Senate Passes Comprehensive Addiction and Recovery Act with Two Provisions Authored by Senator Collins

Washington, D.C.—With overwhelming bipartisan support, the U.S. Senate passed a comprehensive, evidence-based response to combat the heroin and opioid epidemic by a vote of 92-2. The Comprehensive Addiction and Recovery Act, or CARA, is cosponsored by U.S. Senator Susan Collins, a member of the Senate Health, Education, Labor, and Pensions Committee.  The CARA Conference Report contains two amendments authored by Senator Collins, as well as a number of provisions for which she advocated.  Earlier this year, Senator Collins spoke from the Senate floor, urging her colleagues to support this critical bill. 

“CARA is a monumental step forward in our effort to address our nation’s heroin and opioid epidemic that has devastated countless families and communities across the country. Maine has been particularly hard hit by this unprecedented addiction crisis, with a record 272 overdose deaths in 2015, the vast majority of which were caused by heroin, fentanyl, or prescription opioids. In addition, a recent survey found that 60 percent of Mainers know someone who has either used heroin or abused prescribed opiate painkillers within the past five years,” said Senator Susan Collins. “CARA will help address this burgeoning public health crisis through a multifaceted approach that expands treatment, prevention, law enforcement, and recovery efforts in our communities nationwide.”

Among its provisions, CARA will create two task forces to develop best practices for prescribing prescription opioids and examining policies related to criminal justice policies.  The bill will authorize several new grant programs to help communities combat substance abuse and overdose deaths and to expand treatment and prevention efforts.  Other grant programs will target substance abuse recovery services for young people in schools and colleges, as well as treatment services for pregnant and postpartum women.  The bill will also support the expansion of drug takeback programs, an initiative Senator Collins has long championed and which help individuals safely and securely dispose of their unused prescription drugs.

The legislation also includes the following two provisions that were authored by Senator Collins:

• The Safe Treatments and Opportunities to Prevent Pain (STOP Pain) Act, which will encourage the National Institutes of Health to increase research into alternatives to opioid therapy for pain management.  Senator Collins is an original cosponsor of this legislation.
• The Infant Plan of Safe Care Act, which will require states to ensure that a “plan of safe care” is developed for drug-dependent infants before they leave the hospital.  Senator Collins is an original cosponsor of this legislation.

Other key provisions of CARA will:

• Allow nurse practitioners and physician assistants to dispense buprenorphine for opioid addiction treatment until October 2021, for up to 30 patients in the first year and up to 100 patients after the first year and going forward.  Senator Collins has long fought to increase access to buprenorphine for opioid addiction treatment.  In 2015, Senator Collins led a letter urging DHHS to increase access to medication assisted treatment.  This year, she cosigned a letter calling on DHHS to further increase access.   
• Reauthorize a grant program for residential treatment for pregnant and postpartum women who have an opioid use disorder.  Senator Collins is a cosponsor of similar legislation.
• Clarify that, in accordance with state law, pharmacists are permitted to dispense only part of a prescription for a Schedule II substance – such as an opioid – if a doctor or patient requests that it not be filled in its entirety.  Senator Collins supported this legislation in Committee.

This legislation has garnered significant support from medical professionals, those in recovery, law enforcement professionals, and other experts in the field.

More than 200 National Drug Groups have endorsed CARA, writing, “As you know 129 Americans die each day as a result of drug overdose and this epidemic affects the public health and safety in every community across the country. This bill is the critical response we need.”

As a senior member of the Senate Appropriations Committee, Senator Collins has successfully advocated for increased funding to help address the opioid epidemic.  In June, the Appropriations Committee approved the fiscal year (FY) 2017 Labor, Health and Human Services, and Education and Related Agencies Appropriations bill, which included $261 million for the Department of Health and Human Services’ opioid abuse initiatives, a 93 percent increase.  The legislation passed the Committee by a vote of 29 to 1 and currently awaits consideration by the full Senate.  In addition, this May, the Committee unanimously approved the FY 2017 Commerce, Justice, Science and Related Agencies Appropriations bill, which included $132 million to combat the heroin and opioid abuse crisis.  The bill awaits passage by the full Senate.

Senator Collins has also led efforts to examine how the abuse of heroin and prescription painkillers have affected infants as well as seniors, populations that are often not associated with this public health crisis.  In Maine, approximately 1,000 babies were born addicted to or affected by drugs in 2015, which accounts for 1 in 12 births.  Late last year, the Senate passed—and the President signed into law—the Protecting our Infants Act, bipartisan legislation cosponsored by Senator Collins that will help address the growing crisis of opioid use and abuse among pregnant women and its effect on newborns.

In February, Senator Collins chaired an Aging Committee hearing titled, “Opioid Use Among Seniors—Issues and Emerging Trends,” which explored the medical use of opioids for pain relief and the challenges health care providers face in treating pain in an environment where the diversion of prescription painkillers is contributing to the ongoing opioid abuse epidemic. 

Both the House and Senate previously passed two similar versions of CARA with strong bipartisan support. A bicameral Conference Committee reconciled the differences between the two pieces of legislation.  Following negotiations, the Committee issued the CARA Conference Report, which consolidates 18 bills and authorizes $181 million for new programs to help meet the opioid crisis.  The House passed the Conference Report last week (407-5), and following Senate passage today, CARA will be sent to the President’s desk for his signature.