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fentanyl
Trump-GOP Cuts Could Reverse Last Year's Historic Drop in Drug Overdose Deaths, Warn Experts
Cuts to Medicaid and prevention, harm reduction, and treatment programs "will equal more people dying," said one public health expert.
May 15, 2025
Federal public health officials on Thursday announced an unprecedented drop last year in drug overdose deaths, which have plagued the United States for decades and had been rising steadily over the past several years.
But experts warned that now is exactly the wrong time to "take our foot off the gas pedal," as the Republican Party and President Donald Trump are threatening to do with steep cuts to Medicaid and other federal programs.
The Centers for Disease Control and Prevention (CDC) reported that an estimated 80,391 people in the U.S. died of drug overdoses in 2024—a 27% drop, with about 30,000 fewer deaths than in 2023 and "more than 81 lives saved every day."
Synthetic opioids like fentanyl were still involved in most overdose deaths last year, but those deaths were down 37% between 2023-24.
"I would characterize this as a historically significant decrease in overdose deaths," Brandon Marshall, a Brown University School of Public Health epidemiologist, toldThe Washington Post. "We're really seeing decreases almost across the entire nation at this point."
Experts noted that numerous factors are likely behind the plunging fatal overdose numbers. The CDC said it has been able to strengthen overdose prevention capacities across the U.S. since Trump declared the opioid crisis a public health emergency in 2017 during his first term, making congressional support available.
As CNNreported, with new federal support, local policymakers in places like Mecklenburg County, North Carolina have been able to secure vending machines with naloxone, a medication that can rapidly reverse an opioid overdose; employ epidemiologists who focus on opioid trends to prevent deaths; and infrastructure that has helped public workers determine where to target their overdose prevention work.
But the CDC's National Center for Injury Prevention and Control, which funded those programs, was targeted by the so-called Department of Government Efficiency earlier this year as its Trump-appointed leader, billionaire tech CEO Elon Musk, sought to cut federal jobs. The center is also identified as a "duplicative, DEI, or simply unnecessary" program that should be cut in the White House's proposed budget.
"Any changes or impacts to those funding streams would mean that we either have to find other funding to support the team that works in that department, or we would have to lay them off. That would, of course, impact the work," Dr. Raynard Washington, director of the county health department, told CNN. "Experts work hand-in-hand with us on the strategies that we choose to implement on the ground, and then how we're evaluating what's working, and then how we share those best practices. That technical assistance is also just as invaluable as the actual grant dollars that we receive."
Medicaid cuts in the proposed budget, which would slash $880 billion in federal spending to secure tax cuts for the wealthiest Americans and corporations, could also reverse the historic progress made in 2024, as the healthcare program covers 47% of people with opioid use disorder and 64% of people who receive outpatient treatment.
Chad Sabora, a drug policy expert who helped spearhead the letter, told The Washington Post that cuts to Medicaid will leave people without medications they use to diminish the effects of opioid use disorder, like buprenorphine.
"It will equal more people dying," he told the Post.
On Monday, more than 320 faculty members from universities and other institutions wrote to Republican and Democratic Senate leaders to warn them that "dismantling the lifesaving work" of the CDC and other health agencies in the budget would have "dire consequences."
"At a time when the federal government should be boosting investments in behavioral health systems, service delivery, and public health surveillance programs, we are seeing drastic cuts to key agencies, including the Substance Abuse and Mental Health Services Administration (SAMHSA), the CDC, and the Health Resources and Services Administration (HRSA)," they said.
The 2026 fiscal year budget proposes over $1 billion in cuts to SAMHSA—a reduction of 16% of its funding—and $3.6 billion in cuts to the CDC, or nearly half if its funding.
The faculty members listed a number of programs that will be impacted those cuts, including:
- State and local health departments and behavioral health agencies;
- Evidence-based prevention programs like community-based naloxone distribution, peer outreach programs, drug-use related infectious disease prevention programs, and drug test strip programs, which help people determine whether a drug is laced with fentanyl;
- The National Survey on Drug Use and Health (SAMHSA), which is used extensively by policymakers, researchers, and health professionals and gives accurate population estimates of trends in alcohol, tobacco, and other drug use; and
- The Addiction Medicine Fellowship Program and Substance Use Disorder Treatment and Recovery Loan Repayment Program (HRSA), which will train the next generation of substance use care specialists across the country, with special programs dedicated to rural areas.
"Members of Congress, we urge you to protect these vital substance use and mental health services. Millions of Americans are depending on you," wrote the experts.
The White House signaled in the proposed budget that it doesn't support evidence-based harm reduction programs funded through SAMHSA grants, calling them "dangerous activities."
Adams Sibley, a researcher at the University of North Carolina, told CNN that "now is the time to double down on efforts to educate and recruit folks into harm reduction and treatment, whatever their version of safer use looks like."
With fellow researcher Nabarun Dasgupta, Sibley tracked gradual declines in overdose deaths in cities and states over the past three years, before the national shift was seen in 2024.
They identified shifts in the population of drug users, with a growing number of people in the at-risk population taking advantage of newly funded treatment options—or having already died of overdoses—as one contributing factor to the plunging overdose death numbers last year, as well as a change in the supply of drugs available.
"The general dissatisfaction with the illicit opioid supply right now is surprisingly high," Dasgupta told CNN, pointing to the animal sedative xylazine, also known as "tranq."
Many users have reached an "inflection point" with their substance use disorders, said Sibley and Dasgupta, and policymakers must ensure the treatment and prevention programs funded by the CDC, SAMHSA, and other agencies are still there for them.
"The one thing that substance use treatment providers and people who use drugs alike will tell you is that people are ready when they're ready, and there are a lot of people ready right now," Sibley said.
Daniel Ciccarone, a researcher at the University of California, San Francisco, cautioned that even with last year's significant decrease, "we're still at very high levels of overdose."
"We need steady pressure," he told CNN. "To the degree that we stop paying attention... we will see a reversal."
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Drug Policy and Rights Groups Decry Senate Passage of HALT Fentanyl Act
"The flawed legislation passed in the Senate today threatens to repeat the same mistakes that were made with the so-called ‘war on drugs,'" wrote one leader at a civil rights group.
Mar 14, 2025
The U.S. Senate on Friday passed a bill that would make permanent harsh criminal penalties for fentanyl-related drugs—but critics warn that the Halt All Lethal Trafficking of Fentanyl Act takes the wrong approach to drug prevention by prioritizing criminalization.
The bill passed by a vote of 84-16, with all the no votes coming from members of the Democratic caucus. The legislation now goes back to the House of Representatives for a procedural vote where it's expected to pass again and then go on to U.S. President Donald Trump, who is expected to sign it into law, according to the group the Drug Policy Alliance, which fights for equitable and nonpunitive drug policy.
The legislation would automatically and permanently put fentanyl-related substances in Schedule I under the Controlled Substances Act, the U.S. Drug Enforcement Agency's list of most dangerous drugs. The bill is expected to increase the number of criminal convictions for fentanyl-related substances, according to the Congressional Budget Office (CBO).
The HALT Fentanyl Act cements policy changes first enacted by the first Trump administration, which temporarily classified fentanyl-related substances as Schedule I drugs in 2018.
Drug policy and rights groups argue the passage of the bill doubles down on "failed, punitive" drug policy.
"Overdose deaths are declining not because of harsh sentencing laws, but because we are finally investing in what works—harm reduction, expanded treatment, and proven public health strategies," said Amy Fettig, acting co-executive director of the group Fair and Just Prosecution, in a statement on Friday.
"The HALT Fentanyl Act threatens this progress by doubling down on ineffective and extreme sentences and fueling unjust prosecutions that disproportionately target communities of color. We have decades of evidence showing that harsh sentencing laws don't stop drug use or save lives," Fettig continued. "Why are we repeating the same mistakes?"
The U.S. Centers for Disease Control and Prevention (CDC) released data in February predicting a nearly 24% decline in drug overdose deaths in the United States for the 12 months ending in September 2024, compared to the previous year.
The CDC credits multiple factors for the drop, including "widespread, data-driven distribution of naloxone," "better access to evidence-based treatment for substance use disorders," and "shifts in the illegal drug supply."
Jesselyn McCurdy, executive vice president for government affairs at the Leadership Conference on Civil and Human Rights, made similar comments to Fettig, writing: "The flawed legislation passed in the Senate today threatens to repeat the same mistakes that were made with the so-called 'war on drugs'... This legislation will not deter crime, protect public safety, or decrease drug use or trafficking."
Maritza Perez Medina, director of federal affairs at the Drug Policy Alliance, said in a Friday statement, "Our elected leaders must invest more in these lifesaving health approaches, yet Congress is doing the opposite."
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Even Those Who Believe Tariffs Are Useful Think Trump's Trade War Makes 'Zero Sense'
One economist warned the tariffs would amount to the "largest tax increase... that has ever been imposed" on working-class families.
Feb 03, 2025
The trade war that U.S. President Donald Trump launched over the weekend by announcing sweeping new tariffs on imports from Canada, Mexico, and China drew intense criticism from experts and analysts across the ideological spectrum, including those who believe strategically deployed tariffs can help protect domestic jobs and workers.
"Tariffs are a powerful, effective tool to deliver certain goals. But Trump's Canada/China/Mexico tariffs make zero sense. And even undermine tariffs' legit uses," Lori Wallach, director of the Rethink Trade program at the American Economic Liberties Project, wrote on social media late Sunday, expressing agreement with United Auto Workers president Shawn Fain.
Fain said in a
statement that the UAW "supports aggressive tariff action to protect American manufacturing jobs as a good first step to undoing decades of anti-worker trade policy," pointing specifically to the North American Free Trade Agreement (NAFTA) and its successor agreement that Trump negotiated during his first White House term.
The union does not, however, "support using factory workers as pawns in a fight over immigration or drug policy," Fain continued. "The national emergency we face is not about drugs or immigration, but about a working class that has fallen behind for generations while corporate America exploits workers abroad and consumers at home for massive Wall Street paydays."
The officially stated purpose for Trump's 25% tariffs on Canadian and Mexican imports and 10% tariffs on Chinese imports is to confront what the White House described as the "extraordinary threat" posed by the movement of migrants and drugs across the southern and northern U.S. borders.
But Wallach argued Sunday that using tariffs to address immigration and the flow of drugs "is like trying surgery using a saxophone—wrong tool!"
"After decades of an American trade policy run by and for the largest corporations and to the detriment of American workers, independent farmers, and small businesses, we certainly do need a new approach," she added. "But simply imposing 25% tariffs on Mexico and Canada and another 10% on China will not rebuild American manufacturing/create U.S. manufacturing jobs or raise wages. Particularly, if such tariffs can be axed, lowered, or upped at the president's whim for reasons unrelated to trade/jobs."
"While tariffs can play a constructive role in protecting U.S. jobs and enforcing labor and environmental standards when part of a strategic industrial policy, Trump's approach is neither strategic nor appropriate."
Trump told reporters late last week that he is "not looking for a concession" in response to the new tariffs, which prompted swift retaliation from Canada, Mexico, and China.
The announced tariffs, which are set to take effect on Tuesday, also shook U.S. and global equity markets as Trump threatened additional duties against imports from European Union nations and admitted Americans could experience "some pain" stemming from the trade war. Mexican President Claudia Sheinbaum said Monday that her country reached an agreement with Trump to delay implementation of the tariffs on Mexican imports for a month, reportedly in exchange for the deployment of 10,000 Mexican soldiers to the country's northern border.
Contrary to Trump's insistence that tariffs are paid by targeted nations, they are in fact paid by U.S. importers, who then either eat the costs or pass them on to consumers through higher prices. Economist Dean Baker noted that the new tariffs amount to "a tax increase of roughly $200 billion a year ($1,600 per family) that will overwhelmingly be paid by moderate-income and middle-income families."
"It is the largest tax increase on them that has ever been imposed," Baker wrote Sunday. "And retaliation from both countries is likely to impose additional costs."
Melinda St. Louis, Global Trade Watch director at the consumer advocacy group Public Citizen, said in a statement that "no matter the intractable problem, Trump's go-to playbook is to bully our neighbors through tariffs and to scapegoat immigrants."
"Instead of addressing the actual causes or seeking real solutions to the complex public health crisis surrounding fentanyl, Trump jumps to impose damaging and self-defeating across-the-board tariffs and to spout more hateful rhetoric that dehumanizes our immigrant neighbors," said St. Louis. "While tariffs can play a constructive role in protecting U.S. jobs and enforcing labor and environmental standards when part of a strategic industrial policy, Trump's approach is neither strategic nor appropriate."
"Using tariffs to bully countries to advance an anti-immigrant and anti-humanitarian agenda will do nothing to support U.S. workers and will make our immigrant neighbors less safe," she added.
The tariffs also drew backlash from the right-wing Wall Street Journaleditorial board, which slammed the president for launching "the dumbest trade war in history."
"Bad policy has damaging consequences," the editorial board wrote late Sunday, "whether or not Mr. Trump chooses to admit it."
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