Opinion

CARA a Step Forward For Addiction Treatment

Every day in the United States, 129 people die from a drug overdose. Drug overdose is the current leading cause of accidental death in the country, having surpassed traffic fatalities. Overdoses resulting from the use of heroin and misuse of prescription drugs is fueling this epidemic.  The age-adjusted drug overdose death rate in 2014 was 14.7 per 100,000, but my home state of Ohio had a rate of 24.6, one of the highest in the US.

Last year, Congress introduced legislation that would provide a vast amount of funding and resources to address opioid addiction and overdose deaths. The Comprehensive Addiction and Recovery Act, also known as CARA, lays the foundation for a comprehensive national response to the opioid epidemic which includes prevention, law enforcement strategies, addressing overdose deaths and expansion of evidence-based treatment and support for those in, or seeking, recovery.

This bipartisan legislation was introduced in the Senate by Senators Sheldon Whitehouse (D-RI) and Rob Portman (R-OH). The bill was marked up last Thursday, February 11, and will be voted on by committee and sent to the Senate floor.

As the major professional society representing clinicians who treat patients with addiction, the American Society of Addiction Medicine (ASAM) implores Congress to pass CARA this year. There is no race, class, age or gender that is immune to opioid addiction and overdose. Every community has experienced the horrible repercussions of this epidemic and one out of every three households in America has been impacted by addiction.

This Congress has the opportunity to enact CARA and other meaningful legislation that will improve access to quality evidence-based treatment and medications with proven effectiveness, including increasing the number of patients eligible prescribers may treat in order to save lives.

While it has been known that addiction is a primary, chronic disease of the brain that can be treated to help patients manage their disease to reduce or eliminate symptoms, there is a very large treatment gap that is driving this crisis. Nearly 90 percent of Americans with addiction do not receive the treatment they need and 80 percent of individuals with opioid addiction are not treated. It is clear that urgent action is needed to stem the tide of overdose deaths in America.

Specifically, this bill would promote primary prevention by developing a set of best practices for pain management and prescribing pain medication. CARA would also establish grants to train law enforcement officers to carry and administer naloxone, a medication used to reverse the effects of opioids. The legislation would establish grants to state substance abuse agencies to expand the availability of the three FDA-approved medications, methadone, buprenorphine and naltrexone, that have shown to be both clinically and cost effective in treating addiction.

It is time that we, as a country, respond to the opioid epidemic and implement solutions that will help patients, families and the clinicians who care for them. We can no longer look at those with addiction as second-class citizens through the lenses of stigma and shame. There is evidence that treatment works and those with addiction can and do achieve long-term recovery.

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