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Substance use disorder (SUD) and opioid use disorder are significant public health threats that affect millions of Americans each year. To help address overdose deaths and lack of access to treatment, the Comprehensive Addiction and Recovery Act (CARA) was signed into law on July 22, 2016. CARA is extensive legislation intended to address many facets of the opioid epidemic, including prevention, treatment, recovery, law enforcement, criminal justice reform, and overdose reversal. It authorizes more than $181 million each year in new funding to fight the opioid epidemic and it requires the implementation of programs and services across the United States to address SUD and recovery.

Following the passage of CARA, the Departments of Education, Health and Human Services (HHS), and Labor, along with the 2018 Related Agencies Appropriations Act, included appropriations for a study of the Substance Abuse and Mental Health Services Administration (SAMHSA) components in CARA, to be conducted by the National Academies of Sciences, Engineering, and Medicine. In response to this charge, the National Academies formed an ad hoc committee to review outcomes achieved by four programs funded by SAMHSA through CARA: State Pilot Grant Program for Treatment for Pregnant and Postpartum Women (PPW-PLT), Building Communities of Recovery (BCOR), Improving Access to Overdose Treatment (OD Treatment Access), and First Responders (FR-CARA). The committee's review is designed to result in three reports over 5 years. This report, the second in the series, reviews reported outcomes and metrics to assess progress toward achieving program goals.

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Product Details

ISBN-13: 9780309265690
Publisher: National Academies Press
Publication date: 12/11/2021
Pages: 156
Product dimensions: 8.50(w) x 11.00(h) x 0.00(d)

Table of Contents

Acronyms and Abbreviations xvii

Summary 1

1 Introduction and Background 11

Comprehensive Addiction and Recovery Act 12

Statement of Task and Report Methodology 13

Organization of the Report 15

2 PPW-PLT and BCOR Programs 17

Introduction 17

PPW-PLT Program Description 17

BCOR Program Description 18

Methodology 18

Government Performance Reports Act (GPRA) Data Reports 18

Grantee Progress Reports 22

Cross-Cutting Data Limitations 22

Findings: PPW-PLT 24

Required Activity 1 24

Required Activity 2 30

Required Activity 3 31

Allowable Activity 1 32

Allowable Activity 2 32

Allowable Activity 3 33

Summary of PPW-PLT Program Progress 33

Findings: BCOR 33

Required Activity 33

Allowable Activity 1 37

Allowable Activity 2 39

Allowable Activity 3 40

Summary of BCOR Program Progress 42

3 OD Treatment Access and FR-CARA Programs 45

Introduction 45

OD Treatment Access Program Description 45

FR-CARA Program Description 45

Methodology 46

Summary Report from the CSAP Division of State Programs Management Reporting Tool (DSP-MRT) 48

Report from the OD Treatment Access Reporting Form 50

Cross-Cutting Data Limitations 51

Findings: OD Treatment Access 51

Required Activity 1 51

Required Activity 2 53

Required Activity 3 55

Required Activity 4 59

Required Activity 5 61

Allowable Activity 1 61

Allowable Activity 2 62

Allowable Activity 3 62

Summary of OD Treatment Access Program Progress 64

Findings: FR-CARA 64

Required Activity 1 64

Required Activity 2 66

Required Activity 3 66

Required Activity 4 67

Allowable Activity 1 68

Allowable Activity 2 68

Additional Consideration: Sustainability 68

Summary of FR-CARA Program Progress 69

4 Conclusions 71

Data Limitations 71

A Note on the COVID-19 Pandemic 71

Conclusions 74

Summary of Evidence of Progress 74

The Forthcoming Final Report 76

Assessing Progress and the Effectiveness of Funded Programs 76

Ensuring Cost-Effectiveness in the Federal Government's Response to the Opioid Epidemic 78

References 79


A Supplementary Program Information 83

B Summary Tables of CSAT GPRA Data 91

C Summary of Committee Recommendations in Report 1 127

D Committee Biographical Sketches 135

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