White House Executive Order establishes national substance use disorder response

Key Takeaways

On January 29, the White House issued an Executive Order (EO) establishing the Great American Recovery Initiative, a new federal effort aimed at coordinating a national response to substance use disorder (SUD). The EO calls for a more unified, data-driven federal approach to prevention, treatment and recovery amid continued concern about the scope of the SUD crisis across the nation.  

According to the Administration, over 15 percent of Americans, or 48.4 individuals, have a SUD. In addition, the vast majority of individuals who need treatment do not receive it or do not perceive a need for care. The EO is intended to better align federal programs, reduce fragmentation and elevate recovery as a national priority.

Read the Executive Order  Read the Fact Sheet

About the Executive Order

The EO formally creates the Great American Recovery Initiative, which will be co-chaired by the Secretary of Health and Human Services and the Senior Advisor for Addiction Recovery. Key elements of the Initiative include:

• Cross-agency coordination: The Initiative brings together senior leaders from the U.S. Departments of Health and Human Services, Justice, Housing and Urban Development, Labor, Education and other federal agencies to align policies and programs addressing SUDs.
• Strategic planning and transparency: The Initiative is directed to recommend steps to better coordinate the federal response, set clear objectives and provide data-driven updates on progress
• Whole-continuum approach: Agencies will be advised on integrating prevention, early intervention, treatment, recovery supports and re-entry across public health, healthcare, criminal justice, housing, education and workforce systems
• Grant alignment: The Initiative will advise agencies on directing federal grants toward SUD prevention, treatment and long-term recovery and resilience.

The EO does not create new mandatory programs or funding streams, but it establishes a framework for coordination and future policy and funding decisions.

What does this mean for counties

Counties play a central role in America’s behavioral health system, making them key partners in the goals outlined by the Initiative. Potential implications for counties include:

• Increased federal coordination affecting local systems: As federal agencies align SUD-related programs, counties may see changes in how grants, guidance and reporting requirements are structured across health, justice and human services.
• Opportunities for input and partnership: The EO explicitly directs the Initiative to consult with local jurisdictions, creating opportunities for counties to share on-the-ground challenges and best practices.
• Focus on recovery and re-entry: Counties operating treatment courts, jail-based treatment programs, re-entry services and recovery supports may benefit from a stronger federal emphasis on continuity of care and long-term recovery.
• Potential grant realignment: While no new funding is guaranteed, counties should monitor how federal agencies prioritize and target existing SUD-related grants under the Initiative’s guidance.
• Emphasis on data and outcomes: Counties may be asked to engage with new or refined performance measures as the Initiative advances data-driven objectives.
• Potential for county-supported policy reforms: The EO’s emphasis on increasing flexibility to cover inpatient residential treatment could open the door to federal policy changes aligned with long-standing county priorities, such as reforms to the Institutions for Mental Disease (IMD) exclusion, that would expand capacity for county-based inpatient mental health treatment.