Trump Administration's Proposed Cuts to Narcan Programs

Jun 14, 2025

The Trump administration has proposed significant cuts to federal programs that distribute and provide training for Narcan (naloxone), the life-saving opioid overdose reversal medication, sparking controversy amid ongoing efforts to combat the opioid crisis.

Key Proposed Budget Cuts

The Trump administration's draft budget proposal for fiscal year 2026 includes the termination of a $56 million annual grant program that distributes naloxone kits and trains first responders on their use 1 2 3. This program, known as the First Responders-Comprehensive Addiction and Recovery Act (FR-CARA), is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA) 1 4.

In fiscal year 2023, the FR-CARA program distributed more than 101,000 opioid overdose reversal medication kits and trained nearly 77,000 people on how to administer them 3 5. Plans for fiscal year 2024 had raised goals to distributing 130,000 kits and training tens of thousands more 3.

Broader SAMHSA Restructuring

The proposed cuts are part of a larger restructuring plan that would eliminate SAMHSA entirely and consolidate it with four other federal agencies into a new entity called the Administration for a Healthy America (AHA) 6. The broader Department of Health and Human Services faces $33.3 billion in proposed cuts, with plans for a 50-percent reduction in SAMHSA's workforce 1 6.

In late March, HHS abruptly revoked $11 billion in COVID-19 pandemic-era funding, including $1 billion in SAMHSA grants that had already been awarded to community groups 6. While a federal judge granted a temporary injunction protecting this funding, many community organizations continue to receive conflicting information about their grant status 6.

Policy Contradictions

The proposed cuts appear to contradict the administration's stated drug policy priorities. The White House Office of National Drug Control Policy released a strategy document in April 2025 that explicitly states: "To combat the drug crisis and the opioid epidemic, largely driven by fentanyl, the Administration will expand access to overdose prevention education and life-saving opioid overdose reversal medications like naloxone" 3 7.

Health and Human Services Secretary Robert F. Kennedy Jr., who has referenced his own history with heroin addiction, has publicly supported naloxone access, stating at a Nashville summit: "We need Narcan. We need good fentanyl detectors that can detect it in pills, et cetera, so that kids are less likely to overdose" 8.

Congressional and State Pushback

Congressional Republicans from states heavily affected by the opioid crisis are pushing back against the proposed cuts 9.Some Republican lawmakers have indicated they will not support Trump's proposal to eliminate naloxone funding, saying the overdose-reversing drug saves too many lives to slash 9.

Representative Gabe Vasquez sent a letter to President Trump urging the administration to protect and expand access to overdose reversal medications, calling on the administration to reverse course on any proposed funding cuts for naloxone distribution and training programs 10.

Twenty-three states and the District of Columbia successfully sought a restraining order to protect the $11 billion in revoked funding, with a federal judge granting a temporary injunction on their behalf 6.

Impact on Overdose Deaths

The proposed cuts come at a time when naloxone access has been credited with contributing to recent declines in overdose deaths 1 11. The medication was made available for over-the-counter purchase in 2023 and has become standard for first responders to carry 1 11.

In Tennessee, for example, more than 1,300 fewer people died of an overdose in 2024 than the year before, with public health experts attributing this success to harm-reduction efforts like broad access to Narcan 8. Huntington, West Virginia, once known as "ground zero" for the opioid crisis, has seen overdose deaths drop more than 70% from their peak 12.

Expert Concerns

Medical experts and addiction specialists have expressed alarm about the potential impact of these cuts. Dr. Melody Glenn, an addiction medicine physician at the University of Arizona, stated: "Reducing the funding for naloxone and overdose prevention sends the message that we would rather people who use drugs die than get the support they need and deserve" 2.

Medical anthropologist Jennifer Syvertsen emphasized the importance of naloxone programs: "While some skeptics may think that naloxone - and harm reduction more generally - enable people, there is decades of research that show giving people the information and tools they need helps keep people safe. Naloxone simply enables people to breathe" 1 11.

Current Status

While spokespeople from the White House Office of Management and Budget and the Department of Health and Human Services have stated that no final decisions have been made about the upcoming fiscal budget, advocates worry about the loss of this key component in addressing the overdose epidemic 3. The administration has also not opened applications for new grants, which experts see as another indication that the programs may be eliminated 2.

The controversy highlights the tension between the administration's stated commitment to combating the opioid crisis and its proposed budget cuts to programs that directly support overdose prevention efforts.