Another Stepping Stone to Recovery: What You Need to Know about the 21st Century Cures Act
This December, President Obama signed the 21st Century Cures Act. The legislation is one of several bills passed by Congress this session taking aim at the nation’s ongoing opioid abuse epidemic. Here’s what you need to know about this bill, how it compares to other similar legislation and what its impact on one of our country’s biggest public health crises could look like.
The 21st Century Cures Act is separate from another well-known piece of legislation, the Comprehensive Addiction Recovery Act (CARA). Although both acts address the opioid addiction crisis, they do so in distinctly different ways. CARA represents a group of best practices toward decreasing the number of fatal overdoses as well as preventing addiction, emphasizing public education through community-specific grants while also increasing first responders’ access to life-saving medications like naloxone.
In contrast, the 21st Century Cures Act is not exclusively oriented towards addiction treatment and does not mandate specific outcomes. Rather, this bill directs the federal government to provide a block sum of money to each state’s department for addiction services, which can then be used however state administrators see fit. Giving states more agency over their addiction treatment services and educational programs could be an excellent way to ensure more tailored, community-specific interventions are utilized to end or prevent addiction.
Exactly how funding for the 21st Century Cares Act would be split between states remains to be seen. It’s possible that federal assistance will be stacked based on how much of a problem opioid abuse is in each state. Advocates interested in getting more help for their state should contact their representatives to make sure they know exactly how much help their programs need.
Of course, all this assumes the bill will be funded. This is the catch in modern American policy-making; even if a bill is passed, it still must be funded in order to take effect. While both CARA and the Cures Act have passed the Senate, the House, and been signed by the President, the legislation will have little effect on clinical practice and community services until they’re empowered with full funding and properly administered.
Some critics of the 21st Century Cures Act, including the National Council for Behavioral Health’s State Associations of Addiction Services, cite lack of institutional reform as one of the bill’s major limitations. There’s no use in funding treatment, they argue, if there’s no capacity in our health infrastructure to utilize these funds. In other words, we need more treatment beds and spaces in outpatient programs, and this bill does nothing to address that problem. Still, the State Associations think the potential benefits of a bill like the 21st Century Cures Act far outweigh potential structural difficulties.
While it’s important to maintain a critical eye towards the bill’s limitations, including little oversight on states’ spending and a lack of structural improvements, funding the 21st Century Cares Act would be a decisive step in the direction of ending our opioid overdose crisis. As those struggling with an opioid addiction and the people who love them know first-hand, when it comes to fighting addiction, we need all the help we can get.