Budget calls for increased funding for evidence-based prevention, harm reduction, treatment, recovery, interdiction, and supply reduction approaches to save lives

WASHINGTON, D.C. – Today, President Biden released his FY 2023 budget request to Congress, which calls for a historic investment of $42.5 billion for National Drug Control Program agencies, a $3.2 billion increase over the FY 2022 continuing resolution level at a time when overdose deaths, driven primarily by illicitly manufactured synthetic drugs, have reached a record high. This increased funding would support the expansion of evidence-based prevention, treatment, harm reduction, and recovery support services, with targeted investments to support underserved communities. The budget also includes an increase in funding for efforts to reduce the supply of illicit drugs like fentanyl and stop drug trafficking.

“A core component of President Biden’s Unity Agenda is beating the opioid and overdose epidemic that claims an American life every five minutes,” said Dr. Rahul Gupta, Director of the White House Office of National Drug Control Policy (ONDCP). “This budget supports the Administration’s ongoing work to expand access to evidence-based treatment, reduce the flow of illicit drugs like fentanyl from entering our communities, and prevent overdose. It also includes significant investments for evidence-based prevention and harm reduction services that are critical to saving lives. With these new resources, the Administration will build on the decisive actions taken this past year and comprehensively address two of the big drivers of the overdose epidemic – untreated addiction and drug trafficking profits.”

The President’s FY 2023 Budget builds on his American Rescue Plan, which has already appropriated nearly $4 billion to enable the Department of Health and Human Services’ Substance Use And Mental Health Services Administration (SAMHSA) and the Health Resources and Services Administration to expand access to vital mental health and substance use disorder services, including $30 million dedicated to enhancing harm reduction interventions like syringe services programs.

Specifically, the President’s budget includes $21.1 billion for the Department of Health and Human Services (HHS) in resources to support prevention, treatment, and interdiction efforts. Notably, it also includes a historic $85 million for CDC’s evidence-based harm reduction services and $63 million for SAMHSA’s First Responder Training program.  The President’s budget also continues the 10 percent set-aside for recovery in the SAMHSA Substance Abuse Prevention and Treatment Block program. The President is also calling for more than an $18 billion investment to reduce the supply of illicit substances in the United States. This includes $747.5 million in increases for efforts to reduce the availability of drugs, including efforts to interdict illicit drugs at ports of entry and disrupt drug trafficking networks, support domestic law enforcement efforts to reduce drug-related violence and property crime, and availability of illicit substances and work with international partners to reduce drug production. The FY 2023 budget requests an increase of $335.5 million for Drug Enforcement Administration investigations, diversion control, and other counterdrug efforts. The budget also includes an increase of $293.4 million for Customs and Border Protection (CBP) to stop drugs from entering the country at and between ports-of-entry. The budget also calls for increases of funding for the Office of National Drug Control Policy’s Drug Free Communities Support (DFC) program and High Intensity Drug Trafficking Areas (HIDTA) program, which strengthens collaboration between Federal, State, local, and Tribal law enforcement and public health officials.

To read more about the President’s FY 2023 budget request, click here.

To read the FY 2023 Drug Control Budget Highlights in full, click here.

In its first-year drug policy priorities, the Biden-Harris Administration outlined a strategy that includes expanding access to evidence-based prevention, treatment, harm reduction, and recovery support services, as well reducing the supply of illicit drugs. Since January, the Office of National Drug Control Policy has worked with other agencies across the government to advance President Biden’s drug policy priorities. Among the actions taken by the Biden-Harris Administration are:

Prevention

  • The Department of Health and Human Services’ (HHS) released a new Overdose Prevention Strategy that supports substance use prevention by expanding research of new and improved prevention efforts, investing in community resources to help prevent harms related to substance use, increasing access to high-quality pain management to reduce preventable suffering, and promoting responsible prescription of medications to protect patient safety.
  • The Centers for Disease Control and Prevention (CDC) launched four complementary education campaigns that provide information about the prevalence and dangers of fentanyl, the risks and consequences of mixing drugs, the life-saving power of naloxone, and the importance of reducing stigma around drug use to support treatment and recovery.
  • In 2021, the White House Office of National Drug Control Policy (ONDCP) announced a total of 745 community coalitions in all 50 states received over $93 million through Drug Free Communities program grants. This represents the largest single-year investment in the program’s history.
  • The Drug Enforcement Administration (DEA) issued its first national public safety alert in six years and launched the “One Pill Can Kill” public awareness campaign to raise awareness of the dangers of counterfeit pills laced with fentanyl.
  • DEA released details on the use of social media by criminal drug networks to market and sell deadly fake pills to teenagers and young adults. DEA publicly released known emojis and code words that are used to facilitate drug trafficking on social media to help inform the public of this growing threat.
  • The Division of Overdose Prevention (DOP) and National Center for Injury Prevention and Control (NCIPC) at CDC partnered with the National Association of County and City Health Officials (NACCHO) on a project to investigate the literature available on health inequities when it comes to substance use disorder treatment and services, as well as tools and resources which could provide guidance for health departments on addressing drug overdose through the use of a health equity lens.

Harm Reduction

  • HHS released the new Overdose Prevention Strategy that promotes harm reduction by increasing the availability and access to high-quality harm reduction services, decreasing negative effects of substance use, and reducing stigma related to substance use and overdose.
  • CDC and SAMHSA announced that federal funding may now be used to purchase fentanyl test strips in an effort to help curb the dramatic spike in drug overdose deaths.
  • CDC worked to identify and document novel, innovative, and emerging harm reduction strategies implemented as a result of the COVID-19 pandemic and to fund promising strategies for ensuring or increasing access to services during COVID-19.
  • ONDCP co-hosted a two-day National Harm Reduction Summit with SAMHSA and CDC, which convened a diverse group of partners and experts from local, tribal, state and federal governments and non-government organizations, including representatives from the fields of harm reduction, substance use prevention, treatment, recovery, and criminal justice to develop a framework of harm reduction for SAMHSA to help guide policies, programs, and practices at the agency.
  • CDC and SAMSHA established a $3 million partnership to leverage CDC’s National Harm Reduction Technical Assistance Center to support implementation of effective, evidence-based harm reduction programs, practices, and policies in diverse settings and decrease health disparities.

Treatment and Recovery

  • HHS announced three grant programs totaling $44 million to strengthen mental health and substance use services for individuals at risk for or living with HIV/AIDS.
  • HHS prioritized treatment and recovery in its  new Overdose Prevention Strategy which advances evidence-based treatment by making treatment easy to get, delivering health care and support services in a seamless and coordinated way, and implementing new and improved models of care that appeal to and help those who need them. It also aims to improve recovery support by developing different types of support throughout the lifespan, increasing the quality of services, supporting the recovery workforce, and expanding access to ongoing, affordable, and effective recovery support services.
  • The American Rescue Plan invested nearly $4 billion to allow HHS to expand access to vital mental health and substance use disorder services.
  • HHS released the Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder, which exempt eligible health care providers from federal certification requirements related to training, counseling and other ancillary services that are part of the process for obtaining a waiver to treat up to 30 patients with buprenorphine. This action expands access to evidence-based treatment by removing a critical barrier to buprenorphine prescribing.
  • DEA revised existing regulations for narcotic treatment programs (NTPs) to allow the operation of a mobile component. This rule change will help provide treatment to rural and other underserved communities, including incarcerated individuals.
  • SAMHSA announced the extension of the methadone take-home flexibilities for one year, effective upon the eventual expiration of the COVID-19 Public Health Emergency. The flexibility promotes individualized, recovery-oriented care by allowing greater access for people who reside farther away from an Overdose Treatment Programs or who lack reliable transportation.
  • National Institutes of Health (NIH) supported research to accelerate scientific solutions to the overdose crisis, including research on prevention of substance use and use disorders; novel treatment strategies for addiction and overdose reversal; interventions to reduce drug harms and infection transmission; models of recovery support; and implementation of evidence-based practices in healthcare, community and justice settings.
  • ONDCP hosted more than 300 State, local, and Tribal leaders from all 50 States, Washington, D.C., American Samoa, Virgin Islands, Puerto Rico, and the Northern Mariana Islands for a virtual convening entitled “Opioid Litigation Settlement: Using Evidence to Lead Action.” At the convening, government officials, researchers, and experts discussed how State, local, and Tribal governments can use evidence and data to guide decisions about how funds from opioid litigation can be spent to address addiction and the overdose epidemic, while advancing equity.
  • ONDCP announced the release of a model law for state legislatures that would help ensure opioid litigation settlement funds are directed to addressing addiction and the overdose epidemic in impacted communities and with public accountability.
  • CDC and ONDCP invested in communities by expanding our investment in the Combatting Opioid Overdoses through Community Level Intervention (COCLI) initiative to fund 8 new projects to implement innovative, evidence-based, and scalable solutions – like the Merrimack Valley MA – Wheels of Hope program for persons with substance use disorder to receive rides to treatment appointments. 
  • The Department of Justice’s (DOJ) Office of Justice Programs (OJP) announced the Bureau of Justice Assistance (BJA) is providing $94 million to adult reentry and recidivism reduction programs, including $29.6 million for substance use disorder treatment.
  • CDC expanded its investment in Public Health Analysts participating in the HIDTA program’s Overdose Response Strategy. This collaboration is helping communities reduce fatal and non-fatal drug overdoses by connecting public health and public safety agencies, sharing information, and supporting evidence-based interventions. CDC is funding public health analysts in all 50 states, DC, the US Virgin Islands, and Puerto Rico.
  • CDC has provided $300M+ per year through Overdose Data to Action to support 47 states, Washington, DC, 2 territories and 16 high burden cities and counties in collecting high quality, comprehensive, and timely data on nonfatal and fatal overdoses and in using those data to inform prevention and response efforts, such as ensuring people are connected with the care they need; supporting health care providers and systems with overdose response efforts; and developing partnerships with public safety and first responders to improve data sharing and response.

Supply Reduction

  • At the request of the United States, and with the recommendation of the International Narcotics Control Board, the UN Commission on Narcotic Drugs (CND) voted to control three chemicals used by drug traffickers to produce illicit fentanyl, a powerful synthetic opioid that is driving overdose deaths.
  • President Biden announced two Executive Orders to counter transnational criminal organizations and illicit drug trafficking, first by formally establishing the U.S. Council on Transnational Organized Crime, and second, by modernizing and expanding the U.S. Government’s ability to target drug trafficking organizations, their enablers, and financial facilitators through sanctions and other related actions.
  • ONDCP designated six new counties as part of its High Intensity Drug Trafficking Areas (HIDTA) program. These counties, located in California, Illinois, Kentucky, and Pennsylvania, will receive support for regional law enforcement efforts to disrupt and dismantle drug trafficking organizations.
  • ONDCP and CDC provided funding for the nationwide expansion of the HIDTA Overdose Response Strategy to all 50 states, Puerto Rico, the U.S. Virgin Islands, and the District of Columbia. The Strategy brings together drug intelligence officers and public health analysts at the local and regional level to share information and develop evidence-based intervention and support services that reduce overdoses.
  • ONDCP, HHS, and the Department of Justice (DOJ) presented to Congress the Biden-Harris Administration’s recommendations for a long-term, consensus approach to reduce the supply and availability of illicitly manufactured fentanyl-related substances (FRS), while safeguarding against racial disparities in prosecution and sentencing and reducing barriers to scientific research for all Schedule I substances.
  • DEA coordinated nationwide enforcement operations to rid American communities of significant quantities of counterfeit pills laced with deadly fentanyl.
  • The Biden-Harris Administration announced a new United States-Mexico Bicentennial Framework for Security, Public Health, and Safe Communities that addresses multiple factors fueling the opioid epidemic and aims to protect the American people by investing in public health, preventing transborder crime, and pursuing criminal networks.
  • CBP significantly increased the amount of fentanyl seizures along the Southwest border, seizing an average of more than 800 pounds of fentanyl each month in fiscal year 2021, over twice as much as fiscal year 2020 and four times the amount seized in 2019.
  • DEA seized more than 15,000 pounds of fentanyl in 2021. DEA also seized more than 20.4 million potentially deadly fake pills marketed by criminal drug networks, many of which contain lethal amounts of fentanyl.
  • ONDCP released a new, holistic U.S.-Colombia counternarcotics strategy developed by the Counternarcotics Working Group between the United States and Colombian governments that broadens focus to include specific actions on rural security and development, environmental protection, and supply reduction.

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