Safer Solutions: Bipartisan SUPPORT in Congress?
On Sept. 18, 2025, something good happened: The Senate unanimously passed legislation to direct significant funds toward combating the opioid crisis. More accurately, no one objected when Sens. Maggie Hassan (D-N.H.) and Bill Cassidy (R-La.) asked for unanimous consent to pass the SUPPORT for Patients and Communities Reauthorization Act of 2025 (i.e., the SUPPORT Act), which the House passed in June. The SUPPORT Act’s passage is surprising since it languished in legislative limbo for two years after the original version expired.
The Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act of 2018 was, at the time, the largest congressional investment in overdose prevention ever made. Many of its provisions were limited to five years, expiring at the end of September 2023. Upon that expiration, Congress modified or continued many of the act’s elements via other legislation. These stopgap measures were important, but a full reauthorization gives communities and providers support they can rely on. It also reminds us that bipartisan cooperation—including on evidence-based harm reduction approaches like overdose reversal medications—is still achievable.
A Step in the Right Direction
Many states have too few treatment facilities, making it unsurprising that only 6.3 percent of people in the United States who have substance use disorder (SUD) receive treatment each year. Similarly, there are existing and predicted shortages of healthcare providers who offer SUD treatment, further limiting treatment capacity.
The reauthorized SUPPORT Act attempts to ease some of these challenges while providing much-needed investment in our prevention, treatment, and harm reduction infrastructure. It attempts to expand treatment capacity by investing in programs that support SUD treatment providers, such as educational loan assistance and professional development, and exploring less restrictive regulation of Suboxone, a medication for opioid use disorder that contains buprenorphine and naloxone. Funding for different treatment options, including comprehensive opioid recovery centers, community-based programs, and programs led by people in recovery, is included in the reauthorization. The act also addresses SUD more broadly, allocating funding to programs that support youth prevention and recovery, treatment during and after pregnancy, career support for people in recovery, expanded access to the overdose reversal medication naloxone, overdose reversal training for first responders, and infectious disease monitoring related to injection drug use.
More Work to Do
The passage of the SUPPORT Act reauthorization is good news, but more action is needed to address SUD and overdose deaths. Congress should continue to remove obstacles to a range of intertwined harm reduction and treatment options. Improving access to treatment for opioid use disorder (OUD) is particularly important. It’s also important that treatment options be evidence-based, diverse, and able to meet different needs rather than forcing people into a single type of treatment. (We looked at some limitations of current treatment options in a recent Safer Solutions post).
One important piece of legislation to expand access to evidence-based treatment has stalled in Congress: the Modernizing Opioid Treatment Access Act (MOTA-A). Introduced in 2023, MOTA-A would expand access to methadone—a “gold standard” treatment for people with OUD. Currently, patients can only access methadone through specialized clinics known as opioid treatment programs (OTPs). This system presents a number of barriers for patients, including limited geographic access and restrictive hours and policies. MOTA-A would increase the number of access points to methadone by allowing addiction specialist physicians to prescribe it and pharmacies to dispense it—independent of the OTP system.
Congress can also remove barriers via the Temporary Emergency Scheduling and Testing of Fentanyl Analogues Act of 2023, the Telehealth Response for E-prescribing Addiction Therapy Services Act, and the Reentry Act and Due Process Continuity of Care Act. Respectively, these bills would empower scientists to conduct research on the substances in our drug supply, make SUD treatment more accessible (especially for people in rural areas), and boost uninterrupted access to treatment for people re-entering society from incarceration.
Effectively addressing SUD will require action at all levels of government. Congress can set the tone by clearing federal regulatory barriers to treatment and other services that can help people with SUD be healthy and well. Although overdose deaths are decreasing, we cannot become complacent. Congress has shown it can enact sensible, bipartisan SUD legislation and should continue this momentum.