A group of eight senators on Tuesday unveiled bipartisan legislation that would increase funding for addiction treatment and prevention by roughly $1 billion and impose a sweeping three-day limit on opioid prescriptions for initial pain treatment.

The CARA 2.0 Act, billed as the sequel to the Comprehensive Addiction and Recovery Act of late 2016, would be the most substantive action Congress has taken to address the opioid crisis since President Trump took office.

The legislation’s unveiling comes as Republicans in both chambers of Congress are ramping up their legislative efforts to address the opioids crisis. The two-year budget deal Congress passed earlier this year included $6 billion in extra funding to address the crisis in 2018 and 2019, but offered only broad outlines of how the funds would be used. Now, legislators, lobbyists, and policy advocates are hurrying to identify policies that could fit into that funding framework.

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The bill’s eight co-sponsors are divided evenly between Democrats and Republicans, and include the authors of CARA’s first iteration, Sens. Rob Portman (R-Ohio) and Sheldon Whitehouse (D-R.I.).

The bill would aggressively limit doctors’ ability to hand out lengthy opioids prescriptions, exempting only cancer, chronic pain, and hospice treatment from the three-day initial prescription limits. The Centers for Disease Control and Prevention issued new prescription guidelines in 2016 that indicate three-day prescriptions are typically sufficient and seven-day prescriptions are rarely necessary. A number of states have already enacted laws limiting first-time opioid prescriptions to three, five, or seven days.

The bill would also make permanent temporary provisions that allow nurse practitioners to prescribe buprenorphine, a form of medication-assisted treatment, and that waive the current 100-patient limit for physicians wishing to prescribe the drug. It would fund $300 million in training and expanded access to the overdose-reversal drug naloxone for first responders, more stringently require physician use of prescription drug monitoring programs, and fund a variety of other new treatment and outreach programs.

The bill’s quick introduction matches the aggressive timeline congressional leaders had recently begun to outline for opioids-related packages in 2018. The chairmen of the two primary health committees in Congress pledged to push major legislation to address the opioid crisis within the next several months. Energy and Commerce Committee Chairman Greg Walden of Oregon has said he will push the House to pass legislation before Memorial Day, and convened the first of three legislative hearings this week.

Senate Health, Education, Labor, and Pensions Committee Chairman Lamar Alexander of Tennessee has said his committee’s markup could come as soon as the end of March.

The initial CARA, in combination with the 21st Century Cures Act, authorized roughly $1 billion in annual spending on a more limited scope of programs.

Some provisions in the new bill mirror the 56 recommendations issued by the White House commission last November. Members of that commission and treatment experts alike had openly fretted that much of the document was likely to be ignored.

The White House is also holding an “opioids summit” on Thursday, at which Trump adviser Kellyanne Conway — who has largely taken over the White House addiction policy portfolio — and other federal officials are expected to tout steps they have taken since the administration declared a national public health emergency in October.

Erin Mershon contributed reporting.

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  • Congress and senate both sides have a minimum of $8 million each in personal net worth. Their salaries are approximately $120k a year. How did this happen and how can these people possibly know what laws will help people living on $600.00 – $2,000.00 a month? Their world is very different than yours and insider trading is legal for them and illegal for you. Read books by Peter Schweizer (used for as low as $4.00) to see what is really going on in Washington!

  • Will people resort to street drugs when they cannot get regular pain relief? Abortions are a perfect example. Will deaths from opioid increase as a result f those seeking relief on the streets withou medical supervision. Will health insurance programs pay for CBC and medical marijuana which have been shown to transition people off opioids? Too many questions and fearful of the answers.

  • I am a chronic pain sufferer. I’m also a retired police officer who was injured in the line of duty. I have been in chronic pain since 1999. I try very hard to take as little Vicodin as I can but it is impossible for me to move without it. My doctor found out only about the new bill last month and has been going crazy trying to find specialists that are allowed to write for over 3 days. There just aren’t enough taking new patients. I will probably be hospitalized within a month. This bill is a knee jerk reaction. I am qualified for medical marijuana. The problem is trying to pay for it

  • I have been on methadone for chronic pain for 20 years.I am very upset with the laws that are being created to supposedly get the opioid crisis under control. I have taken my pain contract very serious with my dr.I have abided buy my agreement with my dr.I feel it’s a witch hunt and a lot of law abiding citzens are gonna be victims of these laws.The only thing that’s going to happen is people are going to turn to self medicating. It’s time for Virginia to get on board with medicinal marijuana and cbds.stand up and fight for natures cure and help addicts find affordable help for addiction. I’m scared of what’s to come with my personal pain management. I would love for some crooked ass politician to walk in my shoes for a day!they would see what it feels like to be in chronic pain.

  • I just saw my MD to get a refill on my pain meds. I have RA and have tried every known treatment to decrease my pain. It is now to the point that I can hardly walk or sleep due to the pain. My MD said, I’m sorry, if you want a script, go to the White House. Or start smoking Pot, it is legal and you can get as much as you want. Oh ok that is helpful. How can such legislation happen without hearing the other side. My first thought was I will have to resort to street drugs if I want to have any kind of life. That is a horrible thought and brings so many other problems. Not sure what to do next. So I have 40 tramadols to last me 3 months. Not sure what my next move will be….a visit to the White House, no thanks, I do not want to see that idiot in person.

  • How can you legislate pain? chronic pain since 2009
    I retired early due to increasing pain that was no longer tolerable in a work environment. Put my affairs in order and retired with zero debt, had enough retirement savings, and have lived a responsible life and never abused my medication. And for all my trouble find out that the government will cut my medication by one third because they know more about my pain than I do. I would like to ask Donald Trump and every U.S. congressman , what gives you the right to play God, with my right to pursue a relatively pain free life for the rest of my life. I take my medication responsibly, other than a traffic ticket or so, I have no criminal record, I neither abuse my medication nor sell it. Why do those that follow the rules always get punished? I have pursued other alternative sources of pain relief, injections, physical therapy, two surgeries, the only thing left is a neuro-stimulator, possible side effects outweigh the benefits, and I would still have to take medication with it.
    This country is tense enough without adding to it a large number of people in chronic pain. Rethink what you are doing, gun control has not stopped the mass shooting epidemic, what makes you think this will stop the opioid epidemic. There are those that will obtain it illegally and those of us who will suffer the rest of our lives because we are law-abiding.
    Thank you U.S. government for looking after our welfare and well being.

  • I COMPLETELY AGREE WITH WHAT YOU SAID DEB AND I CAME TO FLORIDA BECAUSE MY MOM HAD A STINT PUT IN HER HEART BEFORE I CAME HERE I WAS LIVING IN BALTIMORE MARYLAND AND I WAS IN PAIN MANAGEMENT THERE. WHAT IS FUNNY IS THE FACT THAT THEY SELL HEROIN ON EVERY SINGLE CORNER. I DID NOT HAVE A PROBLEM GETTING MY PRESCRIPTIONS AND WHEN I GOT HERE WITH MY MEDICINE AND A PRESCRIPTION HISTORY GOING BACK 18 YEARS I COULD NOT GET A PRESCRIPTION FOR THE MEDICINE THAT I HAD BEEN ON FOR MOST OF THE TIME I WAS IN MARYLAND. I FIND THIS SHIT COMPLETELY AND UTTERLY RIDICULOUS

  • My daughter has lived with chronic pain for 15+ years. She is an intelligent, college-educated young woman who has spent many of those years researching her conditions and treatments. She has tried a variety of medications, surgeries, nerve blocks, pain pumps, etc. She has been prescribed fentanyl for most of the 15+ years of pain. Her pain management doctor has started to reduce her dosage due to the new government imposed guidelines. Meanwhile, the government is aiding those who abuse the drug. They are being rewarded with treatment and care while chronic pain sufferers are being punished. These new guidelines will NOT reduce drug-related deaths. Addicts will find another drug to abuse and people with chronic pain, like my daughter, will have to live with increased pain. It seems the government is giving pain sufferers two choices: buy street drugs to try and control their pain, or commit suicide. I’m sure the elected officials who proposed and supported this legislation do not suffer from chronic pain. If they (or one of their family members) did, they wouldn’t have been so quick to support it. Please, please help the innocent people who need help, not the criminals.

    • Put some Blame on the people that get medication and sell it to the addicts. I’ve seen this going on all over. Selling pills for 20 dollars each. It’s sickening.

  • I am in agreement with that. The new free way should be called FreeHell cause with out my medicine I will TRULY BE IN HELL. I JUST DON’T KNOW WHAT IS GOING TO HAPPEN. I ALREADY HAVE HIGH BLOOD PRESSURE DUE TO MY PAIN AND THEN TAKE MY MEDICINE AWAY. HELL I WILL NEVER MAKE IT TO THE HOSPITAL I WILL CRASH AND BURN IN MY DOCTORS OFFICE

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