Comprehensive Addiction and Recovery Act

The Comprehensive Addiction and Recovery Act (CARA)carafactsheet

A new bill called the Comprehensive Addition and Recovery Act (CARA) passed the U.S. House of Representatives on May 13, 2016, by a vote of 400-5. On July 13, 2016, the US Senate passed CARA with a 94-1 vote on this bill that aims to combat the nation’s drug and heroin epidemic. CARA will allow the Department of Justice and the Department of Health and Human Services to provide grants for states to expand treatment efforts and to expand access to a drug that studies show can cut the overdose death rate by up to 50% by reversing an overdose.

As exciting as it is to see CARA passed, including promising provisions related to treatment and recovery, the impact of the new law in terms of its ability to fill the so called “treatment gap” is severely limited by the minimal level of funding for many of these promising new programs and initiatives to expand evidence-based treatment. Without adequate appropriations, CARA can be a powerful statement without a punch.

The “treatment gap” refers to the more than 1.2 million people who are unable to receive treatment. According to the 2014 National Survey on Drug Use and Health, although 2.27 million individuals met criteria for substance use disorders, only about one million received methadone, buprenorphine, or a drug to reverse overdoses at any given time in 2014.

The predominant reasons for this gap between the need and receipt of care include: inability to afford treatment (39%) and lack of desire to seek treatment (29%). Other commonly cited barriers to receiving treatment include the stigma of addiction in the work place and the community, not enough providers and a person’s belief that they do not have a problem that needs care.

The President’s proposal of $920 million in funding for CARA over two years amounts to $2,190 per person in the addressable treatment gap. That figure represents an important initial investment in eliminating the “treatment gap”. If we intend to keep the promise of CARA to really provide comprehensive recovery to people with opioid use disorders, then Congress will have to step up to the plate and fully fund its provisions.

Brief Summary of Provisions of CARA

  • Expand prevention and educational efforts—particularly aimed at teens, parents and other caretakers, and aging populations—to prevent the abuse of methamphetamines, opioids and heroin, and to promote treatment and recovery.
  • Expand the availability of naloxone to law enforcement agencies and other first responders to help in the reversal of overdoses to save lives.
  • Expand resources to identify and treat incarcerated individuals suffering from addiction disorders promptly by collaborating with criminal justice stakeholders and by providing evidence-based treatment.
  • Expand disposal sites for unwanted prescription medications to keep them out of the hands of our children and adolescents.
  • Launch an evidence-based opioid and heroin treatment and intervention program to expand best practices throughout the country.
  • Launch a medication assisted treatment and intervention demonstration program.
  • Strengthen prescription drug monitoring programs to help states monitor and track prescription drug diversion and to help at-risk individuals access services.

CARA authorizes $181.1 million per year for five years, for a total $905 million in funding. Congress must now re-negotiate those dollars through the appropriations process. This is the process that establishes the country’s annual budget. Building a federal program is like building a car. The ‘authorizers’ build the car; they are the engineers, the builders. The ‘appropriators’ fill the tank up and add the ‘gas’, the dollars to make it go. With CARA, we’ve built the car — now let’s fill it up.

If you would like to receive updates about CARA as it makes its way through the appropriations process and we continue to advocate for sufficient funding, please send an email to