In the United States, about 129 people per day die from a drug overdose. Within that population, the opioid overdose epidemic accounts for about 80 people a day. According to the Centers for Disease Control and Prevention, 75 percent of people using heroin became addicted to prescription opioids first, before turning to heroin when they could no longer get their prescriptions refilled. Heroin is also cheaper and easier to obtain.

Whites aged 18 to 44, especially white males, lead the nation in heroin deaths.


During the summer of 2016 Congress accomplished something rarely seen in these days of divided government. They passed a bipartisan bill to attack the overdose epidemic with a significant focus on prevention and treatment. The bill, known as the Comprehensive Addiction and Recovery Act of 2016, or CARA, was signed into law by President Barack Obama on July 22, 2016. The legislation represents a major shift in America's war on drugs, which has focused on apprehension and detention.

When CARA was passed by both the Senate (March 10) and by the House (May 13), Republican leaders in Congress held a signing ceremony that received lots of press coverage. But there is a major problem with the bill celebrated that day — Congress did not provide the funding to implement the bill. As described by Sen. Charles Schumer of New York, "This bill is like a Hollywood movie set. Something that appears real on the surface but has no substance and no life behind its facade."

Since the signing, Republicans have voted twice against a $1 billion request by President Obama and congressional Democrats to fund the provisions outlined in the bill. "We believe you've got to walk the walk, not just talk the talk," Schumer said. "Republicans talk about it because they know it's a real problem," he said, "but they don't want to fund it because they know the hard right doesn't want to fund anything."

In its regular operating budget, Congress has approved about $321 million in 2016 to deal with the opioid crisis in the United States. None of this previous funding, however, is directed at the provisions in the CARA bill.

This problem was partly corrected on Sept. 28 when Congress provided $37 million for temporary CARA funding. This temporary funding was part of a continuing budget resolution to keep the federal government operating through Dec. 9. What happens to CARA after the new Congress meets in January remains to be seen, but we can hope that the spirit of bipartisanship continues on this important issue and that the bill's programs and guidelines are adequately supported.

Among other provisions, CARA calls for expanding prevention and education efforts for teens and seniors about the dangers of opioid prescription drugs, expanding disposal sites for prescription medications so that leftover opioid medications become less accessible to teens in their homes, expanding research treatments and intervention programs as an alternative to incarceration, and strengthening prescription drug monitoring programs for patients using opioid drugs for pain management.

Because war veterans frequently have injuries that require opioid drugs for pain control, a large part of the bill is directed at the Department of Veterans Affairs to prevent future pain medication addictions and to deal with current addictions among veterans. None of these new proposals in CARA are funded for 2017.

The $1 billion proposed by Obama is "the very bare minimum of what is needed" to carry out the proposals outlined in CARA, according to Dr. Andrew Kolodny, a scientist at Brandeis University and executive director of Physicians for Responsible Opioid Prescribing. Daniel Raymond, policy director at the Harm Reduction Coalition, stated, "We've always supported CARA's provisions as good policy, but good policy isn't enough to end the overdose epidemic without a more substantial commitment of funding to close the treatment gap."

With 129 people dying in the United States each day because of drug overdoses, and many of these addictions first caused by them becoming addicted to prescribed medication, it makes sense to attack the problem where it begins — at the prescription stage. CARA is the first comprehensive attempt in the United States at tackling the drug overdose problem with an emphasis on prevention and treatment programs instead of building more jails and prisons.

CARA is a smart bill supported by Democrats and Republicans, as well as drug addiction experts. Addressing this crisis is long overdue. CARA is a first step. Adequate funding for CARA is the next step.

Tom Zirpoli writes from Westminster. He is program coordinator of the Human Services Management program at McDaniel College. His column appears Wednesdays. Email him at tzirpoli@mcdaniel.edu.