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The 2010s in America

Comprehensive Addiction and Recovery Act of 2016 (CARA)

by Donald A. Watt

Definition: Bill introduced to combat heroin- and opioid-related deaths.

The Comprehensive Addiction and Recovery Act was introduced in the Senate in 2015 as an attempt to meet the challenge of the rapidly increasing number of heroin- and opioid-caused deaths. This was the first legislative action in decades that was designed to meet a major new drug abuse problem. It includes provisions that attempt to educate the general public regarding the problem, as well as funding to assist those using these drugs. In addition, it authorizes research to find pain medication that can be substituted for opioids, and funds for first responders to purchase drugs that can save the lives of those who overdose on these substances.

Need for the Legislation

For decades, traffic fatalities were the leading cause of accidental deaths in the United States. However, as documented in a survey of deaths in hospital emergency rooms, by 2010, deaths from drug overdoses surpassed the number of traffic fatalities. According to the National Institute on Drug Abuse, the number of prescriptions for opioids almost tripled in two decades, peaking at 219 million in 2011. The misuse of opioids increased more rapidly; for example emergency room visits due to non-heroin opiates more than doubled from 2004 to 2008, and hospital admissions for problems with prescription pain relievers (opioids) was five times larger in 2011 than it was in 2001. Deaths from these drugs quadrupled from 1999 to 2012. As doctors became more aware of the problems that these prescription medications were causing, they did begin to cut back on the number of prescriptions. While studies have not been completed that could prove a substitution, with the decrease in prescription opioid abuse came an increase in heroin use, with a dramatic increase in the number of deaths. Thus, the prescription and street drugs seem to be directly related and needed to be dealt with simultaneously.

Legislative Process and Provisions

On February 12, 2015, Sen. Sheldon Whitehouse (D-RI) introduced legislation to deal with these issues. Similarly, Rep. Jim Sensenbrenner (R-WI) introduced a bill in the house. They were joined by Sen. Rob Portman (R-OH) and Rep. John Conyers (D-MI) as the sponsors of the legislation. A little over a year later, the Senate Judiciary Committee recommended passage of the bill. In a Congress known for its partisan bickering and legislative inaction, this was a major achievement. It passed the Senate in March, 2016 with a 94-1 vote and then, in May, passed the House, after an amendment, by 400-5. It took two months for the conference committee to act, but finally a bill was sent to both houses and passed in July, 2016. On July 22, 2016, President Obama signed the bill.

The bill authorizes $181 million for combating the opioid and heroin epidemic, but the actual money must be appropriated each year. The funding, to be channeled through local entities, is to serve several purposes. First, it is to increase prevention and educational efforts, with a focus on groups who have been most likely to misuse opioids. A part of this is an increase in the number of authorized disposal sites for any unneeded prescription medicines. Although there are three drugs that can be used to decrease the effects of opioids, naloxone has a more immediate effect and therefore funds will be used to purchase this for first responders. It will provide funds for proven medically assisted treatments in the general public and among the prison population. This will include research into improving treatment programs. Finally, it will allow states to have more resources to monitor and track prescription drugs and their possible diversion to addicted individuals. While most of the funds are earmarked for governmental agencies, certain nonprofit organizations may apply for funds to assist in the treatment and recovery of addicted individuals.

Impact

While many have celebrated the enactment of this legislation, others worry about the level of funding. The initial request was for $920 million over a two-year period, much higher than what was authorized. Assuming no new people become addicted, an unrealistic assumption, more than two million people have opioid or heroin addiction problems which would meet the criteria for assistance. Under other programs less than half of that group is being helped. Assuming less than half of the remaining people desire assistance, a realistic assumption, deducting funds needed for other aspects of the law, the current level of funding could assist less than ten percent of those who might want help. This causes concern for the medical community, which is attempting to combat and overcome this problem. The Comprehensive Addiction and Recovery Act of 2016 enables movement toward meeting the needs of the general public and those directly affected by opioid or heroin addiction, but the current need outpaces the available. However, with the passage of CARA, the mechanisms are in place for future efforts to deal with the substance abuse problems.

Citation Types

Type

Format

MLA 9th

Watt, Donald A. "Comprehensive Addiction And Recovery Act Of 2016 (CARA)." The 2010s in America, edited by Mari Rich & Salem Press , Salem Press, 2021. Salem Online, online.salempress.com/articleDetails.do?articleName=TW10IA_0060.

APA 7th

Watt, D. A. (2021). Comprehensive Addiction and Recovery Act of 2016 (CARA). In M. Rich & S. P. (Eds.), The 2010s in America. Salem Press. online.salempress.com.

CMOS 17th

Watt, Donald A. "Comprehensive Addiction And Recovery Act Of 2016 (CARA)." Edited by Mari Rich & Salem Press . The 2010s in America. Hackensack: Salem Press, 2021. Accessed December 14, 2025. online.salempress.com.

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