I am thrilled you have signed on to the Bulwark; we are headed into some dark times in health care, we need an informed correspondent to let us know what is going on in DC.
I'm concerned about the elimination of SAMHSA; their work in substance abuse and mental health are vital pieces of health care. The pulling back of funding will not only result in more deaths (both suicides and overdoses) but will have an affect on businesses and will lead to increased public spending. Drug abusers often do not have a dependable source of income, i.e. they steal. They often do not have homes, i.e. they sleep in doorways in front of businesses and the sidewalk is used as their toilet. Most substance abusers are covered under Medicaid and are frequent flyers in the ER; many requiring admission to the hospital and some to the ICU. Even when addicts are ready for sobriety, they currently often have to wait 3-6 months for a bed in a treatment facility. I believe a significant accounting for the reduction in deaths has to do with Suboxone and the incredible substance use navigators (SUNs) in hospital ERs as well as the providers and counselors at MAT (medically assisted treatment) clinics. We are making headway in substance use disorder (it could be better) but to cut back on funding for research and treatment will be devastating.
Welcome Jonathan - another fab addition to The Bulwark team! I don’t look forward to reading your newsletters but only because the topic is painful. Good luck with the new job.
As someone who has been in recovery for 23 years, I have seen first-hand from friends how treatment works, and just punishment doesn't. The so-called "war on drugs" since the Nixon administration has been a miserable failure in terms of reducing addiction and overdosing. The current Mexican President made an excellent point (although didn't harp on it) that if we want to stop fentanyl coming from Mexico, we should work more on drying up demand. Punishment alone may keep people clean for a short period but it doesn't address WHY they became addicts - that comes from the hard work of recovery. The cycle of despair in rural areas that is a big part of the opioid crisis has to be addressed holistically, or people will simply return to their drug of choice - or just switch to something else when the government cracks down on supply. It is also worth mentioning that the crack cocaine epidemic was not taken nearly as seriously by Republicans (and some Democrats) as the opioid crisis, but that's my social justice flag going up.
We just got a cease and desist all grant funded (ARPA) activities connected with substance abuse treatment. And that's not SAMHSA, its DMHAS (mental health and substance abuse) . Its all coming apart.
Welcome aboard. Thanks for explaining SAMHSA so well. I want to pay particular attention to what happens with 988. It's so important that people have that number to call, and I'm worried about what will happen to it.
Both he doesn’t know and doesn’t care. He’s more likely to criticize substance abuse workers and abusers and call them names than care. He never bothers to consult others about data or anything. He just makes it up to satisfy himself. The only data he cares about is $ in his coffers and those of his friends. Damn, I’ve become even more cynical.
Remember, when you leave your home with your little protest sign--you are not alone. With the anticipated thousands [million+?] of heroic protestors on April 5th (actually any and all days, including Women's March) here's an updated partial list of those fighting back every day [as of 3-30-25). I'm also adding courageous law firms who haven't caved. Besides upstanding lawyers, and law-abiding honorable (present and former) judges (including James Boasberg, chief judge, D.C. District Ct.), here's a growing list of Profiles in Courage men, women, and advocacy groups who refuse to be cowed or kneel to the force of Trump/Musk/MAGA/Fox "News" intimidation:
I'll begin (again) with Missouri's own indomitable Jess[ica] (à la John Lewis's "get in good trouble") Piper/"The View from Rural Missouri," then, in no particular order, Francie Garber Pepper (1940-2025), Heather Cox Richardson/"Letters from an American," Joyce Vance/"Civil Discourse," Bernie Sanders, AOC, Gov. Tim walz, Sarah Inama, Rev. Mariann Edgar Budde, Rev. William J. Barber II, Jasmine Crockett, Ruth Ben-Ghait, Rachel Maddow, Lawrence O'Donnell, Chris Hayes, Ali Velshi, Prof. Lawrence Tribe, Stephanie Miller, Gov. Janet Mills, Gov. Beshear, Gov. JB.Pritzker, Gov. Kathy Hochul, Amb. Susan Rice, Mayor Michelle Wu, Jim Acosta, Jen Rubin And the Contrarians, Dan Rather, Robert Reich, Jay Kou, Steve Brodner, Rachel Cohen, Brian TylerCohen, Jessica Craven, Scott Dworkin, Brett Meiselas, Joy Reid, D. Earl Stevens, Melvin Gurai, Dan Pfeiffer, Anand Giridharadas Anne Applebaum, Lucian Truscott IV, Chris Murphy, Jeff Merkley, Michael Bennett, Elizabeth Warren, Tammy Duckworth, Sheldon Whitehouse, Adam Schiff, Jon Ossoff, Elyssa Slotkin, Tristan Snell, Delia Ramirez,Tim Snyder, Robert B. Hubbell, Ben Meiseilas, Rich wilson, Ron Filpkowski, Jeremy Seahill, Thom Hartmann, Jonathan Bernstein, Simon Rosenberg, Marianne Williamson, Mark Fiore, Jamie Raskin, Rebecca Solnit, Steve Schmidt, Josh Marshall, Paul Krugman, Andy Borowitz, Jeff Danziger, Ann Telnaes,͏ ͏Will Bunch, Jim Hightower, Dan Pfeifer, Dean Obeidallah, Michel Zeitgeist, Liz Cheney, Adam Kimzinger, Cassidy Hutchinson, John Cusack. Rep. Pramila Jayapal, Jonathan V Last, Sarah Longwell, Andrew Egger, Aaron Parnas
American Bar Association, 23 blue state Attorney Generals, Indivisible. FiftyFifty one, MoveOn, DemCast, Blue Missouri, Third Act, Democracy Forward, Public Citizen, Democracy Index, Protect Democracy, DemocracyLabs, Fred Wellman/On Democracy, Hands Off, Marc Elias/Democracy Docket, Public Citizen, League of Women Voters, Lambda Legal, CREW, CODEPINK, ACLU, The 19th/Errin Haines, Working Families Party, American Oversight, Every State Blue, Run for Something, Jessica Valenti/Abortion Everyday, The American Manifesto, The Dr. Martin Luther King Center, Bulwark Media, Bill Kristol/all NeverTrumpers
And, as Joyce Vance says, "We're in this together"--or via Jess Piper, from rural Missouri: "Solidarity." FIGHT BACK! WE ARE NOT ALONE! (Latest addition h/t , Robert B. Hubbell: Law firms, see below). All suggestions are welcome.
* Perkins Coie and Covington & Burling have resisted Trump, fighting back with the help of other courageous firms like Williams & Connolly. Per The ABA Journal, Wilmer Cutler Pickering Hale and Dorr, representing fired inspectors general. (Law.com)
Hogan Lovells, seeking to block executive orders to end federal funding for gender-affirming medical care. (Law.com)
Jenner & Block, also seeking to block the orders on cuts to medical research funding. (Law.com, Reuters)
Ropes & Gray, also seeking to block cuts to medical research funding. (Law.com)
Gibson, Dunn & Crutcher, representing the Amica Center for Immigrants Rights and others seeking to block funding cuts for immigrant legal services. (Law.com)
Arnold & Porter Kaye Scholer.
Wilmer Hale
Keker, Van Nest & Peters
Southern Poverty Law Center
Perhaps I should add our nation's motto--and on our Great Seal--the phrase "E pluribus unum" (out of many, One ). Ii's 13 letters makes its use symbolic of the original 13 Colonies which rebelled against the rule of the Kingdom of George III . . .And now we protest together against King Donald. As my rural MO. indomitable Jess Piper always says: "Solidarity."
Welcome Jonathan! I’m a grandmother who studied Abnormal Psychology in 1961 and subsequently taught MS Science. I’ve also worked in Outcomes Research but my comments are just my opinions. Too many of our wonderful people are “drowning” in drugs. We need to address all types of drugs, prescription and street, that are taken to not only for pain but also to feel up or come down, for sleep, anxiety and stress. There was an article today on the terrible difficulty getting off Zoloft because it actually causes changes in the brain. Marijuana smoking leaves bits of tar in the brain slowing thinking and movement. Kids sucking Helium from a balloon makes their voices sound squeaky but for every group of kids who do it, those with asthma get quite ill. We could go on and on with Poppers, Hallucinogens, Ketamine, valium and cocaine plus all the party drugs. In my life, I have taken prescribed drugs plus weed and Benzedrine a couple of times in college but I’m fortunate to have friends, family and doctors who helped me stop and get into healthier activities. We have focused on opioids in the past 10 years but to get folks off their phones and drugs of choice, we also need to provide more affordable activities to do together in groups.
It's a major part of the MAGA strategy: anyone who is poor, disabled, different, and could use some kind of assistance for any reason, like having the measles, the best way to make the problem disappear is to let those people die. It also saves money that can be used to pay Musk for his exploding rockets
I'm glad to have your help ! We are in a hell scape of miseries measles flu viruses RFKjr as health czar is causing suffering and death just like Covid ! Help!
I think they couldn't care less. Elon and trump are so out of touch with normal people, and really ANY normal experiences, that they live in an alternate reality. We are not real people to them.
Trump and Musk do not care about the impact their actions have and had on the American society and population. Their sole goal is to eliminate government supervision over their economic interests and extend the tax cut enacted in Trump's first term.
welcome... I feel like this administration is deliberately trying to kill people... save some bucks here and there for tax cuts for the rich and contracts for Elon
I already lost one granddaughter, and two of her brothers are users, thus are part of the opioid crisis. I don't know what to do to help my grandsons but pray that they get the help they need to come clean.
I am thrilled you have signed on to the Bulwark; we are headed into some dark times in health care, we need an informed correspondent to let us know what is going on in DC.
I'm concerned about the elimination of SAMHSA; their work in substance abuse and mental health are vital pieces of health care. The pulling back of funding will not only result in more deaths (both suicides and overdoses) but will have an affect on businesses and will lead to increased public spending. Drug abusers often do not have a dependable source of income, i.e. they steal. They often do not have homes, i.e. they sleep in doorways in front of businesses and the sidewalk is used as their toilet. Most substance abusers are covered under Medicaid and are frequent flyers in the ER; many requiring admission to the hospital and some to the ICU. Even when addicts are ready for sobriety, they currently often have to wait 3-6 months for a bed in a treatment facility. I believe a significant accounting for the reduction in deaths has to do with Suboxone and the incredible substance use navigators (SUNs) in hospital ERs as well as the providers and counselors at MAT (medically assisted treatment) clinics. We are making headway in substance use disorder (it could be better) but to cut back on funding for research and treatment will be devastating.
Welcome Jonathan - another fab addition to The Bulwark team! I don’t look forward to reading your newsletters but only because the topic is painful. Good luck with the new job.
As someone who has been in recovery for 23 years, I have seen first-hand from friends how treatment works, and just punishment doesn't. The so-called "war on drugs" since the Nixon administration has been a miserable failure in terms of reducing addiction and overdosing. The current Mexican President made an excellent point (although didn't harp on it) that if we want to stop fentanyl coming from Mexico, we should work more on drying up demand. Punishment alone may keep people clean for a short period but it doesn't address WHY they became addicts - that comes from the hard work of recovery. The cycle of despair in rural areas that is a big part of the opioid crisis has to be addressed holistically, or people will simply return to their drug of choice - or just switch to something else when the government cracks down on supply. It is also worth mentioning that the crack cocaine epidemic was not taken nearly as seriously by Republicans (and some Democrats) as the opioid crisis, but that's my social justice flag going up.
We just got a cease and desist all grant funded (ARPA) activities connected with substance abuse treatment. And that's not SAMHSA, its DMHAS (mental health and substance abuse) . Its all coming apart.
It is all coming apart.......
Welcome aboard. Thanks for explaining SAMHSA so well. I want to pay particular attention to what happens with 988. It's so important that people have that number to call, and I'm worried about what will happen to it.
Both he doesn’t know and doesn’t care. He’s more likely to criticize substance abuse workers and abusers and call them names than care. He never bothers to consult others about data or anything. He just makes it up to satisfy himself. The only data he cares about is $ in his coffers and those of his friends. Damn, I’ve become even more cynical.
Welcome, and thank you!
Remember, when you leave your home with your little protest sign--you are not alone. With the anticipated thousands [million+?] of heroic protestors on April 5th (actually any and all days, including Women's March) here's an updated partial list of those fighting back every day [as of 3-30-25). I'm also adding courageous law firms who haven't caved. Besides upstanding lawyers, and law-abiding honorable (present and former) judges (including James Boasberg, chief judge, D.C. District Ct.), here's a growing list of Profiles in Courage men, women, and advocacy groups who refuse to be cowed or kneel to the force of Trump/Musk/MAGA/Fox "News" intimidation:
I'll begin (again) with Missouri's own indomitable Jess[ica] (à la John Lewis's "get in good trouble") Piper/"The View from Rural Missouri," then, in no particular order, Francie Garber Pepper (1940-2025), Heather Cox Richardson/"Letters from an American," Joyce Vance/"Civil Discourse," Bernie Sanders, AOC, Gov. Tim walz, Sarah Inama, Rev. Mariann Edgar Budde, Rev. William J. Barber II, Jasmine Crockett, Ruth Ben-Ghait, Rachel Maddow, Lawrence O'Donnell, Chris Hayes, Ali Velshi, Prof. Lawrence Tribe, Stephanie Miller, Gov. Janet Mills, Gov. Beshear, Gov. JB.Pritzker, Gov. Kathy Hochul, Amb. Susan Rice, Mayor Michelle Wu, Jim Acosta, Jen Rubin And the Contrarians, Dan Rather, Robert Reich, Jay Kou, Steve Brodner, Rachel Cohen, Brian TylerCohen, Jessica Craven, Scott Dworkin, Brett Meiselas, Joy Reid, D. Earl Stevens, Melvin Gurai, Dan Pfeiffer, Anand Giridharadas Anne Applebaum, Lucian Truscott IV, Chris Murphy, Jeff Merkley, Michael Bennett, Elizabeth Warren, Tammy Duckworth, Sheldon Whitehouse, Adam Schiff, Jon Ossoff, Elyssa Slotkin, Tristan Snell, Delia Ramirez,Tim Snyder, Robert B. Hubbell, Ben Meiseilas, Rich wilson, Ron Filpkowski, Jeremy Seahill, Thom Hartmann, Jonathan Bernstein, Simon Rosenberg, Marianne Williamson, Mark Fiore, Jamie Raskin, Rebecca Solnit, Steve Schmidt, Josh Marshall, Paul Krugman, Andy Borowitz, Jeff Danziger, Ann Telnaes,͏ ͏Will Bunch, Jim Hightower, Dan Pfeifer, Dean Obeidallah, Michel Zeitgeist, Liz Cheney, Adam Kimzinger, Cassidy Hutchinson, John Cusack. Rep. Pramila Jayapal, Jonathan V Last, Sarah Longwell, Andrew Egger, Aaron Parnas
American Bar Association, 23 blue state Attorney Generals, Indivisible. FiftyFifty one, MoveOn, DemCast, Blue Missouri, Third Act, Democracy Forward, Public Citizen, Democracy Index, Protect Democracy, DemocracyLabs, Fred Wellman/On Democracy, Hands Off, Marc Elias/Democracy Docket, Public Citizen, League of Women Voters, Lambda Legal, CREW, CODEPINK, ACLU, The 19th/Errin Haines, Working Families Party, American Oversight, Every State Blue, Run for Something, Jessica Valenti/Abortion Everyday, The American Manifesto, The Dr. Martin Luther King Center, Bulwark Media, Bill Kristol/all NeverTrumpers
And, as Joyce Vance says, "We're in this together"--or via Jess Piper, from rural Missouri: "Solidarity." FIGHT BACK! WE ARE NOT ALONE! (Latest addition h/t , Robert B. Hubbell: Law firms, see below). All suggestions are welcome.
* Perkins Coie and Covington & Burling have resisted Trump, fighting back with the help of other courageous firms like Williams & Connolly. Per The ABA Journal, Wilmer Cutler Pickering Hale and Dorr, representing fired inspectors general. (Law.com)
Hogan Lovells, seeking to block executive orders to end federal funding for gender-affirming medical care. (Law.com)
Jenner & Block, also seeking to block the orders on cuts to medical research funding. (Law.com, Reuters)
Ropes & Gray, also seeking to block cuts to medical research funding. (Law.com)
Gibson, Dunn & Crutcher, representing the Amica Center for Immigrants Rights and others seeking to block funding cuts for immigrant legal services. (Law.com)
Arnold & Porter Kaye Scholer.
Wilmer Hale
Keker, Van Nest & Peters
Southern Poverty Law Center
Perhaps I should add our nation's motto--and on our Great Seal--the phrase "E pluribus unum" (out of many, One ). Ii's 13 letters makes its use symbolic of the original 13 Colonies which rebelled against the rule of the Kingdom of George III . . .And now we protest together against King Donald. As my rural MO. indomitable Jess Piper always says: "Solidarity."
Thanks for the post. The list is encouraging and yes, April 5th will be, I think, huge!
Thanks for reading. Forward in solitary
Welcome Jonathan! I’m a grandmother who studied Abnormal Psychology in 1961 and subsequently taught MS Science. I’ve also worked in Outcomes Research but my comments are just my opinions. Too many of our wonderful people are “drowning” in drugs. We need to address all types of drugs, prescription and street, that are taken to not only for pain but also to feel up or come down, for sleep, anxiety and stress. There was an article today on the terrible difficulty getting off Zoloft because it actually causes changes in the brain. Marijuana smoking leaves bits of tar in the brain slowing thinking and movement. Kids sucking Helium from a balloon makes their voices sound squeaky but for every group of kids who do it, those with asthma get quite ill. We could go on and on with Poppers, Hallucinogens, Ketamine, valium and cocaine plus all the party drugs. In my life, I have taken prescribed drugs plus weed and Benzedrine a couple of times in college but I’m fortunate to have friends, family and doctors who helped me stop and get into healthier activities. We have focused on opioids in the past 10 years but to get folks off their phones and drugs of choice, we also need to provide more affordable activities to do together in groups.
It's a major part of the MAGA strategy: anyone who is poor, disabled, different, and could use some kind of assistance for any reason, like having the measles, the best way to make the problem disappear is to let those people die. It also saves money that can be used to pay Musk for his exploding rockets
Similarly old and in the way, I agree with your diagnosis.
What an informative and well-written article. Tx u!
I'm glad to have your help ! We are in a hell scape of miseries measles flu viruses RFKjr as health czar is causing suffering and death just like Covid ! Help!
I think they couldn't care less. Elon and trump are so out of touch with normal people, and really ANY normal experiences, that they live in an alternate reality. We are not real people to them.
Trump and Musk do not care about the impact their actions have and had on the American society and population. Their sole goal is to eliminate government supervision over their economic interests and extend the tax cut enacted in Trump's first term.
welcome... I feel like this administration is deliberately trying to kill people... save some bucks here and there for tax cuts for the rich and contracts for Elon
I already lost one granddaughter, and two of her brothers are users, thus are part of the opioid crisis. I don't know what to do to help my grandsons but pray that they get the help they need to come clean.
I'm so sorry.