The Turn the Tide Act provides substantial federal funding from 2027 through 2030 to combat substance use disorders, mental health challenges, and opioid-related deaths through a range of prevention, treatment, and recovery programs. The bill appropriates hundreds of millions of dollars annually for overdose prevention, medication-assisted treatment, recovery housing, drug courts, and first responder training, with priority funding directed to states experiencing the highest drug overdose death rates. A key provision eliminates insurance barriers by prohibiting states from using prior authorization requirements to restrict Medicaid coverage of medication-assisted treatment, effective October 2026, or face loss of federal Medicaid reimbursement. The legislation also expands loan repayment assistance for substance use disorder treatment workers and establishes a demonstration project to test whether recovery housing services reduce hospitalizations and emergency department visits for people with opioid use disorder. Additionally, the bill creates a new grant program providing $10 million annually to support trauma response teams working with children and families affected by adverse childhood experiences.