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Thursday, March 31, 2016

Comprehensive Addiction and Recovery Act and President Obama's Budget -- Fund the Fight Against Opioid Epidemic


The Comprehensive Addiction and Recovery Act, or CARA, has broad bipartisan support. As written, CARA contains several key provisions designed to combat opioid addiction, including:
  • Creation of a task force to develop prescribing guidelines for physicians writing prescriptions for opioid painkillers
  • Grants for state and local governments to expand educational outreach about opioids and addiction
  • Create treatment alternatives to incarceration for people arrested on drug-related charges
  • Improve veterans’ access to treatment for opioid addiction
  • Expand use of naloxone and other opioid antagonists by law enforcement officials

(“Opiate Addiction & Politics: Opioid Epidemic a Victim of Bureaucracy.” Waissman Method. March 08, 2016.)

The U.S. Senate passed the Comprehensive Addiction and Recovery Act this March (2016). The bill was approved in a 94 to 1 vote. CARA now moves to the House. If approved there, it will make its way to the Presidents desk. 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.

But the legislation, sponsored by Senators Sheldon Whitehouse, D-R.I., and Rob Portman, R-Ohio, provides no new money to fund its ambitious goals after Republican lawmakers killed a Democratic plan to provide $600 million in funding for the measure.

Several companion bills in the House of Representatives, H.R. 953, sponsored by Rep. James Sensenbrenner, R-Wis., and H.R. 3719, sponsored by Rep. Frank Guinta, R-N.H., are still in committee.

(Tony Pugh. “Senate passes anti-heroin bill, but provides no money to fund it.” March 10, 2016.)

Often, Congressional infighting stalls much-needed help for the opioid epidemic in the United States. The consequences of delaying emergency funding are widespread destruction and death. 
The Substance Abuse and Mental Health Services Administration (SAMHSA) estimates 4.3 million Americans are using prescription opioids for non-medical purposes while more than 400,000 more are using heroin. Approximately 44 people die each day because of prescription painkiller overdose, according to SAMHSA.

A reluctance to act speaks directly to the stigma related to drug addiction. If addiction was properly prioritized, Congress would support immediate action. Lawmakers cannot continue to ignore the demon in our midst while playing political games. Evidently, some judge arguing provisions as more important than saving lives. Political posturing and pressure from lobbyist groups can prevent real progress from being made. 
Just recently, the Centers for Disease Control and Prevention released guidelines regarding the prescription of opioid use for chronic pain. Thank God for that long-needed action. 


Much controversy rages about putting opioid abusers on medication, typically methadone and buprenorphine. Conservatives warn of problems with supplying these drugs. Of course these substances can be abused. There’s also a risk that the medications will be diverted and sold to other addicts.
Still, I believe, in the face of the epidemic, we have no choice but to use these medications just like we do other medicines that help heart patients or diabetes patients or the mentally ill maintain their lives.

For skeptics, abstinence is the treatment of choice. They believe replacing one drug with another drug is foreign to the goal of recovery. In a perfect world, these skeptics would be right, but, unfortunately, 2016 poses an ugly, undeniable reality – most addicts will never have success going “cold turkey.” The real alternatives to the prescribed combination of medication, monitored treatment, and counseling are permanent impairment, prison, or death.

What is the truth about opioid funding? CARA represents a fine beginning to combating addiction; however, much more is needed.

To further the solution to help states combat the opioid epidemic, President Obama has made a budget request for $1.1 billion for 2017.

The mandatory funding from the FY 2017 budget would go towards increasing access to treatment for prescription drug abuse and heroin use including:
  • $920 million for cooperative agreements with states to increase access to medication-assisted treatment for opioid use disorders over a 2-year period
  • $50 million towards the National Health Services Corps (NHSC) to increase access to providers who treat these disorder (enabling roughly 700 providers to offer substance use disorder treatment services in areas with poor access to behavioral health providers)
  • $30 million to assess how effective treatment program are in delivering medication assisted therapy "under real-world conditions" 

    Yet ... 
This particular Republican-controlled Congress has said — in an unprecedented move — that it will not even hold hearings on Obama’s budget. Even before it is printed! This refusal is in the face of the Centers for Disease Control and Prevention confirmation that prescription painkillers, heroin, and other opioids killed more than 28,000 people in the United States last year, driving the highest number of drug overdose deaths on record.

The Los Angeles Times' Jon Healey says, “The message to the administration, is, in short: We don't want to work with you. But we're still going to cry foul if you don't work with us.”


The decision to refuse to take up the President's budget proposal has not set well with Democrats. Nancy Pelosi stated, "The Republican Chairmen’s contemptuous attitude is unworthy of the U.S. Congress and the American people."

Presidential candidate Bernie Sanders now running as a Democrat and also a ranking member on the Senate Budget Committee wrote, "The president's budget is more than a political document. It is a compilation of the opinions of experts throughout the government."

Over the past few weeks, pieces of the final budget have been previewed, prompting Republicans to have no interest in bringing it up for a hearing for the first time in history. It included additional spending to combat ISIS and increase presence in Europe while asking for $19 billion to up cyber security, a threat of the future.

(Chase Hunt. “Republicans refuse to look over Obama's budget despite falling deficit.” February 10, 2016.)

We, as concerned Americans, must demand all funds not only be appropriated but also spent to enact the Comprehensive Addiction and Recovery Act's and President Obama's provisions. Enough “talk.” It is time to “walk the walk.” Money – funds in large sums -- must be approved for success against a drug epidemic that is homeland threat Number One. Just consider the lives in the balance.


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