CADCA will be holding a webinar on June 17 at 2:00 PM, in which our Public Policy Consultant, Sue Thau, will provide a more detailed briefing about the President’s Budget Request including what we are advocating for with Congress and to answer questions from the field.

CADCA is working its way through the recently released Fiscal Year (FY) 2026 President’s Budget Request (PBR). The PBR represents an important part of the appropriations process. Proposals in the PBR do not represent final numbers appropriated for federal programs. Congress must pass, and the President must sign, appropriations bills into law before any funding amounts can be considered final. Regardless, the PBR contains many proposals of vital importance to the substance use prevention field.

The PBR proposes substantial cuts to various programs, including substance use prevention programs, and proposes to reorganize large parts of the federal government. Many programs would either be eliminated or moved to a proposed new agency, the Administration for a Healthy America (AHA). AHA will be “the primary agency focused on prevention [and] will centralize the work of multiple federal agencies”. AHA would impact programs in the Office of National Drug Control Policy (ONDCP), Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Disease Control and Prevention (CDC).

Details on the proposed cuts and changes to substance use prevention infrastructure are below.

ONDCP

• The Drug-Free Communities (DFC) program is proposed to be moved from ONDCP to AHA and funded at only $70 million ($39 million less than the FY 2025 appropriated amount of $109 million).
  • This proposed decrease in funding is a reduction of 36% from FY 2025. This would drastically scale back the national reach of the DFC program and could result in funding decreases to existing grantees and halt any new grants from being awarded in FY 2026.
• The Comprehensive Addiction and Recovery Act (CARA) Section 103 enhancement grant program’s funding to current and former DFC grantees to do more with more intensity around opioid and stimulant issues is proposed to be totally eliminated  (-$5.2 million).
• The High Intensity Drug Trafficking Area (HIDTA) program is proposed to be moved to the Department of Justice and funded at $196 million ($102.5 million less than the FY 2025 appropriated amount of $298.5 million).

SAMHSA

The PBR proposes to cut over $1 billion from SAMHSA. Most of the proposed cuts would come from the Programs of Regional and National Significance (PRNS) across the three SAMHSA centers, the Center for Substance Abuse Prevention (CSAP), Center for Substance Abuse Treatment (CSAT) and the Center for Mental Health Services (CMHS).

CSAP

• The following CSAP programs would be totally eliminated:
  • The Strategic Prevention Framework/Partnership for Success (SPF/PFS) grant program (-$125.4 million).
• The Sober Truth on Preventing Underage Drinking (STOP) Act programs (-$14.5 million).
  • Enhancement Grants to current and former DFCs to do more with more intensity around underage drinking (-$11 million)
  • National Adult-Oriented Media Campaign (-$2.5 million)
  • Interagency Coordinating Committee for the Prevention of Underage Drinking (ICCPUD) (-$1 million)
• Tribal Behavioral Health Grants (-$23.66 million)
• Minority AIDS Initiative (-$43.2 million)
• Strategic Prevention Framework – Prescription Drugs (SPF-Rx) (-$10 million)
• Minority Fellowship Program (-$1.3 million)

CSAT

• Programs of Regional and National Significance (PRNS) is zeroed out (-$576.2 million)

CMHS

• A number of mental health Programs of Regional and National Significance would be eliminated. Other mental health programs. formerly in SAMHSA, would be moved to AHA. This list of mental health programs moved to AHA includes:
  • 988 Suicide and Crisis Lifeline ($520 million proposed)
  • National Strategy for Suicide Prevention ($28 million proposed)
  • Garrett Lee Smith Youth Suicide Prevention ($63 million proposed)
  • American Indian and Alaska Native Suicide Prevention ($4 million proposed)
  • Project AWARE ($121 million proposed)
  • Child Traumatic Stress Network ($99 million proposed)
  • Children’s Mental Health ($125 million proposed)
  • Projects for Assistance in Transition from Homelessness ($67 million proposed)
  • Assisted Outpatient Treatment ($21 million proposed)
  • Disaster Response ($2 million proposed)
  • Certified Community Behavioral Health Clinics ($385 million proposed)
• A totally new block grant called the Behavioral Health Innovation Block Grant would be created that combines all of the funding from the Substance Use Prevention, Treatment and Recovery Services (SUPRTS) Block Grant (funded at $2 billion in FY 2025), the State Opioid Response (SOR) Grants (funded at $1.575 billion in FY 2025) and the Center for Mental Health Services (CMHS) Block Grant (funded at $1 billion in FY 2025).
  • There is not much information in the budget about how the new Behavioral Health Innovation block grant would be implemented and structured. 78% of the money in this new block grant comes from the substance use related sources. However, it is not clear how much money would be dedicated in this new block grant to substance use related issues, nor is it clear what would happen to the 20% prevention set aside in the current Substance Use Prevention, Treatment and Recovery block grant that is currently the largest single source of funding for the substance use prevention field (funded at $401.6 million in FY 2025).

CDC

• The CDC’s National Center for Chronic Disease and Health Promotion (which houses the Office on Smoking and Health and the Division of Cancer Prevention and Control) would be eliminated (-$655.5 million).
• CDC’s opioid overdose prevention work formerly in the Center for Injury Prevention and Control is moved to AHA and funded at $475 million (-$30 million from the FY 2025 appropriated amount of $505 million).

The appropriations process is still months away from being finished and the numbers discussed here are not final. Congress will debate and mark up appropriations bills this summer, and the field will have ample opportunity to weigh in at that time.

CADCA will keep the field fully informed throughout the FY26 appropriations process.