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December 16, 2021

Trone, Kuster, Warren, Baldwin, Maloney Lead More than 100 Democrats in Senate and House in Reintroducing Landmark CARE Act to Combat the Substance Use Epidemic


December 16, 2021

Contact: Sasha Galbreath, 

Trone, Kuster, Warren, Baldwin, Maloney Lead More than 100 Democrats in Senate and House in Reintroducing Landmark CARE Act to Combat the Substance Use Epidemic

The CARE Act is the most ambitious legislation of its kind in Congress and would allocate $125 billion over 10 years to defeat the substance use crisis, including $3.3 billion per year to the hardest-hit counties and cities.

View Full List of Endorsements (PDF)

Bill Text (PDF) | One Pager (PDF) | Tribal One Pager (PDF) | Section-by-Section (PDF)

WASHINGTON, D.C. — Congressman David Trone (D-MD), Senator Elizabeth Warren (D-MA), Representative Carolyn B. Maloney (D-NC), Chairwoman of the House Committee on Oversight and Reform, along with Senator Tammy Baldwin (D-WI), and Representative Ann Kuster (D-NH) today led over 100 democrats in the Senate and House in reintroducing the Comprehensive Addiction Resources Emergency (CARE) Act, the most ambitious legislation ever introduced in Congress to confront the substance use epidemic. 

Endorsed by over 175 organizations, the CARE Act would provide state and local governments with $125 billion in federal funding over ten years, including nearly $1 billion per year directly to tribal governments and organizations.

“The opioid epidemic has taken hold of communities in every corner of the country. Even still, the treatment between substance use disorder and other diseases such as cancer couldn’t be more different,” said Congressman David Trone, founder and co-chair of the Bipartisan Addiction and Mental Health Task Force. “The CARE Act meets the moment by providing crucial funding to not only treat addiction but also prevent the disease in the first place. We must achieve parity in how we treat addiction in America. This bill is a step in the right direction.”

Last year, approximately 275 Americans died each day from a drug overdose while the COVID-19 pandemic exacerbated our nation’s mental health and substance use disorder crises. According to recent data from the Centers for Disease Control and Prevention, it is estimated that more than 100,000 people died of drug overdoses between April 2020 and April 2021, an increase of more than 20 percent over the previous year. The Substance Abuse and Mental Health Services Administration’s 2020 National Survey on Drug Use and Health revealed that 40.3 million people reported suffering from substance use disorder in the past year. Despite the critical need for substance use disorder services, only about 6.5% of those in need of specialty treatment for substance use disorders were able to access it in 2020.

This is not the first time we have faced a public health crisis of this scale. During the 1980s and 1990s, deaths from HIV/AIDS grew rapidly, and the country’s medical system was ill-equipped to provide effective, evidence-based care. In 1990, Congress passed the bipartisan Ryan White Comprehensive AIDS Resources Emergency Act (Ryan White Act) to provide funding to help state and local governments, and community-based organizations, combat this epidemic.  

The CARE Act is modeled directly on the Ryan White Act, supporting local decision-making and programs to expand access to evidence-based treatments and recovery support services. The CARE Act also recognizes the need for expanded mental health supports, early intervention, and harm reduction tactics.  

The CARE Act would provide $125 billion over ten years to fight this crisis, including:

  • $4.6 billion per year to states, territories, and tribal governments, including $2.3 billion to states with the highest levels of overdoses and $1.84 billion through competitive grants. 
  • $3.3 billion per year to the hardest hit counties and cities, including $1.75 billion to counties and cities with the highest levels of overdoses and $1.22 billion through competitive grants. 
  • $2 billion per year for public health surveillance, biomedical research, and improved training for health professionals, including $1 billion for the National Institutes of Health (NIH), $500 million for the Centers for Disease Control and Prevention (CDC) and regional tribal epidemiology centers, and $500 million to train and provide technical assistance to professionals treating substance use disorders;
  • $1.6 billion per year to support expanded and innovative service delivery, including $1 billion for public and nonprofit entities, $500 million for projects of national significance that provide treatment, recovery, and harm reduction services, $50 million to help workers with or at risk for substance use disorders maintain and gain employment, and $50 million to expand treatment provider capacity; and
  • $1 billion per year to expand access to overdose reversal drugs (Naloxone) and provide this life-saving medicine to states for distribution to first responders, public health departments, and the public.

Of the total funding, the CARE Act would invest nearly $1 billion a year provided directly to tribal governments and organizations, including:

  • $790 million per year for grants to tribal governments to help fight this crisis and invest in substance use prevention and treatment;
  • $7.5 million in additional funding for tribal nations and regional tribal epidemiology centers to improve data collection on overdoses;
  • 50 million a year to Tribal Colleges and Universities, Indian Health Service-funded organizations, and medical training programs that partner with tribal nations and tribal organizations to train Native health professionals to improve substance use disorder treatment services;
  • $150 million a year in funding to Native non-profits and clinics, including to urban Indian organizations, Native Hawaiian organizations, and projects designed to test innovative service delivery and culturally-informed care models to tackle addiction; and
  • $1 billion per year to expand access to the overdose reversal drug Naloxone and provide this life-saving medicine to states to distribute to tribal nations, first responders, public health departments, and the public.

“These drug overdoses are tragic and preventable. The CARE Act contains many provisions to implement solutions we know work to prevent these unnecessary deaths. Expanding access to Naloxone reduces overdose fatalities.2 Providing funding directly to the communities most impacted by this epidemic, especially our tribal communities, is important to ensure solutions are tailored to address community-specific issues. NSC also supports increasing funding for research into substance use disorders (SUD), public health surveillance and improved training of health care providers treating individuals with SUDs,” wrote Lorraine M. Martin, President and CEO of The National Safety Council (NSC). Full letter can be found here

“While the treatment community is grateful for the continued commitment of Congress to address addiction, our service needs consistently outpace our capacity. A historically low-resourced sector, the behavioral health system continues to be strained by the enormity and urgency of its needs. This legislation would make a significant difference in access to addiction treatment services for individuals and families living with substance use disorders. It provides $125 billion in federal funding over ten years to support and expand treatment and recovery services, federal research and prevention programming,” wrote Lydia Conley, President and CEO of Association for Behavioral Healthcare (ABH). Full letter can be found here

Substance use by expecting moms can have an adverse effect on the baby and can lead to a condition known as neonatal abstinence syndrome (NAS), which usually results in babies having withdrawal symptoms from drugs (including prescribed opioids) after birth. In addition, substance use during pregnancy, even if it’s a prescription, can lead to miscarriages, preterm births, and birth defects. That is why March of Dimes proudly supports your legislation, as it would provide critical investments to the most affected families and communities, as well as increase access to life-saving surveillance, training, treatment and recovery programs, and overdose reversal drugs. It would also incentivize states to use Medicaid funding to cover the costs of treatment, and create a new grant program to support at-risk parents struggling with addiction to maintain or find employment while they are in treatment and recovery,” wrote Stacey Y. Brayboy, Sr. Vice President of the March of Dimes. Full letter can be found here

“This legislation offers increased access to treatment and will improve care for individuals with substance use disorders (SUDs). The demand for access for mental health and addiction services has increased dramatically since the COVID-19 pandemic and has reached the level of a public health crisis. The CARE Act delivers significant funding and resources to state and local governments efforts to combat SUDs as well as advance federal research and programs to expand access to evidence-based treatments and recovery support services. We appreciate your leadership on this issue and applaud your efforts,” wrote George Abraham, President American College of Physicians (ACP). Full letter can be found here

“The passage of the Opioid Crisis Response Act of 2018 was an important first step to creating necessary substance abuse programs and begin addressing prevention and trauma from the opioid overdose crisis. Now, more action is needed to ensure those affected by trauma and substance abuse have the support they need. At a time when the opioid overdose epidemic poses a serious threat to the stability and wellbeing of families and communities across the country, the CARE Act can provide much needed resources to those that have been impacted by this crisis, and continue the journey to ending the epidemic,” wrote Nia West-Bey, Director of Youth Policy, and Isha Weerasinghe, Senior Policy Analyst, of the Center for Law and Social Policy (CLASP). Full letter can be found here

Congressman David Trone was elected to the House of Representatives in November 2018 to serve the 6th District of Maryland, which includes all or part of Montgomery, Frederick, Washington, Allegany, and Garrett Counties. Trone serves on the Appropriations, Veterans’ Affairs, and Joint Economic Committees. In Congress, Trone is fighting to make progress on issues that matter to Marylanders, including the mental health and addiction crises, criminal justice reform, and funding for medical research.