A coalition of addiction experts said more than 300 physicians, harm reduction workers and researchers signed a letter delivered to Congress late on Monday warning of "dire consequences" if the U.S. cuts funding for programs that help communities battle the drug overdose epidemic.
"[W]e are seeing drastic cuts to key agencies," the letter said, pointing to proposals in the White House budget for 2026 that would slash billions of dollars from the Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration, and other programs.
The letter, sent to Democratic and Republican leaders, noted that fatal overdoses dropped by roughly 26 percent in 2024 compared with the previous year, according to the . That's the biggest one-year reduction in death since the opioid crisis began in the 1990s.
"The reduction in overdose deaths we witnessed in 2024 was the result of sustained and increasing financial investment," the letter reads. "Now is not the time to reduce these investments."
The effort to lobby lawmakers was organized in part by attorney Chad Sabora, an addiction recovery activist and a former drug user in St. Louis who helped circulate the letter. He said the addiction community is frightened by the magnitude of spending cuts proposed by the White House.
"This would basically implode the current structure that treats addiction as a public health issue," Sabora said. "This would reverse what has worked."
President Trump campaigned in part on a promise to "end" the fentanyl crisis that fueled a deadly surge in overdoses over the last decade. NPR asked White House officials for comment on how proposed spending cuts could affect the nation's fentanyl and drug overdose response. They didn't respond.
Drug overdose deaths still claim roughly 82,000 lives in the U.S. every 12 months, according to the latest available preliminary CDC data from November 2024.
That rate of drug death remains far higher than in other countries, but represents a steep drop from a peak of roughly 114,664 deaths in a 12 month period recorded in August 2023.
Experts warned addiction recovery programs in rural areas and poor urban neighborhoods could be hit especially hard if lawmakers follow the Trump administration's proposed budget. There is also concern that research efforts tracking new synthetic street drugs being sold in American communities could also be defunded. "It will make everything basically a guessing game," Sabora said.
This comes as drug policy experts, hospitals and recovery clinics are also bracing for possible cuts to Medicaid funding. Under the Affordable Care Act, Medicaid expanded rapidly and now provides much of the insurance coverage in the U.S. for people seeking medical treatment for addiction.
"It's a scary time. We're terrified about the possibility of what might happen if Medicaid is diminished significantly," said Dr. Stephen Taylor with the American Society of Addiction Medicine. "Our hope is to be able to convince policymakers and people who have control of things to not make changes we know would devastate the people we take care of."
A preliminary , released by Democratic lawmakers on Sunday, found that Medicaid cuts proposed by House Republicans would reduce the number of low income Americans covered by health insurance by "at least 8.6 million in 2034." It's not clear how many of the people affected are receiving care for addiction.
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