Healio Special Report: Health Care and Politics

Healio Special Report: Health Care and Politics

March 06, 2018
2 min read
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Proposed opioid bill increases funding, limits prescriptions to 3 days

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A bipartisan group of U.S. Senators recently introduced an updated version of the Comprehensive Addiction and Recovery Act, known as CARA 2.0, to build upon past efforts of the program to increase funding authorization levels and establish new policy reforms that respond to the opioid crisis most effectively.

“Now that CARA has been implemented and is starting to help communities around the country, it’s time to start the discussion about reauthorizing this important federal law,” Sen. Rob Portman, R-Ohio, said in a press release. “Passage of CARA was a historic moment, the first time in decades that Congress passed comprehensive addiction legislation, and the first time Congress has ever supported long-term addiction recovery.”

“Now we have the opportunity to build on this effort, increasing funding levels for programs we know work and implementing additional policy reforms that will make a real difference in combatting this epidemic,” he added.

Under CARA 2.0, initial opioid prescriptions for acute pain are limited to 3 days. This limitation excludes patients who require opioids for chronic pain or pain from ongoing conditions, such as cancer.

“We are concerned about the mandated 3-day limit for opioid prescriptions, which is not actually in keeping with the CDC recommendations,” the AMA told Healio Internal Medicine. “We are reviewing the bill in its entirety before offering a more comprehensive judgement.”

The new act will authorize physician assistants and nurse practitioners to prescribe buprenorphine with the guidance of a qualified physician. When prescribing or dispensing opioids, physicians and pharmacists will now be required to consult their state prescription drug monitoring program. CARA 2.0 also intensifies penalties for malpractice related to opioids.

The law allows states to waive the cap of 100 patients that physicians can prescribe buprenorphine to. Additionally, the bill guarantees quality housing for long-term recovery.

CARA 2.0 authorized $1 billion to fund resources for evidence-based prevention, enforcement, treatment and recovery programs. This funding includes $300 million to develop more evidence-based medication-assisted treatment and $300 million to increase access to first responder training and naloxone.

ACP told Healio Internal Medicine that it anticipates that it will send a letter to Congress outlining its views and comments on CARA 2.0.

Soon after the introduction of CARA 2.0, the White House Opioid Summit was held to discuss efforts to address the opioid epidemic through prevention, treatment and recovery.

“It was very encouraging to hear that the administration’s approach to the crisis will emphasize prevention, treatment and recovery, and reducing the stigmatization of those suffering from addiction or in recovery,” Bob Doherty, senior vice president of the Governmental Affairs and Public Policy at ACP, said in a press release. “ACP has long called for substance use disorders to be viewed as a preventable and treatable public health issue, not as a character or moral failing, and the administration’s approach appears to be in sync with this.” – by Alaina Tedesco