Impact of the Federal Funding Pause on Access to Addiction Treatment

On January 27, 2025 the Executive Office of the President, Office of Management and Budget issued Executive Order M-25-13: Temporary Pause of Agency Grant, Loan and Other Financial Assistance Programs. This memo required federal agencies to identify and review all Federal financial assistance programs and supporting activities. This includes federal funding for addiction treatment and support.

The goal of the review was to ensure that federal spending is aligned with President Trump’s priority of advancing Administration priorities including using taxpayer dollars to advance a stronger and safer America. In addition to the federal review the order called for an immediate temporary pause related to the obligation or disbursement of all Federal financial assistance.

By January 31, a U.S. District Judge issued a temporary restraining order against funding pauses related to M-25-13. However many important programs were still finding disruptions to these financial promises. These include many community health care centers that provide alcohol and substance use programs as well as mental health care in the most vulnerable communities.

Substance Abuse and Mental Health Services Administration (SAMHSA) Programs

The Substance Abuse and Mental Health Services Administration (SAMHSA) is an agency within the United States Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation.

Their mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse and provide treatments and support to foster recovery while ensuring equitable access and better outcomes.

SAMHSA supports programs at the local and state levels through block grants and other formula and discretionary grants backed by federal budget allocations.

These programs include education and research support, suicide prevention, harm reduction services, homelessness programs and resources, drug free workplace initiatives, an evidenced based practice resource center, a nationwide national helpline for treatment referral and information, substance use treatment locator services and various faith-based and community initiatives (FBCI).

Substance Abuse Prevention and Treatment Block Grant (SABG)

The Substance Abuse Prevention and Treatment Block Grant (SUBG) is a program offered through the SAMHSA. Their programs fund grants in all 50 states, the District of Columbia and U.S. territories. They provide support for local and state organizations by helping them plan, implement and evaluate activities that prevent and treat substance abuse.

Organizations that receive funding from SUBG must meet certain requirements and have programs that target pregnant women and women with dependent children, injection drug users, tuberculosis services, early intervention services for HIV/AIDS and primary prevention services.

Loss of grant funding would have a detrimental impact on the communities that rely on these funds to support gaps in care and care for their most vulnerable individuals.

State Opioid Response (SOR) Grants

State Opioid Response (SOR) Grants is another program provided through SAMHSA. The purpose of this program is to address the opioid overdose crisis by providing resources to states and territories for increasing access to FDA approved medication for the treatment of opioid use disorder.

The grants also support the continuum of prevention, harm reduction, treatment and recovery support services and other concurrent substance use disorders.

Programs supported by these grants have a tremendous impact on reducing the number of overdose deaths. They help to support long term recovery for individuals with addiction and reduce crime within the communities they serve.

Medication-Assisted Treatment for Prescription Drug and Opioid Addiction (MAT-PDOA)

The Medication Assisted Treatment- Prescription Drug and Opioid Addiction (MAT-PDOA) provided through SAMHSA funds grants that expand or enhance access to medications for opioid use disorder.

These programs include increasing access to medication assisted treatment programs, education regarding opioid addiction and overdose prevention, harm reduction services, telehealth programs to reach, engage and keep patients in treatment and community outreach programs that assist the most vulnerable members of their communities.

The loss of these types of programs would increase overdose deaths and criminal activity. This would drastically reduce the success of opioid use disorder treatment and increase the spread of infectious diseases such as HIV OR Hepatitis within the community.

Grants for the Benefit of Homeless Individuals (GBHI)

Grants for the Benefit of Homeless Individuals (GBHI) is another program funded through the SAMHSA that helps communities expand and strengthen treatment and recovery support services for individuals experiencing homelessness who have substance use disorders or co-occurring mental and substance use disorders.

Programs supported by these grants provide outreach and engagement for high risk groups, mental and substance use screening and assessments, treatment for substance use disorders, assistance in accessing permanent housing, case management services, assistance with obtaining health insurance and access to recovery support services.

Loss of funding for these programs would impact the mental and physical health and stability of the most vulnerable members of the community which in turn has negative consequences for the entire community in terms of economics, safety and overall health.

Targeted Capacity Expansion (TCE) Grant Programs

The Targeted Capacity Expansion (TCE) grant is funded through the SAMHSA. It provides money for programs that expand harm reduction services and alcohol and substance use disorder treatment and recovery in underserved communities to meet unmet community needs. These include HIV/AIDS programs, mobile crisis units including medical and non medical services and harm reduction programs.

Cuts to funding for these types of grants would have negative impacts especially on the rural communities and disadvantaged cities that rely on outside support to maintain programs for their community members impacted by the drug epidemic and healthcare disparities.

Recovery Community Services Program (RCSP)

The Recovery Community Services Program is supported by funds through the SAMHSA. It provides peer recovery support services for people with substance use disorder or co-occurring substance use disorder and mental health disorders.

Peer recovery support has been shown to increase the success of alcohol and substance use treatment and long term recovery. It offers a place where individuals can connect with other men and women with similar experiences, find mentorship, get help with employment and housing support and connect with recovery coaching.

Without funding for these programs communities lose the ability to provide drop in centers, sober living homes, community based classes that promote healthy coping skills, relationship building and education, support groups for individuals and families facing alcohol and substance use disorders and critical housing support.

National Institute on Drug Abuse (NIDA) Programs

The National Institute on Drug Abuse (NIDA) receives funding from the U.S. Department of Health and Human Services through the National Institutes of Health. The goal of this funding is to support scientific research on drug use and addiction.

NIDA prioritizes funding for research programs that strategically support and conduct basic and clinical research on drug use, its consequences and the underlying neurobiological, behavioral and social mechanisms involved.

They also support programs promoting the effective translation, implementation and dissemination of scientific research findings to improve the prevention and treatment of substance use disorders and enhance public awareness of addiction as a brain disorder.

Clinical Trials and Research Grants

For NIDA Clinical Trials and Research Grants researchers submit proposals for studies that examine drug use and addiction to NIDA for consideration. With this financial support researchers can conduct studies on the efficacy of current treatments, therapies and diagnostic tools.

They also help to develop new evidence based treatments, therapies and diagnostic tools that improve the lives of individuals who are faced with alcohol, substance use and co-occurring disorders.

Advancements in the field of addiction medicine would be negatively impacted without funding for clinical trials and research.

This includes missing the development of new treatment options including medications and supportive therapies which limits the understanding of alcohol and substance use disorder and inadequate public health responses to the drug crisis in this country.

The lack of funding for clinical trials and research grants impacts everyone.

HEAL Initiative (Helping to End Addiction Long-Term)

HEAL Initiative (Helping to End Addiction Long-Term) is a program that receives funding from the National Institutes of Health. This program was developed to accelerate research to address the national opioid public health crisis through understanding, managing and treating pain and improving prevention and treatment for opioid misuse and addiction.

HEAL scientists and researchers are looking at how the opioid crisis impacts individuals, families and the community due to issues such as pain management strategies, lost productivity and economic opportunity, intergenerational and childhood trauma and the community impact such as strain has on first responders, emergency departments, hospitals and treatment centers.

Lack of funding for programs like HEAL harms individuals, families and communities. Without new and ongoing research understanding of substance use disorder and improved treatment options will be lost which only furthers the opioid crisis in this country.

Centers for Disease Control and Prevention (CDC) Initiatives

The Center for Disease Control and Prevention (CDC) is the national public health agency under the Department of Health and Human Services in the United States. The CDC uses science based, data driven findings to protect public health by focusing national attention on developing and applying disease control and prevention.

The CDC has recognized the need for more education and intervention surrounding substance use disorders in this country.

Through government funded initiatives they provide communities with information and support to create programs to decrease alcohol and substance use, raise awareness about the impact drugs and alcohol have on individuals and the community and improve treatment services and practices.

Overdose Data to Action (OD2A)

Overdose Data to Action (OD2A) is a program funded through the CDC. This program is a cooperative agreement that provides funding to 90 health departments under two distinct programs to reduce drug overdose and the impact of related harms.

OD2A supports the implementation of prevention activities in collecting accurate, comprehensive and timely data on nonfatal and fatal overdoses and uses that data to enhance programs and surveillance efforts.

Without funding for this program tracking of important data related to drug overdoses and community programs would be lost. Researchers would not have access to the latest data needed to evaluate trends, the efficacy of prevention programs and the need for additional community support.

Additionally these programs support the expansion of harm reduction services including syringe exchange programs and Narcan distribution services.

Prevention for States Program

The Prevention for States Program is funded by the CDC. This is an initiative that provides funding to state health departments to implement strategies aimed at preventing opioid overdoses.

This program distributes funds to individual states so they can design and implement prevention programs that are specific to that state’s needs. This includes overdose prevention programs, prescription drug monitoring programs and community resource services.

The CDC uses data collected from these programs to further develop new treatment strategies and assess the impact prevention strategies have on communities.

The loss of funding for these programs impacts everyone. Not only would a loss of funding for this program harm individuals facing substance use disorders but would also impact access to data that is critical to the evaluation of program efficacy and would hinder the development of improved treatment options and understanding.

Department of Veterans Affairs (VA) Addiction Treatment Programs

The Department of Veterans Affairs (VA) Addiction Treatment Program is funded through the U.S. Department of Veterans Affairs. The VA provides services including medical and mental health care for active and former members of the U.S. military.

VA Substance Use Disorder Treatment Programs

The Addiction Treatment Program offers vets substance use resources including access to medication assisted treatment (MAT), inpatient and outpatient treatment, counseling services and relapse prevention services. Without funding for these services vets will not receive the treatment needed for alcohol and substance use treatment.

Veterans Crisis Line

The Veterans Crisis Line is a program funded by the Department of Veterans Affairs. It provides support to veterans dealing with mental health and substance use crises.

The telephone hotline is staffed 24/7 and helps callers in immediate crisis to find the help they need including access to counseling and treatment for substance use disorder.

Loss of funding for this program would result in harm to vets needing immediate crisis support.

Indian Health Service (IHS) Alcohol and Substance Abuse Program (ASAP)

The Indian Health Service (IHS) Alcohol and Substance Abuse Program (ASAP) is funded by the U.S. Department of Health and Human Services. This program serves to reduce the incidence and prevalence of alcohol and substance abuse among American Indians and Alaska Natives to a level at or below the national average.

These programs include behavioral health services in person and telehealth programs, provide comprehensive education related to prevention and ensure treatment services.

Without funding for these programs individuals, families and communities that rely on the Indian Health Services for care would not have access to valuable, lifesaving alcohol and substance use treatment.

Drug-Free Communities (DFC) Support Program

The Drug-Free Communities (DFC) Support Program receives funding from the Office of National Drug Control Policy (ONDCP). DFC programs aim to mobilize community leaders to identify and respond to drug problems unique to their community especially among youth.

These programs help communities to create sustainable change that reduces the number of youth using alcohol and drugs. They support positive youth engagement, establish safe and supportive school environments and education related to alcohol and substance use disorder.

Loss of funding for these programs would put youth at risk by shutting down programs aimed at prevention and education related to the risk of drug use.

Comprehensive Opioid, Stimulant and Substance Abuse Program (COSSAP)

The Comprehensive Opioid, Stimulant and Substance Abuse Program (COSSAP) receives funds from and is managed by the U.S. Department of Justice.

The goal of this program is to provide financial and technical assistance to state and local governments for substance use prevention and treatment emphasizing a partnership and collaboration across public health, behavioral health and public safety sectors.

They have programs that promote public safety by supporting access to substance use treatment for those in the criminal justice system and support the use of diversion programs for those in need of treatment.

Without funding for these types of programs individuals that may benefit from diversion programs and jail based treatment will not have access to the treatment they need.

Ryan White HIV/AIDS Program

The Ryan White HIV/AIDS Program is funded by the U.S. Department of Health and Human Services. It provides free or low cost services to people with HIV who are underinsured or have no health insurance.

These programs ensure access to care, reduce the spread of HIV and ensure improved health outcomes. This includes medical care, access to antiretrovirals and peer and community support services.

Without the necessary funding that supports this program individuals who rely on assistance to afford their medical care and life saving medications will lose access to these services resulting in devastating consequences.

Time will tell whether or not M-25-13 will impact the funding for these critical programs. One thing is for sure: These programs benefit the individuals, families and communities that are impacted by the drug epidemic in this country.

Support for continued funding is imperative if we are to successfully combat this crisis.