Press Release

Leaders of 12 Big City Health Departments Urge U.S. Senate to Pass CARA and TREAT Act to Address National Opioid Epidemic

March 2016


FOR IMMEDIATE RELEASE: March 7, 2016              

Chrissie Juliano, MPP, Executive Director, issued the following statement:

WASHINGTON, D.C –Members of The Big Cities Health Coalition (BCHC) today sent a letter to the Senators Mitch McConnell and Harry Reid, requesting passage of the “Comprehensive Addiction and Recovery Act” (CARA) and “The Recovery Enhancement for Addiction Treatment” (TREAT) Act. CARA would direct resources to prevention, treatment, and recovery in response to the national opioid abuse epidemic, while TREAT would expand the types of practitioners who are able to prescribe buprenorphine, a medication designed to treat opioid addiction and prevent death due to overdose.

The Coalition consists of the largest, most urban public health departments in the country, representing approximately 1 in 6 Americans. These local health departments are on the front lines of the opioid epidemic. They work to save lives every day through partnerships with physicians and law enforcement to prevent opioid-related overdoses, increase provider education, and expand access to treatment.

The full text of the letter is included below:

March 7, 2016

Dear Majority Leader McConnell and Minority Leader Reid:

As you know, opioid misuse is a growing public health crisis. Large, urban health departments are on the front lines of the epidemic where they work for increased community access to prevention and treatment, monitor local and state data to analyze trends, educate healthcare providers on the proper opioid prescribing practices, and train first responders and community members on how to use lifesaving medications that reverse the effects of an opioid overdose and save lives.

S.524, the “Comprehensive Addiction and Recovery Act (CARA),” which directs resources across the continuum of prevention, treatment, and recovery, is an important response to the epidemic.

However, additional steps are needed to address the epidemic of opioid abuse and overdose. The following officials from large urban health departments urge the Senate to approve The “Recovery Enhancement for Addiction Treatment (TREAT) Act,” (S.1455) to specifically expand the types of qualifying practitioners who can prescribe medication-assisted treatment.

Medication-assisted treatment, including buprenorphine, is the most effective way to treat opioid addiction. This medication reduces death from opioids, drug use, and crime, and, most importantly, helps individuals regain their ability to participate in their communities, families, and workplaces.

According to the Centers for Disease Control and Prevention, opioid overdose deaths increased by 14 percent in 2014, the most recent year for which data is available. Since 2000, overdose deaths have claimed the lives of half a million Americans. But, overdose deaths and other consequences of opioid misuse are preventable. 

As health commissioners leading the nation’s largest, most urban health departments, we have seen firsthand the damage opioid misuse has done to our communities. Together we have worked to align strategies to address the opioid crisis, but local action is not enough. It is critical to recovery that the full range of treatment and harm reduction strategies are available. We need the federal government as a partner in this effort in order to improve treatment access by remedying the shortages in prescribers certified to offer buprenorphine treatment.

Although nurse practitioners and physician assistants can prescribe addictive opioid medications, they are not permitted to prescribe the very drug – buprenorphine – needed for the treatment of opioid addiction under federal law.

This limitation in the current law ignores the important and successful partnership between primary care physicians, nurse practitioners and physician assistants in the treatment of addiction, and hampers access to buprenorphine. Building on these strong partnerships between physician and non-physician providers is vital in expanding access to effective treatment.

The TREAT Act, authored by Senator Edward Markey (D-MA) would relax patient limits and allow nurse practitioners and physician assistants who receive specialized training to prescribe buprenorphine under the supervision of qualified physicians.

We strongly feel that this bill supports a responsible approach to increase prescribing capacity, while ensuring that practitioners are adequately trained and supervised. As public health agencies we have broad support for this approach in our communities and stand ready to implement changes quickly once Congress acts to pass legislation.


Tomas Aragon, MD, DrPH, Health Officer, City of San Francisco

Rex Archer, MC, MPH, Director of Health, Kansas City (Missouri)

Mary T. Bassett, MD, MPH, Commissioner, New York City Department of Health and Mental Hygiene

Kelly Colopy, MPP, Director, Long Beach Department of Health and Human Services

Abdul El-Sayed, MD, DPhil, Executive Director & Health Officer, Detroit Health Department

Bob England, MD, MPH, Director, Maricopa County Department of Public Health

Thomas Farley, MD, MPH, Commissioner, Philadelphia Department of Public Health

Cynthia A. Harding, M.P.H., Interim Director, Los Angeles County Department of Public Health

Joseph P. Iser, Chief Health Officer, Southern Nevada Health District

Monica Valdes Lupi, JD, MPH, Executive Director, Boston Public Health Commission

Latricia Tillman, MPH, Director of Public Health, Multnomah County Health Department

Leana Wen, MD, MSc, Commissioner, Baltimore City Health Department

CONTACT: Max Mays or 913-233-6830 


About the Big Cities Health Coalition

The Big Cities Health Coalition (BCHC) is a forum for the leaders of America’s largest metropolitan health departments to exchange strategies and jointly address issues to promote and protect the health and safety of their residents. Collectively, BCHC member jurisdictions directly impact nearly 62 million people, or one in five Americans. For more information, visit