In 2025, the Trump administration began its promised reform of health and science, announcing in February 2025 that the National Institute for Health (NIH)’s funding would be slashed by $4 billion. A May memo outlined their further intentions, removing billions of funding from other public bodies that funded “radical gender and climate ideologies antithetical to the American way of life”.
These changes to medical, social and public research will impact millions of studies, altering our understanding of substance use, addiction and more. It’s not just research into drugs that has been impacted: work into cancer treatment, climate change and populational health has also been targeted for termination. Speaking to defunded addiction researchers and harm reduction experts, we’ve looked at what has been slated for termination, and what defunding may mean for the US in the long run.
Borders over research
Looking at the projects that have been defunded, those focused on broad matters of identity were clearly a top target. Whether it was people who use drugs, those with HIV, LGBTQ+ people, or racial minority groups, it is clear that already-marginalised people are particularly set to lose from these budget cuts.
Projects with the largest quantity of funds detracted were all linked to discrimination, eliminating barriers, racism, or gender. Terms like “inclusion”, “equity”, “diversity”, and “gender” were specifically – yet simultaneously poorly – targeted.
For example, studies with “inclusion” as a term were defunded – even when meant as “inclusion criteria” for determining sample populations, and not about gender or racial diversity. The initial defunding strategy seems to have just been to terminate any and all studies with these keywords.
The Trump administration’s memo outlining priorities for the 2026 budget makes his agenda clear by suggesting that “niche [projects] committed to radical gender and climate ideologies antithetical to the American way of life” are being overfunded by the government. Within it, it outlines over US$22 billion cut just from the NIH and other drug-related bodies, like the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centre for Disease Control (CDC). Instead, it made clear that this government’s interest was to focus on border security, law enforcement and supply-side drug market crackdowns through a $42 billion reinforcement for the Department of Homeland Security (DHS).
The intentions for the budget make clear that the Trump administration affirms and seeks to expand upon previous U.S. governmental priorities of curbing drug supply through law enforcement and border control. This is in contrast to an approach that supports the reduction of demand for and harm done by drugs through the funding of research, prevention, and harm reduction.
Consequences of research defunding
The politicisation of the American research agenda holds both severe domestic and global consequences. Dr. Sheila Vakharia, the Managing Director at the Department of Research and Engagement at the Drug Policy Alliance (DPA), has highlighted that research projects with an international scope or focus on global health have also been disproportionately targeted.
“[NIH research represents] an estimated 80% of the world’s drug and alcohol or drug addiction related research. So it’s not even just affecting people who use drugs and people who have substance use disorders in the United States,” Vakharia commented. “This could affect global drug research.”
Dr. Thomas Babor, Professor Emeritus of Public Health from the University of Connecticut, also highlighted that the US’ ejection from the World Health Organisation (WHO) coupled with ending international drug-related studies will impede our understanding of wider drug trends, which “is going to have an effect not only in the US but on other countries.”
Ending research that focused on specific differences between groups will erase our understanding of how certain common behaviours – like using drugs – impact them differently. This is particularly important when there’s ample evidence that certain populations are suffering from drug-related harms at higher rates than the average. Recent research into fentanyl overdose deaths has shown how race, ethnicity and geography have played an increasingly important role in determining overdose deaths. Additional research has shown that Black Americans are less likely to engage with opioid substitution therapy. Ending studies into why these factors impact overdose death rates would rob the country of vital data to guide more targeted life-saving interventions – the same kind of interventions that have led to a reduction in overdose deaths in the past two years.
The loss of research and data into drug-using patterns of specific groups also means that there is less information to guide existing drug policies, and how to refine future ones. Different people, from different backgrounds and in different environments, respond distinctly to drug use or other medical interventions. For any evidence-based policy-making process, tailoring interventions to a specific group, health harms, or behaviours is crucial for overall success.
“We will have less information to give to guide decision-making and policy-making for a variety of communities who have been disproportionately impacted or who might be at risk of a variety of health conditions,” Vakharia said.
“And this goes beyond drug and alcohol research, because NIH research includes cancer research, it includes respiratory issues, cardiovascular research, beyond the drug and substance use related research being affected. We’re actually talking about broader health disparities research that could be helping us to better understand who is impacted by issues, but then also how to best help them.”
Given the Government’s broad targeting of research terminology, many data centres and projects that supported work beyond diversity or inclusion were also terminated. Programmes into vaccines development, post-disaster nutrition support, cancer research, epidemiology and more have been cut.
Defunded research is not likely to be saved by other funders. Private organisations lack the sheer amount of funds needed that were supported by public bodies. As Vakharia put it, “the money that [private institutions] can offer is dwarfed by how much the federal government can offer”. With other public bodies like the CDC and SAMHSA – who represent the bulk of behavioural health research and prevention efforts in America – also facing cuts, it’s unlikely for an organisation with the funding and staffing capacity to support the majority of suspended studies.
Even if funding is reinstated for studies, there’s research that may still be lost. Speaking to Dr. Diana Fishbein, a Senior Research Scientist at the University of North Carolina, she highlighted that researchers are “losing data” waiting for a decision on their grants.
“When you have longitudinal studies, you can’t be missing entire waves of data collection,” Fishbein said. “Animals are being destroyed, samples, mRNA research right is now being affected.”
An alarming example of defunded long-term research is the National Longitudinal Study of Adolescent to Adult Health (known as Add Health): this study, which has accompanied the lives of 20,000 adolescents since 1994, collects incredibly rich data on people’s life developments, careers, geographical effects and more. The NIH has funded the study since its inception. However, both Vakharia and researchers contacted by TalkingDrugs confirmed that Add Health staff was fired last Spring as part of budget cuts, with a skeleton staff rehired solely to finish the project’s latest data release. Since March 2025, Add Health’s data is “under review for potential modification in compliance with Administration directives”.
Dr. Elliot Stein, a now-retired researcher who worked within the NIH, emphasised the danger that prolonged defunding poses for America’s status as a leader in addiction, harm reduction, and drug research. He posited the question, “Would I go to grad school right now? Would I say, ‘Gee, I just really want to be a scientist’. Hard to imagine, right? And so people will self-select into a career that is protected”. Dr. Stein called the health and science defunding as a “reverse brain drain” moment, where researchers will more likely migrate to other, more welcoming, countries such as France or Australia to continue their work. As the United States previously was a leader in funding drug-centric research worldwide, this massive budget cut has indicated that their willingness to fill this role is waning.
America’s advantage in the world is from a scientific standpoint. And that’s just not just biomedical research, right? All research,” Dr. Stein said.
“When you throw away knowledge, you’re throwing away your leadership.”
What happens now?
In the wake of this intellectual and financial drainage, some defunded research projects have continued covertly: interviewed researchers told TalkingDrugs that some studies have been re-submitted for public funding, tweaking their language to avoid having their research flagged for termination again. Others are hoping to have their work picked up by private organisations, whether nationally or abroad. Yet, NIH funding, which totals over $40 billion per year, cannot be replaced by these efforts, which offer only a few billion dollars a year in comparison.
Others are fighting against defunding. The Drug Policy Alliance is engaged in advocacy work, developing funding and impact trackers, policy reports, and toolkits for defunded researchers to contact their political representatives to explain the future impact of these cuts.
In addition to this, the Addiction Science Defense Network (ASDN), which is a national network of over 300 substance professionals and 32 professional societies, is targeting policymakers, science academies and the general public to express their concerns on the future impacts of these budget cuts. Speaking to ASDN’s steering committee members, who are mostly late-career or retired researchers, they felt it was important to organise and mobilise to protect their sciences; this was especially important as younger scientists feared further defunding or termination if they spoke out against budget and project cuts.
These advocacy efforts have had some success: political representatives have fought to maintain NIH funding, as well as some other health and science programmes. But the scale of funding attacks means that advocacy can only reduce the impact of this funding catastrophe, not reverse it.
