It’s been nearly a decade since Congress passed the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, which, at the time of its passage in 2018, was the largest Congressional investment in overdose prevention.
The SUPPORT Act of 2018 provided unprecedented funding for community-based treatment and recovery programs and enacted key policy changes. The most notable is that state Medicaid programs were required to cover all three Food and Drug Administration (FDA)-approved medications for opioid use disorder (MOUD), which included naltrexone, buprenorphine, and methadone. While this legislation was a huge step for overdose prevention in America, it contained, like many federal policies, an end date.
SUPPORT Act was reauthorized in 2025
While Congress failed to reauthorize the legislation prior it its September 30, 2023 end date, Congress did what it does best—kicked the can down the road by passing short-term legislation to extend the funding and provisions that were set to expire. This allowed the continuation of programs, which is imperative for continuity of services in the fight against the overdose epidemic, but hampers the ability to make more progress. This practiced continued until 2025, when President Trump signed the bipartisan SUPPORT for Patients and Communities Reauthorization Act of 2025 into law.
Provisions of reauthorization legislation broadly fall into one of three categories: reauthorizing, revising, or new requirements.
SUPPORT Act legislative provisions
Provisions of reauthorization legislation broadly fall into one of three categories: reauthorizing, revising, or new requirements. The bill reauthorizes many federal programs and grants through federal fiscal year (FFY) 2030. These programs fund and support activities relating to:
- Mental and behavioral health education and training for medical and allied health students
- Community organizations facilitating recovery from substance use disorders
- Prevention of overdoses of controlled substances
- Addressing substance use disorders with respect to pregnant and postpartum women
- Prevention and recovery from substance use disorders for youth
- Treatment of children experiencing psychological trauma
- Loan repayment for certain health care providers treating substance use disorders
- Housing for individuals in recovery from substance use disorders
Stand out SUPPORT Act revisions
The two most notable revisions included in the legislation are expanding a program that provides financial assistance to first responders to allow for the purchase of devices or drugs to treat non-opioid overdoses. The other is to begin allowing transportation services to be covered for individuals in recovery who are apart from specific employment services.
Finally, the bill includes new requirements for the Department of Health and Human Services (HHS). HHS must now review and potentially revise the scheduling of approved pharmaceuticals that have both naloxone and buprenorphine under the Controlled Substances Act, establish a Federal Interagency Work Group on Fentanyl Contamination of Illegal Drugs, and protect the National Suicide Prevention Lifeline (988) from cybersecurity threats.
The SUPPORT Reauthorization Act of 2025 represents a critical continuation of efforts to combat the opioid epidemic while also creating opportunities for further advancements.
It is imperative that the administration, which supported the legislation, does not continue to act in ways that diminish the positive effects of the policy. The Center for Community Solutions will continue to follow and report on legislation that affects behavioral healthcare.
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