For months, Congress has been hard at work on the fiscal year (FY) 2024 appropriations process. Programs of importance to the substance use prevention field are spread across three appropriations bills: Financial Services and General Government, Labor, Health and Human Services and State, Foreign Operations (SFO). With approximately two months until the start of FY 2024, here is where substance use prevention programs stand in the appropriations process.

Financial Services and General Government (FSGG)

This bill includes programs in the Office of National Drug Control Policy.

• Drug-Free Communities (DFC) Program: $109 million in the House and Senate FSGG appropriations bills. This is level with the final FY 2023 appropriated amount and includes $2.5 million for the National Coalition Institute.
• Comprehensive Addiction and Recovery Act (CARA) Section 103 enhancement grants: $5.2 million in the House and Senate FSGG appropriations bills. This is level with the final FY 2023 appropriated amount.

Labor, Health and Human Services and Education (LHHSE)

This bill includes programs in the Substance Abuse and Mental Health Services Administration (SAMHSA), Centers for Disease Control and Prevention (CDC), National Institute on Drug Abuse (NIDA) and National Institute on Alcohol Abuse and Alcoholism (NIAAA). Please note that House-appropriated levels are not available for some programs because the House has not released its LHHSE report. The Senate released its report on Thursday, July 27; therefore, its numbers are reported first below.

Substance Abuse and Mental Health Services Administration

• Center for Substance Abuse Prevention (CSAP) Programs of Regional and National Significance: $236.8 million (level with the final FY 2023 appropriated amount and $57.2 million above the House-proposed amount of $179.6 million). This includes:
  • The Sober Truth on Preventing (STOP) Underage Drinking Act: $14.5 million in the Senate (level with the final FY 2023 appropriated amount), including:
    • $11 million for STOP Act enhancement grants (level with the final FY 2023 appropriated amount).
    • $2.5 million for the Adult-Oriented National Media Campaign (level with the final FY 2023 appropriated amount).
    • $1 million for the Interagency Coordinating Committee for the Prevention of Underage Drinking (level with the final FY 2023 appropriated amount).
  • The Strategic Prevention Framework/Partnership for Success (SPF/PFS) program: $135.4 million in the Senate (level with the final FY 2023 appropriated amount). This includes:
    • $125.4 million for the Strategic Prevention Framework program (level with the final FY 2023 appropriated amount).
    • $10 million for the Strategic Prevention Framework-Rx program (level with the final FY 2023 appropriated amount).
  • Center for Substance Abuse Treatment (CSAT): $4.21 billion in the Senate (+$143.2 million above the final FY 2023 appropriated amount of $4.07 billion and $239.1 million above the House proposed amount of $3.9 billion). This includes:
    • $576.2 million in the Senate for Programs of Regional and National Significance (PRNS) (+$4 million above the final FY 2023 appropriated amount).
    • $2.04 billion in the Senate for the Substance Use Prevention, Treatment and Recovery Services (SUPTRS) Block Grant (+$120 million above the final FY 2023 appropriated amount of $1.92 billion).
    • $1.595 billion in the Senate for the State Opioid Response (SOR) Grants (+$20 million above the final FY 2023 appropriated amount of $1.575 billion).
  • Center for Mental Health Services (CMHS): $2.85 billion in the Senate (+$160 million above the final FY 2023 appropriated amount of $2.69 billion and +$150 million above the House-proposed amount of $2.7 billion). This includes:
    • CMHS Block Grant: $1.04 billion in the Senate (+$56 million above the final FY 2023 appropriated amount of $986.53 million).

Centers for Disease Control and Prevention (CDC)

• CDC Tobacco program: $246.5 million in the Senate (level with the final FY 2023 appropriated amount).
• CDC Excessive Alcohol program: $6 million in the Senate (level with the final FY 2023 appropriated amount).
• CDC Opioid Overdose Prevention and Surveillance: $506 million in the Senate (+$1 million above the final FY 2023 appropriated amount).

National Institutes of Health

• National Institute on Alcohol Abuse and Alcoholism (NIAAA): $595.3 million in the Senate (level with the final FY 2023 appropriated amount).
• National Institute on Drug Abuse (NIDA): $1.67 billion in the Senate (+$10 million above the final FY 2023 appropriated amount of $1.66 billion).

Health Resources and Services Administration (HRSA)

• Rural Communities Opioid Response Program: $155 million in the Senate (+$10 million above the final FY 2023 appropriated amount of $145 million).

State, Foreign Operations (SFO)

This bill includes programs in the State Department.

• International Narcotics and Law Enforcement (INL) Demand Reduction Program: $20 million in the House (level with the final FY 2023 appropriated amount) and $15 million in the Senate (-$5 million under the final FY 2023 appropriated amount of $20 million).

Report Language

The Senate LHHS report also included the following report language of relevance to the substance use prevention field: “The Committee is concerned about SAMHSA’s lack of emphasis and funding for primary substance use prevention to stop use and delay the age of initiation. SAMHSA has conflated metal health promotion with substance use prevention, thereby diluting the already scarce resources for actual substance use prevention in CSAP. The Committee instructs SAMHSA to ensure that all the funding provided to the Center for Substance Abuse Prevention, as well as the 20 percent prevention set aside in the Substance Use Prevention, Treatment, and Recovery Services Block Grant, be used only for evidence-based substance use prevention activities and not for any other purposes, to include mental health promotion and harm reduction. The Committee further requests a report to Congress within 120 days of enactment that includes how this guidance is being applied to all CSAP programs as well as in the guidance to the States and territories regarding the 20 percent prevention set aside in the SUPTRS Block Grant.”

Conclusion

It is important to understand that the FY 2024 appropriations process is not yet finished. The House and Senate must iron out the differences in their respective versions of the appropriations bills and President Biden must sign them into law. CADCA is continuing our work to ensure that all programs of interest to the substance use prevention field are funded at the highest possible level in FY 2024. CADCA will keep the field informed throughout the rest of the FY 2024 process.