State and county public health departments and nonprofit groups are reeling after the Trump administration announced abrupt cancellation and revocation of roughly $11.4 billion in COVID-era funding for grants linked to addiction, mental health and other programs.
"This is chopping things off in the middle while people are actually doing the work," said Keith Humphreys, an addiction policy researcher at Stanford University, who also volunteers doing harm reduction work with people in addiction. He warned the move could trigger layoffs and treatment disruptions.
"Services will be dropped in the middle. Bang, the clinic is closing. It's a brutal way to make these cuts," Humphreys said.
The federal grant funding had been scheduled to run through September 2025. In a statement sent to NPR, a spokesperson with the U.S. Department of Health and Human Services said it made sense to freeze the program immediately.
"The COVID-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago," the statement said, adding that the Trump administration will refocus funding on America's "chronic disease epidemic."
Drug overdoses linked to fentanyl and other substances have declined sharply in recent years, thanks in part to a surge in funding for addiction treatment during the Biden administration. But street drugs still kill more than 84,000 people in the U.S. every year, according to the latest data from the Centers for Disease Control and Prevention.
President Donald Trump has made fentanyl smuggling a top concern during the opening weeks of his administration, extending an emergency declaration linked to the powerful street opioid.
But his team has also rapidly slashed the number of federal researchers focused on addiction and Trump pardoned a tech mogul convicted of building a "dark web" platform used to traffic illicit drugs.
The Substance Abuse and Mental Health Services Administration is also being merged into a new organization, called the Administration for a Healthy America (AHA), as part of a restructuring of HHS that's expected to eliminate 20,000 federal employees.
The move to rescind funds that include addiction-care grants drew criticism from experts who warned progress reducing overdose deaths could be reversed.
"DOGE is now actively cutting funding aimed at reducing overdose deaths by clawing back money from states," wrote Regina LaBelle, an expert on drug policy at Georgetown University who served in the Biden administration in a post on social media. "With overdose deaths still exceeding 80,000 annually, is DOGE declaring victory?"
In a statement sent to NPR, a spokesman for Ohio's Republican Governor Mike DeWine said they are "awaiting firm details before commenting" on the cuts.
Some Democratic leaders across the U.S. condemned the move.
"Senselessly ripping away this funding Congress provided will undermine our state's ability to protect families from infectious diseases like measles and bird flu and to help people get the mental health care and substance use treatment they need," said U.S. Sen. Patty Murray, a Democrat from Washington state, in a statement.
She said the loss of $160 million in federal funds designated for use in her state could cost "more than 200 jobs" in public and non-profit health organizations.
New York Governor Kathy Hochul said her state would lose roughly $300 million in funding, much of it earmarked for county health departments in rural areas.
"At a time when New York is facing an ongoing opioid epidemic, multiple confirmed cases of measles and an ongoing mental health crisis, these cuts will be devastating," Hochul said. "There is no state in this country that has the financial resources to backfill the massive federal funding cuts."
A spokesperson for Colorado's Behavioral Health Administration said $250 million in federal cuts to her state would affect as many as 60 programs and could put patient at risk.
"In so many cases, these are life-saving programs and services, and we worry for the wellbeing of those who have come to count on this support," spokeswoman Allie Eliot, wrote in an email to Colorado Public Radio.
In their statement to NPR, HHS officials downplayed the impacts of the cuts and said most grants being rescinded fund outdated programs linked to the pandemic, including efforts to "address COVID-19 health disparities among populations at high-risk and underserved, including racial and ethnic minority populations."
Tom Wolf, an addiction activist in San Francisco who has been critical of Democratic approaches to address the overdose crisis, said he remains broadly supportive of Trump's policy ideas.
"There are certain aspects of what he's doing that I think are good. For me it's about getting things done," Wolf said.
But he also voiced concern about the pace of change and the risk that effective addiction treatment programs could be defunded at a time when tens of thousands of people in the U.S. are still dying from fatal overdoses each year.
"Are they stopping to look at the efficacy of those programs?" Wolf said.
Addiction experts told NPR they are now bracing for what many believe will be deep cuts to Medicaid funding, which provides the largest single source of insurance coverage for drug and alcohol treatment nationwide.
"It's very hard to look at the budget framework created by Republicans and imagine a scenario other than Medicaid being cut severely," Stanford University's Keith Humphreys said. "It's a frightening prospect. That will be extremely painful for families facing addiction."
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