During a recent conference on addiction held in Nashville, Tennessee, Robert F. Kennedy, Jr., the U.S. Secretary of Health and Human Services, shared his personal battles with drug addiction. He described addiction as both a cause and a symptom of suffering. Nonetheless, Kennedy’s speech overlooked the implications of recent federal budget reductions and staffing cuts which may jeopardize the advances made in combating drug overdoses and managing addiction treatments.

This omission prompted an outcry from several specialists present at the event, including Caleb Banta-Green, a research professor from the University of Washington who specializes in addiction studies. During Kennedy’s address, Banta-Green stood up and loudly called for adherence to scientific evidence, yelling “Believe science!” before being escorted out of the venue. The Department of Health and Human Services did not give a comment on this incident.

“I felt compelled to intervene,” stated Banta-Green, who has devoted his career to aiding drug users and previously served as a senior science advisor at the Office of National Drug Control Policy under the Obama administration. He emphasized the importance of public awareness regarding the dismantlement of critical services and its profound impact on individuals and their families.

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The Trump administration has withdrawn financial support from public health initiatives and plans to reorganize or eliminate programs that monitor outcomes, creating challenges in tracking the lethal effects of substance abuse, according to Banta-Green. For instance, reductions in staff for the Overdose Data to Action and the Opioid Overdose Prevention and Surveillance programs will impede previous tracking efforts by the Centers for Disease Control and Prevention and various local and state health departments. A dismissed policy analyst from the CDC’s National Center for Injury Prevention and Control, who requested anonymity due to fears of retaliation, shared with Scientific American that her role involved providing policy guidance to health departments in 49 states and reporting overdose data to Congress.

Despite her veteran status, which typically safeguards employment, she was let go during the federal cutbacks in February. “The surveillance and prevention efforts by the CDC were unmatched,” she lamented. “So much has been lost.” A CDC spokesperson, when asked for an interview by Scientific American, commented on the changes under the new administration and declined to provide further details.

Effective Measurement Guides Management

Provisional data indicates a nearly 25 percent decrease in drug-related deaths in 2024, though overdoses continue to be the leading cause of death for Americans aged 18 to 44. However, cuts to the National Survey on Drug Use and Health will make it difficult to continue measuring such statistics accurately in the future.

According to Banta-Green, because substance use is heavily stigmatized, it is vital to have comprehensive, local, and timely data from various agencies to properly assess the need for services and their utilization. “Without knowing the extent of the need, it’s impossible to design effective public health or policy responses,” he explains.

He also noted that overdose trends differ regionally—for instance, the synthetic opioid fentanyl emerged earlier on the East Coast compared to the West—highlighting the importance of understanding local patterns to identify effective interventions. While certain medications like naloxone can quickly reverse opioid overdoses in emergencies, longer-term medications such as methadone and buprenorphine are crucial for reducing cravings and withdrawal symptoms, thus helping to prevent deaths over the long term.

However, the decline in deaths might also mask more tragic dynamics. It’s possible that the most vulnerable individuals have already succumbed to overdoses, leaving fewer people at risk. “It’s like a forest fire that has burned itself out,” Banta-Green remarked.

This highlights the critical need for extensive data collection now threatened by proposed budget and staff reductions at the CDC and National Institutes of Health, noted Regina LaBelle, an addiction policy expert at Georgetown University. “What the administration is doing seems shortsighted,” she stated, questioning the rationale behind the cuts since they don’t seem to consider the effectiveness or outcomes of the programs being targeted.

A Path Toward Redemption

When LaBelle was the acting director of the White House Office of National Drug Control Policy during the Biden administration, she championed evidence-based initiatives that provided clean syringes and drug testing to users. She describes harm reduction as a strategy that meets people where they are and provides them with necessary services to prevent death.

José Martínez, a substance use counselor in Buffalo, N.Y., credits harm reduction practices with saving his life. Before securing a job as a peer advocate, Martínez had endured a decade of homelessness and violence. The day after he started his new role, he moved into a shelter in New York City. As he began to heal physically, he also acquired life skills he hadn’t learned at home. “For many, drugs are a coping mechanism,” Martínez explained. “It’s rarely the drugs themselves that are the problem. Instead, drug use is often a symptom.”

Working with others who recognized the importance of risk minimization, Martínez found a way to progress in recovery that he believes wouldn’t have been possible with abstinence-only programs. “I don’t believe someone has to be sober to start making changes,” he stated.

Over the past six years with the National Harm Reduction Coalition, Martínez has helped build a national support network for peer program workers and community members—a trusted source of education and support for drug users. “There’s no set time limit,” he said. “Everyone progresses at their own pace.”

Although Martínez’s program doesn’t rely on federal funding, similar peer support initiatives are facing cuts under the Trump administration. He believes that peer work not only provides users with purpose and stability but also helps them avoid previous harmful behaviors. The proposed 2026 federal budget plans to reduce CDC’s opioid surveillance programs by $30 million and create a new subdivision called the Administration for a Healthy America, which will consolidate the agency’s prevention efforts along with existing programs at the Substance Abuse and Mental Health Services Agency (SAMHSA). This consolidation is also expected to result in more than $1 billion in cuts to programs formerly managed through SAMHSA, with a likely shift towards funding abstinence-only priorities—a move Martínez warns could lead to more overdoses. (Research indicates that abstinence-based treatment may actually increase the risk of fatal overdose compared to receiving no treatment at all.)

Martínez, who is Puerto Rican, points out that these cuts could disproportionately impact communities already experiencing higher overdose rates. In recent years, U.S. Black, Latino and Indigenous communities have seen increases in drug overdose deaths. While white overdose death rates have declined in many states, rates among Black and brown communities remain high. LaBelle warns that impending cuts to Medicaid programs are likely to exacerbate inequalities in healthcare access, making these communities more vulnerable.

In Kentucky, where Governor Andy Beshear recently celebrated a 30 percent reduction in overdose deaths, Shreeta Waldon, executive director of the Kentucky Harm Reduction Coalition, notes that the situation is more complex. While national overdose deaths among white populations decreased from 2021 to 2023, they continued to rise among people of color. Black and Latino communities often encounter barriers to accessing health services, many of which have been established by predominantly white institutions. Waldon emphasizes the importance of diverse participation in policy decisions and the equitable distribution of opioid abatement funds—legal funds allocated for treatment and prevention.

Without sufficient federal funding, Waldon predicts that treatment programs in Kentucky will experience backlogs, potentially pushing more people into crisis situations that result in emergency services or incarceration rather than recovery. These financial and political pressures not only make it more challenging to support people in crisis, but they also hinder the ability to discuss community needs. Waldon knows some social workers who now avoid using terms like “Black woman” or “marginalized” in grants and public discussions for fear of losing funding.

Moreover, people currently in need of treatment for substance-use disorders may not be aware of the federal funding changes—or the barriers they will face when seeking treatment, Waldon adds. “Addressing their immediate needs is far more critical than modifying how I speak.”

Funding and staffing reductions not only limit resources for those in greatest need but also impair the ability to understand individuals’ backgrounds, which is essential for providing meaningful care, according to Martínez. Harm reduction involves more than just offering services and tools; it’s about the approach. “When you consider the whole person, you plant seeds of health and dignity,” he says. “If everyone deserves a chance at redemption, we need to rethink our strategies.”