When the Trump administration in covid-era funds to states in late March, addiction recovery programs suffered swift losses.
An Indiana organization that employs people in recovery to help peers with substance use disorders and mental illness was forced to lay off three workers. A Texas digital support service for people with addiction and mental illness prepared to shutter its 24/7 call line within a week. A Minnesota program focused on addiction in the East African community curtailed its outreach to vulnerable people on the street.
Although the federal assistance was awarded during the covid-19 pandemic and some of the funds supported activities related to infectious disease, a sizable chunk went to programs on mental health and addiction. The latter are both chronic concerns in the U.S. that were exacerbated during the pandemic and continue to . Colorado, for example, received more than $30 million for such programs and Minnesota received nearly $28 million, according to health and human services agencies in those states.
In many cases, this money flowed to addiction recovery services, which go beyond traditional treatment to help people with substance use disorders rebuild their lives. These programs do things that insurers often don鈥檛 reimburse, such as driving people to medical appointments and court hearings, crafting r茅sum茅s and training them for new jobs, finding them housing, and helping them build social connections unrelated to drugs.
A federal judge the Trump administration鈥檚 cuts, allowing the programs to continue 鈥 for now 鈥 receiving federal funding. But many of the affected programs say they can鈥檛 easily rehire people they laid off or resurrect services they curtailed. And they鈥檙e unsure they can survive long-term amid an environment of uncertainty and fear, not knowing when the judge鈥檚 ruling might be lifted or another funding source cut.
The week it slashed the funding, the Trump administration also of the Department of Health and Human Services, including the consolidation of the main federal agency focused on addiction recovery services. Without a stand-alone office like the Substance Abuse and Mental Health Services Administration, , recovery work 鈥 and the funding to support it 鈥 will no longer be a priority. Although private foundations and state governments may step in, it鈥檚 unlikely they could match the tranches of federal funding.
鈥淩ecovery support is treated as optional,鈥 said , founder of HardBeauty, a Colorado-based addiction recovery organization.
The federal cuts put at risk a roughly $75,000 grant her team had received to care for pregnant women with substance use disorders in two rural counties in Colorado.
鈥淚t鈥檚 very easy to make sweeping decisions from the top in the name of money, when you don鈥檛 have to be the one to tell the mom, 鈥榃e can鈥檛 show up today,鈥欌 Garcia said. 鈥淲hen you never have to sit in front of the mama who really needed us to be there.鈥
Mental health conditions, including substance use disorders, are of maternal mortality in the U.S. And although national overdose deaths have decreased recently, rates in many . Many people in the addiction field worry these funding rollbacks could reverse hard-earned progress.
U.S. Department of Health and Human Services spokesperson Emily Hilliard told 麻豆女优 Health News that the department is reorganizing to improve efficiency, foster a more coordinated approach to addiction, and prioritize funding projects that align with the president鈥檚 Make America Healthy Again initiative.
鈥淲e aim to streamline resources and eliminate redundancies, ensuring that essential mental health and substance use disorder services are delivered more effectively,鈥 she said in a statement.
But to Garcia, it doesn鈥檛 feel like streamlining. It feels like abandoning moms in need.
Between the time the cuts were announced and when the federal judge paused them, two women served by Garcia鈥檚 program gave birth, she said. Though her grant funding was in limbo, Garcia told her employee to show up at the bedside for both moms. The employee followed up with daily check-ins for the new moms, connected them to treatment or housing services when needed, and helped them navigate the child services system.
鈥淚 just can鈥檛 leave moms鈥 without services, Garcia said. 鈥淚 just can鈥檛 do it.鈥
Nor can she abandon that employee, she said. Although the federal funding provided half of that employee鈥檚 salary, Garcia has continued to keep her on full time.
Garcia said she primarily employs women in recovery, many of whom spent years trapped in abusive situations, relying on welfare benefits. Now they鈥檙e sober and have found meaningful work that allows them to provide for their families, she said. 鈥淲e created our own workforce of mamas who help other mamas.鈥
This type of recovery workforce development seems to align with the Republican Party鈥檚 goals of getting more people to work and reducing reliance on welfare benefits. The Trump administration鈥檚 drug policy priorities, , identified creating 鈥渁 skilled, recovery-ready workforce鈥 and strengthening peer recovery support services as crucial efforts to help people 鈥渇ind recovery and lead productive, healthy lives.鈥 Many recovery programs train people for blue-collar jobs, which could support Trump鈥檚 goal of reviving the manufacturing industry.
But the administration鈥檚 actions appear to conflict with its stated goals, said , the nation鈥檚 drug czar during the Biden administration.
鈥淵ou can鈥檛 have manufacturing if people can鈥檛 pass a urine drug test or continue to suffer from addiction or relapse,鈥 said Gupta, who is now president of GATC Health, a company using artificial intelligence for drug development.
Even if jobs return to rural America, cutting funding for recovery services and the main federal office overseeing such efforts could mean fewer people are employable, Gupta said.
Research on recovery programs, particularly those run by people with personal addiction experience, suggests they can , reduce the prevalence of rearrest, , and improve the likelihood of .
sees these benefits daily. As a state director for the national nonprofit , O鈥橞ryan oversees about a that teach people in recovery life skills, such as balancing a checkbook and interviewing for jobs, and show them how to have fun in sobriety, through group hikes and glow-in-the-dark Ultimate Frisbee games.
Providing recovery services 鈥渋s when we really invest in their future,鈥 said O鈥橞ryan, who is in recovery too.
Six of his chapters were affected by the federal funding cuts. That has meant dipping into his organization鈥檚 rainy day fund to pay staff and cutting back on community events, including cleanup days in which chapter members gather used syringes off the street, pass out the overdose reversal medication naloxone, and talk to people using drugs about the possibility of recovery.
He鈥檚 exploring fundraising efforts now, but not all his chapters have the same ability.
鈥淚n a city like Louisville, fundraising is not a problem,鈥 O鈥橞ryan said, 鈥渂ut when you get out into Grayson, Kentucky鈥 鈥 a rural area in the Appalachian Mountains 鈥 鈥渢here鈥檚 not a lot of opportunities.鈥
In Minnesota, Kaleab Woldegiorgis and his colleagues at used to spend hours a day at soup kitchens, community events, mosques, and on the streets of East African and Muslim neighborhoods, trying to connect with people using drugs. They spoke Somali, Amharic, and Swahili, among other languages.
Those outreach efforts allowed them to 鈥渇ind individuals in need of recovery services鈥 who 鈥渨eren鈥檛 seeking it out themselves,鈥 said Woldegiorgis, who previously attended Niyyah鈥檚 support groups when he was dealing with addiction.
After building relationships with people, Woldegiorgis could help them connect with formal recovery services that bill their insurance, he said. But help couldn鈥檛 always wait for a contract.
One afternoon shortly before the federal funding cuts, Woldegiorgis and his colleagues spoke with a man who began weeping, recounting how he had wanted to get treatment a few days earlier but had lost his belongings, returned to using drugs, and ended up on the street. Woldegiorgis said he helped the man reconnect with a sister and begin exploring treatment options.
With the federal funding cuts, Niyyah may no longer be able to support this type of outreach work. Woldegiorgis fears it means people won鈥檛 receive the message of hope that can come from interacting with role models in recovery.
鈥淧eople don鈥檛 pick up pamphlets to receive these messages. And people don鈥檛 read emails and people don鈥檛 look at billboards and find inspiration,鈥 he said. 鈥淧eople need people.鈥