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CARA and the Fight Against the Opioid Epidemic

by Sherie Sanders on February 15, 2017
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Pills in an Article About CARA and Grants to Fight the Opioid EpidemicAccording to the New York Times, there were so many fatalities from opioids in Montgomery County, Ohio, this month, the coroner ran out of morgue space and had to prevail upon a local funeral home for assistance with temporary storage. In order to stem the 91 deaths per day we are experiencing as a result of this crisis, last summer the government enacted the Comprehensive Addiction and Recovery Act (CARA). The first major legislation to address addiction in forty years, anti-drug coalitions laud CARA for addressing the six pillars needed for effective response to this crisis: prevention, treatment, recovery, law enforcement, criminal justice reform, and overdose reversal.

The Comprehensive Opioid Abuse Site-Based Program

Established through CARA, The Comprehensive Opioid Abuse Site-based Program provides grants to expand drug prevention, education, treatment and recovery. There are six categories for this program. Below are selected examples of eligible uses for each one. See NOFA for a complete list of all eligible activities, mandatory project components, and further requirements. The deadline for all six categories is April 25, 2017. Submission 72 hours in advance of this deadline is recommended.


Category 1: Overdose Outreach Projects

This category supports programs that link individuals to treatment and recovery resources after non fatal overdoses. Eligible applicants are Native American tribes, local governments and consortia. Allowable uses of funds include:

  • Connect survivors with treatment providers or other recovery resources in ERs or immediately following the overdose.
  • Provide survivors and members of their support networks with naloxon.
  • Provide overdose community education and outreach.


Category 2: Technology-Assisted Treatment Projects

This category supports pilot programs that explore how technology can be used to expand treatment to justice-involved persons who have limited access to service because of geographic location. Eligible applicants are state governments and consortia. Allowable uses include:

  • Purchasing technology to connect clients with treatment providers.
  • Purchase monitoring devices for justice-involved individuals.
  • Provide training and staff support.


Category 3: System-level Diversion and Alternatives to Incarceration Projects

Category 3 is focused on county-bases approaches to diversions and alternatives to incarceration. Native American tribes and the 41 U.S. cities not within a county system are also eligible. Allowable uses include:

Planning Phase

  • Identify individuals who have high frequency intersections with criminal justice and other public agencies, then identify policies and approaches to engage these individuals in treatment and recovery services.

Implementation Phase

  • Link high-frequency utilizers with evidence-based treatment services in order to reduce visits to ERs and the criminal justice system.
  • Screen those entering community-based supervision and jails for overdose risk and connect them to services.
  • Develop data tracking systems to report on outcomes.


Category 4: Statewide Planning, Coordination, and Implementation Projects

Category 4 supports projects jointly planned by state administrative agencies in charge of criminal justice planning and single state agencies responsible for substance abuse services. There are two subcategories, subcategory A supports efforts for the above mentioned state agencies to develop coordinated plans to assist localities in seeking treatment and alternatives to incarceration for those with opioid use disorders and reducing the number of overdose deaths. Subcategory B mandates state agencies passing federal funds to localities within the state. Allowable uses include:

  • 4A Develop state plans that assist localities in helping affected individuals seek treatment, and develop alternatives to incarceration as part of a larger statewide substance abuse strategy.
  • 4B Provide financial support to localities/regions that support above activities.


Category 5: Harold Rogers PDMP Implementation and Enhancement Projects

Category 5 is limited to state governments that are in the process or have already enacted prescription drug monitoring programs (PDMPs), and cities , counties, or regions that have local PDMPs in the absence of state systems, as long as they agree to transition to the state PDMP if and when and if their state adopts one. Allowable uses of funds include:

  • Establish or enhance a PDMP system.
  • Facilitate the exchange of information among states.
  • Support collaborations with criminal justice agencies.


Category 6: Data-driven Responses to Prescription Drug Misuse

Category 6 supports activities that bring diverse stakeholders with multiple perspectives and sets of information to engage in holistic analysis of the opioid epidemic in order to implement and expand proven practices. Eligible applicants are state and local governments and consortia. Allowable uses of funds include:

  • Develop multi-disciplinary data-driven projects to create target interventions.
  • Identify which policies and procedures are effective and implement them on a larger scale.
  • Implement additional innovative, multi-disiplinary, evidence based approaches to the opioid crisis.

Further Resources

 The National Governors Association has made Finding Solutions to the Prescription Opioid and Heroin Crisis: A Road Map for States available as a tool for state governments to effectively assess and address this epidemic. Although it is geared towards the state level, some suggestions can be implemented by local governments as well.



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