SAMHSA Just Funded the Overdose Antidote. It's Still Not Funding an Answer for Meth.

On September 25, SAMHSA announced $247.9 million in new awards, and two of the line items are the ones frontline overdose work runs on: $69.4 million through the Medication-Assisted Treatment–Prescription Drug and Opioid Addiction program, which expands access to medications for opioid use disorder, and $34.6 million for the First Responders-CARA program, which trains first responders and community members to give and hand out overdose-reversal medication. More than $96 million more goes to children’s mental health and trauma services, per the same announcement and reporting on it.

That is real money, and it keeps real things alive. Naloxone and opioid medication funding survived another cycle. If you carry naloxone, or work somewhere that hands it out, this is still yours, and it is funded.

Naloxone money is the right money. It cannot be the only money.

Here is the number that doesn’t fit the press release. In 2023, according to the CDC, nearly 60,000 overdose deaths involved cocaine or psychostimulants such as methamphetamine, about 57 percent of all overdose deaths that year. Reporting from Acuity in September notes that close to half of overdose deaths involved both an opioid and a stimulant, which is why naloxone training matters for people who think of themselves as meth or cocaine users. It also means that a training grant helps a person in a stimulant overdose only when an opioid is part of it. The stimulant piece has no antidote and no approved medication. The awards announced this week do not change that, and to be fair, no grant could: the science has to catch up, and it is behind.

One caution about this reporting. The award breakdown comes from SAMHSA’s announcement and a secondary outlet, and we have not seen the full award list, so we can’t yet say which states or agencies received the money.

The provider move this week is specific. If your agency handles overdose response, check whether your naloxone training covers people who use stimulants and say so out loud to the person who thinks it doesn’t apply to them. If you run a program, ask your team what you offer someone who comes in using meth only. If the answer is thin, that is your next grant conversation, and a contingency management pilot is a concrete thing to name in it.

For everyone else: the overdose-reversal medicine is funded, fentanyl shows up in supplies people didn’t expect it in, and carrying naloxone costs you nothing but a pocket. Somebody at a party who took what they thought was cocaine is counting on someone in the room having it.