This bill reauthorizes through FY2028 and modifies various grants, programs, and activities that address substance use and misuse. This includes reauthorizing (1) data collection, education, and surveillance activities; (2) grants and other support for substance use disorder prevention, treatment, and recovery; (3) student loan repayment and other programs for the substance use disorder workforce; and (4) programs for addressing trauma, particularly for children, youth, and their families. Generally, the modifications expand programs. Additionally, the bill modifies provisions related to the scheduling of controlled substances, including by incorporating illicit xylazine (a compound used in veterinary medicine as a nonopioid tranquilizer) into schedule III of the Controlled Substances Act. Further, the bill makes permanent a requirement that Medicaid programs cover medication-assisted treatment for individuals with substance use disorders.