Indiana Prevention Resource Center (IPRC)

Up-Coming Federal Prevention and Treatment Funding, The Good News and the Bad: White House Budget and the Fate of CARA

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Published on March 10, 2016

The government has been sending mixed messages lately regarding anticipated spending for substance abuse prevention and treatment. This report describes recent events.

Regarding treatment: A mirage?
When the White House announced a new $1.1 billion fund (of which $920 is for treatment) to combat the opioid epidemic, that announcement was celebrated by the addiction field (ADAW, 2016a). Further investigation, however, upon release of the actual budget revealed what ADAW calls the true story: that this appears to have been “a gimmick” for public relations purposes. It turns out that the “mandatory” part of the budget is subject to congressional approval and needs to be part of a law or series of laws passed by the Congress. Given that currently the Congress is opposing the president’s proposals, including his budget, the chances of such a law or laws being passed are next to none. So, despite any White House desire for this funding to materialize, the new funding intended to address opioid use disorders is expected to consist of “smoke and mirrors” (ADAW, 2016b). And according to the Alcohol and Drug Abuse Weekly Report, the FY2017 budget is peppered with equally misleading and vapory funding proposals, e.g., also affecting the National Institutes of Health, which would suffer a $2 billion to be partially recuperated via $1 billion in “mandatory” funds that are unlikely to happen. (ADAW, 2016b)

Source: http://bigthink.com/going-mental/your-brain-on-drugs-dopamine-and-addiction

A mirage? Maybe not.
Regarding prevention and treatment: Breaking News -- CARA approved by the Senate.
A major piece of good and encouraging news is the passage by the Senate on March 10th of the Comprehensive Addiction and Recovery Act (CARA). CARA includes funds for prevention and education targeting seniors and teens directly and through their parents and other caregivers to prevent opioid and heroin use and support treatment and recovery. It will also expand Rx medication disposal sites, initiate intervention and treatment programs, and fortify Rx monitoring programs. (ADAW, 2016d) It is the most expansive legislation so far in support of addiction treatment and recovery support, with $40 for treatment and $80 for recovery support services at the state and local levels. (CADCA, 2016) The bill is now returning to the House for their approval.

This bill will help current and former Drug-Free Communities grantees address an Rx drug abuse crisis by way of a new community-based coalition $5 million enhancement grant.  The provisions of CARA are:

• Title 1: Prevention and Education
• Development of best prescribing practices
• National education campaign
• Community-based coalition enhancement grants to address local drug crises

• Title 2: Law Enforcement and Treatment
• Treatment alternative to incarceration programs
• Law enforcement naloxone training and implementation
• Prescription take-back expansion

• Title 3: Treatment and Recover
• Evidence-based opioid and heroin treatment and interventions demonstration
• Criminal justice medication assisted treatment and interventions demonstration
• National Youth recovery initiative
• Building communities of recovery

• Title 4: Addressing Collateral Consequences
• Expansion of educational opportunities for incarcerated individuals
• Revision of FAFSA form to remove questions about prior convictions for the possession or sale of illegal drugs from federal student loan applications.
• Creation of a national task force on recovery and collateral consequences

• Title 5: Addiction and Recovery Services for Women and Veterans
• Addressing opioid and heroin abuse by pregnant and parenting women
• Grants for family-based substance abuse treatment
• Veterans’ treatment courts

• Title 6: Incentivizing Comprehensive Responses to Addiction and Recovery
• State demonstration grants for comprehensive opioid response

To read more about CARA visit the CADCA webpage devoted to explaining its provisions.  Another piece of good news is that the White House budget proposal includes no cuts to the SAPT Block Grant. 

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