AILSA CHANG, HOST:
Street drug deaths in the U.S. plummeted by 27% last year. That's according to the Centers for Disease Control and Prevention. It's an unprecedented decline that translates into tens of thousands fewer fatal overdoses across the country. Of course, this comes at a moment when the White House and Republicans in Congress have proposed deep cuts for addiction programs that many experts say are saving lives. NPR addiction correspondent Brian Mann is here to catch us up. Hi, Brian.
BRIAN MANN, BYLINE: Hi, Ailsa.
CHANG: OK, so a 27% drop - that's more than a quarter in a single year. I mean, that seems really substantial. Have we seen anything like that before?
MANN: Wow, no. This drop in deaths from all street drugs, it's huge. The CDC, which tracks fatal overdoses, called this moment remarkable. Doctors, researchers, people living with addiction that I've been talking to say there's just been a massive positive shift from the fentanyl crisis that once seemed unstoppable to this moment, when more and more people are surviving. It's important to say a lot of people are still dying from drugs - roughly 80,000 lives lost to street drugs in 2024. But that is a massive drop from the roughly 105,000 people who died the year before.
CHANG: Wow. But let me ask you - I mean, fentanyl, it's been so deadly. Do we know why so many more people are surviving now?
MANN: Experts say it's likely not any one thing, Ailsa. They point to the fact that under the Biden administration, the public health response to fentanyl and these other street drugs grew really fast. Communities flooded the streets with naloxone. That's the medication that reverses opioid overdoses. Also appears fentanyl on the streets appears to be weaker in many areas. The shift also may reflect the waning impact of the COVID pandemic. And one sad note is that a lot of vulnerable people have already died - hundreds of thousands of deaths over the last five years. Taken together, this is widely seen as a huge public health victory. It's the biggest improvement in drug deaths we've seen since the opioid crisis began in the 1990s. And I want to point to one other bit of good news here, Ailsa - there's no sign of this trend slowing. Each month, when new CDC data comes out, it shows another big drop in deaths. That trend's been happening now for 16 straight months.
CHANG: Wow. That said, as we mentioned, the Trump administration is now proposing deep cuts to many of the federal programs and agencies that have been battling the fentanyl crisis - right? - including the CDC. So what are experts saying about the effects of those cuts?
MANN: I'm hearing real fear that this could slow or even reverse progress on drug deaths. The White House budget envisions a deep hit - about a billion dollars - to the Substance Abuse and Mental Health Services Administration, known as SAMHSA. That organization would be restructured. Experts say these cuts could cripple efforts to track new drugs turning up on the streets - deadly drugs like xylazine and medetomidine. It's really hard to fight addiction when you don't know what people are using out there. Chad Sabora is a former drug user and activist in St. Louis. He helped organize an effort by more than 300 addiction effort experts to lobby Congress against these proposed cuts.
CHAD SABORA: This would take us light-years back - basically implode the current structure that treats substance use as a public health issue.
MANN: House Republicans, of course, are also considering cuts to Medicaid, and that's the insurance program many people facing addiction use to get health treatment.
CHANG: Exactly. Well, how does the Trump administration defend these proposed cuts?
MANN: Well, we asked the White House for comment. They didn't respond, But yesterday, Health Secretary Robert F. Kennedy Jr. was asked about this while testifying. He spoke with Congresswoman Madeleine Dean, a Democrat from Pennsylvania, about these changes to SAMHSA and CDC.
(SOUNDBITE OF ARCHIVED RECORDING)
ROBERT F. KENNEDY JR: It's shifting to a subdivision where we can operate it more efficiently with other chronic diseases.
MADELEINE DEAN: But do you realize that...
KENNEDY: CDC is going to do infectious disease, which is why we created it. It had mission creep, and it was operating with...
DEAN: Mission creep as it was saving lives?
MANN: And in that exchange, Dean asked Kennedy repeatedly, Ailsa, if there was any analysis done about how these cuts to these organizations and this big shakeup to the public health system might affect this positive trend we've been seeing. He didn't respond. Again, addiction doctors, drug policy experts say changing the public health response now when progress is suddenly being made - they say that's really risky.
CHANG: That is NPR addiction correspondent Brian Mann. Thank you so much, Brian.
MANN: Thanks, Ailsa. Transcript provided by NPR, Copyright NPR.
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