December 10, 2020

Whitehouse, Portman, Klobuchar Introduce CARA 2.0 to Increase Access to Treatment, Prevention & Bolster Fight against Addiction Epidemic

Legislation will serve as a marker for bipartisan progress in the new Congress

Washington, DC – Today, U.S. Senators Sheldon Whitehouse (D-RI), Rob Portman (R-OH), and Amy Klobuchar (D-MN) introduced the bipartisan Comprehensive Addiction and Recovery Act (CARA) 2.0 to increase the funding authorization levels for the Comprehensive Addiction & Recovery Act (CARA) programs enacted in 2016 and put in place additional policy reforms to help combat the opioid epidemic that has worsened during the coronavirus pandemic. CARA was a bipartisan, national effort designed to ensure that federal resources were devoted to evidence-based education, treatment and recovery programs that work. In FY 2020, CARA programs were funded at $658 million. CARA 2.0 builds on this effort by increasing the funding authorization levels and laying out new policy reforms to strengthen the federal government’s response to this crisis.

“Senator Portman’s and my CARA bill was the most wide-ranging federal addiction legislation ever passed,” said Senator Whitehouse. “Now, it’s time to deepen CARA’s reach into communities where the opioid crisis rages, and add important new reforms like expanding treatment options for new mothers and building our recovery workforce. I’m pleased to join Senator Portman and a bipartisan group of cosponsors to expand on the progress we’ve made in the fight against the opioid crisis.”

“In recent years we have made real 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 a 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 Senator Portman. “In the new Congress, we have a unique opportunity to work together in a bipartisan way and I believe that CARA 2.0 can help us make a real difference in combating this epidemic. I want to thank Senator Whitehouse and my bipartisan colleagues for their leadership and partnership on this important national effort.”

“Every day, families across Minnesota and the country lose loved ones to addiction,” Senator Klobuchar said. “The Comprehensive Addiction and Recovery Act 2.0 will give Americans access to vital treatment and recovery services. It will also ensure that commonsense prevention measures are implemented across the country, such as requiring the use of state prescription drug monitoring programs. We must continue to address this public health emergency and provide assistance to the millions of Americans who are suffering.”

CARA 2.0 authorizes $765 million in dedicated resources to evidence-based prevention, enforcement, treatment, criminal justice, and recovery programs. CARA 2.0 is part of the necessary response to the urgent call for adequate and sustained resources that appropriately reflect the magnitude of the crisis.

CARA 2.0 Policy Changes:

  • New research into non-opioid pain management alternatives.
  • 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.
  • Sets a three-day limit on initial opioid prescriptions for acute pain as recommended by the Centers for Disease Control and Prevention (CDC).
  • Requires physicians and pharmacists use their state PDMP upon prescribing or 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 patients a physician can treat with buprenorphine and methadone.
  • Creates a sense of Congress that an employee using medication-assisted treatment is not in violation of the drug-free workplace requirement.
  • 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.

CARA 2.0 Authorization Levels:

  • $10 million to fund a National Education Campaign on the dangers of prescription opioid misuse, heroin, and lethal fentanyl.
  • $25 million for training and employment for substance abuse professionals, including peer recovery specialists.
  • $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.

The CARA 2.0 bill text is here, section-by-section here, and a summary here.

Press Contact

Meaghan McCabe, (202) 224-2921