CARA - Comprehensive Addiction and Recovery Act of 2016

   On July 22, 2016, President Barak Obama signed into law the Comprehensive Addiction and Recovery Act of 2016, known as CARA.  The full title of the bill is:

To authorize the Attorney General and Secretary of Health and Human Services to award grants to address the national epidemics of prescription opioid abuse and heroin use, and to provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication, and for other purposes.

Overdoses from heroin, prescription drugs, and opioid pain relievers last year surpassed car accidents as the leading cause of injury-related death in America, according to the Centers for Disease Control. Deaths have reached their highest levels of the 21st century in 2014, the most recent year for which data is available, according to the National Institute on Drug Abuse. Heroin overdoses have more than tripled in the last five years, an issue receiving outsize attention nationally but especially during the presidential campaign season as New Hampshire has been one of the hardest-hit states.

New legislation aims to tackle this epidemic. The Comprehensive Addiction and Recovery Act, S. 524 and H.R. 953, was introduced by Sen. Sheldon Whitehouse (D-RI) and Rep. Jim Sensenbrenner (R-WI5).  According to Sen. Whitehouse, the new law will:

  • Expand the availability of naloxone — which can counter the effects of a heroin or opioid overdose — to law enforcement agencies and other first responders;
  • Improve prescription drug monitoring programs to help states monitor and track prescription drug diversion “and to help at-risk individuals access services,” because inefficiencies and loopholes in the current programs allow many individuals to game the system and obtain more drugs than they should;
  • Shift resources towards identifying and treating incarcerated people who are suffering from addiction, rather than just punishment as is often the case currently, and
  • Prohibit the Department of Education from including questions about the conviction of an applicant for the possession or sale of illegal drugs on the Free Application for Federal Student Aid (FAFSA) financial aid form.

     Of interest to nurse practitioners is a provision that deems an NP to be "other qualified providers" for purposes of prescribing "all drugs approved by the Food and Drug Administration for the treatment of opioid use disorder, including for maintenance, detoxification, overdose reversal, and relapse prevention," if the NP meets the requirements for a waiver from otherwise prohibited medications. 
     MNPA understands that the waiver process is not yet in operation, and we will advise members when we have more information about the process.  We greatly appreciate the support of Sen. Angus King in efforts to implement the waiver provision in the new law.