Bill proposed to lift cap on number of patients a physician can treat for opioid addiction

CDC: 30 percent rise in ER visits for opioid overdoses

The Centers for Disease Control and Prevention (CDC) reports that emergency department (ED) visits for opioid overdoses rose 70 percent in the Midwest between July 2016 and September 2017. Now, federal legislation designed to increase funding for communities battling the opioid crisis would also lift a capped restriction on the number of patients a physician can treat.

The bill, dubbed CARA 2.0, follows the 2016 CARA legislation that was signed into law by President Obama that set forth major funding from the federal government to combat the opioid public health crisis.

CARA 2.0 would make Section 3 of CARA permanent, allowing physician assistants and nurse practitioners to prescribe buprenorphine under the direction of a qualified physician. It would also allow states to waive the limit on the number of patients a physician can treat with buprenorphine so long as they follow evidence-based guidelines. There is currently a cap of 100 patients per physician.

Buprenorphine (i.e., Subutex) is one of three FDA-approved medicated-assisted therapy (MAT) treatment programs for opioid addiction.

U.S. Senators Sherrod Brown (D-OH) and Rob Portman (R-OH) both support CARA 2.0 and the measures to increase funding and access to MAT.

“Ohioans know too well the devastation the opioid epidemic has brought on our state, and communities on the frontlines need our help. CARA is already helping states tackle this epidemic — from putting more people into treatment and supporting law enforcement, to boosting prevention and education,” said Brown. “We must build on CARA’s strides by directing additional resources toward this public health crisis before it takes more lives.”

Deaths from opioids rose 366 percent in Ohio between 2000 and 2012, according to the Ohio Department of Mental Health and Addiction Services. Each day over 100 Americans die from drug overdoses.

In addition to increasing funding and access for MAT, CARA 2.0 would impose a three-day limit on initial opioid prescriptions for acute pain. That recommendation is from the Centers for Disease Control and Prevention (CDC), according to press releases.

CARA 2.0 also creates a national standard for recovery residence to ensure quality housing for individuals in long-term recovery, press releases state.

Portman, the author of the bi-partisan CARA legislation signed into law in 2016, introduced CARA 2.0 Feb. 27 with seven other bipartisan U.S. Senators who support the measures.

“Now that CARA has been implemented and is starting to help communities around the country, it’s time to start the discussion about reauthorizing this important federal law,” said Portman. “Passage of CARA was a historic moment, the first time in decades that Congress passed comprehensive addiction legislation, and the first time Congress has ever supported long-term addiction recovery. Now we have the opportunity to build on this effort, increasing funding levels for programs we know work and want implementing additional policy reforms that will make a real difference in combating this epidemic. I want to thank Sentaor Whitehouse and my bipartisan colleagues for their leadership and partnership on this important national effort.”

Following its introduction on the Senate floor last month, CARA 2.0 was read twice and is currently referred to the Committee on Health, Education, Labor, and Pensions for review.

CARA 2.0 creates a $300 million funding expansion for evidence-based MAT programs, up from $25 million in funding in the original CARA. The bill also expands funding for first responder training and access to Naloxone to $300 million, up from $12 million in the original CARA.

Speaking March 1 from the opioid summit in the East Room in the White House, President Donald Trump said, “The administration is going to be rolling out policy over the next three weeks, and it will be very, very strong.”