ONDCP National Drug Control Strategy Report
The White House Office of National Drug Control Policy recently released the 2026 national drug control policy. Like most people in our space, I have never read a strategy report that fully aligned with my own views in entirety, full disclosure, I do not agree with myself one hundred percent of the time, but I digress. That is the nature of processes like those at the ONDCP which brings together goals from across government to create a single plan. One section, while quite aspirational, is worthy of highlighting. The concept of making recovery as accessible as addictive drugs in all of our communities, particularly for young people.
The section below from page 50 of the report:
“It is time to bring help for addiction to the forefront in America. It should be easier to access treatment than it is to buy illicit drugs, and this means that the general public should know how to detect signs of potential addiction, obtain screening and assessment, and access treatment when necessary. Addiction, also known as substance use disorder, is a chronic, relapsing disease of the brain that is treatable. Like other chronic conditions, addiction emerges from a combination of genetic and environmental risk factors. Sadly, in the United States drugs are readily accessible, especially to young people, leading to 48.4 million, or 16.8% of Americans suffering a past-year substance use disorder.
Tackling the addiction crisis requires a serious effort at multiple levels. It must begin with a clear understanding that drug use is risky and unhealthy. Next, there must be an emphasis on recognizing drug use and providing help early, before the development of severe addiction. While addiction is typically seen as an adult condition, it can also be a pediatric disease that can begin as early as middle school. Like any other medical condition, early detection and intervention leads to much better outcomes and is less costly than treatment after the disease has progressed. And finally, treatment for addiction should be readily available and integrated into mainstream healthcare, while utilizing the various specialty treatment, peer support, and other community, justice-involved, and faith-based services that meet an individual’s needs.”
The goal of making treatment, recovery support, faith-based resources and recovery community assets easily accessible for all Americans is vitally important. It is a higher order goal that would fundamentally change the trajectory for millions of people. Yet, it is not something we have been able to accomplish to date. Beyond the words written on the pages of the report, the reduction in resources through discretionary federal funding, block grants and Medicaid will in reality make it much harder to get help, but that is why we have a representative form of government. Congress holds the power of the purse. History shows us that advocacy efforts with the administration, with Congress and the various states can move the needle when grassroot efforts take hold, unite and speak in unison. We can make recovery as easy to access as addictive drugs but to do so would have to take a great deal of action.
These points are the same with respect to addiction and recovery in young people. Addressing emerging risky and harmful drug use in early life users is critical. Even if only partially achieved these two goals do much more than save thousands of lives. If we improved these outcomes, we would also reap huge dividends in human potential across all of America.
A 2023 study titled Economic benefits of substance use disorder treatment: A systematic literature review of economic evaluation studies from 2003 to 2021 found that the benefits of SUD treatment occur across several domains; 1) reduced health care utilization; 2) reduced criminal activity by offense type; 3) increased productivity and decreased use of social services. The other main benefit of getting more people into recovery is that they end up being significant contributors to society. Surveys have found that people in recovery are twice as likely to be civically engaged as the average person. Recovery is a socially generative process with broad benefits to the larger community. All these benefits occur when people sustain recovery.
Additionally, Social Models of recovery have been found to organically foster the development of competencies that strengthen empathy, leadership and collaboration while building individual and community level recovery capital. These benefits extend beyond the recovery community as recovery capital fuels the development of social capital. Social capital is the framework of a healthy community. The Life in Recovery surveys conducted in recent years across the United States, the United Kingdom, Canada, and Australia consistently demonstrate that individuals in recovery exhibit high levels of volunteering, voting, and community service. Things which are of great benefit to our whole society (Best et al, Laudet).
In respect to an expanded focus on youth. One way view this is through a public health lens. To target interventions early in life and severity progression is foundational to public health strategies. For many other conditions, we have learned to focus significant resources rapidly on their amelioration early in the progression. To get ahead of the pathology before the patient deteriorates. Outcomes are almost always better, and it is less costly if not delayed or diluted. This is particularly true for communicable conditions.
Addiction is communicable, particularly in our youth. We know that drug use occurs through social contagion in young people. Addiction is communicable, but so is recovery. Yet treatment is difficult to find for young people. Services are nearly always delayed until later in life after the condition progresses to the point they are severe. Harder and more expensive to treat with poorer prognosis. I have heard Dr John Kelly talk about this with the analogy of a fire. What we do currently is to wait until the structure is fully engulfed to raise the alarm and send out the firefighters instead of dousing the flames when it ignites. This is in part a result of how we fund care and limit services to only the most progressed cases. To add insult to injury we then ration care, which would be like rationing water in a fire storm.
While these aspirational goals buried in the ONDCP report would be well worth the effort, no federal administration in my memory has effectively marshalled the requisite resources to move the needle much at all in this direction. It is very hard to do. And even if they did our whole system design across the fifty states would also require retooling. We would also need a much more robust workforce with lower turnover rates so that the field had mastery of the necessary skills to help people obtain and sustain recovery. We would need to move away from assessment criteria for services that center on acute short-term interventions only when a person has developed high severity substance use and replace them with criteria that actually made services as accessible as drug use. Those things are a moon shot away from where we are today. But moon shots can and do happen when we marshal the resources and we set them as a goal.
Deep Concerns About Policy Direction
There are many significant and serious concerns with the report and stated policy direction that need to be heard and addressed. Civil rights, access to life preserving resources, funding cuts that impact marginalized communities and too much emphasis on long enforcement strategies could derail recovery efforts for thousands of Americans. The May 6th press release from the Legal Acton Center of New York perhaps summarizes these concerns best when they wrote:
“National Drug Control Strategy from the Office of National Drug Control Policy (ONDCP), there are numerous concerning components of the Strategy that risk undermining public health and civil rights at large. Moreover, the Administration has made several moves antithetical to their stated mission to “save lives and protect America” in the recent past that we fear will cost many lives by putting services out of reach for many who need them, including the recently enacted enormous cuts to Medicaid and SNAP, slashing of SAMHSA staff and grants, proposed budget cuts to CSAP (the Center for Substance Abuse Prevention) and the Drug-Free Communities program, rejection of some proven harm reduction initiatives, retreat from enforcing current parity protections, and ramping up of punitive approaches to homelessness.”
One of the advantages of our multi-tiered government system is that representative government can allow us opportunities to move beyond aspirational rhetoric and legitimately address concerns and develop better policies with more effective outcomes. It has been described as a messy sausage making process, but it works best when large numbers of people participate. Should we look at this report and only focus on the sections with broad opposition? This is a huge part of why progress is so hard in this field to move the needle much at in durable ways. Yet the recovery lesson we could apply is to focus on building up strengths instead of focusing on pathology.
Our own experiential knowledge is asset based and we should apply those life lessons here. We can embrace and support facets that do resonate with us even as we register concern about ones that harm our people. Advocacy is vital on both the strengths and limitations of the ONDCP policy statement. The current administration stated goals of supporting young people more fully and making recovery as accessible as drug use are very worthy objectives that would save millions of lives.
It is also true that making support as easy to obtain as drugs, particularly for young people would take a long time and significant collaborative effort to meaningfully achieve. It could only be accomplished if a whole lot of systems worked together on them. That requires broad support. The recovery history lesson here is that we have always achieved the most headway when recovery movement objectives have resonated across the political divide. Recovery community has a vital role to play as there are millions of Republicans and Millions of Democrats in recovery and we can raise our voices together. Most if not all significant improvements in our field has been accompanied by a broad ground swell of grassroots community support. Things too far out to either side of the political divide end up getting clawed back after a few brief years. This is why finding common ground is so important. Failure to focus on broadly shared goals becomes a waste of opportunity, time and resources.
We could come together and support these two goals as they are likely to resonate broadly. We should get help to support our young people earlier in their lives before their futures burn down. Recovery should indeed be as accessible in our communities as drugs are. Recovery history shows us we can and do achieve hard things when we work together and have the stamina to go the distance. We would need to change our care system at every level to accomplish these goals and to do so would take many years and focused effort at the federal, state and local levels.
That is a healthier America well worth working towards, together.
Sources
Best, D., et al. (2015). Life in Recovery: An Examination of the Recovery Experience in the UK. Sheffield Hallam University. https://shura.shu.ac.uk/12200/1/FINAL%20UK%20Life%20in%20Recovery%20Survey%202015%20report.pdf
Fardone E, Montoya ID, Schackman BR, McCollister KE. Economic benefits of substance use disorder treatment: A systematic literature review of economic evaluation studies from 2003 to 2021. J Subst Use Addict Treat. 2023 Sep;152:209084. doi: 10.1016/j.josat.2023.209084. Epub 2023 Jun 9. PMID: 37302488; PMCID: PMC10530001. https://pmc.ncbi.nlm.nih.gov/articles/PMC10530001/
Laudet, A., (2013). Life in Recovery Survey: Report on the Survey Findings. For Faces & Voices of Recovery. https://www.drugsandalcohol.ie/19784/1/Life_in_Recovery_Survey2.pdf
Legal Action Center of New York. (2026). LAC’s Response to ONDCP’s National Drug Control Strategy. https://www.lac.org/news/lacs-response-to-ondcps-national-drug-control-strategy
NATIONAL DRUG CONTROL STRATEGY. (2026). https://www.whitehouse.gov/wp-content/uploads/2026/05/National-Drug-Control-Strategy-2026-1.pdf Watts, L.L., Hamza, E.A., Bedewy, D.A. et al. A meta-analysis study on peer influence and adolescent substance use. Curr Psychol 43, 3866–3881 (2024). https://doi.org/10.1007/s12144-023-04944-z
