The Ripple Effect: How a Government Shutdown Reaches Recovery - An Interview with Libby Jones

A government shutdown can create uncertainty and disruptions in health care and social services, putting people with opioid use disorder (OUD) at serious risk. We talk with Libby Jones, Associate Vice President of the Overdose Prevention Initiative at GHAI, about how the shutdown may affect access to medications (like buprenorphine or methadone), recovery programs and life-saving harm reduction services.  

Q: How would a shutdown affect access to naloxone and harm reduction services?  

A: Many programs rely on federal funding and technical support. In fact, federally-funded programs distribute over 1 million naloxone kits annually. The longer the shutdown continues, the greater risk that distribution, training and other harm reduction efforts could be scaled back or delayed. According to the Centers for Disease Control and Prevention (CDC), timely access to naloxone prevents thousands of overdose deaths every year. Any interruption in distribution or training could reverse this progress. Communities could see more preventable overdose deaths if fewer kits are distributed or fewer people are trained to use them. The fact remains that overdose deaths have been declining nationally, because of these interventions. Any threats against access to naloxone and harm reduction services will reverse that progress; we can’t let that happen.  

Q: Will all treatment and recovery services stop during a shutdown? 

A: Thankfully, many essential programs should continue to operate, though if the shutdown drags on too long, some services may be limited or delayed. Delays in funding could result in staffing shortages at treatment programs, which ultimately would limit the availability of life-saving treatment. 

A government shutdown directly impacts people seeking treatment for OUD. Maintaining uninterrupted access to medications, harm reduction services like naloxone and telehealth support is critical for public health. Policymakers must prioritize continuity of care to ensure these life-saving services remain available for those who need them most. Opening the government, keeps care within reach.   

Q: Will Medicaid or Medicare coverage still work?   

A: Yes. Medicaid and Medicare are funded separately from the regular annual appropriations process. As a result, Medicaid and Medicare should continue to pay benefits during a federal funding lapse. Claims will still be processed and coverage should remain intact, including coverage for OUD treatment. However, as the shutdown continues, staffing limitations at Centers for Medicare & Medicaid Services (CMS) will result in delays in processing paperwork. Medicaid beneficiaries will likely experience delays in eligibility verification and healthcare providers may experience delays in processing claims.   

Q: What should I do if my usual treatment provider is affected by the government shutdown? 

A: Seek alternative or backup providers to ensure continuity of care. Local harm reduction coalitions, recovery centers and overdose prevention programs often have up-to-date information about such services available. Community connections are more important than ever during a shutdown.  

Another real area of concern is access to telehealth services, especially in rural communities. Telehealth has been a lifeline for many people with OUD, allowing them to connect with providers, refill prescriptions and access counseling without traveling long distances. It is a lifesaving bridge to treatment. Some special telehealth flexibilities that expanded during the pandemic recently expired or have become limited as a result of the shutdown, leaving rural patients with fewer options for care and increasing their risk of lapse in treatment.  

Q: What keeps you up at night when it comes to the government shutdown?  

A: I’m fearful of the lasting impacts this shutdown could have. There will be no “back to normal” when the government reopens. Since the shutdown began, as many as 100 employees at the Substance Abuse and Mental Health Services Administration (SAMHSA) have been let go, this is in addition to the 10% personnel cuts that occurred in April. As a result, the workforce of the federal agency charged with leading federal overdose prevention efforts is less than half of what it was at the start of the Trump Administration. These devastating cuts are both counterproductive and counterintuitive, especially when considering that Secretary Kennedy renewed the opioid public health emergency as recently as September.  

There is so much at stake. Renewal of the ACA tax credits is critically important– these credits make health insurance affordable for people who might otherwise struggle to pay premiums, giving them access to essential care, including mental health and substance use disorder treatment. People suffering from substance use disorder should be able to receive treatment and recovery services whenever and wherever they need it and at a cost they can afford. If not, lives will be lost. And the idea of people being disconnected from treatment or life-saving services because of political squabbling is unconscionable to me.  

For more information about the Overdose Prevention Initiative, visit our program page.