Tracker: Federal Cuts Raise Healthcare Costs, Delay Care, and Increase Overdose Risk.

April 29, 2026

American families across the country are feeling the devastating impacts of fentanyl, addiction, and overdose. In response, the federal government is dramatically cutting funding for proven health and treatment solutions that keep people alive and healthy. As a result, healthcare costs are climbing, waitlists for addiction treatment can be weeks or months long, and the cost of living for essential human needs like food and housing are rising. Proposed and recently approved cuts will make this situation dire.

We asked Americans how these cuts are impacting their lives and here’s just a few of the responses we received:

“Programs I serve have reduced or eliminated important services for people who use drugs. This has led to job loss, economic despair, and a further strain on organizations and service providers who were already at maximum capacity. Funding cuts = lives lost, full stop.”

“We are in a rural area, so any cuts to addiction treatment and overdose prevention makes already slim and hard to access resources even more inaccessible.”

“So many people are not receiving the treatment they deserve and need…People are dying. Loved ones are suffering.”

A recent analysis shows that 400 hospitals across the U.S. are at risk of closing or drastically reducing services due to President Trump’s “Big, Beautiful Bill.” The Trump administration’s proposed FY2027 budget, stacked on top of previous cuts, would slash even more. If implemented, this would be a major blow to the public health infrastructure that keeps the country’s treatment, overdose prevention, and addiction research systems running.

El recent decline in overdose deaths shows that when people can access treatment, overdose prevention tools, and health services, communities are safer and lives are saved. Without reliable funding for drug prevention and treatment programs, community health services, and overdose prevention tools like naloxone, communities spiral into crises: symptoms of mental health and substance use increase strain on local systems, public drug use risks becoming more visible, communities become less safe, and taxpayers face higher costs while lives continue to be lost.

Federal funding has been clawed back from communities across the country, destabilizing the lifesaving work of public health and behavioral health professionals. The federal staff who oversaw our nation’s response to the overdose crisis have been laid off in chaotic firings, jeopardizing critical substance use data that guides and measures the impact of our policy decisions. And recent guidance from the federal government attempts to cut off SAMHSA funding for tools like fentanyl test strips, which help people avoid using fentanyl. Now, the Trump administration is proposing even more devastating cuts to care.

Proposed FY2027 cuts to U.S. public health infrastructure

The Trump administration’s FY2027 budget proposal would escalate this crisis dramatically by cutting an additional $10 billion, shuttering treatment and mental health services nationwide. In addition to slashing community-based treatment and overdose response, and closing health centers and youth prevention programs, the administration’s proposed cuts will:

Dismantle the backbone of public health response: Cutting nearly $753 million from the Substance Abuse and Mental Health Services Administration (SAMHSA) and $3 billion from the Centers for Disease Control and Prevention (CDC) would further devastate these agencies and reduce funding for treatment programs, recovery services, community-based prevention, medications that prevent overdose, and the data systems that guide lifesaving interventions.
Gut addiction research: National Institutes of Health (NIH) funding would be cut by $5 billion, including $165 million cut from addiction research, slowing critical development of new treatments for emerging synthetic drugs.
Eliminate overdose data collection: Programs that track and prevent infectious diseases and opioid overdoses would lose critical funding, weakening our ability to respond to emerging crises. This data informs decisions on where to deploy overdose prevention resources.
Reduce state flexibility and local capacity: Cuts would reduce funds that states use for prevention, treatment, and recovery programs based on local need. From small rural towns to urban cities, local communities could face fewer treatment beds, reduced services, and limited capacity to respond to overdose.
Replace proven health solutions with coercion and punishment: The proposal to restructure the Department of Health and Human Services (HHS) into the “Administration for a Healthy America” (AHA) would eliminate more federal staff and funding, uprooting the federal health system that has contributed to the national decline in overdose deaths since 2023. AHA would reduce the infrastructure that people rely on to survive and replace it with systems that punish people for their illnesses. It would shift our response to addiction to one of coercion and punishment, all while people seeking voluntary treatment still face weeks- to months-long waitlists and rising healthcare costs.

The impact of cuts so far

Even before Trump’s budget proposal for FY2027, families and communities felt the consequences of federal budget decisions which have already cut:

Nearly $1 trillion from Medicaid—la mayor fuente de financiación para el tratamiento de las adicciones en EE. UU. Nearly 400 hospitals could close or reduce services as a result.
At least $333 million from federal overdose prevention programs, which directly impact access to naloxone, fentanyl test strips, and treatment.
$41 million from drug-related research, hurting our ability to research new treatments.

Policymakers and communities need to understand the massive scale of the cuts and their real-world consequences on community safety and health. We must come together to fight for investments that keep people alive, healthy, and supported. Join us in speaking out against these cuts and calling for investment in health solutions that work.

La Alianza de Políticas de Drogas y el Centro de Acción Legal are tracking these threats. Read our full analysis below.

La SAMHSA está siendo desmantelada, y con ella, los servicios de tratamiento de adicciones y de prevención de sobredosis.

The Substance Abuse and Mental Health Services Administration (SAMHSA) funds treatment programs, medications for opioid use disorder, naloxone distribution, and helps connect people—especially in rural and underserved communities—to care. Despite SAMHSA’s central role in addressing the overdose crisis nationwide, the Trump administration is choosing to dismantle it by reducing its funding and workforce.

Lifesaving programs that support people struggling with addiction are under threat—$245 million cut and over 400 people laid off.
- At least $245 million in funding for addiction and overdose prevention programs has been cut from SAMHSA’s grant portfolio since this administration took office.
  - Un tribunal ha intervenido para bloquear temporalmente estos recortes, pero sólo para 23 estados y Washington, DC. Eso significa que el resto del país aún podría perder el acceso a fondos críticos que respaldan servicios que salvan vidas.
- These cuts are separate from the Trump administration’s additional proposed $752.9 million reduction to the agency for the next FY2027 budget.
- SAMHSA’s workforce has been reduced by nearly half (400+ employees)—the vast majority of whom were laid off. This number includes regional staff, who served as direct lines of communication between the federal government and treatment providers, community organizations, and other grantees, providing crucial services across the country.
- Se han destruido varios centros y oficinas clave de SAMHSA, incluidos aquellos que apoyan el tratamiento de adicciones, estudian datos nacionales sobre el consumo de drogas y garantizan que los servicios de prevención y tratamiento de sobredosis lleguen a todas las personas, independientemente de quiénes sean o dónde vivan.
  - The National Survey on Drug Use and Health (NSDUH) provides nationally representative data on the use of tobacco, alcohol, and illicit drugs, substance use disorders, receipt of substance use treatment, and recovery, along with other estimates of behavioral health conditions. This survey, used by researchers, state governments, academics, and politicians, helps steer policy decisions and the direction of resources to combat the overdose crisis. The entire office of federal staff, mostly statisticians, who oversaw the survey were laid off in April 2025. The survey has been handed to a government contractor.
- In January 2026, the administration attempted to terminate nearly $2 billion in SAMHSA discretionary grants, only to reverse the decision a day later following widespread public backlash and pressure from Congress. These proposed cuts and subsequent reversals leave substance use providers in constant fear and uncertainty, threatening staff positions, reducing hours of operation, and making it harder for people to access lifesaving treatment. The reversal also demonstrates the value and impact in communities forcefully pushing back against these harmful cuts.
- In April 2026, the administration released new guidance announcing that fentanyl test strips would no longer be supported by federal funds, contradicting previous guidance that had explicitly allowed test strips. This lifesaving tool decreases overdose risk by detecting the presence of fentanyl (or other drugs) in the illicit supply. People who use test strips are more likely to avoid using fentanyl and make safer decisions such as going slower, not using that batch, or using with a friend.
SAMHSA is facing nearly $753 million in additional cuts and could be entirely replaced by the newly proposed Administration for a Healthy America (AHA) under Secretary Kennedy.
- Under the Trump administration’s proposed plan for FY2027, the Department of Health and Human Services (HHS) would be restructured into the Administration for a Health America (AHA) and SAMHSA could be completely eliminated as an agency.
- SAMHSA’s activities would be cut by $752.9 million with only a portion of its current activities folded into the new agency. Despite Congress rejecting HHS restructuring in the FY2026 appropriations process, the administration continues to push for restructuring in its proposed budget for FY2027.
- La mayoría de estos recortes provendrían de la fusión o eliminación de subvenciones clave de SAMHSA que ayudan a los estados a pagar programas de prevención, servicios de tratamiento y esfuerzos de respuesta a sobredosis, servicios que han salvado vidas en todo el país.
  - Merging SAMHSA’s grant programs, such as the Substance Use and Mental Health Block Grants and State Opioid Response grant into the proposed Behavioral Health Innovation Block Grant, would reduce focus and specificity for substance use funding, create increased competition between mental health and substance use providers, and could potentially shift critical substance use funding away from its intended purpose.
  - Eliminating portions of programs like SAMHSA’s Center for Substance Abuse Treatment’s Programs of Regional and National Significance (PRNS) would cut $66 million that communities use to provide substance use, HIV, and viral hepatitis prevention and treatment services.
Estados como Wisconsin pueden perder atención vital para mujeres y familias en recuperación.

En Milwaukee, Wisconsin, Meta House ofrece tratamiento de adicciones específicamente para mujeres, ofreciendo servicios ambulatorios y residenciales que también apoyan a sus hijos. Solo en 2024Meta House atendió a 331 mujeres y 168 niños. Las usuarias que permanecieron en atención ambulatoria durante al menos 90 días mostraron altas tasas de abstinencia o un menor consumo. Sin las subvenciones de SAMHSA, este programa en Wisconsin no sería posible y cientos de mujeres podrían quedar sin tratamiento ni atención para la adicción, y sus familias sin apoyo.

Los recortes de financiación a los Institutos Nacionales de Salud (NIH) perjudican nuestra capacidad de prevenir y tratar la adicción.

Los Institutos Nacionales de la Salud (NIH), principalmente a través del Instituto Nacional sobre el Abuso de Drogas (NIDA), lideran la investigación científica, los ensayos clínicos y la educación pública para comprender, prevenir y tratar la adicción. Financian estudios sobre cómo el consumo de sustancias afecta el cerebro y el cuerpo, y desarrollan y prueban medicamentos y terapias conductuales para el tratamiento de la adicción. Si bien la investigación sobre drogas y adicciones es ahora más necesaria que nunca, la administración Trump y el Congreso están recortando subvenciones vitales y despidiendo a nuestros principales expertos e investigadores. For a deeper analysis of the impact on NIH research cuts, read our fact sheet here.

Addiction research stalled—$41 million in drug research grants cut and 1,200 people laid off.
- At least $41 million has been cut from NIH drug, addiction, and overdose prevention research. This amount, while staggering, is only after more than half a billion dollars of previous cuts to addiction research grants were reinstated.
  - Even temporary funding disruptions can cause permanent damage. These short disruptions—caused by sudden grant terminations, prolonged funding renewal, and agency restructuring—have derailed research, displaced scientists, and set back our country’s progress in addressing the overdose crisis.
  - In 2025, the administration attempted to cancel at least $588 million in NIH funding for addiction and overdose prevention research. After widespread public backlash and Congressional pushback, at least 118 NIH grants were reinstated. At least $41 million in addiction research grants remain terminated.
- Alrededor de 1.200 empleados del NIH han sido despedidos, lo que reduce la capacidad de procesar y gestionar la financiación de futuras investigaciones.
- La mayoría de las subvenciones de los NIH fueron canceladas sin motivo aparente. Los estudios afectados abarcan desde la implementación de un programa de prevención de drogas para jóvenes en riesgo hasta la evaluación de si la capacitación en reducción del estigma para el personal de servicios médicos de emergencia podría ayudarles a atender mejor a las víctimas de sobredosis y facilitar el acceso a la atención. Estas cancelaciones injustificadas de subvenciones afectarán negativamente nuestra capacidad para investigar los problemas relacionados con las drogas y las adicciones que afectan a los jóvenes, evaluar los programas de prevención, garantizar una respuesta rápida de los servicios médicos de emergencia (SME) a quienes se encuentran en crisis, y mucho más.
NIH funding would be reduced by an additional $5 billion under Secretary Kennedy’s Administration for a Healthy American (AHA).

The Trump administration has proposed collapsing the two institutes in the NIH that focus on substance use (i.e. National Institute on Alcohol Abuse & Alcoholism and National Institute on Drug Abuse) into one center, reducing their funding by $165 million from 2026 levels. This restructuring would dramatically impact the way that addiction science is conducted, create increased competition for limited funding opportunities, and risk destabilizing ongoing addiction research and training projects.
Los retrasos en la investigación a nivel nacional significan un progreso más lento en los avances terapéuticos.

Muchos estudios y ensayos clínicos críticos sobre adicción se encuentran actualmente en suspenso, lo que tendrá un impacto mundial, ya que el NIDA (dentro de los NIH) financia 85% de la investigación global sobre adicción. Dejar esta investigación en suspenso pone en peligro el progreso futuro en medicamentos, tratamientos conductuales y prevención de sobredosis.

Los recortes a la financiación de los CDC significan menos servicios de prevención de sobredosis en su comunidad.

The Centers for Disease Control and Prevention (CDC) supports health centers, overdose prevention, and public health surveillance across the country. It funds local health departments that provide frontline overdose prevention and infectious disease prevention services. They also collect and analyze national overdose data.

Miles de despidos y millones en fondos para la prevención de sobredosis están en juego.
- Casi 1.600 Se ha despedido a gente del CDC, con 200 personas Habiendo perdido sus trabajos en el Centro de Prevención de Lesiones de los CDC, que incluye al equipo enfocado en prevenir las sobredosis de drogas. La última vez que el Congreso financió este trabajo, asignó casi... $505 million Para apoyar las iniciativas de prevención de sobredosis del Centro. Sin personal para administrar estas subvenciones, millones de dólares en fondos no pueden distribuirse a los estados.
  - These layoffs also included staff focused on tracking overdose data at the state and local level, including in the Overdose Data to Action (OD2A) program and the Opioid Overdose Prevention and Surveillance program. Our ability to make informed policy decisions relies on accurate data and these layoffs only impede our ability to understand overdose trends.
- Around $11 billion in federal CDC grants have been halted—many of which supported critical overdose prevention and addiction services. While it is unclear exactly how much of that funding went towards overdose prevention or public health surveillance, we have identified at least $1.34 million in terminated CDC grants directly related to substance use prevention. The lack of transparency makes it hard to know the full impact on communities that rely on these lifesaving programs. As discussed in the SAMHSA section, as of August 2025, there is a preliminary injunction in place.
- In February 2026, the administration announced that it would withhold more than $600 million in public health grants to California, Illinois, Colorado, and Minnesota—funds supporting HIV prevention and sexually transmitted infection testing and monitoring. The following day, a federal judge issued a temporary restraining order, blocking the administration’s actions. These disruptions leave public health departments in constant uncertainty, threatening the stability of lifesaving work carried out in states, counties, and communities across the country.
The CDC’s total budget would be cut by an additional $3 billion between terminated programs and agency restructuring under Secretary Kennedy’s Administration for a Healthy American (AHA).

The CDC’s Injury Prevention and Control activities would be moved to the Administration for a Healthy America, with its funding cut by more than $173 million from current funding levels. The Division of Overdose Prevention, housed within the Injury Prevention Center, is tasked with monitoring, preventing, and reducing the harms associated with drug use, misuse, and overdose. HHS restructuring would disrupt our federal response to overdose, undercutting our ability to identify and address emerging drug trends.
Los estados ya se han visto obligados a cerrar servicios que ayudan a las personas que luchan contra la adicción.
- Texas had to shut down a Línea de llamadas 24/7 que apoyaba a personas que luchaban contra la adicción y las enfermedades mentales.
- An Indiana organization that employs especialistas en recuperación de pares Se vio obligado a despedir trabajadores.
- Si se aprueban otros recortes propuestos, se podría revertir el progreso logrado en la reducción de muertes por sobredosis. Y afectará especialmente a los estados con el mayor número de muertes por sobredosis. como Virginia Occidental lo que podría perder entre 1TP y 1,2 millones de dólares en fondos de los CDC, lo que pondrá en peligro su capacidad para monitorear y prevenir sobredosis.

Recortar la financiación del Departamento de Justicia significa que más personas se enfrentarán a la cárcel en lugar de recibir atención médica.

The Department of Justice (DOJ) funds addiction treatment and recovery programs for people involved in the criminal legal system. These individuals have high rates of addiction and are also at increased risk of overdose. DOJ funds are used for things like alternatives to incarceration and programs that respond to health emergencies and connect people to lifesaving services. If further DOJ cuts go through, it will create barriers to treatment and recovery with higher risk of overdose for people involved in the criminal legal system. It would also threaten programs that have successfully diverted people with first-time drug offenses from jail to treatment.

$88 millones eliminados: las personas con alto riesgo de sobredosis quedarán atrás.
- $88 millones in grants focused on addressing substance use and mental health disorders in the criminal legal system were terminated in 2025.
- Este conjunto de recortes fue parte de un esfuerzo más amplio para terminar Más de 370 subvenciones por un valor de $820 millones, incluyendo fondos para iniciativas de seguridad comunitaria y servicios de reinserción social. Estos recortes más amplios también afectarían a personas con necesidades de salud mental y trastornos por consumo de sustancias que tienen contacto con el sistema judicial penal.
The DOJ’s grant funding would be cut by an additional $1.4 billion in the FY2027 budget.

Approximately 30 grant programs that were historically funded at más de $1 mil millones would be eliminated. Some of these programs focused on forensic support for opioid and synthetic drug investigations, which improved our understanding of fatal overdoses and the drug supply, and mentoring for youth affected by the opioid crisis.
Los estados ya han perdido la financiación de programas que desvían a personas de la cárcel al tratamiento.

Por ejemplo, en Carolina del Norte, el Proyecto Lázaro, una organización sin fines de lucro creada en respuesta a las altísimas tasas de mortalidad por sobredosis en el condado de Wilkes, perdió su subvención del Departamento de Justicia. Esto resultará en menos segundas oportunidades, más encarcelamientos y un retroceso en el progreso de una comunidad que ya ha luchado arduamente para reducir las muertes por sobredosis.

These cuts are deadly to Americans’ health and safety—but change is possible. What’s next and what you can do:

The Trump administration has already cut nearly $1 trillion from federal funding for lifesaving overdose prevention, addiction treatment, and public health services. And now they are trying to slash $10 billion more—gutting critical programs funded by SAMHSA, the CDC, NIH, and DOJ. These devastating cuts would strip communities of lifesaving tools like naloxone, fentanyl test strips, and addiction treatment.

The result? More overdoses. Fewer treatment options. Less help during a crisis. A public health emergency made worse.

But we’ve faced impossible fights before—and won. The Drug Policy Alliance fought for naloxone, medications that reduce overdose risk, and fentanyl test strips when few others would. Today, those tools are saving lives and have bipartisan support. And despite demands for massive cuts by the Trump administration, we urged Congress to protect critical funding for overdose prevention and addiction treatment in the FY2026 federal budget.

Now we need your help to do it again in the next budget.

Tomar acción

Protect funding for treatment, overdose prevention & lifesaving services

Esto es más que una lucha presupuestaria: es una lucha por la vida. Juntos, luchemos contra estos recortes y protejamos la salud y el bienestar de nuestros seres queridos.

Si tiene preguntas o consultas sobre el rastreador, envíe un correo electrónico a [email protected].

Acerca de la recopilación de datos, DPA y LAC

Este proyecto es una colaboración entre la Alianza de Políticas de Drogas y el Centro de Acción Legal. Recopilamos datos para este proyecto de diversas fuentes, incluyendo noticias, información publicada por el gobierno federal y reportajes no oficiales dirigidos por miembros actuales y anteriores del gobierno. Obtenga más información sobre nuestras fuentes de datos y metodología aquí.

El Alianza de Políticas de Drogas (DPA) Aborda los daños del consumo de drogas y su criminalización a través de soluciones políticas, organización y educación pública. Abogamos por un enfoque holístico de las drogas que priorice la salud, el apoyo social y el bienestar de la comunidad. La DPA se opone a los enfoques punitivos que desestabilizan a las personas, bloquean el acceso a la atención médica y agotan los recursos de las comunidades. Creemos que la regulación de las drogas debe basarse en la evidencia, la salud, la equidad y los derechos humanos. En colaboración con otros movimientos, cambiamos las leyes, promovemos la justicia y salvamos vidas.

El Centro de Acción Legal (LAC) Es una organización legal y de políticas que trabaja para combatir la discriminación, promover la equidad en salud y restaurar las oportunidades para las personas y comunidades afectadas por el sistema judicial penal, el consumo de sustancias y las afecciones de salud mental, y/o el VIH/SIDA. LAC busca erradicar y revertir las políticas punitivas sobre drogas que han impulsado el encarcelamiento masivo y no han contribuido a mitigar la actual crisis de sobredosis; eliminar el estigma generalizado que rodea al trastorno por consumo de sustancias y el tratamiento basado en la evidencia; y crear un acceso equitativo a una atención comunitaria asequible y de calidad. LAC visualiza una sociedad que defiende los derechos civiles de todas las personas, independientemente de su condición médica y/o antecedentes de arresto/condena, y busca desmantelar el racismo estructural en nuestros sistemas de salud y justicia, que ha causado daños desproporcionados a las personas negras y morenas en todo el país.

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