addiction. She has visited all over North and South America. Single mom to two beautiful children she has learned parenting is without a doubt the most rewarding job in the world. Currently the Outreach Director at Stodzy Internet Marketing.

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