Trump Takes Another Blowtorch to Substance Abuse and Mental Health Service

Potentially $2b was just cut from a key HHS agency despite bipartisan support for its work.

(Composite by Hannah Yoest / Photos: GettyImages / Shutterstock)

Update (January 14, 2026, 10:45 EST): The Department of Health and Human Services on Wednesday night reversed its termination of roughly $2 billion in substance abuse grants.

HHS officials did not immediately explain why the department was backing off the terminations just a day after announcing them. Maybe this isn’t so surprising, given that officials never really explained why HHS was canceling those grants in the first place.

But one likely explanation is that these programs have widespread support, both in statehouses around the country and in Congress. In fact, just as word of the reversal was coming down, a bipartisan group of one hundred House members was releasing an open letter calling on HHS to restore the funds.

Just how safe these programs are now remains to be seen. The Trump administration has been hacking away at the agency that administers these programs, the Substance Abuse and Mental Health Services Administration, to the point where estimates suggest it has just half the staff it did when Trump took office. There’s every reason to think administration officials will keep looking for ways to downsize the agency, its mission, and its programs.

But the way this story unfolded over the last twenty-four hours suggests that officials in and around the White House still pay attention to Congress—and will back down when the pressure is strong enough.

Maybe there’s a lesson in that.

In the meantime, below is our original Wednesday morning story about the terminations. It explains what these programs do and why cutting off their funds—as the Trump administration had done—was so worrisome.

–Jonathan Cohn

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THE TRUMP ADMINISTRATION on Tuesday cut off funding for hundreds—and maybe thousands—of organizations that provide substance abuse services across the country.

The cuts were made to ongoing grants from the Substance Abuse and Mental Health Services Administration (SAMHSA), part of the Department of Health and Human Services. Organizations had applied for these grants, had them approved, and were operating with the funds—and then, on Tuesday night, received notices that those grants had been terminated.

Those notices, delivered via email, said the reason for the termination was that their work no longer aligned with SAMHSA priorities.

The affected programs include ones that provide services like housing and peer support for people who are in recovery, as well as ones that train substance abuse professionals. And while the full scope of the cancellations is not clear, people in the field whom I consulted said the number of affected organizations could reach 2,000. In all, the cuts could end up representing some $2 billion—or about a quarter of the total SAMHSA budget.

“These are tens of thousands of people that will lose access to services, hundreds of providers, thousands of providers that are going to lose access to their training and technical assistance resources,” Yngvild Olsen, a National Advisor at Manatt Health and former director of SAMHA’s Center for Substance Abuse Treatment, told me.¹ “These organizations are going to have to lay off staff. They don't have high margins and other sources of funding that they can necessarily turn to. I heard from one grantee that said she doesn't know how she's going to pay staff and bills.”

Rep. Paul Tonko, a New York Democrat who has been leading efforts to document and spotlight Trump administration attacks on mental health services, denounced the cuts in a statement that his office provided to me.

“The result of these SAMHSA cuts will be a death sentence for individuals who most need support and care,” Tonko said. “Anyone who cares about addressing addiction and mental health in their communities should be decrying this heartless action.”

Tonko went on to note that the grants come from money that Congress already appropriated, and that are part of the agency’s budget—producing yet another instance of the Trump administration defying Congress by refusing to spend money it has approved.

“The cancellations were to bipartisan grants already approved by Congress and the President himself that cover programs from youth overdose prevention to prenatal and postpartum care for women,” Tonko said.

HHS did not immediately respond to requests for comment.

SAMHSA is one of the agencies that has already taken deep cuts to staff and funding through several rounds of layoffs. Some estimates suggest it has only half the staff it did before Trump took office.

It is also one of the agencies HHS Secretary Robert F. Kennedy Jr. envisioned folding into a new “Agency for a Healthy America” in a major restructuring that he proposed last year.

Congress, where support for mental health and substance abuse services has frequently been bipartisan, has resisted. Lawmakers have continued to fund the agency at its current levels despite administration requests for cuts, and are gearing up to do so again in the appropriations for this year that it is still negotiating.

Congress must pass a funding bill by the end of this month to avert a government shutdown, and the SAMHSA cuts could potentially complicate those negotiations.

As for the administration’s stated rationale for the SAMHSA cuts—that the programs are out of step with current guidelines—the sources I consulted said they could see no obvious reason the administration would object to these programs.

“If you look at the letter that went out, it mentions that these programs are not in line with SAMHSA strategic priorities at the moment—which is, if you really understood what these grants do, is just not accurate,” said Olsen, who stepped down from her SAMHSA position last year. “You look at some of these programs . . . and they are designed specifically to address overdoses, which is one of the strategic priorities on the SAMHSA website right now.”

“It seems pretty clear that somebody made these decisions without any knowledge of what these programs are actually designed to do—without any thought of whether this makes any sense,” Olsen said.

This is a developing story.

1. Correction (January 14, 2026, 11:59 a.m. EST): An earlier version of this article misspelled Olsen’s first name as “Yngvlid” rather than the correct “Yngvild.”