Over the past decade, overdose protections and programs like Project Weber-Renew have expanded, but with Trump back in office, this trend may be short lived.
Employees with Project Weber-Renew in Providence, Rhode Island.(Project Weber-Renew)
In 2015, a year into his recovery from drug addiction, Dennis Bailer was determined to give back. While receiving support from various harm reduction programs, he searched for a place where he could help others navigate their own recovery journeys but came up empty. A friend told him about Project Weber in Providence, Rhode Island; a harm reduction site rooted in peer-led recovery. After just a few volunteer shifts, he knew he had found his place.
“I wasn’t dealing with people with degrees, who read about substance use disorder, or who maybe even had some family members,” said Bailer, now the center’s overdose program prevention director. “There’s something different about working for an organization where the people who ran the organization had lived experience with being unhoused and trying to navigate treatment detox facilities. This gave it an entirely more grounded feel in regards to connecting with the people we were trying to serve.”
At the time, Project Weber operated out of a weathered brick building with just five part-time employees. Now, after merging with a similar organization, Project Renew, the group has 40 full-time employees, and has just established an overdose prevention center this year.
The project is just one of many community-based programs made possible through federal investments aimed at tackling the overdose crisis. Over the past decade, the federal government has expanded access to medications for opioid use disorder, increased naloxone distribution, and promoted harm reduction strategies such as the use of fentanyl test strips. All of these efforts have laid the groundwork for measurable progress nationwide. Project Weber-Renew is one of the few in the nation offering real-time overdose prevention and wraparound support, and advocates argue that its model could deepen and sustain progress in addressing the opioid crisis. A place of understanding and acclaim, Project Weber-Renew serves around 6,000 people annually, helping contribute to the 27 percent reduction in overdose deaths in the country—the first time the rate has declined nationally since 2019.
But with President Trump back in office, this trend may be short lived. Cuts to federal health programs and agencies, along with a deprioritization of harm reduction strategies, risk undermining efforts like those of Project Weber-Renew. Such policy shifts not only jeopardize the center’s work but could accelerate the rise in overdose deaths in the years ahead.
“Any funding cuts have the potential to cut critical services that people rely on to stay safe, healthy, and alive,” said Colleen Ndoye, the executive director of Project Weber-Renew. “We could see increases in the overdose death rate, which would be devastating given how hard we have worked to contribute to the decrease the last two years.”
“The state of Rhode Island has been a critical partner in the work we’ve been doing,” Ndoye said. “We’ve been lucky in the active and thoughtful way our state partners prioritize overdose prevention and the way they’ve unanimously passed that type of legislation..” Individual states may be able to help fill the loss, but federal funding is still a critical component to addressing a national epidemic.
Overdose deaths surged during the Covid-19 era partly from changes in the drug supply, as the virus also disrupted treatment options and boosted feelings of isolation and anxiety; this contributed to an increase in risky drug use, especially among those between 15 and 34, and deaths peaked at around 112,600 in 2022.
In response, the Biden administration, through the American Rescue Plan and other initiatives, invested heavily in harm reduction and substance use treatment to curb the crisis. Efforts included $30 million in grants for syringe services, over $5 billion to expand mental health and substance use care, and more than $170 million to support local coalitions. The government also distributed more than 178,000 naloxone kits, released model laws to expand naloxone and syringe access, and eased guidelines for prescribing buprenorphine to improve opioid treatment access.
According to Stephen Holt, director of the Addiction Recovery Clinic at the Yale–New Haven Hospital, the provisions provided by the Biden administration helped many of his patients access medications like methadone. He explains that the medications put an end to the daily “hustle” of their lives: They don’t have to buy drugs illegally or commit crimes for money to obtain these drugs, and patients have been able to rekindle relationships and build purpose.
The Substance Abuse and Mental Health Services Administration, or SAMHSA, played a huge role in trying to curb the crisis. This branch of the Department of Health and Human Services, with addiction expertise, promotes policies that improve the treatment and prevention outlook for those struggling with addiction.
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“SAMHSA promotes policies that increase access for patients dealing with addiction,” said Holt. “As a vehicle for federal funding grants, they’ve found ways to promote education for clinicians and medical about substance use disorder. They’ve distributed Narcan in multiple places. They’ve even spearheaded the NSDUH, the National Survey on Drug Use and Health.”
In addition to these national programs, there were also local efforts to curb the overdose rate, including Project Weber-Renew, which supports those struggling with addictions comprehensively and systematically, and is one of the only state-sanctioned overdose prevention centers. The organization began as two separate groups that provided support to the unhoused, sex workers, and drug addicts. Merging in 2016, Project Weber-Renew provides a full spectrum of harm reduction, recovery, and essential support services through peer-led programs.
“People struggling with addictions are really stigmatized,” said Ndoye. “They may have gone to another location, or another medical provider.… Our philosophy is really low-barrier, one-stop shop, just sort of breaking down all of the silos so that people don’t have to go to seven different places.”
According to Bailer, meeting people where they’re at is especially important for people of color. Almost 90 percent of those who use recovery and detox services are white, non-Hispanic individuals. By intentionally working in neighborhoods most affected by addiction in communities of color, harm reduction workers can bridge gaps in access, build trust, and ensure that recovery support reaches those who have historically been underserved.
With full-time nurses and behavioral health clinicians, the center’s overdose prevention treatments are just one tool for bringing stability and ultimately health back to people’s lives. They offer clean needles and fentanyl test strips, distribute naloxone to reverse overdoses in emergencies, and offer HIV and Hepatitis C testing and treatment. They also employ three outreach vans which are placed in the largest bus hubs in the state, allowing people to receive mobile preventive care.
“No one was in the street, the way that we were in our state,” Bailer said. “Our first outreach vehicle was my Chevy Trailblazer. We bought some magnets, stuck them on the side of my Chevy Trailblazer, and we started driving to where the people are. We started driving into the encampments and going to the abandoned buildings and providing the harm reduction supplies, taking it directly to them.”
The center also makes sure to provide cleaning supplies, toiletries, and other basic necessities, ranging from clothing to female hygiene products. And anyone can drop in at any time to access supplies and services.
The center prioritizes hiring individuals who share the same experiences as the people they serve. This can translate to individuals in recovery, individuals who struggled with addiction, or those who experienced homelessness. The center recognizes that peer support fosters trust, breaks down stigma, and strengthens community-based healing.
“Once a person has accessed the tools and been treated with dignity and respect, they will often work with staff to set small personal goals, like getting an ID, or reducing their substance use:, Ndoye said. “This can build momentum and self-efficacy which can lead to really powerful outcomes.”
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Opioid overdose prevention centers are more common internationally. With over 38 sites in Canada and nearly 100 in 16 European countries, they have prevented thousands of overdoses. In Vancouver, a prevention center has saved the city close to $1.6 million in medical costs.
Project Weber Renew is one of the 2 states that have overdose prevention centers; another opened in NYC in 2021 and is operated by OnPoint NYC. Connecticut has also looked to create sites in the state. But with Trump now in office, that broader momentum toward expanding harm reduction efforts has slowed considerably. According to Holt, the president’s efforts to dismantle various committees and agencies at the federal level will reverse the trend of opioid overdoses in the country. They have dismantled the National Survey on Drug Use and Health, making it harder to better understand national indications of drug use. They’ve eliminated the Substance Abuse and Mental Health Services Administration or SAMHSA, which shows a “naïveté of how to deal with the drug crisis in this country.”
The center relies on an organization that receives funding from SAMHSA, directly impacting the operation capabilities of Project Weber-Renew to provide services that prevent overdose accumulation.
Josiah Rich, professor of epidemiology at Brown University, emphasized that with the dismantling of SAMHSA more physicians, medical care personnel, and community health workers like at Project Weber-Renew would be working blind. There won’t be any administrative oversight to advocate for interventions and to promote this work happening on a national scale.
“The key for tackling the overdose crisis is to listen to the people with the deepest understanding of the problem, those who are directly affected,” Ndoye said. “They are the experts and they are the ones who can solve this problem, if they are empowered to do so. If we only listened, and invested in long-term rather than short-term solutions, who knows how many tens of thousands of lives could have been saved?”
Fareed SalmonFareed Salmon is a 2025 Puffin student writing fellow focusing on science, health, and technology for The Nation and a student at Yale University.