The Trump administration abruptly terminated up to $1.9bn in federal funding for substance use and mental health services on Tuesday evening, a move providers say will force immediate program closures and staff layoffs affecting thousands of patients.
“It feels like Armageddon for everyone who’s on the frontlines of the addiction and mental health space,” said Ryan Hampton, founder of Mobilize Recovery, a national advocacy organization for people in and seeking recovery. Hampton said the cuts could have severe consequences for people trying to access care: “Tens of thousands, if not hundreds of thousands, of people will die.”
According to people familiar with the decision, as many as 2,800 recipients of Substance Abuse and Mental Health Services Administration (Samhsa) grants received notices ending their funding effective immediately — about 26% of the agency’s overall budget. Two sources said Samhsa staff were not consulted or informed ahead of time. The agency had also faced major reductions throughout 2025.
Hampton said organizations learned of the cancellations overnight and began preparing to shut down services and lay off staff. Many affected initiatives operate as first-contact programs for people seeking help for addiction or mental health crises.
“These are programs that save lives, so the impact could be really devastating,” said Regina LaBelle, a former acting director of the White House office of national drug control policy under President Biden and now a professor at Georgetown University.
The terminated grants supported a wide range of services, including overdose-prevention efforts, naloxone distribution and use by first responders, school-based mental health and substance use support, treatment support for pregnant and postpartum people, underage drinking prevention, and recovery programs — all canceled without warning.
“Overnight, our entire backbone and infrastructure of addiction and mental health in this country flipped up on its head,” Hampton said. He argued these grants have been part of the reason the US has started to see improvements in overdose trends.
Overdose deaths rose sharply over the past two decades but have recently declined. In 2024, the US overdose rate fell by 27%. Hampton said he fears the sudden cutbacks will reverse that progress quickly: “A lot of harm is happening in real time.”
“The cuts came as a surprise, given all the changes that grantees had already made in response to executive orders and Samhsa guidance,” said Yngvild Olsen, who served as director of Samhsa’s Center for Substance Abuse Treatment until last July and is now a national adviser at Manatt Health. She said the terminations could severely limit access to care, with “thousands of people losing access to the treatment.”
Congress appropriates Samhsa funding, and the agency distributes grants to organizations nationwide. LaBelle said Congress does not appear to have been involved in these cancellations and suggested the decision may be political. “We didn’t know that the administration would just basically use their regulatory authority to pull the plug,” she said.
In a letter to grantees, Christopher Carroll, Samhsa’s deputy assistant secretary, said the awards were ended because they no longer aligned with the administration’s priorities. The letter said the goals include “innovative programs and interventions” to reduce mental illness, substance use, overdoses and suicide.
Hampton disputed that reasoning, arguing that core services such as naloxone distribution, school mental health support, outreach to connect unhoused people to treatment, and drug court programs fit directly within stated public health goals. “All of us are in a state of complete and utter shock that the administration would take such a reckless action,” he said.
The cancellations reportedly apply to most discretionary funding, which totals close to $2bn of Samhsa’s budget. Programs not impacted include state opioid response block grants, the certified community behavioral health clinics program, and the 988 suicide and crisis lifeline.
Samhsa did not respond to questions about whether staff were consulted or how the changes will affect patient care.
The cuts were made under the same rule used for earlier health agency layoffs and cutbacks, which have previously faced successful legal challenges. Hampton said he expects court fights but warned that the damage may be immediate: “The harm is happening in real time right now… and as this gets sorted out in the courts, people will die.”
