Less than 24 hours after terminating the discretionary grants that represent nearly $2 billion in funding for public health and social services programs, including many harm reduction programs, the Substance Abuse and Mental Health Services Administration has reinstated them. On January 13, hundreds of grant recipients received letters of termination citing “non-alignment” with SAMHSA’s new strategic priorities. Then, following public outcry, on January 14 the agency reversed course with even less explanation.
SAMHSA employees, including leadership, were reportedly unaware of the cuts until a few hours before the letters went out. The decision to terminate the grants is being widely attributed to Department of Health and Human Services Secretary Robert F. Kennedy Jr., who in 2025 gutted SAMHSA and intends to consolidate the remains into his proposed Administration for a Healthy America, once it exists.
“After national outrage, Secretary Kennedy has bowed to public pressure and reinstated $2 billion in SAMHSA grants that save lives. These are cuts he should not have issued in the first place,” Representative Rosa DeLauro (D-CT) stated January 14. “Our policy must be thoughtful—not haphazard and chaotic. This episode has only created uncertainty and confusion for families and healthcare providers.”
The services targeted include naloxone distribution, access to medication for opioid use disorder and treatment for pregnant and postpartum SUD patients, among others. But SAMHSA grants keep the lights on for a huge number of projects that extend beyond harm reduction, like suicide prevention and first responder training. Even the American Psychiatric Association Foundation’s program offering free mental health training in K-12 schools would have been shuttered.
“[N]o corrective action is possible here since no corrective action could align the award with current agency priorities,” SAMHSA told the grant recipients.
“Although in its discretion SAMHSA may suspend (rather than immediately terminate) an award to allow the recipient an opportunity to take appropriate corrective action before SAMHSA makes a termination decision,” stated the letter issued en masse the night of January 13, “after review and consideration, no corrective action is possible here since no corrective action could align the award with current agency priorities.”
Government Executive reported that a source with access to the data put the number of affected grants at between 2,500 and 2,900. Because the grants had already been awarded, terminating them would have not just pulled the plug on future projects, but cut off substance use disorder (SUD) patients from treatment and cost providers their jobs.
“A majority of the funding for these grants was already appropriated by Congress, so their termination is technically illegal,” Maggie Hart of Drug Policy Alliance (DPA) said in a statement. “And over the last few months of ongoing federal appropriations negotiations, this funding was on track to being preserved by Congress. These terminations come on top of $1 trillion cuts to Medicaid—the single largest source of funding for addiction treatment.”
However, on the same day it issued the grant termination letters, SAMHSA posted a $231 million grant to run the 988 Suicide & Crisis Lifeline. The National Council for Mental Wellbeing stated January 14 that in addition to the 988 lifeline, funding has continued for the State Opioid Response Grant and the Certified Community Behavioral Health Clinic program.
The turmoil comes just two weeks before the deadline for Congress to reach a new funding agreement or face another government shutdown. It also hasn’t been the only chaotic reversal within HHS during this time.
The same day grant recipients were notified of the cuts, HHS reinstated some 400 National Institute for Occupational Safety and Health employees. They’d been on paid leave since April 2025, in limbo with no indication from HHS as to the future of their jobs, until they were unexpectedly informed that the previous “reduction in force” notice they’d received was being revoked, effective immediately.
Image via State of Oregon
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