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

• 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.
  • A court has stepped in to temporarily block these cuts—but only for 23 states and Washington, D.C. That means the rest of the country could still lose access to critical funding that supports lifesaving services.

• 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.
• Several key SAMHSA centers and offices have been gutted, including those that support addiction treatment, study national drug use data, and ensure overdose prevention and treatment services reach all people regardless of who they are or where they live.
  • 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.

• 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.
• Most of these cuts would come from merging or removing key SAMHSA grants that help states pay for prevention programs, treatment services, and overdose response efforts—services that have saved lives across the country.
  • 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.

In Milwaukee, Wisconsin, Meta House provides addiction treatment specifically for women—offering outpatient and residential services that also support their children. In 2024 alone, Meta House served 331 women and 168 children. Clients who stayed in outpatient care for at least 90 days showed high rates of abstinence or reduced use. Without SAMHSA grants, this program in Wisconsin would not be possible and hundreds of women could be left without addiction treatment and care—and their families without support.

• 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.
• Around 1,200 NIH employees have been laid off, reducing the ability to process and manage future research funding.
• Most NIH grants were terminated for seemingly no good reason at all. The affected studies range from implementing a drug prevention program for at-risk youth to evaluating whether stigma-reduction training for emergency medical services personnel could help them better serve overdose victims and facilitate access to care. These unjustified grant terminations will adversely affect our ability to research drug- and addiction-related issues affecting young people, assess prevention programs, ensure prompt EMS response for those in crisis, and so much more.

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.

Many critical addiction studies and clinical trials are now on hold which will have impacts worldwide because NIDA (which is housed within NIH) funds 85% of global addiction research. Putting this research in limbo jeopardizes future progress in medications, behavioral treatments, and overdose prevention.

• Nearly 1,600 people have been laid off at the CDC–with 200 people having lost their jobs at the CDC’s Injury Prevention Center, which includes the team focused on preventing drug overdoses. The last time Congress funded this work, it allocated nearly $505 million to support the Center’s overdose prevention efforts. Without staff to administer these grants, millions of dollars in funding cannot be distributed to states.
  • 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 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.

• Texas had to shut down a 24/7 call line that supported people struggling with addiction and mental illness.
• An Indiana organization that employs peer recovery specialists was forced to lay off workers.
• If other proposed cuts go through, it could undo the progress we’ve made in reducing overdose deaths. And it will especially impact states with the highest overdose deaths like West Virginia which could lose $1.2 million in CDC funding which will jeopardize its ability to monitor and prevent overdoses.

• $88 million in grants focused on addressing substance use and mental health disorders in the criminal legal system were terminated in 2025.
• This set of cuts was part of a larger effort to terminate over 370 grants valued at $820 million, including funding for community safety efforts and reentry services. These broader cuts would also affect individuals with mental health needs and substance use disorders who have touchpoints with the criminal legal system.

Approximately 30 grant programs that were historically funded at over $1 billion 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.

For example, in North Carolina, Project Lazarus—a nonprofit formed in response to sky-high overdose death rates in Wilkes County—lost its DOJ grant. This will result in fewer second chances, more incarceration, and a reversal of progress in a community that has already fought hard to reduce overdose deaths.