The opioid overdose reversal drug commonly referred to as Narcan plays a vital role in saving countless lives each year and is frequently commended by public health authorities for helping reduce opioid-related fatalities. However, the Trump administration is planning to cut a $56 million annual grant program meant for distributing Narcan and training emergency responders nationwide, as revealed in a draft budget proposal.
This proposal outlines significant reductions and a major reorganization within the Department of Health and Human Services, with the grant being one of many initiatives aimed at preventing and treating addiction slated for elimination.
States and local governments still have options to procure Narcan, also known by its generic name, naloxone, with block grants available for various opioid addiction countermeasures seemingly unaffected by the proposed cuts.
Nevertheless, addiction experts express concern regarding the implications—both symbolic and practical—of dismantling a federal grant specifically intended for naloxone training and distribution.
“Cutting funds for naloxone and overdose prevention conveys a message that we prefer drug users to perish rather than receive essential support,” commented Dr. Melody Glenn, an addiction medicine specialist and assistant professor at the University of Arizona, who oversees such initiatives near the state’s southern border.
Neither the Department of Health and Human Services nor the White House’s drug policy office provided comments when asked.
Although the budgetary choices are not final and could be modified, Dr. Glenn and others perceive the administration’s failure to even open applications for new grants as an indication that these programs might be cut entirely.
Additional addiction-related grants facing elimination include those aimed at supporting pregnant and postpartum women; peer support initiatives, often operated by individuals in recovery; a program focused on youth prevention and recovery; and projects establishing pain management protocols to minimize opioid use in emergency departments.
Federal Health Secretary Robert F. Kennedy Jr. has long had a deep commitment to tackling the drug crisis and has openly discussed his recovery from heroin addiction. The proposed removal of addiction programs appears contradictory to this commitment. Last year, Mr. Kennedy’s presidential campaign produced a documentary highlighting federally supported recovery pathways.
These grants were distributed through the Substance Abuse and Mental Health Services Administration, an entity within the health department that would be eliminated under the draft budget, although some programs may continue under a new organization called the Administration for a Healthy America.
In 2024, naloxone grant recipients—including cities, tribal areas, and nonprofit organizations—trained 66,000 police officers, firefighters, and emergency medical responders, distributing over 282,500 naloxone kits, according to a spokesman for the substance abuse agency.
“Narcan has been a tremendous asset in the fight against the opioid crisis, especially as we confront the fentanyl epidemic,” stated Donald McNamara, who oversees naloxone procurement and training with the Los Angeles County Sheriff’s Department. “We rely heavily on this funding because it saves lives every day.”
Matthew Cushman, a firefighter and paramedic in Raytown, Mo., mentioned that through the naloxone grant program, he has trained thousands of first responders in Kansas City and surrounding rural areas. This program supplies trainees with naloxone pouches for field administration and “leave-behind” kits containing information on detox and treatment facilities.
In 2023, federal data indicated that national opioid overdose deaths were finally on the decline, a trend that many public health experts attribute in part to the increased accessibility of naloxone, which the Food and Drug Administration approved for over-the-counter sales that year.
Tennessee reported that between 2017 and 2024, naloxone was responsible for saving 103,000 lives. In Kentucky, where emergency medical workers in 68 rural communities receive training and supplies, a health department spokesperson noted a nearly 10 percent decrease in overdose fatalities in 2023.
And while the Trump administration’s Office of National Drug Control Policy emphasizes border security and drug enforcement, its stated priorities include enhancing access to “lifesaving opioid overdose reversal drugs like naloxone.”
“They consistently mention their desire to support first responders and naloxone distribution,” remarked Rachel Winograd, director of addiction science at the University of Missouri-St. Louis, which runs the state’s federally funded naloxone program. “Contrasting these supportive statements with the proposed cuts creates significant confusion.”
Mr. Cushman, the paramedic in Missouri, expressed concerns that ending the naloxone grant program would not only eliminate a source of the drug for first responders but also halt training sessions that offer much more than just teaching its administration.
He highlighted the value of insights from his co-instructor, Ray Rath, who has recovered from heroin and serves as a certified peer support counselor. In training, Mr. Rath shares his experience of being revived after an overdose, recalling how he looked up at police and emergency responders who were laughing at his situation.
“Ah, this junkie again, he’s just going to kill himself; we’re out here for no reason,” he remembered their comments.
Mr. Rath emphasizes to trainees that those they revive are “people with an illness.”
“When we begin to treat them as individuals, they feel valued and are more inclined to change,” he stated. “I’ve been revived by naloxone at least ten times during my years of opioid use. Now, after five years of recovery, I have been teaching others for three years and also provide services to individuals in homeless encampments. My T-shirt says: ‘Hope Dealer.’”
