A three-year decline in drug overdose deaths in the United States offers a glimmer of hope after years of escalating rates. But falling overdose numbers represent a window of opportunity, not the end of a mission.
To prevent a resurgence and prepare for an ever-evolving public health landscape, Congress must stop reacting and start investing in long-term structural change.
By rejecting many of the Trump administration’s proposed budget cuts, the 119th Congress has prevented some of the most significant damage to the federal government’s overdose prevention and addiction response.
Addiction is not a niche issue; its collateral damage is felt nationwide, in every community and in every congressional district.
However, simply protecting the status quo is not enough given the continued urgency of the issue. Alcohol use still contributes to nearly 180,000 deaths annually, and opioid-related morbidity and mortality remain at unacceptable levels.
The following five priorities should guide congressional efforts to reset the nation’s approach to addiction.
1. Restore congressional leadership on addiction
At the height of the overdose epidemic, Congress devoted sustained, bipartisan attention to drug policy, with numerous hearings over the course of several years and the passage of significant legislation. Today, as overdose deaths have declined, the issue is receiving less attention in Congress.
Yet, the public has not moved on. Public sentiment reveals a consistent concern about opioid deaths.
Congress must reestablish bipartisan leadership on alcohol, drug, and addiction policy through regular oversight, targeted hearings, and legislative engagement.
A Cornell University survey released earlier in 2026 found that over 88% of Americans surveyed believed opioid overdose deaths were a very serious problem. Moreover, people remain concerned about the broader drug issue. Approximately 7 in 10 respondents in a Gallup survey felt the drug problem in the U.S. was either “extremely” serious or “very” serious.
As with other chronic conditions, a decrease in the most severe outcome of a disease — in this case overdose deaths — does not mean the underlying issue has been eliminated. Continued legislative engagement remains vital to managing the long-term reality of substance use disorder in the U.S.
Congress must reestablish bipartisan leadership on alcohol, drug, and addiction policy through regular oversight, targeted hearings, and legislative engagement.
2. Invest in the federal response
Recent reductions in the federal workforce and wholesale elimination of agency divisions — including the branch overseeing the nation’s sole comprehensive survey on mental health and substance use and the CDC’s Office on Smoking and Health — have left the federal response to addiction in a state of disrepair.
A diminished federal capacity has left many agencies without the staffing, expertise, or governance structures needed to oversee complex national programs. Rebuilding this operational capacity must be a congressional priority.
At the same time, the Department of Health and Human Services (HHS) must not only restore these weakened structures, but fundamentally evaluate whether existing structures are working. This analysis should be done thoughtfully; it will require insight from a cross sector of individuals, including state and local policymakers as well as people most impacted by substance use and addiction.
The goal should not be merely to recreate systems that simply respond to current events. Congress must ensure existing public health structures are prepared to adapt to a rapidly evolving synthetic drug supply and polysubstance use; integrate scientific consensus regarding the health risks of alcohol use; respond to changes in tobacco and nicotine use; and modernize the nation’s behavioral health system to prevent and treat gambling disorder.
3. Prioritize policymaking
Political polarization has led Congress to increasingly defer policymaking authority to the executive branch, a dynamic also apparent in addiction policy. Congress must balance three core policymaking responsibilities to demonstrate its leadership: draft and pass modern, evidence-based statutes; monitor the execution of existing laws; and ensure the federal workforce is adequately funded to execute congressional actions.
One of the most urgent responsibilities facing lawmakers in the new Congress will be revisiting new Medicaid work requirements. Failing to intervene will jeopardize health care access for millions of individuals navigating substance use disorders, making swift legislative oversight a paramount public health priority.
Treatment should serve as an entry point to long-term, coordinated care, just as it does for other chronic conditions, such as heart disease.
Congress should also revive critical bipartisan legislation that has stalled in recent years. Bills like the No Red Tape For Addiction Treatment Act, the Due Process Continuity of Care Act, and The Reentry Act — all of which expand access to care for people with substance use disorders — should be immediately reintroduced and considered in the next Congress.
Improving the nation’s addiction treatment system must transcend partisan politics. If the Trump administration’s Great American Recovery Initiative yields actionable proposals to strengthen treatment quality and access, Congress should work collaboratively to advance those reforms.
Furthermore, as recent calls to expand treatment — including mandatory treatment in some circumstances — grow louder, policymakers must look at the quality of existing treatment.
Congress should strengthen oversight to identify ineffective, exploitative, or low-quality programs while routing federal resources to providers that consistently deliver evidence-based care. Such treatment should serve as an entry point to long-term, coordinated care, just as it does for other chronic conditions, such as heart disease.
4. Strengthen data and surveillance
Policymakers cannot effectively manage addiction policy without timely, reliable data. Currently, reductions in surveillance capacity have significantly weakened the federal data infrastructure, threatening core data systems such as the National Survey on Drug Use and Health.
The result is a federal response that is increasingly reactive. The problem of inadequate data is not new, but it is taking on increased urgency.
Real-time, verified data is the cornerstone of an effective public health response.
Recognizing the importance of data, Congress included a requirement in the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act) for the White House Office of National Drug Control Policy (ONDCP) to develop a national data dashboard.
However, a dashboard is only as good as its underlying data. Some of the data in the dashboard is over a decade old, limiting its value for policymakers responding to rapidly changing public health threats.
As noted in a recent Brookings Institution analysis, real-time, verified data is the cornerstone of an effective public health response. While congressional appropriators are often reluctant to fund administrative data collection, gathering information is a critically important aspect of an effective drug and alcohol strategy.
The same can be said for the lack of federal surveillance data on gambling disorder. The nation is flying blind into a commercialized gambling public health emergency.
Congress cannot hold agencies accountable for outcomes if it does not invest in the data needed to measure effectiveness.
5. Leverage existing oversight mechanisms
The ONDCP is statutorily required not only to develop a National Drug Control Strategy (Strategy) but to ensure that the federal budget and agency actions support the Strategy. Congress must hold the ONDCP accountable for this coordinating mandate.
Recent executive branch actions — including reductions in force, as well as other proposed and implemented program cuts — are directly at odds with the Strategy.
A national Strategy has little value if agencies simply ignore it.
One example is the administration’s elimination of the Organized Crime Drug Enforcement Task Force (OCDETF), previously housed in the U.S. Department of Justice. OCDETF’s functions were moved to the Department of Homeland Security’s Homeland Security Task Force, whose primary mission is immigration enforcement.
To complicate matters further, the OCDETF Fusion Center, which provides the data and information needed to support drug trafficking and money laundering efforts, remains critically underfunded.
A national Strategy has little value if agencies simply ignore it. Congress must insist that ONDCP exercise its statutory authority whenever an agency’s budgetary or operational actions conflict with the National Drug Control Strategy.
A forward-looking approach
When the 120th Congress convenes next year, it will face no shortage of pressing issues. However, the intersection of alcohol, drug, and addiction policy must remain a top-tier priority.
Addiction is not a niche issue; its collateral damage is felt nationwide, in every community and in every congressional district.
While Congress has successfully blocked the most devastating budget cuts, defensive legislative maneuvering is no longer enough.
The nation’s addiction response cannot be rebuilt simply by recreating existing structures or tinkering at the edges of a disjointed system. It requires a forward-looking approach that looks around the corner to anticipate emerging threats, adapts swiftly to clinical evidence, and builds a stronger foundation for the future.
