Raskin, Warren, Baldwin, Kuster, Trone, Pettersen, 86 Lawmakers Reintroduce Landmark Bill to Combat Substance Use Epidemic

Washington, D.C. – Rep. Jamie Raskin, Ranking Member of the Committee on Oversight and Accountability, U.S. Senator Elizabeth Warren, Senator Tammy Baldwin, along with Representatives Ann Kuster, David Trone, and Brittany Pettersen, led 86 lawmakers to reintroduce the Comprehensive Addiction Resources Emergency (CARE) Act, the most ambitious legislation ever introduced in Congress to confront the substance use epidemic. 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.

“Today, I’m proud to reintroduce the Comprehensive Addiction Resources Emergency Act, originally authored by our beloved former Chairman Elijah E. Cummings, and to carry on his fight against the substance use and mental health crises devastating families across the country,” said Ranking Member Raskin.  “Substance use disorder touches nearly every family and certainly every community in America, with drug overdose deaths surpassing 100,000 annually. By providing urgently needed resources for communities on the ground to prevent substance use disorder before it begins and to strengthen essential services for people suffering, Congress can address this crisis head on and make sustained, life-saving progress for our people.”

Senator Warren originally introduced the CARE Act in 2018 and 2019 with the late Representative Elijah Cummings, and reintroduced the legislation with Representative Carolyn Maloney in 2021 to renew their push to combat the substance use epidemic, including the opioid epidemic. 

“The substance use disorder crisis has affected communities big and small, urban and rural, all across our country – and state and local leaders and first responders have had to manage this crisis without enough help from the federal government,” said Senator Warren.  “We learned from the fight to end the HIV/AIDS crisis that supporting local decision-making and expanding access to treatment and recovery services is powerfully important, and the CARE Act draws from these lessons to deliver billions in transformational federal resources that communities can use to tackle this public health crisis head-on.” 

“Millions of families like mine have watched their loved ones struggle with substance use disorder, and too often, seen their family, friends, and neighbors lose their lives to overdose or poisoning. We can and must do more to stop the opioid and fentanyl epidemic in its tracks and save lives,” said Senator Baldwin. “The CARE Act gives states and local communities the resources they need to expand substance use prevention, treatment, research, and education to address this crisis head on and help Wisconsinites in need.” 

“Every life lost to substance use disorder is a tragedy – we can and must do more to address the addiction and mental health crisis and ensure our communities have the tools and support they need,” said Rep. Kuster, founder and co-chair of the Bipartisan Mental Health and Substance Use Disorder Task Force. “I am proud to help introduce the CARE Act to invest in substance use disorder prevention, treatment, and research and strengthen our federal response to this epidemic. Together, we can help save lives.”

“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 Mental Health and Substance Use Disorder 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.” 

“Families across Colorado and the nation have been deeply impacted by the opioid epidemic, including my own. My mom suffered with a prescription opioid addiction that led to heroin and lasted for decades, until she finally got the help she desperately needed. She has been in recovery for over six years and is an example of what's possible, but there are far too many who aren’t as lucky,” said Representative Pettersen.  “I’m proud to partner with my colleagues on this bold legislation, which will ensure people struggling with substance use disorders can access the treatment and recovery services they need, as well as give our local and state partners the tools to prevent these incidents in the first place and save lives.” 

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 June 2022 and June 2023, an increase of more than 20 percent over the previous year.  The Substance Abuse and Mental Health Services Administration’s 2022 National Survey on Drug Use and Health revealed that 48 million people reported suffering from substance use disorder in the past year.  Despite the critical need for substance use disorder services, only about 24% of those in need of treatment for substance actually received it.

This is not the first time the United States has faced a public health crisis of this scale. During the 1980s and 1990s, deaths from HIV/AIDS grew rapidly and the country faced a public health crisis – the 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 the HIV/AIDS 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  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.

Under the CARE Act, Massachusetts would receive an estimated $131.3 million annually over ten years, with $63.5 million in state formula grants and $67.8 million distributed among the counties. 

The legislation is cosponsored by Senators Cory Booker (D-N.J.), Richard Blumenthal (D-Conn.), Sherrod Brown (D-Ohio), Bob Casey (D-Pa.), John Fetterman (D-Pa.), Martin Heinrich (D-N.M.), Amy Klobuchar (D-Minn.), Jeff Merkley (D-Ore.), Alex Padilla (D-Calif.), Brian Schatz (D-Hawaii), Tina Smith (D-Minn.), Chris Van Hollen (D-Md.), and Peter Welch (D-Vt.) and 73 members of the House of Representatives.

The full list of co-sponsors in the House of Representatives includes: Balint (D-Vt.), Barragan (D-Calif.), Blumenauer (D-Ore.), Blunt Rochester (D-Del.), Bonamici (D-Ore.), Bowman (D-N.Y.), Brown (D-Ohio), Brownley (D-Calif.), Bush (D-Mo.), Cárdenas (D-Calif.), Carson (D-Ind.), Casar (D-Texas), Chu (D-Calif.), Connolly (D-Va.), Crockett (D-Texas), Cuellar (D-Texas), Davis (D-Ill.), Dean (D-Pa.), DeGette (D-Colo.), Dingell (D-Mich.), Escobar (D-Texas), Frost (D-Fla.), García (D-Ill.), Garcia (D-Calif.), Garcia (D-Texas), Goldman (D-N.Y.), Gomez (D-Calif.), Grijalva (D-Ariz.), Hayes (D-Conn.), Huffman (D-Calif.), Jackson Lee (D-Texas), Jayapal (D-Wash.), Johnson (D-Ga.), Kelly (D-Ill.), Khanna (D-Calif.), Krishnamoorthi (D-Ill.), Larson (D-Conn.), Lee (D-Calif.), Lee (D-Pa.), Leger Fernández (D-N.M.), Lieu (D-Calif.), Lynch (D-Mass.), Matsui (D-Calif.), McCollum (D-Minn.), McGovern (D-Mass.), Meeks (D-N.Y.), Meng (D-N.Y.), Mfume (D-Md.), Moore (D-Wis.), Morelle (D-N.Y.), Moulton (D-Mass.), Nadler (D-N.Y.), Neguse (D-Colo.), Norton (D- D.C.), Ocasio-Cortez (D-N.Y.), Omar (D-Minn.), Panetta (D-Calif.), Pingree (D-Maine), Pocan (D-Wis.), Porter (D-Calif.), Pressley (D-Mass.), Ross (D-N.C.), Sanchez (D-Calif.), Sarbanes (D-Md.), Scanlon (D-Pa.), Schakowsky (D-Ill.), Schiff (D-Calif.), Spanberger (D-Va.), Stansbury (D-N.M.), Titus (D-Nev.), Tlaib (D-Mich.), Tokuda (D-Hawaii), Tonko (D-N.Y.), Torres (D-N.Y.), Trahan (D-Mass.), Underwood (D-Ill.), Velázquez (D-N.Y.), Wasserman Schultz (D-Fla.), Williams (D-Ga.). 

Supporting Organizations 

“Ending the overdose epidemic in the United States requires an all hands on deck public health approach that provides harm reduction organizations, recovery community organizations, and evidence based treatment and prevention groups with sustained, substantial funding that meets the needs of our most impacted communities. The CARE Act builds off of the successful path laid down by the Ryan White HIV/AIDS Care Act over 3 decades ago, enabling the creation of a overdose crisis response infrastructure that can meet the gravity of the moment and provide people who use drugs, people on recovery, and all those who love them with the opportunity to live well and thrive,” said Drew Gibson of AIDS United. 

"The CARE Act is the most ambitious legislative approach to confronting overdose in this country. We support this bill because it is a public health approach to a public health crisis, one that ensures that funding will go to people, organizations, and localities who can actually save lives and keep people safe—not to police, prisons, or any aspect of the carceral state.  Most importantly, this bill invests in Harm Reduction, understanding that in order to keep people safe, we need to meet them where they are and give them the resources necessary to use drugs safely," said Vinay Krishnan, National Field Organizer, Center for Popular Democracy.

“As the CEO of a free, behavioral, outpatient, addiction treatment facility, and representative of the entire staff, the Board of Directors, and the 2,000+ patients that we service every year, I wholeheartedly endorse the Comprehensive Addiction Resources Emergency (CARE) Act and will do whatever is necessary to help it become a reality,” said Dan Hostetler, CEO of the Above and Beyond Family Recovery Center. 

“We cannot end the HIV epidemic in the U.S. without also addressing substance use.  People who are struggling with substance use disorder deserve to have the support they need to reach their best health outcomes, and in turn this can help us to prevent new HIV transmissions,” said Omar Martinez Gonzalez of the AIDS Foundation Chicago. 

“Addiction is at a crisis level in the United States, but it is a crisis we can meet with strong efforts around prevention, treatment and recovery. We are pleased to support the Comprehensive Addiction Resources Emergency (CARE) Act, which will help combat this public health emergency through local and state substance use disorder grants, programs and workforce development,” said American Psychiatric Association President Petros Levounis, M.D., M.A.

“The American Psychological Association applauds Senator Elizabeth Warren for reintroducing the Comprehensive Addiction Resources Emergency Act. APA supports the population health-based approach of this legislation for how we better address mental health and substance use issues in our nation. The bill recognizes the need to prioritize ‘upstream services,’ and promotes prevention, harm reduction, treatment, and recovery support services. As we recognize September as Recovery Month, Senator Warren’s bill addresses the use or misuse of opioids, stimulants and other substances, particularly in underserved areas, including rural and marginalized communities,” said APA CEO Arthur C. Evans Jr., PhD. 

“We strongly support the CARE Act which provides critically needed resources to combat the  rising overdose deaths seen in New York. This will increase access to treatment and reduce barriers for delivering care,” said Allegra Schorr, President of the Coalition of Medication Assisted Treatment Providers and Advocates (COMPA).

“Community Catalyst is proud to support the CARE Act, a huge step forward in ensuring addiction is treated as a health issue and not a criminal one. Expanding access to health and social supports, overdose prevention, and harm reduction services through the large-scale investment in community centered approaches like those outlined in the CARE Act will help save lives,” said Emily Stewart, Executive Director of Community Catalyst. 

“Faces & Voices of Recovery is pleased to endorse and support the reintroduction of the CARE Act, as it recognizes the crucial role of recovery support service providers in communities across the nation.  This legislation recognizes how important it is to have comprehensive services for all people in need at the right time and right place.  This includes prevention, treatment, recovery support and harm reduction services and supports. People with lived experience are at the forefront of this work with their boots on the ground meeting people where they are at.  This legislation recognizes that the recovery community has a pivotal role to play and it provides resources to support efforts to bring health and wellness to a nation that has suffered for too long,” said Patty McCarthy, CEO of FAVOR. 

“On behalf of Friends of Recovery- New York (FOR-NY), I write in strong support of the Comprehensive Addiction Resource Emergency (CARE) Act. This bill constitutes the necessary public health response to meet the urgency of the opioids crisis. 

New York and the United States in the midst of an Overdose Public Health Crisis. In totality, the country lost more than 111,000 individuals to overdose in the 12-month period ending April, 2023. In the same time period, NYS lost almost 6,900 individuals, equating to 19 people dying per day NYS.

FOR-NY is dedicated to building infrastructure around the state through local Recovery Community Organizations (RCOs) and Recovery Community Outreach Centers (RCOCs) that build support for people living in recovery and others in need.  Our network of RCOs and RCOCs are strongly in support of life saving, evidence-based practices to support people seeking recovery- over 260,000 known members in New York alone. The numbers continue to grow of those in recovery and we need to expand support for them with assistance. Your CARE Act represents an important response in reaching those goals. 

Importantly, the CARE Act also provides resources to support a Recovery Ready Workforce.  Workers with painful injuries have frequently been overprescribed opioids, resulting in as many as 25% developing opioid dependence and OUD/SUD. A RRW program addresses prevention of addiction related to workplace injury and stress while also providing support for workers who are struggling and opportunities for people in recovery to reenter the workforce. Between 2009 – 2015, an estimated 225,000 New York workers were lost from the labor market due to opioids. New York’s economy cumulatively lost $179.4 billion in real economic output, which translates to the state’s annual real GDP growth rate slowing by 0.8 percentage points. 

The CARE Act will provide funding that will support sustained recovery support services. We thank you for introducing this important piece of legislation,” said Christopher Assini of Friends of Recovery - New York.

"We will not succeed in our effort to expand prevention, treatment, and recovery services for substance use disorders without an expanded workforce that is well trained and committed to serving the public.  This legislation recognizes the importance of these professionals- at all levels, from peers to counselors- as well as the need for credentialing and uniformity. We endorse this legislation and look forward to it ushering in a new generation of educated professionals," said Mark Attanasi, CEO of IC&RC. 

"In facing the overdose epidemic, we must pivot to public health solutions that truly address the crisis.  I stand behind transformative laws like the CARE Act, the Medicaid Reentry Act, and the Due Process Continuity of CARE Act, advocating for harm reduction, housing, and treatment over incarceration. These efforts are vital for our communities' safety and dignity.  I urge everyone to join us in this fight for health equity and justice, pushing for systemic change at the legislative level. Together, we can make a difference," said Alejandra Muneton, Health Equity Organizer at Make the Road Nevada. 

“I, as Founder and CEO of Many Paths One Destination, fully support the CARE ACT to address the current National epidemic of substance abuse and its devastating impact on the lives of individuals and families across the Country. Many Paths One Destination was created to support individuals in all phases of Recovery as well as other non-profit providers who have a similar focus to address the impact of substance abuse/addiction in our community,” said William G Fritz, Founder of Many Paths One Destination. 

“The Massachusetts Medical Society applauds Senator Warren’s leadership and commitment to fighting for patients through the reintroduction of the CARE Act. This legislation will provide critical, life-saving resources to patients who need it most.  Importantly, it will also help physicians and other health care professionals get the tools they need to better prevent illness by screening and treating patients who are suffering from substance use disorder. We commend the Senator for recognizing that we must attack this public health crisis with action, and we look forward to working with her to help pass this critical legislation,” said the Massachusetts Medical Society. 

“I support the CARE act, one of the most significant pieces of legislation being considered this session. We urge Congress to pass this legislation with all haste. Investment in our communities and to treat substance use is critical to making safer, healthier communities,” said Michael Galipeau of Michael Galipeau Consulting. 

“As registered nurses, we are on the frontlines caring for patients with opioid addiction and other substance use disorders. We see every day how the opioid crisis wreaks havoc in our communities.  Congress must take action now to adequately address this crisis, which means providing robust investments into prevention, treatment, and recovery services and programs across the country. Senator Warren and Congresswoman Kuster’s legislation would do just that, which is why National Nurses United strongly endorses the Comprehensive Addiction Resources Emergency Act and urges every Member of Congress to support passage of this legislation,” said Jean Ross, RN, President of National Nurses United. 

“Leaders in our network across differences of race, class, and ZIP code have fought to move our country away from mass incarceration towards a harm-reduction approach to the overdose crisis–and the CARE Act is a responsible and humane step in that direction. The CARE Act will provide desperately needed investments in harm reduction and treatment services, save thousands of lives, and give directly impacted people a seat at the table in deciding the care they need. Our members need these resources to build stronger, safer, healthier communities,” said Sulma Arias, Executive Director of People’s Action.

“It is so important for our legislators to remember that substance use disorder is a treatable disease that improves with the proper resources and supports,” said Shane Sims of People Living in Recovery.

“We support the CARE Act because it is imperative that working solutions like harm reduction  gain more support and expansion in order to tackle the addiction and overdose epidemic. It is not only a compassionate response to a significant public health issue but also a strategic investment in the well-being of individuals, communities, and society as a whole. With input from those on the frontlines this legislation could address the root causes of addiction, provide effective treatment, and support to individuals and families who have been devastated by the disease of addiction and/or negatively impacted by substance use,” said Elizabeth Burke Beaty, Executive Director, Sea Change RCO & National Sea Change Coalition. 

“If the CARE Act does pass it will provide the needed support for organizations doing the work to help people recover from substance use disorder. I fully stand by this bill,” said Tara Moreno-Wallen, Founder & Executive Director of Serenity House Communities.

"SMART Recovery strongly supports and endorses this important legislation, which, when enacted, will provide a significant contribution toward alleviating the suffering of the many affected by the opioid epidemic and the substance use crisis," said David Koss, Director of Government Relations, SMART Recovery. 

"According to recent statistics, Alaska has one of the highest rates of substance abuse and addiction in the United States. This is a pressing issue that requires immediate action and comprehensive solutions. 

Stand UP Alaska applauds the efforts of Senators Warren and Baldwin, as well as Representatives Kuster, in introducing the CARE Act. This legislation will provide much-needed resources to address the substance abuse epidemic and support individuals and communities affected by addiction. 

We wholeheartedly endorse this initiative and are convinced that by establishing the necessary infrastructure, addiction and recovery services can reach every individual in need,” said Erin Jackson-Hill, Executive Director of Stand UP Alaska. 

“It is so important to support the Bill that Senator Warren, Senator Baldwin, and Representative Kuster are preparing to reintroduce the Comprehensive Addiction Resources Emergency (CARE) Act. It will ensure that we are able to continue our vital work being done to help those struggling with Substance Use Disorder,” said Substance Abuse Services, Inc. 

"The Council of Southeast Pennsylvania wholeheartedly supports the CARE Act. A multi-faceted approach like this one is essential to addressing the devastating impact of the overdose crisis, and we were especially encouraged to see funding for Recovery Supports included in the legislation. We know firsthand the power of peer-led Recovery Supports in helping individuals survive and thrive in their recovery from Substance Use Disorder," said Jennifer King, Executive Director of The Council of Southeast Pennsylvania, Inc.

“Our organization has been fighting for individuals' rights to access treatment since our inception in 2015. The CARE Act would go a long way to achieving our nationwide goals to reduce overdose fatalities,” said Alexis Pleus, Founder and Executive Director of Truth Pharm, and mother of Jeff Dugon lost to an overdose in August 2014.

“The CARE Act acknowledges Tribal sovereignty and the trust obligation, as well as the disproportionate impact of substance use disorder in Indian Country, by ensuring Tribal Nations have access to substantial direct funding to address the opioid crisis, with an option to receive this funding through Indian Self-Determination and Education Assistance Act contracts and compacts. USET SPF commends Senators Warren and Baldwin, along with Representative Kuster, for reintroduction of the CARE Act. We continue to extend our strong support to this legislation and call upon Congress for its swift passage," said Chief Kirk Francis, President of the United South and Eastern Tribes Sovereignty Protection Fund.

“Coming out of Covid, the CARE Act is more essential than ever. Youth and young adults  are experiencing a substance use and mental health crisis. With the omnipresence of fentanyl in the illicit drug supply leading to unprecedented overdose death rates, we must invest in evidence-based prevention, treatment, and recovery support services to save lives,” said Ann Herbst, Executive Director of Young People in Recovery.

"Homelessness is driven by different things and can look different ways. It can be purely through poverty. That is my story as Executive Director of VOCAL-KY and now newly elected Louisville Metro Council District3 Councilwoman. It can also be driven through poverty along with drug use and/or mental health issues, which my family has experienced for many years. Housing insecurity continues to grow at alarming rates. No matter what our housing plan is, it needs short term and long term goals that include mixed use options. The term affordable needs to be clearly defined. We need a clear process to hold housing providers accountable that includes the residents' voice. We always need pathways to homeownership. Renters do contribute to our communities, cities and towns. Solutions need to be able to address rural, urban and suburban neighborhoods. Too many Louisvillians, Kentuckians and Americans are impacted by low wages, declining health, rising cost and a failed drug war that continues to feed people into homelessness. We need housing that meets the needs of ALL people! Housing for people who are struggling just with poverty. AND for those struggling with substance use and/or mental health needs who need supportive services. AND even for those coming home from incarceration. ALL THESE PEOPLE need housing to help get stable!

These solutions help the people impacted and the whole community! We want to drive home that providing housing, and critical services and care benefits those people struggling with homelessness, drugs, etc - AND everyone else! We know this works because our members, staff, leaders and community partners continue to provide advocacy,  direct services and care. As our unhoused community grows we need special projects that help seniors age in place, artists and young people deserve housing diversity too. Our immigrant communities need housing that helps them thrive, not just survive. We must work together to reduce the red tape to access affordable, sustainable and adequate housing for all or no plan will work. Every day we are laying the groundwork to do better together. Let's invest in people. Housing first means housing everyone no matter their station in life or zip code,” said Shameka Parrish-Wright, Executive at Voices of Community Activists and Leaders-Kentucky. 

"We are in the midst of history's worst humanitarian crisis and future generations will look to us and ask us why we didn't do more and I want to be able to tell them we did," said Elissa Tierney of WorthSaving.  

Click here to read the bill text.