Despite rhetoric otherwise, recent actions of the current federal administration seem to demonstrate that it views the overdose crisis solely as an issue of fentanyl trafficking at the border, not as a health problem. Extensive research demonstrates addiction is a health issue, requiring a public health response that includes prevention, harm reduction, treatment, and recovery resources. Yet, the administration’s recent actions remove the federal structures and supports needed for health-based strategies to address addiction, putting millions of people with addiction and their families at risk.
In recent weeks, the administration and Congress have:
- Announced a restructuring of the Department of Health and Human Services (HHS) that includes cutting 10,000 staff and merging the Substance Abuse and Mental Health Services Administration (SAMHSA), along with four other agencies, into a new Administration for a Healthy America (AHA). Importantly, substance use has not been identified as an AHA priority, signaling that substance use will not be a federal health priority.
- Cancelled more than $12 billion in federal grants from the Centers for Disease Control and Prevention (CDC) and SAMHSA, including $1 billion in substance use block grant funding, which states rely on for all parts of their response to the addiction crisis. The abrupt cancelation of this funding, months before it was set to expire, forced many programs, initiatives and services to end unexpectedly.
- Terminated hundreds of grants, mainly to universities, many of which were related to mental health and substance use research.
- Nominated a director of the Office of National Drug Control Policy that has no background in drug policy, public health, law enforcement, or government.
- Pushed a budget plan that would require steep cuts to Medicaid, the largest payer of substance use disorder care.
All of these actions endanger progress on addressing the mental health and addiction crises on several fronts.
For example:
- The HHS reorganization could cripple SAMHSA, the agency responsible for mental health and addiction funding, resources, regulation, etc. Folding SAMHSA into the new sub-agency along with other unrelated departments dilutes and weakens its focus. SAMHSA has also experienced significant cuts to its offices and staff. The staff that conduct the National Survey on Drug Use and Health, the only national survey that tracks nationwide prevalence of substance use, mental health, risk factors, treatment, etc., have been eliminated. (See more on SAMHSA’s importance here.)
- Restructuring CDC to focus only on infectious diseases threatens the substance-used related work at the CDC’s Injury Center Division of Overdose Prevention, and other programs/divisions focused on tobacco prevention and reducing risk factors for and consequences of substance use (e.g., adverse childhood experiences, HIV).
- Cuts to National Institutes of Health (NIH) staff, combining several research agencies, and recent cuts to HHS grants will significantly curtail scientific and policy research on addiction, threatening advancements in addiction prevention and treatment.
- The cuts to substance use block grant funding will disrupt treatment and other services for people with addiction.
- Medicaid changes and cuts will pose a particular risk to those with substance use disorder. When people gain Medicaid coverage, they are more likely to seek treatment for addiction and get treated with lifesaving medications. People in treatment are less likely to overdose and die than those not in treatment. Dramatic reductions in Medicaid, and therefore treatment spending, will likely result in more overdoses and deaths. (See more on Medicaid’s importance here.)
These actions will harm people with addiction and their families. Like most families, President Trump, Vice President Vance, and HHS Secretary Kennedy all have experience with addiction – either personally or as an impacted family member. We implore them to make the overdose crisis a priority and support the broad range of interventions – both supply side and demand side – that this crisis requires.
Send the letter below to these officials, as well as to your members of Congress, urging them to protect the federal health response to substance use and addiction and strengthen public health agencies, not tear them down.
Remember, you can also call or meet with federal officials to share your story about how you’ve been impacted by addiction and how these actions affect you and/or your family. (See our Advocacy Toolkit for tips on how to advocate!)