Capito Introduces Bipartisan CARA 2.0 Act to Bolster Fight Against Opioid Epidemic

Legislation would increase opioid funding, limit opioid prescriptions for acute pain to three days, enhance prescription drug monitoring

WASHINGTON, D.C. — U.S. Senator Shelley Moore Capito (R-W.Va.) today joined Senators Rob Portman (R-Ohio) and Sheldon Whitehouse (D-R.I.) in introducing the Comprehensive Addiction and Recovery Act (CARA) 2.0 Act. The bipartisan legislation would increase the funding authorization levels for the CARA programs enacted in 2016 and put in place additional policy reforms to help combat the opioid epidemic—including limiting opioid prescriptions for acute pain to three days.
“The opioid epidemic truly is a national crisis that is affecting families and communities across the country, and in West Virginia, we’ve become far too familiar with its consequences,” Senator Capito said. While we’ve accomplished a lot in terms of drawing attention to the drug epidemic and providing resources to help address it, it’s painfully clear that we still have a long way to go and need to be doing even more. This bipartisan legislation will help continue efforts that are critical to fighting the opioid epidemic and providing help to individuals struggling with addiction. This is an important next step in a much broader effort, and I’m confident it will bring us closer to making real progress in this fight.”
CARA 2.0 will build on the original law by increasing the funding authorization levels for CARA’s evidence-based programs to better coincide with the recent budget agreement and laying out new policy reforms to strengthen the federal government’s response to this crisis. The bill will authorize $1 billion in dedicated resources to evidence-based prevention, enforcement, treatment, and recovery programs.

CARA 2.0 Policy Reforms

  • Imposes three-day limit on initial opioid prescriptions for acute pain as recommended by the Centers for Disease Control and Prevention (CDC), with exceptions for chronic pain or pain for other ongoing illnesses.
  • Makes permanent Section 303 of CARA which allows physician assistance and nurse practitioners to prescribe buprenorphine under the direction of a qualified physician.
  • Allows states to waive the limit on the number patients a physician can treat with buprenorphine so long as they follow evidence-based guidelines. There is currently a cap of 100 patients per physician.
  • Require physicians and pharmacists use their state PDMP upon prescribing or dispensing opioids.
  • Increases civil and criminal penalties for opioid manufacturers that fail to report suspicious orders for opioids or fail to maintain effective controls against diversion of opioids.
  • Creates a national standard for recovery residence to ensure quality housing for individuals in long-term recovery.

CARA 2.0 Authorization Levels

  • $10 million to fund a National Education Campaign on the dangers of prescription opioid misuse, heroin, and lethal fentanyl (up from $5 million in the original CARA).
  • $300 million to expand evidence-based medication-assisted treatment (up from $25 million in the original CARA).
  • $300 million to expand first responder training and access to naloxone (up from $12 million in the original CARA).
  • $200 million to build a national infrastructure for recovery support services to help individuals move successfully from treatment into long-term recovery (up from $1 million in the original CARA).
  • $20 million to expand Veterans Treatment Courts (up from 6$ million in the original CARA).
  • $100 million to expand treatment for pregnant and postpartum women, including facilities that allow children to reside with their mothers (up from $17.9 million in the original CARA).
  • $60 million to help states develop an Infant Plan of Safe Care to assist states, hospitals and social services to report, track and assist newborns exposed to substances and their families (no authorization in the original CARA).
  • $10 million for a National Youth Recovery Initiative to develop, support, and maintain youth recovery support services (no authorization in the original CARA).

Other original co-sponsors include Senators Amy Klobuchar (D-Minn.), Dan Sullivan (R-Alaska), Maggie Hassan (D-N.H.), Bill Cassidy (R-La.), and Maria Cantwell (D-Wash.).
More information on the legislation is available here.
Legislative text is available here.           


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