Inside CARA 3.0: Critical, bi-partisan legislation increases access to treatment and funding for prevention

Sen. Rob Portman

The Comprehensive Addiction and Recovery Act 3.0 (CARA) is designed to ensure that federal resources are devoted to evidence-based education, treatment and recovery programs that work.

In 2016, Congress passed the Comprehensive Addiction & Recovery Act (CARA), and once signed into law, it provided financial and policy support necessary to take on the growing opioid addiction crisis across the country.

Since then, elements of the SUPPORT Act strengthened these efforts, and with the newly-introduced CARA 3.0 bill, there could be even more (and long-awaited) help coming to people fighting addiction.

Action targeting a growing problem

Led by Senator Rob Portman, R-Ohio, the CARA 3.0 bill addresses the sharp rise in addiction-related issues brought to light by a spike in suspected overdoses nationally within the first three months of the COVID-19 pandemic and moves our policies further toward a model of prevention, education, treatment, and recovery rather than simply jailing addicts, a news release states.

Among CARA 3.0’s policy changes are programs that explore non-opioid pain management options for physicians, a pilot program to study the impact of mobile methadone clinics in rural and underserved areas, an expansion to federal housing access that includes individuals who have misused sentences or received criminal convictions, and many other helpful ideas and programs.

Funding to support evidence-based care

Along with the policy changes, the funding allocated from this bill will provide much-needed federal funding for research, training, court programs, treatment, and recovery programs. With this support, our criminal justice programs, which have become the front lines for tackling addiction issues, will have research-backed, evidence-based solutions at their disposal.

“In recent years we have made progress in fighting the scourge of addiction thanks to resources from the bipartisan CARA law, in addition to other bipartisan efforts in Congress. However, the COVID-19 pandemic has created unprecedented challenges and we are now seeing another heartbreaking surge in overdose deaths. That is why we must redouble our efforts to combat addiction and help those who are suffering during this crisis,” said Portman. “In the new Congress, we have a unique opportunity to work together in a bipartisan way and I believe that CARA 3.0 can help us make a real difference in combating this epidemic. I want to thank Senators Whitehouse and Klobuchar for their leadership and partnership on this important national effort.”

Building on the success of CARA 2.0

CARA 3.0 Policy Changes/Portman, Whitehouse, Capito, Klobuchar, Shaheen

  •  New research into non-opioid pain management alternatives and New research on long-term treatment outcomes to sustain recovery from addiction.
  • Establishes a National Commission for Excellence in Post-Overdose Response to improve the quality and safety of care for drug overdoses and substance use disorders.
  • Requires physicians and pharmacists use their state PDMP (Prescription Drug Monitoring Program) upon prescribing/dispensing opioids.
  • Mandates physician education on addiction, treatment, and pain management.
  • Prohibits states from requiring prior authorization for medication-assisted treatment under Medicaid.
  • Establishes a pilot program to study the use of mobile methadone clinics in rural and underserved areas.
  • Removes the limit on the number of patients a physician can treat with buprenorphine and methadone.
  • Permanently allows providers to prescribe medication-assisted treatment and other necessary drugs without a prior in-person visit, and to bill Medicare for audio-only telehealth services.
  • Expands access to federal housing for individuals who have misused substances or have a drug-crime conviction.
  • Incorporates changes in grant programs to gather more data on who receives services to achieve more equitable outcomes across race and socioeconomic status and emphasizes delivering culturally competent services.

Putting the dollars to work

CARA 3.0 Authorizations/Portman, Whitehouse, Capito, Klobuchar, Shaheen

  • $10 million or more to fund a National Education Campaign on the dangers of prescription opioid misuse, heroin, and lethal fentanyl.
  • $55 million for training and employment for substance abuse professionals, including peer recovery specialists and $5 million set aside for workforce retention efforts.
  • $10 million for community-based coalition enhancement grants to address local drug crises.
  • $300 million to expand evidence-based medication-assisted treatment (MAT).
  • $200 million to build a national infrastructure for recovery support services to help individuals move successfully from treatment into long-term recovery.
  • $100 million to expand treatment for pregnant and postpartum women, including facilities that allow children to reside with their mothers.
  • $20 million to expand Veterans Treatment Courts.
  • $10 million for a National Youth Recovery Initiative to develop, support, and maintain youth recovery support services.
  • $50 million to provide quality treatment for addiction in correctional facilities and in community reentry programs.
  • $30 million for deflection and pre-arrest diversion programs in the criminal justice system.

Reason for hope

CARA 3.0 renews and strengthens these programs and provides a significant boost in funding as well. When added with existing CARA programs that are reauthorized through 2023, we will be investing well over $1 billion to address this long-standing epidemic, putting us on the path toward a brighter future free from addiction. The tragic rise in overdose deaths during COVID-19 underscores the need for CARA 3.0. My hope is that we can come together quickly and pass this important bipartisan legislation to once again turn the tide of addiction and help all Americans live up to their God-given potential.