The Comprehensive Addiction Recovery Act (CARA) sailed through the Senate with nary a nay, but it has been languishing in the House for a month. It is possible that a backlog of bills waiting to work its way through House discussion, debate and decision has delayed the bill. However, one legislation watcher site gives the bill only a 40 percent chance of passing. Individuals with dual diagnosis must wait and see whether they will reap the benefits CARA promises them specifically.
The bill’s chances
GovTrak.us gives the bill slim hope of getting through the House. However, this isn’t surprising for congressional bills. Only 21 percent of those to make it past committee between 2013 and 2015 were passed. According to the site, one cosponsor is a ranking member of the committee to which it has been referred; another cosponsor is the chairman of the committee; the House’s companion piece of legislation was introduced by a member of the opposing party. All of these bode well for the bill, but the odds are still stacked against it.
The benefits of CARA if passed
Should the House ultimately approve the bill, individuals with dual diagnosis would benefit in three ways.
First, under section Title II – Law Enforcement and Treatment, the bill specifies a person who has been determined by a qualified health professional to be suffering from co-occurring conditions qualifies as an eligible participant for treatment alternatives to jail. This may sound like an innocuous distinction, but consider this: According to a report commissioned by the Substance Abuse Mental Health Services Administration, over 70 percent of incarcerated individuals have a substance abuse problem; as many as 15 percent have serious mental health problems. Both rates far exceed the occurrence rates in the regular population.
Second, CARA would fund programs to train law enforcement on co-occurring conditions. This is pivotal when considering that half of all people shot by police are mentally ill. Someone with a mental illness who self-medicates or a person who exacerbates a mental illness by substance abuse can become irrational, confrontational and wholly unpredictable. Without proper training, officers often resort to the gun to resolve a situation.
Third, CARA seeks to improve the entire behavioral health system. One of the more significant improvements is establishing a continuum for care. This entails early intervention and prevention, crisis intervention, supporting treatment and recovery. While this continuum will provide benefits to everyone in the behavioral health system, it has the potential to dramatically benefit those with co-occurring conditions. This is seen most clearly with respect to recidivism.
According to the Center for Evidence-Based Practices, individuals with co-occurring conditions have a recidivist rate of 68 percent. This is substantially higher than the rate for individuals diagnosed only with a mental illness (54 percent) and marginally higher than the rate for a person with a substance abuse problem (66 percent). A Harvard study found repeat driving under the influence (DUI) offenders have a much higher rate of psychiatric disorders than the normal population. The study tracked these individuals for five years. Untreated, they were more likely to reoffend, either by picking up another DUI or by committing some other crime. A continuum of care could reduce recidivism by ensuring individuals continue to receive treatment long after an initial escalation or episode.
Sovereign Health Group specializes in treating co-occurring conditions. Our dual diagnosis program breaks the cycle of abuse that exacerbates mental illness by getting to the underlying conditions that fuel addiction. Contact our 24/7 helpline for more information.
About the author
Darren Fraser is a content writer for Sovereign Health Group. He worked two and half years as reporter and researcher for The Yomiuri Shimbun until they realized he did not read, speak or write Japanese and fired him. Undeterred, he channels his love of research into unearthing stories that provide hope to those dealing with addiction and mental illness. Darren loves the Montreal Canadiens hockey club and horror films and would prefer to enjoy these from the comforts of his family’s farm in Quebec. For more information about this media, contact the author at firstname.lastname@example.org.