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Last week, the National Journal published an article detailing how the Comprehensive Addiction Recovery Act (CARA) came to be. The piece follows all the key players that worked together to make the bill a reality, including the Partnership for Drug-Free Kids. The setting for CARA to become a bill has been bolstered by the evolving public perception of addiction – a disease now more commonly viewed as a public-health problem, rather than a moral failing.
Our President and CEO, Marcia Lee Taylor, talks about how the Partnership has supported and advocated for the passing of the CARA bill in the article. Please read the full text of the National Journal article below:
How the Addiction Lobby Got Its Bill
A relatively informal group of advocates has become a coherent D.C. force, and now the Comprehensive Addiction and Recovery Act is nearing the finish line.
The addiction community doesn’t necessarily have the manpower or resources of Washington’s powerful health care lobbying forces, such as the American Medical Association or Blue Cross Blue Shield. But with major legislation inching closer to passage, it’s coalescing in a way it hasn’t really before.
The Comprehensive Addiction and Recovery Act easily passed the Senate 94-1 this month, and now the bill’s increasingly well-organized advocacy coalition is pushing for final approval in the House.
“I think this is really the first time we’ve seen this scale of uniting behind an issue within the addiction field,” said Jessica Nickel, who’s been working on these issues for more than two decades and serves as Addiction Policy Forum’s executive director.
Those who focus on addiction in Washington already have a relatively informal group that’s been holding meetings for close to 20 years. But Nickel’s group, a partnership of policymakers, stakeholders, and organizations, formed three years ago to add even more structure to the effort.
They were able to corral a robust group of more than 150 national organizations—with grassroots efforts to match the D.C. push—because CARA aims to curb a tangible problem in America: the frequency of parents, friends, and relatives learning that a loved one died of a prescription-painkiller or heroin overdose.
Advocates say they’ve united behind the bill because it’s comprehensive, and that means nearly all facets of the community—from district attorneys to treatment providers, public-health officials to those in long-term recovery—have a stake in the fight for passage.
“What’s different is [beforehand] we didn’t have thousands of people dying—literally that was probably the single biggest difference,” said Robert Morrison, the executive director of the National Association of State Alcohol and Drug Abuse Directors. “And people bracing, knowing that we do need a comprehensive approach.”
That’s one in a confluence of other reasons why advocates say so many people and groups are helping support CARA: The perception of addiction has evolved, and it’s now generally viewed as a public-health problem. Parents spoke out and told their personal stories of losing a child to an overdose. Stakeholders were intimately involved with helping create the bill. And the Addiction Policy Forum helped pull various organizations together.
“I think really having a piece of legislation that we all believed in, and that we all believed was going to make a difference in this critical time, and also that was going someplace” helped, Marcia Lee Taylor, president and CEO of Partnership for Drug-Free Kids, said. “That’s one of the critical pieces as well because if you are going to be rallying your constituency to advocate for something, you want to make sure that it has a chance of going someplace.”
The groups were involved at the very start of the legislative process, which Sen. Rob Portman detailed in a March 3 speech on the Senate floor.
“Two years ago, before Senator (Sheldon) Whitehouse and I drafted this bill, we engaged with individuals in the treatment and recovery community, with physicians and nurses, and with outside experts,” the Ohio Republican said. “We met with families who had been impacted by the struggle with addiction.”
Whitehouse, Portman, and other members and advocates held a series of forums on opioid abuse. Advocates stayed in communication with Hill staff and began mobilizing those in the prevention, treatment, recovery, and law enforcement communities to rally around CARA.
Facing Addiction held a concert and rally on the National Mall. There were fly-in days. They’ve sent letters to leadership. The groups have asked their base to contact their congress members. And the organizations stay updated on the state-of-play of CARA—which hasn’t been put to a vote in the House—in Congress through the Addiction Policy Forum’s email updates.
In the past, substance-abuse issues were viewed differently, Taylor said. She recalled working on drug-policy issues for nine years for Senate Democrats. “What’s interesting is in the time when I was on the Hill—which was the late ‘90s and early 2000s—the perspective really was criminal-justice first, and prevention and treatment second,” Taylor said. “And that’s really flip-flopped.”
Yet, in the past, the community has worked together on some major legislation, such as the Mental Health Parity and Addiction Equity Act of 2008, which prevented health insurance plans from providing less benefits for mental-health and substance-use disorders than for medical issues. The substance of this legislation was different than CARA, according to Patty McCarthy Metcalf, Faces & Voices of Recovery executive director, and that meant the advocacy was different.
“The advocacy around the Parity bill was a turning point for a movement that people got behind because of unjust insurance regulations that prevented people from getting treatment, and that people in recovery, family members, and provider/advocacy organizations had a lot at stake in such a huge shift in the law,” she wrote in an email. “It was driven by a call for action on reversing discriminatory practices, which is different from CARA.”
The broad support for CARA extended to the upper chamber, where only Sen. Ben Sasse voted against the bill. (Democrats argued that funding is needed for the authorization bill, but didn’t hold up its passage.)
Advocates say they’re hoping to use this momentum to shore up support for the bill in the House—and if possible, for other bills that encompass a wide variety of stakeholders. And, Nickel said, the Addiction Policy Forum aims to keep spreading awareness of the disease and staying plugged in on issues impacting the community.
“I think it definitely is a great example of a model of how to get things done,” Metcalf said. “We have an incredible determination to make things happen because really, at the drop of the hat, you can mobilize thousands of people to make calls, send emails, and I’m sure there’s other groups that can do that on other issues, but these are people that normally don’t come out about an issue that’s very stigmatizing, and that’s a very personal issue.”