On Feb. 2, the Department of Health and Human Services announced that it was investing $100 million in what it called “Great American Recovery.” This funding will support a pilot program in eight U.S. cities focused on court-ordered treatment, psychiatric care, crisis intervention, and recovery-oriented housing. It rejects harm-reduction and housing-first approaches. In the announcement, Secretary Robert F. Kennedy Jr. says, “addiction begins in isolation and ends in reconnection.”
On its face, the new program seems to have strong scientific grounding: Social connection is central to recovery from substance use disorders. As studies have shown, and as I found in my own doctoral dissertation on social connection and substance use, social relationships emerge as a critical factor, both in terms of the risk of isolation and the benefits of social supports in recovery.
But despite the new program’s promising rhetoric, the scientific framing of the announcement obscures a deeper policy problem. HHS is advancing a vision of abstinence-only recovery rooted in social connection, while simultaneously rejecting harm-reduction and housing-first strategies that have been shown to create stability, trust and sustained engagement in care. That contradiction weakens the foundation of the initiative and threatens its credibility before it begins.
To start, the administration is positioning the new $100 million investment as a corrective response to what it characterizes as “Biden-era policies” that focused on “non-effective interventions such as harm reduction, supporting housing first, and other strategies that enabled future drug use.” Harm reduction and housing-first models are not ideological experiments; they are among the most rigorously studied and empirically supported interventions in the field.
They have been shown repeatedly to reduce mortality, stabilize housing and increase engagement with health care for people with substance use disorders. They meet people where they are, and in doing so, they create the relationships that make change possible. That’s because community-based harm reduction programs, such as overdose prevention centers, are inherently social, and serve as places of belonging. These centers reduce overdose risk and infectious disease transmission in part through their distribution of harm reduction supplies, and in part because they provide dignity and human connection.
Rejecting these approaches is political theater with real consequences, eroding support for interventions that have been shown to save lives.
Beyond that, HHS’s approach introduces a fundamental contradiction. If addiction ends in reconnection, as Kennedy says, then dismissing interventions that create stability, trust, and continuity in people’s lives is counterproductive. You cannot build community while defunding and discrediting the very systems that allow people to remain alive and housed long enough to build one.
The new program will focus on court-ordered Assisted Outpatient Treatment, crisis intervention and psychiatric care. These tools can play an important role in the broader continuum of care. But on their own, they reflect a familiar, individual-level approach that has failed repeatedly to resolve the addiction crisis because it does not sufficiently address structural factors.
Assisted Outpatient Treatment programs were designed for people with serious mental illnesses, not for people who use drugs. Further, they lack a strong evidence base and do not build community. In fact, opponents of court-ordered Assisted Outpatient Treatment programs highlight the harms that they have caused to minoritized communities, predominantly Black Americans, fracturing communities and infringing upon civil liberties.
A second unresolved issue is the source of the $100 million itself. The announcement does not specify whether these funds represent new appropriations or reallocations from existing programs. That distinction matters. If this pilot is funded by diverting resources from existing initiatives, mental health and addiction grants, or services, it risks weakening the very infrastructure that supports recovery nationwide. Without transparency about funding sources, it is impossible to assess the true cost of this investment, or who will bear it.
Finally, there is the question of data access and accountability. The agency has framed this initiative as a pilot study designed to evaluate long-term recovery outcomes across housing, substance use and mental health care. That is an ambitious and worthwhile goal. But it requires rigorous, transparent science and public access to findings.
At present, the federal government has struggled to maintain and update several of its existing data repositories, with little public explanation as to why. Whether due to staffing shortages, administrative disruptions or policy decisions, the result is the same: researchers, policymakers and communities are left without the information needed to evaluate what works.
If this pilot study is to contribute meaningfully to the evidence base, its methods, data and results must be accessible and insulated from political interference. Otherwise, it risks becoming another short-lived initiative that generates headlines but little learning.
It is still possible for Kennedy’s new investment to yield real benefits for people who use drugs, people living with mental health conditions and people experiencing homelessness or poverty. But that depends on whether the administration is willing to engage honestly with existing evidence, fund rather than undermine community-based systems of care — including harm reduction and housing first models — and commit to transparency throughout the research process.
Substance use disorders are not often resolved in isolation. But reconnection is not something that can be mandated or studied into existence while dismissing the structures that sustain it. Community is built through consistent investment in people, places and policies that allow individuals not just to recover, but to belong.
Nina C. Christie, MPH, Ph.D., works at the intersection of substance use, social connection, and public health policy.
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