On July 14, President Donald Trump nominated Timothy Westlake, MD, of Wisconsin, to serve as assistant secretary for mental health and substance use at HHS — the position that oversees the Substance Abuse and Mental Health Services Administration.
Dr. Westlake currently serves as chief of staff at SAMHSA, where he supports agency leadership and operations that advance national mental health and substance use priorities. If confirmed by the Senate, he would move from that behind-the-scenes role into the top job leading the agency — succeeding a post that has sat without a Senate-confirmed leader for stretches of the current administration.
Who is Dr. Westlake?
Dr. Westlake is a board-certified emergency physician with more than 25 years of clinical experience in community emergency medicine. He has spoken publicly about nearly three decades of his own long-term recovery, which he has cited as informing his approach to addiction policy.
In Wisconsin, he built an extensive record in state health policy, chairing the Wisconsin Medical Examining Board and serving on the Wisconsin Controlled Substances Board, and was the physician architect of the state’s prescription opioid reform strategy, including serving on the governor’s task force on opioid abuse. He’s also testified before Congress multiple times on the fentanyl crisis, including before House Energy and Commerce and Senate Judiciary panels.
Why the nomination matters
Dr. Westlake’s signature policy achievement is class-wide fentanyl scheduling, treating fentanyl-related substances as a category rather than requiring the Drug Enforcement Administration to schedule each new chemical variant individually. He originated the initial legislative framework in Wisconsin in 2016, and that approach evolved into federal law as the HALT Fentanyl Act in 2025. He’s also credited with drafting the VA prescription opioid reform provisions included in the Comprehensive Addiction and Recovery Act, known as CARA.
The Wisconsin bill, known as the SOFA Act — Stopping Overdoses of Fentanyl Analogues — grew out of the death of a Wisconsin teenager, Archie Badura, whom Dr. Westlake treated for overdoses before Mr. Badura’s fatal poisoning, a personal story he has referenced in congressional testimony.
His nomination puts a physician with direct emergency-room experience treating overdoses, a personal recovery history, and a policy track record on fentanyl scheduling in charge of the federal agency that sets national priorities on mental health and substance use treatment, prevention and crisis response, including the 988 Suicide and Crisis Lifeline.
The nomination is pending before the Senate. His confirmation hearing has not yet been scheduled.
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