The Comprehensive Addiction and Recovery Act (CARA)

addictionAddiction treatment and prevention are crucial if we are ever to get a handle on the prescription opioid and heroin epidemic in the United States. As presidential candidates criss-cross the country, addiction is a major talking point – especially in some of the most rural areas. Everyone is interested in learning how the potential leaders will tackle the problem, a crisis that is stealing 78 lives every day, according to the Centers for Disease Control and Prevention (CDC).

On top of an interagency effort to curb overprescribing, expand access to the life saving drug naloxone and create more substance use disorder treatment facilities Senators have been working to pass the Comprehensive Addiction and Recovery Act.

A Fighting Chance

The Comprehensive Addiction and Recovery Act (CARA), if passed, the bill authorizes the Attorney General to award grants to address the national epidemics of prescription opioid abuse and heroin use. After concerns that there would not be enough funding for the bill to be effective, an amendment to the bill was put forward for an additional $600 million in funding. On Wednesday, the amendment failed to receive the 60 votes needed to approve the additional funds, The Washington Post reports. Despite the amendment being voted down, Senate Democrats said they will not block the legislation over funding.

“There certainly is no desire to take the bill down over that through the caucus at large,” said Sen. Sheldon Whitehouse (D-R.I.), an author of legislation. “If somebody’s so mad about that that they just can’t bring themselves to vote for it, that will be their personal decision.”

The Big Picture

The democratic Senators choice to not block the bill because of the vote on Wednesday is indicative of how much attention the crisis deserves. While the amendment had the support of Senators from both sides of the aisle, there are a number of republicans who feel that the bill had enough funding to adequately address the opioid epidemic, according to the article. One could argue that some lawmakers do not fully grasp the true scope of the problem.

“It just seems ill-advised, to say the least, to appropriate more money when in fact there’s already $571 million available to deal with this epidemic,” said Senate Majority Whip John Cornyn (R-Texas).

This is a story we will continue to follow.

Needle Exchanges Have Funding On The Way

needle exchangeIt is fair to say that people are going to continue to use both prescription opioids and heroin despite the recent interagency actions of the Federal government which are doing what they can to assist states that are struggling to address the crisis. Of late, there have been three areas that have been the focus topics, some of which are controversial.

In a number of states, opioid addicts and their loved ones can acquire the life saving drug naloxone without a prescription. The drug, if administered in a timely manner, can reverse the deadly symptoms of an opioid overdose. There have also been reports of opioid addicts having to wait lengthy periods for a bed at substance use disorder treatment facilities, which is why the White House is calling upon Congress for $1.1 billion to expand access to treatment throughout the country.

Arguably, needle exchange programs remain to be controversial, despite the fact that they not only reduce the transmission of disease, they also provide a forum for addiction counselors to reach addicts that they would otherwise not see. Historically, many lawmakers have been opposed to such programs, arguing that they promote continued drug use; however, every lawmaker is aware that the opioid crisis in America has reached epidemic proportions and they are coming to see that they may have to think outside the box.

A Federal Ban On Needle Exchanges

Every day, needle exchanges operate throughout the country, but they do so without any financial support from the federal government. Needle exchange programs do a lot of good and with the spike of opioid addiction there is a much higher demand for clean needles – a reality which is spreading the programs thin.

In an attempt to assist such programs, last month Congress passed a measure that would lift a ban on funding needle exchanges, WBUR reports. While the measure’s passing could easily be considered to be a paradigm shift, the funding cannot be used for purchasing syringes – which can account for a third of the facilities overhead.

The funding can only be used for:

  • Staff
  • Vehicles
  • Counseling
  • Outreach

Baby Steps

It could easily be argued that the measure is lacking, but anything helps and we can only hope that this measure will be amended after Congress sees what the good needle exchange programs do for communities that have been hit hard by the opioid epidemic. Without expanded access to clean needles, the problem is only exacerbated.

“It is really an important and historic moment for us at syringe exchanges,” said Mark Casanova, Executive Director of Homeless Healthcare Los Angeles, which runs a syringe exchange. “But it doesn’t go far enough.”

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