CNN
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The Trump administration has designated overdose prevention among its top drug policy priorities, but a recent leaked preliminary budget proposal suggests cutting around 20 substance abuse prevention and treatment programs.
A document released last month by the President’s Office of the National Drug Management Policy states the first strategy described in the original objectives as follows: “Powered primarily by fentanyl to combat the drug crisis and the opioid epidemic, the administration will expand access to overdose education and life-saving opioid overdose remedies like naloxone.”
However, among the potential cuts listed in the April budget proposal, there were programs that directly expand access to naloxone. It will help distribute the $56 million annual grants through the Department of Substance Abuse and Mental Health Services, or Samhsa, or kits and other trains on how to use them.
In 2023, the Comprehensive Addiction and Recovery Act (FR-CARA) trained nearly 77,000 people on how to distribute and manage opioid overdose inverted kits for over 101,000 people, according to a budget request document from SAMHSA. The 2024 plan aims to distribute 130,000 kits and train tens of thousands more.
A spokesman for the White House Office of Management and Budget and the U.S. Department of Health and Human Services said there have been no final decisions on future fiscal budgets, including potential cuts to the naloxone program. The reorganization at HHS will integrate SAMHSA under the new administration for a healthy America. It says it is intended to “more efficiently coordinate chronic care and disease prevention programs and harmonize health resources with low-income Americans.”
However, supporters are concerned that the loss of a critical part of the strategy to address the US overdose epidemic could lead to progress.
“Naloxone – an antidote to overdose – saves lives every day, and the naloxone distribution program has been part of the federal government’s overdose response for over ten years,” said Regina Label, director of the Addiction and Public Policy Initiative at Georgetown University, in an email to CNN.
“The administration has recently updated the opioid public health emergency, but at the same time, it is calling for the removal of programs that work to reduce overdose mortality. These actions will sound the emergency declaration and, worse, if the programs are eliminated, will have a serious negative impact on communities across the country.”
Cherokeination received approximately $1 million through the FR-Cara grant. It estimates that 25,000 kits featuring Narcan, one of the brand names for naloxone, are distributed among law enforcement agencies, schools and communities in northeastern Oklahoma.
“With this grant, we trained law enforcement officers, emergency management services and firefighters to distribute Narcan in Cherokeination reservation training, and armed with Narcan to save lives when we got caught up in an overdose scene. “All of these agencies could not afford Narcan if we didn’t provide it, so we hope the grant will continue as we know it’s strong and effective.”
Annual overdose deaths have fallen by about 23% since peaking in mid-2023, according to preliminary data from the Centers for Disease Control and Prevention. Experts say the decline is probably the result of a wide range of sustained efforts that have begun to have an impact, including increased access to naloxone.
Despite the hopeful trend, more people are dying from overdose than before the Covid-19 pandemic, and experts say it’s not the time to be satisfied.
“I’ve been working on this issue for almost 20 years and I’m very scared of what’s going to happen and what’s ahead. It’s not just about removing the bureaucrats, it’s about damaging the entire system that’s spent decades building up,” Label said. “I’m really afraid to step back.”
HHS secretary Robert F. Kennedy Jr. spoke about his own 14 years of heroin addiction and recovery, but generally focuses on the importance of preventing addiction through faith and community.
At last week’s drug summit in Nashville, Kennedy called addiction “not only a disastrous source, but also a symptom of misery.” He emphasized that young people need a sense of purpose to prevent them from turning into drugs in their lives.
He did not address the recent cuts in HHS that many fears could put public health at risk, including overdose prevention.