Advocates Question Whether the Federal Plan Can Deliver Real Solutions
Los Angeles’s Skid Row is an encampment with a million stories. Behind each broken smile and tent there lies a harrowing tale.
For Brenda, a Texas-bred mother of three, this is a far journey from home, and the road to recovery has been riddled with addiction disorder and a decades-long struggle to find her footing and loved ones. Brenda longs for the life she once lived before substance use stripped her of everything she held dear.
“I’ve been homeless for about 20 years,” Brenda explained in a street interview with Invisible People. “I’m trying to find my kids, and I came out here to find them and to find their dad.”
Brenda described the brutal process of rifling through records and coming up empty-handed.
“I didn’t know how to find them,” she said, of her estranged children. Staring down at the ground, she revealed a sobering reality. “So, I’ve been on Skid Row for 8 years.”
Brenda represents the approximately 37% of homeless people who have a substance use disorder. While the role addiction plays in causing homelessness is often amplified, homelessness and drug addiction do intersect.
Recently, the Trump Administration touted an effort they claimed would rectify the nation’s drug addiction and homeless crisis, calling it the Great American Recovery Initiative. The $100 million strategy claims it will connect homeless people suffering from addiction with safe housing and services.
Invisible People recently spoke with Daniel Fishbein, MSW, a policy manager in the Office of Federal Affairs at the Drug Policy Alliance, about the pros and cons of the executive order. This organization is the United States’ largest nonprofit that addresses the harms of drug use and drug criminalization through policy solutions, organizing, and public education.
New policies can bring about confusion, but Fishbein’s educational background and extensive experience make his perspective a window for fellow advocates to see the truth.
Experts Say The Great American Recovery Initiative Does Not Provide Any New Funds
“Firstly, we applaud the administration for taking concern with the overdose crisis, and we also applaud any efforts to expand access to treatment,” Fishbien began. “One of the things that immediately stood out to me is that the executive order doesn’t provide new funds for any programs, nor does it reverse the hundreds of millions of dollars in cuts that have already been made to the substance use infrastructure.”
Among other things, Fishbien is referring to the Trump administration’s $345 million cuts from federal programs that fund addiction and overdose prevention services, as well as the $588 million cuts made for drug-related research.
Additionally, the Trump administration proposed to cancel $2 billion more in funding for substance use and mental health services through SAMHSA grants. The latter decision was rapidly reversed in the wake of extensive public backlash.
As a result, the Trump administration appears to have highlighted a problem it is not fully funding. And even though the SAMHSA grants have been restored, there are still hundreds of millions of dollars missing that could be used to promote addiction recovery.
The New Executive Order Changes the Advisory Body
“The other thing that stood out is that all the executive order really does is establish a new advisory body to the White House,” Fishbein continued. “That seems a little duplicative of the Office of National Drug Control Policy’s purpose. ONDCP typically sets the administration’s drug policy priorities. They work across federal agencies to direct grant programs and funds. And what the executive order does is just create another advisory body to do very similar things.”
Given the president’s reputation for cutting vital funding from social programs, the idea of a new advisory body to the White House handling addiction and drug policy is deeply unsettling.
Under the Trump Administration’s eye, money allocated toward solving problems connected to homelessness, such as poverty, mental health, and addiction, continues to be redistributed into more punitive and forceful programs, such as police and military objectives. This is a dead-end street, not a road to recovery from addiction.
Amid Talks of Prioritizing Addiction and Recovery, the Trump Administration Cut $1 Trillion from the Biggest Payer for Substance Use Treatment.
In July 2025, under the Big Beautiful Act, the Trump Administration brazenly cut $1 trillion from Medicaid funds. This leaves homeless people fighting to overcome the throes of addiction without the financial means to access treatment. The effects of this can be dire or even deadly.
“Medicaid is the biggest payer for substance use treatment in the United States, which means that most people are accessing publicly funded treatment,” Fishbein said. “And to take a trillion dollars from Medicaid funds will have a devastating impact on people seeking treatment, and people seeking medical care for consequences from substance use, such as skin wounds or infectious disease. Ultimately, these Medicaid cuts will make it harder for people seeking care.”
Vague Initiatives and Coercive Tactics Leave Addiction Experts with ‘Real Concerns’
The Drug Policy Alliance supports policies that expand access to housing and treatment. The concern is whether the Great American Recovery Initiative is achieving, or even aspiring to achieve, that goal.
Drawing from experience and careful analysis, Fishbein said he has “real concerns” about the true objective, adding that the “devil is in the details.”
“While the administration has named the overdose crisis as a priority area, and we certainly are in agreement with that, we would love to see more policies that expand access to housing for people with substance use issues,” Fishbein continued.
“There’s a lot of research that supports housing first policies, not just in substance use specifically, but also for people with complex mental illness,” he said. “When people are treated with dignity and care, we tend to see them do a lot better when they’re seeking services, when they’re trying to make a healthy change to their substance use, whether that’s abstinence or cutting back or changing the route that they’re taking that substance.”
Some mental health and addiction approaches suggested by the Trump administration include forced entry into rehabilitation programs and state-sanctioned encampments. While Fishbein didn’t dismiss these tactics outright, he mentioned that they raise alarm.
“As I previously stated, the DPA applauds any effort to expand access to evidence-based treatment. However, we do have real concerns about coercive policies and coercive treatment,” he warned.
“The executive order was signed on a Friday, and the following Monday, RFK announced two initiatives within HHS,” Fishbein said. “One of them was the STREETS Initiative, which is new. STREETS stands for Safety Through Recovery, Engagement, and Evidence-based Treatment Supports.”
“When that was announced, RFK said it was a $100 million initial investment,” Fishbein continued, “and said that STREETS was an effort to solve longstanding homelessness issues, fight opioid addiction, and improve public safety by expanding treatment that emphasizes recovery and self-sufficiency.”
“I think that for this particular initiative, the devil is in the details,” he continued. “We don’t know where this $100 million will come from or how this program is being paid for, and our concern is wondering where this money will come from and if it will be cut from other programs that have already helped stem the tide of overdose deaths.”
“The other initiative that RFK announced was assisted outpatient treatment, or AOT, which, as you mentioned, is another form of coercive treatment. It is a form of civil commitment,” Fishbein said. “With AOT in particular, it’s not a new initiative. SAMHSA has awarded AOT grants since 2016. And specifically with AOT, a government accountability office report from last year found that HHS’s assessments of its AOT grant programs were inconclusive. So, again, our question is, if these coercive grant programs have produced inconclusive results, should we continue to fund them?”
“Efforts to expand access to treatment are commendable, especially for those most in need, such as people who are unhoused, who are experiencing substance use or complex mental health issues,” he said. “But this executive order has left us with real concerns about whether evidence-based treatments are being prioritized and where all of the cut funding has gone. $100 million is a drop in the bucket compared to the cuts that have already been made to SAMHSA, and the administration continues to disregard the evidence surrounding the success of Housing First.”
Talk to Your Legislators About The Lack of Transparency and the Growing Need for Housing and Services
Behind the legal jargon of executive initiatives, there lies a simple truth. For homeless people suffering from addiction disorder, housing and recovery go hand-in-hand. Any initiative that highlights the need for addiction services but fails to provide the funding to make that change possible lacks transparency.
The general public deserves clear and transparent information. Tell your local legislators to embrace strategies that prioritize permanent access to housing and services, because recovery requires more than just relief from addiction. It requires community, consistency, and purpose, and these things are difficult to acquire if you have no stable home.