After years of increases, overdose deaths in the United States are on the decline: the reported 68,632 drug overdose deaths in 2025 represents a 15.1% reduction from the prior year. Researchers point to several contributors, including broader naloxone access, expanded treatment, stronger surveillance systems, community-based prevention and shifts in the drug supply. Despite this progress, unfortunately, that means nearly 70,000 families and communities are still being confronted by an almost unimaginable and preventable, loss.
Our progress is evidence that sustained investment can save lives. It reflects more than a decade of federal, state and local work to build the substance use disorder and overdose prevention infrastructure communities rely on, from treatment and recovery supports to overdose response, data systems and prevention programs. At the same time, the fact that so many people are still at risk shows us that the journey is not over—and progress can be resersed. Which is exactly the risk from the President’s FY 2027 Budget Request.
The President’s request proposes to restructure or reduce much of the country’s lifesaving overdose infrastructure at the very moment communities need stability to sustain the decline.
Roughly 70,000 people still died last year. That is not a trend to coast on. It is a reason to keep funding what is working, close the gaps that remain and make sure this progress continues instead of becoming a temporary exception.
"Roughly 70,000 people still died last year. That is not a trend to coast on."
This analysis (link to pdf) from the Overdose Prevention Initiative at the Global Health Advocacy Incubator (GHAI) does what advocates, program staff and legislative offices need right now: it translates the Administration’s budget proposal into plain consequences for the programs doing this work.
A 95% cut to the White House Office of National Drug Control Policy (ONDCP).
The elimination of more than 25 Substance Abuse and Mental Health Services Administration (SAMHSA) competitive grant programs worth $591.4 million.
A consolidation of three major behavioral health formula grants into one block grant that pits overdose prevention against mental health and recovery services for the same pool of money.
A $160.7 million cut to National Institute of Health (NIH) drug and alcohol research. Another attempt to reorganize SAMHSA out of existence entirely.
The analysis also includes a crosswalk comparing proposed FY 2027 funding levels against FY 2026 enacted levels across the full substance use disorder (SUD) portfolio at SAMHSA. You do not have to reconstruct the picture from scattered agency documents. It is here, side by side, program by program.
The President’s Budget Request is not law. Congress writes the final appropriations that become law. Last year, the Administration proposed eliminating SAMHSA and the CDC Injury Center; Congress funded both and kept them intact on a bipartisan basis. The same appropriations fight is coming for FY 2027. What changes the outcome is when advocates, providers and community leaders show up with specific, local, dollar-for-dollar evidence about what these programs actually do and what goes away without them. This analysis is built to supply that evidence.
Advocates who want to engage the federal budget process directly can also access the Overdose Prevention Initiative’s U.S. Federal Advocacy Action Guide, free on the Health Advocacy Training and Collaboration Hub (HATCH), for a practical walkthrough of how the appropriations cycle works and how community-level evidence can influence it.
