Chaos Reigns as Trump Administration Cancels then Reinstates $2 Billion Worth of Federal Grants Supporting Addiction and Mental Health Services
By Michael T. Abrams, M.P.H., Ph.D.
On January 14, 2026, an estimated 2,800 grants under the auspices of the federal Substance Abuse and Mental Health Services Administration (SAMHSA) were abruptly and completely defunded. SAMHSA’s expert staff, already diminished by large cuts in 2025, were reportedly not consulted prior to the announcement that their agency would immediately cancel an additional $2 billion in committed funds for frontline efforts to prevent and treat brain-based illnesses including opioid addiction, depression and schizophrenia. Fortunately, within 24 hours — due to resistance from many behavioral health advocates and some members of Congress — those SAMHSA cuts were rescinded, for now.
With yet another budgetary shutdown looming at the close of January 2026, and given Trump’s strident desire to slash government services in exchange for tax breaks for billionaires, more reckless cuts to SAMHSA must be anticipated and resisted for the good of the nation’s overall well-being.
Here’s what is at stake.
SAMHSA is a 33-year-old agency under the U.S. Department of Health and Human Services (HHS). This subagency’s mission is to lead public health efforts that advance the nation’s behavioral health, especially the oversight and evolution of systems that address addiction and other serious disorders such as generalized anxiety; post-traumatic stress; and social, emotional and learning disability experienced by children (school-based violence prevention programs, for example, are the purview of SAMHSA).
The programs targeted for defunding reportedly included those that aim to help people recover from psychiatric breakdowns and overdoses, among other serious and often recurring illness episodes. Important subpopulations of interest in these projects are vulnerable groups such as racial and ethnic minorities, LGBTQ+ individuals, young children or transition-age adults, low-income people, rural residents and people who have been arrested or incarcerated. Reportedly, the administration aimed to eliminate these grants because they do not comport with President Trump’s and HHS Secretary Robert F. Kennedy, Jr.’s health priorities. At least one report noted the irony of the health secretary’s destructive approach given his personal challenges with addiction.
Had these latest SAMHSA budget cuts been implemented, they would have exacerbated the ones instigated in 2025 that slashed $1.7 billion dollars from that agency. Prior to the 2025 cuts, SAMHSA’s total budget was $7.5 billion. For comparison, consider that this year’s budget for the Department of Homeland Security’s Immigration and Customs Enforcement (ICE) is nearly $10 billion, and under legislation recently signed by President Trump, the ICE budget will swell to over $30 billion per year through 2029. The 2025 SAMHSA cuts began the evisceration of the nation’s mental health and substance use prevention and treatment effort. Here are of some of the program and staff reductions that occurred in 2025:
- 500 of 900 total employees left or were terminated, turning the headquarters of SAMHSA into what some referred to as a “ghost town” and further hobbling its expert independence.
- Departures of at least 12 of 17 senior leaders
- Cutting 130 staff from the Center for Mental Health Services, including all but one individual responsible for youth programs
- Losing other key leadership such as Yngvild Olsen, M.D., M.P.H., who in 2024 led the effort to advance the nation’s antiquated and stigmatizing approach to delivering methadone treatment to people with opioid use disorders
- “Temporary reassignment” of senior staff from SAMHSA’s Washington, D.C., headquarters to remote locations in the west, including the reassignment (to an Indian Health Service facility in Montana) of the respected biostatistics researcher and the Director of the Center for Substance Abuse Prevention, Captain Christopher M. Jones, Pharm.D., Dr.P.H., M.P.H.
- Laying off numerous personnel involved in convening a new workgroup studying the use of psychedelics as potential therapies for psychiatric illnesses, including addiction
- Laying off personnel involved in developing “involuntary commitment” as a strategy to address the most severe manifestations of psychiatric illness
- $350 million in reductions specifically regarding addiction and overdose prevention
- Halting a crisis hotline in Wisconsin
- Dropping clients at a Pennsylvania recovery organization
- Laying off state employees at an organization in Nevada that supports children with “severe emotional disturbances”
- Laying off local personnel focused on reducing the scourge of homelessness
Had the January 2026 SAMHSA cuts been implemented, the following types of local programs would have been damaged or completely eliminated:
- Programs delivering “comprehensive treatment” of opioid addiction, including adolescent and young-adult addiction-prevention efforts, harm-reduction strategies including naloxone rescue and referral-to-treatment strategies, and buprenorphine induction and maintenance programs
- The $15-million-per-year Opioid Response Network, a program that specifically offers training to local authorities
- The $6 million Building Communities of Recovery Program, which provides resources enabling recovery for people with substance use disorders, illnesses that typically are long term and cycling
- Programs delivering tailored services to people with behavioral health challenges who also face the common comorbidities of serious infectious diseases such as HIV or hepatitis
- Mental health and substance abuse “first-responder” programs, which are designed to address in-community crises where law enforcement is ill equipped
- The American Psychiatric Association Foundation’s (APAF’s) behavioral health Workforce Development Initiative, which encourages high school and college students to consider a career in psychiatry
- The APAF’s Notice. Talk. Act. At School Program, which provides free mental health training for K-12 staff
- Chicago’s Haymarket Center, the largest nonprofit center in that city, which treats individuals with all types of addiction. Haymarket also faced the immediate loss of $1.8 million to offer employment training to individuals suffering from homelessness.
- Programs specifically designed to treat pregnant women suffering from addiction
- Programs aimed at reducing the occurrence of suicide
- A $5.2 million program to train staff to appropriately use overdose-reversal medications such as naloxone (NARCAN)
- $20 million to the American Academy of Addiction Psychiatry’s programs that educate 500,000 doctors, social workers and nurses about screening and treating individuals addicted to opioids and further addresses the prevention of such disorders as well as the stigma that is persistently tied to them
- Programs to reduce underage drinking and cannabis use
Accordingly, as SAMHSA shrinks under the cruel, ideologic weight of President Trump’s second term in office, the behavioral health of the U.S. population worsens. Moreover, as SAMHSA faces additional unwarranted budgetary assaults, damage mounts because of the uncertainty and stigma such threats bring to the already challenging endeavor of coping with behavioral health issues, which are distinctively exacerbated by such machinations and undeniably connected to our overall wellbeing. The only hope one can take from Trump and Kennedy’s latest attempt to eviscerate SAMHSA is that their brazen effort was thwarted by advocates, including families, patients and experts on the frontline of service implementation.
As a public health researcher for more than 30 years, I have often relied on SAMHSA as a quintessential source of trustworthy data and practical solutions related to the ongoing challenges posed by illnesses impacting brain health. The Trump administration seems both foolish and wicked regarding their management of SAMHA; indeed, Trump and Kennedy seem bent on near-complete destruction of that effort. Evidence-based resistance against these harmful Trump/Kennedy tendencies is more important than ever. Our collective wellbeing is at stake.
References
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Hoffman J. H.H.S. reverses decision to cut $2 billion for mental health and addiction services. New York Times. January 14, 2026.
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