A federal program credited with helping bring down opioid overdose deaths has stalled due to a delay in receiving its grant money. Dr. Céline Gounder has more.

The Food and Drug Administration has gutted a division responsible for training agency staff and outside health-care professionals on an array of key public health, regulation and safety practices and supporting professional development for employees, CNBC has learned. 

In an email viewed by CNBC, workers were notified that the Division of Learning and Organizational Development, or DLOD, faces cuts under Robert F. Kennedy Jr.’s broader plan to restructure the Department of Health and Human Services, or HHS. All of the more than 30 employees in the division were laid off. While it was a small team within the FDA, it was a key resource for the entire agency and external doctors, nurses, pharmacists and pharmacy technicians, among other professionals.

Kennedy is slashing 10,000 jobs at HHS, including roughly 3,500 full-time employees at the FDA, to focus on what HHS called “streamlining operations and centralizing administrative functions.” The FDA is responsible for regulating and overseeing the safety, efficacy, and security of human and veterinary drugs, medical devices, food and cosmetics, among other items.

HHS has said the cuts at the agency will not affect inspectors or reviewers of drugs, medical devices or food, and will primarily target workers deemed as having unnecessary responsibilities. But reports suggest that the Trump administration is eliminating some employees who played a key role in protecting public health, such as top veterinarians overseeing the FDA’s bird flu response amid outbreaks in poultry and U.S. dairy cows, along with several recent human cases.

Kennedy last week said some personnel and programs at federal agencies affected by his sweeping reductions will be reinstated, but it is unclear if that includes DLOD employees. The FDA did not immediately respond to a request for comment. 

The division is canceling all planned activities, including scientific and regulatory education along with leadership and organizational development, according to the email. It is also scrapping the processing and approval of any so-called continuing education activities across the FDA, which refers to formal educational programs that help agency staff and external health-care professionals stay up to date on medical science, public health and regulatory practices, the email said.

For example, some programs trained agency staff and external doctors, nurses and pharmacists about opioid safety, avoiding medication errors, infectious and rare diseases, clinical trials and using artificial intelligence to support regulatory decisions, according to two FDA employees, who requested anonymity to speak freely. The division also held monthly presentations to highlight research across the agency – such as a recent study on tobacco use –  and its impact on protecting public health, the employees said. 

There are now no staff available to award credits, or points for completing approved educational activities, such as lectures, online modules or workshops, according to one FDA employee. Depending on the state, health-care professionals must earn a certain number of credits each year or licensing cycle to maintain their credentials and stay up to date with medical knowledge and standards.

The FDA is also losing a central resource that employees can go to for professional development and training. 

“With the removal of DLOD, there’s a great deal of uncertainty about how learners and professionals will adapt,” one of the FDA employees said. “They are now responsible for independently finding and selecting their own courses, which may result in confusion or inefficiency.”

One office in the division was fully funded by so-called user fees, not taxpayer dollars, according to the two FDA employees. The FDA collects those fees from companies that produce certain products like drugs and medical devices and from other entities, such as certain certification bodies. 

The Trump administration has cited federal cost savings as part of its justification for laying off employees at HHS, raising questions about why it targeted that unit.

The office – known as the Continuing Education and Consultation Accreditation Team – was the only group within the FDA authorized to issue credits to both FDA employees and outside health-care professionals, the two employees said. The office included six workers, all of whom will lose their jobs.

The office was also the only “jointly accredited” unit within the FDA, which means it was qualified to provide training across different health-care disciplines, the employee said.

Opioid overdose deaths have now slowed to the lowest levels nationwide since 2020, according to new estimates from the Centers for Disease Control and Prevention. This marks the 12th straight month of decline since a peak last year. 

Around 70,655 deaths linked to opioids like heroin and fentanyl were reported for the year ending June 2024, the CDC now estimates, falling 18% from the same time in 2023.

Almost all states, except for a handful in the West from Alaska through Nevada, are now seeing a significant decrease in overdose death rates. Early data from Canada also suggests overdose deaths there might now be slowing off of a peak in 2023 too.

“While these data are cause for optimism, we must not lose sight of the fact that nearly 100,000 people are still estimated to be dying annually from drug overdose in the U.S.” said Dr. Nora Volkow, director of the National Institute on Drug Abuse, in a statement.

Other types of drug overdoses beyond opioids are also slowing. While they make up a smaller share of overall deaths, overdoses linked to drugs like methamphetamine and cocaine are also showing signs of dropping nationwide following a peak last year. 

“We are encouraged by this data, but boy, it is time to double down on the things that we know are working. It is not a time to pull back, and I feel very strongly, and our data shows, that the threat continues to evolve,” Dr. Allison Arwady, head of the CDC’s National Center for Injury Prevention and Control, told CBS News. 

Arwady pointed to a long list of factors that officials hope are contributing to the decline, ranging from broader availability of the overdose reversing spray naloxone, also known as Narcan, to efforts to ease gaps in access to medications that can treat opioid use disorder.

Trends in what health officials call “primary prevention” have also improved in recent years — meaning fewer people using the drugs to begin with. As an example, Arwady cited CDC surveys showing a clear decline in high school students reporting that they have tried illegal drugs. 

The CDC and health departments have also gotten faster at gathering and analyzing data to respond to surges in overdoses, Arwady said, often caused by new so-called “adulterants” that are mixed in. Health authorities study this by testing blood and drug samples taken in the wake of surges, in search of potential emerging drug threats.

Agency researchers are now looking closer at what could be behind gaps in communities that are still not seeing slowdowns, Arwady said.

“Unfortunately, for the most affected groups, namely Native Americans and Black American men, the death rates are not decreasing and are at the highest recorded levels,” said Volkow.

Why are drug overdose deaths declining?

In the months since CDC data first began showing real signs of a nationwide change to the deadly record wave of opioid overdose deaths, experts have floated a number of theories to explain what caused the change.

“We had been seeing the numbers go down, on the national aggregate level, since last April, and we were skeptical and kind of holding our tongues. Then we started hearing from a lot of folks on the ground, frontline providers,'” said Nabarun Dasgupta, a senior scientist at the University of North Carolina Chapel Hill who studies opioid overdose deaths.

Dasgupta led an analysis in September by the university’s Opioid Data Lab illustrating the nationwide scope of the downturn and probing a number of theories that might explain it.

Some explanations they dismissed as unlikely, like stepped-up law enforcement operations. Other ideas they judged as plausible, but complicated to prove, like a so-called “depletion of susceptibles” — essentially the epidemic burning itself out, as users either found ways to survive the influx of fentanyl or died — or the wider availability of naloxone.

Dasgupta said they received a flood of interest since their initial post proposing more theories, like new scanners that were deployed on the U.S.-Mexico border.

There are likely a number of factors all playing a role in the shift, Dasgupta says. But he said early data from research they are wrapping up now supports one leading explanation: a shift in the illegal drug supply.

“Our hypothesis is that something has changed in the drug supply. This kind of pronounced shift, something that happens suddenly, if numbers had suddenly shot up, we would definitely be pointing to a change in the drug supply to explain it,” said Dasgupta. 

Amid its downsides, xylazine‘s rise might have led to less injection drug use, they speculate. Its longer high could also be reducing the number of times people use fentanyl each day.

“We’re not in our offices celebrating. We’re still losing too many people that we love. So I just want it to be very clear that with like a hundred thousand people still dying, that’s obscenely high,” he said.

“With one push, you could save a life.” Framingham offers free Narcan training

Tasha Withrow, a co-founder of harm reduction organization Project Mayday, said Narcan wasn’t something she ever had access to when she was using opioids. A person in recovery, she now helps place boxes of naloxone in a community distribution box, where those in need can obtain the life-saving medication for free. 

Naloxone, a nasal spray most commonly known as Narcan, is used as an emergency treatment to reverse drug overdoses. Naloxone distribution containers have been proliferating across the country in the more than a year since the U.S. Food and Drug Administration approved its sale without a prescription. 

“People can just reach in and grab what they need — we didn’t have that back then,” Withrow said, while stocking a container in a residential neighborhood of Hurricane, West Virginia, earlier this week. “To actually see that there is some access now — I’m glad that we’ve at least moved forward a little bit in that direction.”

Such boxes — appearing in neighborhoods, in front of hospitals, health departments and convenience stores — are one way those supporting people with substance use disorder have sought to make Narcan, which can cost around $50 over the counter, accessible to those who need it most. Not unlike little free libraries that distribute books to anyone who wants one, the metal boxes  formerly used as newspaper receptacles aren’t locked and don’t require payment. People can take as much as they think they need.

Advocates say the containers help normalize the medication — and are evidence of steadily reducing stigma around its use. 

“It’s fortunate and unfortunate,” said Jeff Card, whose family company, for decades, was known for manufacturing the once ubiquitous tin boxes where people could buy newspapers on the street. Card started making the Narcan containers over two years ago. “Fortunate for us that we’ve got something to build, but unfortunate that this is what we have to build, given how bad the drug problem is in America.”

Sixty Narcan receptacles were distributed across 35 states in honor of Thursday’s “Save a Life Day” — a naloxone distribution and education event started by a West Virginia nonprofit in 2020. Containers were purchased from Card’s Texas-based Mechanism Exchange & Repair, which still serves newspaper customers but has expanded to manufacturing other products amid the newspaper industry’s decline.

Opioid deaths skyrocketed during pandemic

Opioid deaths were already at record levels before the coronavirus pandemic, but they skyrocketed when it hit in early 2020. The U.S. Centers for Disease Control and Prevention estimated there were about 85,000 opioid-related deaths in the 12 months that ended in April 2023. But since then, they fell. The CDC estimate for the 12 months that ended in April 2024 was 75,000 — still higher than any point before the pandemic.

The reasons for the decline are not fully understood. But it does coincide with Narcan, a medication that’s been hard to get in some communities, becoming available over the counter, as well as with the ramping up of spending of funds from legal settlements between governments and drugmakers, wholesalers and pharmacies.

The U.S. Food and Drug Administration approved use of Narcan to treat overdoses back in 1971, but its use was confined to paramedics and hospitals for decades. Narcan nasal spray was first approved by the FDA in 2015 as a prescription drug, and in March, it was approved for over-the-counter sales and started being available last September at major pharmacies.

“That took the barriers away. And that’s when we realized, ‘OK, now we need to increase access. How can we get naloxone into the communities?'” said Caroline Wilson, a West Virginia social worker and person in recovery who coordinated this year’s Save a Life Day.

Last year, all 13 states in Appalachia participated in the day spearheaded by West Virginia nonprofit Solutions Oriented Addiction Response. Community organizations in hundreds of counties table in parking lots, outside churches and clinics handing out Narcan and fentanyl test strips and training people on how to use it. They also work to educate the public on myths surrounding the medication, including that it’s unsafe to have in easily accessible places. Narcan has no effect on people who use it without opioids in their system.

This year, with the effort expanding to 35 states and a theme of “naloxone everywhere”, the group sent out 2,000 emergency kits containing one Narcan dose to be placed in locations like convenience store bathrooms or parks. The 60 tin newspaper boxes — which sell for around $350 apiece — were purchased with grants.

Aonya Kendrick Barnett’s harm reduction coalition Safe Streets Wichita installed one of the Kansas’ first Narcan receptacles — which she refers to as “nalox-boxes” — in February. The boxes, now sold by a few different companies, can look different, too. Some look like newspaper boxes, while others look like vending machines.

Since installing a vending machine Narcan container — which just requires a zip code be entered on the keypad to access the medication — it’s distributed around 2,600 packages a month.

“To say, ‘Hey, we have a 24-hour vending machine, come over here and come get what you need — no judgment,’ is so bold in this Bible belt state and it’s helping me break down the the stigma,” she said.

Kendrick Barnett said there’s no place for judgment when it comes to what she calls live-saving health care: “People are going to use drugs. It’s not our job to condemn or condone it. It’s our job to make sure that they have the necessary health care that they need to survive.”

The Save a Life Day box her organization received is going to go in front of their new clinic, scheduled to open in October.

In Erie, Pennsylvania, 74-year-old stained glass artist Larry Tuite said he grew concerned seeing overdoses increasing in his city. He began leaving Narcan packages on the windowsills of 24-hour markets in town that sell products like pipes and rolling papers. He was shocked at how quickly they disappeared.

“As many as I give out, I run through them really quickly,” said Tuite, who keeps cases of the drugs stacked along the walls of his studio apartment.

The Save a Life Day container, which he got permission to put outside one such store, has helped him to disperse even more Narcan. At least a dozen people have been saved by the medication he’s distributed, he said.

Opioid overdose deaths have dropped to the lowest they have been in three years, new estimates from the Centers for Disease Control and Prevention suggest, in the wake of a record surge of fatalities from the class of drugs that includes heroin and fentanyl during the COVID-19 pandemic. 

The CDC estimates that there were 75,091 opioid overdose deaths for the year ending in April 2024, according to provisional figures published this week by the agency. 

At its peak over last summer, the U.S. reached more than 86,000 estimated annual deaths. The pace of opioid overdose deaths still remains far worse than before the pandemic, when there were fewer than 50,000 fatal overdoses a year.

Fatal overdoses from other groups of drugs, like cocaine and other stimulants, have also been largely trending down. But the recent decline in opioid overdoses has driven the largest share of this year’s slowdown in deaths, which is down around 10% from its peak in August.

Not all states are tracking a decline in deaths. Several states around the Northwest, including Alaska, Colorado, Nevada, Oregon, Washington and Wyoming are still reporting overdoses nearly as high or higher than previous records.

Campaigning on overdoses

This year’s slowdown comes as former President Donald Trump has made the issue a central part of his campaign, often pointing out that overdoses were lower during his term.

The Republican candidate has made a number of pledges to “end the scourge of drug addiction” in the country, including working with states to force homeless addicts into treatment and punishing drug dealers with the death penalty.

“Under Kamala, drug overdose deaths are up 18%. But we’re going to stop the scourge,” Trump said last week, speaking to the Fraternal Order of Police in North Carolina.

Both Trump and his Democratic rival, Vice President Kamala Harris, have also tied curbing drug overdoses to immigration and border issues.

As a candidate in recent weeks, Harris has cited past work as a prosecutor in California trying cases against drug cartels and as vice president supporting a bipartisan immigration bill that the Biden administration blamed Trump for thwarting.

“It would have allowed us to stem the flow of fentanyl coming into the United States. I know there are so many families watching tonight who have been personally affected by the surge of fentanyl in our country,” Harris said at Tuesday’s debate.

Colorado law enforcement warning about opioid recently showing up in overdose toxicology reports

London — As authorities clamp down on fentanyl distribution and the amount of heroin produced in Afghanistan decreases under the Taliban, criminal enterprises have turned to a deadly alternative. Some health agencies in Europe are reporting a rise in deaths and overdoses from a type of synthetic opioid that can reportedly be hundreds of times stronger than heroin and up to forty times stronger than fentanyl.

2-Benzyl Benzimidazole opioids, commonly known as nitazines, are a class of synthetic compound developed in the 1950s as painkillers, but which were never approved for use as medicines.

Because of their potency, compared with natural opioids such as heroin or morphine, they can be much more addictive and more dangerous. Nitazines have been linked to a significantly greater proportion of overdose deaths in Estonia and Lithuania, and have been linked to overdoses in Ireland and on the French island of La Réunion.

Rising use of the drugs has also been noted in the U.S., where they’ve been dubbed “Frankenstein opioids,” in recent years, and they have been labelled a public health concern by the Drug Enforcement Administration. 

“Nitazenes pose a credible threat and… predicted changes in heroin availability in Europe could herald an increase in the use of synthetic opioids with possibly profound implications for public health,” the European Monitoring Centre for Drugs and Drug Addiction wrote in a letter to the Lancet public health journal in February. “We cannot assume that existing approaches to responding to opioid problems will be sufficient without adapting to the challenges posed by the appearance of a range of highly potent but pharmacologically diverse substances.”

On Wednesday, the U.K. government announced that it was classifying 14 nitazenes as Class A drugs, meaning they will be placed under the strictest controls alongside fentanyl, “to prevent drug related deaths in the U.K. and ensure anyone caught supplying these substances faces tough penalties.”

“Synthetic opioids are significantly more toxic than heroin and have led to thousands of deaths overseas,” Britain’s Crime and Policing Minister Chris Philp said in a statement. “We are determined to ensure these destructive and lethal drugs do not take hold in our communities in the U.K.”

Dr. Adam Holland, a drug researcher at England’s Bristol University, wrote a commentary piece in the Lancet in January saying nitazenes had been detected in other drugs being sold as other opioids, along with benzodiazepines and cannabis products, meaning users may not be aware of the risks they face. 

Holland said the gap in the European heroin market created by the Taliban’s crackdown on production in Afghanistan could lead to a boom in nitazenes across Europe.

“Without concerted action, nitazenes could devastate communities of people who use a range of drugs, including those who use drugs infrequently or source benzodiazepines and opioid painkillers from the internet,” Holland warned.

Kroger said Friday that it will pay up to $1.4 billion over 11 years to settle most of the litigation against the grocery giant stemming from the opioid epidemic that has ravaged the U.S. for more than a decade.

Kroger, one of the country’s largest supermarket and drugstore chains, said the money will go to states and local governments, including $36 million to Native American tribes, to help fund treatment and other efforts to deal with the ongoing crisis. Another $177 million will go to cover attorney costs and related legal fees. 

Kroger has stores in 35 states, and 33 would be eligible for money as part of the deal. The company previously announced settlements with New Mexico and West Virginia.

“This is an important milestone in the company’s efforts to resolve the pending opioid litigation and support abatement efforts,” Kroger said in a statement. “Kroger has long served as a leader in combating opioid abuse and remains committed to patient safety.”

The company did not admit any wrongdoing or liability under the settlement. 

Opioids kill an estimated 80,000 people a year in the U.S., with the latest wave of deaths tied to illicit synthetic drugs such as fentanyl rather than prescription painkillers.

Jayne Conroy, a lawyer for the governments suing the companies, told The Associated Press in an interview Friday that it is appropriate that major prescription drug providers help fund efforts to deal with the devastating impact of opioids.

“It really isn’t a different problem,” she said. “The problem is the massive amount of addiction. That addiction stems from the massive amount of prescription drugs.”

Many of the nation’s largest retailers have paid out billions of dollars to states and cities around the country to resolve lawsuits over their role in dispensing opioids, which experts say has claimed hundreds of thousands of lives in the U.S. and other countries around the world. 

In May, for example, Walgreens agreed to pay San Francisco nearly $230 million to settle a case over the pharmacy chain’s distribution of opioids. 

Walmart this summer reached a $168 million deal with Texas prosecutors, who had accused the largest U.S. retailer of worsening the opioid crisis. That followed a $3.1 billion settlement Walmart struck in 2022, while pharmacy gains CVS and Walgreens last year agreed to pay more than $10 billion combined to resolve opioid-related suits. 

Opioid litigation is continuing against other retailers, including supermarket chains Publix and Albertsons. Pharmacy benefit managers such as Express Scripts and OptumRx also face opioid claims from governments.

—The Associated Press contributed to this report.

MINNEAPOLIS – It’s a struggle many in the East African community suffer through silently.

Opioid addiction is impacting young and old, and now a documentary – “The Forgotten Ones” – is being released in order to break down stigmas and encourage support.

Abdirahman Warsame is the film’s producer.

“Through the storytelling you know, people will start to empathize. And through that empathy we hope to create connection because the opposite of addiction and sobriety is connection,” Warsame said.

He says this story needed to be told.

MORE NEWS: Minnesota Poison Control reports “alarming” rise in opioid poisoning in young children

“So many people are struggling all around, and I feel like there’s such a disparity in resources,” Warsame said. “Being a Somali immigrant, there’s no data collection, there’s no stats when it comes to our community. People are struggling and dying everyday and nobody knows about it.”

The documentary highlights the suffering.

“Parents would wake up in the morning to wake their children up and they would see them dead,” he said. “I remember there was a month where seven people died within our community. Nobody talked about it.”

This 25-year-old knows firsthand how bad the opioid epidemic is.

“I was addicted to fentanyl,” he said. “I didn’t think that I was gonna reach 22.”  

Warsame’s struggles are typical in Minneapolis’ Cedar-Riverside neighborhood, where he grew up.

“I grew up in that neighborhood and I struggled in that neighborhood, and there wasn’t really much people to help me,” he said. “But it’s not because people didn’t want to help me. They didn’t know how.”

That’s why he founded Generation Hope, a licensed peer recovery support organization that provides help to overcome addiction. 

“A lot of times people just try to keep that stuff inside in fear of judgment, in fear of being pushed away. And it’s really why we do the work that we do and try to shed light on the issue, and try to show people that, you know, you’re not alone.”

MORE NEWS: New interactive dashboard reports on opioid, substance use cases in Hennepin County

“The Forgotten Ones” shows addiction up close in hopes of getting rid of stigmas that stop people from reaching out for help, and gather resources to make it all possible.

“We’re all struggling with this, and this is not a Somali issue. This is not a minority issue. This is a human issue,” Warsame said. “Addiction’s affecting lives everywhere.”

There’s a special showing of “The Forgotten Ones” Friday at 7 p.m. at Macalester College in St. Paul. 

Warsame will also unveil plans for a new drop-in center at Cedar-Riverside, the epicenter of the opioid epidemic in the East African Community.