Senate Budget Restores Funding for Pain Therapies and Addiction Recovery

Congress controls federal budgets, and this year’s appropriations funding provides for restoration of key research dollars for pain medicine drug discovery and for preventing opioid addiction. To the relief of physicians across specialties (e.g., pain medicine, anesthesiology, and addiction), Health and Human Services Secretary Robert F. Kennedy Jr.’s attempts to strip funding from promising research or to de-fund the Substance Abuse and Mental Health Services Administration (SAMHSA) have largely been overridden.

On Jan. 20, the Senate released a “minibus” appropriations package that included four spending bills, including the fiscal year (FY) 2026 Labor, Health and Human Services, Education, and Related Agencies (Labor HHS). The bill provides key funding for substance use and mental health agencies and programs across the country. The Senate proposal reflects continued bipartisan support for community-based prevention, treatment, and recovery efforts, with modest increases to selected programs.

The Senate proposal includes $48.716 billion to the National Institutes of Health, a $415 million increase from FY 2025, with funding to the National Institute on Drug Abuse (NIDA), National Institute on Alcohol Abuse and Alcoholism (NIAAA), and National Institute of Mental Health (NIMH).

The bill also allocates $7.438 billion to SAMHSA, an increase of $65 million from FY 2025, supporting programs such as the 9-8-8 Suicide and Crisis Lifeline, drug courts, opioid treatment programs, and substance use prevention and treatment block grants.

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The new budget legislation also provides $9.22 billion to the Health Resources and Services Administration (HRSA), including $145 million to the Rural Communities Opioid Response Program and $9.202 billion to the CDC.

“This Senate package reads like a recognition that overdose prevention is not a ‘pilot project’—they’re essential health infrastructure,” said Lynn R. Webster, MD, of Salt Lake City, a member of the Pain Medicine News editorial advisory board. “From a clinician’s perspective, you can’t separate chronic pain, mental health, and addiction. Budgets that support integrated services are the ones that actually change outcomes.”

Calm After ‘Chaos’

The new FY 2026 Labor HHS bill includes $48.716 billion to the NIH, a $415 million increase from FY 2025 levels. The act also reaffirms and includes funding for the following NIH agencies: $1.662 billion to NIDA, $595 million to NIAAA, and $2.189 billion to NIMH.

The bill also allocates $7.438 billion to SAMHSA, an increase of $65 million from FY 2025. The bill includes funding for multiple SAMHSA programs (Table).

Table. SAMSHA Funding Under Labor HHS Bill

$21.42 million for assisted outpatient treatment

$80 million for SAMHSA criminal justice activities

$10.7 million for opioid treatment programs

$1.012 billion for the Community Mental Health Services Block Grant

$2.013 billion for the Substance Use Prevention, Treatment, and Recovery Block Grant

$26.84 million for screening, brief intervention, and referral to treatment

$59 million for CARA first responder overdose reversal training

$1.5 million for CARA improving overdose treatment access

CARA, Comprehensive Addiction and Recovery Act; Labor HHS, Labor, Health and Human Services, Education, and Related Agencies; SAMHSA, Substance Abuse and Mental Health Services Administration.

Sen. Kirsten Gillibrand, D-N.Y., noted that the “chaotic disruption” of SAMSHA funding caused “permanent” damage to trust between “patients” and “providers.” Rep. Rosa DeLauro, D-Conn., highlighted that the “reversal” back to SAMSHA programs including naloxone training serves as a “lesson learned” and asserted that “Congress holds the power of the purse,” as stated during the House Committee on Appropriations hearings.

The bill proposes $9.202 billion to the CDC, a decrease of $20 million from FY 2025.

“These funding choices implicitly recognize that pain care and addiction care are inseparable in real-world practice,” Webster said. “Undertreated pain, mental illness, and addiction often co-occur, and systems that only fund one side of the equation fail patients.

“The most meaningful pain-related (budget) impact here may be indirect: Investments in treatment capacity (SAMHSA), workforce programs (HRSA), and new research (NIH/NIDA) shape whether clinicians can deliver integrated pain along with behavioral health and requisite [opioid use disorder] treatment rather than ‘opioids versus no opioids,’” Webster said.

He declared: “Are we just funding (sensational) headlines? A practical question is: ‘Are we funding care pathways like nonopioid pain options, behavioral health, [medication for opioid use disorder] access, and recovery supports? The budget summary suggests Congress is leaning toward the complete continuum infrastructure which is a good thing.

“The pain community pushback and resistance of Congress led to reversals and reinstatements for some programs,” he said. “It’s fair to describe instability and this political pressure provided resistance. It now appears that Congress is signaling continuity in appropriations for these needed synergistic programs.”

—Mike Smith