Health
Federal Agency Dedicated to Mental Illness and Addiction Faces Huge Cuts
Every day, Dora Dantzler-Wright and her colleagues distribute overdose reversal drugs on the streets of Chicago. They hold training sessions on using them and help people in recovery from drug and alcohol addiction return to their jobs and families.
They work closely with the federal government through an agency that monitors their productivity, connects them with other like-minded groups and dispenses critical funds that keep their work going.
But over the last few weeks, Ms. Wright’s phone calls and emails to Washington have gone unanswered. Federal advisers from the agency’s local office — who supervise her group, the Chicago Recovering Communities Coalition, as well as addiction programs throughout six Midwestern states and 34 tribes — are gone.
“We just continue to do the work without any updates from the feds at all,” Ms. Wright said. “But we’re lost.”
By the end of this week, the staff of the agency, the Substance Abuse and Mental Health Services Administration, could be cut by 50 percent, according to senior staff members at the agency and congressional aides who attended briefings by Trump officials.
With just under 900 employees and a budget of $7.2 billion for large state grants and individual nonprofits that address addiction and mental illness, SAMHSA (pronounced SAM-sah) is relatively small. But it addresses two of the nation’s most urgent health problems and has generally had bipartisan support.
The agency’s broad mandate includes overseeing 988, the National Suicide and Crisis Lifeline, which fields millions of calls through state offices; regulating outpatient clinics that dispense opioid treatment drugs such as methadone; directing funds to drug courts (also called “treatment courts”); and producing nationwide annual surveys of substance use and mental health issues.
It provides best-practice training and resources for hundreds of nonprofits and state agencies, and helps establish centers that provide opioid addiction prevention, treatment and social services. It is also a federal watchdog that closely monitors the spending of taxpayer-funded grants for mental health and addiction.
Both President Trump and Robert F. Kennedy Jr., the federal health secretary, whose portfolio includes SAMHSA, have been outspoken about addressing the country’s drug crises. Mr. Trump has invoked overdose fatalities as a rationale for imposing tariffs on Canada, Mexico and China. Mr. Kennedy has often discussed his ongoing recovery from heroin addiction. During his presidential campaign, he produced a documentary about the impact of addiction in the United States that also explored different treatment options.
While the rates of U.S. overdose fatalities remain high, they have been declining consistently since 2023. Many drug policy experts say SAMHSA is the federal agency most directly responsible.
“Cutting SAMHSA employees without understanding the impact is extremely dangerous, given the behavioral health crises impacting every corner of our nation,” Representatives Paul D. Tonko of New York and Andrea Salinas of Oregon wrote in a letter to Mr. Kennedy, signed by 57 Democratic House members.
Reductions in staff, they argued, could lead to a surge in relapse rates, a strain on the health care system and poorer health outcomes overall.
Asked about the pending cuts, a spokeswoman for SAMHSA replied: “The important collaboration facilitated by SAMHSA’s regional offices continues, regardless of personnel changes, and SAMHSA staff remain diligently responsive to partners around the nation.”
On Tuesday, the Department of Health and Human Services announced that it was reducing its number of regional offices, which house agencies that include SAMHSA, from 10 to four.
Proposals to shrink staff sizes across government departments are due Thursday. In the last month, SAMHSA’s staff was reduced by roughly 10 percent through layoffs of workers in their probationary period, a designation that included people recently promoted to new positions. Last weekend, the agency’s employees and other personnel overseen by Mr. Kennedy received emails offering $25,000 to those who left their jobs by this Friday, characterized as a “voluntary separation.”
In interviews, a dozen current and former SAMHSA employees, including executives, said the threat posed by layoffs and policy shifts is beginning to be felt at sites everywhere, from the heart of troubled city neighborhoods to rural outposts. Some newer SAMHSA projects scarcely underway are in jeopardy, like one to map Chicago housing projects to better distribute the lifesaving overdose medication naloxone, and others to establish systems to speedily relay suicide intervention calls to on-the-ground response teams.
They said it was unlikely that funding for centers focused on treating the mental health or substance use disorders of specific populations, such as Black and L.G.B.T.Q. communities, would be reauthorized.
Regina LaBelle, the former acting director of the Office of National Drug Control Policy during the Biden administration, called the staff cuts “ shortsighted.”
“It might reduce numbers, but it also reduces oversight and accountability,” she said, by hindering the agency’s ability to monitor grant funds and collect behavioral health data.
During the Biden administration, the agency’s budget and staff grew substantially, a development that mental health and addiction experts described as an attempt to make up for persistent underfunding. In 2019, just before the onset of the pandemic, SAMHSA had about 490 full-time staff members and a budget of roughly $5.5 billion. According to the Centers for Disease Control and Prevention, there were 70,630 overdose deaths that year.
In March 2020, the pandemic bore down. Over the next three years, annual overdose fatalities soared to well over 100,000. Mental health problems surged, including deaths by suicide. The increases to SAMHSA’s budget had bipartisan support.
Now there is widespread talk that the Trump administration may fold SAMHSA into another health agency or return staff numbers and grant funds to 2019 levels, even though rates of overdose deaths remain significantly higher than in 2019. According to the most recent C.D.C. update, between September 2023 and September 2024, roughly 87,000 people died of drug overdoses.
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Just four minutes of daily strength exercises can dramatically improve mobility, balance and leg strength in older adults, per new research from the Penn State College of Medicine.
Standard public health guidelines recommend at least 150 minutes of moderate exercise per week. However, the study suggests that fewer than one in five older adults meet the recommended muscle-strengthening guidelines.
The research team designed a home-based program called Functional Activity Strength Training, or FAST-2. They evaluated 97 sedentary participants 65 and older, with an average age of 74.
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Before entering the study, these individuals were averaging just 18 minutes of total physical activity each week.
The older adults were randomly split into two groups, with one group performing the daily exercise routine and the other serving as a control group that received no intervention, according to the study’s press release.
Just four minutes of daily home strength training can significantly improve mobility, balance and leg strength in older adults, according to a Penn State College of Medicine study. (iStock)
Participants performed four basic movements for 30 seconds each, separated by 30-second rest intervals. The entire routine lasted exactly four minutes. The circuit consisted of push-ups, chair stands, two-arm resistance-band rows and stair stepping.
To keep the routine accessible, researchers provided written explanations and simple modifications. For example, participants could perform push-ups against a kitchen counter or wall, or use their hands on their knees for support during chair stands.
Participants were also given four elastic resistance bands and an adjustable step platform.
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“Exercise is actually really complicated, because you have to decide how many repetitions, how far, how many sets, how much rest and how many times per week,” co-author Smita Dandekar, associate professor of pediatrics at Penn State College of Medicine, said in the press release.
“It’s hard work … so if we can make it short, we’re part [of the] way there.”
The program consisted of four basic movements: push-ups, chair stands, resistance-band rows and stair stepping. (iStock)
As the participants grew stronger, they were encouraged to progress to higher levels of difficulty, such as transitioning away from modifications or increasing the height of the stepper.
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After 12 weeks, the results suggested that a tiny dose of regular exercise could yield noticeable physical benefits. In a 30-second chair-stand test, the exercise group performed an average of 4.2 more repetitions than the control group.
“These indicators … give you a sense of whether or not you’re going to be able to be active in the future.”
The adults doing the exercises also shaved 2.3 seconds off their time during a test measuring how they could stand up and sit down five times consecutively. Furthermore, they extended their one-legged balance time by an average of 3.6 seconds.
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The researchers emphasized that these specific measurements are critical medical indicators of an older adult’s future health.
By keeping the routine ultra-short, researchers eliminated common barriers like time constraints and exhaustion, resulting in an exceptionally high 81% workout completion rate. (iStock)
“These indicators predict your future ability to go into a nursing home, your future likelihood of falling and of developing difficulty walking,” noted lead author Christopher Sciamanna, professor of medicine and of public health at Penn State College of Medicine, in the press release.
“They give you a sense of whether or not you’re going to be able to be active in the future.”
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While traditional home exercise programs generally see low engagement, the participants in this study successfully completed their workouts on 81% of the tracked days, according to the researchers.
After 12 weeks, exercising seniors gained the ability to complete an average of four more chair-stand repetitions than those who did not exercise. (iStock)
The study had several noted limitations. As it tracked a relatively small sample size of fewer than 100 individuals over a brief 12-week time frame, it is unknown whether these mobility gains can be sustained long-term.
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Additionally, the researchers did not specify the exact dropout rates or detail how the routine might affect seniors who already relied on assistive devices like walkers or canes.
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Because the final trial results reflected a specific group of participants who met the entry criteria, further investigation is required to determine whether the short routine can safely benefit older adults facing more severe physical limitations or cognitive decline.
The study was published in the journal PLOS One.
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Jill Smokler, founder of Scary Mommy, has died at age 48 after a battle with glioblastoma, an aggressive form of brain cancer.
The popular “mommy blogger” had been fighting the disease for the past two years, according to an announcement posted on ScaryMommy.com on Monday.
The stay-at-home mother of three launched the blog in 2008 as a place to share the “joys and pitfalls” of parenting, according to the article.
As Scary Mommy expanded from a personal blog into a major parenting brand, Smokler built a following with her honest, often self-deprecating take on motherhood. She went on to speak at blogging conferences, author bestselling books, appear on national television programs and earn three Webby Awards, her biography states.
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“Jill spent her life telling the truth about motherhood — that it could be wonderful and impossible in the very same breath — and in doing so, she gave millions of women permission to stop pretending and feel a little less alone,” her family shared in a statement following her passing.
Jill Smokler, founder of Scary Mommy (pictured in 2018), has died at age 48 after a battle with glioblastoma, an aggressive form of brain cancer. (Lloyd Fox/Baltimore Sun/ZUMA Press Wire / Shutterstock)
“She was funny, fearless, generous and entirely herself. More than anything she built, Jill was proudest of her three children, Lily, Ben and Evan. We are heartbroken to lose her, and endlessly proud of the mark she left on the world.”
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Smokler’s first sign of the disease was in April 2024, when she experienced a sudden seizure. She then underwent surgery to remove a brain tumor, after which she didn’t recognize her own children, she previously shared with Today.
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“I am definitely grateful that I don’t remember the looks on their faces when I didn’t recognize them,” she said. “That must have been gutting.”
Smokler was diagnosed with glioblastoma, the most common malignant primary brain tumor in adults and one of the deadliest forms of brain cancer. There is currently no cure.
About 13.9% of all brain tumors are glioblastomas, according to the American Brain Tumor Association. (iStock)
Following surgery, the blogger underwent radiation and chemotherapy, during which she was open about her treatment side effects, including fatigue and hair loss. Additional surgeries and clinical trials followed, according to previous interviews.
“Thank you, Jill, for everything. May you rest in peace,” the Scary Mommy post concluded.
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About 13.9% of all brain tumors are glioblastomas, according to the American Brain Tumor Association. More than 12,000 new cases are diagnosed in the U.S. each year.
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Median survival is approximately 12 to 18 months after diagnosis, even with treatment. Only about 5% to 7% of patients survive five years after diagnosis, data shows.
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