The Trump Budget Would Cut $10 Billion More From Addiction Treatment. Here’s Who Pays.

As Overdose Deaths Rise After Initial Medicaid Cuts, the Administration Proposes Cutting the Programs Proven to Stop Them

The Trump Administration has repeatedly stated its commitment to helping people with addiction disorders. Its proposed Fiscal Year 2027 budget tells a different story.

Life is Bad in The Badlands: Kensington, Philadelphia, 2026

Kensington, Philadelphia, is an urban cityscape with a bustling arts scene and rich historical significance. But since the opioid epidemic hit, its streets have been infamous for one thing alone: hosting what the Drug Enforcement Administration has called the largest open-air drug market on the East Coast.

The sights around Kensington Avenue are certainly not a haven for tourists, but they are a magnet for digital influencers who get rich filming around-the-clock human suffering. Fentanyl fixes and Xylazine wounds are on public display for the watching world. This is the epicenter of America’s drug addiction, and it’s the place people are most likely to envision when politicians do their best to paint addiction as the face of homelessness.

Spoiler alert: the majority of homeless people are not drug addicts. As rampant as the opioid crisis is, it is not displacing people at nearly the same pace as the lack of affordable housing. All of the data reflect this reality. But there is a bigger picture here if you look closely. Drug addicted homeless people have conveniently become the poster children of homelessness. They make it easier for people in positions of power to ignore the housing crisis. But just because the Trump Administration is shining a spotlight on this subset of homeless people doesn’t mean there is a genuine push to help them.

Indeed, as politicians spew speeches about a drug-free country from their podiums, they are removing tens of billions of dollars from the programs that would make it possible. Meanwhile, in Kensington, reality cuts deep. Unsheltered addicts seek help and services that are scant or completely nonexistent.

“As far as resources, there aren’t too many, and the ones that we do have are getting shut down,” said one unhoused Philadelphian who briefly appeared in an Invisible People interview.

We are not cutting programs. We are cutting people. We are cutting the services they need to survive and recover.

$1 Trillion in Cuts for Medicaid Have Already Impacted Addiction Treatment

Congress recently passed legislation that the Congressional Budget Office estimates will cut Medicaid spending by approximately $1 trillion over ten years, and addiction treatment is already feeling the impact. To better understand the dilemma, Invisible People reporters reached out to the Chair of the Harm Reduction Working Group, Bill McColl, who has spent two and a half decades working with unhoused community members, helping them through addiction disorder and chronic illnesses like HIV. McColl explained that these initial cuts were already detrimental and removing access to potentially life-saving treatments and medications.

“These cuts are coming in multiple forms and resulting in a loss of different kinds of services, including access to treatment services, which everyone says we do need. There’s a real problem there,” said McColl.

It’s important to highlight that about 60% of addiction treatment services go directly through Medicaid. So, if cuts are made to Medicaid, people with addiction disorders lose access to treatment programs.

“The other thing is that, in terms of Medicaid itself, when people lose access to coverage or to bills, they have to move to a different system or go without,” McColl continued. “Going without obviously results in greater health issues, and eventually, at least in the case of homeless people with HIV, it will lead to hospitalization and/or death, raising the costs immensely.”

While these cuts reduce federal spending, the costs don’t disappear. They shift to states, individuals, and emergency systems that are far more expensive in the long run. For homeless people with chronic illness, the price can be their lives.

“There is always an unintended consequence to trying to shift financial resources,” explained Lieutenant Diane Goldstein, who spoke passionately about the subject in an Invisible People interview. Goldstein is a retired Redondo Beach Patrol Officer and the Executive Director of the Law Enforcement Action Partnership (LEAP).

“The federal government right now, with this administration, wants to send staff and Medicaid costs and offload them to the states,” said Goldstein. “What do we think that’s going to do? It’s going to increase deaths, disease, and addiction. It’s going to put law enforcement back as first responders to problems we’re never going to be able to arrest our way out of, instead of really critically assessing what works. At LEAP, we support evidence-based approaches to addiction.”

Since the trillion-dollar cut commenced, people with addiction disorders have already lost access to:

Harm reduction services, including service programs and fentanyl test strips

Naloxone, a drug used to prevent opioid overdoses

Specialized treatment facilities

Recovery and support services

Behavioral health services and more

CDC data shows overdose deaths dropped nearly 27% between 2023 and 2024, the largest single-year decline ever recorded, following expanded access to harm reduction programs and addiction medications. Now, studies show that federal funding cuts are threatening to reverse that progress. The Trump Administration’s response to this failure is to cut even more funding from evidence-based solutions to addiction.

The FY2027 Budget Proposes $10 Billion in Additional Cuts

According to the Drug Policy Alliance’s comprehensive federal funding tracker, the Trump Administration now seeks to strip funding yet again for addiction-aligned programs. If granted, this will create the following negative consequences:

Obstruct access to overdose prevention medications like naloxone

Slash addiction treatment programs

Eliminate harm reduction methods

Eradicate the ability to collect substance use data and research

Reduce the number of available treatment beds, particularly in rural areas

Increase the number of overdose deaths

Put a strain on communities across the nation by eliminating proven health solutions to the growing crisis

Lt. Goldstein added, “At LEAP, we believe in evidence-based approaches. Empirical research shows that cutting these types of programs is penny-wise and pound-foolish.”

Talk to Your Lawmakers About the Troubling Direction Legislation is Taking

Since the Trump Administration took office, legislation has shifted away from evidence-backed strategies to the homeless crisis and the opioid epidemic in favor of approaches that are more expensive and less effective.

The best way to solve addiction disorder is through services, and the most successful approach to ending homelessness is with housing. Tell your representatives we need both today.