The medication known as Narcan, which reverses opioid overdoses, saves hundreds of thousands of lives annually and is often commended by public health professionals for its role in reducing opioid-related fatalities. However, the Trump administration is planning to cut a $56 million annual grant program that supplies doses of Narcan and trains emergency responders nationwide to use it, according to a draft budget proposal.
The proposal includes information about a significant reorganization and budget cuts affecting the Department of Health and Human Services, with this grant being one of several addiction prevention and treatment initiatives slated for elimination.
States and local governments have alternative methods to acquire Narcan, also referred to by its generic name, naloxone. A key funding source, a block grant program enabling states to fund a range of initiatives tackling opioid addiction, appears to remain unaffected.
However, addiction specialists express concern about both the symbolic and practical consequences of shutting down a federal program specifically aimed at training and distributing naloxone.
“Cutting funding for naloxone and overdose prevention suggests that we prefer people using drugs to die rather than receive the support they require,” stated Dr. Melody Glenn, an addiction medicine specialist and assistant professor at the University of Arizona, who monitors these initiatives along the southern border of the state.
Neither the Department of Health and Human Services nor the White House’s drug policy office has commented on the matter.
While budget decisions are not yet finalized and may change, Dr. Glenn and others interpret the fact that the Trump administration has not opened applications for new grants as a sign these programs may be cut.
Other addiction-related programs facing cuts include those designed to support pregnant and postpartum women; peer support systems usually led by individuals in recovery; a program titled the “youth prevention and recovery initiative”; and initiatives aimed at creating pain management strategies for emergency departments to reduce reliance on opioids.
The federal health secretary, Robert F. Kennedy Jr., has been a strong advocate for addressing the drug crisis and has publicly shared his personal journey of recovering from heroin addiction. The proposed elimination of addiction programs seems contradictory to this mission. Last year, Mr. Kennedy’s presidential campaign released a documentary showcasing federally supported avenues for overcoming addiction.
These grants were distributed by the Substance Abuse and Mental Health Services Administration, a division of the federal health department that is also proposed for elimination under the draft budget, although some of its programs may continue under a new entity called the Administration for a Healthy America.
In 2024, naloxone grant recipients, including cities, tribes, and nonprofit organizations, trained 66,000 police officers, firefighters, and emergency medical personnel, distributing over 282,500 naloxone kits, according to a spokesperson from the substance abuse agency.
“Narcan has been incredibly beneficial in combating the opioid epidemic, especially amidst the current fentanyl crisis,” noted Donald McNamara, who oversees naloxone distribution and training for the Los Angeles County Sheriff’s Department. “We rely on this funding because it saves lives every day.”
Matthew Cushman, a paramedic in Raytown, Mo., explained that through the naloxone grant initiative, he has trained thousands of emergency responders across Kansas City and rural western areas. The program provides trainees with naloxone to use in the field as well as “leave behind” kits with information about detox and treatment facilities.
In 2023, federal statistics began indicating a decline in national opioid deaths, a development many public health experts attribute partly to the increased availability of naloxone, which the Food and Drug Administration approved for over-the-counter sales this year.
Tennessee reports that from 2017 to 2024, naloxone has been credited with saving 103,000 lives. In Kentucky, where training and supplies are provided to emergency medical personnel in 68 rural areas, a health department spokesperson noted that in 2023, overdose fatalities decreased by nearly 10 percent.
Although the Trump administration’s Office of National Drug Control Policy focuses heavily on border enforcement and drug prosecutions, its priorities, released in a statement this month, include expanding access to “lifesaving opioid overdose reversal medications like naloxone.”
“They frequently mention their desire to support first responders and naloxone distribution,” remarked Rachel Winograd, director of the addiction science team at the University of Missouri-St. Louis, who oversees the state’s federally funded naloxone initiative. “The contradiction between those supportive statements and the proposed cuts is confusing.”
Mr. Cushman emphasized that discontinuing the naloxone grant program would not only eliminate a source of the medication for emergency responders but would also halt training sessions that cover much more than just administering the drug.
He cited insights from his co-instructor, Ray Rath, a certified peer support counselor and recovery advocate, who shares his personal experience recovering from heroin overdose during training. Mr. Rath recounts how a Narcan nasal spray revived him from an overdose, bringing him back while he lay on the ground before paramedics, who were laughing.
“Oh, it’s this junkie again; he’s just going to overdose again; we’re out here for nothing,” he recalled their comments.
Mr. Rath explains to trainees that the individuals they revive are “people who suffer from an illness.”
“When we start treating them like actual people, they begin to feel valued, and they become more inclined to make positive changes,” he elaborated. “During my years of opioid use, naloxone revived me from overdoses at least 10 times. Now in recovery for five years, I’ve been a training instructor for the last three. I also provide services to individuals using drugs in homeless encampments in Kansas. My T-shirt reads: ‘Hope Dealer.’”
