‘People will die’: Trump administration cancels up to $1.9bn for substance use and mental health | Trump administration
The Trump administration unexpectedly canceled up to $1.9 billion in funding for drug addiction and mental health care late Tuesday, which providers say will immediately affect thousands of patients.
“This feels like Armageddon for everyone on the front lines of addiction and mental health,” said Ryan Hampton, founder of Mobilize Recovery, a national advocacy organization for people in or seeking recovery.
“The scope of care disrupted by these subsidies is catastrophic. Tens of thousands, if not hundreds of thousands, of people will die.”
As many as 2,800 Substance Abuse and Mental Health Services Administration (SAMHSA) beneficiaries received a letter immediately ending their funding – approximately 26% of SAMHSA’s total budget.
SAMHSA staff were not consulted about the reductions or even informed about their implementation, according to two sources familiar with the matter who requested anonymity to speak about sensitive matters. The agency also suffered massive cuts throughout 2025.
Providers woke up this morning to learn they would have to lay off staff and end programs immediately, Hampton said. Many of these programs are on the front lines of mental health and addiction, and are the first point of contact for people who need care.
“These are life-saving programs, so the impact could be really devastating,” said Regina LaBelle, former acting director of the Biden White House Office for National Drug Control Policy and a professor at Georgetown University.
“It really covers the spectrum of prevention, treatment and recovery services, both in addiction and mental health,” said Yngvild Olsen, who until last July was director of the Substance Abuse Treatment Center at SAMHSA and is now a national advisor at Manatt Health.
The cuts will affect overdose prevention work, distribution and use of naloxone by first responders, mental health and substance abuse support in schools, support for pregnant and postpartum women who receive assistance for substance use disorders, underage drinking prevention programs, and recovery support programs — all cut without warning.
“Overnight, our entire infrastructure and substance abuse and mental health infrastructure in this country was turned upside down,” Hampton said. “These grants are life-saving tools and, honestly, they’re a good reason why we’ve started to see a reversal in drug overdose trends in this country. »
Overdoses have skyrocketed over the past two decades, but they have started to decline in recent years. By 2024, the overdose rate in the United States has fallen by 27%. Now, with these abrupt reductions, “many lives are going to be lost,” Hampton said. “A lot of damage is happening in real time this morning. »
The reductions “came as a surprise, given all the changes grantees had already made in response to SAMHSA’s executive orders and guidance,” Olsen said. “This could potentially have an incredibly disruptive impact on people’s access to services. It could mean thousands of people losing access to treatment.”
Funding was appropriated by Congress to SAMHSA, which then distributes funds to organizations across the country. Congress does not appear to have been involved in these cancellations. Republicans and Democrats negotiated funding, and the cuts appear to be politically motivated, said LaBelle, who added, “We didn’t know the administration would just use its regulatory authority to pull the plug.”
The awards were removed because they no longer aligned with the Trump administration’s priorities, according to a letter to beneficiaries from SAMHSA deputy assistant secretary Christopher Carroll, obtained by the Guardian. The administration’s goals include “innovative programs and interventions” to reduce mental illness, substance use, overdoses and suicide, the letter said.
“You can’t tell me that distributing naloxone, providing mental health support in schools, outreach to get unhoused people into treatment, providing drug court services, are not consistent with the administration’s priorities. They are 100 percent consistent with the administration’s priorities, as the administration stated just two or three months ago,” Hampton said.
“We are all completely and utterly shocked that the administration would take such a reckless action. »
The cuts affect almost all discretionary funds, which account for nearly $2 billion of SAMHSA’s budget. Grants that have not been affected include the state’s Opioid Response Block Grants, the Certified Community Behavioral Clinics program and the 988 hotline.
SAMHSA did not respond at press time to the Guardian’s request for comment on whether staff had been consulted or informed of the changes and how they would affect care.
The reductions were made under the same rule as previous layoffs and reductions at health agencies, which were successfully challenged in court.
“I hope this matter goes to court and the courts put an end to it,” Hampton said. But “evil is happening in real time right now, and as the case moves through the courts, people will die.” People will die. »
