On May 4, 2026, the White House Office of National Drug Control Policy (ONDCP) released the 2026 National Drug Control Strategy (NDCS). Published every two years, the Strategy is the federal government's central plan for how it will address addiction across agencies. This year's version gets the priorities right. It treats addiction as a chronic and treatable disease, commits to making FDA-approved medications for opioid use disorder widely available, keeps naloxone affordable for the people who need it and invests in the behavioral health workforce that provides care. Each of these reflects what the evidence says actually helps people recover.
However, one month earlier, the budget that would pay for that plan moved in the opposite direction.
What the FY 2027 Budget Request would cut
The FY 2027 President's Budget Request (PBR), released on April 3, 2026, does not fund the Strategy. It would weaken several parts of the federal overdose prevention and treatment system at once.
It proposes more than $222 million in cuts to prevention programs at the Substance Abuse and Mental Health Services Administration (SAMHSA). It merges three major behavioral health formula grants into a single pool, which would force addiction programs and mental health programs to compete for the same dollars. It shrinks the federal behavioral health workforce pipeline by close to 44 percent. It eliminates housing programs that the Strategy itself calls essential to lasting recovery. And it cuts ONDCP by 95 percent, even though federal law puts that office in charge of coordinating and certifying the entire federal drug control budget.
Why this matters right now
We are finally turning a corner. Provisional data from the Centers for Disease Control and Prevention (CDC) estimate 68,632 drug overdose deaths in 2025, a decline of 15 percent from the year before. That is roughly 12,000 people who were alive at the end of 2025 and would not have been at the prior year's rate. Twelve thousand parents, children, neighbors and coworkers.
That decline did not happen on its own but followed more than a decade of steady federal investment in the prevention, treatment and recovery programs the PBR now proposes get cut. The services that brought the numbers down are the services on the chopping block.
A plan on paper does not keep anyone alive. Treatment slots, naloxone supplies, the data systems that show us where people are dying, recovery housing and reentry support all run on funding that Congress provides each year. Reduce the funding and the Strategy's promises go unmet, starting with the people who rely on these programs most.
What you can do about it
The budget request is not final, but it is the Administration's opening proposal. Congress writes and passes the bills that set the actual numbers. When the Administration proposed similar cuts for FY 2026, Congress protected funding for most of these programs with votes from both parties. The same result is within reach for FY 2027, and the window to make the case is open now.
You can help shape it
Read our full Strategy analysis, which walks through what each proposed cut would mean, program by program. Then bring it to the people with the power to influence and manage behavioral health funding. Tell them what these programs do in your community and what their loss would cost. The decisions are being made over the coming months and they will be shaped by the people who speak up while there is still time.
Advocates who want to engage the federal budget process directly can also access the Overdose Prevention Initiative’s U.S. Federal Advocacy Action Guide, free on the Health Advocacy Training and Collaboration Hub (HATCH), for a practical walkthrough of how the appropriations cycle works and how community-level evidence can influence it.
When Gretchen Burns Bergman testified in California in 2014 for a bill that would let organizations distribute naloxone, someone asked why she wanted to support drug use.
She was thinking about what a mother might need in her medicine cabinet.
“Mothers are oftentimes the first responder, right?” she told me during Brave Recovery: The Women Impacted. “So why would I not be able to have it in my medicine cabinet?”
That question has stayed with me. Gretchen knew the moment she was trying to prepare for. She also knew that the people writing the rules did not necessarily see it the way she did.
WASHINGTON, D.C. (September 29, 2026)- The National Safety Council (NSC) and the Global Health Advocacy Incubator’s Overdose Prevention Initiative (GHAI) applaud the U.S. Department of Labor and the Occupational Safety and Health Administration (OSHA) for giving employers practical guidance on responding to an opioid overdose at work. Released on September 24, “Save a Life Day”, during National Recovery Month, the guidance calls on workplaces to keep opioid overdose reversal medication accessible, prepare workers to use it and call 911 when an overdose occurs.
CMS's proposed CY2027 payment rule rewards screening, weakens treatment accountability and opens new questions about AI and sensitive patient information. Here is what GHAI’s Overdose Prevention Initiative’s told Centers for Medicare and Medicaid Services.
