At a Cabinet meeting in late April, Attorney General Pam Bondi lavishly praised Donald Trump for saving 75% of the American populace. “Since you have been in office, President Trump, your DOJ agencies have seized more than 22 million fentanyl pills — 3,400 kilos of fentanyl,” she gushed. Turning to the cameras, she added that the seizures “saved — are you ready for this, media? — 258 million lives.” 258 million of the 340 million people living in America were miraculously saved thanks to Trump’s singular genius, Bondi apparently believes.
As Bondi counts lives saved in her imagination, in the real world the Trump administration is doing the opposite. A draft budget proposal for the Department of Health and Human Services would cut funding to a crucial program that equips first responders with naloxone. The opioid antagonist, which can be snorted or injected, instantly jolts a person awake and restores breathing if they’ve overdosed. It’s not pleasant — the user goes into instant withdrawal — but it works in minutes to reverse an overdose and save the user’s life.
Though Trump has made battling fentanyl a centerpiece of his presidency, his actual strategy leaves much to be desired.
The $56 million annual grant, FR-CARA (First Responder Comprehensive Addiction and Recovery Act), dispensed 101,000 kits to first responders in fiscal year 2023. As many as 77,000 first responders were trained in their proper use. “If you’re in harm reduction, public health or first response — there’s a good chance you’ve benefited from it,” says former prosecutor and harm reduction specialist Chad Sabora.
First synthesized in 1960, naxolone was approved for overdose treatment in 1971. Its introduction, unfortunately, coincided with the beginning of the war on drugs, preventing widespread use despite its efficacy. For decades, users had to get prescriptions from their doctors, who were often reluctant to dispense naloxone due to stigma about drug use.
But most studies — with some exceptions — have shown that increased access doesn’t promote substance abuse. In the mid-aughts, local programs that dispensed naloxone began to pop up around the country. Efforts to equip and train first responders also gained traction. In 2013, the Obama administration declared that the drug “should be in the patrol cars of every law enforcement professional across the nation.” FR-CARA began accepting applications in 2017.
Though Trump has made battling fentanyl a centerpiece of his presidency, his actual strategy leaves much to be desired. He’s blasted Canada for its alleged role in the fentanyl crisis, even though less than 1% of fentanyl entering the U.S. comes through Canada. He offered to send U.S. troops to Mexico to battle the cartels, a plan politely rejected by Mexican President Claudia Sheinbaum. Fentanyl is a major justification for the China tariffs that dictate how many dolls your kids get to have. And more broadly, Trump has used the opioid crisis to vilify asylum-seekers and immigrants who come across America’s southern border, even though 86.2% of people charged with fentanyl trafficking in 2021 were U.S. citizens.
Naloxone, in fact, is a simpler fix to fentanyl deaths than upending the global economy or a military strikes against Mexican cartels. Earlier this year, the Centers for Disease Control and Prevention (CDC) reported an astonishing 24% drop in opioid overdose deaths in the 12 months ending in September 2024, compared to the previous year. Public health authorities are hesitant to draw definitive conclusions just yet, but most cite increased access to naloxone for drug users and programs that supply first responders with the medication. “Naloxone is a silver bullet for opioid overdose,” AmandaLynn Reese, chief program officer for the nonprofit Harm Reduction Ohio, told The Washington Post.
Federal funding plays a crucial role because naloxone is easily accessed in some parts of the country, but difficult to get in others.
Alice Bell, project director at a Pittsburg harm reduction clinic, notes that prior to federal funding for naloxone, harm reduction programs mostly relied on private donations and volunteers. FR-CARA has helped put the lifesaving medication in the hands of police, firefighters and EMTs. And federal funding plays a crucial role because naloxone is easily accessed in some parts of the country, but difficult to get in others.
Bell recalls heartbreaking conversations with the families of dead people before naloxone was more accessible: “Parents learning about naloxone would say, ‘You mean to tell me if I would have had this, my child would still be alive today?”
Quite simply, the cuts are a matter of life and death. “Last year, nationally, over 100,000 people died of overdose,” Bell says. “It represents an obvious disregard for people’s lives and for the families and people who love them.”
“We know that naloxone saves lives,” she says. “If there is less access, more people will die.”