July Monthly Policy Update

Overseeing the annual appropriations process is perhaps the most important role that Congress plays.

In determining the level of funding for thousands of government programs, appropriators in essence establish the priorities of Congress. The process is long and laden with procedural hurdles.

Earlier this month, the House of Representatives released their appropriations bill and report for the Department of Health and Human Services, which dictates funding for agencies such as the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Disease Control (CDC).

Appropriations reports not only set dollar amounts, but also contain verbiage which clarifies Congress’ position and explains why certain decisions were made. This year’s House appropriations report contained several passages on overdose and harm prevention that were disturbing and shocking to our community.

The bottom line: the House seeks to eliminate the entire Injury Prevention Center from the Centers for Disease Control, including the $500 million Overdose Center and their “Overdose 2 Action” grants.

The Overdose Center works with states and localities to advance overdose prevention in communities across the country. There were two funding announcements made available in 2023 for city, county, and state health departments and territories to known as the Overdose Data to Action (OD2A) cooperative agreements. Through these funding opportunities, the center supports innovation, expands harm reduction strategies, links people to life-saving care, and makes the latest data available so that we can get ahead of this complex and constantly evolving epidemic.

Elimination of the Injury Prevention Center would also erase critical programs tangential to behavioral health, like the Suicide Prevention program ($30 million) and the Rape Prevention program ($62 million).

Continuing the hit parade, the House favors the elimination of $247 million for tobacco use prevention and control and $220 million for the Ending the HIV Epidemic initiative.

In its report, the House seems quite hostile to harm reduction, which may be owing to a fundamental misunderstanding of the concept. In the section regarding SAMHSA, the House wrote the following:

Harm Reduction- The Committee is concerned that SAMHSA has confused the normalization of illegal drug use with its mission to support prevention and recovery in relation to substance use dis- order. The Committee continues to support the availability and provision of naloxone to reduce overdose deaths; however, the Committee provides no funding to support harm-reduction activities related to supporting the continued misuse of controlled substances.

Based on this language, it would appear programs most at risk for losing funding include syringe exchange and fentanyl test strips. The House’s sorely misguided approach led to an additional elimination of $34 million for the Screening/Brief Intervention/Referral to Treatment program:

Screening, Brief Intervention, and Referral to Treatment—The Committee provides no funding for the Screening, Brief Intervention, and Referral to Treatment program. The Committee notes that SAMHSA has labeled the program as supporting ‘‘harm reduction’’ activities. The Committee further notes that following the decriminalization of drugs for personal use in Oregon in 2021, overdose deaths increased almost 50 percent.

We are still awaiting the Senate’s action, as their bill will certainly look quite different from the House version. The two chambers will then need to convene and work out their differences.

In the meantime, Faces & Voices of Recovery authored a Statement to the Hearing Subcommittee opposing the funding cuts. 16 organizations signed on in solidarity.

Stay tuned. We’ll post updates as we get them.