Last July, President Obama signed into law the much heralded, Comprehensive Addiction and Recovery Act or CARA. CARA was the first major federal addiction legislation in 40 years, and the most comprehensive effort undertaken to address the opioid epidemic, encompassing six identified pillars necessary for a coordinated community response – prevention, treatment, recovery, law enforcement, criminal justice reform, and overdose reversal. This is a good thing, right?

Finally, a recognition that the closely-linked problems of mental illness and drug addiction were going to get the true-north attention long advocated by public health activists. About time we all say! In 2015, the Centers for Disease Control said heroin deaths surpassed gun homicides for the first time accounting for 33,092 deaths. San Diego County contributed our sad share with an opioid-related death every 33 hours.

Despite today’s Congressional divisiveness and drama, when the CARA bill passed in 2016, the Senate and the House signaled their strong bi-partisan support by voting in favor, 94-1 and 400-5, respectively. It certainly begs the question if fighting drug addiction and mental health was important enough to pass this bill, almost unanimously, seven months ago, why has CARA not been funded? For several months, no money was appropriated by Congress and then in December 2016, Congress passed a Continuing Resolution (CR).  In fact, the CR stretches to the end of April 2017 and since Congress did not appropriate funding before the CR, and before their recess, we wait. Eight months and waiting.

The rates of Emergency Room visits involving heroin is highest among individuals in their 20s. But then again, those 20- and 30-somethings account for over half of all ER visits involving heroin and narcotic cases. In 2011 data, there were over 1.5M emergency room visits for non-medical use of pharmaceuticals, and almost 140,000 additional ER visits involved opioids or heroin (SAMHSA).

Since President Obama signed CARA, over 200 San Diegans have lost their lives to opioid overdose. Eight months and waiting.

Family Health Centers of San Diego is in a race. A race to build the best mental health, and substance abuse treatment system we can. This past year, we have increased our hiring of mental health staff and now employ 12 psychiatrists and over 50 mental health therapists. In addition, FHCSD has 12 Alcohol and Drug Counselors and is set to open another mental health clinic and a larger Alcohol and Drug Counseling location in the 2017-18 timeframe. The need is now.

Everyone knows a friend or family member who, at some point, needed the support of a mental health therapist, psychiatrist or counselor. Hopefully, help was there. In most cases it is not. The shortages in the mental health professionals are woefully well-documented.

As a community, we need a coordinated response to combat the heroin and opioid addiction in our young people. We should all be shocked into action that CARA promised such a direction, and still is not funded. Was 2016 a great year for mental health care? Hopefully, we will find out the answer soon. But for now, we are eight months and waiting.


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