In July 2016, the U.S. Senate approved the final version of the “Comprehensive Addiction and Recovery Act” (CARA) – S. 524. The formal House-Senate negotiations to finalize this opioid misuse legislation concluded last week and the U.S. House of Representatives overwhelmingly approved the package on Friday by a vote of 407 to 5.
The legislation, which President Obama is expected to sign into law within a few days, includes several important ACEP-supported provisions that would:
- Expedite training of military medics who become civilian emergency medical technicians (EMTs);
- Improve access to opioid overdose reversal treatments, including grants to purchase and distribute naloxone to first responders, and expand physician co-prescribing of naloxone in conjunction with an opioid prescription for patients at an elevated risk of drug overdose;
- Reauthorize grants to states to help them establish, implement and improve prescription drug monitoring programs (PDMPs);
- Increase the number of disposal sites for unwanted prescription medications;
- Allow more appropriately trained/supervised providers to dispense medication for maintenance or detoxification of narcotics;
- Expand veteran drug/treatment courts that balance supervision, support and encouragement as alternatives to criminal incarceration;
- Permit the partial filling of Schedule II controlled substances at the request of the patient or prescribing physician;
- Require the Government Accountability Office (GAO) to conduct a study on Good Samaritan laws at the state level and efforts by the White House Office of National Drug Control Policy to address protections for prescribers or administers of naloxone, as well as those who call 911 to report an overdose;
- Oblige Medicare programs to account for emergency medical situations when it requires a beneficiary to use one physician to write opioid prescriptions and one pharmacy to fill those prescriptions.
See the "Emergency Medicine Opioid Principles" that ACEP shared with U.S. Senators and Representatives while Congress was developing this legislation. Action on opioid legislation that included these key principles was one of the priorities shared by emergency physicians with federal lawmakers during ACEP's 2016 Leadership and Advocacy Conference in Washington, D.C.
ACEP and other coalition partners are urging Congress to provide additional funding and resources for these programs through the annual appropriations process to ensure they are effectively implemented.