Fears that the budget of the Office of National Drug Control Policy (ONDCP) would be slashed in the first year of the Trump administration were significantly eased on Tuesday when the president's fiscal 2018 spending proposal called for most of the coordinating agency's efforts to be funded at levels similar to past-year spending.
Two popular ONDCP programs that sources and an internal e-mail had indicated were on the chopping block, the Drug-Free Communities Support Program and the High-Intensity Drug Trafficking Areas (HIDTA) initiative, are proposed to be funded at levels close to past-year levels in the administration's budget proposal. The requests are $91.9 million for Drug-Free Communities, which supports the efforts of local community anti-drug coalitions, and $246.5 million for HIDTA, which boosts state and local law enforcement agencies' efforts to combat trafficking.
ONDCP acting director Richard Baum announced that President Trump's overall fiscal 2018 budget proposal includes $12.1 billion for drug treatment and prevention efforts and $15.6 billion for interdiction, law enforcement and international efforts. This represents a departure proportionally from recent federal anti-drug budgets that have supported demand- and supply-side initiatives in largely equal shares.
The administration's priority efforts in areas such as improving border security to stem the flow of drugs are essentially resulting in a budget where growth in supply-side initiatives is outpacing efforts on the demand side.
The treatment and prevention funding breaks down to $10.8 billion for treatment, a proposed increase of nearly 2% from fiscal 2017, and $1.3 billion for prevention, an 11% decrease. The proposed treatment funds include $500 million in state grants authorized in the 21st Century CURES Act for responses to the opioid crisis.
Sue Thau, public policy consultant for Community Anti-Drug Coalitions of America (CADCA), tells Behavioral Healthcare Executive that while the proposal to fund Drug-Free Communities at just under its $97 million fiscal 2017 appropriation is an overall positive development, a proposed $61 million cut to Strategic Prevention Framework (SPF) Partnership for Success grants under the federal Center for Substance Abuse Prevention (CSAP) is a major cause for concern in the president's budget proposal.
"There is already such sparse emphasis and funding on primary prevention for substance use (34% reduction over the past eight years), and cutting one of the last remaining mainstay programs to states for this purpose is a big problem that will need to be addressed with the Congress," says Thau, who has emphasized that policymakers must not lose sight of prevention's ongoing importance as they take steps to manage the opioid crisis.
Were protests heard?
It remains unclear as to how seriously the administration had considered what had been reported to be a possible gutting of the ONDCP budget, since the initial media reports appear to have been based mainly on internal communications. It appeared on Tuesday that ONDCP would not experience a massive reduction in staffing or operations under the administration's budget proposal.
If the White House was seriously contemplating substantial cuts, protests from political leaders on both sides of the aisle clearly could have contributed to a change of heart. Leaders questioned the wisdom of slashing spending for the lead agency in coordinating anti-drug response at a time when communities are struggling to curb opioid overdose deaths and other damaging effects of the epidemic.
U.S. Sen. Charles Grassley (R-Iowa) on Tuesday said in a statement, “I'm pleased the administration agrees that the right signal to send to the communities battling opioid addiction, methamphetamine, and other dangerous drugs is that the federal government appreciates their struggle and how they work to get the most bang for the buck out of the federal dollars sent their way.”
Still, there are plenty of other developments in the budget proposal for the treatment and prevention communities to process this week, including steep cuts to Medicaid and to federal research initiatives that already have come under fire from addiction field leaders.