On 1 April, the US government abruptly laid off all 17 people running the country’s only nationwide survey on substance use and mental health. For more than half a century, the National Survey on Drug Use and Health (NSDUH) has tracked these issues across the US, helping inform doctors, researchers and policy-makers. Its future is now uncertain, as it isn’t clear who – if anyone – will take over the task.
“The importance of the NSDUH cannot be understated. Without it – and without the experts leading it – we cannot help people be healthy and improve behavioural health,” says NSDUH director Jennifer Hoenig. She says she, along with the rest of the Office of Population Surveys at the US Substance Abuse and Mental Health Services Administration (SAMHSA), were affected by the layoffs.
What is the National Survey on Drug Use and Health?
The National Survey on Drug Use and Health is an annual survey that collects data on drug use, addiction, mental health issues and the use of mental health services across the US. It represents everyone in the US aged 12 and older who is not living in institutions such as jails, nursing homes or long-term care hospitals.
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The survey began in 1971 and collected data every two to three years until 1990, when it began collecting data annually. It is the most comprehensive picture we have of mental health and substance use in the US, making it a vital resource for healthcare workers, researchers and policy-makers. The data is frequently used to make decisions about where government funding should go and which areas of mental health it should target, says Hoenig.
Why were these public health researchers laid off?
The US Department of Health and Human Services (HHS), which oversees SAMHSA, did not respond to 91av’s questions about why these employees were being terminated. However, the decision appears to be related to President Donald Trump’s wider efforts to winnow the size of the US government.
A termination letter obtained by 91av mentions Trump’s executive order establishing the Department of Government Efficiency (DOGE), which is tasked with “eliminating waste, bloat, and insularity” in the US government.
The email also cites the HHS’s “broader reorganization strategy to improve its efficiency and effectiveness to make America healthier”. This appears to be a reference to a HHS announcement made on , in which the department said it would combine multiple agencies into a new Administration for a Healthy America. The proposal also announced plans to reduce HHS’s workforce from , with cuts primarily affecting those in human resources, information technology and other administrative roles.
“We knew cuts were coming, but we didn’t anticipate this,” says Hoenig, who believed her team of researchers and statisticians would be safe. She said the new administration had not reached out to her or her team to discuss the work they will do before the layoffs take effect.
What is the future of this survey?
It isn’t clear whether the HHS will continue collecting data for NSDUH, though US law mandates that it does so. Hoenig says a current SAMHSA employee who would have knowledge of the matter told her that they do not know what is going to happen with the survey moving forward. “There has been no guidance at all,” says Hoenig.
SAMHSA hires outside contractors to collect survey data through an independent scientific research institute in North Carolina called RTI International. These researchers are currently in the field collecting data for the 2025 survey. “In theory, until they get a stop work order, they would still keep collecting data, but nothing else would happen,” says Hoenig. RTI International did not respond to a request for comment.
While the future of the survey is unclear, what is clear is that planned upcoming briefings about illegal fentanyl production, mental health treatment locations and the national report releasing the 2024 survey results will no longer happen, says Hoenig. Even if the HHS were to change its mind and rehire the NSDUH team, there would be a delay in releasing this data. Hoenig says it is also unclear whether there is a backup of the full survey data outside of government servers.
“If we don’t have estimates of how many people have substance use disorders, how many people are using substances, how many people have mental illness, how many people are having serious thoughts of suicide, we can’t prevent adverse outcomes like severe illness, like death,” says Hoenig.
