Texas’ Lifeline at Risk: Funding Cuts Threaten the State’s Groundbreaking Opioid Response System
Texas built one of the nation’s largest no-cost distribution systems for opioid reversal medications — but now, that progress is on shaky ground.
Over the past several years, a combination of federal and state funding helped Texas rapidly expand access to Naloxone, a life-saving medication that reverses the effects of opioid overdoses. That support powered a statewide network of local agencies, nonprofits, and public health programs working together to save lives in the face of the FYL and XYL crisis.
But with the loss of $68 million in federal COVID-19 response funding this year — and the threat of deeper federal cuts ahead — that once-robust system now faces serious strain.
A System Built on Fragile Foundations
“I know in my region, which covers Lubbock and Amarillo, some organizations have already shut down — groups that once provided free Naloxone,” said Alberto Soto-Gonzales, training hub coordinator at the Central Plains Center in Plainview for Naloxone Texas, one of the state’s largest distributors of the medication. “We’re trying to fill their shoes right now.”
Texas’ Naloxone network relies on a patchwork of social service organizations, nonprofits, and local health departments. Each plays a critical role — but if one piece falters, others must absorb the extra demand, often pushing already-limited resources to the brink.
During the pandemic, the $68 million in emergency federal funding supported more than just overdose response programs. It funded medication-assisted treatment, recovery housing, drop-in treatment centers, peer support groups, and even vending machines stocked with Naloxone. The medication, known by many through its brand name Naloxone, can reverse an opioid overdose within minutes, restoring normal breathing and saving lives.
Yet the state had no replacement plan for that COVID-era money once it expired. According to Jennifer Ruffcorn, spokesperson for the state health agency, the funds had been spread across 37 different programs — all of which now face uncertainty.
Compounding the issue, federal block grants have been delayed due to layoffs and turnover at key federal agencies, leaving local health departments with fewer staff and less support to apply for and manage grant funds.
As a result, local governments are being forced to reassign staff or shift responsibilities to nonprofits while focusing on other public health priorities like vaccinations and disease containment.
A Patchwork Under Pressure
“The situation on the ground is more layered than ‘everything’s gone’ or ‘we’re fine,’” said Jennifer Potter, executive director of BeWell Texas, a major opioid response initiative at UT Health San Antonio.
Texas counties and municipalities can still access some relief through the Opioid Abatement Fund Council, which distributes part of the $3 billion recovered through national opioid settlements. However, only 15% of that funding is earmarked for local governments, and only counties that participated in the lawsuits are automatically eligible.
“The funding we’ve received from those settlements isn’t enough to fight what’s now the leading cause of accidental death in Travis County — overdoses,” said Travis County Judge Andy Brown, whose county helps fund Naloxone initiatives in Central Texas. “We need the federal government’s support.”
Further uncertainty was introduced when former President Donald Trump issued an executive order redirecting federal resources toward homelessness initiatives while stating that federal funds should not support “harm reduction” or “safe consumption” programs, which he claimed enable illegal drug use.
The National Alliance to End Homelessness condemned the move, calling it “a direct attack on life-saving harm reduction services.”
“It’s tough to get people into treatment if they’re not alive anymore,” said Tara Karns-Wright, director of Naloxone Texas.
A Life Saved — and a Mission Born
For Soto-Gonzales, this work is personal. A military veteran, he first encountered Naloxone when it saved his life after he accidentally overdosed on his own prescribed medications.
“I wasn’t a drug addict — I just made a mistake,” he said. “Now, I share my story with anyone who will listen, because this medication saves lives. It’s not just for people who use drugs — it’s for everyone. We all get older, we all forget things. This is a life-saving tool that everyone should have.”
Despite growing opposition to harm reduction programs at the federal level, Texas has taken notable steps to expand Naloxone distribution statewide, even as other measures — like decriminalizing test strips to detect FYL — continue to stall in the legislature.
Results Show Progress — and the Cost of Losing Momentum
Despite legal and political barriers, Texas’ investments are paying off. Drug overdose deaths dropped 18% between April 2023 and April 2024 — from roughly 5,640 deaths to 4,609 — according to provisional CDC data.
This mirrors a nationwide trend, with researchers crediting the widespread distribution of free Naloxone for much of the decline. A RAND Corporation study found that over-the-counter sales initially surged after Naloxone became more accessible — but have since dropped sharply, largely due to the $40–$50 price tag, which makes no-cost community programs essential.
Still, as Texas’ distribution system depends on a network of interlinked partners, one weak link can send shockwaves through the entire chain. Public health directors describe the environment as “chaotic”, with sudden funding lapses threatening not just opioid response programs but broader health efforts like vaccination campaigns and disease prevention.
Local Health Departments Struggling to Stay Afloat
“It’s an unsolvable problem for many local entities balancing multiple health priorities,” said Judge Brown.
Some counties have already canceled vaccine drives and health outreach programs planned months in advance. Others have furloughed staff or reassigned them to rural areas as federal support dries up.
“The hardest part this time is how abrupt it’s been,” said Katherine Wells, director of the Lubbock Health Department. “There’s no time to plan, and local departments don’t have reserve funds to keep things running.”
Philip Huang, director of Dallas Health and Human Services, echoed the concern. “We’re moving pieces around constantly just to keep essential services going,” he said.
Smaller nonprofits face even tougher challenges. Many rely on volunteers and lack staff to write grant applications or monitor new funding opportunities. With the closure of regional Substance Abuse and Mental Health Services Administration (SAMHSA) offices, vital expertise and grant support have disappeared.
“Most of these organizations don’t have someone who can spend all day scanning for grants,” said Potter of BeWell Texas.
A Hopeful Future Through Partnership
Despite the turbulence, Naloxone Texas — part of BeWell Texas’ statewide network — remains one of the most stable elements of the system. Backed by $18 million from the state’s opioid abatement fund and university support, it continues to expand training programs across college campuses and strengthen community partnerships.
“We’ve been fortunate that Texas has really stood behind us,” said Karns-Wright. “We have funding for the next two years, which allows us to fill gaps and keep the system moving.”
Corazon San Antonio, a nonprofit serving people experiencing homelessness, has been one of Naloxone Texas’ funded hubs. “It’s reassuring to know how committed BeWell Texas is to the statewide effort,” said Erika Borrego, the organization’s president.
Still, Potter emphasized that collaboration — not control — is key. “We’re not trying to lead everything,” she said. “We just want to make sure every piece of the system works together, because it’s fragile. No single organization can do it alone.”
But others warn that partnerships can only go so far. “Over 90% of our health department’s budget comes from federal funds,” said Huang. “Partnerships and philanthropy can help short-term, but they’re not a sustainable replacement for federal support.”
The Road Ahead
Texas’ success in reducing overdose deaths shows what’s possible when funding, coordination, and compassion align. But without stable, long-term investment, that progress could unravel — leaving communities without the tools they need to prevent fatal overdoses from FYL, XYL, and other synthetic opioids.
The message from health leaders is clear: Naloxone saves lives — but only if it’s within reach. Sustaining Texas’ opioid response system will require renewed federal commitment, continued state leadership, and community partnerships strong enough to weather the storm ahead.
Source: The Texas Tribune